Dentistry Journal

13 pages, 241 KB

Open AccessArticle

Orofacial Pain and Temporomandibular Disorders Education at Umm Al-Qura University: Perceptions and Curriculum Improvement Recommendations

by Mohammad Hasan Al-Harthy

Dent. J. 2025, 13(10), 465; https://doi.org/10.3390/dj13100465 - 10 Oct 2025

Abstract

Objectives: To evaluate dental students’ and recent graduates’ perceptions of the integration, effectiveness, quality, and clinical relevance of orofacial pain (OFP) and temporomandibular disorders (TMDs) education in the Oral Medicine (OM) course at Umm Al-Qura University’s Faculty of Dental Medicine (UQUDENT), and to [...] Read more.

Objectives: To evaluate dental students’ and recent graduates’ perceptions of the integration, effectiveness, quality, and clinical relevance of orofacial pain (OFP) and temporomandibular disorders (TMDs) education in the Oral Medicine (OM) course at Umm Al-Qura University’s Faculty of Dental Medicine (UQUDENT), and to identify educational gaps and opportunities for curriculum improvement. Methods: This cross-sectional study was conducted using a self-administered online questionnaire distributed via Google Forms to 117 participants, including fourth- to sixth-year students, interns, and recent (2022–2024) graduates. Respondents provided demographic information and assessed the effectiveness (10 items), quality (4 items), and value/relevance (4 items) of the OM course using a 5-point Likert scale. Results: Respondents provided moderate ratings for course effectiveness (mean = 35.2/50) and quality (mean = 13.5/20), and rated OFP/TMD content as having high clinical value (mean = 16.1/20). They had limited confidence in OFP/TMD diagnosis (mean = 3.09/5) and management (mean = 3.19/5). More than 80% believed the curriculum should include more OFP/TMD content. No significant differences were observed by gender, sector, study/work area, clinical exposure (all p > 0.05). Conclusions: Students recognize the importance of OFP/TMD education, but the current curriculum may be insufficiently structured to build competence. Improvement of curricular depth, teaching methods, and clinical exposure is recommended. Full article

(This article belongs to the Section Dental Education)

11 pages, 2093 KB

Open AccessFeature PaperArticle

Comparison of Conventional Root Tip Resection with Digitally Guided Resection—An In Vitro Study

by Paul Kübel, Aydin Gülses, Juliane Wagner, Cedric Hinrichs, Jörg Wiltfang and Johannes Spille

Dent. J. 2025, 13(10), 464; https://doi.org/10.3390/dj13100464 - 10 Oct 2025

Abstract

Background/Objectives: In oral and maxillofacial surgery, apicoectomy is a standard procedure for treating persistent periapical infections after insufficient conservative treatment. Traditional techniques rely on direct visualization, while navigated methods offer advantages in precision and safety. This in vitro study compared conventional apicoectomy [...] Read more.

Background/Objectives: In oral and maxillofacial surgery, apicoectomy is a standard procedure for treating persistent periapical infections after insufficient conservative treatment. Traditional techniques rely on direct visualization, while navigated methods offer advantages in precision and safety. This in vitro study compared conventional apicoectomy with dynamically guided navigation. The aim was to assess the feasibility, accuracy, and safety of dynamic navigation and to determine whether it reduces complication risks, improves surgical predictability, and minimizes bone loss. Methods: Ten experienced surgeons performed both techniques on custom-designed models. Operation time was assessed, as well as cavity volume, resected root length, incision width and height, and preservation of adjacent structures. Results: The navigated approach demonstrated significantly improved accuracy in root-end resection, with a reduction in access cavity volume (p < 0.001). No significant differences were found in operation time (p = 0.499), resection length (p = 0.054), or incision dimensions (p > 0.05). The risk of damaging adjacent structures was not significantly different between the two methods. Conclusions: Dynamic navigation for apicoectomy can offer an alternative in cases requiring high precision to conventional techniques. However, the routine clinical implementation of dynamic navigation remains limited due to the extensive preoperative planning required. The necessity for additional planning increases complexity, time, and cost. Full article

(This article belongs to the Section Oral and Maxillofacial Surgery)

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11 pages, 5563 KB

Open AccessArticle

Preliminary Assessment of a Hybrid Implant Design Submitted to Immediate Placement with Abutment Exposure: A Pilot Study in One Dog Model

by Carlos Araujo, Maria Angelica Araujo, César Augusto Magalhães Benfatti, Anderson Camargo Moreira, Celso Peres Fernandes and Roberta Michels

Dent. J. 2025, 13(10), 463; https://doi.org/10.3390/dj13100463 - 10 Oct 2025

Abstract

Background: Dental implants are widely used to replace missing teeth, particularly in aesthetically sensitive areas. The implant’s macrogeometry is crucial for ensuring primary stability and successful osseointegration. Internal conical connections and reactive surfaces on implants have shown positive outcomes in tissue and bone [...] Read more.

Background: Dental implants are widely used to replace missing teeth, particularly in aesthetically sensitive areas. The implant’s macrogeometry is crucial for ensuring primary stability and successful osseointegration. Internal conical connections and reactive surfaces on implants have shown positive outcomes in tissue and bone stability. In response, a hybrid conical dental implant was designed to address a variety of clinical scenarios. Materials and Methods: This pilot study evaluated the performance of the hybrid conical implant using histological and micro-CT analysis in a preclinical model with immediate loading. Five implants were placed in a mongrel dog, and histomorphometric and micro-CT assessments were performed after 60 days of healing. Results: Analysis showed a high degree of osseointegration, with BIC at 61.56% and BT/TV at 77%. Micro-CT confirmed these findings, with nBIC at 82.20%. Vertical measurements indicated stable crestal bone. Peri-implant tissue displayed organized supracrestal connective tissue, without signs of inflammation or bone saucerization. Polarized light microscopy revealed collagen fibers in perpendicular and oblique orientations around the abutment, suggesting mechanical integration and biological sealing despite the absence of a prosthetic crown. Conclusions: Within the limitations of this exploratory study with one animal study, the hybrid conical implant showed favorable biological and structural responses under immediate loading. These preliminary findings provide useful insights for the refinement of implant design, although further investigations in larger preclinical and clinical studies are required before clinical applicability can be confirmed. Full article

(This article belongs to the Section Dental Materials)

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12 pages, 1728 KB

Open AccessArticle

Effectiveness of an AI-Assisted Digital Workflow for Complete-Arch Implant Impressions: An In Vitro Comparative Study

by Marco Tallarico, Mohammad Qaddomi, Elena De Rosa, Carlotta Cacciò, Silvio Mario Meloni, Ieva Gendviliene, Wael Att, Rim Bourgi, Aurea Maria Lumbau and Gabriele Cervino

Dent. J. 2025, 13(10), 462; https://doi.org/10.3390/dj13100462 - 9 Oct 2025

Abstract

Background: The accuracy and consistency of complete-arch digital impressions are fundamental for long-term success of implant-supported rehabilitations. Recently, artificial intelligence (AI)-assisted tools, such as SmartX (Medit Link v3.4.2, MEDIT Corp., Seoul, South of Korea), have been introduced to enhance scan body recognition [...] Read more.

Background: The accuracy and consistency of complete-arch digital impressions are fundamental for long-term success of implant-supported rehabilitations. Recently, artificial intelligence (AI)-assisted tools, such as SmartX (Medit Link v3.4.2, MEDIT Corp., Seoul, South of Korea), have been introduced to enhance scan body recognition and data alignment during intraoral scanning. Objective: This in vitro study aimed to evaluate the impact of SmartX on impression accuracy, consistency, operator confidence, and technique sensitivity in complete-arch implant workflows. Methods: Seventy-two digital impressions were recorded on edentulous mandibular models with four dummy implants, using six experimental subgroups based on scan body design (double- or single-wing), scanning technique (occlusal or combined straight/zigzag), and presence/absence of SmartX tool. Each group was scanned by both an expert and a novice operator (n = 6 scans per subgroup). Root mean square (RMS) deviation and scanning time were assessed. Data were tested for normality (Shapiro–Wilk). Parametric tests (t-test, repeated measures ANOVA with Greenhouse–Geisser correction) or non-parametric equivalents (Mann–Whitney U, Friedman) were applied as appropriate. Post hoc comparisons used Tukey HSD or Dunn–Bonferroni tests (α = 0.05). Results: SmartX significantly improved consistency and operator confidence, especially among novices, although it did not yield statistically significant differences in scan accuracy (p > 0.05). The tool mitigated early scanning errors and reduced dependence on operator technique. SmartX also enabled successful library alignment with minimal data; however, scanning time was generally longer with its use, particularly for beginners. Conclusions: While SmartX did not directly enhance trueness, it substantially improved scan reliability and user experience in complete-arch workflows. Its ability to minimize technique sensitivity and improve reproducibility makes it a valuable aid in both training and clinical settings. Further clinical validation is warranted to support its integration into routine practice. Full article

(This article belongs to the Special Issue Advancements and Implications of Digital Workflow Integration in Implant Dentistry)

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21 pages, 2038 KB

Open AccessReview

Densifying the Future: A Critical Review of Osseodensification and Implant Dentistry

by Rafael Ortiz, Paulo Maurício and Paulo Sobral Mascarenhas

Dent. J. 2025, 13(10), 461; https://doi.org/10.3390/dj13100461 - 9 Oct 2025

Abstract

Osseodensification (OD) compacts trabecular bone during implant site preparation rather than removing it, potentially enhancing primary stability versus conventional drilling. This review critically appraised clinical and preclinical evidence for OD’s biological and biomechanical efficacy in implant dentistry. We conducted electronic searches in seven [...] Read more.

Osseodensification (OD) compacts trabecular bone during implant site preparation rather than removing it, potentially enhancing primary stability versus conventional drilling. This review critically appraised clinical and preclinical evidence for OD’s biological and biomechanical efficacy in implant dentistry. We conducted electronic searches in seven databases (PubMed, Scopus, Web of Science, ScienceDirect, SciELO, LILACS, DOAJ) for the period January 2014 to March 2024. Studies comparing osseodensification with conventional drilling in clinical and large-animal models were included. Primary outcomes were insertion torque, implant stability quotient (ISQ), bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), and complications. Of 75 retrieved records, 38 studies (27 clinical, 11 preclinical) provided analysable data. Based on descriptive averages from the narrative synthesis, osseodensification increased mean insertion torque by around 45% (range 32–59%) and initial ISQ by 3–10 units compared with conventional drilling. These gains permitted immediate loading in 78% of cases and shortened operating time (mean reduction 15–20 min). Animal studies demonstrated 12–28% higher BIC and increased peri-implant bone density at 4–12 weeks. No serious adverse events were recorded. Postoperative morbidity was similar between techniques. The collated evidence indicates that osseodensification significantly improves primary stability and may accelerate healing protocols, particularly in low-density (Misch D3–D4) bone. However, the predominance of short-term data and heterogeneity in surgical parameters limit definitive conclusions. Long-term randomised controlled trials with standardised protocols are needed before universal clinical recommendations can be established. Full article

(This article belongs to the Section Dental Implantology)

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18 pages, 6845 KB

Open AccessArticle

From Bench to Chairside: Collagen Scaffolds in Combination with Mesenchymal Stromal Cells for Gingival Augmentation

by Polina Koteneva, Nastasia Kosheleva, Alexey Fayzullin, Yana Khristidis, Egor Bunin, Yuri Efremov, Diana Zhukova, Sergey Tkachev, Aida Kulova, Timur Rasulov, Anna Vedyaeva, Tatiana Brailovskaya and Peter Timashev

Dent. J. 2025, 13(10), 460; https://doi.org/10.3390/dj13100460 - 8 Oct 2025

Abstract

Background/Objectives: Gingival tissue deficiencies present significant treatment challenges. We investigated three xenogeneic collagen scaffolds—Fibro-Gide, FibroMATRIX, and Mucoderm—with and without human gingival MSCs for soft tissue augmentation. Methods: The study assessed scaffold properties (mechanical properties and micro-CT structure), cytocompatibility, ex vivo vascular growth stimulation [...] Read more.

Background/Objectives: Gingival tissue deficiencies present significant treatment challenges. We investigated three xenogeneic collagen scaffolds—Fibro-Gide, FibroMATRIX, and Mucoderm—with and without human gingival MSCs for soft tissue augmentation. Methods: The study assessed scaffold properties (mechanical properties and micro-CT structure), cytocompatibility, ex vivo vascular growth stimulation (CAM-test), and in vivo effects in rabbit model. Results: All scaffolds were cytocompatible and maintained MSC viability via extract and contact cytotoxicity tests. Fibro-Gide showed the highest porosity at 78.5%, followed by FibroMATRIX at 64.3%, while Mucoderm had the lowest porosity at 33.2%. Mucoderm exhibited the greatest stiffness due to its dense structure, contrasting with the more similar mechanical properties of Fibro-Gide and FibroMATRIX. In an ex vivo HET-Cam model of the angiogenic response, Fibro-Gide exhibited reduced blood vessel length and blood flow rate compared to FibroMATRIX and Mucoderm. In vivo, Mucoderm resorbed completely, FibroMATRIX demonstrated optimal partial degradation, and Fibro-Gide retained most of its collagen structure. Conclusions: The FibroMATRIX with MSCs combination showed particularly promising results for enhancing tissue thickness and vascularization, suggesting this approach could significantly improve gingival regeneration outcomes. Full article

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

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17 pages, 664 KB

Open AccessReview

Influence of Ultrasonic Activation of Endodontic Irrigants on Microbial Reduction and Postoperative Pain: A Scoping Review of In Vivo Studies

by Jacob Marx, Corban Ward, Bayler Gunnell, Zachary Marx, Alicia Parry, Samuel Dyal, Amir Mohajeri and Man Hung

Dent. J. 2025, 13(10), 459; https://doi.org/10.3390/dj13100459 - 8 Oct 2025

Abstract

Objective: Root canal irrigation plays a critical role in achieving effective chemomechanical disinfection during endodontic therapy. Conventional syringe irrigation, typically using sodium hypochlorite, ethylenediaminetetraacetic acid, and chlorhexidine, is limited by its delivery method and often fails to adequately penetrate complex canal anatomies, compromising [...] Read more.

Objective: Root canal irrigation plays a critical role in achieving effective chemomechanical disinfection during endodontic therapy. Conventional syringe irrigation, typically using sodium hypochlorite, ethylenediaminetetraacetic acid, and chlorhexidine, is limited by its delivery method and often fails to adequately penetrate complex canal anatomies, compromising disinfection. Advancements such as ultrasonic and multisonic irrigation systems aim to address these limitations. This scoping review compares the clinical effectiveness of ultrasonic irrigation techniques with conventional syringe irrigation, focusing exclusively on in vivo studies conducted within the oral environment. Methods: A comprehensive scoping review was conducted using PubMed, Scopus, Dentistry & Oral Sciences Source, and Google Scholar. Peer-reviewed, full-text articles published in English between 2015 and 2025 were screened by four independent reviewers based on predefined inclusion and exclusion criteria. Eligible studies were thematically analyzed. Results: Of 312 records screened, eleven studies met the inclusion criteria. Ultrasonic irrigation was associated with improved clinical outcomes, particularly greater reductions in bacterial load and endotoxins; however, findings regarding its effect on postoperative pain were inconsistent, with some studies reporting a benefit while others observed no significant difference. These outcomes were attributed to mechanisms such as acoustic streaming and cavitation, which enhance irrigant penetration, promote fluid dynamics, and facilitate debridement in anatomically complex regions. Conclusions: Ultrasonic irrigation appears to hold promise for enhancing the efficacy and efficiency of root canal treatment. Existing in vivo studies suggest potential clinical advantages over conventional syringe irrigation, underscoring the need for further high-quality clinical research to more definitively establish its benefits. Full article

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16 pages, 4433 KB

Open AccessArticle

Comparison of Long-Term Oral Bacterial Flora Before and After Orthognathic Surgery in Surgical Orthodontic Treatment

by Rumi Matsumoto, Masahiro Takahashi, Kazuyoshi Hosomichi, Satoko Okuwaki, So Koizumi, Yu Hikita, Reina Hatanaka and Tetsutaro Yamaguchi

Dent. J. 2025, 13(10), 458; https://doi.org/10.3390/dj13100458 - 8 Oct 2025

Abstract

Background/Objectives: Multi-bracket appliances are essential in surgical orthodontic treatment, and perioperative oral management during orthognathic surgery is critical. Thorough plaque control, appropriate use of antibiotics, and shortening of operative time have been reported to be effective in preventing postoperative infections and ensuring surgical [...] Read more.

Background/Objectives: Multi-bracket appliances are essential in surgical orthodontic treatment, and perioperative oral management during orthognathic surgery is critical. Thorough plaque control, appropriate use of antibiotics, and shortening of operative time have been reported to be effective in preventing postoperative infections and ensuring surgical success. As highly invasive orthognathic surgery involving osteotomy may influence the postoperative oral microbiota, this study aimed to investigate the characteristics of and clarify the changes occurring in the salivary oral microbiota after orthognathic surgery. Methods: The study included 14 patients (Group S; mean age 29.3 ± 9.8 years) who underwent surgical orthodontic treatment and 15 control patients (Group C; mean age 27.1 ± 8.7 years) who received orthodontic treatment alone. Salivary samples were analyzed via 16S rRNA gene sequencing, and the relative abundances of bacteria were evaluated using the Linear Discriminant Analysis Effect Size. Results: The prevalence of Neisseria, which is associated with early biofilm formation, decreased over time in both groups. In contrast, Streptococcus exhibited an increase in prevalence. In Group S, members of Pseudomonas, the family Saccharimonadaceae, and the order Rhizobiales showed increases at 5–8 months post-surgery. Conclusions: Surgical orthodontic treatment may influence the oral microbiota and promote colonization by opportunistic pathogens. Instructions regarding oral hygiene and appropriately timed professional cleaning interventions are critical in preventing such colonization. Longitudinal monitoring of the microbiota using metagenomic analysis may be useful for future perioperative management and guidance of oral hygiene. Full article

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

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17 pages, 514 KB

Open AccessArticle

Knowledge, Attitude and Practices Towards Treating Pregnant Patients Among Dental Professionals in Russia

by Ksenia Babina, Maria Polyakova, Irina Makeeva, Inna Sokhova, Anna Mikheikina, Alexandr Zaytsev and Nina Novozhilova

Dent. J. 2025, 13(10), 457; https://doi.org/10.3390/dj13100457 - 6 Oct 2025

Abstract

Objectives: The study assessed knowledge, attitude, and practices of dentists towards treating pregnant patients. Methods: It was based on a cross-sectional, electronically administered survey of a convenience sample of Russian dentists conducted between March and April 2025. Our questionnaire was developed [...] Read more.

Objectives: The study assessed knowledge, attitude, and practices of dentists towards treating pregnant patients. Methods: It was based on a cross-sectional, electronically administered survey of a convenience sample of Russian dentists conducted between March and April 2025. Our questionnaire was developed based on international guidelines and previously published surveys and validated through expert review and pilot testing. It contains four sections: Demographics, Knowledge, Attitude, and Practice. The overall knowledge and attitude scores were calculated and compared across subgroups based on gender, specialty, and experience using the Kruskal–Wallis and Dunn’s tests. Spearman’s coefficient was calculated to reveal pair-wise correlations between knowledge, attitude, and age of the participants. Results: Overall, 403 dentists completed the questionnaire. The majority of the participants (53%) demonstrated fair knowledge about providing dental care throughout pregnancy. Female dentists had a significantly higher median knowledge score compared with that of males; orthodontists and prosthetic dentists showed lower knowledge scores than other specialists. All participants demonstrated a positive attitude toward treating pregnant patients; however, a considerable number of dentists agreed that they do not feel comfortable treating pregnant women and prefer not to do that. A large majority of dental practitioners (83%) indicated that they had treated pregnant women. Liability concerns (42%) and a lack of knowledge (24%) were reported as the main barriers for providing dental care to pregnant patients. Conclusions: It can be concluded that insufficient knowledge influenced by gender and specialty is one of the key barriers to the dental treatment of pregnant women, despite generally positive attitudes of the practitioners. Full article

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16 pages, 2906 KB

Open AccessArticle

Tailored Synthesis and Profiling of Capped Silver and Selenium Nanoparticles for Topical Applications in Paediatric Dentistry

by Amjad Almuqrin, Chaminda Jayampath Seneviratne, Laurence J. Walsh and Sobia Zafar

Dent. J. 2025, 13(10), 456; https://doi.org/10.3390/dj13100456 - 6 Oct 2025

Abstract

Background: Silver fluoride medicaments effectively arrest caries progression but cause permanent staining. Nanoparticles are increasingly utilised in paediatric dentistry due to their antimicrobial properties. Aim: This study reports the synthesis and characterisation of silver and selenium nanoparticles stabilised with natural agents. Methods: Six [...] Read more.

Background: Silver fluoride medicaments effectively arrest caries progression but cause permanent staining. Nanoparticles are increasingly utilised in paediatric dentistry due to their antimicrobial properties. Aim: This study reports the synthesis and characterisation of silver and selenium nanoparticles stabilised with natural agents. Methods: Six silver and selenium nanoparticles were chemically synthesised and stabilised using biocompatible eco-friendly capping agents, including casein, bovine serum albumin, chitosan, citrate, and tannic acid. Characterisation was performed using Tyndall scattering, UV-Vis spectroscopy, transmission electron microscopy, and ICP-OES. Results: The synthesised particles were spherical in shape, ranging in size from 2.5 to 24 nm for silver and 35 to 43 nm for selenium. Elemental analysis confirmed the absence of heavy metals. Conclusions: These findings highlight the successful synthesis of capped silver and selenium nanoparticles. The observed characteristics suggest potential relevance for future antimicrobial applications in paediatric dentistry. Full article

(This article belongs to the Section Restorative Dentistry and Traumatology)

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13 pages, 530 KB

Open AccessReview

Oral Health Status in Patients with Amyotrophic Lateral Sclerosis: A Scoping Review

by Leopoldo Mauriello, Alessandro Cuozzo, Vitolante Pezzella, Gaetano Isola, Gianrico Spagnuolo, Vincenzo Iorio-Siciliano, Luca Ramaglia and Andrea Blasi

Dent. J. 2025, 13(10), 455; https://doi.org/10.3390/dj13100455 - 3 Oct 2025

Abstract

Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative syndrome which often leads to progressive muscular dysfunction and therefore oral health deterioration. The aim of this scoping review is to evaluate oral health status in ALS patients focusing on the importance of dental [...] Read more.

Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative syndrome which often leads to progressive muscular dysfunction and therefore oral health deterioration. The aim of this scoping review is to evaluate oral health status in ALS patients focusing on the importance of dental care in improving patient’s quality of life. Methods: A comprehensive literature search was conducted on PubMed, Scopus, Web of Science, and Embase databases until June 2025 using a combination of keywords and MeSH terms related to ALS and oral health. Studies were screened and selected based on inclusion and exclusion criteria, focusing on human clinical data reporting oral health outcomes in ALS. Results: Eight studies met the inclusion criteria. The findings showed a high prevalence of oral complications in bulbar-onset ALS patients. Common issues included reduced tongue mobility, poor oral hygiene, sialorrhea, and decreased masticatory function were evaluated. Conclusions: Oral health impairment in ALS patients frequently contributes to systemic risks and reduced quality of life. A dental expert may play an important role in multidisciplinary care teams in terms of early diagnosis and conservative treatment of oral diseases ranging from periodontal disease to temporomandibular disorders (TMD). Personalized oral hygiene strategies and adjunctive therapies may serve as key elements in maintaining overall health and patient comfort in ALS. Therefore, the objective of the following review was to evaluate oral health complication in patients with ALS, highlighting the impact of oral care on patients’ quality of life. Full article

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18 pages, 3286 KB

Open AccessArticle

Proof-of-Concept Digital-Physical Workflow for Clear Aligner Manufacturing

by Shih-Hao Huang, I-Chiang Chou, Mayur Jiyalal Prajapati, Yu-Hsiang Wang, Po-Kai Le and Cho-Pei Jiang

Dent. J. 2025, 13(10), 454; https://doi.org/10.3390/dj13100454 - 2 Oct 2025

Abstract

Introduction: Clear aligner therapy has become a mainstream alternative to fixed orthodontics due to its versatility. However, the variability in thermoforming and the limited validation of digital workflows remain major barriers to reproducibility and predictability. Methods: This study addresses that gap by presenting [...] Read more.

Introduction: Clear aligner therapy has become a mainstream alternative to fixed orthodontics due to its versatility. However, the variability in thermoforming and the limited validation of digital workflows remain major barriers to reproducibility and predictability. Methods: This study addresses that gap by presenting a proof-of-concept digital workflow for clear aligner manufacturing by integrating additive manufacturing (AM), thermoforming simulation, and finite element analysis (FEA). Dental models were 3D-printed and thermoformed under clinically relevant pressures (400 kPa positive and −90 kPa negative). Results and Discussion: Geometric accuracy was quantified using CloudCompare v2.13.0, showing that positive-pressure thermoforming reduced maximum deviations from 1.06 mm to 0.4 mm, with all deviations exceeding the expanded measurement uncertainty. Thickness simulations of PETG sheets (0.5 and 0.75 mm) showed good agreement with experimental values across seven validation points, with errors <10% and overlapping 95% confidence intervals. Stress analysis indicated that force transmission was localized at the aligner–attachment interface, consistent with expected orthodontic mechanics. Conclusion: By quantifying accuracy and mechanical behavior through numerical and experimental validation, this framework demonstrates how controlled thermoforming and simulation-guided design can enhance aligner consistency, reduce adjustments, and improve treatment predictability. Full article

(This article belongs to the Section Digital Technologies)

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17 pages, 407 KB

Open AccessArticle

Root Canals and Conspiracies: A Social Semiotic Analysis of Digital Narratives on Social Media and the Promotion of Misinformation

by Alexander C. L. Holden

Dent. J. 2025, 13(10), 453; https://doi.org/10.3390/dj13100453 (registering DOI) - 2 Oct 2025

Abstract

Objectives: Narratives related to root canal treatment on social media can be problematic. This research examines discourses relating to root canal treatment on the popular platform Instagram. Through this analysis, the way different health discourses relating to endodontics are being communicated to the [...] Read more.

Objectives: Narratives related to root canal treatment on social media can be problematic. This research examines discourses relating to root canal treatment on the popular platform Instagram. Through this analysis, the way different health discourses relating to endodontics are being communicated to the public and consumers will be explored. Methods: A search was conducted on Instagram to access consumer-focused information related to root canal treatment. Posts were identified, transcribed to capture the audio component in text form, and watched cyclically, with analytical memos being kept on video content. A social semiotic analysis was conducted on posts to capture the multimodal nature of discourse on endodontics. Results: A total of 100 Instagram posts were included in this study. Two overarching themes were used to structure the analysis of posts: (1) presentation of root canal treatment and (2) presentation of expertise. The majority of posts were negative in tone towards root canal treatment. Conclusions: The variety and nature of the misinformation featured in this research present a complex professional challenge for dentistry. The majority of the posts identified and analysed featured sensationalised explanations of dental disease and treatment processes, blended with inaccuracies, many of which were produced by dentists. Conspiracy discourses relating to root canal treatment were also encountered, which questioned the integrity and intentions of the dental profession. Full article

(This article belongs to the Section Dental Education)

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13 pages, 1607 KB

Open AccessArticle

Evaluation of Tooth Color Changes at Different Concentrations of Zirconia Toothpaste: A Pilot In Vitro Study

by Teuta Pustina, Besir Salihu, Miranda Stavileci, Zana Lila and Jacques Veronneau

Dent. J. 2025, 13(10), 452; https://doi.org/10.3390/dj13100452 - 1 Oct 2025

Abstract

Background: The demand for natural, minimally invasive teeth whitening solutions has led to interest in products using natural abrasives. Zirconium, known for its abrasive properties, has been suggested as a potential whitening agent, but its efficacy compared to traditional methods is underexplored. [...] Read more.

Background: The demand for natural, minimally invasive teeth whitening solutions has led to interest in products using natural abrasives. Zirconium, known for its abrasive properties, has been suggested as a potential whitening agent, but its efficacy compared to traditional methods is underexplored. This study aims to address this gap by evaluating zirconium powder at various concentrations as a novel approach to tooth whitening while preserving the enamel surface. Materials and Methods: Forty extracted mandibular teeth (twenty anterior, twenty posterior) were allocated into four groups and brushed for 2 min with zirconia toothpaste at one of the four concentrations. Color parameters (CIE Lab*), ΔE, and WID were measured before and after brushing using a spectrophotometer; surface roughness was assessed with a profilometer. Data were analyzed with paired tests and ANOVA/Kruskal–Wallis (p < 0.05). Results: All groups showed detectable color change (ΔE > 1.2); several exceeded clinical acceptability (ΔE ≥ 2.7). WID increased in all groups, with the largest gains at 2% zirconia for posterior teeth (+31.58) and 1% or 5% for anterior teeth (+21.07, +21.19). Surface roughness decreased significantly at 0.5% (p ≈ 0.002) and increased at 5% (p ≈ 0.002); no significant change occurred at 1% and 2%. Conclusions: Zirconia toothpaste at 1–2% offers the best balance between whitening efficacy and enamel preservation, while 5% increases roughness and 0.5% produces smaller whitening results. Full article

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10 pages, 1232 KB

Open AccessArticle

Functional Masticatory Angle and Hyoid Bone Position: A Pilot Study on Occlusal Symmetry and Morphofunctional Adaptation

by Lorena Sigwald-Serpa, Icíar Sanz-Orrio Soler, Laura Marqués-Martínez, Juan-Ignacio Aura-Tormos, Esther García-Miralles and Clara Guinot-Barona

Dent. J. 2025, 13(10), 451; https://doi.org/10.3390/dj13100451 - 1 Oct 2025

Abstract

Background: The hyoid bone is a key anatomical structure involved in the functional coordination of the stomatognathic system. Although its position may vary in response to masticatory patterns, its relationship with functional occlusion remains insufficiently studied in orthodontics. Objective: This pilot [...] Read more.

Background: The hyoid bone is a key anatomical structure involved in the functional coordination of the stomatognathic system. Although its position may vary in response to masticatory patterns, its relationship with functional occlusion remains insufficiently studied in orthodontics. Objective: This pilot study aimed to explore the association between masticatory type and hyoid bone position and to assess the clinical utility of the Functional Masticatory Angle of Planas (AFMP) in classifying masticatory patterns. Materials and Methods: A descriptive, observational, cross-sectional study was conducted with 18 patients. Right and left AFMPs were measured using standardized intraoral photographs, and hyoid bone position was assessed via panoramic radiographs, classified as either aligned or displaced. Measurements were repeated to assess intraobserver reliability. Results: In most cases, hyoid bone elevation occurred on the same side as the smaller AFMP, suggesting a possible adaptive response to unilateral masticatory dominance. High intraobserver agreement was confirmed for both AFMP and hyoid measurements. Conclusions: The findings suggest a potential relationship between functional masticatory asymmetry and hyoid bone position. While further studies with larger samples are needed, the AFMP appears to be a promising tool for evaluating functional occlusion in relation to craniofacial dynamics. Full article

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22 pages, 942 KB

Open AccessFeature PaperArticle

Gingivo-Periodontal Alterations in Pediatric Leukemia: A Comparative Analysis of IL-1β, IL-6, IL-17α and TGF-β1 Levels in Gingival Crevicular Fluid and Plasma

by Alina Adumitroaie, Larisa Ghemiș, Vasilica Toma, Ancuta Goriuc, Oana Tanculescu, Melissa Entuc, Simina Vacariu and Liliana Georgeta Foia

Dent. J. 2025, 13(10), 450; https://doi.org/10.3390/dj13100450 - 30 Sep 2025

Abstract

Background/Objectives: Our study aimed to evaluate the oral health status associated with levels of certain inflammatory biomarkers in the gingival crevicular fluid (GCF) and plasma of children and adolescents with leukemia, in comparison to healthy subjects, in order to assess the correlation [...] Read more.

Background/Objectives: Our study aimed to evaluate the oral health status associated with levels of certain inflammatory biomarkers in the gingival crevicular fluid (GCF) and plasma of children and adolescents with leukemia, in comparison to healthy subjects, in order to assess the correlation between pediatric leukemia and gingivo-periodontal alterations. Methods: The study was conducted on 97 subjects, divided into two groups: the study group, n = 47 leukemia subjects, and the control group, n = 50 healthy subjects. The collected GCF and plasma samples were analyzed for interleukins IL-1β, IL-6 and IL-17α and transforming growth factor TGF-β1 values using ELISA (enzyme-linked immunosorbent assay) techniques. Results: IL-6, IL-17α, and TGF-β1 recorded higher values for leukemia subjects, both in the GCF and plasma, compared to healthy subjects. Our results also pointed out higher gingival fluid IL-1β values in children with leukemia compared to the control group. Conclusions: Elevated expressions of IL-1β in the GCF and IL-6, IL-17α, and TGF-β1, both systemic and local, in the GCF of children with leukemia were associated with oral hygiene status and gingival inflammation, respectively. All inflammatory biomarkers generally tended to rise in close correlation with oral hygiene worsening and gingival inflammation extension; however, IL-1β in the GCF and plasma, plasma IL-6, and gingival fluid IL-17α pointed out a stronger correlation with gingival inflammation status. Full article

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22 pages, 2075 KB

Open AccessSystematic Review

Endodontic Surgery for Separated Instrument Removal: Success Rates and Techniques in a Systematic Review

by Mario Dioguardi, Ciro Guerra, Khrystyna Zhurakivska, Diego Sovereto, Lorenzo Lo Muzio, Angelo Martella, Andrea Ballini, Eleonora Lo Muzio and Stefania Cantore

Dent. J. 2025, 13(10), 449; https://doi.org/10.3390/dj13100449 - 30 Sep 2025

Abstract

Background: Instrument separation is a frequent issue in root canals, often complicated by intriguing anatomical variations that make treatment more challenging. These variations in canal structure can lead to various iatrogenic complications, such as missed canals, instrument separation, gouging, perforation, and overextension of [...] Read more.

Background: Instrument separation is a frequent issue in root canals, often complicated by intriguing anatomical variations that make treatment more challenging. These variations in canal structure can lead to various iatrogenic complications, such as missed canals, instrument separation, gouging, perforation, and overextension of obturation materials. One such complication is instrument breakage, which can disrupt the cleaning and shaping processes and potentially cause pain or discomfort. Materials and Methods: The present systematic review was conducted following PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The present systematic review aimed to identify all clinical trials focused on the removal of separated instruments from endodontic canals using an endodontic surgical approach. Results: A total of 21 studies were included, reporting 22 cases involving surgical approaches for separated instrument removal. Conclusions: The analysis of available evidence, although prim Information added.arily based on clinical cases and case series, emphasizes that surgical approaches for removing separated endodontic instruments are a viable therapeutic option when non-surgical treatments are ineffective or not feasible. Techniques such as apicoectomy, intentional replantation, surgical removal, and the technique provide innovative, customized solutions for addressing complications related to separated instruments, showing favorable clinical and radiographic success rates in follow-up assessments. Full article

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12 pages, 1062 KB

Open AccessReview

Vitamin D in Peri-Implant and Periodontal Tissue

by Felipe de Souza Duarte, Nathália Dantas Duarte, Gabriel Mulinari-Santos, Paula Buzo Frigério, Roberta Okamoto, Rogerio Leone Buchaim, Daniela Vieira Buchaim and João Paulo Mardegan Issa

Dent. J. 2025, 13(10), 448; https://doi.org/10.3390/dj13100448 - 30 Sep 2025

Abstract

This review aims to provide an overview of the role of vitamin D in peri-implant and periodontal tissue. Electronic searches were carried out of the PubMed/Medline database. Since this is a narrative review, no systematic search, meta-analysis, or statistical analysis was performed. Vitamin [...] Read more.

This review aims to provide an overview of the role of vitamin D in peri-implant and periodontal tissue. Electronic searches were carried out of the PubMed/Medline database. Since this is a narrative review, no systematic search, meta-analysis, or statistical analysis was performed. Vitamin D plays a crucial role in bone balance and metabolism, contributing to reducing early implant failure and improving dental implant osseointegration. Vitamin D deficiency poses a challenge to clinical outcomes, and its supplementation can be an effective alternative to overcome this limitation. The results reported in this article show that vitamin D application on implants can improve the osseointegration, bone-to-implant contact, implant stability, and bone density. Moreover, vitamin D supplementation can increase RUNX2, ALP, OPN, and OCN expression, contributing to periodontal tissue health and its regeneration. Together, findings provide an overview of these topics and present future perspectives for clinical practice in dentistry. Full article

(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management: 2nd Edition)

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Graphical abstract

15 pages, 2414 KB

Open AccessArticle

Mechanical and Antimicrobial Evaluation of Chitosan-Coated Elastomeric Orthodontic Modules

by Lucía Gabriela Beltrán-Novelo, Fernando Javier Aguilar-Pérez, Myriam Angélica De La Garza-Ramos, Arturo Abraham Cienfuegos-Sarmiento, José Rubén Herrera-Atoche, Martha Gabriela Chuc-Gamboa, Jacqueline Adelina Rodríguez-Chávez and Juan Valerio Cauich-Rodríguez

Dent. J. 2025, 13(10), 447; https://doi.org/10.3390/dj13100447 - 29 Sep 2025

Abstract

Background/Objectives: Orthodontic appliances disrupt oral biofilm homeostasis, leading to an increase in plaque and disease risk. Elastomeric modules (EMs) promote bacterial growth due to their material composition. Surface coatings have been developed to reduce bacterial colonization. We evaluated the mechanical, antimicrobial, and [...] Read more.

Background/Objectives: Orthodontic appliances disrupt oral biofilm homeostasis, leading to an increase in plaque and disease risk. Elastomeric modules (EMs) promote bacterial growth due to their material composition. Surface coatings have been developed to reduce bacterial colonization. We evaluated the mechanical, antimicrobial, and cell viability properties of a chitosan coating for EMs. Methods: EMs were coated with chitosan (CS) and chitosan-glutaraldehyde (CS-GTA) to assess antimicrobial and cell viability. Uncoated EMs were used as a control. These surface-coated modules were characterized and analyzed with Fourier transform infrared (FTIR) and Raman spectroscopy, and tensile testing. Antibacterial activity was assessed by colony-forming units (CFU) counts after incubation. Cell viability was tested with gingival fibroblasts using the MTT assay. ANOVA, Tukey, Kolmogorov–Smirnov, and Kruskal–Wallis tests were used for statistical analysis. Results: Raman spectra of the chitosan coatings showed characteristic molecular vibration bands. ANOVA revealed a significant difference in mechanical properties between the materials and between the control and the CS-GTA groups, confirmed by the Tukey post hoc test. No significant difference was observed between the groups in the Yield Stress test. All the coated groups showed reduced CFU counts in the antibacterial assay. The average cell viability of the coated groups was 85% and 89%. Conclusions: We synthesized CS and GTA-cross-linked chitosan coatings. The coatings did not affect the mechanical properties of the elastomeric modules. The chitosan and glutaraldehyde-cross-linked CS coatings inhibited bacterial growth. No significant differences were observed in antibacterial activity between the CS and the GTA-crosslinked chitosan coatings. Full article

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