Dentistry Journal

10 pages, 922 KB

Open AccessArticle

Impact of Bone Grafts Containing Metformin on Implant Surface Hydrophilicity: An In Vitro Study

by Rahul Minesh Shah, Nina Anderson, Rafael Delgado-Ruiz and Georgios Romanos

Dent. J. 2025, 13(12), 611; https://doi.org/10.3390/dj13120611 - 18 Dec 2025

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Background/Objectives: The effect of metformin combined with bone grafting materials and its effect on the hydrophilicity of different implant surfaces has not been investigated. Investigation of the use of metformin as a therapeutic for implant surface treatment may be useful in improving [...] Read more.

Background/Objectives: The effect of metformin combined with bone grafting materials and its effect on the hydrophilicity of different implant surfaces has not been investigated. Investigation of the use of metformin as a therapeutic for implant surface treatment may be useful in improving overall implant longevity and success. Methods: Herein, a 1.5% metformin solution was created with crystalline metformin and distilled water. Titanium alloy (machined surface), titanium with sandblasted, large-grit acid-etched surface (Ti-SLA), and zirconia (SDS) surfaces were treated with five different solutions: 0.9% sodium chloride (Group A), bovine cancellous bone graft (Bio-Oss^®)/0.9% sodium chloride solution (Group B), Bio-Oss^® bone graft with metformin/0.9% sodium chloride solution (Group C), algae-based bone graft (AlgOss^®)/0.9% sodium chloride solution (Group D), and AlgOss^® bone graft with metformin/0.9% sodium chloride solution (Group E). Hydrophilicity tests utilizing droplet angle measurements (n = 20 droplets/disk) of each of the solutions were carried out (total N = 600 contact angle measurements). Statistical comparison between treatment groups for each implant surface using ANOVA and Bonferroni correction at p < 0.05 was performed. Results: Analyses revealed a statistically significant improvement in hydrophilicity for group C compared to group B (p < 0.05) in Ti-alloy, but a significant decrease in hydrophilicity for group E compared to group D in Ti-SLA. Zirconia surfaces displayed a decrease in hydrophilicity for all groups compared to group A. Conclusions: Thus, there were varying effects of combined metformin and bone graft on implants. Full article

(This article belongs to the Special Issue Advances in Periodontal and Implant Therapies: Regeneration, Biomaterials, and Clinical Innovations)

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20 pages, 1025 KB

Open AccessArticle

Assessing Esthetic and Functional Benefits of Three Types of Maxillary Partial Denture Designs over Five Years

by Sanja Peršić Kiršić, Asja Čelebić, Irina Filipović-Zore, Ljiljana Strajnić and Nikola Petričević

Dent. J. 2025, 13(12), 610; https://doi.org/10.3390/dj13120610 - 18 Dec 2025

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Abstract

Background/Objectives: The design of removable partial dentures (RPDs) influences long-term clinical success and patient satisfaction. Maxillary Kennedy Class I partial edentulism can be treated with clasp-retained (C-RPD), attachment-retained (A-RPD), or implant-retained (I-RPD) removable partial dentures. Evidence on their long-term effects on esthetics, oral [...] Read more.

Background/Objectives: The design of removable partial dentures (RPDs) influences long-term clinical success and patient satisfaction. Maxillary Kennedy Class I partial edentulism can be treated with clasp-retained (C-RPD), attachment-retained (A-RPD), or implant-retained (I-RPD) removable partial dentures. Evidence on their long-term effects on esthetics, oral health-related quality of life (OHRQoL), and masticatory function is limited. This study compared patient-reported outcomes of these three RPD types over five years. Methods: Eighty-eight patients received C-RPD, semi-precision attachment A-RPD, or mini-implant I-RPD. Outcomes: Esthetic satisfaction (OES), OHRQoL (OHIP-14), and chewing function (CFQ) were assessed pre-treatment, post-treatment, and at 1- and 5-year follow-ups. Treatment effect sizes were analyzed using ANCOVA adjusting for baseline scores, age, gender, and education, while long-term trends were assessed by repeated-measures ANCOVA. Results: Treatment group significantly influenced outcomes. C-RPD users reported lower esthetic satisfaction, OHRQoL, and chewing function than A-RPD or I-RPD users (p < 0.001). Baseline scores predicted post-treatment outcomes (lower pre-treatment = lower post-treatment scores). Over five years, OES worsened in all groups (p = 0.004) with C-RPDs, consistently showing the worst scores. OHIP-14 scores increased most in C-RPD wearers (17.6 → 28.4; p < 0.001) indicting worst OHRQoL, while A-RPD and I-RPD scores remained significantly lower (10.8 → 17.4 and 10.9 → 13.1, respectively). CFQ scores followed similar trend: C-RPD: 20.43; A-RPD: 13.59; I-RPD: 12.40 (p < 0.001). Age, gender, and education had minimal or no significant impact. Conclusions: C-RPDs are associated with lower esthetic satisfaction, poorer OHRQoL and reduced chewing function, with a marked decline over five years. In contrast A-RPDs and I-RPDs showed higher treatment effect sizes and more stable patient-reported outcomes over 5 years. Due to study limitations, results should be interpreted cautiously, as they may reflect treatment self-selection rather than prosthesis design alone. Full article

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

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26 pages, 1377 KB

Open AccessReview

The Role of Inflammasomes in Chronic Oral Inflammatory Disease and Oral Cancer: A Narrative Review

by Banan Al-Natour, Issam Rasheed and Ikhlas A. El Elkarim

Dent. J. 2025, 13(12), 609; https://doi.org/10.3390/dj13120609 - 18 Dec 2025

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Abstract

Background: Chronic inflammation is a hallmark of many oral and systemic diseases and has long been recognised as a risk factor for cancer development. Central to inflammatory responses are inflammasomes—multiprotein complexes that, upon activation, trigger caspase-1–mediated release of the pro-inflammatory cytokines interleukin-1β (IL-1β) [...] Read more.

Background: Chronic inflammation is a hallmark of many oral and systemic diseases and has long been recognised as a risk factor for cancer development. Central to inflammatory responses are inflammasomes—multiprotein complexes that, upon activation, trigger caspase-1–mediated release of the pro-inflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18). Their emerging contribution to chronic oral inflammatory conditions has generated interest in understanding whether persistent inflammasome activity may also influence pathways involved in oral carcinogenesis. This review summarises current evidence on the role of inflammasomes in oral inflammatory diseases and explores their potential involvement in the transition from chronic inflammation to malignant transformation. Methods: A narrative review of the literature was conducted by searching major scientific databases for studies investigating inflammasome activation in oral tissues, inflammatory oral diseases, and mechanisms linking chronic inflammation to oral cancer. Eligible articles included experimental studies, animal models, observational clinical research, and review papers that provided mechanistic or associative insights. Due to heterogeneity in study designs, a qualitative synthesis was performed. Results: Available evidence indicates that inflammasomes, particularly NLRP3 and AIM2, contribute to the pathophysiology of pulpitis, periodontitis, and several systemic conditions that affect oral health. Preclinical and observational findings also suggest potential involvement of inflammasome-related pathways in early tumorigenic processes, although these associations require further clarification. Preliminary biomarker-based studies demonstrate that inflammasome components measurable in saliva, pulpal blood, or gingival crevicular fluid may offer minimally invasive indicators of inflammatory burden and oral health status. Conclusions: Inflammasomes appear to play a meaningful role in oral inflammatory diseases, and growing evidence links their persistent activation to mechanisms relevant to oral carcinogenesis. However, current findings are largely associative and derived primarily from experimental and early clinical research. Additional work is needed to define precisely how inflammasomes contribute to the progression from chronic oral inflammation toward malignant change and to evaluate whether targeting inflammasome pathways offers viable therapeutic or diagnostic potential. Full article

(This article belongs to the Special Issue Feature Review Papers in Dentistry: 2nd Edition)

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13 pages, 1456 KB

Open AccessArticle

Efficacy of Herbal vs. Chlorhexidine Mouthwash in Experimental Gingivitis: A Cross-over Clinical and Microbiological Study

by Zaineb Aslam, Jamie Wu, Zhong Wang, Nina K. Anderson, Nathan E. Estrin and Georgios E. Romanos

Dent. J. 2025, 13(12), 608; https://doi.org/10.3390/dj13120608 - 18 Dec 2025

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Abstract

Background: Chlorhexidine (CHX) is an effective antiseptic rinse for managing gingival inflammation; however, side effects such as staining and altered taste limit its long-term use. StellaLife^® (SL), an herbal-based mouth rinse and a gel, has shown promising in vitro effects, including [...] Read more.

Background: Chlorhexidine (CHX) is an effective antiseptic rinse for managing gingival inflammation; however, side effects such as staining and altered taste limit its long-term use. StellaLife^® (SL), an herbal-based mouth rinse and a gel, has shown promising in vitro effects, including enhanced biocompatibility and wound healing. This study aimed to compare the clinical efficacy of SL and 0.12% CHX in an experimental gingivitis model. Methods: In this randomized, controlled, cross-over clinical trial, 34 dental students received both treatment regimens in alternating two-week phases following prophylaxis. Group 1 used SL (mouth rinse and the gel) and then crossed over to CHX with placebo gel. Group 2 followed the reverse sequence. Participants refrained from oral hygiene during treatment phases. Clinical parameters and gingival crevicular fluid (GCF) were assessed at baseline and post-treatment. Paired t-tests and Bonferroni corrections were applied (p < 0.05). Bacterial count was determined by an external laboratory using a PCR test. Mean values for bacteria after SL and CHX use measured in genome copies/mL for Aggregatibacter actinomycetemcomitans, P. gingivalis, T. denticola, T. forsythia and F. nucleatum. Results: No statistically significant differences were observed between the SL and CHX groups for PI (p = 0.057), GI (p = 0.960), PD (p = 0.112), BOP (p = 0.895), GR (p = 0.768), CAL (p = 0.112), or GCF (p = 0.951). Both regimens improved periodontal parameters similarly. No significant differences were found between CHX and SL use in respect to periodontal pathogenic bacteria in the oral cavity. Conclusions: SL demonstrated clinical efficacy comparable to CHX in managing experimental gingivitis. Given its favorable safety profile, SL may serve as a promising alternative to CHX, though larger and longer-term studies are warranted. Full article

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13 pages, 258 KB

Open AccessArticle

Cross-Sectional Study of Atypical Swallowing and Occlusal Characteristics in 6–16-Year-Old Patients Presenting for Orthodontic Care

by Sara Caruso, Francesco Cipriani, Claudia Martino, Lucilla Calgani, Mauro Arcangeli, Roberto Gatto, Silvia Caruso and Antonella Mattei

Dent. J. 2025, 13(12), 607; https://doi.org/10.3390/dj13120607 - 17 Dec 2025

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Abstract

Introduction: Malocclusion and dysfunctional or atypical swallowing are two conditions that significantly affect the health and well-being of the stomatognathic system, so much so that they often interact, influencing each other, and the presence of one can cause the onset or aggravation of [...] Read more.

Introduction: Malocclusion and dysfunctional or atypical swallowing are two conditions that significantly affect the health and well-being of the stomatognathic system, so much so that they often interact, influencing each other, and the presence of one can cause the onset or aggravation of the other. In this regard, over the years studies have been carried out that tried to discover the correlation between atypical swallowing and malocclusion. The aim is to evaluate the prevalence of dysfunctional swallowing in patients with malocclusion, to examine the pathophysiological mechanisms linking malocclusion and dysfunctional swallowing, and above all to investigate what potential risk factors may be. Materials and Methods: A sample of 60 patients aged between 6 and 16 years was analyzed at the Department of Dentistry of the University of L’Aquila. Some characteristics of the subjects’ face and posture were analyzed both from a frontal and lateral point of view. An orthodontic, temporomandibular joint, and masticatory muscle diagnosis was made. In addition, an examination of oral structures and functions was performed that allowed breathing, swallowing, chewing, and phono-articulation to be assessed. Results: It was observed that all the children had atypical swallowing, with significant postural abnormalities of the tongue; in fact, only 5% had a correct posture of the tongue at rest. In the analysis of occlusal characteristics, it emerged that with regard to the transverse plane, 21.67% of subjects have a condition of No Cross, while 10% show a Unilateral Cross. Finally, 68.33% show a Bilateral Cross. As far as the anterior–posterior plane is concerned, most of the subjects, equal to 76.67%, are placed in Class I, while 23.33% are in Class II. Finally, in relation to the vertical plane, 63.33% of subjects have normal occlusion, while 25% suffer from deep bite and 11.67% from open bite. The sample, stratified by presence or absence of alerts, shows significant differences for atypical swallowing (p = 0.031), for the presence of Class II malocclusion (p = 0.002), for low lingual posture, (p < 0.001), and for labial incompetence (p = 0.001). The multivariate logistic regression model showed that the presence of atypical swallowing (OR 1.04, 95% CI 1.04–1.07, p = 0.029), open bite malocclusion (OR 1.09, 95% CI 1.01–1.18, p = 0.013), low lingual posture (OR 1.11, 95% CI 1.04–1.18, p = 0.002), and the presence of labial incompetence (OR 1.06, 95% CI 1.02–1.10, p = 0.029) were significant clinical risk factors independently associated with the presence of alerts. Conclusions: The data collected confirm that atypical swallowing is a key element in the development of malocclusions, with a strong impact on posterior crossbite, anterior overjet, and other occlusal discrepancies. Among the data collected in the diagnostic phase, patients who presented at least one significant alert were also considered and atypical swallowing, low lingual posture, open bite malocclusion, and the presence of labial incompetence were statistically significant. Full article

13 pages, 7648 KB

Open AccessCase Report

Clinical Management of Worn Ball Abutments in Mandibular Mini-Implant Overdentures: A Case Report in a Skeletal Class II Patient

by Cătălina Murariu-Măgureanu, Elena Preoteasa, Cristian Teodorescu and Cristina Teodora Preoteasa

Dent. J. 2025, 13(12), 606; https://doi.org/10.3390/dj13120606 - 16 Dec 2025

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Abstract

Background/Objectives: Complete denture rehabilitation in edentulous patients presents functional and biomechanical challenges. Mini-implant-supported overdentures improve retention, stability, function, and comfort, particularly in complex class II or class III mandibulo-maxillary relationships. However, mechanical complications such as ball abutment wear may compromise long-term success. [...] Read more.

Background/Objectives: Complete denture rehabilitation in edentulous patients presents functional and biomechanical challenges. Mini-implant-supported overdentures improve retention, stability, function, and comfort, particularly in complex class II or class III mandibulo-maxillary relationships. However, mechanical complications such as ball abutment wear may compromise long-term success. This case report aims to describe the clinical context, methods employed to manage ball abutment wear, and related complications in a patient with a mandibular mini-implant overdenture. Methods: This retrospective case report presents two approaches to managing abutment wear and enhancing overdenture retention: silicone matrices (Retention.Sil, Bredent Medical GmbH & Co.KG, Senden, Germany) and abutment reconstruction using prefabricated cemented spheres (Concave Reconstructive Sphere, Rhein83, Bologna, Italy). Results: A significant mechanical complication associated with mini-implant overdentures is the wear of ball abutments, which may develop over time as a result of continuous interaction between the O-ring system and the abutment surfaces. Both techniques effectively preserved mini-implants while enhancing denture retention, function, and comfort. Conclusions: Mechanical complications, such as ball abutment wear, may compromise the retention and functional performance of mandibular overdentures. Alternatives like silicone matrices and reconstructive spheres address abutment wear in mandibular overdentures, ensuring long-term retention and sustainable, patient-centered care for the elderly. Full article

(This article belongs to the Special Issue Dentistry in the 21st Century: Challenges and Opportunities)

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10 pages, 2924 KB

Open AccessCase Report

Establishment of the Occlusion Plane Using Broadrick Occlusal Plane Analyzer for Immediate Complete Dentures

by Marisol López-Pulido, Luis Angel Sánchez-Chaidez, Kenji Miguel Ishino-Cortez, Verónica Manteca-López and Andréa Dolores Correia Miranda Valdivia

Dent. J. 2025, 13(12), 605; https://doi.org/10.3390/dj13120605 - 16 Dec 2025

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Abstract

Background/Objectives: Pathological tooth loss resulting from poor oral hygiene or systemic diseases can lead to partial edentulism, affecting patients both psychologically and physically. These consequences include facial height reduction, temporomandibular dysfunction, and impaired phonetics and mastication. Immediate complete dentures are often an [...] Read more.

Background/Objectives: Pathological tooth loss resulting from poor oral hygiene or systemic diseases can lead to partial edentulism, affecting patients both psychologically and physically. These consequences include facial height reduction, temporomandibular dysfunction, and impaired phonetics and mastication. Immediate complete dentures are often an effective provisional solution during the transition to full edentulism; however, establishing the occlusal plane can be challenging when remaining teeth prevent a conventional wax try-in. This clinical case aims to present a qualitative clinical case study of a single patient, illustrating the use of the Broadrick Occlusal Plane Analyzer (BOPA) for the establishment of an occlusal plane in harmony with the anterior and condylar guidance. Methods: A 51-year-old male patient presented to the Department of Prosthodontics at the School of Dentistry, Autonomous University of Guadalajara, with partial edentulism, periodontal disease, and generalized Grade III tooth mobility. Immediate maxillary and mandibular complete dentures were selected as the treatment of choice. Due to the presence of remaining teeth that hindered clinical determination of the occlusal plane, the BOPA was used during the denture design process. Results: Anatomical landmarks were combined with BOPA tracing to establish an occlusal plane harmonious with anterior and condylar guidance. The center of the curve was modified to accommodate anatomic variability in anteroposterior reference points. Conclusions: The use of the Broadrick Occlusal Plane Analyzer facilitated the accurate determination of the occlusal plane for the fabrication of immediate complete dentures in a patient where clinical assessment was limited. This modification allowed the establishment of a bilateral balanced occlusal scheme, contributing to functional and acceptable provisional oral rehabilitation during postoperative alveolar healing. Full article

(This article belongs to the Special Issue Restorative Dentistry: Emerging Trends and Personalized Treatment Strategies for Optimal Patient Care)

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15 pages, 25878 KB

Open AccessArticle

The Evolution of Extended Platelet-Rich Fibrin Membranes for Socket Grafting: Part One: Technical Development of Protocols

by Nathan E. Estrin, Alan Rene Espinoza, Paras Ahmad, Jean-Claude Imber, Nima Farshidfar and Richard J. Miron

Dent. J. 2025, 13(12), 604; https://doi.org/10.3390/dj13120604 - 16 Dec 2025

Viewed by 418

Abstract

Background: Platelet-rich fibrin (PRF) is an autologous biomaterial utilized as an adjunct in dental implant surgeries owing to its significant biocompatibility, supra-physiological concentration of growth factors, and ability to speed either soft or hard tissue regeneration. Methods: Today, PRF is available in both [...] Read more.

Background: Platelet-rich fibrin (PRF) is an autologous biomaterial utilized as an adjunct in dental implant surgeries owing to its significant biocompatibility, supra-physiological concentration of growth factors, and ability to speed either soft or hard tissue regeneration. Methods: Today, PRF is available in both solid and liquid forms with an average resorption period of roughly 2 weeks. While various research endeavors have attempted to utilize Solid-PRF as a barrier membrane in guided bone regeneration (GBR) and various other applications, its two-week resorption period has limited its use as a solo “barrier” membrane owing to its faster-than-ideal resorption properties. Results: Recent studies have demonstrated that by heating and denaturing Liquid-PRF/albumin, the resorption properties of the heated albumin gel could be extended from 2 weeks to 4–6 months by utilizing the Bio-Heat technology. This emerging technology was given the working name ‘extended-PRF’ or e-PRF, with many clinical indications being proposed for further study. Numerous clinicians have now utilized extended-PRF (e-PRF) membranes as a substitute for collagen barrier membranes in various clinical applications, such as guided tissue/bone regeneration, recession coverage, and lateral window sinus lifts. Conclusions: This two-part case series paper aims to first illustrate the evolution of techniques developed taking advantage of this new technology in clinical practice for alveolar ridge preservation. This includes four different methods of fabrication of e-PRF along with its application in clinical practice. This article discusses the clinical outcomes, including the advantages/disadvantages of utilizing each of the four separate techniques to prepare and utilize e-PRF membranes for ridge preservation. Full article

(This article belongs to the Special Issue Regenerative Dentistry: Innovations and Clinical Applications)

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26 pages, 741 KB

Open AccessReview

A Crosstalk Between Periodontal Disease and Human Immunodeficiency Virus: Application of Artificial Intelligence and Machine Learning in Risk Assessment and Diagnosis—A Narrative Review

by Bhavyasri Gaddam, Leela Subhashini C. Alluri, Ihunna Amugo, Lemlem Berta, McKayla Butler, Shania Ferguson, Alexys Ferguson, Ethel Harris, Vladimir Berthaud, Siddharth Pratap, Qingguo Wang, Chethan Sampath, Zaid H. Khoury and Pandu R. Gangula

Dent. J. 2025, 13(12), 603; https://doi.org/10.3390/dj13120603 - 16 Dec 2025

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Abstract

Periodontal disease (PD) is an inflammatory condition caused by multiple periodontal pathogens, particularly those belonging to the Red Complex. Various risk factors influence the development of PD, including age, sex, socioeconomic status, ethnicity, and underlying health issues. Numerous molecular and cellular processes govern [...] Read more.

Periodontal disease (PD) is an inflammatory condition caused by multiple periodontal pathogens, particularly those belonging to the Red Complex. Various risk factors influence the development of PD, including age, sex, socioeconomic status, ethnicity, and underlying health issues. Numerous molecular and cellular processes govern the inflammatory response, which affects the gums and tooth-supporting structures and ultimately leads to alveolar bone loss. Accumulating evidence suggests that Human Immunodeficiency Virus-1 (HIV-1) infection significantly impacts the initiation and progression of PD. While HIV-1 is treated with antiretroviral therapy, this treatment can also affect the course of periodontal disease and systemic health status. AI/ML and precision medicine integrates genomic and computational data to enable individualized disease prevention and treatment strategies. When applied responsibly, these technologies can assist clinicians in the timely detection of both PD and HIV-1. This review aims to discuss the factors that exacerbate PD and the available therapeutic options for persons living with (PLWH) and without HIV-1. Additionally, we emphasize the need for developing biomarkers for early diagnosis and intervention to manage PD effectively, ultimately improving the quality of life for those living with HIV. Full article

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15 pages, 1195 KB

Open AccessArticle

Impact of Tooth Loss on Heart Failure After Myocardial Infarction: A Cross-Sectional Study Bridging Oral and Cardiovascular Health

by Corina Cinezan, Camelia Bianca Rus, Alexandra Cinezan and Gabriela Ciavoi

Dent. J. 2025, 13(12), 602; https://doi.org/10.3390/dj13120602 - 15 Dec 2025

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Abstract

Background: Oral health and cardiovascular disease share common inflammatory pathways, yet the relationship between tooth loss and post-myocardial infarction (MI) heart failure remains underexplored. Objective: To investigate the association between tooth loss and heart failure among patients with acute MI. Methods: In this [...] Read more.

Background: Oral health and cardiovascular disease share common inflammatory pathways, yet the relationship between tooth loss and post-myocardial infarction (MI) heart failure remains underexplored. Objective: To investigate the association between tooth loss and heart failure among patients with acute MI. Methods: In this cross-sectional study, 200 patients with documented MI were evaluated for tooth loss, cardiac function, and comorbidities. Heart failure was defined as an ejection fraction <40% or clinical diagnosis. Patients were categorized by tooth loss (0–8, 9–20, >20 missing teeth). Multivariate logistic regression was used to identify independent predictors of heart failure. Model performance was assessed using receiver operating characteristic (ROC) analysis. Results: The prevalence of heart failure was 38%. Mean ejection fraction declined progressively with greater tooth loss (50.1%, 44.8%, and 38.4% across the three categories; p for trend <0.001). After adjustment for age, sex, diabetes, and smoking, severe tooth loss (>20 missing teeth) remained independently associated with heart failure (adjusted OR 2.45; 95% CI, 1.15–5.23; p = 0.02). The final model demonstrated good discriminative ability (AUC = 0.78). Conclusions: Extensive tooth loss is strongly associated with heart failure among MI patients, suggesting a potential link between oral health deterioration and adverse cardiac remodeling. Integrating dental assessment into cardiovascular care may enhance risk stratification and promote holistic prevention strategies. Full article

(This article belongs to the Special Issue Oral Health and Dysbiosis)

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18 pages, 2968 KB

Open AccessFeature PaperArticle

Mechanical Behaviour of Dental Luting Cements: Static, Dynamic, and Finite Element Studies

by Tamás Tarjányi, Csongor Mészáros, Rebeka Anna Kiss, Zsolt Tóth and István Pelsőczi

Dent. J. 2025, 13(12), 601; https://doi.org/10.3390/dj13120601 - 15 Dec 2025

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Abstract

Background/Objectives: The long-term clinical success of dental luting cements largely depends on their mechanical performance. This study systematically compared six commonly used definitive dental cements by assessing key mechanical characteristics such as compressive strength and fatigue resistance. Methods: The tested materials included Adhesor [...] Read more.

Background/Objectives: The long-term clinical success of dental luting cements largely depends on their mechanical performance. This study systematically compared six commonly used definitive dental cements by assessing key mechanical characteristics such as compressive strength and fatigue resistance. Methods: The tested materials included Adhesor Zinc Phosphate (AphC), Harvard Zinc Phosphate (HphC), polycarboxylate cement (CaC), glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), and resin cement (ReC). Both static and dynamic compressive load tests were performed using an Instron ElectroPuls E3000 dynamic testing instrument. During static testing, 77 samples were subjected to an increasing load up to 1500 N. Dynamic tests on 78 samples involved cyclic loading over seven phases from 50 N to 1600 N, with 1500 cycles per phase at 10 Hz. Results: Static load results indicated that GIC, CaC, and phosphate cements exhibited similar performance and were significantly weaker compared to RMGIC and ReC. In the dynamic fatigue tests, most ReC and RMGIC samples maintained integrity throughout the entire protocol, demonstrating markedly superior mechanical reliability. Finite element analysis (FEA) further confirmed the experimental observations, revealing more homogenous stress distribution and lower peak stresses in ReC and RMGIC compared with the conventional cements. Conclusions: Overall, the resin-based and resin-modified glass ionomer cements showed the highest compressive strength and fatigue resistance, indicating superior long-term mechanical stability compared to the conventional cements. These findings support the clinical use of resin-based cements as reliable luting agents for definitive fixation in high-load prosthodontic applications. Full article

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

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9 pages, 1122 KB

Open AccessArticle

Biomechanical Comparative Evaluation of Atrophic Edentulous Maxilla Rehabilitation Using the All-on-Six Concept with Zygomatic Implant and Tilted Implant as Posterior Implant—Finite Element Analysis

by Abhay Datarkar, Neha G. Pawar, Prashant K. Pandilwar, Varsha S. Manekar, Prasad Godase and Eitan Mijiritsky

Dent. J. 2025, 13(12), 600; https://doi.org/10.3390/dj13120600 - 15 Dec 2025

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Abstract

Background: All-on-six implants are a reliable and efficient full-arch restoration option in patients with atrophic maxilla. Aim: The present study aimed to evaluate and compare the distribution of stress surrounding implants and adjacent osseous structures by utilizing all-on-six tilted and zygomatic methodologies in [...] Read more.

Background: All-on-six implants are a reliable and efficient full-arch restoration option in patients with atrophic maxilla. Aim: The present study aimed to evaluate and compare the distribution of stress surrounding implants and adjacent osseous structures by utilizing all-on-six tilted and zygomatic methodologies in the maxillary region by using finite element (FEA) analysis. Materials and Methods: Two finite element models were constructed with CT images of 50-year-old female. Model 1 was constructed with zygomatic implants, while model 2 was constructed with tilted implants. A vertical force of 150 N on the anterior component and 300 N on the posterior component were applied and maximum stress and deformation was assessed. Results: In the present study, the von Mises stress on the bone and implant overall was higher in the tilted implant model than the zygomatic implant model. Conclusions: The findings of the present study suggests that zygomatic implants help distribute occlusal loads more favourably, especially under horizontal and combined loading conditions in an all-on-six configuration. Full article

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11 pages, 840 KB

Open AccessArticle

Quantification of Bisphenol A in the Saliva of Patients Wearing Clear Aligners

by Andrea Vitores-Calero, Verónica García-Sanz, Vanessa Paredes-Gallardo, Natalia Zamora-Martínez and Beatriz Tarazona-Álvarez

Dent. J. 2025, 13(12), 599; https://doi.org/10.3390/dj13120599 - 15 Dec 2025

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Abstract

Background/Objectives: To analyze the behavior and release of bisphenol A (BPA) in the saliva of patients wearing clear aligners, and to evaluate differences in BPA levels between patients treated with aligners from the market-leading brand and those treated with in-office aligners. For the [...] Read more.

Background/Objectives: To analyze the behavior and release of bisphenol A (BPA) in the saliva of patients wearing clear aligners, and to evaluate differences in BPA levels between patients treated with aligners from the market-leading brand and those treated with in-office aligners. For the in-office group, 0.762 mm (0.30”) thick thermoforming sheets from Ortolan^® were used to fabricate the aligners. Methods: Patients about to begin orthodontic treatment with clear aligners in the Master’s degree program in Orthodontics at the University of Valencia were recruited for this prospective observational study. Patients were divided into two groups based on the type of aligners: The Invisalign^® group and the In-Office aligner group. Four saliva samples were taken from each patient at different times during treatment, with a one-week follow-up. The samples were stored at −80 °C and analyzed using mass spectrometry. Results: A total of 24 patients were included in the study, with 12 patients in each group. A statistically significant difference was found between baseline BPA levels and the increase observed half an hour after bonding the attachments. After a week, values returned to pre-treatment levels. Furthermore, BPA levels changed significantly during the follow-up period and were similar in both groups. Conclusions: An immediate increase was observed when the attachments were bonded with both treatments; however, differentiation from the ‘peak’ and recovery to baseline values was faster in patients treated with In-Office aligners. In those treated with Invisalign^®, after the placement of the aligners, values recorded were not significantly different from baseline, nor from the previous peak. Full article

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15 pages, 4409 KB

Open AccessArticle

Impact of Printing Orientations on the Trueness and Precision of Additively Fabricated Complete Denture Base Before and After Thermal Aging

by Sara Tarq AL-Zayyat, Turki Alshehri, Shahad T. Alameer, Sarah Hajaj Althunayyan, Reem A. Aldhafiri, Zainab Albasry, Abdulrahman A. Balhaddad, Haidar Alalawi and Mohammed M. Gad

Dent. J. 2025, 13(12), 598; https://doi.org/10.3390/dj13120598 - 12 Dec 2025

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Abstract

Objectives: This in vitro study assessed the accuracy (trueness and precision) of different 3D-printed resin denture bases with 0°, 45°, and 90° printing orientations. Methods: Denture base was designed and fabricated using three 3D-printed denture base resins (DentaBASE, Denture 3D+, and FormLabs). Each [...] Read more.

Objectives: This in vitro study assessed the accuracy (trueness and precision) of different 3D-printed resin denture bases with 0°, 45°, and 90° printing orientations. Methods: Denture base was designed and fabricated using three 3D-printed denture base resins (DentaBASE, Denture 3D+, and FormLabs). Each resin was printed with its own printer and fabricated with different printing orientations, resulting in a total of 72 specimens (n = 8). Trueness and precision were evaluated before and after thermal aging using the superimposition method with best-fit alignment. The data were collected and analyzed using two-way ANOVA followed by post hoc Tukey’s test (α = 0.05). Results: The printing orientation significantly affected the trueness of 3D-printed resins (p < 0.001). The highest trueness was observed for NextDent at 0° printing orientation, while the lowest value was observed for ASIGA at 0° and 45° printing orientations. The precision of the denture base was significantly affected by different printing orientations for ASIGA (p = 0.006) and NextDent (p < 0.001) before thermal cycling, while the precision of FormLabs was significantly affected (p = 0.017) after thermal cycling. The highest precision was recorded for FormLabs at 45° printing orientation, while the lowest precision was observed for NextDent at 45° and 90° printing orientations. Moreover, the effect of thermal cycling on trueness was only significant for ASIGA at 0° printing orientation; however, the effect of thermal cycling on precision was significant for NextDent at 0° and 90° printing orientations. A 45° printing orientation provided the most accurate clinical fit. Conclusions: ASIGA showed the lowest trueness, while FormLabs exhibited the lowest precision, revealing performance differences between printers. Full article

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18 pages, 1561 KB

Open AccessArticle

Pain Perception and Psychoemotional Responses Across Different Scaling Technologies: A Comparative Pilot Clinical Study

by Nelsi Carmina Turturica, Mindra E. Badea, Vlad I. Bocanet, Radu Chifor and Iulia C. Badea

Dent. J. 2025, 13(12), 597; https://doi.org/10.3390/dj13120597 - 12 Dec 2025

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Abstract

Background/Objectives: Scaling is central to non-surgical periodontal therapy; however, it is often perceived as uncomfortable, particularly in periodontitis. Psychological distress may amplify pain and reduce adherence. This comparative pilot study assessed whether ultrasonic technology influences patient-reported pain and psychoemotional status while quantifying [...] Read more.

Background/Objectives: Scaling is central to non-surgical periodontal therapy; however, it is often perceived as uncomfortable, particularly in periodontitis. Psychological distress may amplify pain and reduce adherence. This comparative pilot study assessed whether ultrasonic technology influences patient-reported pain and psychoemotional status while quantifying the contribution of the periodontal condition and baseline psychological factors. Methods: A monocentric split-mouth design enrolled 42 adults (21 with stage I–III, grade B periodontitis; 21 periodontally healthy). Maxillary scaling was performed with Device nr.1 and mandibular scaling was performed with Device nr.2, and no anesthesia was used. Pain was measured immediately post-procedure using the Short-Form McGill Pain Questionnaire (SF-MPQ; sensory and affective subscales). Psychological status was assessed pre- and post-session with the Kessler Psychological Distress Scale (K10) and the Rosenberg Self-Esteem Scale (RSES). Construct validity was examined via exploratory factor analysis. The Mann–Whitney U, Wilcoxon signed-rank, Spearman’s ρ, and Cliff’s δ were applied (α = 0.05). Results: The overall pain was low. Between devices, sensory pain did not differ, whereas affective pain was modestly lower with the “No Pain” device (p = 0.017). Periodontitis was the dominant determinant of pain: higher sensory (U = 509.00, p = 0.0004; δ = 0.42) and affective scores (U = 290.00, p < 0.0001; δ = 0.67) occurred irrespective of device, while device-related effects were negligible (sensory δ = −0.03) to small (affective δ = 0.27). Somatic distress correlated with affective pain (ρ = 0.25, p = 0.023) and was borderline for sensory pain (ρ = 0.21, p = 0.060); emotional distress showed no significant associations. During the session, K10 scores decreased and RSES values increased, indicating immediate psychoemotional benefits. Conclusions: Pain perception during scaling is shaped primarily by periodontal status and psychological distress rather than by ultrasonic technology per se. Although the electronic module to dynamically adjust the power of the instrument technology may attenuate the affective component, standardized atraumatic techniques and routine psychosocial screening are likely to yield greater gains. The observed short-term improvements in distress and self-esteem support integrating patient-reported outcomes into individualized, patient-centered periodontal care. Full article

(This article belongs to the Special Issue Dental Public Health Landscape: Challenges, Technological Innovation and Opportunities in the 21st Century)

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14 pages, 1243 KB

Open AccessArticle

Efficacy of UVC Radiation in Reducing Bacterial Load on Dental Office Surfaces

by Souat Tsolak, Eugen Bud, Sorana Maria Bucur, Mariana Păcurar, Adrian Man and Daniela Manuc

Dent. J. 2025, 13(12), 596; https://doi.org/10.3390/dj13120596 - 12 Dec 2025

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Abstract

Background/Objectives: Environmental contamination of dental surfaces is a major vector for cross-infection. Ultraviolet-C (UVC) irradiation provides rapid, chemical-free decontamination; however, depending on wavelength and ventilation conditions, ozone generation may occur. This study evaluated the germicidal efficacy of UVC on three high-touch surfaces: [...] Read more.

Background/Objectives: Environmental contamination of dental surfaces is a major vector for cross-infection. Ultraviolet-C (UVC) irradiation provides rapid, chemical-free decontamination; however, depending on wavelength and ventilation conditions, ozone generation may occur. This study evaluated the germicidal efficacy of UVC on three high-touch surfaces: a wooden work table, a stainless-steel consumables table, and a dental unit table. Methods: Surfaces were sampled at baseline, after 5 min (27 mJ/cm²), and after 10 min (54 mJ/cm²) of UVC exposure at 90 µW/cm². Colony-forming units (CFU/cm²) were enumerated using Mueller–Hinton agar. Results: UVC achieved >99% reduction after 5 min and complete elimination after 10 min. Material properties (porosity, reflectivity, and grooves), along with quantified parameters like surface roughness (Ra) and contact angle, influenced minor differences in decontamination. Conclusions: Used with appropriate safety protocols, short-duration UVC irradiation effectively decontaminates dental surfaces and can complement chemical disinfection. Future studies must incorporate artificially soiled surfaces, biofilms, and emerging far-UVC/UV-LED technologies. Full article

(This article belongs to the Special Issue Dental Public Health Landscape: Challenges, Technological Innovation and Opportunities in the 21st Century)

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18 pages, 2490 KB

Open AccessSystematic Review

Periodontitis and Oral Pathogens in Colorectal Cancer: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis

by Luis Chauca-Bajaña, Andrea Ordoñez Balladares, Alejandro Ismael Lorenzo-Pouso, Rosangela Caicedo-Quiroz, Rafael Xavier Erazo Vaca, Rolando Fabricio Dau Villafuerte, Yajaira Vanessa Avila-Granizo, Carlos Hans Salazar Minda, Miguel Amador Salavarria Vélez and Byron Velásquez Ron

Dent. J. 2025, 13(12), 595; https://doi.org/10.3390/dj13120595 - 12 Dec 2025

Viewed by 388

Abstract

Background: Periodontitis and oral dysbiosis have been linked to systemic inflammation and carcinogenesis. Among oral pathogens, Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) are biologically plausible contributors to colorectal cancer (CRC) via inflammatory and immunomodulatory pathways. However, the magnitude and consistency of [...] Read more.

Background: Periodontitis and oral dysbiosis have been linked to systemic inflammation and carcinogenesis. Among oral pathogens, Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) are biologically plausible contributors to colorectal cancer (CRC) via inflammatory and immunomodulatory pathways. However, the magnitude and consistency of these associations remain uncertain. Objective: To evaluate whether periodontitis and key oral pathogens are associated with CRC risk and prognosis through a systematic review, meta-analysis, and trial sequential analysis (TSA). Methods: We searched PubMed, Scopus, and Web of Science from inception to December 2024 following PRISMA 2020. Eligible observational studies assessed periodontitis exposure or detection of oral bacteria in relation to CRC incidence or survival. Effect estimates (RRs/HRs) were log-transformed and pooled using random-effects models; heterogeneity was quantified with I². TSA was conducted to appraise information size and the stability of the primary association. Risk of bias was evaluated with ROBINS-I/QUIPS as appropriate. PROSPERO: CRD420251168522. Results: Five studies evaluating periodontitis/oral-pathogen exposure and CRC incidence yielded a 70% higher risk (HR = 1.70; 95% CI: 1.33–2.19; I² = 0%). Detection of Fn was associated with approximately threefold higher risk of CRC (RR = 3.20; 95% CI: 1.76–5.82; p < 0.001). Pg presence was linked to worse overall survival (HR ≈ 2.4; p < 0.01). TSA suggested that the accrued evidence for the primary incidence association is likely sufficient to reduce random errors; nevertheless, interpretability is constrained by the small number of observational studies and between-study differences in exposure and outcome ascertainment. Conclusions: Current evidence indicates that periodontitis and oral pathogens—particularly Fn and Pg—are significantly associated with CRC development and progression. These findings support the clinical relevance of the oral–gut axis and underscore oral health as a potentially modifiable factor in cancer prevention. Further large, well-designed prospective cohorts and mechanistic studies are warranted to strengthen causal inference. Full article

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22 pages, 1792 KB

Open AccessReview

Awareness, Knowledge and Practice of Dental Professionals Regarding Biomedical Waste Management for a Green Dentistry: A Scoping Review

by Alice Murariu, Gabriela Luminița Gelețu, Livia Bobu, Simona Stoleriu, Gianina Iovan, Diana Zapodeanu, Bianca-Andreea Onofrei, Costin Iulian Lupu and Elena-Raluca Baciu

Dent. J. 2025, 13(12), 594; https://doi.org/10.3390/dj13120594 - 11 Dec 2025

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Abstract

Background/Objectives: Climate change is a major global issue affecting all facets of society, including dentistry. In response, the idea of green dentistry has developed, prioritising the reduction in environmental damage and the protection of patient health. This scoping review seeks to assess [...] Read more.

Background/Objectives: Climate change is a major global issue affecting all facets of society, including dentistry. In response, the idea of green dentistry has developed, prioritising the reduction in environmental damage and the protection of patient health. This scoping review seeks to assess the level of awareness, understanding and practices of oral health professionals concerning the proper management of biomed. Methods: Searches were carried out in the Medline/PubMed, Scopus, Web of Science, Embase, and Google Scholar databases, analysing studies published between 2020 and 2025. Out of a total of 822 articles, 27 met the eligibility criteria. Results: In most of these studies, the respondents’ level of knowledge was found to be unsatisfactory or average, and only 17% of the studies reported respondents having a positive attitude towards adherence to sustainability principles. Although many professionals stated they were aware that dental waste could negatively impact the environment and human health if not properly managed, some still failed to provide correct answers to all the questions. Conclusions: The synthesis results indicated that oral health professionals have significant gaps in certain aspects of biomedical waste management, highlighting the need for proper training and to supplement the undergraduate and postgraduate curricula with courses on this topic. Full article

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9 pages, 347 KB

Open AccessArticle

Radiographic Outcome of Endodontic Treatment of Teeth with Primary Apical Periodontitis: Results from a Postgraduate Clinic

by Pia Titterud Sunde, Erika Giving, Tabish Dilshad, Trude Handal and Dag Ørstavik

Dent. J. 2025, 13(12), 593; https://doi.org/10.3390/dj13120593 - 11 Dec 2025

Viewed by 495

Abstract

Objective: The aim of the study was to analyze factors influencing the radiographic outcome of first-time endodontic treatment of teeth with periapical lesions. Methods: From March 2008 to October 2022, 804 cases of primary apical periodontitis with radiographically detectable lesions were treated conservatively [...] Read more.

Objective: The aim of the study was to analyze factors influencing the radiographic outcome of first-time endodontic treatment of teeth with periapical lesions. Methods: From March 2008 to October 2022, 804 cases of primary apical periodontitis with radiographically detectable lesions were treated conservatively by postgraduate students at the Department of Endodontics. A total of 437 patients had recall 11–48 months after completion. Post-operative and control radiographs of the teeth were scored by the periapical index (PAI) adjusted to define strict and lenient criteria for success. Patients’ sex and age, the tooth treated, the number of visits, and several tooth- and treatment-related factors were registered and related to radiographic outcomes in bivariate and regression, with actual p levels recorded. Results: Overall success rate was 68% by strict and 83% by lenient criteria. In binary analyses, a high preoperative PAI score, older age, poorer periodontal status, tooth type (anterior teeth and premolars), and higher number of visits were negatively related to the outcome. Logistic regression analysis of the whole material confirmed an adverse effect on outcome by these factors. In particular, the number of visits (OR = 1.3, p = 0.003) and the initial PAI (OR = 1.9, p < 0.001) were the strongest predictors of reduced success. Conclusions: Outcome of treatment of primary apical periodontitis by postgraduate students was negatively affected by higher preoperative PAI score, higher patients’ age, poorer periodontal status, and higher number of visits for completion. Clinical Relevance: This study provides clinically relevant insight into multiple prognostic factors that influence the outcome of primary root canal treatment in teeth with periapical lesions, including patient-related, tooth-related, and procedural variables. The results reflect real-world outcomes in a postgraduate clinical setting and confirm the favorable outcome of single-visit treatments found in randomized studies. Full article

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

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12 pages, 2141 KB

Open AccessArticle

An In Vitro Analysis of Implant Site Preparation and Placement Protocols on Implant Accuracy in Robot-Assisted Procedures

by Yunxiao Wang, Yulan Wang, Richard J. Miron, Yufeng Zhang and Qi Yan

Dent. J. 2025, 13(12), 592; https://doi.org/10.3390/dj13120592 - 10 Dec 2025

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Abstract

Background/Objectives: To determine the optimal site preparation and placement protocols for immediate implant positioning in robot-assisted surgeries. Methods: In vitro models of immediate and healed extraction sockets were created using 3D printing. A robotic system was used for implant site preparation [...] Read more.

Background/Objectives: To determine the optimal site preparation and placement protocols for immediate implant positioning in robot-assisted surgeries. Methods: In vitro models of immediate and healed extraction sockets were created using 3D printing. A robotic system was used for implant site preparation and implant placement. The implant surgeries were allocated into eight experimental groups using 12 printed models in total. Each model incorporated two implant sites, an immediate site (tooth 21) and a healed site (tooth 26), resulting in 24 implants overall. With 3 implants assigned to each group, the 24 implant placements were evenly distributed across the 8 groups. For each group, the lateral force experienced during surgery was recorded by the haptic sensor on the robotic arm, and implant positional deviations were assessed by superimposing post-surgical CBCT images with the virtual implant planning. Results: Healed sites showed significantly higher accuracy than immediate sites, with reduced platform and apical deviations (p < 0.001) and markedly lower lateral force experienced by drills. In fully guided procedures, thread tapping greatly improved accuracy in immediate sites but had limited benefit in healed sites. Compared with partially guided workflows, fully guided rCAIS markedly enhanced accuracy in immediate sites (≈0.8 mm reduction in platform/apical deviation, p < 0.001), while no meaningful differences were observed in healed sites. Fully guided protocols also reduced insertion force in healed sites. Conclusions: Immediate sites showed lower implant positional accuracy and experienced higher lateral forces during surgery than healed sites. In immediate sites, thread tapping and fully guided rCAIS improved placement accuracy. Full article

(This article belongs to the Special Issue Digital Implantology in Dentistry)

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13 pages, 817 KB

Open AccessArticle

Inflammatory Cytokine Variations After Non-Surgical Periodontal Therapy Across Periodontal Stages and Grades

by Mirlinda Sopi Krasniqi, Zana Sllamniku Dalipi, Donika Bajrami Shabani, Etleva Droboniku, Gramos Begolli, Gerta Kaçani and Aida Meto

Dent. J. 2025, 13(12), 591; https://doi.org/10.3390/dj13120591 - 9 Dec 2025

Viewed by 486

Abstract

Background: Periodontitis is associated with systemic inflammation; however, the relationship between disease severity and systemic inflammatory biomarkers remains unclear. This study aimed to evaluate the association between periodontitis stage and grade with systemic levels of C-reactive protein (CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6), and [...] Read more.

Background: Periodontitis is associated with systemic inflammation; however, the relationship between disease severity and systemic inflammatory biomarkers remains unclear. This study aimed to evaluate the association between periodontitis stage and grade with systemic levels of C-reactive protein (CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) and assess changes following standardized non-surgical periodontal therapy. Methods: Patient records from the University Dentistry Clinical Center of Kosovo were reviewed. Periodontitis was classified using the 2018 staging and grading system. Periodontal parameters (probing pocket depth, clinical attachment loss, bleeding on probing, plaque index, and gingival index) were assessed at six sites per tooth (excluding third molars). Serum levels of IL-1β, IL-6, TNF-α, and high-sensitivity CRP were measured before and after therapy using high-sensitivity ELISA. Blood samples were centrifuged, and serum was stored at −20 °C. All patients underwent standardized non-surgical periodontal therapy, including full-mouth scaling and root planning, without systemic antibiotics. Data were analyzed using SPSS v22.0. Results: Among the patients, 28.0% had Stage I–II, 40.0% Stage III, and 32.0% Stage IV periodontitis; 29.3% were Grade A, 45.3% Grade B, and 25.3% Grade C. At baseline, all systemic inflammatory biomarkers (CRP, IL-1β, IL-6, and TNF-α) were significantly higher in periodontitis patients compared with the control group, indicating an increased systemic inflammatory burden before therapy. After therapy, significant reductions in CRP, IL-1β, IL-6, and TNF-α were observed across all stages and grades (all p < 0.01), indicating a decrease in systemic inflammatory burden. Conclusions: Non-surgical periodontal therapy significantly lowers systemic inflammatory biomarkers regardless of periodontitis severity, supporting their role as indicators of disease activity and treatment response. Full article

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26 pages, 7099 KB

Open AccessArticle

In-Depth Multi-Approach Analysis of WGS Metagenomics Data Reveals Signatures Potentially Explaining Features in Periodontitis Stage Severity

by Ignat V. Sonets, Iulia S. Galeeva, Danil V. Krivonos, Alexander V. Pavlenko, Andrey V. Vvedenskiy, Anna A. Ahmetzyanova, Karen A. Mikaelyan, Elena N. Ilina, Oleg O. Yanushevich, Zalina E. Revazova, Elena I. Vibornaya, Galina S. Runova, Vasiliy V. Aliamovskii, Irina S. Bobr, Madina O. Tsargasova, Ekaterina I. Kalinnikova and Vadim M. Govorun

Dent. J. 2025, 13(12), 590; https://doi.org/10.3390/dj13120590 - 8 Dec 2025

Viewed by 339

Abstract

Background: Periodontitis is a chronic inflammatory disease mostly associated with Porphyromonas gingivalis infection and characterized by progressive destruction of the supporting structures of the tooth, including the gingiva, periodontal ligament and alveolar bone. However, the impact of other members of the periodontal [...] Read more.

Background: Periodontitis is a chronic inflammatory disease mostly associated with Porphyromonas gingivalis infection and characterized by progressive destruction of the supporting structures of the tooth, including the gingiva, periodontal ligament and alveolar bone. However, the impact of other members of the periodontal microbiome on stage of the severity of the periodontitis remains largely uncharacterized. Methods: This exploratory study employs whole-genome shotgun (WGS) metagenomics to characterize the periodontal microbiome in patients suffering from mild and severe periodontitis, aiming to identify microbial signatures linked to disease severity via analysis of taxonomic composition, predicted metabolic pathways and metagenome-assembled genomes (MAGs). After initial selection, 28 adult patients with a computer tomography (CT)-confirmed diagnosis of mild and severe stage of periodontitis from 2 clinics were included in the research project. Results: Taxonomic analysis confirms the presence of various commensal and pathogenic bacteria detectable at the species level, especially belonging to so-called “red, orange and green periodontal complexes”—P. gingivalis, T. forsythia, C. rectus, and Capnocytophaga spp. that may contribute to disease heterogeneity. The conducted investigation suggests that non-microbial factors such as cardiovascular diseases and antibiotic usage in the last 6 months prior to the hospital admission could explain variance of disease progression and impact on severity. Analysis of microbial functional composition revealed metabolic traits showing positive correlations with severe stage of periodontitis. Robust network analysis suggested interactions between pathogenic bacteria of the red complex and other members of the periodontal microbiome. Conclusions: These findings underscore the multifactorial nature of periodontitis pathogenesis, highlighting the need for integrated approaches combining microbial, host, and environmental data to unravel drivers of disease progression. The study provides a foundation for future large-scale investigations into personalized diagnostic or therapeutic strategies. Full article

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

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19 pages, 2003 KB

Open AccessSystematic Review

Prevalence and Severity of Oral Conditions in Elite Athletes: A Systematic Review and Meta-Analysis

by Fátima Campana Zamudio, Victor Sebastián Aleman Soto, Diego Azañedo and Akram Hernández-Vásquez

Dent. J. 2025, 13(12), 589; https://doi.org/10.3390/dj13120589 - 8 Dec 2025

Viewed by 310

Abstract

Background: Oral health problems are common among elite athletes, yet the evidence remains fragmented and inconsistent. Objectives: To estimate the prevalence and severity of oral conditions in elite athletes through a systematic review and meta-analysis. Methods: Studies published in English, Spanish, or Portuguese, [...] Read more.

Background: Oral health problems are common among elite athletes, yet the evidence remains fragmented and inconsistent. Objectives: To estimate the prevalence and severity of oral conditions in elite athletes through a systematic review and meta-analysis. Methods: Studies published in English, Spanish, or Portuguese, with observational design, available in PubMed, Embase, CINAHL, Web of Science, Scopus, Dentistry & Oral Science Source, and LILACS databases until 5 January 2025, were included. A narrative synthesis was used to describe the studies, and a meta-analysis of prevalences was performed using a random-effects model. Study quality assessment was performed using the Joanna Briggs Institute Critical Appraisal tools. Results: A total of 10 articles were included in the systematic review and meta-analysis. The overall combined prevalence of caries was found to be 44.4% (95%CI: 33.9–55.1%), the prevalence of dental erosion was 36.5% (95%CI: 22.6–51.7%), the prevalence of gingivitis was 41.4% (95%CI: 14.7–71%), the prevalence of pericoronitis was 18.7% (95%CI: 2.3–45.4%), the prevalence of periodontitis was 10.8% (95%CI: 2.7–23.3%) and the prevalence of orofacial trauma was 15.6% (95%CI: 5.3–29.7%). High heterogeneity was observed across studies. Most studies presented limitations related to participant recruitment and sample size adequacy. Conclusions: Dental caries, gingivitis, and dental erosion are highly prevalent among elite athletes, underscoring the importance of integrating oral health assessments into sports medicine care. High heterogeneity across studies limits the precision of prevalence estimates, emphasizing the need for standardized methodologies in future research. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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12 pages, 1775 KB

Open AccessArticle

Erosive Potential of Pediatric Syrup Medications on the Human Enamel: Ex Vivo Study

by Fatima-Zohra Douiri and Amir Shayegan

Dent. J. 2025, 13(12), 588; https://doi.org/10.3390/dj13120588 - 8 Dec 2025

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Abstract

Background: Pediatric syrups are frequently prescribed but may pose a risk to dental enamel due to their acidity and viscosity. Aim: To evaluate the erosive potential of commonly prescribed pediatric syrups on enamel from primary and permanent human teeth under ex vivo [...] Read more.

Background: Pediatric syrups are frequently prescribed but may pose a risk to dental enamel due to their acidity and viscosity. Aim: To evaluate the erosive potential of commonly prescribed pediatric syrups on enamel from primary and permanent human teeth under ex vivo conditions. Design: Enamel–dentin blocks from sound primary and permanent teeth were assigned to nine groups (eight syrups and one control). Samples were immersed in their respective solutions four times daily for a 6-day exposure period. Mineral loss (ΔF) was assessed via Quantitative Light-Induced Fluorescence (QLF), surface roughness via profilometry, and morphological changes via scanning electron microscopy (SEM). Syrup pH and viscosity were also measured. Results: Significant ΔF changes were found only for dextromethorphan on primary enamel (p = 0.0054). No significant enamel loss was observed by profilometry. Surface roughness increased significantly with glycerin, distilled water, and azithromycin. Syrups showed a wide pH range (3.92–8.44) and varied viscosity, with ibuprofen and glycerin being the most viscous. Conclusions: Most pediatric syrups did not cause significant enamel demineralization or loss under short-term ex vivo exposure. However, increased surface roughness suggests that specific formulations may affect enamel texture, underscoring the need for preventive care in frequent users. Full article

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16 pages, 3746 KB

Open AccessArticle

Relationship Between the Changes in the Inclination of the Incisors and Soft Gingival Tissue Remodeling During the First Phase of Orthodontic Treatment Without Premolar Extraction

by Oleksandr Kobylyanskyy, Marco Aoqi Rausch, Alina Kobylyanska, Oleh Andrukhov and Xiaohui Rausch-Fan

Dent. J. 2025, 13(12), 587; https://doi.org/10.3390/dj13120587 - 8 Dec 2025

Viewed by 456

Abstract

Background/Objectives: The present study aimed to investigate how the changes in the inclination of the upper and lower incisor regions during the alignment phase of orthodontic treatment (OT) without premolar extraction influence the height and thickness of the gingiva around these incisors. [...] Read more.

Background/Objectives: The present study aimed to investigate how the changes in the inclination of the upper and lower incisor regions during the alignment phase of orthodontic treatment (OT) without premolar extraction influence the height and thickness of the gingiva around these incisors. Methods: This prospective clinical study included 62 patients undergoing OT without premolar extraction. Cone beam computed tomography and intraoral 3D scans were taken before and after the alignment phase, and superimposed using specialized software. The changes in the inclination of each tooth, alveolar bone height (ABH), clinical crown height (CCH), and gingival thickness on the level of the cement–enamel junction (CEJ) and 1 mm below it were determined on both tooth sides. Results: The alignment phase of OT was accompanied by an increase in CCH on the buccal side of both upper and lower incisors. In contrast, on the palatal/lingual sides, either a decrease or an increase in CCH was observed, depending on the direction and amount of the changes in the inclination. Furthermore, in many cases, a decrease in the gingival thickness was observed, which was especially pronounced on the palatal side of the upper incisors after proclination. The changes in the CCH and gingival thickness on the palatal/lingual sides exhibited a weak to moderate correlation with the changes in the inclination. In addition, a very weak to weak correlation between the changes in gingival parameters and ABH was observed. Conclusions: Our data suggest that there is some soft tissue remodeling during the alignment phase of OT, and the changes in soft tissue parameters exhibit some dependency on the changes in inclination. Potential changes in the soft tissue should be considered in planning orthodontic treatment. Full article

(This article belongs to the Special Issue Current Research Topics in Orthodontics)

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25 pages, 22063 KB

Open AccessArticle

Prosthetic Cap-Free Implant Restorations: Five-Year Clinical Performance with Mechanical Verification

by Ioan-Achim Borșanu, Laura-Cristina Rusu, Sergiu-Manuel Antonie and Emanuel-Adrian Bratu

Dent. J. 2025, 13(12), 586; https://doi.org/10.3390/dj13120586 - 8 Dec 2025

Viewed by 325

Abstract

Background: The use of prosthetic caps in screw-retained implant restorations aims to enhance passivity and protect abutment threads; however, these components may increase prosthetic volume and impair esthetics. Advances in high-strength zirconia have raised the question of whether such caps remain necessary. Methods: [...] Read more.

Background: The use of prosthetic caps in screw-retained implant restorations aims to enhance passivity and protect abutment threads; however, these components may increase prosthetic volume and impair esthetics. Advances in high-strength zirconia have raised the question of whether such caps remain necessary. Methods: A retrospective clinical analysis was conducted on 20 partial screw-retained zirconia restorations comparing cases fabricated with and without a prosthetic cap. All restorations were followed for 3–5 years. Clinical outcomes included screw stability, marginal adaptation, esthetics (VAS), hygiene access, and biological response. A supplementary mechanical verification was performed on four standardized zirconia crowns fabricated through digital and conventional impression workflows to qualitatively assess their behavior under 30 N·cm torque and compressive loading above 1200 MPa. Results: Throughout follow-up, no mechanical or biological complications were recorded in either group. One restoration with a cap required screw re-tightening, while none failed in the cap-free group. Radiographic analysis showed smaller mean marginal gaps in cap-free restorations (0.183 mm) compared to those with caps (0.289 mm; p < 0.01). Esthetic satisfaction scores were higher in the cap-free group (VAS = 9.3 ± 0.1 vs. 8.2 ± 0.1; p < 0.001). Mechanical verification confirmed that all zirconia crowns tolerated torque and compressive loads without visible fracture or deformation. Conclusions: Within the study limitations, cap-free screw-retained zirconia restorations exhibited excellent 5-year clinical stability, improved esthetics, and better hygiene access compared with capped designs. The small-scale mechanical verification supported the clinical findings, indicating that cap omission does not compromise mechanical performance when accurate fit and digital workflow precision are ensured. Full article

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14 pages, 3484 KB

Open AccessArticle

Clinical and Histological Assessment of Knife-Edge Thread Implant Stability After Ridge Preservation Using Hydroxyapatite and Sugar Cross-Linked Collagen: Preliminary Report

by Lidija Veljkovic, Miljana Nedeljkovic, Gvozden Rosic, Dragica Selakovic, Nemanja Jovicic, Momir Stevanovic, Jovana Milanovic, Aleksandra Arnaut, Milica Vasiljevic and Pavle Milanovic

Dent. J. 2025, 13(12), 585; https://doi.org/10.3390/dj13120585 - 8 Dec 2025

Viewed by 412

Abstract

Background: Primary stability of dental implants depends on bone quality, bone quantity, and implant design. In cases of large defects, such as periapical lesions, the selection of an appropriate alveolar ridge preservation (ARP) material is crucial for bone regeneration and preparation for [...] Read more.

Background: Primary stability of dental implants depends on bone quality, bone quantity, and implant design. In cases of large defects, such as periapical lesions, the selection of an appropriate alveolar ridge preservation (ARP) material is crucial for bone regeneration and preparation for implant placement. Objective: The aim of this study was to evaluate clinical and histological outcomes of a novel ARP material hydroxyapatite and sugar cross-linked collagen (HSCC) combined with a knife-edge thread implant (KTI) design. Methods: Thirty patients were divided into two groups: a control group treated with KTI after spontaneous alveolar ridge healing, and an experimental group that underwent ARP using HSCC, and six months later, KTIs were placed in newly formed bone. Clinical parameters including insertion torque value (ITV), resonance frequency analysis (RFA), implant stability quotient (ISQ), and horizontal bone dimension were evaluated. Histological analysis was also performed. Results: No significant differences were observed between groups in ITV, ISQ, or horizontal bone dimension (p > 0.05). However, histological analysis demonstrated a significantly higher number of active osteoblasts in the ARP group compared to the control (p < 0.001), whereas collagen deposition was significantly greater in the control group (p < 0.001). Conclusions: ARP using HSCC, combined with KTI, provides favorable conditions for primary stability and successful graft integration, supporting reliable implant placement in sites with bone defects. Full article

(This article belongs to the Special Issue Bone Augmentation in Dentistry)

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26 pages, 7845 KB

Open AccessArticle

Sinus Lift with Collagenated Porcine Xenograft in Severely Atrophic Posterior Maxillae: Case Series with Histologic Correlation and Long-Term Outcomes

by Alexandru Spînu, Felicia Manole, Alexandru Burcea, Cristina-Crenguţa Albu, Lavinia-Florica Mărcuț, Roxana Daniela Brata, Alexia Manole and Claudia Florina Bogdan-Andreescu

Dent. J. 2025, 13(12), 584; https://doi.org/10.3390/dj13120584 - 5 Dec 2025

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Abstract

Background: Maxillary sinus floor augmentation is widely used to enable implant placement in the atrophic posterior maxilla, yet comparative data for porcine-derived xenografts remain limited. Objective: To evaluate long-term bone regeneration and implant outcomes following sinus augmentation using a collagenated porcine xenograft. Methods: [...] Read more.

Background: Maxillary sinus floor augmentation is widely used to enable implant placement in the atrophic posterior maxilla, yet comparative data for porcine-derived xenografts remain limited. Objective: To evaluate long-term bone regeneration and implant outcomes following sinus augmentation using a collagenated porcine xenograft. Methods: This paper reports a retrospective case series of three partially edentulous patients (aged 46–56 years) who underwent lateral sinus augmentation with a small-particle collagenated porcine xenograft (THE Graft™, Purgo Biologics, Gyeonggi-do, Republic of Korea) and staged implant placement. In one case, a controlled perforation of the Schneiderian membrane was performed to access and remove a sinus mucocele, followed by repair using a resorbable collagen membrane. Core biopsies were harvested at implant placement for histology (hematoxylin-eosin, Masson–Goldner) and tartrate-resistant acid phosphatase (TRAP) staining. Clinical outcomes included surgical events, vertical bone gain, marginal bone levels, and implant survival at long-term follow-up. Results: Healing was uneventful in all cases. Mean vertical bone gain was 12.0 mm (baseline 1.33 mm to 13.33 mm final). At a mean 46.8-month follow-up (range 38.3–52.2 months), 100% of implants were functional without failure; marginal bone loss remained < 1 mm during the first year and was stable thereafter. Histology at 3.7, 4.7, and 7.5 months showed vascularized new trabecular bone intimately contacting residual xenograft particles (new bone 20–30%, residual biomaterial 30–40%, connective tissue 30–50%). TRAP-positive multinucleated giant cells at 7.5 months indicated ongoing biomaterial degradation without severe inflammatory reactions. Conclusions: Within the limits of a small case series, collagenated porcine xenograft supported predictable bone regeneration and stable long-term implant function after sinus floor elevation, with favorable histologic integration and gradual resorption. Full article

(This article belongs to the Special Issue Innovations and Challenges in Dental Implantology)

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12 pages, 1751 KB

Open AccessArticle

Evaluation of Flexural Resistance in Co-Cr Ceramic Systems: Conventional Casting Versus 3D Printing—A Pilot Study

by Alexandra Elena Biculescu, Anca Iuliana Popescu, Tudor-Petru Ionescu, Ioana Ana Maria Ciorniciuc, Daniel Alexandru Referendaru, Costin Coman, Andrei Constantinovici, Stefan-Eugen Chirsanov-Capanu, Mirel Stoian-Albulescu and Raluca Monica Comaneanu

Dent. J. 2025, 13(12), 583; https://doi.org/10.3390/dj13120583 - 5 Dec 2025

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Abstract

Introduction: The success of metal–ceramic restorations depends on the mechanical and adhesive properties of the metal–ceramic interface. With the emergence of additive manufacturing technologies such as selective laser melting (SLM), there is growing interest in comparing these methods with conventional casting. This [...] Read more.

Introduction: The success of metal–ceramic restorations depends on the mechanical and adhesive properties of the metal–ceramic interface. With the emergence of additive manufacturing technologies such as selective laser melting (SLM), there is growing interest in comparing these methods with conventional casting. This pilot study aimed to generate hypothesis-forming data on how fabrication method (casting and 3D printing) and alumina sandblasting with two particle sizes (125 μm and 250 μm) influence flexural performance of Co-Cr metal–ceramic systems within the standardized ISO 9693 framework. Materials and Methods: Rectangular Co-Cr alloy specimens were manufactured using two techniques: conventional casting and 3D printing via SLM. Each group was divided based on the sandblasting particle size. After ceramic application in accordance with ISO 9693:2012, samples underwent a three-point bending test using a universal testing machine (Instron 8872) to assess the displacement force required to fracture the ceramic layer. Five specimens were tested per group, and mean values and standard deviations were calculated. Data were statistically analyzed using two-way ANOVA followed by Tukey’s HSD post hoc test (p < 0.05). Results: Cast samples exhibited significantly higher displacement strength than printed ones. Among all groups, the cast samples sandblasted with 250 μm particles (CCT_250) showed the best performance (mean: 12.48 ± 0.91 N), while the 3D-printed group treated with 125 μm particles (CCP_125) showed the lowest strength (mean: 7.24 ± 0.65 N). Larger abrasive particles (250 μm) improved bond strength in both fabrication techniques. Two-way ANOVA revealed significant main effects of manufacturing method (F(1,16) = 13.63, p = 0.002, η² = 0.46) and particle size (F(1,16) = 6.17, p = 0.024, η² = 0.28), with no interaction between factors. Conclusions: Both the manufacturing method and the sandblasting protocol significantly influence the flexural performance of Co-Cr ceramic systems. Conventional casting combined with 250 μm particle sandblasting ensures the highest ceramic adhesion, while SLM-printed substrates may require additional surface treatments to improve bonding efficiency. Complementary surface treatments such as bonding agents or chemical oxidation may enhance the metal–ceramic bond in SLM-fabricated frameworks. Full article

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

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16 pages, 2424 KB

Open AccessReview

Clinical Management of Orthodontic Miniscrew Complications: A Scoping Review

by Cristina del Rosso, Pier Paolo Poli, Martina Ghizzoni and Alberto Caprioglio

Dent. J. 2025, 13(12), 582; https://doi.org/10.3390/dj13120582 - 5 Dec 2025

Viewed by 787

Abstract

Background/Objective: To outline strategies for the safe clinical use of orthodontic temporary anchorage devices (TADs) by analyzing papers that examine associated risks, complications, and approaches for their prevention and resolution. Methods: The research protocol used PubMed, Medline, and Scopus [...] Read more.

Background/Objective: To outline strategies for the safe clinical use of orthodontic temporary anchorage devices (TADs) by analyzing papers that examine associated risks, complications, and approaches for their prevention and resolution. Methods: The research protocol used PubMed, Medline, and Scopus up to May 2024, focusing on controlled and randomized clinical trials aligned with the review objective. Fourteen studies were included; bias risk was assessed, key data extracted, and a descriptive analysis performed. Study quality and evidence strength were also evaluated. Results: TADs optimize anchorage control without relying on patient compliance. However, they carry risks and complications. TAD contact with the periodontal ligament or root without pulp involvement requires removal for spontaneous healing. If pulp is involved, the TAD should be removed and endodontic therapy performed. If anatomical structures are violated, TAD should be removed. If transient, spontaneous recovery occurs, but sometimes pharmacological treatment may be needed. A 2 mm gap between the TAD and surrounding structures can prevent damage. In the maxillary sinus, a less than 2 mm perforation of the Schneiderian membrane recovers spontaneously; wider perforations require TAD removal. Good oral hygiene and TAD abutments prevent soft tissue inflammation, which resolves with 0.2% chlorhexidine for 14 days. Unwanted forces can cause TAD fractures, requiring removal. Minor TAD mobility due to loss of primary stability can be maintained; significant instability requires repositioning. Conclusions: The use of TADs requires meticulous planning, radiological guidance, and monitoring to minimize risks and manage complications. With proper care, TADs improve orthodontic outcomes and patient satisfaction. Full article

(This article belongs to the Special Issue Innovations and Trends in Modern Orthodontics)

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Dent. J., Volume 13, Issue 12 (December 2025) – 66 articles

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