Dentistry Journal

20 pages, 1017 KiB

Open AccessReview

Biomaterials for Guided Tissue Regeneration and Guided Bone Regeneration: A Review

by Nathália Dantas Duarte, Paula Buzo Frigério, Gloria Estefania Amaya Chica, Roberta Okamoto, Rogério Leone Buchaim, Daniela Vieira Buchaim, Michel Reis Messora and João Paulo Mardegan Issa

Dent. J. 2025, 13(4), 179; https://doi.org/10.3390/dj13040179 - 21 Apr 2025

Viewed by 385

Abstract

This review aims to provide an overview of the types of membranes, bone substitutes, and mucosal substitutes used for GTR and GBR and briefly explores recent innovations for tissue regeneration and their future perspectives. Since this is a narrative review, no systematic search, [...] Read more.

This review aims to provide an overview of the types of membranes, bone substitutes, and mucosal substitutes used for GTR and GBR and briefly explores recent innovations for tissue regeneration and their future perspectives. Since this is a narrative review, no systematic search, meta-analysis, or statistical analysis was conducted. Using biomaterials for GTR and GBR provides a reduction in postoperative morbidity, as it contributes to less invasive clinical procedures, serving as an alternative to autogenous grafts. Moreover, randomized clinical trials (RCTs) and systematic reviews are essential for the evaluation of new biomaterials. These studies provide more robust evidence and help guide clinical practice in the selection of safer and more effective biomaterials, allowing for the personalization of treatment protocols for each patient. Full article

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

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14 pages, 1280 KiB

Open AccessReview

Effects of Vitamin D, Melatonin, and Omega-3 Fatty Acids on Periodontal Health: A Narrative Review

by Dora Dragičević Tomičić, Nikolina Lešić, Ivana Škrlec, Larissa Steigmann, Kristina Tseneva, Martina Čalušić Šarac, Tin Crnić, Igor Tomičić, Željka Perić Kačarević and Marija Čandrlić

Dent. J. 2025, 13(4), 178; https://doi.org/10.3390/dj13040178 - 20 Apr 2025

Viewed by 289

Abstract

Periodontitis is a chronic inflammatory disease characterized by the destruction of tooth-supporting structures, influenced by immune system dysregulation, oxidative stress, and imbalances in bone metabolism. Given its multifactorial pathogenesis, bioactive compounds such as vitamin D, melatonin, and omega-3 fatty acids have emerged as [...] Read more.

Periodontitis is a chronic inflammatory disease characterized by the destruction of tooth-supporting structures, influenced by immune system dysregulation, oxidative stress, and imbalances in bone metabolism. Given its multifactorial pathogenesis, bioactive compounds such as vitamin D, melatonin, and omega-3 fatty acids have emerged as potential adjuncts to periodontal therapy due to their immunomodulatory, anti-inflammatory, and antioxidative properties. This narrative review explores the role of these three supplements in periodontal health, their potential in synergistic effects, and existing research gaps, providing a foundation for future studies on their clinical applications. Vitamin D is essential for calcium homeostasis, bone remodeling, and immune function. It modulates both innate and adaptive immune responses, enhancing antimicrobial peptide production and reducing inflammatory cytokine expression. Omega-3 fatty acids reduce the production of pro-inflammatory eicosanoids while promoting the synthesis of pro-resolving lipid mediators, contributing to bone preservation and immune balance. Melatonin, known for its antioxidant and osteogenic properties, supports bone remodeling by stimulating osteoblast proliferation and inhibiting osteoclast activity, while also regulating circadian rhythms, which may influence oral health. Although these bioactive compounds show promising effects in preclinical and clinical studies, significant knowledge gaps remain regarding optimal dosages, long-term efficacy, combined use, and standardized treatment protocols. Further clinical trials are necessary to elucidate their therapeutic value in periodontal disease management, especially those focused on their potential synergistic mechanisms. Understanding their synergistic mechanisms may open new avenues for adjunctive strategies in periodontal therapy. Full article

(This article belongs to the Special Issue Feature Review Papers in Dentistry)

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12 pages, 1509 KiB

Open AccessArticle

Effect of a Recombinant Human Basic Fibroblast Growth Factor 2 (rhFGF-2)-Impregnated Atelocollagen Sponge on Vertical Guided Bone Regeneration in a Rat Calvarial Model

by Keisuke Kogure, Akira Hasuike, Risa Kurachi, Yasuyuki Igarashi, Masataka Idesawa and Shuichi Sato

Dent. J. 2025, 13(4), 177; https://doi.org/10.3390/dj13040177 - 20 Apr 2025

Viewed by 87

Abstract

Background/Objectives: Achieving a sufficient volume of augmented bone, particularly for vertical bone regeneration, remains challenging. This study investigated the use of basic fibroblast growth factor 2 (FGF-2) to promote bone augmentation beyond the skeletal envelope in the rat calvarium. Methods: Seven [...] Read more.

Background/Objectives: Achieving a sufficient volume of augmented bone, particularly for vertical bone regeneration, remains challenging. This study investigated the use of basic fibroblast growth factor 2 (FGF-2) to promote bone augmentation beyond the skeletal envelope in the rat calvarium. Methods: Seven rats were included in the study, with bilateral experimental sites in the calvarium. Two plastic caps were placed in the calvarium, containing either 0.3% FGF-2 with an atelocollagen sponge or an atelocollagen sponge alone as a control. Bone augmentation within the plastic caps was evaluated using micro-computed tomography (micro-CT) scans and histological sections. Micro-CT measurements, including bone volume measurements, were obtained at 1 week to 12 weeks after surgery. At 12 weeks, the area and height of the newly formed bone were evaluated using histological sections. Results: Starting at 8 weeks after surgery, the volume of the newly formed bone in the 0.3% FGF-2 group was significantly greater than that in the control group. At 12 weeks, histomorphometric analyses revealed that the area and height of the newly augmented bone were 35.6% and 41.9%, respectively, in the FGF-2 group, compared with 9.1% and 13.4%, respectively, in the control group. Conclusions: The inclusion of 0.3% FGF-2 in atelocollagen sponge enhanced vertical bone augmentation beyond the skeletal envelope in the rat calvarium. These findings have potential applications for improving bone regeneration outcomes in dental implant procedures. Full article

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

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11 pages, 1299 KiB

Open AccessArticle

Mandibular Asymmetry Index and Dental Occlusion in Patients with Temporomandibular Disorders Treated with Occlusal Splint

by Sergio Paduano, Raffaella Grimaldi, Ludovica Nucci, Mario Fordellone, Rossana P. Rotolo, Vincenzo Grassia and Fabrizia d’Apuzzo

Dent. J. 2025, 13(4), 176; https://doi.org/10.3390/dj13040176 - 20 Apr 2025

Viewed by 148

Abstract

Objectives: To evaluate any changes in condylar and mandibular ramus height and dental malocclusion in adult patients with temporomandibular disorders (TMDs) diagnosed with DC/TMD criteria after treatment with an upper occlusal splint. Methods: This retrospective observational study included 48 adult patients with TMDs [...] Read more.

Objectives: To evaluate any changes in condylar and mandibular ramus height and dental malocclusion in adult patients with temporomandibular disorders (TMDs) diagnosed with DC/TMD criteria after treatment with an upper occlusal splint. Methods: This retrospective observational study included 48 adult patients with TMDs treated with an occlusal splint in the upper arch for about 12 months. For each patient, panoramic dental X-rays were analyzed using the Habets method to calculate the asymmetry index between the condyles and mandibular branches before and after treatment. The digital dental models were also studied at T0 and T1 to define the occlusal sagittal molar relationship and the posterior dental crossbite. The statistical analysis was performed using the Shapiro–Wilk normality tests, Student t-tests, or Wilcoxon tests using the R studio software (released version 4.3.3). Results: Condylar height showed a statistically significant difference (p = 0.022) and reduced condylar asymmetry between T0 and T1. The measurement of the condylar branch showed a statistical significance (p = 0.037), revealing an improvement of the mandibular symmetry in the vertical direction after treatment. Moreover, at T0, posterior dental crossbite was found in 37.5% of patients, specifically, bilateral in 12.5%, while unilateral crossbite in 22.9% on the right and 2.1% on the left side, and Class I malocclusion was found in the main part of the sample (72.9%). Conclusions: Patients with TMDs diagnosed according to DC/TMD and treated with an upper stabilization occlusal splint in the case of symptoms of masticatory muscle dysfunction showed a symmetrization in the mandibular ramus and condyle pre- and post-treatment (T0-T1). At the same time, no clinical differences were found in the occlusal characteristics. Full article

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16 pages, 2467 KiB

Open AccessArticle

Micro-Computed Tomography Analysis of Reciprocating Systems in Three-Dimensional Models of Mandibular Premolars with Two Canals

by María Medina-Gil, Ana Martín-Díaz, Natalia Navarrete, José Aranguren, P. S. Ortolani-Seltenerich, Giulia Malvicini, Gaya C. S. Vieira and Alejandro R. Pérez

Dent. J. 2025, 13(4), 175; https://doi.org/10.3390/dj13040175 - 19 Apr 2025

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Abstract

Objective: This study investigated the shaping efficiency of four reciprocating systems—WaveOne Gold, Reciproc Blue, Excalibur, and One Reci—in three dimensional (3D) resin models of natural mandibular premolar teeth with two canals. Methods: Forty 3D-printed mandibular premolars (Vertucci configuration type V) were divided into [...] Read more.

Objective: This study investigated the shaping efficiency of four reciprocating systems—WaveOne Gold, Reciproc Blue, Excalibur, and One Reci—in three dimensional (3D) resin models of natural mandibular premolar teeth with two canals. Methods: Forty 3D-printed mandibular premolars (Vertucci configuration type V) were divided into four groups, each of which was assigned one of the reciprocating systems. According to the manufacturer’s protocols, each canal was prepared, with pre- and post-instrumentation micro computed tomography (micro-CT) scans evaluating canal volume, surface area, percentage of unprepared canal walls, and resin reduction in the pericervical area. Instrumentation time and screw-in sensation were recorded as qualitative performance indicators. Statistical analysis was performed using one-way ANOVA and chi-square tests with a significance of (p < 0.05). Results: All systems increased canal volume and surface area, primarily in the apical third, with Reciproc Blue and One Reci achieving the largest volume. WaveOne Gold had the highest percentage of unprepared walls (27.03%) and Reciproc Blue the lowest (19.65%), though these differences were not statistically significant (p > 0.05). Reciproc Blue caused the highest pericervical resin loss (22.24%), significantly higher than Excalibur (15.09%) and One Reci (15.17%) (p = 0.035). Reciproc Blue exhibited the highest incidence of screw-in sensation (70%), while WaveOne Gold achieved the shortest instrumentation time (86.7 s), although neither variable showed statistical significance. Conclusions: All systems effectively shaped complex canal anatomies, with Reciproc Blue demonstrating the highest dentin removal and WaveOne Gold proving the most time efficient. Clinically, these findings suggest that instrument selection should balance shaping efficiency with dentin preservation. Minimizing unprepared areas and preserving pericervical dentin are essential for enhancing disinfection and reducing the risk of root fractures, ultimately contributing to the long-term success of endodontic treatment. Full article

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

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12 pages, 543 KiB

Open AccessArticle

Evaluation of Quality of Record-Keeping and Root Canal Therapy Performed by Two Predoctoral Cohorts

by Wei Chun Yeoh, Chun Giok Koay, Genevieve Yuiin Sze Kong, Emilyn Wenqi Gan, Rikan Libat, Muneer Gohar Babar and Abhishek Parolia

Dent. J. 2025, 13(4), 174; https://doi.org/10.3390/dj13040174 - 19 Apr 2025

Viewed by 191

Abstract

Objectives: A retrospective clinical audit was carried out to evaluate and compare the quality of record-keeping (QRK) and quality of root canal therapy (QRCT) performed by 4th-year and 5th-year predoctoral students. Methods: Electronic records and periapical radiographs of 702 root canal treated teeth [...] Read more.

Objectives: A retrospective clinical audit was carried out to evaluate and compare the quality of record-keeping (QRK) and quality of root canal therapy (QRCT) performed by 4th-year and 5th-year predoctoral students. Methods: Electronic records and periapical radiographs of 702 root canal treated teeth performed by 4th-year and 5th-year predoctoral students from July 2018 to December 2021 were evaluated in compliance with standard European Society of Endodontology (ESE) and American Association of Endodontists (AAE) guidelines. Associations between the QRK and the QRCT were statistically analysed using the chi-square test (p < 0.05). Results: Overall acceptability of the QRK and the QRCT was 72.08% and 50.57%, respectively. The reference point of working length was the most common criterion not recorded (33.91%). No significant difference was observed in the QRK between 4th-year (76.05%) and 5th-year (69.70%) students (p = 0.226), as well as the QRCT between 4th-year (51.33%) and 5th-year (50.11%) students (p = 0.755). Acceptable root canal fillings were significantly higher in anterior teeth (57.48%) than in posterior teeth (47.54%) (p = 0.015). Satisfactory QRK was significantly associated with satisfactory QRCT (p = 0.046). Conclusions: Both predoctoral cohorts showed no difference in QRK and QRCT. However, QRK was better than QRCT. Comprehensive and accurate record-keeping positively impacted the QRCT. Full article

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17 pages, 1455 KiB

Open AccessArticle

Color and Translucency Compatibility Among Various Resin-Based Composites and Layering Strategies

by Elena Bianca Varvara, Cristina Gasparik, Javier Ruiz-López, Alexandra Iulia Aghiorghiesei, Bogdan Culic and Diana Dudea

Dent. J. 2025, 13(4), 173; https://doi.org/10.3390/dj13040173 - 18 Apr 2025

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Abstract

(1) Background: Natural-looking dental restorations require careful selection of the restorative material, with color and translucency characteristics similar to the natural dental structures. (2) Objectives: This research aimed to evaluate if there is compatibility regarding the color and translucency between different commercial RBCs [...] Read more.

(1) Background: Natural-looking dental restorations require careful selection of the restorative material, with color and translucency characteristics similar to the natural dental structures. (2) Objectives: This research aimed to evaluate if there is compatibility regarding the color and translucency between different commercial RBCs in different layering recipes. (3) Methods: Sixty 1 mm thick disk specimens were produced from three different RBCs: ESS (Essentia-GC), BEG (Brilliant Ever Glow-Coltene), and IPS (IPS Empress Direct-Ivoclar Vivadent). Three different opacities and translucencies (enamel, dentin, and opaque shades) from each system were used in four recipes (R1-enamel, R2-dentin, R3-enamel and dentin, R4-enamel, dentin, and opaque) to obtain single-, double-, and triple-layered samples, respecting the anatomical layering technique. CIE L*, a*, b*, C*, h⁰ coordinates were recorded, and the relative translucency parameter (RTP₀₀) was calculated. Further, the color differences (ΔE₀₀) and the difference in translucencies ΔRTP₀₀ were analyzed between the materials and between the layered recipes. (4) Results: The CIE L* and h° color coordinates and RTP₀₀ showed significant differences among all three RBCs for all four recipes (p < 0.001). The decreasing order of translucency for each recipe was R1: ESS > BEG > IPS, R2 and R3: BEG > IPS > ESS, R4: BEG > ESS > IPS. Important differences were found in color and translucency among the recipes for each of the three RBCs tested (p < 0.001). The decreasing order of translucency for the tested RBCs was ESS: R1 > R3 > R4 > R2, BEG and IPS: R1 > R3 > R2 > R4. (5) Conclusions: No significant compatibility was observed in color and translucency among different layering recipes of the same composite materials nor between similar layering recipes when using different composites. The color differences between materials were more significant than the differences in translucency for each recipe. Full article

(This article belongs to the Special Issue State of the Art in Dental Restoration)

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15 pages, 945 KiB

Open AccessReview

Electrolytic Cleaning of Dental Implants: A Scoping Review of Clinical Studies

by Anastasia Klein, Giulio Rasperini, Reinhard Gruber, Oleh Andrukhov and Xiaohui Rausch-Fan

Dent. J. 2025, 13(4), 172; https://doi.org/10.3390/dj13040172 - 18 Apr 2025

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Abstract

Background/Objectives: This literature review aims to systematically analyze the efficacy of electrolytic cleaning for treating peri-implantitis, including its impact on disease resolution, re-osseointegration of treated implants, and peri-implantitis recurrence. It also compares various study and treatment protocols used in the selected papers. Methods: [...] Read more.

Background/Objectives: This literature review aims to systematically analyze the efficacy of electrolytic cleaning for treating peri-implantitis, including its impact on disease resolution, re-osseointegration of treated implants, and peri-implantitis recurrence. It also compares various study and treatment protocols used in the selected papers. Methods: A comprehensive search was conducted in MEDLINE (via PubMed) and the Cochrane Central Register of Controlled Trials using the keywords “electrolytic cleaning implant” or “GalvoSurge”. Studies published until 31 December 2024 were considered for inclusion. Results: Out of 141 articles retrieved, four publications were selected for the review. These studies were analyzed for implant type, number, evaluation methods, observation periods, surgical procedures, and additional treatments. Disease resolution was reported in one study, while peri-implantitis recurred in the remaining studies. However, re-osseointegration of treated implants was observed in all selected papers. Conclusions: Due to the limited and heterogeneous nature of the studies, it is difficult to draw definitive conclusions about the effectiveness of electrolytic cleaning as a treatment for peri-implantitis. To ensure consistent trial outcomes and improve predictability, clear clinical guidelines and surgical protocols for electrolytic decontamination are essential. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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12 pages, 239 KiB

Open AccessArticle

by Ali Al Ibraheem, Clara Dürsch and Katrin Bekes

Dent. J. 2025, 13(4), 171; https://doi.org/10.3390/dj13040171 - 18 Apr 2025

Viewed by 163

Abstract

Background/Objectives: Oral health-related quality of life (OHRQoL) has become increasingly significant in dentistry. By incorporating patient perspectives through questionnaires alongside objective diagnoses, the understanding of diseases is enhanced. This study examines OHRQoL during the early COVID-19 pandemic in children aged 0–10 who visited [...] Read more.

Background/Objectives: Oral health-related quality of life (OHRQoL) has become increasingly significant in dentistry. By incorporating patient perspectives through questionnaires alongside objective diagnoses, the understanding of diseases is enhanced. This study examines OHRQoL during the early COVID-19 pandemic in children aged 0–10 who visited the Emergency unit of Pediatric Dentistry at the Medical University of Vienna from March to May 2020, focusing on the impact of COVID-19 restrictions on various social and health aspects. The study aimed to assess OHRQoL in children during the early weeks of the COVID-19 pandemic and correlate it with other health and social conditions. Materials and Methods: Children (up to 10 years) and their parents visiting the Emergency Unit of the department completed OHRQoL questionnaires. In children aged 0–6, their parents answered the Early Childhood Oral Health Impact Scale questionnaire (ECOHIS), while 7–10-year-olds completed the Child Perception Questionnaire (CPQ) by themselves. Summary scores and associations between oral and general health subdomains were analyzed. Results: Both the ECOHIS and CPQ groups showed high general summary scores, indicating decreased OHRQoL (ECOHIS 12.22 [±8.68] and CPQ 18.36 [±12.35]). The highest scores were in the “oral symptoms” domain, mainly due to “toothache”. Significant correlations were observed between “general health” and “oral health” with the “family section” in the ECOHIS group and between “oral health” and “oral symptoms” with “emotional well-being” in the CPQ group. Conclusions: During the pandemic, both age groups experienced decreased OHRQoL. Family background influenced oral health (ECOHIS), while oral symptoms and emotional well-being correlated with oral health (CPQ). Further research is needed to understand pandemic-related factors affecting OHRQoL and develop preventive strategies. Full article

(This article belongs to the Special Issue Current Advances in Pediatric Odontology)

14 pages, 612 KiB

Open AccessReview

Dental Splints and Sport Performance: A Review of the Current Literature

by Cornelia Popovici, Ioana Roxana Bordea, Alessio Danilo Inchingolo, Francesco Inchingolo, Angelo Michele Inchingolo, Gianna Dipalma and Ana Lucia Muntean

Dent. J. 2025, 13(4), 170; https://doi.org/10.3390/dj13040170 - 18 Apr 2025

Viewed by 267

Abstract

Background/Objectives: Lately, there has been a greater focus on the function of the dento-mandibular apparatus, specifically on the location of the jaw and occlusion. Given the new potential insights, the current study aimed to comprehensively analyze the published literature on the use [...] Read more.

Background/Objectives: Lately, there has been a greater focus on the function of the dento-mandibular apparatus, specifically on the location of the jaw and occlusion. Given the new potential insights, the current study aimed to comprehensively analyze the published literature on the use of occlusal splints and their effects on exercise performance. Methods: A search was conducted on PubMed, Scopus, and Web of Science for papers published between 2014 and 2024. Starting from the 128 identified records, 28 were finally included for review. Results: The extensive literature review revealed significant diversity in the experimental conditions, suggesting that the occlusal splints may enhance exercise performance and support dental health. Conclusions: The present study highlights the growing interest in occlusal splints research and its impact on sport and exercise science. Mouthguards or occlusal splints should continue to be worn in sports with a considerable risk of orofacial injury. Regardless of how they affect performance, mouthguards or occlusal splints are crucial for athletes in many sports to prevent oral and dental injuries. Full article

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27 pages, 1179 KiB

Open AccessReview

Treatment Options for Unilateral Agenesis of the Maxillary Lateral Incisor Combined with Contralateral Microdontic or Peg-Shaped Lateral Incisor: A Systematic Review

by Federica Bitonto, Alessio Verdecchia, Massimiliano Lombardo, Erica Lipani, Claudia Dettori and Enrico Spinas

Dent. J. 2025, 13(4), 169; https://doi.org/10.3390/dj13040169 - 17 Apr 2025

Viewed by 270

Abstract

Background: Managing unilateral maxillary lateral incisor agenesis (UMLIA) with an associated microdontic or peg-shaped contralateral incisor (Mi or Peg MLI) presents clinical and esthetic challenges. Deciding between orthodontic space opening (OSO) or closure (OSC) and whether to restore or extract the Mi or [...] Read more.

Background: Managing unilateral maxillary lateral incisor agenesis (UMLIA) with an associated microdontic or peg-shaped contralateral incisor (Mi or Peg MLI) presents clinical and esthetic challenges. Deciding between orthodontic space opening (OSO) or closure (OSC) and whether to restore or extract the Mi or Peg MLI are critical factors for achieving optimal treatment outcomes. Methods: A systematic review was conducted using a dual strategy across Scopus, Web of Science, Embase, PubMed, and Cochrane Central Register of Controlled Trials databases. The Cochrane RoB2 tool was used for randomized controlled trials (RCTs), the ACROBAT-NRSI tool for non-randomized studies, and the JBI Manual for case reports. High-quality case reports were included when the literature was limited. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) tool evaluated the certainty of evidence, considering bias, inconsistency, indirectness, imprecision and other considerations. Results: Thirty-five studies met the inclusion criteria, assessing treatment modalities, esthetic outcomes, periodontal health, and occlusal and temporomandibular joint (TMJ) function. Both OSO and OSC demonstrated similar occlusal and TMJ outcomes, while slight differences in esthetic and periodontal results were noted between the two approaches. Direct composite and indirect ceramic restorations showed comparable effectiveness for reshaping the Mi or Peg MLI. Extraction combined with OSC contributed to improved smile symmetry. Conclusions: A personalized, multidisciplinary approach is essential for treating UMLIA with an Mi or Peg MLI. Both OSO and OSC are viable options, and the choice should be tailored to the patient’s specific clinical scenario, with attention to achieving the best esthetic and periodontal outcomes. Further research is needed to refine treatment protocols and support clinical decision-making. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)

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10 pages, 1545 KiB

Open AccessArticle

Calcium and Microhardness Quantification in Healthy and Fluorotic Dentin Conditioned with a Self-Etching System: An In Vitro Study

by José Alejandro Rivera Gonzaga, Ana Josefina Monjarás Ávila, Louis Hardan, Norma Verónica Zavala Alonso, Carlos Enrique Cuevas Suárez, Nicolas Nassar, Ahmed A. Holiel, Naji Kharouf, Youssef Haikel and Rim Bourgi

Dent. J. 2025, 13(4), 168; https://doi.org/10.3390/dj13040168 - 17 Apr 2025

Viewed by 183

Abstract

Background: Dental fluorosis can affect the micromorphology of dentin, a fact that could present constraints relating to the structural, mechanical, and chemical stability of dentin when it is demineralized in operative maneuvers. Introduction: The aim of this article is to quantify the amount [...] Read more.

Background: Dental fluorosis can affect the micromorphology of dentin, a fact that could present constraints relating to the structural, mechanical, and chemical stability of dentin when it is demineralized in operative maneuvers. Introduction: The aim of this article is to quantify the amount of calcium and the microhardness of both a healthy and a fluorotic dentin through conditioning with a two-step self-etching system (Optibond Versa, Kerr, CA, USA). Methods: Dentin samples were obtained from healthy molars diagnosed with mild, moderate, and severe fluorosis. The amount of calcium was quantified utilizing an atomic absorption spectrophotometer. The hardness was evaluated using a Vickers durometer. Two dentin samples from each study group were examined using scanning electron microscopy (SEM). Results: A one-way analysis of variance (ANOVA) and Tukey–Kramer test were applied as post hoc tests for determining the differences in calcium values between the study groups and to show the difference in the hardnesses evaluated. The Student’s t-test was applied to related samples. The level of significance was set at p < 0.05. Statistically significant results were obtained for the amount of calcium and microhardness of the healthy dentin group. The SEM images demonstrated irregular etching patterns in the fluorotic dentin, indicating potential bonding challenges. Conclusion: In conclusion, there is a lower amount of calcium and a significant reduction in microhardness in healthy dentin when applying the self-etching system compared to fluorotic dentin. Fluorotic dentin is more resistant to demineralization, which may influence adhesive bonding strategies. Clinicians should consider adjusting conditioning protocols for optimal adhesion in fluorotic teeth. 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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12 pages, 537 KiB

Open AccessArticle

Temporomandibular Disorders: Management of Diagnostics and Therapy in the Context of Orthodontic Treatment—A Survey Among German Orthodontists

by Tobias Klur, Sara Portegys, Isabelle Graf, Sven Scharf, Bert Braumann and Teresa Kruse

Dent. J. 2025, 13(4), 167; https://doi.org/10.3390/dj13040167 - 17 Apr 2025

Viewed by 198

Abstract

Background/Objectives: To evaluate the role of temporomandibular disorder (TMD)-related diagnostics in orthodontic treatment routines and investigate what consequences are drawn from symptoms concerning orthodontic treatment planning and therapy. Methods: All officially listed orthodontists in Germany were surveyed about their professional background, [...] Read more.

Background/Objectives: To evaluate the role of temporomandibular disorder (TMD)-related diagnostics in orthodontic treatment routines and investigate what consequences are drawn from symptoms concerning orthodontic treatment planning and therapy. Methods: All officially listed orthodontists in Germany were surveyed about their professional background, TMD-related specialization, and concrete clinical procedures. Anonymized responses were systematized, manually checked, and statistically analyzed. Differences in reported TMD-related procedures depending on orthodontists’ professional experience and specialization were determined using Fisher’s exact tests. Results: A total of 2359 questionnaires were sent out, of which 630 could be evaluated. The majority of the orthodontists surveyed stated that they perform either a brief TMD screening or a complete functional analysis. In total, 21.1% of the respondents base their examination on the patient’s medical history. A second complete functional analysis is performed by 33% of the responding orthodontists during the course of orthodontic therapy, and by 56.6% only in the case of an initial pathological finding. For 60.1% of the respondents, pre-therapeutically diagnosed, non-painful temporomandibular joint clicking has an influence on orthodontic treatment planning. Only 4.3% of respondents take no further action prior to orthodontic therapy in the case of TMD symptoms. There is an indication that professional experience has no influence on the procedure, whereas a specialization in the field of TMDs does. Conclusions: A discrepancy between the current state of research and standard procedures in German orthodontic practices may lead to an overly detailed examination. However, this has no health disadvantages for the patient. Full article

(This article belongs to the Special Issue Management of Temporomandibular Disorders)

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11 pages, 593 KiB

Open AccessSystematic Review

How Does Allergen Sensitization Affect Orthodontic Tooth Movement-Associated Phenomena? A Systematic Review of Animal Studies

by Fatima Saeed Bineshaq, Athanasios E. Athanasiou, Miltiadis A. Makrygiannakis, Sotirios Kalfas and Eleftherios G. Kaklamanos

Dent. J. 2025, 13(4), 166; https://doi.org/10.3390/dj13040166 - 15 Apr 2025

Viewed by 204

Abstract

Background: The immune reactions of patients suffering from chronic allergies and asthma are associated with systemic imbalances that may lead to the overexpression of mediators potentially involved in bone remodeling during orthodontic tooth movement. Aim: The aim of this systematic review was to [...] Read more.

Background: The immune reactions of patients suffering from chronic allergies and asthma are associated with systemic imbalances that may lead to the overexpression of mediators potentially involved in bone remodeling during orthodontic tooth movement. Aim: The aim of this systematic review was to evaluate the existing evidence from animal studies with regard to the effects of allergen sensitization on the phenomena correlated with orthodontically induced tooth movement. Materials and Methods: This systematic review was based on PRISMA 2020 guidelines. A search without restrictions and hand searching were performed from inception to December 2024. The investigation focused on the impact of allergen sensitization on phenomena associated with orthodontic tooth movement. After the retrieval and selection of relevant studies, data extraction was performed, and the data’s risk of bias was evaluated with the SYRCLE’s Risk of Bias Tool. Results: From the detected records, the inclusion criteria were met by only three studies. At the beginning of tooth movement, periodontal ligament was found to be more compressed in the stress area and more stretched in the tension area in sensitized animals. The amount of tooth movement after 14 days of force application was also greater. However, there were conflicting outcomes regarding root resorption. The risk of bias in the retrieved studies was assessed as high overall. Conclusions: Despite the fact that existing evidence is not directly related to human beings and is based on a limited number of animal studies, allergen sensitization could potentially influence the phenomena associated with orthodontic tooth movement, and orthodontists should be aware of the relevant implications. Full article

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

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14 pages, 1980 KiB

Open AccessArticle

The Clinical and Antibacterial Effects of a Herbal Toothpaste Containing White Mustard Sinapis alba Extract: A Randomized Clinical Trial

by Konrad Michałowski, Bartłomiej Górski and Aniela Brodzikowska

Dent. J. 2025, 13(4), 165; https://doi.org/10.3390/dj13040165 - 15 Apr 2025

Viewed by 184

Abstract

Objectives: The aim of this double-blind, clinical trial study was to evaluate the clinical and antibacterial effects of a herbal toothpaste containing white mustard Sinapis alba extract in comparison to a placebo toothpaste. Methods: One hundred and thirteen participants with gingivitis were randomly [...] Read more.

Objectives: The aim of this double-blind, clinical trial study was to evaluate the clinical and antibacterial effects of a herbal toothpaste containing white mustard Sinapis alba extract in comparison to a placebo toothpaste. Methods: One hundred and thirteen participants with gingivitis were randomly assigned to the test group (experimental herbal toothpaste) or the control group (placebo toothpaste). The plaque index (PI), approximal plaque index (API), gingival index (GI), and bleeding on probing (BoP) were evaluated, and salivary samples for microbial evaluation of the loads of Streptococcus mutans and Lactobacillus spp. were collected at baseline (T₀) and after 4 weeks (T₁). Comparisons were performed between and within groups. Results: A reduction in all periodontal parameters (PI, API, GI, and BoP) was observed. The experimental toothpaste reduced the PI by 2.43, compared to a 1.95 reduction for the placebo (p = 0.041), and BoP by 30.6%, compared to a 26.8% reduction for the placebo (p = 0.037). Statistically significant reductions in salivary S. mutans and Lactobacillus spp. counts were found in the test group. Among patients who used the experimental toothpaste, 19.2% and 9.6% showed counts of S. mutans and Lactobacillus spp., respectively, below 10⁵ CFU/mL, compared to 44.2% and 40.4% in the placebo group. Conclusions: Toothpaste enhanced with white mustard extract was more effective in reducing the PI and BoP indices and decreasing S. mutans and Lactobacillus spp. counts compared to placebo toothpaste. Full article

(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)

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9 pages, 993 KiB

Open AccessArticle

Operative Preventive Oral Hygiene Protocols in Pediatric Patients with Leukemia: A Non-Randomized Clinical Trial

by Guido Galbiati, Lucia Giannini, Daniela del Rosso, Maria Grazia Cagetti and Cinzia Maspero

Dent. J. 2025, 13(4), 164; https://doi.org/10.3390/dj13040164 - 11 Apr 2025

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Abstract

Objective: The objective of this study is to highlight the critical role of pediatric dentists in promoting oral health prevention among leukemia patients. In fact, oral manifestations frequently serve as the initial clinical indicators of leukemia, occurring in up to 10% of cases. [...] Read more.

Objective: The objective of this study is to highlight the critical role of pediatric dentists in promoting oral health prevention among leukemia patients. In fact, oral manifestations frequently serve as the initial clinical indicators of leukemia, occurring in up to 10% of cases. In acute myelomonocytic leukemia, oral lesions are observed in 65–90% of patients. Methods: A cohort of 63 patients (30 males and 33 females) with a mean age of 10 years participated in this study. All participants adhered to a standardized preventive dental care protocol, referred to as the “Preventive Iter”. This protocol focuses on individualized oral hygiene education, regular monitoring, and professional dental interventions aimed at preventing and managing oral health complications associated with systemic conditions such as leukemia. Results: The results demonstrated a statistically significant and progressive improvement across all evaluated oral health parameters as patients advanced through the Preventive Iter protocol. Conclusions: The Preventive Iter protocol has proven to be highly effective in improving oral health outcomes, as evidenced by notable reductions in plaque accumulation, microbial imbalance, and gingival inflammation. The structured, individualized approach—incorporating professional hygiene interventions and tailored educational strategies—appears to be a key factor in achieving and maintaining these improvements. These findings underscore the critical importance of early and ongoing preventive care, particularly for medically vulnerable populations. Full article

(This article belongs to the Special Issue Current Advances in Pediatric Odontology)

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10 pages, 841 KiB

Open AccessArticle

Assessing Discrimination and Acceptance for Lightness and Chroma During Shade Selection: A Comparison of Dental and Non-Dental Professionals

by Haruna Konishi, Yuichi Ishida, Takaharu Goto and Tetsuo Ichikawa

Dent. J. 2025, 13(4), 163; https://doi.org/10.3390/dj13040163 - 11 Apr 2025

Viewed by 213

Abstract

Background/Objectives: Tooth color is key in determining aesthetic appearance during restorative and prosthodontic treatments. To establish a more reliable methodology for shade selection, this study investigated differences in the discrimination and acceptance of tooth color between dental and non-dental professionals, focusing on [...] Read more.

Background/Objectives: Tooth color is key in determining aesthetic appearance during restorative and prosthodontic treatments. To establish a more reliable methodology for shade selection, this study investigated differences in the discrimination and acceptance of tooth color between dental and non-dental professionals, focusing on color attributes such as lightness and chroma. Methods: This study included 30 dentists, 30 dental technicians, 30 patients, and 30 dental students. They were asked to compare pairs of shade tabs with different lightness and chroma from the VITA Toothguide 3D-MASTER^® (VITA Zahnfabrik, Bad Säckingen, Germany). The number of answers in which participants could discriminate color differences (discrimination numbers) and answers in which they could not accept color differences (non-acceptance numbers) were recorded. Statistical analysis was performed using Spearman’s rank correlation coefficient, the Mann–Whitney U test, the Kruskal–Wallis test, and multiple regression analysis (p < 0.05). Results: Significant factors influencing lightness discrimination were participant group and age, while those influencing acceptance were subject group and sex. Conclusions: This study revealed differences in the discrimination and acceptance of lightness and chroma between dental and non-dental professionals, particularly concerning lightness. Dental technicians exhibited a higher discrimination ability and stricter acceptance of lightness and chroma, regardless of age. Based on an understanding of these characteristics, appropriate shade selection and adequate communication will be important. Full article

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

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10 pages, 224 KiB

Open AccessArticle

The Relationship Between the Perceived Personality Traits of Dentists, Dental Anxiety, Negative Stories, and Negative Experiences with Dental Treatment: A Cross-Sectional Study

by Martine Eide Furnes, Sondre Lillejord, Vetle Lillejord and Jan-Are K. Johnsen

Dent. J. 2025, 13(4), 162; https://doi.org/10.3390/dj13040162 - 10 Apr 2025

Viewed by 263

Abstract

Background/Objectives: Negative stories about dentists are prevalent in mass media and in social discourse. This study explores the associations between dental anxiety, negative dental stories, and negative dental experiences, and how these phenomena are related to the perception of dentists’ personality traits. Methods: [...] Read more.

Background/Objectives: Negative stories about dentists are prevalent in mass media and in social discourse. This study explores the associations between dental anxiety, negative dental stories, and negative dental experiences, and how these phenomena are related to the perception of dentists’ personality traits. Methods: An anonymous electronic survey was distributed among students at UiT The Arctic University of Norway, and 118 students chose to participate in the study. The questionnaire included questions on dental anxiety, negative stories about dental treatment, negative experiences of dental treatment, and ratings of dentists’ personality traits. Results: Almost half of the participants (46%) had at least one negative dental experience, while the majority (80%) of the participants had heard a negative story about the dentist. There were significant differences in the ratings of dentists’ personality traits based on having previous negative dental experiences and based on dental anxiety scores. Participants without negative dental experiences and with low dental anxiety rated the dentist more favorably in terms of personality traits than anxious participants or participants with negative dental experiences. Negative dental treatment experiences (OR 10.35; p < 0.001) and rating dentists as having low extraversion (OR 0.34; p < 0.05) emerged as the most important predictors of high dental anxiety. Conclusions: The interplay between negative stories about the dentist, dental anxiety, and negative dental experiences should be explored further, as well as the impact of the perceived personality traits of dental health professionals. Full article

(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)

11 pages, 1663 KiB

Open AccessArticle

Ultra-Low Frequency TENS as an Adjunctive Therapy for Pain Management in Non-Surgical Periodontal Treatment: A Pilot Study

by Eleonora Ortu, Sara Di Nicolantonio, Roberta Di Felice, Antonella Barone, Davide Pietropaoli and Annalisa Monaco

Dent. J. 2025, 13(4), 161; https://doi.org/10.3390/dj13040161 - 9 Apr 2025

Viewed by 250

Abstract

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, [...] Read more.

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, ultimately compromising their oral health outcomes. Methods: This prospective randomized crossover split-mouth study involved the application of Ultra-Low Frequency (ULF) Transcutaneous Electrical Nerve Stimulation (TENS) in 20 adult patients undergoing non-surgical periodontal treatment. Pain and discomfort levels were quantitatively assessed during procedures conducted with and without the ULF-TENS intervention. Results: The assessment of maximum voluntary opening, pain intensity, and overall comfort levels indicated a statistically significant reduction in pain (p < 0.0001) and discomfort (p < 0.0001) when ULF-TENS was employed during the treatment, and an increase in the maximum mouth opening after TENS (p = 0.00062). Conclusions: The findings of this pilot study suggest that ULF-TENS may serve as a valuable adjunctive therapy in non-surgical periodontal treatment by reducing pain and discomfort, potentially enhancing patient comfort and compliance. Further research with larger sample sizes is warranted to confirm these findings. Full article

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

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14 pages, 2019 KiB

Open AccessArticle

Effects of Nisin A Combined with Antifungal Drug Against Growth of Candida Species

by Yoshie Niitani, Kouji Ohta, Kanako Yano, Yoshino Kaneyasu, Tomoko Maehara, Honami Kitasaki, Hideo Shigeishi, Hiromi Nishi, Rumi Nishimura, Mariko Naito, Fumie Shiba, Miki Kawada-Matsuo, Hitoshi Komatsuzawa and Toshinobu Takemoto

Dent. J. 2025, 13(4), 160; https://doi.org/10.3390/dj13040160 - 8 Apr 2025

Viewed by 290

Abstract

Background/Objectives: Nisin A, an antimicrobial peptide produced by Lactococcus lactis, primarily shows antimicrobial activity against Gram-positive bacteria, with efficacy increased when used in combination with an antimicrobial drug. On the other hand, oral candidiasis, caused by Candida, occurs in immunocompromised patients [...] Read more.

Background/Objectives: Nisin A, an antimicrobial peptide produced by Lactococcus lactis, primarily shows antimicrobial activity against Gram-positive bacteria, with efficacy increased when used in combination with an antimicrobial drug. On the other hand, oral candidiasis, caused by Candida, occurs in immunocompromised patients and requires antifungal therapy. However, antifungal drug-resistant Candida strains are increasing worldwide, leading to serious problems. Methods: To examine the effects of nisin A against Candida species, we investigated the combined effects of nisin A and antifungal drugs on the growth and viability of Candida strains. Results: While nisin A alone had no antifungal effect, together with amphotericin (AMPH), it showed synergistic effects towards C. albicans, as well as the non-albican strains C. glabrata, C tropicalis, and C. parapsilosis in checkerboard assay results. Furthermore, nisin A with miconazole (MCZ) or micafungin (MCFG) demonstrated a synergistic or additive effect on those strains. Cell viability assay results showed that nisin A enhanced the fungicidal activity of AMPH against both C. albicans and C. glabrata. Biofilm reduction assays showed that nisin A with AMPH, MCZ, or MCFG inhibited biofilm activity against C. albicans as compared with each antifungal drug alone. Finally, nisin A with AMPH, MCZ, or MCFG resulted in a reduced minimum inhibitory concentration of those antifungal drugs against clinically isolated C. albicans and C. glabrata.Conclusions: When used in combination with nisin A, the antifungal drug dosage can be lowered, thus helping to prevent adverse side effects and the emergence of drug-resistant oral Candida species. Full article

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16 pages, 3242 KiB

Open AccessArticle

Characterization of Fibronectin-Adherent, Non-Fibronectin-Adherent, and Explant-Derived Human Dental Pulp Stem Cell Populations

by Heoijin Kim, Shelley J. Williams and John S. Colombo

Dent. J. 2025, 13(4), 159; https://doi.org/10.3390/dj13040159 - 2 Apr 2025

Viewed by 294

Abstract

Background/Objectives: Dental pulp stem cells (DPSCs) are of significant interest due to their mesenchymal lineage and relative availability from extracted teeth. This study aims to examine the relationship between fibronectin-adherent, non-fibronectin-adherent, and explant-derived DPSC populations in terms of the population doubling rate in [...] Read more.

Background/Objectives: Dental pulp stem cells (DPSCs) are of significant interest due to their mesenchymal lineage and relative availability from extracted teeth. This study aims to examine the relationship between fibronectin-adherent, non-fibronectin-adherent, and explant-derived DPSC populations in terms of the population doubling rate in culture and the expression of mesenchymal cell surface markers and their capacity for osteodifferentiation. Methods: Human pulp tissue was removed from healthy extracted human teeth, enzymatically digested prior to seeding onto fibronectin-coated plates, and left to adhere for 20 min, yielding a fibronectin-adherent population. The remaining non-adherent cells were transferred and designated ‘non-fibronectin-adherent.’ Intact pulp was placed on uncoated plastic for 5 days, with the migrated cells designated ‘explant-derived’. DPSCs from these populations were examined in terms of population doubling rates, the expression of CD90, CD44, CD105, and CD73, and the expression of RUNX2, SPP1, and BGLAP after 7 days in osteoinductive media. Results: The fibronectin-adherent cells had the greatest population doubling over time. All populations demonstrated comparable percentages of cells positive for mesenchymal markers, though individual marker expression varied slightly. The explant-derived cells showed increased expression of RUNX2 after 7 days in osteoinductive media, while the treated single-cell-suspension-derived populations showed increased expression of SPP1 mRNA. Conclusions: Fibronectin enrichment resulted in a population with the greatest rate of population doubling over extended culture compared to the other two populations. The proportion of cells positive for all four mesenchymal surface markers was the same between populations. The fibronectin-adherent and non-adherent cultures may have responded more rapidly to osteoinductive media than the explant-derived cells. Full article

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

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13 pages, 241 KiB

Open AccessArticle

The Prevalence of Oral Anomalies Among Healthy Newborns at a Gynecological Obstetric Hospital in Quito, Ecuador: An Observational, Cross-Sectional Study

by Eleonor Vélez-León, Emilia Guerrero, Mauricio Orlando Carrillo, Marina Cabrera, Gustavo Tello and Patricia Pinos

Dent. J. 2025, 13(4), 158; https://doi.org/10.3390/dj13040158 - 2 Apr 2025

Viewed by 559

Abstract

Objectives: Early observations often fail to detect anomalies that may impact the health and quality of life of newborns. This study aimed to determine the prevalence of oral anomalies in newborns and explore their possible associations with sociodemographic factors. Methods: A cross-sectional study [...] Read more.

Objectives: Early observations often fail to detect anomalies that may impact the health and quality of life of newborns. This study aimed to determine the prevalence of oral anomalies in newborns and explore their possible associations with sociodemographic factors. Methods: A cross-sectional study was conducted in Quito, Ecuador, analyzing a sample of 241 newborns. The presence of oral anomalies was recorded, and their association with sex, birth weight, maternal age, and gestational factors was evaluated. Results: The prevalence of oral anomalies was 72.3%, with Epstein’s pearls being the most common (50%). Other findings included Bohn’s nodules and dental lamina cysts, while no cases of natal teeth or congenital epulis were observed. Ankyloglossia was identified in 1.36% of newborns. No significant correlations were found between the presence of oral anomalies and sex, birth weight, maternal age, or gestational factors. Conclusions: The high prevalence (72.3%) of oral anomalies in the studied newborns underscores the importance of early detection and management. Epstein’s pearls were the most frequent anomaly, followed by Bohn’s nodules, dental lamina cysts, and ankyloglossia, while no cases of natal teeth or congenital epulis were identified. No statistically significant associations were found with sex, birth weight, maternal age, or pregnancy complications. These findings emphasize the need for early pediatric dental assessment and an interdisciplinary approach to ensure proper neonatal oral health. Further research is recommended to explore potential causes and interventions to optimize oral health from birth. Full article

(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)

30 pages, 1344 KiB

Open AccessReview

Bioceramics in Endodontics: Limitations and Future Innovations—A Review

by Peramune Arachchilage Amila Saman Prasad Kumara, Paul Roy Cooper, Peter Cathro, Maree Gould, George Dias and Jithendra Ratnayake

Dent. J. 2025, 13(4), 157; https://doi.org/10.3390/dj13040157 - 1 Apr 2025

Viewed by 741

Abstract

Bioceramic materials for endodontic treatments have gradually transformed over the years into materials with enhanced biocompatibility and chemical and mechanical properties compared to earlier generations. In endodontics procedures, these materials are used as restorative material in applications such as root-end fillings, pulp capping, [...] Read more.

Bioceramic materials for endodontic treatments have gradually transformed over the years into materials with enhanced biocompatibility and chemical and mechanical properties compared to earlier generations. In endodontics procedures, these materials are used as restorative material in applications such as root-end fillings, pulp capping, perforations repair, and apexification repair procedures. However, they have far from ideal mechanical and handling properties, biocompatibility issues, aesthetic concerns due to tooth discolouration, limited antibacterial activity, and affordability, which are amongst several key limitations. Notably, bioceramic materials are popular due to their biocompatibility, sealing ability, and durability, consequently surpassing traditional materials such as gutta-percha and zinc oxide–eugenol sealers. A lack of recent advancements in the field, combined with nanomaterials, has improved the formulations of these materials to overcome these limitations. The existing literature emphasises the benefits of bioceramics while underreporting their poor mechanical properties, handling difficulties, cost, and various other drawbacks. The key gaps identified in the literature are the insufficient coverage of emerging materials, narrow scope, limited insights into future developments, and underreporting of failures and complications of the existing materials. Consequently, this review aims to highlight the key limitations of various endodontic materials, primarily focusing on calcium silicate, calcium phosphate, and bioactive glass-based materials, which are the most abundantly used materials in dentistry. Based on the literature, bioceramic materials in endodontics have significantly improved over recent years, with different combinations of materials and technology compared to earlier generations while preserving many of their original properties, with some having affordable costs. This review also identified key innovations that could shape the future of endodontic materials, highlighting the ongoing evolution and advancements in endodontic treatments. Full article

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

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13 pages, 1190 KiB

Open AccessArticle

Resin Composite Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler for Non-Carious Cervical Lesions: A Double-Blinded, Randomized, Split-Mouth Clinical Trial

by Adam Lowenstein, Carlos Fernando Mourão, Mabi L. Singh, Sarah E. Pagni, Ronald D. Perry and Gerard Kugel

Dent. J. 2025, 13(4), 156; https://doi.org/10.3390/dj13040156 - 1 Apr 2025

Viewed by 222

Abstract

Background/Objectives: This double-blinded study aimed to evaluate the clinical performance of a giomer restorative material in comparison to a nanotechnology-based restorative system for the restoration of non-carious cervical lesions over a period of 48 months. Methods: A 48-month randomized, controlled, split-mouth [...] Read more.

Background/Objectives: This double-blinded study aimed to evaluate the clinical performance of a giomer restorative material in comparison to a nanotechnology-based restorative system for the restoration of non-carious cervical lesions over a period of 48 months. Methods: A 48-month randomized, controlled, split-mouth trial was conducted with 49 subjects at its baseline, which was reduced to 34 subjects at follow-up, yielding a statistical power of 69.55%. Cervical lesions were restored using either BEAUTIFIL II LS (BL) or 3M/ESPE Filtek Supreme Universal Restorative (FS). Clinical assessments were performed by blinded examiners, excluding the one who placed the restorations. Evaluations were based on the Hickel criteria, covering esthetic, functional, and biological properties, with comparisons made using the Wilcoxon signed-rank test. Results: Hickel scores were analyzed with the Mann–Whitney U test to compare BL and FS groups within subjects. Changes in median Hickel scores, sensitivity, and the gingival index were assessed via Friedman’s test, followed by Wilcoxon signed-rank tests with a Bonferroni correction for post-hoc comparisons. The p-values under 0.05 were considered significant, except with the Bonferroni correction. Statistical analysis showed no significant differences between materials across most Hickel parameters (p > 0.05), though BL exhibited a trend of better surface staining (76.5% excellent with BL vs. 76.5% excellent with FS) and adjacent mucosa, while FS showed slight advantages in surface luster and color match. Conclusions: The clinical evaluation of restorations for non-carious cervical lesions using giomer and nanotechnology-based restorative systems revealed no statistically significant differences according to the Hickel criteria, indicating a similar clinical performance for both restorative materials. Full article

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

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18 pages, 3340 KiB

Open AccessArticle

Interfacial Effects Between Dental Impression and Die Materials and Their Role in the Internal Fit of Indirect Resin-Based Composite Restorations

by Murillo Weissheimer, João Carlos S. N. Foly, Fabíola G. Carvalho and Eliseu A. Münchow

Dent. J. 2025, 13(4), 155; https://doi.org/10.3390/dj13040155 - 31 Mar 2025

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Abstract

Background/Objectives: This study tested a method for evaluating the internal fit of indirect resin-based composite (RBC) restorations, as well as the influence of different combinations of impression and die materials on the reproducibility of the topography of teeth prepared for indirect RBC restoration. [...] Read more.

Background/Objectives: This study tested a method for evaluating the internal fit of indirect resin-based composite (RBC) restorations, as well as the influence of different combinations of impression and die materials on the reproducibility of the topography of teeth prepared for indirect RBC restoration. Methods: Bovine incisors received flattened and cavitated areas at the cervical and middle thirds of the buccal surface, respectively. The samples were randomly assigned to two groups according to the material used for impression taking (n = 5): irreversible hydrocolloid and polyvinyl siloxane (PVS). Die replicas were obtained with Type IV gypsum or elastomeric material. RBC restorations were fabricated through an indirect technique (test) and a direct-indirect technique as the control. The internal fit of restorations was assessed by measuring the cementation line thickness with a digital caliper (simulated cementation protocol with ultra-light PVS) and validated using scanning electron microscopy (SEM). Surface topography (Sa, Sq, and Sz) was analyzed via optical profilometry, and wettability was assessed through the water contact angle method. The data were analyzed using t-test, ANOVA, and Pearson correlation tests (α = 5%). Results: The simulated cementation resulted in internal gap values positively correlated to the values from SEM (R² = 0.958; p = 0.0102). The internal gap of restorations was not significantly correlated with the discrepancies between the topography of the die and tooth substrate (p ≥ 0.067). The combination of irreversible hydrocolloid and gypsum resulted in restorations with the lowest cementation line thickness, although in terms of roughness, this combination was the only one that resulted in significant differences from the control (p ≤ 0.028). The internal mean gap values of restorations were significantly correlated to the cumulative wettability difference of materials used during impression taking, fabrication of die replica, and restoration build-up (R² = 0.981; p = 0.003). Conclusions: The reproducibility of topographical characteristics of the tooth in the die replica did not affect the internal adaptation of indirect RBC restorations, whereas surface wettability of materials presented a more relevant effect on the overall gap formation. The simulated cementation technique tested in the study shows potential as a simpler, cost-effective, and non-destructive method for evaluating the adaptation of indirect RBC restorations. Full article

(This article belongs to the Special Issue Dental Materials Design and Innovative Treatment Approach)

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12 pages, 4360 KiB

Open AccessArticle

Histological Analysis of Biological Width and Collagen Fibers Orientation Around Screw-Less, Morse Taper, Hemispherical Base Abutments 8 and 16 Weeks After Implant Uncovering: An Observational Clinical Trial

by Fabrizio Zaccheo, Giulia Petroni, Marco Tallarico, Cherana Gioga, Raffaella Carletti, Cira Rosaria Tiziana Di Gioia, Vincenzo Petrozza, Silvio Mario Meloni, Dario Melodia, Milena Pisano and Andrea Cicconetti

Dent. J. 2025, 13(4), 154; https://doi.org/10.3390/dj13040154 - 31 Mar 2025

Viewed by 357

Abstract

Objectives: This study aimed to histologically evaluate, in humans, the orientation of collagen fibers around screw-less, Morse taper, hemispherical base abutments. Methods: This study was designed as an observational, case–control, clinical trial to evaluate the histological orientation of collagen fibers around implants. Biopsies [...] Read more.

Objectives: This study aimed to histologically evaluate, in humans, the orientation of collagen fibers around screw-less, Morse taper, hemispherical base abutments. Methods: This study was designed as an observational, case–control, clinical trial to evaluate the histological orientation of collagen fibers around implants. Biopsies of the peri-implant tissue were performed 8 (group A, control) or 16 (group B, test) weeks of implant uncovering, and histologically analyzed under optical microscope using Hematoxylin and Eosin, Masson, and Picro Sirius histochemical staining and a scanning electron microscope. Results: Eight patients were enrolled in this study and 16 biopsies were performed. All the biopsies were correctly analyzed. The histological examination of cross-sectional portions of the tissue taken 8 weeks after implant uncovering showed the almost complete absence of epithelial lining, while the connective tissue bundles in the superficial portion showed a lower circular pattern. The histochemical cross-section examination of the tissue taken 16 weeks after implant uncovering showed the partial presence of non-keratinizing epithelial lining at the implant site and the collagen bundles showed a greater organization, with a circumferential course around the abutment. At 8 weeks, the final histological analysis showed an average height of 1.01 mm for the keratinized epithelium, 0.83 mm for the non-keratinized epithelium, and 1.39 mm for the connective tissue. While, at 16 weeks, the values were 1.20 mm, 0.48 mm, and 1.11 mm, respectively. No statistically significant differences were found between the groups (p > 0.05). Conclusions: Histologically, there were not any differences in the height and profile of the gingiva between 8 and 16 weeks of healing after prosthesis delivery. Greater organization of the collagen fibers with a circumferential course around the abutment was found in the test group (16 weeks) compared with the control group (8 weeks). Full article

(This article belongs to the Special Issue Oral Implantology and Bone Regeneration)

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18 pages, 14500 KiB

Open AccessArticle

Bone-Regenerating Capacity of Chitosan Membrane and Chitosan Foam Scaffolds in Critical Size Defects: In Vitro and In Vivo Study

by Iman A. Fathy, Dina M. Ali, Youssef Elmansy, Nour E. A. Abd El-Sattar and Sherif Elsayed

Dent. J. 2025, 13(4), 153; https://doi.org/10.3390/dj13040153 - 31 Mar 2025

Viewed by 259

Abstract

Objectives: The objective of this study is to compare the bone-regenerating capacity between chitosan foam and chitosan membrane scaffolds. Methods: A medium-weight chitosan acidic mixture was used to prepare two scaffolds of freeze-dried chitosan foam (CF). One of the two CF [...] Read more.

Objectives: The objective of this study is to compare the bone-regenerating capacity between chitosan foam and chitosan membrane scaffolds. Methods: A medium-weight chitosan acidic mixture was used to prepare two scaffolds of freeze-dried chitosan foam (CF). One of the two CF scaffolds was physically crosslinked by NaHCO₃ to obtain chitosan membrane (CM). A morphological assessment of the specimens’ porosity was carried out by scanning electron microscopy (SEM). An MTT assay of the CM and CF specimens using rats’ bone marrow mesenchymal stem cells (MSCs) was carried out. Then, 38 albino rats were subjected to surgical implantation in a critical-size defect of the femur bone. The rats were divided into three groups according to the type of implanted scaffold (Control (no scaffold) n = 10, CM (chitosan membrane) n = 14, CF (chitosan foam) n = 14). Each group was equally subdivided into two subgroups according to the time of euthanasia (21 d, 35 d). The femur bones were dissected for a histological analysis (hematoxylin and eosin, and Masson trichrome). The results of the histological analysis were graded according to a scoring system. A statistical analysis of the pore size and histological grading was carried out. Results: CF had a higher mean pore size (65.42 µm) compared to CM (6.44 µm); CM showed a significantly higher proliferation of MSCs at 72 h. Both the CM and CF groups showed a significantly higher bone regeneration and lower inflammation than the control group. The CF group showed a significantly higher bone regeneration score than the CM group, especially at 35 d with more dense compact lamellar bone structure. Conclusions: The higher mean pore size of CF allowed for a higher bone regenerating capacity than the crosslinked CM. Full article

(This article belongs to the Section Dental Materials)

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11 pages, 12290 KiB

Open AccessProtocol

Incorporation of Greater Palatal Artery Pathway Projection into a Static Surgical Guide

by Alexandru E. Petre, Andrei Macris, Cezar Ionita, Gabriel Cojocariu and Sergiu Drafta

Dent. J. 2025, 13(4), 152; https://doi.org/10.3390/dj13040152 - 30 Mar 2025

Viewed by 192

Abstract

Background/Objectives: The purpose of this study was to develop a digital workflow to incorporate the mucosal projection of the pathways of the greater palatal artery into a static surgical guide used for free gingival graft harvesting and connective-tissue grafting techniques. Methods: A cone-beam [...] Read more.

Background/Objectives: The purpose of this study was to develop a digital workflow to incorporate the mucosal projection of the pathways of the greater palatal artery into a static surgical guide used for free gingival graft harvesting and connective-tissue grafting techniques. Methods: A cone-beam computed tomography file was uploaded and segmented using specific tools from digital design software. The artery pathways were identified and marked on cone-beam computed tomography. A standard tessellation file format was obtained and uploaded into three-dimensional mesh-processing software; this was merged into an intraoral scan file. New files were obtained and uploaded into three-dimensional modeling software. The final model with projections of the artery pathways was generated using specific tools. The digital model was uploaded into guided surgery planning software to design a digital surgical guide that could later be printed with the artery pathways marked on its surface. Results: The static surgical guide to the palatal mucosa could be used during a surgical approach for marking the safe-zone area against the artery pathways. Conclusions: The proposed technique is a viable method for visualization and marking the artery pathway projection on a static surgical guide when performing free gingival graft harvesting and connective-tissue grafting techniques. Full article

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8 pages, 1115 KiB

Open AccessArticle

Evaluation of the Ideal Horizontal X-Ray Beam Angulation to Accurately Identify Two Separate Canals in Maxillary First Premolars—A Retrospective Clinical Study Using Cone-Beam Computed Tomography in an Austrian Subpopulation

by Benedikt Schneider, Luisa Klinkhamels, Wilhelm Frank, Constantin von See and Jörg Philipp Tchorz

Dent. J. 2025, 13(4), 151; https://doi.org/10.3390/dj13040151 - 30 Mar 2025

Viewed by 272

Abstract

Background/Objectives: Intraoral (IO) radiographs are critical for endodontic diagnostics, yet conventional orthoradial imaging often results in superimposition, limiting the visibility of individual root canals. Maxillary first premolars pose challenges due to their anatomical characteristics and positioning within the dental arch. This study aimed [...] Read more.

Background/Objectives: Intraoral (IO) radiographs are critical for endodontic diagnostics, yet conventional orthoradial imaging often results in superimposition, limiting the visibility of individual root canals. Maxillary first premolars pose challenges due to their anatomical characteristics and positioning within the dental arch. This study aimed to retrospectively analyze cone-beam computed tomography (CBCT) data to determine the horizontal X-ray beam angulations for maxillary first premolars at which root canals overlap and neighboring tooth superimposition occur, providing clinically relevant guidance for optimizing IO radiographic techniques. Methods: CBCT scans from 85 patients were analyzed using ImageJ software to measure the angles at which maxillary first premolar root canals overlap or become obscured by adjacent teeth. The mean angles for canal overlap and neighboring tooth superimposition were determined. Statistical analysis was performed using SPSS Version 29.0, and the level of significance was set to 5%. Results: The mean angle for root canal overlap was 93.56° (±10.08). The angles at which neighboring teeth began to superimpose were 124.38° (±9.91) for the distal contour of the canine and 63.46° (±9.38) for the mesial root contour of the second premolar. No significant differences were observed between apical and coronal measurements for root canal overlap but tapering of the roots led to significant differences in neighboring tooth superimposition (p < 0.05). Conclusions: A mesial beam shift within a calculated safe corridor (98.5–129.5°) optimizes canal separation without superimposition from adjacent teeth. For ideal visualization, a mesial angulation close to 40° is recommended. These findings support improved IO radiographic techniques while minimizing the risk of retakes in adherence to the ALARA principle. Full article

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19 pages, 5421 KiB

Open AccessArticle

Accuracy of Three-Dimensional Computer-Aided Implant Surgical Guides: A Prospective In Vivo Study of the Impact of Template Design

by Noel Vartan, Lotta Gath, Manuel Olmos, Konstantin Plewe, Christoph Vogl, Marco Rainer Kesting, Manfred Wichmann, Ragai Edward Matta and Mayte Buchbender

Dent. J. 2025, 13(4), 150; https://doi.org/10.3390/dj13040150 - 29 Mar 2025

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Abstract

Background: Digital planning and the use of a static surgical guide for implant placement provide predictability and safety for patients and practitioners. The aim of this study was to investigate differences in the accuracy and fit of long and short guides. Methods [...] Read more.

Background: Digital planning and the use of a static surgical guide for implant placement provide predictability and safety for patients and practitioners. The aim of this study was to investigate differences in the accuracy and fit of long and short guides. Methods: In patients with at least one missing tooth, long (supported by the entire dental arch) and short templates (supported by two teeth, mesial and distal) were compared via intraoral scans and the superimposition of the STL files of the initial planning and the actual position in the patient’s mouth along the X-, Y- and Z-axes. Furthermore, this study evaluated the conditions (e.g., mouth opening, the implant position) under which fully guided implantation can be realized. Results: The largest deviation was observed in the Z-axis, although this deviation was not as high for the short templates (0.2275 mm) as it was for the long templates (0.4007 mm). With respect to the 3D deviation (dXYZ), the average deviation from the mean value was 0.2953 mm for the short guides and 0.4360 mm for the long guides (p = 0.002). The effect size (Cohen’s d) was 0.709, which was between the medium (0.50) and large effect sizes (0.80). The shorter templates showed a smaller deviation from the actual plan by 80%. With a mouth opening ≥50 mm, fully guided surgery can be performed in the molar region. In the premolar region, the lower limit was 32 mm. Conclusions: The 3D accuracy was significantly higher for the shorter template, which could therefore be favored. Full article

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

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Dent. J., Volume 13, Issue 4 (April 2025) – 43 articles

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