Dentistry Journal

14 pages, 371 KiB

Open AccessArticle

Validity and Reliability of the Dental Neglect Scale in German

by Katharina Marilena Weil, Theresa Marie Weßlau, Laura Agnes Ingrid Magerfleisch, Hannah Tröger, Lisa Irmscher, David Bantel, Clara Theres Meyer-Probst, Katja Petrowski and Hendrik Berth

Dent. J. 2025, 13(5), 225; https://doi.org/10.3390/dj13050225 - 21 May 2025

Viewed by 341

Abstract

Background/Objectives: The Dental Neglect Scale (DNS) is known and used to evaluate and assess adult behaviors and attitudes related to oral self-care and oral-health. In English-speaking countries, the DNS has been used in many studies. At the moment, there is no validated version [...] Read more.

Background/Objectives: The Dental Neglect Scale (DNS) is known and used to evaluate and assess adult behaviors and attitudes related to oral self-care and oral-health. In English-speaking countries, the DNS has been used in many studies. At the moment, there is no validated version of the DNS that is available in the German language. The aim of this study is to validate a German version of the DNS to evaluate and assess the oral health and behavior among the German population. Methods: The study population consisted of N = 311 German adults (180 female, 130 male, 1 diverse) aged from 18 to 90 years from a dental clinic in Germany. The participants answered a questionnaire. In addition to questions on their socio-demographic background and the DNS, the survey included more standardized instruments relating to preventive behavior, dental anxiety, and oral health. Results: The DNS was translated into German. An explanatory factor analysis was conducted, which supported the unifactorial structure of the scale. The following results were obtained for the reliability of the resulting DNS: Cronbach’s Alpha = 0.710, McDonald’s Omega = 0.711, and Mean = 25.63 (SD = 4.02, Range 12–30). Convergent and divergent validity were demonstrated through associations between the DNS and various oral health scales, and by differences between genders and age groups. Conclusions: This study confirms the quality of the criteria of the DNS for German adults. The DNS is a convincing instrument that is used for epidemiological studies in the field of dentistry and psychology. Further validation with other samples should be conducted. Full article

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

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14 pages, 486 KiB

Open AccessArticle

Fluoride Release from Pediatric Dental Restorative Materials: A Laboratory Investigation

by Angelo Aliberti, Roberta Gasparro, Maria Triassi, Mirko Piscopo, Pietro Ausiello and João Paulo Mendes Tribst

Dent. J. 2025, 13(5), 224; https://doi.org/10.3390/dj13050224 - 21 May 2025

Viewed by 385

Abstract

Objectives: Dental caries remains a prevalent issue in pediatric dentistry, necessitating restorative materials that not only repair decay but also provide protective benefits. Fluoride-releasing restorative materials have a key function in preventing recurrent caries by inhibiting bacterial activity and promoting remineralization. The objective [...] Read more.

Objectives: Dental caries remains a prevalent issue in pediatric dentistry, necessitating restorative materials that not only repair decay but also provide protective benefits. Fluoride-releasing restorative materials have a key function in preventing recurrent caries by inhibiting bacterial activity and promoting remineralization. The objective of this study was to examine fluoride release from three pediatric dental restorative materials—Riva Light Cure HV, Fuji IX GP Fast, and the Cention Forte Filling Material—under different pH and temperature conditions. Methods: Specimens (10 mm diameter and 2 mm thickness; n = 3 for each material) were prepared according to the manufacturers’ instructions; immersed in buffer solutions at pH 4.8, 6.8, and 8.8; and stored at 37 °C and 44 °C. Fluoride release was quantified using ion chromatography at three time points (1 day, 7 days, and 28 days). Results: The data revealed that fluoride release was significantly influenced by pH, temperature, and time (p < 0.05). Riva Light Cure HV exhibited the highest release, particularly in acidic conditions (pH 4.8), reaching 40.14 mg/L at 44 °C after 28 days. The Cention Forte Filling Material and Fuji IX GP Fast also showed increased release over time, but with lower cumulative concentrations. Higher temperatures generally enhanced fluoride diffusion across all materials. Conclusions: These findings emphasize the pivotal impact of environmental factors in fluoride release dynamics. Riva Light Cure HV demonstrated superior fluoride release, particularly in acidic environments, suggesting its potential for high-caries-risk pediatric patients. These insights can inform the selection of restorative materials in pediatric dentistry, optimizing caries prevention strategies. Full article

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

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14 pages, 6740 KiB

Open AccessArticle

Er:YAG Laser in QSP Modality for Treatment of Indirect Adhesive Restoration Build-Up: Surface Roughness Analysis and Morphology Assessment by Environmental Scanning Electron Microscopy (ESEM)

by Ilaria Giovannacci, Monica Mattarozzi, Fabrizio Moroni, Giuseppe Pedrazzi, Paolo Vescovi and Maria Careri

Dent. J. 2025, 13(5), 223; https://doi.org/10.3390/dj13050223 - 21 May 2025

Viewed by 280

Abstract

Background/Objectives: Sandblasting build-ups before applying the acid and adhesive significantly improves the bond strength. The aim of this study is to evaluate, for the first time, the effectiveness of an Er:YAG laser used in QSP mode to treat the surface of build-ups before [...] Read more.

Background/Objectives: Sandblasting build-ups before applying the acid and adhesive significantly improves the bond strength. The aim of this study is to evaluate, for the first time, the effectiveness of an Er:YAG laser used in QSP mode to treat the surface of build-ups before the adhesive cementation sequence. Methods: This ex vivo study was conducted on 12 intact, undecayed extracted teeth kept hydrated in NaCl 0.9% solution. A cavity was created in the center and reconstructed with composite resin (build-up). Then, samples were prepared with burs and divided into three groups: control group G1, prepared only with burs; group G2, in which surfaces were treated with a sandblaster (2.5 bar, 10 mm from composite surface, aluminum oxide, 10 s); and group G3, treated using an Er:YAG laser (QSP modality, 1 W, 10 Hz, 100 mJ). The surface roughness of the build-ups was measured using a CCI MP-L digital optical profiler (Taylor Hobson, Leicester, UK), and surface morphology was studied using the Quanta™ 250 FEG (FEI, Hillsboro, OR, USA) ESEM instrument. Results: Regarding enamel, mean surface roughness in G1 vs. G2 was not statistically significant (p = 0.968); meanwhile, differences between the Er:YAG laser group (G3) and G1 or G2 were significant (G3 vs. G1 p < 0.001; G3 vs. G2 p < 0.001). Regarding dentin, G1 vs. G2 was significant (p = 0.021); differences between G3 and G1 or G2 were extremely significant (G3 vs. G1 p < 0.001; G3 vs. G2 p < 0.001). The same trend was detected for resin. Conclusions: An Er:YAG laser in QSP mode used on the build-up surface for indirect adhesive restorations is innovative and should be investigated with further studies. However, it seems extremely effective with increased roughness, the absence of a smear layer and characteristics potentially favorable for good adhesion for all substrates (enamel, dentin, resin). Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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49 pages, 1032 KiB

Open AccessReview

Balancing the Oral Redox State: Endogenous and Exogenous Sources of Reactive Oxygen Species and the Antioxidant Role of Lamiaceae and Asteraceae

by Caterina Nela Dumitru, Lupoae Mariana, Cristian Constantin Budacu, Gabriela Mitea, Marius Daniel Radu, Alina Oana Dumitru, Andreea Lupoae, Alin Tatu and Gabi Topor

Dent. J. 2025, 13(5), 222; https://doi.org/10.3390/dj13050222 - 21 May 2025

Viewed by 751

Abstract

Background/Objectives: Oral health is a complex concept involving physical, psychological, emotional, and social components. A key factor in maintaining oral tissue integrity is redox balance, which is disrupted by oxidative stress (OS) through an imbalance between reactive oxygen species (ROS) and antioxidant defenses. [...] Read more.

Background/Objectives: Oral health is a complex concept involving physical, psychological, emotional, and social components. A key factor in maintaining oral tissue integrity is redox balance, which is disrupted by oxidative stress (OS) through an imbalance between reactive oxygen species (ROS) and antioxidant defenses. This study examines the contribution of endogenous and exogenous sources to OS and explores the therapeutic potential of medicinal plants from the Asteraceae and Lamiaceae families in restoring redox homeostasis and improving oral health. Methods: A literature review was conducted, analyzing the role of OS in oral diseases and the antioxidant mechanisms of selected Asteraceae species. Special attention was given to their phytochemical contents—polyphenols, flavonoids, and essential oils—and their biological relevance to oral health. Results: OS plays a critical role in the onset and progression of oral conditions such as caries, periodontitis, gingivitis, aphthous ulcers, abscesses, precancerous lesions, and oral cancers. ROS and reactive nitrogen species (RNS) cause inflammation, tissue breakdown, and salivary gland dysfunction. Asteraceae plants like Matricaria chamomilla, Calendula officinalis, Cichorium intybus, Taraxacum officinale, Arctium lappa, Achillea millefolium, and Solidago virgaurea demonstrate notable antioxidant, anti-inflammatory, and antimicrobial properties that help counteract OS and support oral homeostasis. Conclusions: Asteraceae and Lamiaceae species show high therapeutic potential in addressing OS-related oral disorders. Their bioactive compounds aid in restoring redox balance and protecting oral tissues. These findings support the integration of phytotherapeutic agents into oral healthcare and call for further clinical validation of plant-based strategies for disease prevention and management. Full article

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

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15 pages, 2268 KiB

Open AccessArticle

Effectiveness of Continuous and Sequential Chelation and Different Agitation Techniques on Smear Layer Removal and Microhardness of Root Canal Dentin (An In Vitro Study)

by Asmaa Aamir Kamil, Ahmed Hamid Ali, Federico Foschi and Francesco Mannocci

Dent. J. 2025, 13(5), 221; https://doi.org/10.3390/dj13050221 - 20 May 2025

Viewed by 328

Abstract

Background/Objectives: This study aimed to assess and compare the elimination of the smear layer and microhardness of dentin in root canals after sequential versus continuous chelation using different agitation techniques. Methods: Sixty-four palatal roots of upper first molars were instrumented to [...] Read more.

Background/Objectives: This study aimed to assess and compare the elimination of the smear layer and microhardness of dentin in root canals after sequential versus continuous chelation using different agitation techniques. Methods: Sixty-four palatal roots of upper first molars were instrumented to size X3 (Protaper Next files). According to the irrigant solution, samples were assigned to two groups (N = 32/group), 3% NaOCl irrigation followed by 17% EDTA (sequential chelation (SC)), or dual-rinse (3% NaOCl/9% HEDP) irrigation (continuous chelation (CC)). Each group has been divided into four subgroups (n = 8/subgroup), based on agitation techniques used: conventional needle (CN) (control group), EndoActivator (EA), ultrasonic agitation (UAI), and Er.Cr.YSGG 2780 nm (laser). SEM images assessed the smear layer, and Vicker microhardness (VHN) was performed at 50 and 100 µm depths. Data were analyzed using: Kruskal–Wallis, Wilcoxon, and the Mann–Whitney U test. Statistical significance was set at p < 0.05. Results: In the UAI and laser agitation, CC significantly reduced the smear layer presence compared to SC in the apical and coronal thirds, respectively (p < 0.05), and no significant differences were observed in the CN and EA groups between SC and CC (p > 0.05). There were significantly higher VHNs of dentine in CC groups than in SC groups in all sections and depths, except in the apical of the CN group at 50 µm and the coronal section of EA and UAI groups at 100 µm. Conclusions: CC was comparable to SC in smear layer removal. CC had a less detrimental effect on dentin compared with SC. Full article

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13 pages, 4448 KiB

Open AccessArticle

Color Stability, Surface Gloss, Surface Roughness, and Wettability of Material Jetting 3D-Printed Denture Material Under Various Surface Treatments

by Toshiki Nagai, Amal Alfaraj and Wei-Shao Lin

Dent. J. 2025, 13(5), 220; https://doi.org/10.3390/dj13050220 - 20 May 2025

Viewed by 522

Abstract

Objectives: To examine the effects of surface treatments on the color stability, surface roughness, surface gloss, and wettability of monolithic polychromatic material jetting (MJT) 3D-printed denture material. Material and Methods: Twenty-one color variants of the same denture material (TrueDent; Stratasys, Eden, MN, USA) [...] Read more.

Objectives: To examine the effects of surface treatments on the color stability, surface roughness, surface gloss, and wettability of monolithic polychromatic material jetting (MJT) 3D-printed denture material. Material and Methods: Twenty-one color variants of the same denture material (TrueDent; Stratasys, Eden, MN, USA) underwent two surface treatments (polishing only or polishing and glazing), creating 42 study groups with a total of 420 samples (n = 10 per group). The samples were manufactured using a PolyJet 3D printer (J5 DentaJet; Stratasys, Eden, MN, USA), a type of MJT 3D printer. Color measurements were taken with a digital spectrophotometer before and after the surface treatments, and quantitative color differences (ΔE₀₀ and ΔC*) were calculated using the CIE2000 system. Comparisons of ΔE₀₀ were made against the 50%:50% acceptability threshold (AT) of 1.8 and the 50%:50% perceptibility threshold (PT) of 0.8 for tooth shade, as well as the 50%:50% PT of 1.72 and the 50%:50% AT of 4.08 for gingival (pink) shade. After surface treatment, the gloss was measured using a glossmeter, surface roughness was measured with optical profilometry, and wettability was measured by contact angle measurements using an optical tensiometer. The significance of surface treatment on color changes for each color variant was evaluated using one-sided, one-sample t-tests against the AT and PT. The effects of surface treatment on surface gloss, surface roughness, contact angle, and ΔC* were analyzed using t-tests for each color variant. Pairwise comparisons between groups were made using Fisher’s Protected Least Significant Differences (α = 0.05). Results: In most cases, glazing caused the color change (ΔE₀₀) to exceed the AT and PT, with a few exceptions. Most materials exhibited a more vibrant (more saturated) appearance and statistically higher chroma, with glazed surface treatments compared to polished ones, though there were some exceptions. For all materials, the glazed samples had significantly higher gloss units than the polished ones (p < 0.0001). Additionally, all materials showed significantly higher surface roughness in glazed samples compared to polished ones (p < 0.0001 for most). The polished samples had significantly higher contact angles (p < 0.0001 for most). Conclusions: Surface treatments significantly influenced the color, surface gloss, surface roughness, and wettability of MJT 3D-printed denture materials. Glazing led to increased chroma and gloss and produced more hydrophilic surfaces, although it also increased surface roughness. These results highlight the importance of surface treatment selection in optimizing the clinical performance of MJT-fabricated dentures. Full article

(This article belongs to the Special Issue 3D Printing and Restorative Dentistry)

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19 pages, 1824 KiB

Open AccessSystematic Review

Considerations for Conservative, All-Ceramic Prosthodontic Single-Tooth Replacements in the Anterior Region: A Systematic Review

by Dubravka Knezović Zlatarić and Mirko Soldo

Dent. J. 2025, 13(5), 219; https://doi.org/10.3390/dj13050219 - 19 May 2025

Viewed by 328

Abstract

Background/Objectives: Conservative options for single-tooth replacements in the anterior region include all-ceramic one-retainer resin-bonded fixed dental prostheses (RBFDPs) and three-unit fixed partial dentures (FPDs). Methods: This systematic review assessed their clinical outcomes. Following the PRISMA 2020 guidelines, an electronic search of MEDLINE/PubMed was [...] Read more.

Background/Objectives: Conservative options for single-tooth replacements in the anterior region include all-ceramic one-retainer resin-bonded fixed dental prostheses (RBFDPs) and three-unit fixed partial dentures (FPDs). Methods: This systematic review assessed their clinical outcomes. Following the PRISMA 2020 guidelines, an electronic search of MEDLINE/PubMed was conducted from November 1991 to March 2025 for randomized clinical trials (RCTs), prospective cohort studies (PCSs), and retrospective cohort studies (RCSs). Keywords included dental prosthesis, fixed prosthesis, resin-bonded prosthesis, single-tooth replacement, anterior teeth, all-ceramic, lithium disilicate, monolithic, zirconia, survival rate, and success rate. Failures and complications were analyzed to determine long-term outcomes. Results: The search identified 990 articles, and the full-text review of 54 articles was performed, resulting in 23 studies meeting the inclusion criteria. This review revealed that one-retainer RBFDPs and three-unit FPDs in the anterior region demonstrated high survival and success rates. However, debonding was a common complication in RBFDPs, while framework design issues were noted in FPDs. Conclusions: These outcomes highlight the reliability of both approaches as conservative, all-ceramic, prosthodontic interventions for anterior single-tooth replacements. The consideration of one-retainer RBFDPs and three-unit FPDs is advisable due to their favorable clinical performance and minimal invasiveness. Full article

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

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14 pages, 3046 KiB

Open AccessArticle

Lingual Foramina Anatomy: An Observational Study in Dry Mandibles

by Charalambos Tsatsarelis, Zoi Maria Thomaidi and Vasileios Papadopoulos

Dent. J. 2025, 13(5), 218; https://doi.org/10.3390/dj13050218 - 19 May 2025

Viewed by 254

Abstract

Background/Objectives: The lingual foramina of the mandible serve as passageways for arterial branches that are susceptible to injury during surgical procedures, potentially leading to varying degrees of hemorrhage. The objective of the present study was to contribute to the quantification and classification [...] Read more.

Background/Objectives: The lingual foramina of the mandible serve as passageways for arterial branches that are susceptible to injury during surgical procedures, potentially leading to varying degrees of hemorrhage. The objective of the present study was to contribute to the quantification and classification of lingual foramina using cadaveric dry mandibles in relation to surgical safety and, especially, to the risk of perioperative bleeding. Methods: This study examined the number, diameter, and spatial relationship of lingual foramina to the genial tubercle, alveolar process, and alveolar crest in dry mandibles. Stainless steel wire threads and Digimatic caliper measurements were utilized. Cluster analysis was employed for the classification of foramina into distinct spatial groups. One-way analysis of variance (ANOVA) was used to compare mean values among ≥3 groups. Results: A total of 100 dry mandibles were initially analyzed for the presence of lingual foramina with a diameter of ≥2 mm. In 96 of them (50 dentate and 46 edentulous), 387 lingual foramina (mean: 4.03 per mandible) were recognized; the remaining 4 had smaller lingual foramina (diameter <2 mm). Only 4 mandibles (4.2%) exhibited a single lingual foramen, whereas the remaining 92 (95.8%) displayed multiple foramina (up to nine). The observed lingual foramina had a diameter of 0.44 ± 0.02 mm and were located at distances of 8.74 ± 0.54 mm from the genial tubercle, 14.19 ± 0.87 mm from the alveolar crest, and 14.53 ± 0.84 mm from the inferior border of the mandible. Based on their relationship to the genial tubercle, the foramina were classified into four distinct groups: (i) right (27/387—7%), (ii) proximal (254/387—66%), (iii) superior (81/387—21%), and (iv) left (25/387—6%). The superior group exhibited the largest mean diameter (0.52 ± 0.22 mm, ANOVA p < 0.001). The probability of detecting a lingual foramen was minimized at a distance of 13.00 ± 0.50 mm from the genial tubercle, delineating a relatively safe zone with a lower risk of hemorrhage. Conclusions: This study provides anatomical insights that contribute to appropriate preoperative planning and the minimization of complications during surgical interventions on the mandible. Full article

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11 pages, 1842 KiB

Open AccessCase Report

Extremely Extensive Vascular Malformation Requires Special Preparation for Simple Dental Surgical Procedures—Case Report

by Natalia Muczkowska, Klaudia Masłowska and Agnieszka Adamska

Dent. J. 2025, 13(5), 217; https://doi.org/10.3390/dj13050217 - 19 May 2025

Viewed by 331

Abstract

Background/Objectives: Vascular anomalies represent a complex group of conditions including vascular malformations and haemangiomas. Haemangiomas are benign tumours that have an endothelial origin. In contrast, vascular malformations are characterized by the abnormal dilation of vessels without proliferation. Depending on the extension of the [...] Read more.

Background/Objectives: Vascular anomalies represent a complex group of conditions including vascular malformations and haemangiomas. Haemangiomas are benign tumours that have an endothelial origin. In contrast, vascular malformations are characterized by the abnormal dilation of vessels without proliferation. Depending on the extension of the disease, there is a higher risk of life-threatening haemorrhages that may occur during simple dental procedures. The aim of this case report is to present the interdisciplinary treatment for patients with venous malformation and to discuss the possible dental management of these patients. Methods: A 66-year-old male patient with an extensive venous malformation of the head and neck was referred for a tooth extraction. The venous malformation involved lips, buccal mucosa, tongue, and floor of the oral cavity. Its proximity to the tooth requiring extraction was associated with a high risk of severe bleeding. Results: Prior to the treatment, CBCT and CT scans were performed to confirm the extensions of the lesion and visualise its margins. Considering the possible risks related with venous malformation, the procedure consisted of tooth removal in a hospital setting with control over severe bleeding complications. Conclusions: The presence of an extensive vascular malformation in the head and neck region is burdened with a higher risk of haemorrhages during simple dental procedures. The radiological and clinical planning enables the choice of an accurate treatment strategy to avoid possible difficulties. In cases where such complications cannot be avoided, it is important to perform the treatment in a hospital setting with the cooperation of maxillofacial surgeons. Full article

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10 pages, 1493 KiB

Open AccessArticle

Effectiveness of Activated Charcoal Toothpaste vs. 6% Hydrogen Peroxide Whitening Pen—An In Vitro Study

by Elena Bardellini, Silvia Marchetti, Alessandra Bordanzi, Simone Zanini, Alessandra Majorana and Giulio Conti

Dent. J. 2025, 13(5), 216; https://doi.org/10.3390/dj13050216 - 19 May 2025

Viewed by 866

Abstract

Background: Tooth whitening is a widely sought-after cosmetic procedure, with various at-home and professional treatments available. This study compares the whitening efficacy of an activated charcoal toothpaste and a 6% hydrogen peroxide whitening pen under controlled in vitro conditions. Methods: Twenty freshly extracted [...] Read more.

Background: Tooth whitening is a widely sought-after cosmetic procedure, with various at-home and professional treatments available. This study compares the whitening efficacy of an activated charcoal toothpaste and a 6% hydrogen peroxide whitening pen under controlled in vitro conditions. Methods: Twenty freshly extracted human teeth were stained with a coffee solution and divided into two groups. Group A underwent daily applications of activated charcoal toothpaste for 30 days, while Group B received a single 5 min application of a 6% hydrogen peroxide whitening pen. Tooth color was assessed using the VITA Classical A1-D4 Shade Guide at baseline, mid-treatment, and post-treatment for Group A and at baseline and immediately after treatment for Group B. Results: The activated charcoal toothpaste exhibited a gradual whitening effect, with the most significant improvements occurring within the first two weeks (p < 0.01), after which the whitening effect plateaued. In contrast, the hydrogen peroxide whitening pen produced immediate and substantial whitening (p < 0.001). Statistical analysis using the Wilcoxon signed-rank test and Mann–Whitney U test confirmed the superior efficacy of the hydrogen peroxide treatment. Conclusions: The hydrogen peroxide whitening pen was significantly more effective in achieving rapid and substantial whitening compared to the activated charcoal toothpaste, which provided gradual but limited improvements. Further clinical studies are needed to evaluate the long-term color stability. Full article

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

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31 pages, 1069 KiB

Open AccessReview

Mapping Review of the Correlations Between Periodontitis, Dental Caries, and Endocarditis

by Mario Dioguardi, Ciro Guerra, Pietro Laterza, Gaetano Illuzzi, Diego Sovereto, Enrica Laneve, Angelo Martella, Lorenzo Lo Muzio and Andrea Ballini

Dent. J. 2025, 13(5), 215; https://doi.org/10.3390/dj13050215 - 16 May 2025

Viewed by 584

Abstract

Background/Objectives: The correlation between cardiovascular diseases, particularly infective endocarditis, and oral disorders such as periodontitis and dental caries has been widely discussed in the scientific literature. In this mapping review, we aim to examine the available evidence on the link between these conditions, [...] Read more.

Background/Objectives: The correlation between cardiovascular diseases, particularly infective endocarditis, and oral disorders such as periodontitis and dental caries has been widely discussed in the scientific literature. In this mapping review, we aim to examine the available evidence on the link between these conditions, focusing on the pathogenetic mechanisms that underlie the development of endocarditis in patients with oral diseases. Methods: A systematic search was conducted across three major databases—PubMed, Scopus, and ScienceDirect—as well as grey literature in Google Scholar. Relevant articles were selected based on inclusion and exclusion criteria, focusing primarily on systematic reviews. The data extracted included study characteristics, main outcomes, and risk-of-bias evaluations. Results: A total of 13 systematic reviews were included in this mapping review. The findings suggest there is a significant connection between periodontal disease, dental caries, and the incidence of infective endocarditis. The evidence highlights that oral bacteria, particularly Streptococcus species, can enter the bloodstream during daily activities and invasive dental procedures, contributing to the development of endocarditis in susceptible individuals. However, the role of antibiotic prophylaxis in preventing endocarditis following dental procedures remains controversial. Conclusions: This review reinforces the importance of oral health in preventing cardiovascular complications, especially infective endocarditis. Although antibiotic prophylaxis may reduce the risk in high-risk individuals, further research is needed to clarify its effectiveness. Enhanced awareness of and education on the shared risks between oral and cardiovascular health could improve prevention strategies and patient outcomes. Full article

(This article belongs to the Section Preventive Dentistry)

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16 pages, 2136 KiB

Open AccessSystematic Review

Periodontal Pathogens Correlate with Rheumatoid Arthritis Disease Parameters: A Systematic Review Based on Clinical Studies

by Luki Astuti, Sri Lelyati Chaidar Masulili, Indrayadi Gunardi, Benso Sulijaya and Yuniarti Soeroso

Dent. J. 2025, 13(5), 214; https://doi.org/10.3390/dj13050214 - 15 May 2025

Viewed by 533

Abstract

Background: Numerous studies have found higher levels of autoantibodies including anti citrullinated protein antibodies (ACPAs), anti-cyclic citrullinated peptides (aCCP), or rheumatoid factor (RF) against periodontal microorganisms in rheumatoid arthritis (RA). Objective: To evaluate the correlation between periodontal bacteria and RA disease parameters. [...] Read more.

Background: Numerous studies have found higher levels of autoantibodies including anti citrullinated protein antibodies (ACPAs), anti-cyclic citrullinated peptides (aCCP), or rheumatoid factor (RF) against periodontal microorganisms in rheumatoid arthritis (RA). Objective: To evaluate the correlation between periodontal bacteria and RA disease parameters. Methods: We utilized PubMed, Scopus, ScienceDirect, and manual search databases up until March 2024 using PRISMA 2020 guidelines. The data were obtained from microbiological assays by RT-PCR/qPCR, sequencing, and serological testing of disease parameters (ACPA, aCCP, and RF) utilizing ELISA method. Results: A total of 1514 documents were discovered based on the inclusion criteria. Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella_9 were associated with elevated levels of ACPA/aCCP and RF in RA with periodontitis. A positive correlation was found between Peptococcus simiae, Aminipila butyrica, Leptotrichia spp., Leptotrichia wadei, and Neisseria bacilliformis with ACPA, and Treponema sp. canine oral taxon 087 with RF. Conclusions: This study found that several oral microorganisms correlate with elevated ACPA/aCCP and RF in RA with periodontitis. Future studies of the oral microbiome and the molecular mechanisms are anticipated to discover new therapies and diagnostic methods for periodontitis and RA. Full article

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

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18 pages, 1968 KiB

Open AccessSystematic Review

Immediate Loading of Implants-Supported Fixed Partial Prostheses in Posterior Regions: A Systematic Review

by Giuseppe D’Albis, Marta Forte, Abdulrahman Omar Alrashadah, Lorenzo Marini, Massimo Corsalini, Andrea Pilloni and Saverio Capodiferro

Dent. J. 2025, 13(5), 213; https://doi.org/10.3390/dj13050213 - 15 May 2025

Viewed by 679

Abstract

Background: Modern dentistry strives to achieve increasingly less invasive procedures as the ultimate therapeutic goal. The careful selection of suitable candidates for immediate dental implants can offer an opportunity to reduce treatment time, lower the relative costs and improve overall patient satisfaction. [...] Read more.

Background: Modern dentistry strives to achieve increasingly less invasive procedures as the ultimate therapeutic goal. The careful selection of suitable candidates for immediate dental implants can offer an opportunity to reduce treatment time, lower the relative costs and improve overall patient satisfaction. Methods: A systematic search was conducted in March 2025, without any time restrictions, in Medline, Pubmed and Web of Science databases. To identify other related references, further research was performed. Articles related to current knowledge about the immediate loading of dental implants supporting fixed partial prosthesis in the posterior region were included. Articles not available in abstract form and articles not published in the English language were excluded. Results: A total of ten studies were eligible for inclusion in the current study. The search strategy resulted in a survival rate ranging from 86% to 100%, and a failure rate of less than 21.6%, with a mean follow-up of 55.6 months. Statistical analysis revealed no significant differences in survival rates between implants placed in the maxilla and mandible (χ² = 0.42, p = 0.81, df = 2). Follow-up varied from one to ten years, reflecting variability both in study design and duration. Conclusions: The selected studies highlight the heterogeneity in immediate loading protocols for implant-supported fixed partial prosthesis in the posterior regions, emphasizing the variability in prosthetic materials and implant types, suggesting that immediate loading is a reliable, patient-centered therapeutic option with favorable long-term outcomes. Full article

(This article belongs to the Special Issue Artificial Intelligence in Oral Rehabilitation)

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18 pages, 25346 KiB

Open AccessArticle

The Impact of Prophylactic Polishing Pastes on the Surface Roughness, Color, and Stain Resistance of CAD/CAM Restorative Materials

by Betul Arkan, Ipek Iscan and Neslihan Tinastepe

Dent. J. 2025, 13(5), 212; https://doi.org/10.3390/dj13050212 - 15 May 2025

Viewed by 377

Abstract

Background: Prophylactic polishing pastes (PPPs) are widely used to clean teeth and dental restorations; however, their effects on restorative materials are crucial for clinical outcomes. This study investigates the impact of PPPs on the susceptibility of CAD/CAM restorative materials to staining and the [...] Read more.

Background: Prophylactic polishing pastes (PPPs) are widely used to clean teeth and dental restorations; however, their effects on restorative materials are crucial for clinical outcomes. This study investigates the impact of PPPs on the susceptibility of CAD/CAM restorative materials to staining and the relationship between surface roughness and discoloration. Methods: Samples of tested materials (resin nanoceramic, hybrid ceramic, feldspathic ceramic, and lithium disilicate-reinforced glass ceramic) were treated with various PPPs (Cleanic, CleanJoy, Detartrine, Proxyt). Surface roughness and color parameters were recorded before and after the PPP application and following coffee immersion for 12 days. Initial measurements of surface roughness (Ra1) and color were taken. The specimens were divided into groups based on the PPP applied. After PPP application, secondary roughness (Ra2) and color values were measured. Changes in roughness (ΔRa), color (ΔE*ab, ΔE00), and whiteness index (ΔWID) were calculated post-application and after coffee immersion. Data normality was tested with the Shapiro–Wilks test. Two-way ANOVA evaluated the effects of material type and PPP on ΔE, ΔWID, and ΔRa. One-way ANOVA, Tukey HDS test, and Pearson correlation were used for further analysis, with significance set at p < 0.05. Results: The Vita Enamic–Detartrine group showed the highest ΔEab 1 and ΔE001 values, while Cerasmart–control showed the lowest. The Vita Enamic–Proxyt group had the lowest ΔWID1, and Vita Enamic–Cleanjoy exhibited the highest values of ΔEab 2, ΔE002, and ΔWID2. The E.MAX–control group had the lowest values for these metrics. No significant correlation was found between ΔRa and color changes (ΔE*ab 2, ΔE002, ΔWID2); however, a moderate positive correlation was found between values of ΔE1 and ΔE2. Conclusions: These findings indicate that PPPs significantly affect the discoloration and surface features of CAD/CAM materials, with both types of PPPs and materials. Full article

(This article belongs to the Section Dental Materials)

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10 pages, 573 KiB

Open AccessArticle

CBCT Evaluation of Maxillary Incisive Canal Characteristics Among Population in Regard to Possibility of Implant Cortical Anchorage—A Multicenter Study

by Fodor Calin, Bartosz Dalewski, Maciej Ellmann, Paweł Kiczmer, Stefan Ihde, Marta Bieńkowska, Jacek Kotuła and Łukasz Pałka

Dent. J. 2025, 13(5), 211; https://doi.org/10.3390/dj13050211 - 14 May 2025

Viewed by 343

Abstract

Background/Objectives: Implant placement in cases of severe bone atrophy or compromised alveolar bone requires careful planning, especially in the anterior maxilla. The nasopalatine canal (NPC) and its cortical walls offer potential anchorage sites. This study evaluates the NPC’s anatomical characteristics using cone beam [...] Read more.

Background/Objectives: Implant placement in cases of severe bone atrophy or compromised alveolar bone requires careful planning, especially in the anterior maxilla. The nasopalatine canal (NPC) and its cortical walls offer potential anchorage sites. This study evaluates the NPC’s anatomical characteristics using cone beam computed tomography (CBCT) to assess its suitability for implant anchorage. Methods: A retrospective analysis of 150 CBCT scans from three dental clinics in Poland was conducted. NPC measurements—including length, width, number of canals, and distances to adjacent anatomical structures—were taken in the sagittal, coronal, and axial planes. Statistical tests included Pearson correlation and Student’s t-test to explore relationships between NPC dimensions and gender. Results: The mean NPC length was 10.27 mm and mean width 3.55 mm. Significant gender differences were observed in the canal length, width, and distances to the labial and palatal plates (p < 0.05). Strong positive correlations were found between the canal width at the palate base and other parameters, such as the midpoint width (r = 0.58) and diameter (r = 0.44). The distance from the palatal opening to the labial plate showed the strongest correlation (r = 0.67), indicating enhanced cortical anchorage potential with increased canal dimensions. Discussion: NPC morphology varied (cylindrical, funnel-like, hourglass), aligning with prior studies. Larger diameters were linked to single-canal configurations. Implant placement strategies—such as direct canal insertion or lateralization—can be effective, especially with polished, single-piece implants that reduce soft tissue ingrowth and improve primary stability. Conclusions: Understanding NPC anatomy is crucial for implant planning in atrophic maxillae. With the proper technique, NPC use for cortical anchorage is a viable treatment option. Full article

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

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11 pages, 3234 KiB

Open AccessArticle

In Situ Eradication of Mature Oral Biofilm on Titanium Implant Surfaces Using Cold Atmospheric Plasma

by Markus Jörg Altenburger, Michael Eckhard Bergmann, Loic Alain Ledernez and Georgios Romanos

Dent. J. 2025, 13(5), 210; https://doi.org/10.3390/dj13050210 - 14 May 2025

Viewed by 408

Abstract

Objective: This study evaluated the effectiveness of a new cold atmospheric plasma device (AmbiJet) for eradicating mature oral biofilm on titanium implant surfaces, aiming to improve decontamination methods for the treatment of peri-implant infections. Material and methods: Mature oral biofilms were grown on [...] Read more.

Objective: This study evaluated the effectiveness of a new cold atmospheric plasma device (AmbiJet) for eradicating mature oral biofilm on titanium implant surfaces, aiming to improve decontamination methods for the treatment of peri-implant infections. Material and methods: Mature oral biofilms were grown on titanium disks placed in participants’ mouths. These disks were divided into control and plasma treatment groups. The AmbiJet device delivered plasma directly to the implant surface for 3 min per 20 mm², utilizing the applicator nozzle and implant as electrodes. Biofilm reduction was quantified by counting colony-forming units (CFUs). Results: Cold plasma treatment rendered approximately 90% of samples bacteria-free. A > 6-log₁₀ reduction (≈99.9999%) in bacterial load was achieved in 30% of samples, with an overall average reduction of 4.9-log₁₀ across all treated samples. The temperature during treatment remained below 40 °C. Conclusions: Within the study’s limitations, cold atmospheric plasma effectively eradicates mature oral biofilm on titanium surfaces. This high disinfection efficacy is likely due to the combined action of reactive species and electrical phenomena, which does not cause significant temperature increases. Full article

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

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16 pages, 4813 KiB

Open AccessArticle

Changes in Upper Airway Airflow After Rapid Maxillary Expansion Beyond the Peak Period of Adenoidal Growth—A CBCT Study Using Computer Fluid Dynamics and Considering Adenoidal Dimensions as a Factor

by Giuseppe Palazzo, Rosalia Leonardi, Gaetano Isola, Manuel Lagravere and Antonino Lo Giudice

Dent. J. 2025, 13(5), 209; https://doi.org/10.3390/dj13050209 - 13 May 2025

Viewed by 373

Abstract

Background/Objectives: This retrospective study used computer fluid dynamics (CFD) to evaluate the medium-term changes in the upper airways (UA) airflow after rapid maxillary expansion (RME) in three age-matched groups with different degrees of adenoidal obstruction. Methods: The sample included Cone-Beam Computed Tomography (CBCT) [...] Read more.

Background/Objectives: This retrospective study used computer fluid dynamics (CFD) to evaluate the medium-term changes in the upper airways (UA) airflow after rapid maxillary expansion (RME) in three age-matched groups with different degrees of adenoidal obstruction. Methods: The sample included Cone-Beam Computed Tomography (CBCT) of 67 adolescents taken before (T0) and 12 months after RME (T1) and divided into three cohorts: Control Group (CG, <25% obstruction: 24 subjects, mean age = 11.8 ± 1.3), Adenoids Group 1 (AG1, >25% <75% obstruction: = 22 subjects, mean age = 10.9 ± 1.5), Adenoids Group 2 (AG2, >75% obstruction: = 21 subjects, mean age = 11.2 ± 1.6). The airflow pressure, velocity and obstruction were simulated using computer fluid dynamics (CFD). Results: The pressure significantly improved in CG and AG1 groups while the velocity improved in AG1 as well as the prevalence of obstruction improvement. The airflow pressure and velocity changes could be attributed to the reduction of the resistances in the adenotonsillar region, which was remarkably more marked in the AG1. Conclusions: Alterations in the adenotonsillar region likely represent the most substantial factors influencing airflow changes after RME. The integration of anatomical and functional data, along with the identification of baseline patient characteristics, may facilitate the characterization of phenotypes most appropriate for initial management through either Rapid Maxillary Expansion (RME) or otolaryngologic (ENT) interventions. Full article

(This article belongs to the Special Issue Malocclusion: Treatments and Rehabilitation)

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13 pages, 606 KiB

Open AccessArticle

Screening for Obstructive Sleep Apnea Among the Adult Population in the Northeastern Region of Romania

by Olja Tanellari, Adela Alushi, Celiana Toti, Carina Balcos, Adina Oana Armencia, Tinela Panaite and Irina Zetu

Dent. J. 2025, 13(5), 208; https://doi.org/10.3390/dj13050208 - 12 May 2025

Viewed by 563

Abstract

Background: Sleep apnea is a breathing affliction that affects sleep quality, with significant implications for overall physical and oral health, as well as mental health. Aim: The aim of this study was to evaluate the validity of the STOP-Bang and Epworth [...] Read more.

Background: Sleep apnea is a breathing affliction that affects sleep quality, with significant implications for overall physical and oral health, as well as mental health. Aim: The aim of this study was to evaluate the validity of the STOP-Bang and Epworth questionnaires as preoperative screening tools for obstructive sleep apnea (OSA) in the adult population from the NE region of Romania. Materials and Methods: A total of 222 participants were selected. The questionnaire method was used, with the subjects completing the STOP-Bang and Epworth questionnaires. A chi-squared test, an ANOVA, and Student’s t-tests were used for the statistical analysis. Results: the STOP-Bang questionnaire revealed an increased risk of OSA among those with a high BMI, an age over 50 years, or a large neck circumference. Regarding the Epworth questionnaire, daytime sleepiness was more frequent among obese individuals and those with associated pathologies. Significant correlations were found between OSA and obesity, age, and associated pathologies, with limited observations on the influence of gender on the risk of OSA. Conclusions: The studied questionnaires are effective and easy-to-use tools for the preoperative screening of OSA, demonstrating a significant correlation between the identified risk factors and the disease severity. Full article

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

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14 pages, 2048 KiB

Open AccessArticle

Factors Influencing the Selection of Materials and Luting Agents for Single-Crown Restorations

by Ahmad Alsahli, Mirza Rustum Baig, Jagan Kumar Baskaradoss, Shoug Alsanea and Athoub AlMousawi

Dent. J. 2025, 13(5), 207; https://doi.org/10.3390/dj13050207 - 9 May 2025

Viewed by 515

Abstract

Objective: Selecting suitable materials and luting agents for single crowns is critical yet challenging, as dentists must consider different factors. This study aimed to assess dentists’ preferences for materials and luting agents under different clinical conditions and evaluate the nonclinical factors influencing their [...] Read more.

Objective: Selecting suitable materials and luting agents for single crowns is critical yet challenging, as dentists must consider different factors. This study aimed to assess dentists’ preferences for materials and luting agents under different clinical conditions and evaluate the nonclinical factors influencing their preferences. Methods: A paper-based survey supplemented with photographs illustrating anterior and posterior single-crown preparation designs was used, incorporating three clinical scenarios for each as examples. Participants provided demographic data and were asked to select their preferred material and luting agent for each scenario. Comparisons between the crown material/luting agent choices and dentist/practice characteristics were performed. Significant differences were determined using the chi-square test. Results: Overall, 262 (87.3%) dentists participated in this survey. The top-selected material for anterior preparation designs was lithium disilicate; monolithic zirconia was the most selected for posterior preparation designs. Dual-cure resin was the most selected luting agent for all anterior and posterior clinical scenarios, except for posterior subgingival preparation design. There was a significant association between the dentist’s age and the selection of material and luting agent (p < 0.05) in all clinical scenarios, except for the luting agent selection in the posterior subgingival preparation designs (p < 0.05). Other nonclinical factors yielded mixed results; some preparation designs showed significant differences, while others did not, depending on the clinical scenario. Conclusions: Reliance on new materials and luting agents that require minimally invasive treatment with dental ceramics and resin cement is increasing. However, the choice of materials and luting agents is influenced by clinical presentation and nonclinical factors, making it crucial for dentists to be aware of these factors when selecting materials for single-crown restorations. Clinical Implications: An overall trend was observed for the use of strong monolithic ceramics with adhesive resin cements. These findings could assist dentists in reviewing and re-evaluating material choices in their clinical practices, both at a national and regional level. Additionally, the findings could be useful for dental policy makers, wholesale suppliers, and retail distributors in making future decisions. Full article

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

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21 pages, 685 KiB

Open AccessReview

Nickel Ion Release in Nickel-Containing Orthodontics Archwires: A Narrative Review of In Vitro and In Vivo Studies

by Angelina Stoyanova-Ivanova, Velizar Georgiev and Jorge N. R. Martins

Dent. J. 2025, 13(5), 206; https://doi.org/10.3390/dj13050206 - 6 May 2025

Viewed by 501

Abstract

Nickel-containing orthodontic archwires, particularly those made of nickel-titanium (NiTi) and stainless steel (SS), play a crucial role in orthodontic treatment using the fixed technique due to their mechanical properties. However, concerns regarding nickel-induced allergic reactions, cytotoxicity, and metal ion release, especially nickel-related ones, [...] Read more.

Nickel-containing orthodontic archwires, particularly those made of nickel-titanium (NiTi) and stainless steel (SS), play a crucial role in orthodontic treatment using the fixed technique due to their mechanical properties. However, concerns regarding nickel-induced allergic reactions, cytotoxicity, and metal ion release, especially nickel-related ones, persist. This narrative review aims to explore recent findings on nickel release from orthodontic appliances, building upon prior systematic reviews by analyzing both in vitro and in vivo studies under various environmental conditions. The databases Web of Science, Scopus, and PubMed were searched for relevant studies that examined the relationship between nickel ion release from nickel-containing archwires and various environmental conditions. The studies found indicate that while metal ion release occurs during short-term treatment, the levels are lower than harmful thresholds, with factors such as pH, corrosion, length of treatment, and environmental influences affecting release rates. Despite this, long-term studies are few and are usually conducted only in an in vitro or in vivo environment, but not both. To establish causal relationships regarding metal ion release, in vivo monitoring of ions like Ni is critical, with further research needed to assess its prolonged effects. Furthermore, collaborative efforts among practitioners, researchers, and regulatory bodies are vital for developing evidence-based guidelines for orthodontic material selection, prioritizing patient safety and addressing metal ion release risks. Full article

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

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18 pages, 858 KiB

Open AccessArticle

Pathways Between Parental Attitudes and Early Childhood Caries in Preschool Children

by Apolinaras Zaborskis, Aistė Kavaliauskienė, Jaunė Razmienė, Augustė Razmaitė, Vilija Andruškevičienė, Julija Narbutaitė and Eglė Aida Bendoraitienė

Dent. J. 2025, 13(5), 205; https://doi.org/10.3390/dj13050205 - 2 May 2025

Viewed by 499

Abstract

Background/Objectives: Parental attitudes play a crucial role in shaping children’s oral health habits and preventing dental diseases. This study aimed to explore the theoretical pathways through which parental behavior and attitudes toward child oral health can influence the dental caries experience as [...] Read more.

Background/Objectives: Parental attitudes play a crucial role in shaping children’s oral health habits and preventing dental diseases. This study aimed to explore the theoretical pathways through which parental behavior and attitudes toward child oral health can influence the dental caries experience as measured by the dmf-t index in preschool children in Lithuania. Methods: A cross-sectional study was conducted involving 302 children aged 4–7 years and their parents (262 mothers). Parental attitudes were assessed using the Parental Attitudes Towards Child Oral Health (PACOH) scale. For the children, the following variables were considered: sex, age, dental caries experience (dmf-t index in the primary dentition), oral hygiene index (Silness–Löe Plaque Index), toothbrushing frequency, and parental assistance with toothbrushing. Structural Equation Modeling (SEM) was applied for the data analysis. Results: The main path through which parental attitudes towards child oral health influenced the dmf-t index was via toothbrushing frequency (β = −0.17) or parental assistance with toothbrushing (β = 0.24). These factors were then linked to the oral hygiene index (β = 0.20 and β = −0.47, respectively), which ultimately influenced dmf-t (β = 0.52). The parents’ attitudes and toothbrushing frequency per se had no significant effect on children’s dmf-t (β = −0.06 and β = −0.04, respectively). The final model met all goodness-of-fit criteria: Chi-square test p = 0.211, Incremental Fit Index IFI = 0.994, Tucker–Lewis Index TLI = 0.982, Comparative Fit Index CFI = 0.994, and Root Mean Square Error of Approximation RMSEA = 0.038. Conclusions: Findings from this study demonstrate that parents play a significant role in determining children’s oral health. Regular toothbrushing, parental assistance with toothbrushing, and good oral hygiene are critical factors linking parents’ oral health-related attitudes to a child’s experience of early caries. Identifying the associations between dental caries risk factors helps plan interventions. Full article

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

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11 pages, 429 KiB

Open AccessSystematic Review

Measuring the Marginal Gap of Pre-Cemented All-Metal Single Crowns: A Systematic Review of In Vitro Studies

by James Dudley and Taseef Hasan Farook

Dent. J. 2025, 13(5), 204; https://doi.org/10.3390/dj13050204 - 2 May 2025

Viewed by 680

Abstract

Background: Different methods have been used to fabricate and measure marginal gap in all-metal crowns, yet a systematic review on this topic has not been conducted. Objective: To review the existing literature regarding the measurement methods employed for the in vitro marginal gap [...] Read more.

Background: Different methods have been used to fabricate and measure marginal gap in all-metal crowns, yet a systematic review on this topic has not been conducted. Objective: To review the existing literature regarding the measurement methods employed for the in vitro marginal gap measurement of pre-cemented all-metal single crowns and examine the influence of crown fabrication method on the marginal gap. Materials and Methods: A systematic search was performed from December 2024 backwards across EBSCO Host, Scopus, PubMed, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and predefined eligibility criteria. The quality of included articles was evaluated using the Joanna Briggs Critical Appraisal Checklist. Results: Ten studies, involving 180 crowns, assessed marginal gaps using computerised superimposition (102 µm), scanning electron microscopy (89 µm), profilometry (100 µm), photogrammetry (59 µm), impression replica techniques (124 µm), and direct view microscopy (35 µm). Marginal gaps varied across crowns constructed with cobalt–chromium (97 µm), titanium (56 µm), noble metals (127 µm), and base metal alloys (35 µm). No significant differences (t = 1.06, p = 0.315) were observed between CAD/CAM (103.21 ± 58.56 µm) and lost wax casting method (71.59 ± 43.94 µm) of crown fabrication when analysed using an independent t-test. Conclusions: Cobalt–chromium was the most used material for AMCs, while titanium alloys produced the lowest mean marginal gap per crown. No significant differences in reported marginal gaps were observed between crowns fabricated using lost wax casting and CAD/CAM techniques. However, the limited number of studies, variation in measurement methods, and inconsistency in methodological rigour restricted the generalisability of the findings. Full article

(This article belongs to the Section Dental Materials)

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12 pages, 332 KiB

Open AccessArticle

Assessing Oral Health-Related Quality of Life in Older Tennessean Adults

by Yeleeya Y. Li, Ying Liu, Memunat Ogunmefun and Kesheng Wang

Dent. J. 2025, 13(5), 203; https://doi.org/10.3390/dj13050203 - 1 May 2025

Viewed by 351

Abstract

Background: Tennessee has one of the worst rankings for older adults’ oral health in the United States. This study aims to evaluate the oral health-related quality of life (OHRQoL) among older individuals (aged 60 and above) in Tennessee using the Oral Health [...] Read more.

Background: Tennessee has one of the worst rankings for older adults’ oral health in the United States. This study aims to evaluate the oral health-related quality of life (OHRQoL) among older individuals (aged 60 and above) in Tennessee using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Methods: The data were collected from the 233 Tennessee Smile-on program participants in the early phase of the COVID-19 pandemic, between December 2019 and August 2021. The frequency and percentage for each subgroup were calculated. Cronbach’s alpha was used to measure the internal consistency or reliability of OHIP in this study. Factor Analysis (FA) with oblique rotation was conducted to explore the underlying factor structure of the OHIP questionnaire set. A p < 0.05 was considered statistically significant. Results: The majority of participants were retired (59.66%), and there was a significant difference in OHIP_sum scores among different employment statuses (p = 0.018). Cronbach’s alpha showed the domains of psychological discomfort, physical disability, and psychological disability were highly correlated with the total score (alpha = 0.8). Factor analysis identified three main dimensions: physical discomfort, psychological distress, and functional disability, and they can explain over 90% of the total variance. Individuals measure of sampling adequacy (MSA) and overall MSA are greater than 0.9, indicating excellent sampling adequacy. Conclusions: The study suggested that oral health can be assessed not only through examinations by dental professionals but also by considering emotional and social well-being. However, a limitation of the study is that it was conducted during the COVID-19 outbreak, which restricted participant involvement. Full article

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11 pages, 214 KiB

Open AccessArticle

Impact of Dental Treatment, Including Multiple Extractions, Under General Anaesthesia on Children’s Oral Health-Related Quality of Life: A Prospective Study

by Haneen Baty, Ibtesam Alzain, Medhat Abdulla and Khlood Baghlaf

Dent. J. 2025, 13(5), 202; https://doi.org/10.3390/dj13050202 - 1 May 2025

Viewed by 544

Abstract

Background/Objectives: Children who undergo several dental extractions with general anesthesia (GA) may face considerable changes in their oral health-related quality of life (OHRQoL), but there is a lack of research on this issue in the Middle East. Aim: This study aimed to assess [...] Read more.

Background/Objectives: Children who undergo several dental extractions with general anesthesia (GA) may face considerable changes in their oral health-related quality of life (OHRQoL), but there is a lack of research on this issue in the Middle East. Aim: This study aimed to assess how the number of dental extractions performed under general anaesthesia due to caries impacts the oral health-related quality of life (OHRQoL) in children aged from three to six years. Methods: This prospective, single-center cohort study included parents of children aged 3–6 years undergoing dental treatment under general anaesthesia in Jeddah, Saudi Arabia. Parents completed the validated Arabic Early Childhood Oral Health Impact Scale (A-ECOHIS) before and after treatment to assess changes in OHRQoL. The number of extractions was recorded, and patients were grouped based on extraction frequency: high (≥mean) and low (<mean). Pearson’s correlation was used to evaluate the relationship between the number of extractions and the effect size of OHRQoL. Results: Ninety-three participants met the inclusion criteria and agreed to participate in this study. The mean age of the children was 4.88 years (SD ± 1.06). The most common procedure performed was extraction, with a mean of 5.34 (SD ± 5.53), followed by stainless-steel crown application, with a mean of 4.03 (SD ± 2.01). No correlation between the number of extractions and the effect size in the change in OHRQoL was noted (Pearson r = −0.002, p-value = 0.98). Conclusions: Dental extractions were the most common procedure performed under GA. While multiple extractions showed no significant association with the effect size of OHRQoL, overall treatment under GA led to significant improvement. These findings highlight the need for timely intervention, parental education, and comprehensive treatment protocols. Utilizing tools like ECOHIS may aid in prioritizing high-risk cases and optimizing resource allocation in pediatric dental care. Full article

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

12 pages, 1136 KiB

Open AccessArticle

Evaluation of the Efficacy of a Dentifrice Tablet to Prevent Dental Caries: A Microbial Study

by Bennett Tochukwu Amaechi, Kannan Kanthaiah, Rayane Farah, Kelly Yang, Amos Chiedu Obiefuna, Parveez Ahamed Abdul-Azees and Mahalakshmi Vijayaraghavan

Dent. J. 2025, 13(5), 201; https://doi.org/10.3390/dj13050201 - 30 Apr 2025

Viewed by 3339

Abstract

Background/Objectives: Dentifrice tablets are a new over-the-counter dentifrice form that are gaining global interest. The aim of this microbial study was to investigate the effectiveness of a dentifrice tablet (DT) containing nanohydroxyapatite (nHAP) to prevent tooth demineralization. Methods: 120 bovine tooth blocks were [...] Read more.

Background/Objectives: Dentifrice tablets are a new over-the-counter dentifrice form that are gaining global interest. The aim of this microbial study was to investigate the effectiveness of a dentifrice tablet (DT) containing nanohydroxyapatite (nHAP) to prevent tooth demineralization. Methods: 120 bovine tooth blocks were randomly assigned to four treatment groups (30/group): Nanohydroxyapatite DT (5% nHAP), placebo DT (Placebo), NaF toothpaste (1100 ppm Fluoride) and no-treatment (Control). Blocks were subjected to 7-day demineralization by plaque growth in a mixed-organism Microbial Caries Model. Toothpaste was made into slurry (1 toothpaste:3 water), while DT was thoroughly crushed and homogenized with water (1 tablet:3 water) to slurry. Both slurries were applied twice daily for 2 min on each occasion. Demineralization was assessed using Surface Microhardness (SMH) testing before and after plaque exposure. Change (ΔSMH) and percentage change (%∆SMH) in SMH (percentage demineralization [%Dem]), and % demineralization inhibition (%Dem-Inhibition) in each group were calculated. Intra-group (SMH) comparison (paired t-test) and intergroup (%∆SMH) comparison (ANOVA/Tukey’s test) were conducted (α = 0.05). Results: The paired t-test indicated a significant difference (p < 0.001) between pre-treatment and post-treatment SMH in all groups. The intergroup comparison based on their %Dem using ANOVA/Tukey’s test showed that Control (29.93 ± 5.58) had significantly (p < 0.05) higher %Dem than Placebo (22.81 ± 7.47, p < 0.05), nHAP (13.93 ± 11.31, p < 0.001) and Fluoride (14.44 ± 10.65, p < 0.001). The Placebo had significantly (p < 0.01) higher %Dem than nHAP and Fluoride. No significant difference between nHAP and Fluoride. Intergroup comparison based on their %Dem-Inhibition (calculated relative to the control) using ANOVA/Tukey’s test, nHAP (51.74 ± 40.05, p < 0.01) and Fluoride (50.56 ± 37.21, p < 0.05) had significantly higher %Dem-Inhibition than Placebo tablet (21.86 ± 5.55). No significant difference in %Dem-Inhibition between nHAP and Fluoride. Conclusions: The present study demonstrated that dentifrice tablets containing 5% nanohydroxyapatite are as effective as NaF toothpastes containing 1100 ppm fluoride in preventing tooth demineralization. Full article

(This article belongs to the Special Issue Updates and Highlights in Cariology)

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31 pages, 1283 KiB

Open AccessReview

The Influence of Diet and Physical Activity on Periodontal Health: A Narrative Review

by Giuseppe Balice, Michele Paolantonio, Giovanna Murmura, Matteo Serroni, Stefania Di Gregorio and Beatrice Femminella

Dent. J. 2025, 13(5), 200; https://doi.org/10.3390/dj13050200 - 30 Apr 2025

Viewed by 1046

Abstract

Periodontal diseases, including gingivitis and periodontitis, are chronic inflammatory conditions that compromise the supporting structures of the teeth, often leading to tooth loss and contributing to systemic comorbidities. Increasing evidence underscores the critical role of modifiable lifestyle factors, particularly diet and physical activity, [...] Read more.

Periodontal diseases, including gingivitis and periodontitis, are chronic inflammatory conditions that compromise the supporting structures of the teeth, often leading to tooth loss and contributing to systemic comorbidities. Increasing evidence underscores the critical role of modifiable lifestyle factors, particularly diet and physical activity, in influencing periodontal health. This narrative review critically evaluates the current body of literature regarding the impact of dietary constituents and physical activity on the periodontium, with a focus on the molecular mechanisms, key biomarkers, and clinical implications. It aims to provide a deeper understanding of the complex interactions between nutrition, exercise, and periodontal health with potential implications for clinical management and preventive strategies. Full article

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

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15 pages, 463 KiB

Open AccessArticle

Influence of Premedication and Dental Anxiety on Anesthetic Efficacy in Patients Undergoing Root Canal for Symptomatic Irreversible Pulpitis in Upper and Lower Molars: A Comparative Study of Articaine and Bupivacaine

by Luis Manteca-Fernández, Cristina Meniz-García, Fernando Fernández-Cáliz, Cristina Barona-Dorado, Juan Santos-Marino and Natalia Martínez-Rodríguez

Dent. J. 2025, 13(5), 199; https://doi.org/10.3390/dj13050199 - 30 Apr 2025

Viewed by 511

Abstract

The use of local anesthetics in dentistry is crucial for pain control. Their efficacy may be related to multiple factors, including gender, the clinical status of the patient, anatomical factors, the type of anesthetic, premedication treatment, and the experience of the professional. Aim: [...] Read more.

The use of local anesthetics in dentistry is crucial for pain control. Their efficacy may be related to multiple factors, including gender, the clinical status of the patient, anatomical factors, the type of anesthetic, premedication treatment, and the experience of the professional. Aim: The objective of this study was to analyze whether premedication or the degree of patient anxiety influences the anesthetic efficacy of 4% articaine with epinephrine 1:100,000 and 0.5% bupivacaine with epinephrine 1:100,000 in patients undergoing root canal treatment for symptomatic irreversible pulpitis in the upper and lower molars. The null hypothesis (H0) of this study was that articaine and bupivacaine would have a similar anesthetic efficacy when used during the treatment of symptomatic irreversible pulpitis of the posterior mandibular and maxillary teeth, independent of non-steroidal anti-inflammatory drugs (NSAIDs) premedication or the patient’s anxiety levels. Methods: A total of 140 patients presenting with pulpitis in the upper and lower molars were randomly assigned to one of two anesthetics: articaine or bupivacaine. Before root canal treatment, patients completed the Modified Corah Dental Anxiety Scale (MDAS) and a Visual Analog Scale (VAS) for pain intensity. Inferior alveolar nerve block was performed for the lower molars and buccal infiltration for the upper molars, and the anesthetic efficacy was verified by the Endo Coldspray^® test. During the procedure, the patients’ heart rate and oxygen saturation were monitored using a pulse oximeter. The patients reported their pain levels using a VAS twenty-four hours postoperatively. Results: High levels of dental anxiety were significantly associated with higher pain scores (p = 0.000) for both groups. The hemodynamic changes during treatment remained within normal limits. The need for anesthetic reinforcement was higher in the bupivacaine group (p = 0.004). The patients in both groups reported low-intensity postoperative pain, although the pain level was slightly lower in the bupivacaine group. Conclusions: The anesthetic efficacy of articaine and bupivacaine in patients with irreversible pulpitis did not appear to be influenced by the degree of anxiety or the intake of AINEs as premedication. The intrinsic anesthetic efficacy was higher for articaine, which required less reinforcement than bupivacaine. Comparing the results obtained when performing buccal infiltration and inferior alveolar nerve block further highlighted the differences between the two anesthetics; these differences were more pronounced in the bupivacaine group, leading to rejection of the null hypothesis proposed at the beginning of the study. Full article

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23 pages, 1288 KiB

Open AccessReview

AI-Driven Advancements in Orthodontics for Precision and Patient Outcomes

by David B. Olawade, Navami Leena, Eghosasere Egbon, Jeniya Rai, Aysha P. E. K. Mohammed, Bankole I. Oladapo and Stergios Boussios

Dent. J. 2025, 13(5), 198; https://doi.org/10.3390/dj13050198 - 30 Apr 2025

Cited by 1 | Viewed by 3019

Abstract

Artificial Intelligence (AI) is rapidly transforming orthodontic care by providing personalized treatment plans that enhance precision and efficiency. This narrative review explores the current applications of AI in orthodontics, particularly its role in predicting tooth movement, fabricating custom aligners, optimizing treatment times, and [...] Read more.

Artificial Intelligence (AI) is rapidly transforming orthodontic care by providing personalized treatment plans that enhance precision and efficiency. This narrative review explores the current applications of AI in orthodontics, particularly its role in predicting tooth movement, fabricating custom aligners, optimizing treatment times, and offering real-time patient monitoring. AI’s ability to analyze large datasets of dental records, X-rays, and 3D scans allows for highly individualized treatment plans, improving both clinical outcomes and patient satisfaction. AI-driven aligners and braces are designed to apply optimal forces to teeth, reducing treatment time and discomfort. Additionally, AI-powered remote monitoring tools enable patients to check their progress from home, decreasing the need for in-person visits and making orthodontic care more accessible. The review also highlights future prospects, such as the integration of AI with robotics for performing orthodontic procedures, predictive orthodontics for early intervention, and the use of 3D printing technologies to fabricate orthodontic devices in real-time. While AI offers tremendous potential, challenges remain in areas such as data privacy, algorithmic bias, and the cost of adopting AI technologies. However, as AI continues to evolve, its capacity to revolutionize orthodontic care will likely lead to more streamlined, patient-centered, and effective treatments. This review underscores the transformative role of AI in modern orthodontics and its promising future in advancing dental care. Full article

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10 pages, 921 KiB

Open AccessArticle

Influence of Time Interval, Temperature, and Storage Condition on Fluoride Release and Recharge from Silorane-Based Restorative Materials

by Prashanthi S. Madhyastha, Dilip G. Naik, Srikant Natarajan and Rachel Sarah Vinodhini

Dent. J. 2025, 13(5), 197; https://doi.org/10.3390/dj13050197 - 30 Apr 2025

Viewed by 323

Abstract

Objectives: The fluoride-releasing properties of restorative materials are crucial for the prevention of secondary caries as these can act as fluoride reservoirs. Hence, the present study aimed to investigate, assess, and compare the impact of time, temperature, and storage conditions on the fluoride [...] Read more.

Objectives: The fluoride-releasing properties of restorative materials are crucial for the prevention of secondary caries as these can act as fluoride reservoirs. Hence, the present study aimed to investigate, assess, and compare the impact of time, temperature, and storage conditions on the fluoride release of silorane-based composites (SBCs) and methacrylate-based composites (MBCs), and also evaluate the variation in their reuptake of fluoride (after recharge). Methods: SBC and MBC test samples of 10 mm × 2 mm dimensions were prepared and tested for fluoride release and recharge in distilled water and artificial saliva at temperatures of 4 °C, 37 °C, and 55 °C. The amount of fluoride released (at 1, 7, 14, and 28 days) and re-released after recharge (with 5000 ppm neutral sodium fluoride (NaF) solution for 5 min at 1, 3, and 7 days for 3 weeks) were studied with the help of a fluoride-selective ion electrode. Results: SBCs had a greater release of fluoride at low temperature in artificial saliva (0.07 ± 0.03) when compared to MBCs (0.04 ± 0.005). Fluoride release increased on day 7 but decreased over time (p < 0.05). Fluoride re-release was greater in MBCs than SBCs and it increased with time (p < 0.05). Conclusion: The amount of fluoride release and recharge depends on the time interval, temperature, and storage condition. These restorative materials can serve as fluoride reservoirs and contribute to sustained fluoride release in oral fluids, thereby preventing the initiation of secondary caries and the failure of restorations. In addition, it may assist in developing measures to improve fluoride delivery for topical applications. Full article

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

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14 pages, 1091 KiB

Open AccessArticle

Perioperative/Periprocedural Antithrombotic Management in Oral Health Procedures. A Prospective Observational Study

by María González-Zamora, Nagore Ambrosio, Raquel González, Paula Anguita, Ana Molina, David Herrera, Mariano Sanz, Francisco Marín, María Anguita-Gámez, Raquel Ferrandis, David Vivas, Manuel Anguita and Elena Figuero

Dent. J. 2025, 13(5), 196; https://doi.org/10.3390/dj13050196 - 29 Apr 2025

Viewed by 379

Abstract

Background/Objectives: This paper evaluates the incidence of thrombotic and/or hemorrhagic adverse events within 30 days after oral health procedures (OHPs) in patients taking antithrombotic agents. Secondary objectives were to determine proper antithrombotic management and its association with adverse events. Methods: As part of [...] Read more.

Background/Objectives: This paper evaluates the incidence of thrombotic and/or hemorrhagic adverse events within 30 days after oral health procedures (OHPs) in patients taking antithrombotic agents. Secondary objectives were to determine proper antithrombotic management and its association with adverse events. Methods: As part of a multicenter multispecialty prospective observational study (ReQXAA), individuals with antithrombotic therapy and receiving at least one OHP were selected. Before OHP, participants were referred to their medical doctors to indicate the antithrombotic therapy management. Adverse events were evaluated thirty days after OHP by phone call. Proportions and odds ratios (ORs) were generated applying Fisher’s exact test, chi-square tests and multiple regression models. Results: A total of 138 patients underwent 144 OHPs. Fifteen adverse events (10.5%) were registered, among which the most frequent was slight bleeding (n = 13), which was followed by bleeding that required suspension of the antithrombotic agent (n = 1) and a myocardial infarction (n = 1). Antithrombotic management was appropriate in 122 (84.7%) cases. In 15.3% of the cases it was inappropriate, the main reason being the unnecessary interruption of the antithrombotic medication (n = 11; 50%). Inadequate management was associated with a higher incidence of adverse events (OR = 4.7; 95% confidence interval [1.3, 16.3]; p = 0.016) after adjusting for confounding factors. Conclusions: The incidence of adverse events 30 days after OHPs was low (10.5%). An inappropriate perioperative/periprocedural antithrombotic management occurred in 15.3% of the cases and was associated with a higher incidence of adverse events (OR = 4.7). Full article

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

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Dent. J., Volume 13, Issue 5 (May 2025) – 46 articles

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