Dentistry Journal

14 pages, 3326 KB

Open AccessCase Report

Multifocal Oral Mucosal Melanoma with an Atypical Clinical Presentation

by Klaudia Podlińska, Monika Monist, Magdalena Sławińska and Wojciech Popowski

Dent. J. 2025, 13(9), 432; https://doi.org/10.3390/dj13090432 - 18 Sep 2025

Background: Oral mucosal melanoma (oral malignant melanoma—OMM) is a rare malignant neoplasm. It arises from the proliferation of atypical melanocytes—cells derived from the neural crest that produce melanin. Unlike cutaneous melanomas, which are etiologically linked to ultraviolet (UV) radiation exposure, the risk [...] Read more.

Background: Oral mucosal melanoma (oral malignant melanoma—OMM) is a rare malignant neoplasm. It arises from the proliferation of atypical melanocytes—cells derived from the neural crest that produce melanin. Unlike cutaneous melanomas, which are etiologically linked to ultraviolet (UV) radiation exposure, the risk factors for mucosal melanomas remain poorly defined. According to the World Health Organization (WHO), these tumors predominantly affect older individuals, with peak incidence occurring in the seventh decade of life and are rarely observed in the first three decades. The primary treatment modality for patients with mucosal melanoma is radical surgical excision with clear margins. The 5-year overall survival rate for OMM ranges from 20% to 50%. Case Presentation: This article reports an atypical clinical manifestation of oral mucosal melanoma in a 99-year-old patient who presented to the Department of Oral Surgery at the University Dental Center, Medical University of Warsaw. The nonspecific clinical appearance did not initially suggest a melanocytic lesion. A definitive diagnosis was established through histopathological examination, which subsequently guided the treatment plan. Conclusions: This report highlights the necessity of performing microscopic evaluation even for lesions with a nonspecific or non-suspicious appearance, underlines the importance of regular dental check-ups, and stresses the need to strengthen oncological vigilance among dental practitioners. Full article

(This article belongs to the Special Issue Dental Oncology)

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17 pages, 1884 KB

Open AccessArticle

Enamel Surface and Elemental Changes Following In Vitro Bleaching: A SEM-EDS Approach

by Berivan Laura Rebeca Buzatu, Ramona Dumitrescu, Magda Mihaela Luca, Roxana Buzatu, Atena Galuscan, Vanessa Bolchis, Gabriela Vlase, Titus Vlase and Daniela Elisabeta Jumanca

Dent. J. 2025, 13(9), 431; https://doi.org/10.3390/dj13090431 - 17 Sep 2025

Abstract

Background and Objectives: Chairside bleaching can alter enamel morphology and mineral content. This in vitro study compared surface changes and elemental shifts after three in-office protocols using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Materials and Methods: Forty-two human premolars/molars were [...] Read more.

Background and Objectives: Chairside bleaching can alter enamel morphology and mineral content. This in vitro study compared surface changes and elemental shifts after three in-office protocols using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Materials and Methods: Forty-two human premolars/molars were sectioned; matched halves served as control or received Opalescence Quick 45% carbamide peroxide (CP), Opalescence Boost 40% hydrogen peroxide (HP), or BlancOne Ultra+ 35% HP with light activation. Gels were applied per manufacturers’ instructions. SEM assessed topography (×500–×1100); EDS quantified atomic percent of O, Ca, P, C and trace elements. One-way ANOVA compared Ca and P between bleached groups (α = 0.05). Results: Controls showed compact surfaces with preserved Ca and P. After Quick, SEM revealed roughness, fissures and microcracks; Ca fell from 11.5 to 12.5 to 9.53–11.73 at% and P from 7.5 to 8.9 to 7.41–8.59 at%. Boost produced mild superficial restructuring and granular deposits with variable Ca 13.80–27.94 at% and P 7.32–14.65 at%. BlancOne Ultra+ caused diffuse erosion and loss of prismatic clarity with marked demineralization (Ca 1.42–7.85 at%, P 1.22–6.71 at%); C rose locally to 46.61 at%. Across bleached groups, Ca and P differed significantly (both p < 0.001). Oxygen remained dominant (~39–50 at%) in all spectra; occasional Al/Si/Cl/K likely reflected residues or preparation artifacts. Conclusions: All protocols produced surface and compositional alterations, with a severity gradient: BlancOne Ultra+ > Boost > Quick. High-concentration, light-activated HP yielded the largest Ca/P losses. Clinically, neutral-pH, non-activated or chemically activated regimens and immediate post-bleach remineralization should ideally be used when feasible, particularly before adhesive procedures. Full article

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16 pages, 2906 KB

Open AccessArticle

Technical Complications and Marginal Bone Loss Depending on the Crown Material of Dental Implants in the Posterior Region: A 3-Year Randomized Clinical Study

by Sigmar Schnutenhaus, Marla Weinmann, Max Römer and Ralph G. Luthardt

Dent. J. 2025, 13(9), 430; https://doi.org/10.3390/dj13090430 - 17 Sep 2025

Abstract

Background/Objectives: This single-center, randomized controlled clinical trial evaluated the impact of two crown materials—lithium disilicate (LS2) and a polymer-infiltrated hybrid ceramic (HC)—on the marginal bone loss (MBL) and the technical complications in implant-supported single-tooth restorations over a three-year period. Methods: Sixty patients with [...] Read more.

Background/Objectives: This single-center, randomized controlled clinical trial evaluated the impact of two crown materials—lithium disilicate (LS2) and a polymer-infiltrated hybrid ceramic (HC)—on the marginal bone loss (MBL) and the technical complications in implant-supported single-tooth restorations over a three-year period. Methods: Sixty patients with posterior single-tooth gaps were randomly assigned to receive either LS2 or HC crowns on iSy (Camlog) implants. All of the restorations were fabricated as CAD/CAM-based hybrid abutment crowns bonded to prefabricated titanium bases. Standardized radiographs were taken at the baseline (T0) and at three years (T1) to assess the MBL using ImageJ software. The technical complications were prospectively recorded. The data analysis was descriptive and exploratory. Results: Fifty-eight cases were available for the final evaluation. The three-year implant survival rate was 100%. The mean marginal bone remodeling was minimal (mesial: LS2 0.15 mm, HC 0.08 mm; distal: LS2 0.13 mm, HC 0.12 mm), with no statistically significant intergroup differences. Bone apposition was observed in 74.1% of the cases. The male patients showed a significantly greater mesial bone loss (p = 0.024). Technical complications occurred more frequently in the HC group, including crown fractures (25%), decementation (17.9%), and screw loosening (14.3%). In the LS2 group, only screw loosening (12.5%) was observed. Conclusions: The lithium disilicate-based hybrid abutment crowns demonstrated a high clinical reliability with stable peri-implant bone and fewer technical complications over three years. In contrast, the hybrid ceramic crowns were associated with a higher rate of mechanical failure. Material selection should therefore be a key consideration in planning implant-supported single-tooth restorations. Full article

(This article belongs to the Section Dental Implantology)

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11 pages, 1203 KB

Open AccessArticle

Impact of Depressive Disorder on Periodontal Status: A Comparative Study

by Bogdan-Constantin Vasiliu, Maria Alexandra Mârțu, Alexandra Cornelia Oanță, Irina Șufaru, Liliana Păsărin, Alexandru Ionuț Luchian and Sorina Mihaela Solomon

Dent. J. 2025, 13(9), 429; https://doi.org/10.3390/dj13090429 - 16 Sep 2025

Abstract

Background/Objectives. Periodontitis is a chronic inflammatory disease influenced by systemic and psychological factors, including depression. Selective serotonin reuptake inhibitors (SSRIs), widely used to treat depression, may also affect periodontal healing. This study aimed to evaluate the clinical efficacy of full-mouth disinfection (FMD) [...] Read more.

Background/Objectives. Periodontitis is a chronic inflammatory disease influenced by systemic and psychological factors, including depression. Selective serotonin reuptake inhibitors (SSRIs), widely used to treat depression, may also affect periodontal healing. This study aimed to evaluate the clinical efficacy of full-mouth disinfection (FMD) in patients with periodontitis, with or without comorbid depression and SSRI therapy. Methods. Eighty participants were enrolled and divided into two groups: periodontitis only (n = 40) and periodontitis with depression (n = 40), the latter subgrouped by SSRI usage. Clinical parameters, including probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI), were assessed at baseline and 12 weeks after FMD. Results. Following FMD, significant improvements were observed in PD, PI, and BOP across all groups (p < 0.001). In the non-depressed group, mean PD decreased from 4.26 ± 0.97 mm to 2.76 ± 0.56 mm (p < 0.001) and PI from 3.85 ± 0.70 to 1.05 ± 0.99. Patients with depression had higher initial PD (4.98 ± 1.05 mm) but still showed improvement to 3.08 ± 0.69 mm (p < 0.001). CAL improved significantly only in non-depressed individuals (p = 0.008), while no statistically significant CAL changes were observed in depressed patients (p > 0.05). SSRI therapy did not significantly influence treatment outcomes (p > 0.05). Conclusions. FMD is clinically effective in reducing periodontal inflammation in patients with or without depression. However, improvements in CAL were more pronounced in non-depressed individuals, suggesting that depression may partially attenuate periodontal healing. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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10 pages, 3467 KB

Open AccessArticle

The Effect of Simvastatin on Odontoblastic Differentiation of Human Dental Pulp Stem Cells: An In Vitro Study

by Carmela Del Giudice, Flavia Iaculli, Carlo Rengo, Alessandro Salucci, Gianrico Spagnuolo, Francesco Riccitiello, Maurizio Bossù, Antonella Polimeni and Gianni Di Giorgio

Dent. J. 2025, 13(9), 428; https://doi.org/10.3390/dj13090428 - 16 Sep 2025

Abstract

Objectives: The aim of the current in vitro study was to assess the effect of simvastatin on the early-stage differentiation of human dental pulp stem cells (hDPSCs) in an odontogenic pattern by evaluating the expression of specific odontogenic-related genes. Methods: hDPSCs were cultured [...] Read more.

Objectives: The aim of the current in vitro study was to assess the effect of simvastatin on the early-stage differentiation of human dental pulp stem cells (hDPSCs) in an odontogenic pattern by evaluating the expression of specific odontogenic-related genes. Methods: hDPSCs were cultured in the presence of different concentrations of simvastatin (0.1, 0.5, 1, 5, and 10 µM) to evaluate cytotoxicity. Moreover, osteogenic differentiation was assessed by Alkaline Phosphatase (ALP) activity and alizarin red staining (ARS) after 7 days of culture. Finally, odontogenic-related gene (OCN, MEPE, DSPP, and DMP-1) expression analysis was performed. Results: Three days after treatment, higher concentrations of simvastatin (1, 5, and 10 µM) significantly limited cell viability. Upregulation of ALP activity and odontoblastic cell-related genes (OCN and MEPE) was observed in the presence of 1 µM simvastatin. The expression was statistically higher for ALP (p = 0.0001) and OCN (p = 0.0231). On the other hand, comparable or slightly less effect concerning mineralization ability with respect to the control group, as well as in the expression of DSPP and DMP-1, was observed. Conclusions: Simvastatin demonstrated a positive influence on dentinogenesis by improving the expression of specific markers such as MEPE and OCN. However, its effect on inflammation reduction and the potential to be used in combination with other materials should be further assessed. Simvastatin might be successfully applied in the regeneration of damaged dental pulp tissues and promotion of reparative dentinogenesis. Additional studies should be carried out to support the obtained outcomes. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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13 pages, 763 KB

Open AccessArticle

Skeletal and Dentoalveolar Effects of the SOCIA III Appliance in Patients with Pseudo-Class III Malocclusion

by Mauro Lorusso, Giovanna Jie Wang, Michele Tepedino, Angela Pia Cazzolla, Fariba Esperouz, Lucio Lo Russo and Domenico Ciavarella

Dent. J. 2025, 13(9), 427; https://doi.org/10.3390/dj13090427 - 15 Sep 2025

Abstract

Objective: This study aimed to assess the dentoskeletal and postural modifications induced by treatment with the Swallowing Occlusal Contact Intercept Appliance (SOCIA III) in patients with pseudo-Class III malocclusion. The main hypothesis was that treatment with the SOCIA appliance induces significant skeletal and [...] Read more.

Objective: This study aimed to assess the dentoskeletal and postural modifications induced by treatment with the Swallowing Occlusal Contact Intercept Appliance (SOCIA III) in patients with pseudo-Class III malocclusion. The main hypothesis was that treatment with the SOCIA appliance induces significant skeletal and dentoalveolar changes in growing patients with pseudo-Class III malocclusion. Methods: Fifty-two pseudo-Class III malocclusion patients with a mean age of 8.5 were analyzed and compared with fifty-two untreated patients. Cephalometric evaluations were carried out at baseline (T0) and at the end of treatment. The cephalometric analysis comprised sagittal measurements (SNA, ANB, WITS, CB, ACB), dental variables (UI-PP, LI-MP, OVERJET, OVERBITE), and postural parameters (SNBa and cranio-cervical angle of the maxilla). Within-group comparisons at baseline (T0) and post-treatment (T1) were performed using the paired t-test or the Wilcoxon signed-rank test. Inter-group comparisons were based on the differences in variables between the two time points (ΔT1–T0), using the independent samples t-test or the Mann–Whitney U test. Results: At the end of treatment with the SOCIA appliance, significant improvements were observed in the ANB angle (0.61° to 2.06°, p = 0.001), SNA (81.56° to 83.26°, p = 0.006), WITS appraisal (−0.75 mm to 1.24 mm, p = 0.001), ACB angle (9.35 mm to 11.45 mm, p = 0.05), CB (64.78 mm to 65.51 mm, p = 0.03), and SNBa angle (127.57° to 129.14°, p = 0.01), as well as in overjet (0.62 mm to 3.60 mm, p = 0.001) and overbite (0.29 mm to 1.82 mm, p = 0.001). Conclusions: The SOCIA III appliance is effective in correcting pseudo-Class III malocclusion in growing patients by improving skeletal and dentoalveolar relationships. Full article

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22 pages, 1146 KB

Open AccessSystematic Review

Effectiveness of Silica Coatings in Enhancing Resin Cement Adhesion to Zirconia: A Systematic Review

by Laura C. Lara-Hernández, Luis C. Jiménez-Borrego and Nelly S. Roa

Dent. J. 2025, 13(9), 426; https://doi.org/10.3390/dj13090426 - 15 Sep 2025

Abstract

Background: The use of zirconia-based restorations has increased in dentistry due to their aesthetics, high strength, and biocompatibility. However, achieving durable adhesion between resin cements and zirconia remains a challenge in restorative dentistry. Adhesive failures can lead to complications ranging from dentin hypersensitivity [...] Read more.

Background: The use of zirconia-based restorations has increased in dentistry due to their aesthetics, high strength, and biocompatibility. However, achieving durable adhesion between resin cements and zirconia remains a challenge in restorative dentistry. Adhesive failures can lead to complications ranging from dentin hypersensitivity to the loss of the restored tooth. This review evaluates the impact of surface treatments based on silica coatings as a strategy to improve the adhesion of resin cements to zirconia. Methods: A systematic review was conducted following PRISMA guidelines. Searches were performed in Scopus, Web of Science, PubMed, EBSCO, and ScienceDirect. In vitro studies were included if they (1) evaluated silica-based coatings on zirconia surfaces; (2) measured bond strength at the zirconia–cement interface through shear tests (MPa) and reported failure type (adhesive, cohesive, mixed); (3) used ≥8 specimens per group; and (4) included an untreated zirconia control group. Data were extracted and compared for conditions before and after thermocycling in the studies that reported this procedure. Results: The average bond strength for silica-coated zirconia was 15 MPa without thermocycling and 11.97 MPa after thermocycling, regardless of the coating technique. These values were significantly higher than those of untreated zirconia (8.45 MPa and 6.41 MPa, respectively). Cohesive and mixed failures predominated in silica-treated groups, suggesting more effective adhesion compared to controls, which presented mainly adhesive failures. Conclusions: Silica coatings, especially when combined with adhesion promoters, MDP-based primers, significantly enhance the bond strength of resin cements to zirconia. This reduces the risk of secondary caries, sensitivity, restoration debonding, and potential tooth fractures. However, the effectiveness of these coatings varies depending on the technique used, suggesting the need to standardize protocols to optimize clinical outcomes. Full article

(This article belongs to the Topic Advances in Dental Materials)

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15 pages, 285 KB

Open AccessArticle

by Patrícia João, Ana Coelho Canta and Sónia Mendes

Dent. J. 2025, 13(9), 425; https://doi.org/10.3390/dj13090425 - 15 Sep 2025

Abstract

Introduction: Type 1 diabetes mellitus (DM1) can influence oral health, increasing susceptibility to various oral manifestations. Objectives: This study aimed to characterise oral health-related quality of life (OHRQoL), reported oral symptoms, and oral health behaviours in paediatric individuals with DM1, and compare them [...] Read more.

Introduction: Type 1 diabetes mellitus (DM1) can influence oral health, increasing susceptibility to various oral manifestations. Objectives: This study aimed to characterise oral health-related quality of life (OHRQoL), reported oral symptoms, and oral health behaviours in paediatric individuals with DM1, and compare them with those without DM1; as well as to identify factors associated with OHRQoL in both groups. Methods: A cross-sectional study was conducted using an online questionnaire completed by caregivers of Portuguese children with or without DM1. The questionnaire collected information on sociodemographic, oral health behaviours, perceived oral health, reported oral manifestations, and OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS). Descriptive statistics were calculated, along with chi-square tests and negative binomial regression analyses (α = 0.05). Results: The sample included 235 individuals (115 with DM1 and 120 without). No significant differences were observed in overall OHRQoL between the groups, although children with DM1 had slightly higher ECOHIS total scores (4.38 vs. 4.02). Oral health behaviours were comparable in both groups. Children with DM1 reported significantly more xerostomia (p < 0.001). Within the DM1 group, better OHRQoL was significantly related to the following variables: female sex, absence of caries, absence of gingivitis, and no taste changes. In contrast, in the non-DM1 group, OHRQoL was associated with different conditions: the caregiver perception, frequent sugar intake, recurrent aphthous stomatitis, burning mouth sensations, and age. Conclusion: Although OHRQoL levels and oral health behaviours were similar between children with and without DM1, the factors influencing these outcomes varied considerably, emphasising the need for targeted oral health strategies tailored to the specific context of this chronic condition. Full article

(This article belongs to the Special Issue Oral Health-Related Quality of Life and Its Determinants)

13 pages, 360 KB

Open AccessReview

Emerging Metal Additive Manufacturing for Individualized Dental Therapies: A Narrative Review

by Peng Chen, Taishi Yokoi, Ying-Sui Sun, Huiyong Yang and Hiroyasu Kanetaka

Dent. J. 2025, 13(9), 424; https://doi.org/10.3390/dj13090424 - 15 Sep 2025

Abstract

Metal additive manufacturing (AM) techniques, particularly laser powder bed fusion, are being increasingly recognized not as brand-new technologies, but as emerging technologies with their recent advancements—such as the development of optimized alloys, seamless digital workflow integration, and applications in patient-specific prostheses. With the [...] Read more.

Metal additive manufacturing (AM) techniques, particularly laser powder bed fusion, are being increasingly recognized not as brand-new technologies, but as emerging technologies with their recent advancements—such as the development of optimized alloys, seamless digital workflow integration, and applications in patient-specific prostheses. With the rise in patient-specific approaches in dentistry, clinicians are seeking customized devices that precisely match individual anatomical and functional needs. AM offers various advantages, such as the fabrication of complex geometries directly from digital designs, enhanced clinical precision, reduced material waste, and simplified manufacturing workflow, and hence can uniquely address these demands. Recent advancements in AM techniques have led to the development of titanium and cobalt–chromium alloys with improved mechanical properties, corrosion resistance, and biological compatibility. These alloys show great potential for clinical applications. Additionally, AM enables precise control over the microstructures and surface topographies of these alloys during fabrication, facilitating their optimized integration with biological tissues. This mini review summarizes recent advancements in metal AM technologies relevant to personalized dentistry, highlights key material developments, discusses current clinical applications, and identifies key challenges such as high cost, materials limitations, and regulatory hurdles, and highlights future opportunities including multi-materials AM, smart implants, and AI-driven optimization for fully integrated, digitally driven personalized dental care. Full article

(This article belongs to the Section Dental Materials)

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11 pages, 223 KB

Open AccessArticle

Dental Staff Members’ Perception Regarding Objective Structured Clinical Examination (OSCE): An Experience from Saudi Arabia

by Ahmad A. Alnazzawi

Dent. J. 2025, 13(9), 423; https://doi.org/10.3390/dj13090423 - 14 Sep 2025

Abstract

Background: The Objective Structured Clinical Examination (OSCE) is a widely used assessment tool in education in the health profession. Understanding faculty perceptions of the OSCE regarding fairness, validity, reliability, and effectiveness is essential to enhancing its implementation in dental education in Saudi Arabia. [...] Read more.

Background: The Objective Structured Clinical Examination (OSCE) is a widely used assessment tool in education in the health profession. Understanding faculty perceptions of the OSCE regarding fairness, validity, reliability, and effectiveness is essential to enhancing its implementation in dental education in Saudi Arabia. Objective: To assess dental faculty members’ perceptions of the OSCE as an assessment method in Saudi Arabia, focusing on its fairness, reliability, validity, and effectiveness compared to other assessment formats. Methods: A cross-sectional analytical survey-based study was conducted among dental faculty members across 11 dental colleges in Saudi Arabia. A modified validated questionnaire was distributed electronically through the college deans to faculty members. Responses were analyzed using SPSS v25, applying descriptive and inferential statistics (chi-square test, significance set at p ≤ 0.05). Results: A total of 181 faculty responses from 11 Saudi dental colleges indicated broad support for the OSCE as a fair (78.3%), well-structured (71.1%), and comprehensive assessment of clinical skills (70%). While nearly half found it less stressful than other formats, 30% still perceived it as intimidating. Faculty agreed that OSCE tasks reflected taught content (65.9%), instructions were clear (75.7%), and scores were largely standardized and unbiased (63.9–72.9%). Compared with other assessment methods, essays/ short-answer questions (SAQs) were viewed as most effective for learning, but the OSCE was most favored for continued use in clinical training (52.8%). Conclusions: Faculty members in Saudi dental schools generally view the OSCE as a fair, valid, and effective assessment method. Despite concerns about student preparedness and perceived difficulty, the OSCE is endorsed as a key tool for evaluating clinical competencies. Addressing these concerns may further enhance its educational value and implementation. Full article

(This article belongs to the Section Dental Education)

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35 pages, 2006 KB

Open AccessReview

Breaking Barriers: Evaluating Challenges in Advancing Periodontal Ligament Cell-Derived Organoids

by Luiza de Oliveira Matos, Mariane Beatriz Sordi, Anahid Ahmadi Birjandi, Paul Thomas Sharpe and Ariadne Cristiane Cabral Cruz

Dent. J. 2025, 13(9), 422; https://doi.org/10.3390/dj13090422 - 13 Sep 2025

Abstract

The objective of this review was to critically evaluate the available literature on the development of periodontal ligament organoids. Articles concerning periodontal ligament organoids were considered eligible. References were selected in a two-phased process. Electronic databases PubMed and Scopus were screened up to [...] Read more.

The objective of this review was to critically evaluate the available literature on the development of periodontal ligament organoids. Articles concerning periodontal ligament organoids were considered eligible. References were selected in a two-phased process. Electronic databases PubMed and Scopus were screened up to June 2024, yielding 1101 studies. After removing duplicates, titles, and abstracts were screened, resulting in 44 articles being included in this review. A detailed analysis of the included articles was organized into four categories: (1) the cell lineages used, including the simultaneous use of two or more cell types, (2) the extracellular matrix composition, (3) the organoid preparation methods, and (4) the characterization techniques employed. The main findings show that collagen combined with biodegradable polymers—such as poly(caprolactone), poly(glycolic acid), and poly(lactic acid)—is the most used material. Periodontal ligament cells and periodontal fibroblasts were the most used cell types, due to their role in extracellular matrix remodeling. The most frequent analyses performed included alkaline phosphatase, extracellular matrix mineralization, and gene expression, providing insights into differentiation and periodontal regeneration. Cementogenic differentiation was the most studied, followed by osteogenic, chondrogenic, adipogenic, and epithelial differentiation. However, challenges remain, including methodological inconsistencies and the need for scaffold optimization. Future research should focus on standardizing protocols, improving biomaterials, and integrating bioprinting techniques to improve clinical translation. Full article

(This article belongs to the Special Issue Regenerative Approaches in Dental Sciences)

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14 pages, 974 KB

Open AccessArticle

Digital Accuracy of Closed-Tray Implant Impressions: Influence of Polyvinyl Siloxane Viscosity and Subgingival Posterior Implant Angulation

by Yousra Ahmed, Shereen Moselhy Abdul Hameed, Zainab Refaey El Sharkawy, Faris A. Alshahrani, Tarek AbdAllah Mahmoud, Inas M. Mohamed and Noha Taymour

Dent. J. 2025, 13(9), 421; https://doi.org/10.3390/dj13090421 - 12 Sep 2025

Abstract

Objectives: To assess the impact of PVS impression material viscosity and implant angulation on the three-dimensional accuracy of implant casts in a partially edentulous situation using the closed-tray technique. Materials and Methods: Three epoxy resin mandibular partially edentulous models (Kennedy Class I) [...] Read more.

Objectives: To assess the impact of PVS impression material viscosity and implant angulation on the three-dimensional accuracy of implant casts in a partially edentulous situation using the closed-tray technique. Materials and Methods: Three epoxy resin mandibular partially edentulous models (Kennedy Class I) were fabricated, each with four implant analogues placed at teeth positions 35, 37, 45, and 47. The anterior analogues were positioned parallel (0), while the posterior analogues were placed at different angulations: Group 1, 30° mesiodistal; Group 2, 20° mesiodistal; Group 3, 20° buccolingual. All analogues were placed 2 mm subgingivally. Closed-tray impressions (n = 8 per subgroup) were made using either heavy + light body PVS or monophase PVS. Resulting stone casts were scanned, and STL files were processed and analyzed using reverse engineering software (Geomagic Control X). Three-dimensional deviations (root mean square, RMS) between reference and test models were calculated by superimposition and best-fit algorithm. Results: With monophase PVS, implant angulation significantly influenced cast accuracy (p < 0.001). The 30° MD group exhibited the highest deviation (96 ± 7 µm), followed by the 20° BL group (81 ± 6 µm), then the 20° MD group (75 ± 6 µm). In contrast, no statistically significant difference in accuracy was observed among angulation groups when using heavy + light body PVS (77 ± 3 µm, 82 ± 13 µm, and 79 ± 8 µm for 30° MD, 20° BL, and 20° MD, respectively; p = 0.550). Conclusions: Both monophase and heavy + light body PVS impression materials produced clinically acceptable accuracy for closed-tray implant impressions. However, the heavy + light body PVS demonstrated greater consistency across various implant angulations and is recommended for multiple angulated subgingival posterior implants when using the closed-tray technique. Full article

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14 pages, 903 KB

Open AccessArticle

Comparison of Narrow (<3.75 mm) and Standard (≥3.75 mm) Diameter Implants Supporting the Same Multiple Fixed Prostheses and Mirroring Real-World Clinical Scenarios: Non-Randomized Clinical Trial

by Eduardo Anitua, Ander Alcaine and Mohammad Hamdan Alkhraisat

Dent. J. 2025, 13(9), 420; https://doi.org/10.3390/dj13090420 - 12 Sep 2025

Abstract

Objective: To compare the survival of narrow (<3.75 mm) implants and standard diameter (≥3.75 mm) implants supporting the same multiple fixed prostheses and mirroring real-world clinical scenarios. Methods: This is a controlled clinical trial where both test (diameter < 3.75 mm) and control [...] Read more.

Objective: To compare the survival of narrow (<3.75 mm) implants and standard diameter (≥3.75 mm) implants supporting the same multiple fixed prostheses and mirroring real-world clinical scenarios. Methods: This is a controlled clinical trial where both test (diameter < 3.75 mm) and control (diameter ≥ 3.75 mm) implants supported the same prosthesis. The principal variable was implant survival and the secondary variables included demographic, surgical and prosthetic variables. Statistical analyses were conducted to compare these variables between the study groups. Results: A total of 42 patients participated in this study, with an age range of 39 to 92 years. The follow-up period was 36 months. Narrow diameter implants (NDIs) were predominantly placed in the premolar region and more frequently in bone types I and II compared to wider diameter implants. No implant failures were recorded during the study period. Marginal bone level remodeling showed statistically significant differences between the study groups at 12-month follow-up. However, these differences were no longer significant after 3 years of follow-up (Test: median −0.2 mm, range −1.5 to 0.8 mm; Control: median 0.0 mm, range −1.3 to 0.8 mm; p = 0.119). None of the prostheses failed, and all remained free of technical complications throughout the study. Conclusions: Within the limitations of this study, narrow-diameter implants demonstrated comparable clinical outcomes to standard-diameter implants when supporting the same prostheses. Full article

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12 pages, 613 KB

Open AccessArticle

Crown–Root Ratio as a Predictive Morphometric Indicator in Mandibular First Molars with Occlusal Trauma and Periodontitis: A Radiographic and Clinical Modeling Study

by Lidya Irani Nainggolan, Bramma Kiswanjaya, Menik Priaminiarti, Sri Lelyati Chaidar Masulili, Hanna H. Bachtiar-Iskandar, Yuniarti Soeroso, Pitu Wulandari, Eha Renwi Astuti and Akihiro Yoshihara

Dent. J. 2025, 13(9), 419; https://doi.org/10.3390/dj13090419 - 12 Sep 2025

Abstract

Background/Objectives: Trauma from occlusion (TFO) is a modifying factor in periodontal disease progression, yet its morphometric impact on mandibular molars remains underexplored. The crown–root ratio (CRR), traditionally used in prosthodontic prognosis, may also serve as a diagnostic marker for structural changes in periodontally [...] Read more.

Background/Objectives: Trauma from occlusion (TFO) is a modifying factor in periodontal disease progression, yet its morphometric impact on mandibular molars remains underexplored. The crown–root ratio (CRR), traditionally used in prosthodontic prognosis, may also serve as a diagnostic marker for structural changes in periodontally compromised teeth. This study evaluated the relationship between crown and root dimensions and clinical/radiographic parameters in mandibular first molars with TFO and developed predictive models emphasizing the role of CRR. Methods: This retrospective cross-sectional study included 99 periodontitis patients clinically and radiographically diagnosed with TFO. Digitized periapical radiographs of mandibular first molars (tooth 36 or 46) were analyzed to measure clinical and radiographic CRR, crown and root length, tooth inclination, alveolar bone loss, and root morphology. Correlation and stepwise multiple regression analyses identified predictors of crown and root length. Results: Males had significantly greater crown length (7.6 vs. 7.2 mm), root length (13.3 vs. 12.3 mm), and radiographic CRR (1.2 vs. 1.0) (p = 0.008). Clinical CRR showed a moderate positive correlation with crown length (r = 0.526) and a strong inverse correlation with root length (r = −0.735) (p < 0.001). Regression models revealed that clinical CRR, root length, and sex significantly predicted crown length (R² = 0.955), while CRR and crown length predicted root length (R² = 0.958). Conclusions: This study demonstrated that the clinical crown–root ratio (CRR) is a strong predictor of both crown and root lengths in mandibular first molars affected by trauma from occlusion (TFO) in periodontitis patients. Full article

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12 pages, 606 KB

Open AccessArticle

Comparative Usability Evaluation of Three Digital Smile Design Software Tools Using the System Usability Scale

by Andrei Macris, Sergiu Drafta, Ștefania Martiniuc and Alexandru E. Petre

Dent. J. 2025, 13(9), 418; https://doi.org/10.3390/dj13090418 - 12 Sep 2025

Abstract

Background/Objectives: Digital Smile Design software tools facilitates aesthetic planning and improves communication between clinicians, patients, and dental laboratories. These software tools have been developed to support facial and dental analysis and to assist users in creating an ideal smile integrated with the patient’s [...] Read more.

Background/Objectives: Digital Smile Design software tools facilitates aesthetic planning and improves communication between clinicians, patients, and dental laboratories. These software tools have been developed to support facial and dental analysis and to assist users in creating an ideal smile integrated with the patient’s appearance. This study aimed to compare the usability of three DSD software tools—Preteeth AI Pro (version 6.0.0), SmileCloud, and Medit Link (version 3.4.3)—using the System Usability Scale. Methods: Twenty-three prosthodontists and prosthodontics residents evaluated each tool following a standardized usage protocol. After completing Digital Smile Designs in each application, participants filled out a 10-item System Usability Scale questionnaire (score 0–100). Descriptive statistics were calculated, and intergroup comparisons were performed using one-way ANOVA (p < 0.05). Results: Mean System Usability Scale scores were 74.24 (Preteeth AI Pro), 80.33 (SmileCloud), and 73.15 (Medit Link). SmileCloud obtained the highest score (A−grade, Curved Grading Scale), indicating “good to very good” usability. No statistical significances were found between the three software tools (F = 1.04, p = 0.36). Conclusions: All three Digital Smile Design software tools achieved System Usability Scale scores above the usability benchmark of 68, with SmileCloud demonstrating the most favorable user experience. These findings may assist clinicians in selecting intuitive and efficient Digital Smile Design platforms to optimize aesthetic treatment workflows. Full article

(This article belongs to the Special Issue Advances in Esthetic Dentistry)

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14 pages, 858 KB

Open AccessArticle

Synergistic Effect of Sodium Hypochlorite and Carbon Dioxide Against Enterococcus faecalis Biofilm

by Júlia Guerra de Andrade, Ana Flávia Folhas Natali, Caroline Loureiro, Gladiston William Lobo Rodrigues, Ana Paula Fernandes Ribeiro, Rayara Nogueira de Freitas, Renan Jose Barzotti, Laura Cesário Oliveira, Yuri Gabriel Chamorro de Moraes, Natália Amanda Gomes, Antônio Hernandes Chaves-Neto, Frederico Canato Martinho and Rogério de Castilho Jacinto

Dent. J. 2025, 13(9), 417; https://doi.org/10.3390/dj13090417 - 10 Sep 2025

Abstract

Objectives: This study aimed to evaluate whether the addition of pressurized carbon dioxide (PCD) influences the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) against Enterococcus faecalis biofilm in root canals and dentinal tubules. Methods: Forty extracted human mandibular premolars with single canals were [...] Read more.

Objectives: This study aimed to evaluate whether the addition of pressurized carbon dioxide (PCD) influences the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) against Enterococcus faecalis biofilm in root canals and dentinal tubules. Methods: Forty extracted human mandibular premolars with single canals were contaminated with E. faecalis for 10 days and randomly assigned to four groups (n = 10): 2.5% NaOCl, 2.5% NaOCl + CO₂, sterile saline, and sterile saline + CO₂. The pH and temperature of the NaOCl solution were measured before and after CO₂ incorporation. Microbial load was assessed by CFU counts before and after irrigation, and in dentin samples from the cervical, middle, and apical thirds. Oxidative stress was evaluated via lipid peroxidation (TBARS), protein carbonyl content, and total protein quantification. Biofilm metabolic activity was analyzed using the XTT reduction assay. Data were analyzed using one-way ANOVA on ranks and two-way repeated measures ANOVA (α = 0.05), a very large effect size (Cohen’s d) ≈ 1.756 was assumed. Results: All irrigation protocols significantly reduced bacterial load (p < 0.05). Both NaOCl groups outperformed the saline controls (p = 0.009). The addition of CO₂ to NaOCl slightly enhanced disinfection in the main canal but did not improve antimicrobial action in dentinal tubules. CO₂ incorporation reduced the pH of NaOCl from ~13.4 to 7.4 and slightly increased the temperature, making the solution more chemically reactive. However, both oxidative stress markers and the XTT assay showed that the combination with CO₂ impaired the antimicrobial effectiveness of NaOCl. Conclusions: Despite the improvement in bacterial reduction in the root canal lumen, the combination of PCD with NaOCl failed to enhance intratubular disinfection and reduced the oxidative damage and metabolic inactivation of the biofilm. CO₂ pressurization appears to limit the antimicrobial action of NaOCl. Full article

(This article belongs to the Special Issue Oral Microbiology and Related Research)

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23 pages, 806 KB

Open AccessSystematic Review

Laser Therapy for Vascular Malformations of the Oral Cavity: A Systematic Review

by Matteo Pellegrini, Martina Bosisio, Federica Pulicari, Carmen Darinca Todea and Francesco Spadari

Dent. J. 2025, 13(9), 416; https://doi.org/10.3390/dj13090416 - 9 Sep 2025

Abstract

Objectives: to compare the clinical effectiveness, safety, and aesthetic outcomes of different laser systems used for the treatment of oral vascular malformations. Materials and Methods: This review followed JBI guidelines and adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews [...] Read more.

Objectives: to compare the clinical effectiveness, safety, and aesthetic outcomes of different laser systems used for the treatment of oral vascular malformations. Materials and Methods: This review followed JBI guidelines and adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. The research was performed through the databases PubMed, Scopus, and Web of Science using MeSH (Medical Subject Headings) terms for MEDLINE (PubMed), while equivalent free-text terms were applied to Scopus and Web of Science. The initial database search was performed on 20 May 2024. Studies published from 2014 to 2024 focusing on laser therapy for oral vascular lesions were included. Data quality was assessed using NHLBI and ROBINS-I V2 tools. Results: Of the 139 articles identified, 11 met inclusion criteria, assessing Nd:YAG, diode, Er,Cr:YSGG, and CO₂ lasers. The Nd:YAG laser was effective for deep vascular lesions with strong thermal effects. The diode laser provided excellent coagulation and minimal postoperative discomfort. The Er,Cr:YSGG laser offered faster healing and better cosmetic results. The CO₂ laser showed effective results with low recurrence rates. Most studies reported reduced bleeding, pain, and recovery time following laser treatment. Conclusions: Laser therapy, particularly Nd:YAG, diode, and CO₂ lasers, offers a safe, effective alternative for oral vascular malformations, providing improved outcomes and fewer complications. Future studies should include larger sample sizes and comparisons with traditional therapies. Full article

(This article belongs to the Special Issue Editorial Board Members’ Collection Series: Laser in Oral Surgery, Diagnosis and Oncology)

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19 pages, 4393 KB

Open AccessArticle

Bond Strength of an Epoxy Resin Root Canal Sealer Prototype

by Matthias J. Roggendorf, Hubert C. Roggendorf, Markus Müller-Krott, Franz-Josef Faber and Roland Frankenberger

Dent. J. 2025, 13(9), 415; https://doi.org/10.3390/dj13090415 - 9 Sep 2025

Abstract

Background/Objectives: We aimed to assess the bond strength of AH Plus Jet (AH) and an epoxy resin-based root canal sealer prototype (K-0189) adhered to three different obturation points. Methods: A total of 120 single-rooted teeth were selected after radiographic analysis, and [...] Read more.

Background/Objectives: We aimed to assess the bond strength of AH Plus Jet (AH) and an epoxy resin-based root canal sealer prototype (K-0189) adhered to three different obturation points. Methods: A total of 120 single-rooted teeth were selected after radiographic analysis, and their root canals were instrumented with ProTaper Next files (PTN) up to size X5. The teeth were randomly assigned to two sealer groups (G) (G1: AH, G2: K-0189, each n = 60) and further divided into three subgroups: (A) ConformFit X5 points (PTN) cold obturation (CO), (B) ProTaper Universal F5 points (PTU) (CO), (C) GuttaCore X5 (GC) warm obturation (WO). After final irrigation (NaOCl 3%, EDTA 17%, NaOCl 3%) and drying, root canals were obturated and stored for 30 days at 37 °C in Simulated Body Fluid (SBF). The specimens were embedded in acrylate and sectioned horizontally; then, push-out bond strength (POBS) analysis was performed. Results: The median POBS values [MPa] were G1A: 2.03; G1B: 2.12; G1C: 3.2; G2A: 1.91; G2B: 2.56; and G2C: 3.36. WO showed significantly higher POBS (p < 0.001 *) than CO. The POBS was not significantly different between the two WO groups (p = 0.508). The POBS of G2B was significantly higher compared to all other CO groups. Conclusions: The epoxy resin sealer prototype demonstrated POBS values comparable to AH Plus when used with WO and PTU points, indicating significantly higher POBS values compared to all other CO points. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences: 2nd Edition)

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10 pages, 674 KB

Open AccessReview

Timing of Treatment for Patients with Hypertrophic Maxillary Labial Frena

by Veronica Lexa Marr, Lauren Grace Stewart, Man Hung and Val Joseph Cheever

Dent. J. 2025, 13(9), 414; https://doi.org/10.3390/dj13090414 - 8 Sep 2025

Abstract

Background/Objectives: The maxillary labial frenum (MLF) is a connective tissue structure attaching the upper lip to the maxillary alveolar process. Its morphology varies significantly among individuals and is often most prominent during early childhood. While hypertrophic or low-attaching frena have been associated [...] Read more.

Background/Objectives: The maxillary labial frenum (MLF) is a connective tissue structure attaching the upper lip to the maxillary alveolar process. Its morphology varies significantly among individuals and is often most prominent during early childhood. While hypertrophic or low-attaching frena have been associated with diastemas, feeding issues, and speech impairments, there is no causal evidence supporting early surgical intervention. This review aims to examine current evidence regarding the timing and necessity of frenectomy procedures and to evaluate the implications of early versus delayed intervention. Methods: A narrative review was conducted using twenty peer-reviewed articles published in the past 10 years, with one additional article from 2012 included for its ongoing relevance. Databases searched included PubMed, the NIH database, the Reference Manual of Pediatric Dentistry, and journals from the American Academy of Pediatrics. Inclusion criteria were English-language, peer-reviewed studies that addressed the morphology, classification, diagnosis, management, and outcomes of MLFs across age groups. Excluded were studies focusing solely on mandibular, buccal, or lingual frena; non-English publications; case reports; and articles lacking full-text availability. Results: The literature suggests that premature frenectomy, prior to the eruption of permanent maxillary canines, typically between 9 and 12 years of age, is associated with frenum regrowth, surgical complications, and orthodontic relapse. Additionally, a lack of standardized diagnostic criteria contributes to inconsistent clinical decision-making. Conservative management, including monitoring, is strongly recommended as the frenum often migrates apically as the maxilla develops. Factors such as airway obstruction and developmental delays should be ruled out before considering surgery. Conclusions: There is insufficient evidence to support early surgical intervention for MLF-related concerns. A conservative, individualized approach, delaying frenectomy until after permanent canine eruption, may minimize complications, improve long-term outcomes, and allow the frenum to migrate apically as the patient develops. Standardized diagnostic tools are urgently needed to guide clinical decision-making. Full article

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