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Dentistry Journal
Volume 13
Issue 10
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Dent. J., Volume 13, Issue 10 (October 2025) – 46 articles

Cover Story (view full-size image): Apicoectomy is a standard procedure for treating persistent periapical infections. Navigated surgery provides help in complex cases with low visability. The present in vitro study shows a comparison of conventional apicoectomy with a dynamically guided approach. The primary objective of this study was to evaluate the feasibility, accuracy, and safety of dynamic navigation. Our study demonstrated that the navigated approach provides an enhancement in the accuracy of root-end resection and a reduction in the volume of the access cavity. This enhanced precision shows the potential of dynamic navigation as a viable alternative for complex cases. The study highlights the challenges of clinical implementation and emphasizes that, although dynamic navigation offers advantages, its introduction depends on its integration into efficient workflows. View this paper
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21 pages, 5465 KB  
Case Report
Modified Roll Flap Soft-Tissue Augmentation at Single-Stage Implant Placement: A Digital-Scan–Verified Case Report
by Kamen Kotsilkov, Hristina Maynalovska and Zdravka Pashova-Tasseva
Dent. J. 2025, 13(10), 483; https://doi.org/10.3390/dj13100483 - 21 Oct 2025
Viewed by 359
Abstract
Background and Objectives: Adequate peri-implant soft tissue dimensions are essential for health, hygiene, and esthetics. When ridge volume is sufficient, phenotype modification may avoid bone grafting. This case report describes a pedicled roll flap performed concurrently with single-stage implant placement after spontaneous socket [...] Read more.
Background and Objectives: Adequate peri-implant soft tissue dimensions are essential for health, hygiene, and esthetics. When ridge volume is sufficient, phenotype modification may avoid bone grafting. This case report describes a pedicled roll flap performed concurrently with single-stage implant placement after spontaneous socket healing, without bone substitute, and assesses soft-tissue stability with serial intraoral scans. Clinical case: A single-tooth edentulous site underwent prosthetically driven, fully guided implant placement. A modified roll flap with vertical and palatal incisions was prepared; the de-epithelialized crestal connective tissue was elevated and rolled into a buccal envelope to augment thickness. No graft material was used. A provisional crown conditioned the emergence profile. Follow-up included photographs, radiographs, and intraoral scan superimpositions at 2 weeks, 3–4 months, 8 months, and 14 months after implant treatment. Healing was uneventful. Buccal soft-tissue thickness increased, keratinized mucosa was preserved, and midfacial levels remained stable. Emergence profile and papillae integrated harmoniously. Crestal bone levels were stable radiographically. Digital scans corroborated soft-tissue thickness maintenance. No donor-site morbidity occurred. Conclusions: In healed sockets with adequate bone, a modified pedicled roll flap at implant placement can thicken the peri-implant phenotype and achieve stable esthetic integration without bone substitutes. Full article
(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management: 2nd Edition)
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14 pages, 3819 KB  
Article
In Vitro Evaluation of Tooth Enamel Abrasion and Roughness Using Toothpaste with and Without Activated Charcoal: An SEM Analysis
by Fiorella Thais Aquino Carmen, Renzo Jesús Pro Romero, Alexander Roger Espinoza Salcedo and Paul Martín Herrera-Plasencia
Dent. J. 2025, 13(10), 482; https://doi.org/10.3390/dj13100482 - 21 Oct 2025
Viewed by 663
Abstract
Background/Objectives: Dental enamel constitutes the first barrier of defense against external factors that constantly generate wear and damage. This study aimed to evaluate in vitro the abrasion and roughness of dental enamel using toothpaste with and without activated charcoal and to analyze this [...] Read more.
Background/Objectives: Dental enamel constitutes the first barrier of defense against external factors that constantly generate wear and damage. This study aimed to evaluate in vitro the abrasion and roughness of dental enamel using toothpaste with and without activated charcoal and to analyze this under scanning electron microscopy (SEM). Materials and methods: The research design was experimental; 10 enamel blocks were randomly assigned to each group to perform brushing cycles with soft- and medium-filament brushes with two types of toothpaste, one with activated charcoal and one without activated charcoal. A pumice stone with etching acid was used as the positive control and artificial saliva served as the negative control; both were analyzed separately. Roughness was evaluated using a roughness meter and abrasion with an analytical balance. The surface of the enamel blocks of each group was randomly analyzed under an SEM. Statistical analysis was performed using the Shapiro–Wilk test and the homogeneity of variances with Bartlett’s test. Student’s t-test (two-tailed) was applied to compare tooth enamel roughness and abrasion. Results: Both enamel roughness (p = 0.0016) and abrasion (p = 0.0001) were significantly higher in the groups using activated charcoal paste and medium-filament brushes. SEM observation revealed greater alteration on the surface of the enamel subjected to brushing cycles with activated charcoal paste and a medium-filament brush. Conclusions: The in vitro study showed that the use of toothpaste with activated charcoal increases the roughness and abrasion of tooth enamel, especially when the medium-filament brush is used. Full article
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17 pages, 491 KB  
Article
Psychological Experiences of Ocular Trauma and Traumatic Dental Injury Victims of Police Violence
by Gonzalo Rojas-Alcayaga, Andrea Herrera, Camila Corral Nuñez, Joaquín Varas, Sebastián Córdova, Carolina Lineros and Matías Ríos-Erazo
Dent. J. 2025, 13(10), 481; https://doi.org/10.3390/dj13100481 - 20 Oct 2025
Viewed by 359
Abstract
Background/Objectives: Ocular trauma (OT) and traumatic dental injuries (TDI) inflicted by police officers not only cause significant physical harm, but also psychological trauma. The clinical attention given by health care teams may induce revictimization or retraumatization phenomena, which affect the psychological status [...] Read more.
Background/Objectives: Ocular trauma (OT) and traumatic dental injuries (TDI) inflicted by police officers not only cause significant physical harm, but also psychological trauma. The clinical attention given by health care teams may induce revictimization or retraumatization phenomena, which affect the psychological status of the victim. The objective of this research is to bring to light the psychological experiences related to emergency care processes and rehabilitation of people affected by OT and TDI caused by police violence. Methods: Qualitative research was conducted based on in-depth interviews with eighteen people affected by OT or TDI during the social outbreak in Chile in 2019–2020. Data analysis was based on the principles of grounded theory. Results: Three main categories emerged: quality of interpersonal relationships with health care providers, expectations of care and treatment and psychological consequences. The findings show that retraumatization and revictimization arise from clinical care in the context of state violence. Conclusions: Revictimization and retraumatization are the most characteristic phenomena occurring in the health care of people affected by OT and TDI caused by police violence. The probability of their occurrence depends mainly on the interpersonal relationships established with the health care team and the management of patient expectations regarding health care. Full article
(This article belongs to the Section Restorative Dentistry and Traumatology)
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13 pages, 470 KB  
Article
Assessment of Common Oral Behaviors in Patients with Temporomandibular Joint Disorders and Their Relationship to Psychosocial Factors
by Nguyen Ngoc Hoa, Hoang Viet Hai, Tran Thai Binh, To Thanh Dong, Tran Thi Minh Quyen and Toan Do
Dent. J. 2025, 13(10), 480; https://doi.org/10.3390/dj13100480 - 20 Oct 2025
Viewed by 403
Abstract
Background: Temporomandibular disorders (TMDs) exhibit a complex relationship with depression, anxiety disorders, and oral behaviors. This cross-sectional study aimed to assess the differences in oral behaviors among subgroups of TMD-related pain and patients with varying levels of anxiety and depression. Methods: A total [...] Read more.
Background: Temporomandibular disorders (TMDs) exhibit a complex relationship with depression, anxiety disorders, and oral behaviors. This cross-sectional study aimed to assess the differences in oral behaviors among subgroups of TMD-related pain and patients with varying levels of anxiety and depression. Methods: A total of 120 patients diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), completed the Oral Behavior Checklist (OBC), Visual Analog Scale (VAS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder (GAD-7), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaire-15 (PHQ-15), and Jaw Functional Limitation Scale-8 (JFLS-8). Associations were examined using Chi-square, Fisher’s exact, and Spearman’s correlation; logistic regression and multivariable linear regression were performed (p < 0.05). Results: In univariate analyses, several item-level OBs were more prevalent with higher anxiety, including nocturnal bruxism, sleep positions exerting jaw pressure, daytime grinding, and gum chewing (p = 0.007, 0.041, 0.011, and 0.014, respectively). A modest difference among pain subgroups was observed for sleep position (p = 0.044). In multivariable models, anxiety was independently associated only with nocturnal bruxism (OR = 2.95; 95% CI: 1.30–6.67; p = 0.010), whereas depression showed no independent associations. Pain intensity remained the sole predictor of total OBC scores (Coef = 1.829; 95% CI: 0.51–3.15; p = 0.007). No independent effects were detected for TMD subgroups. Conclusions: Psychosocial factors appeared related to OBs in univariate analyses, but these associations were explained by confounding influences. After adjustment, pain intensity and anxiety emerged as key determinants. These findings highlight the need for comprehensive TMD management integrating pain control with behavioral strategies. Full article
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19 pages, 1817 KB  
Systematic Review
Salivary Biomarkers as Prognostic Tools in Oral Squamous Cell Carcinoma: A Systematic Review of Survival and Progression Outcomes
by Matteo Pellegrini, Maurizio Pascadopoli, Mario Romolo Faretta, Alessandro Nobili, Carlos Pérez-Albacete Martínez, Francesco Spadari and Andrea Scribante
Dent. J. 2025, 13(10), 479; https://doi.org/10.3390/dj13100479 - 17 Oct 2025
Viewed by 436
Abstract
Background/Objectives: Oral squamous cell carcinoma (OSCC) remains associated with poor survival, and conventional prognostic indicators such as TNM staging provide limited accuracy. Saliva has emerged as a promising liquid biopsy, but evidence regarding its prognostic role is limited. This review systematically assessed [...] Read more.
Background/Objectives: Oral squamous cell carcinoma (OSCC) remains associated with poor survival, and conventional prognostic indicators such as TNM staging provide limited accuracy. Saliva has emerged as a promising liquid biopsy, but evidence regarding its prognostic role is limited. This review systematically assessed salivary proteomic, transcriptomic, and metabolomic biomarkers with prognostic value for survival and disease progression in OSCC patients. Methods: A systematic literature search was performed across PubMed, Scopus, Web of Science, Embase, and Cochrane Library up to 7 June 2025, following PRISMA 2020 and JBI guidelines. Human studies evaluating associations between salivary biomarkers and prognosis in OSCC were included. Risk of bias was assessed with the QUIPS tool. The review protocol was registered on PROSPERO (CRD42024535737). Results: Fifteen studies were included, involving 872 OSCC patients and 548 healthy controls. Biomarkers were identified using proteomic (n = 9), transcriptomic (n = 4), and metabolomic (n = 2) approaches. Among the most promising, miR-423-5p was independently associated with shorter disease-free survival (DFS), AKR1B10 levels above 646 pg/mL predicted worse overall survival (OS), and 3-methylhistidine was validated as a metabolomic marker of reduced OS. Additionally, miR-1307-5p correlated with nodal metastasis and chemoresistance, Cyfra 21-1 with recurrence and grade, and a low apoptotic/non-apoptotic salivary microvesicle ratio with poorer outcomes. However, heterogeneity in methods, small sample sizes, and lack of external validation limit clinical applicability. Conclusions: Salivary biomarkers show potential as non-invasive tools for prognostic stratification in OSCC. Among the identified candidates, miR-423-5p, AKR1B10, and 3-methylhistidine provide the most robust evidence. Future multicenter, longitudinal studies with standardized protocols and validation are essential. Full article
(This article belongs to the Special Issue Dental Oncology)
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15 pages, 2483 KB  
Article
Flapless Immediate Implants: Soft Tissue Alterations Following a Trimodal Approach with or Without Modifying Osseous and Mucosal Compartments in the Esthetic Zone: A Non-Randomized Clinical Trial with Historical Control Group
by Gustavo Cabello, María Rioboo, Daniel Torres-Lagares and Javier Fábrega
Dent. J. 2025, 13(10), 478; https://doi.org/10.3390/dj13100478 - 17 Oct 2025
Viewed by 347
Abstract
Objective: This study aimed to compare two protocols for immediate implants with fixed provisional restoration, no grafting (trimodal approach = TA) versus grafting in both the osseous gap and peri-implant mucosa (a trimodal approach with modification of the bony and mucosal compartments [...] Read more.
Objective: This study aimed to compare two protocols for immediate implants with fixed provisional restoration, no grafting (trimodal approach = TA) versus grafting in both the osseous gap and peri-implant mucosa (a trimodal approach with modification of the bony and mucosal compartments = TAOM), by measuring soft tissue changes over time. The periodontal phenotype was noted to investigate the relationship between its thickness and the clinical outcomes. Methods: Thirty-one patients met the inclusion criteria (15 in the TA group and 16 in the TAOM group). The TA group was a historical control group. Measurements were taken using a digital caliper at T0 and 3, 6, and 12 months following the procedure (T3), (T6), and (T12), respectively, from reference points marked in a dental-supported stent. The periodontal phenotype was determined using an analogical caliper. Results: T12: Vertical midfacial change was −0.17 ± 0.37 in the TAOM group and 0.54 ± 0.33 in the TA group, respectively. Statistical significance (p = 0.0001) was found. Papilla vertical change in the TAOM group was −0.16 ± 0.45 mesially and 0.00 ± 0.44 distally. In the TA group, it was 0.55 ± 0.82 mesially and 0.86 ± 0.95 distally. Statistical significance (p = 0.0001) was also found. Conclusions: There were differences in soft tissue change between the two groups, and changes were related to the periodontal phenotype. Studies with more extended follow-up periods are needed to assess the long-term evolution of both protocols. Full article
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26 pages, 4031 KB  
Systematic Review
Modified Coronally Advanced Flaps: A Systematic Review and Meta-Analysis
by Miriana Gualtieri, Annarita Signoriello, Alessia Pardo, Diana Andreea Muresan, Alessandro Zangani, Paolo Faccioni, Giovanni Corrocher and Giorgio Lombardo
Dent. J. 2025, 13(10), 477; https://doi.org/10.3390/dj13100477 - 17 Oct 2025
Viewed by 541
Abstract
Background: Gingival recession (GR) is defined as the exposure of the root surface due to the gingival margin shifting apically from the cemento-enamel junction. Current effective management of defects related to GR relies on root coverage periodontal plastic surgery (RCPPS), using the [...] Read more.
Background: Gingival recession (GR) is defined as the exposure of the root surface due to the gingival margin shifting apically from the cemento-enamel junction. Current effective management of defects related to GR relies on root coverage periodontal plastic surgery (RCPPS), using the Modified Coronally Advanced Flap (mCAF) with an envelope design. Recent literature also reported the association of different biomaterials to the mCAF procedure. In light of these considerations, a systematic review (SR) was conducted to determine and compare the efficacy of all mCAF adjunctive techniques for the treatment of multiple adjacent GR-type (MAGR) defects. Methods: An electronic search was conducted in 2025 on studies published between 2013 and 2025, using PubMed, Scopus, Web of Science, and Cinahl Complete, to address the focused question: “which is the efficacy of different mCAF adjunctive techniques for the treatment of multiple adjacent GR-type defects, in terms of root coverage (RC), esthetic outcomes, and keratinized tissue (KT) augmentation?”. Randomized controlled trials with a minimum follow-up of 6 months with ≥ 5 patients treated for coverage of MAGR were included. Risk of bias was assessed with RoB 2 Tool. A meta-analysis was performed using RevMan5.4 software and the level of evidence of included studies was analyzed with GRADEPro GDT. Results: A total of 17 studies were included in the SR, 9 of which evaluating mCAF + sCTG (subepithelial connective tissue graft) vs. mCAF adjunctive techniques [Collagen Matrix (CM), xenogeneic acellular dermal matrix (XADM), Platelet-Rich Fibrin (PRF), Enamel Matrix Derivatives (EMD), sCTG harvested double blade scalpel] were then included in the meta-analysis. The primary outcomes of complete root coverage (CRC) and keratinized tissue width variation (ΔKTW) were statistically significant ([CRC: Odds Ratio (OR) 1.70; 95% CI (confidence interval) 1.18, 2.44; p = 0.004]; [ΔKTW: SMD (standardized mean difference) 0.37; 95% CI 0.11, 0.63; p = 0.005]) in favor of mCAF + CTG. Meanwhile, no statistically significant difference was observed in terms of RES. The certainty assessment highlighted relevant results: despite the lack of evidence in the long-term, a high level of evidence showed that sCTG was more effective than XADM in terms of CRC (p = 0.002) and ΔKTW (p = 0.0001). A low level of evidence revealed that sCTG achieved a greater ΔKTW compared to CM (p = 0.0006). Although no significant differences were observed, a low level of evidence suggested that mCAF + EMD and mCAF + sCTG (DBS) may provide good results. To date, only one RCT showed long-term stable results of CTG in terms of RC. Conclusions: The association of sCTG to mCAF demonstrated better results in terms of RC and KTW augmentation in short- and medium-term follow-ups. Long-term studies are needed to confirm the efficacy of the other mCAF adjunctive techniques, considering limitations due to heterogeneity in follow-ups, distribution of techniques analyzed, and different study designs. Registration in PROSPERO (International prospective register of systematic reviews) was performed with ID CRD420251085823. Full article
(This article belongs to the Topic Oral Health Management and Disease Treatment)
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14 pages, 4413 KB  
Article
The Impact of Centrifugation Devices and Collection Tubes on Fibrin Characteristics and Growth Factor Release Under High- and Low-Speed Protocols
by Oranit Bunyatratchata, Wutigri Nimlamool and Supatra Sangin
Dent. J. 2025, 13(10), 476; https://doi.org/10.3390/dj13100476 - 17 Oct 2025
Viewed by 485
Abstract
Background: Platelet-rich fibrin (PRF) is an autologous platelet concentrate (APC) produced through blood centrifugation. Despite the development of various centrifugation systems, protocol variability continues to pose challenges in selecting the optimal method. This study investigated the effects of three different centrifuges and collection [...] Read more.
Background: Platelet-rich fibrin (PRF) is an autologous platelet concentrate (APC) produced through blood centrifugation. Despite the development of various centrifugation systems, protocol variability continues to pose challenges in selecting the optimal method. This study investigated the effects of three different centrifuges and collection tubes on the fibrin characteristics and growth factor release in leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin plus (A-PRF+). Methods: Blood samples from six healthy female volunteers were processed using three centrifuges (Duo, IntraSpin, and LMC-3000) and three collection tubes (Pyrex, A-P, and silica-coated plastic) under high- (~700× g for 12 min) and low-speed (~200× g for 8 min) protocols. Fibrin clot weight and length were assessed. Growth factor release of platelet-derived growth factor-BB (PDGF-BB) and vascular endothelial growth factor (VEGF) was quantified using ELISA. Fibrin architecture was examined via scanning electron microscopy (SEM). Results: High-speed protocols tended to produce larger clots, whereas low-speed protocols generated smaller but more biologically active matrices. The IntraSpin and Duo centrifuges yielded greater clot dimensions and higher growth factor release than the LMC-3000. While tube type had no significant effect on growth factor levels, silica-coated tubes tended to produce the largest clots. The Pyrex tubes demonstrated comparable or superior growth factor release. Conclusions: PRF quality is influenced by centrifuge design, g-force, and tube material. Low-speed protocols with certified centrifuges are recommended, and FDA-approved glass tubes may provide a reliable alternative to reduce silica-related risks. Standardization and appropriate material selection are essential for consistent, safe, and effective regenerative outcomes. Full article
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11 pages, 352 KB  
Article
Tooth Loss and Oral Health-Related Quality of Life: A Study in a Convenience Sample from Austria
by Ana Nikolic, Stefanie Schindler and Hanns Moshammer
Dent. J. 2025, 13(10), 475; https://doi.org/10.3390/dj13100475 - 17 Oct 2025
Viewed by 438
Abstract
Background: To examine the association between the number and location of missing teeth and oral health-related quality of life (OHRQoL) as well as self-assessed general health in a convenience sample of Austrian dental patients, and to evaluate the applicability of the OHIP-G [...] Read more.
Background: To examine the association between the number and location of missing teeth and oral health-related quality of life (OHRQoL) as well as self-assessed general health in a convenience sample of Austrian dental patients, and to evaluate the applicability of the OHIP-G 14 and OHIP-G 12 instruments in this context. Methods: An anonymous questionnaire was distributed to adult patients in the waiting area of a single Austrian dental practice. It included the German version of the OHIP-14, a visual analog scale (EQ-5D VAS) for self-assessed general health, and demographic questions. A dentist clinically assessed the number and location of missing teeth using the FDI tooth numbering system. Regression models were used to evaluate the impact of anterior and posterior tooth loss on both outcome measures. The role of tooth replacement was also explored. A sensitivity analysis was conducted using the OHIP-G 12, a modified version excluding two items from the OHIP-14. Results: OHRQoL was significantly associated with the number of missing anterior teeth, while self-assessed general health was associated only with missing posterior teeth. These associations were consistent across models using OHIP-G 14 and OHIP-G 12. Tooth replacement, as assessed, showed no significant influence on either outcome. Age initially correlated with both outcomes but lost significance after controlling for the number of missing teeth. Conclusions: The hypothesis that anterior tooth loss negatively affects OHRQoL was supported. The association between posterior tooth loss and general health perception was not expected and requires further investigation. The OHIP-G 12 proved to be a valid and efficient alternative in this setting. Full article
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9 pages, 1262 KB  
Article
Effects of Chewing Gum on Plaque Index: A 3-Dimensional Colorimetric Analysis
by Luca Levrini, Piero Antonio Zecca, Virginia Bellora, Alessandro Deppieri, Stefano Saran, Nicola Giannotta and Andrea Carganico
Dent. J. 2025, 13(10), 474; https://doi.org/10.3390/dj13100474 - 17 Oct 2025
Viewed by 345
Abstract
Background: This study aimed to evaluate the effectiveness of xylitol- and fluoride-containing chewing gum in reducing dental plaque using a novel 3D colorimetric analysis, and to compare results with the Plaque Control Record (PCR). Methods: An acute intervention study was conducted on 34 [...] Read more.
Background: This study aimed to evaluate the effectiveness of xylitol- and fluoride-containing chewing gum in reducing dental plaque using a novel 3D colorimetric analysis, and to compare results with the Plaque Control Record (PCR). Methods: An acute intervention study was conducted on 34 healthy adults (18–45 years). A plaque-disclosing solution was applied, and intraoral scans were taken before and after 15 min of gum mastication. Plaque was quantified with PCR and the Placca Read software, which analyzes colorimetric patterns of scanned images. Statistical analyses (Shapiro–Wilk test, paired t-test) were performed with Jamovi Software version 1.6.14. Results: A significant reduction in plaque scores was observed after chewing gum (p < 0.05). Mean reduction reached −14.8% in the experimental group versus −3.9% in controls, where natural saliva flow and pigment washout may explain the modest decline. The 3D analysis provided precise measurements across all dental surfaces and showed strong correlation with PCR, supporting its validity. Conclusions: These findings indicate that functional chewing gum can significantly reduce plaque accumulation even after a single use, and that 3D colorimetric analysis offers a reliable, comprehensive alternative to conventional indices. Full article
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11 pages, 3097 KB  
Case Report
Primary Intraosseous Vascular Malformation in a Child with ELMO2 Mutation: Diagnostic and Dental Management Challenges
by Nadezhda Mitova, Valentina Petkova-Ninova and Peter Bakardjiev
Dent. J. 2025, 13(10), 473; https://doi.org/10.3390/dj13100473 - 16 Oct 2025
Viewed by 1214
Abstract
Background/Objectives: Vascular Malformation—Osteolytic Subtype (VMOS) is an exceptionally rare autosomal recessive disorder caused by homozygous pathogenic variants in the ELMO2 gene, with fewer than ten genetically confirmed pediatric cases reported worldwide. This report presents the longitudinal dental management and clinical course of a [...] Read more.
Background/Objectives: Vascular Malformation—Osteolytic Subtype (VMOS) is an exceptionally rare autosomal recessive disorder caused by homozygous pathogenic variants in the ELMO2 gene, with fewer than ten genetically confirmed pediatric cases reported worldwide. This report presents the longitudinal dental management and clinical course of a child with VMOS, emphasizing the challenges of preventive and restorative care in such cases. Methods: A four-year-old child with a confirmed diagnosis of VMOS and a history of urgent bilateral coil embolization and surgical excision of mandibular aneurysmal bone cysts presented for dental care. The patient was followed for three years (2022–2025). Management focused on staged oral rehabilitation, preventive strategies, and restorative interventions adapted to changes across dentition stages. Results: At initial presentation, the child exhibited mandibular swelling, gingival hypertrophy, and a history of spontaneous intraoral bleeding. The postoperative course had been complicated by cerebral abscesses requiring prolonged intravenous antibiotics. During the primary dentition stage, full oral rehabilitation and strict preventive protocols were implemented to minimize caries and infection risk. In the mixed dentition period, the permanent incisors and molars erupted with enamel hypoplasia and developmental defects, necessitating composite restorations. Ectopic eruption and suboptimal oral hygiene, partly related to parental fear of bleeding, were also managed with reinforced preventive counseling. Conclusions: This case highlights the long-term dental implications of VMOS, underscoring the crucial role of the pediatric dentist in early preventive planning and individualized restorative management. Effective multidisciplinary coordination remains essential to preserve oral health and minimize complications in rare vascular syndromes with craniofacial involvement. Full article
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17 pages, 3859 KB  
Article
Xenograft-Induced Damage and Synechiae Formation in the Maxillary Sinus Mucosa: A Retrospective Histological Analysis in Rabbits
by Yasushi Nakajima, Karol Alí Apaza Alccayhuaman, Ermenegildo Federico De Rossi, Eiki Osaka, Daniele Botticelli, Erick Ricardo Silva, Samuel Porfirio Xavier and Shunsuke Baba
Dent. J. 2025, 13(10), 472; https://doi.org/10.3390/dj13100472 - 16 Oct 2025
Viewed by 239
Abstract
Background: During maxillary sinus floor augmentation, the elevated sinus mucosa may come into close contact with the pristine mucosa. The presence of xenograft granules can lead to unintended mechanical and biological interactions between the two layers, and the resulting tissue damage remains [...] Read more.
Background: During maxillary sinus floor augmentation, the elevated sinus mucosa may come into close contact with the pristine mucosa. The presence of xenograft granules can lead to unintended mechanical and biological interactions between the two layers, and the resulting tissue damage remains poorly understood. The aim of this study was to perform a focused histological evaluation of graft-mediated interactions between the elevated and pristine sinus mucosae. Methods: Histological slides from five previously published rabbit sinus augmentation studies using grafts with different resorption rates were retrospectively analyzed. The following main patterns of tissue alteration were identified: (1) Proximity stage, characterized by epithelial thickening, goblet cell hyperactivity, and ciliary shortening; (2) Fusion stage, with epithelial interpenetration and loss of distinct mucosal boundaries; (3) Synechiae stage, featuring connective tissue bridges linking the two mucosae; and (4) Pristine mucosa lesions, caused by direct contact between residual graft particles and the pristine sinus mucosa. Results: A total of 192 sinuses were evaluated. Sinuses augmented with slowly resorbable grafts showed proximity stage in 22.3% of cases, fusion in 7.7%, direct lesions in 9.6%, and only one instance of synechia. In contrast, the faster resorbable xenograft presented only 11.1% of proximity stage, without further alterations. Conclusions: In this rabbit model, xenografts were associated with histological alterations of the sinus mucosa, while synechiae formation was rare. These preclinical findings should not be directly extrapolated to humans but may provide a basis for future investigations. Full article
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19 pages, 4754 KB  
Article
Comparative Evaluation of SLA and DLP 3D Printing in Dental Implant Guides: Impact on Fabrication Accuracy, Speed, and Resin Usage
by Michel Beyer, Lena Scheller, Alexandru Victor Burde, Sead Abazi, Adelita Sommacal, Lukas Seifert, Neha Sharma and Florian Markus Thieringer
Dent. J. 2025, 13(10), 471; https://doi.org/10.3390/dj13100471 - 16 Oct 2025
Viewed by 654
Abstract
Background: Three-dimensional (3D) printing technologies such as Stereolithography (SLA) and Digital Light Processing (DLP) are widely used in dental implantology for the fabrication of surgical guides. While both methods offer clinical viability, their comparative accuracy, efficiency, and material consumption remain subjects of [...] Read more.
Background: Three-dimensional (3D) printing technologies such as Stereolithography (SLA) and Digital Light Processing (DLP) are widely used in dental implantology for the fabrication of surgical guides. While both methods offer clinical viability, their comparative accuracy, efficiency, and material consumption remain subjects of debate. Objectives: To compare the dimensional accuracy, printing time, and material consumption of dental surgical guides fabricated using an SLA printer (Formlabs Form 3B) and a DLP printer (NextDent 5100) at various printing orientations. Methods: A standardized surgical guide was designed and printed on both printers across seven orientations (0–90°). Five guides per angle were fabricated per technology (n = 35 per printer), scanned, and compared with the CAD reference to evaluate dimensional accuracy. Printing time and resin consumption were recorded. Statistical analyses included the Shapiro–Wilk test and Mann–Whitney U test (α = 0.05). Results: Within the evaluated printers and resins, SLA-printed guides demonstrated slightly lower Root Mean Square (RMS) values in most regions, especially in occlusal and drill hole surfaces, while DLP guides tended to undersize Optimal accuracy was observed at 45° for SLA and 60° for DLP. Material consumption was lower for the SLA printer compared with the DLP printer, but SLA required longer printing time (90–200 min vs. 25–75 min for DLP). Conclusions: Both technologies produced clinically acceptable guides under the tested conditions. The tested SLA printer tended to offer slightly higher accuracy and material efficiency, whereas the DLP printer achieved shorter printing times, supporting its use in high-throughput workflows. Printing orientation significantly influenced accuracy and resource use. Full article
(This article belongs to the Special Issue Advancements and Implications of Digital Workflow Integration in Implant Dentistry)
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13 pages, 136494 KB  
Article
Effect of Bleaching on the Surface Roughness of Resin Composites Evaluated by Atomic Force Microscopy (AFM)
by Kabas Fadhil and Bassam Karem Amin
Dent. J. 2025, 13(10), 470; https://doi.org/10.3390/dj13100470 - 15 Oct 2025
Viewed by 356
Abstract
Background/Objectives: Composite resins are widely used restorative materials, but their surface properties may be altered by bleaching procedures. This study aimed to compare the effects of two bleaching techniques—light-activated (zoom) and diode laser-activated—on the surface roughness of nanohybrid and microhybrid composites using [...] Read more.
Background/Objectives: Composite resins are widely used restorative materials, but their surface properties may be altered by bleaching procedures. This study aimed to compare the effects of two bleaching techniques—light-activated (zoom) and diode laser-activated—on the surface roughness of nanohybrid and microhybrid composites using Atomic Force Microscopy (AFM) for topographic evaluation. Methods: A total of 60 composite resin disks were fabricated, with 30 nanohybrid and 30 microhybrid samples. Each type was divided into three subgroups: control, zoom bleaching, and laser bleaching (n = 10 per group). Zoom bleaching employed 40% hydrogen peroxide gel activated by the Philips Zoom system, while laser bleaching used a 940 nm diode laser (QuickLase, Kent, UK) in combination with QuickLase bleaching gel containing approximately 35–40% hydrogen peroxide. Surface roughness parameters (Sa) were measured using AFM, and statistical analysis was performed. Results: Both bleaching protocols increased surface roughness compared to controls. Microhybrid composites showed higher roughness after zoom (103.12 ± 19.25 nm) and laser bleaching (106.16 ± 25.21 nm), while nanohybrid composites had lower values after zoom (57.77 ± 13.88 nm) and laser bleaching (78.13 ± 23.29 nm). Significant differences were found between composite types post-bleaching (p < 0.001 for zoom; p = 0.019 for laser). However, differences between bleaching methods within the same composite type were not significant (p > 0.05). Conclusions: Both zoom and laser bleaching negatively affect composite surfaces, with laser bleaching showing a greater impact. Nanohybrid composites demonstrated superior resistance to surface alteration, suggesting better clinical durability. These findings are relevant for clinicians when planning restorative treatments in patients likely to undergo bleaching. Full article
(This article belongs to the Section Dental Materials)
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17 pages, 2577 KB  
Article
From Break-Even Point to Dynamic Regenerative Balance: A Conceptual and Quantitative Framework Based on Preclinical Rabbit Sinus Lift Data
by Daniele Botticelli, Karol Alí Apaza Alccayhuaman, Samuel Porfirio Xavier, Erick Ricardo Silva, Yasushi Nakajima and Shunsuke Baba
Dent. J. 2025, 13(10), 469; https://doi.org/10.3390/dj13100469 - 15 Oct 2025
Viewed by 310
Abstract
Background: Traditional parameters such as bone-to-implant contact percentage (BIC%) provide only static insights into implant integration and do not reflect the temporal dynamics of bone regeneration. The concept of Dynamic Regenerative Balance (DRB) was introduced to represent the biological equilibrium between bone formation [...] Read more.
Background: Traditional parameters such as bone-to-implant contact percentage (BIC%) provide only static insights into implant integration and do not reflect the temporal dynamics of bone regeneration. The concept of Dynamic Regenerative Balance (DRB) was introduced to represent the biological equilibrium between bone formation and graft resorption. The break-even point serves as a measurable approximation of this equilibrium. This study aimed to illustrate the usefulness of the break-even point in expressing the balance between graft resorption and new bone formation, rather than to define definitive values for specific biomaterials. Methods: Four preclinical studies on sinus floor elevation in rabbits were selected. Each reported histomorphometric data on new bone formation and graft resorption at two or more time points. Six biomaterials were analyzed: autogenous bone, Bio-Oss®, Bio-Oss Collagen®, Gen-Os®, Maxresorb®, and Maxresorb® Inject. The break-even point was calculated by linear extrapolation as the time at which new bone equals residual graft percentage. Results: The break-even point varied significantly among biomaterials (expressed in days/area %): autogenous bone reached equilibrium fastest (18.4 days/13.5%), followed by Gen-Os® (40.4 d/19.1%). Bio-Oss Collagen® (62.3 d/28.3%), Maxresorb® (73.9 d/36.4%), and Maxresorb® Inject (96.1 d/34.1%). For Bio-Oss®, it occurred at 81.8 days (33.6%) in one study, while in another, it was not reached within 6 months. These differences reflect distinct regenerative kinetics and resorption profiles among materials. Conclusions: The break-even point offers a simple and informative parameter to describe the balance between graft resorption and new bone formation, providing a useful complement to conventional histomorphometric measures and a framework for future studies. Full article
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13 pages, 221 KB  
Article
Periodontists’ Attitudes and Professional Behavior Towards Surgically Facilitated Orthodontic Tooth Movement—A U.S. National Survey
by John J. Schuetz, Trevor D. Richmond, Mark Scarbecz, Ayman Al Dayeh, Sidney Stein and Vrushali Abhyankar
Dent. J. 2025, 13(10), 468; https://doi.org/10.3390/dj13100468 - 15 Oct 2025
Viewed by 412
Abstract
Background: Periodontally accelerated osteogenic orthodontics (PAOO) is a surgical procedure to accelerate orthodontic tooth movement and minimize periodontal complications. This study surveyed U.S. periodontists to assess various aspects of the procedure as regards prevalence, training, and execution. Methods: The authors developed a unique [...] Read more.
Background: Periodontally accelerated osteogenic orthodontics (PAOO) is a surgical procedure to accelerate orthodontic tooth movement and minimize periodontal complications. This study surveyed U.S. periodontists to assess various aspects of the procedure as regards prevalence, training, and execution. Methods: The authors developed a unique questionnaire, the first national study of this type, housed on the Qualtrics® survey platform, to analyze trends in PAOO training and use. Unique recruitment emails were sent to 3154 members of the American Academy of Periodontology. 449 U.S. periodontists/3154 surveyed (14.2%) responded to this web-based, anonymized survey. IBM statistical software (SPSS V28) was used for data analysis. Results: Among respondents, PAOO training was received during residency (32.7%) and by continuing education (CE) (50.8%), with higher CE (57.3%) by those who did not receive PAOO residency training (p < 0.001). 38.5% of periodontists perform PAOO, and those most likely to perform PAOO had both PAOO residency training and CE, with 78.5% performing 1–5 cases/year. Most (87.7%) received 1–2 PAOO referrals/year from orthodontists or general dentists. Differences in techniques and materials were the type of bone graft or membrane used, the position of corticotomies, and the timing of orthodontic movement. The primary PAOO goal was “rapid tooth movement” (41.1%) and to “increase the alveolar housing” (37.2%). The secondary (38%) and tertiary (37.2%) ranked goals were “augment dehiscence or fenestration”, with the “prevention of apical root resorption” ranked as their quaternary goal. Conclusions: The results of this survey provide data on the trends, training, and use of PAOO among U.S. periodontists. This information may aid in developing residency curriculum and performing PAOO research. Full article
(This article belongs to the Special Issue Accelerated Orthodontics: The Modern Innovations in Orthodontics)
11 pages, 218 KB  
Article
Assessment of Dental Care Utilization Based on Health Information Literacy in Korean Adults
by Sun-Kyoung Lee and Jeong-Min Seong
Dent. J. 2025, 13(10), 467; https://doi.org/10.3390/dj13100467 - 14 Oct 2025
Viewed by 369
Abstract
Background/Objectives: This study aimed to examine the utilization of dental care services according to the health information literacy among Korean adults. Methods: This study used secondary raw data from the 9th National Health and Nutrition Examination Survey (2023), which included 3356 adults aged [...] Read more.
Background/Objectives: This study aimed to examine the utilization of dental care services according to the health information literacy among Korean adults. Methods: This study used secondary raw data from the 9th National Health and Nutrition Examination Survey (2023), which included 3356 adults aged 20 years and older. Frequency analysis, cross-analysis, and logistic regression were performed (p < 0.05). Data were analyzed using IBM SPSS software (ver. 22.0). Results: Using cross-analysis to identify the relationship between health information understanding and oral examinations within the last year, statistically significant differences were confirmed for all questions (p < 0.05). A statistically significant association was identified between individuals’ level of health information literacy and their engagement in preventive dental care, particularly the utilization of scaling procedures (p < 0.05). The higher their understanding of health information, the more likely they were to have undergone an oral examination in the previous year (nearly twice as likely higher; p = 0.003). The higher the understanding of health information regarding preventive treatment (scaling), the more likely the participant was to receive it (i.e., 2.2 times higher; p < 0.001). Conclusions: Educational interventions and policy support to improve the ability to understand health information can be important strategies for promoting the practice of preventive oral health and improving oral health level in people. Full article
15 pages, 1961 KB  
Article
Clinical and Radiographic Outcomes of Sloped-Shoulder Implants in the Posterior Mandible: A Retrospective Study
by Guillem Esteve-Pardo, Javier Amigó-Bardají and Lino Esteve-Colomina
Dent. J. 2025, 13(10), 466; https://doi.org/10.3390/dj13100466 - 11 Oct 2025
Viewed by 328
Abstract
Background/Objectives: This retrospective study aimed to evaluate the survival and marginal bone loss (MBL) of sloped-shoulder implants placed in the posterior mandible, and to explore the influence of both patient- and implant-related factors. Materials and Methods: All patients treated with sloped-shoulder-profile implants (Astra [...] Read more.
Background/Objectives: This retrospective study aimed to evaluate the survival and marginal bone loss (MBL) of sloped-shoulder implants placed in the posterior mandible, and to explore the influence of both patient- and implant-related factors. Materials and Methods: All patients treated with sloped-shoulder-profile implants (Astra Tech Implant System, Dentsply Sirona, Bensheim, Germany) in the posterior mandible between 2012 and 2023 at two private clinics were included. Implant survival was analyzed with Kaplan–Meier estimates. MBL was measured from prosthesis delivery (baseline radiograph) to the most recent available radiograph. Outcomes were compared across thresholds of 0, 0.5, and 1.5 mm, which were considered radiographic success criteria. According to the 2017 World Workshop, peri-implantitis was not diagnosed solely based on MBL. Associations with potential risk factors (periodontitis, bruxism, and smoking) were explored. The study was approved by a local ethics committee (PI 106/2023); informed consent was waived due to the retrospective design and anonymization of data. Results: A total of 43 patients with 48 implants were included, with a mean follow-up of 40.1 months. The cumulative survival rate was 93.7%, with all failures occurring before 24 months. Mean MBL at the mesial and distal aspects was 0.27 mm and 0.39 mm, respectively. In 82.2% of implants, MBL remained ≤0.5 mm at a mean follow-up of 44.2 months. No statistically significant associations were found between risk factors such as periodontitis, bruxism, or smoking and implant outcomes. Conclusions: Sloped-shoulder implants in the posterior mandible showed high survival and stable marginal bone levels over the medium term. Their design may simplify treatment in oblique ridges, potentially reducing the need for GBR procedures. Full article
(This article belongs to the Special Issue Innovations and Challenges in Dental Implantology)
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13 pages, 241 KB  
Article
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
Viewed by 451
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  
Article
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
Viewed by 374
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  
Article
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
Viewed by 530
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  
Article
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
Viewed by 583
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  
Review
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
Viewed by 703
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  
Article
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
Viewed by 364
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  
Review
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
Viewed by 974
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  
Article
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
Viewed by 372
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  
Article
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
Viewed by 420
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  
Article
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
Viewed by 325
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  
Review
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
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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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16 pages, 4600 KB  
Article
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
Viewed by 463
Abstract
Background/Objectives: 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 [...] Read more.
Background/Objectives: 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. Conclusions: 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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