Dentistry Journal

14 pages, 2892 KiB

Open AccessArticle

Green-Synthesized Nano-Silver Fluoride for Remineralization of Enamel Lesions in Primary Teeth: A Comparative In Vitro Study with SDF and SDF/KI

by Antonia Palankalieva, Plamen Katsarov and Ani Belcheva

Dent. J. 2025, 13(7), 331; https://doi.org/10.3390/dj13070331 - 21 Jul 2025

Viewed by 421

Abstract

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This [...] Read more.

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This study aimed to evaluate the remineralization potential and aesthetic effects of novel, green-synthesized nano-silver fluoride (NSF) on artificial white spot lesions in primary teeth in comparison to 38% silver diamine fluoride (SDF) and silver diamine fluoride/potassium iodide (SDF/KI). Materials and Methods: NSF was synthesized using green tea extract. Sixty primary teeth specimens with artificial enamel lesions were randomly divided into five groups depending on the applied material: 38% SDF, 38% SDF/KI, single and double application of NSF, and control group. Treatments were followed by pH cycling. Surface microhardness and photographic analysis were conducted to assess remineralization and staining. Statistical analysis was conducted using non-parametric tests including Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Results: The greatest increase in microhardness was observed in the group receiving double NSF application. Its remineralizing potential was comparable to that of 38% SDF/KI, with no statistically significant difference (p = 1.000). Importantly, NSF-treated samples exhibited no teeth discoloration, unlike the black staining observed in SDF and SDF/KI groups. Conclusions: Green-synthesized NSF is a promising alternative to conventional SDF and SDF/KI, offering remineralization benefits without compromising aesthetics. The eco-friendly formulation and non-staining properties support its potential for clinical use in pediatric dentistry. Full article

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14 pages, 381 KiB

Open AccessArticle

A Cross-Sectional Analysis of Oil Pulling on YouTube Shorts

by Jun Yaung, Sun Ha Park and Shahed Al Khalifah

Dent. J. 2025, 13(7), 330; https://doi.org/10.3390/dj13070330 - 21 Jul 2025

Viewed by 564

Abstract

Objective: This cross-sectional content analysis aimed to investigate how oil pulling is portrayed on YouTube Shorts, focusing on the types of speakers, claims made, and alignment with scientific evidence. The study further explored how the content may influence viewer perception, health behaviors, [...] Read more.

Objective: This cross-sectional content analysis aimed to investigate how oil pulling is portrayed on YouTube Shorts, focusing on the types of speakers, claims made, and alignment with scientific evidence. The study further explored how the content may influence viewer perception, health behaviors, and the potential spread of misinformation. Methods: On 28 January 2025, a systematic search of YouTube Shorts was performed using the term “oil pulling” in incognito mode to reduce algorithmic bias. English language videos with at least 1000 views were included through purposive sampling. A total of 47 Shorts met the inclusion criteria. Data were extracted using a structured coding framework that recorded speaker type (e.g., dentist, hygienist, influencer), engagement metrics, stated benefits, oil type and regimen, the use of disclaimers or citations, and stance toward oil pulling rated on a 5-point Likert scale. Speaker background and nationality were determined through publicly available channel descriptions or linked websites, with user identities anonymized and ethical approval deemed unnecessary due to the use of publicly available content. In total, 47 videos met the inclusion criteria. Results: Of the 47 YouTube Shorts that met the inclusion criteria, most were posted by influencers rather than dental professionals. These videos predominantly encouraged oil pulling, often recommending coconut oil for 10–15 min daily and citing benefits such as reduced halitosis and improved gum health. However, a smaller subset advanced more extreme claims, including reversing cavities and remineralizing enamel. Notably, US-licensed dentists and dental hygienists tended to discourage or express skepticism toward oil pulling, assigning lower Likert scores (1 or 2) to influencers and alternative health practitioners (often 4 or 5). Conclusions: YouTube Shorts largely promote oil pulling through anecdotal and testimonial-driven content, often diverging from evidence-based dental recommendations. The findings reveal a disconnect between professional dental guidance and popular social media narratives. While some benefits like halitosis reduction may have limited support, exaggerated or misleading claims may result in improper oral hygiene practices. Greater engagement from dental professionals and improved health communication strategies are needed to counteract misinformation and reinforce oil pulling’s role, if any, as an adjunct—not a replacement—for standard oral care. Future studies should explore viewer interpretation, behavioral influence, and cross-platform content patterns to better understand the impact of short-form health videos. Full article

(This article belongs to the Topic Preventive Dentistry and Public Health)

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13 pages, 299 KiB

Open AccessArticle

Psychometric Validation of the Spanish OSAKA Questionnaire: A Cross-Sectional Study Among Colombian Dental Professionals

by Olga Patricia López-Soto, Juan Alberto Aristizabal-Hoyos, Jackeline Mulett-Vásquez, Héctor Fuentes-Barría, Raúl Aguilera-Eguía, Lissé Angarita-Davila, Diana Rojas-Gómez and Ángel Roco-Videla

Dent. J. 2025, 13(7), 329; https://doi.org/10.3390/dj13070329 - 20 Jul 2025

Viewed by 314

Abstract

Objectives: To evaluate the psychometric properties of the Spanish version of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire among dental professionals in Colombia. Methods: A cross-sectional study was conducted in Manizales, Colombia, between January and June 2024. A total of [...] Read more.

Objectives: To evaluate the psychometric properties of the Spanish version of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire among dental professionals in Colombia. Methods: A cross-sectional study was conducted in Manizales, Colombia, between January and June 2024. A total of 120 dental professionals, including general dentists, specialists, residents, and academic clinicians, were selected through stratified random sampling. Participants completed the Spanish-adapted OSAKA questionnaire and a structured sociodemographic survey. Internal consistency was assessed using Cronbach’s alpha (α) and McDonald’s Omega (Ω). Construct validity was examined through exploratory factor analysis (EFA), with Kaiser Meyer Olkin (KMO) values and Bartlett’s test. Results: The knowledge subscale (18 items) showed good reliability (α = 0.83; Ω = 0.83), while the attitude subscale (5 items) showed near-acceptable reliability (α = 0.68; Ω = 0.59). KMO values were 0.79 for knowledge and 0.57 for attitudes; Bartlett’s test was significant in both cases (p ≤ 0.001). EFA supported structural validity: six components with eigenvalues >1 explained 61.66% of the variance for knowledge, and two components explained 79.49% for attitudes. Significant differences in attitude scores were found among professional groups (p ≤ 0.001, η² = 0.13), with specialists scoring highest (

\bar{X}

= 17.66) and general dentists lowest (

\bar{X}

= 14.62). Knowledge scores did not significantly differ between groups (p = 0.47). Conclusions: The Spanish OSAKA questionnaire is a valid and reliable tool to assess knowledge and attitudes toward obstructive sleep apnea in Colombian dental professionals. Its use may support improved education, screening, and interdisciplinary collaboration in dental settings. Full article

17 pages, 1937 KiB

Open AccessArticle

Detection of Protein Carbonylation in Gingival Biopsies from Periodontitis Patients with or Without Diabetes Mellitus—A Pilot Study

by Alexandra Efthymiou, Pinelopi Anastasiadou, Eleftherios Anagnostou, George Koliakos, Sotirios Kalfas and Ioannis Vouros

Dent. J. 2025, 13(7), 328; https://doi.org/10.3390/dj13070328 - 18 Jul 2025

Viewed by 864

Abstract

Background: Protein carbonylation is an irreversible post-translational modification that is considered indicative of oxidative damage. Objective: The purpose of the study was to examine by an immunohistochemical method for the first time the extent and localization of protein carbonylation in biopsies of gingiva [...] Read more.

Background: Protein carbonylation is an irreversible post-translational modification that is considered indicative of oxidative damage. Objective: The purpose of the study was to examine by an immunohistochemical method for the first time the extent and localization of protein carbonylation in biopsies of gingiva from periodontitis patients with or without diabetes mellitus (DM). Methods: These were processed for immunohistochemical staining of the carbonylated proteins, using the ENVISIOM FLEX Mini Kit, high pH, and anti-dinitrophenyl (DNP) antibody, a marker of oxidative damage to a given protein. The extent of protein carbonylation was semi-quantitatively estimated and evaluated by calculation of the Allred score (percentage of stained cells × intensity of staining). Results: The biopsies from periodontitis patients with diabetes mellitus (DM) exhibited higher staining scores as per the percentage of positively stained cells than the biopsies from patients with only periodontitis (means of 49.2 and 16.7, respectively), the difference being statistically significant (p = 0.036). The same trend was observed in the case of the combination of the above with the intensity of staining (score parameter) as well (means of 59.6 and 20.8, p = 0.036, respectively). Conclusions: An immunohistochemical method with the novelty of utilization for the first time of the anti-dinitrophenyl (DNP) antibody in gingival tissues was introduced and showed efficacy in detecting protein carbonylation indicative of oxidative stress and its impact in the pathogenesis of these two prevalent diseases of periodontitis and diabetes mellitus. Full article

(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)

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17 pages, 283 KiB

Open AccessArticle

Critical–Reflective Self-Assessment in Clinical Activities in a Dentistry Program at a Brazilian Public University

by Luís Eduardo Genaro, Aylton Valsecki Júnior, Silvio Rocha Corrêa da Silva, Elaine Pereira da Silva Tagliaferro and Fernanda Lopez Rosell

Dent. J. 2025, 13(7), 327; https://doi.org/10.3390/dj13070327 - 18 Jul 2025

Viewed by 238

Abstract

Objectives: This study aimed to analyze the critical and reflective self-assessment capacity of dentistry students based on two clinical courses that employ self-assessment processes as a strategy to foster autonomy in health care. Materials and Methods: Reflections from third- and fifth-year students were [...] Read more.

Objectives: This study aimed to analyze the critical and reflective self-assessment capacity of dentistry students based on two clinical courses that employ self-assessment processes as a strategy to foster autonomy in health care. Materials and Methods: Reflections from third- and fifth-year students were evaluated over a three-year period. The methodology sought to identify the presence of critical reflections, perceptions of strengths and weaknesses, and the formulation of improvement plans. Results: The results revealed low levels of continuous reflection, with only 20.0% of third-year students and 24.1% of fifth-year students engaging in reflection in at least half of their clinical activities. However, 78.7% of third-year students and 90.8% of fifth-year students completed at least one reflection during the academic year. The ability to sustain continuous critical reflection was observed in only 22.1% of the 453 students evaluated. These findings present a concerning scenario, as critical reflection is directly linked to competence in health care and informed decision-making. Conclusions: The study concludes that formative assessment processes requiring critical and reflective self-assessment must be broadly integrated into the curriculum to foster significant gains in the development of professional competencies. Full article

10 pages, 842 KiB

Open AccessReview

Comparison of Intraosseous and Conventional Dental Anesthesia in Children—A Scoping Review

by Anastasia Dermata, Sotiria Davidopoulou, Aristidis Arhakis, Nikolaos Dabarakis, Konstantinos N. Arapostathis and Sotirios Kalfas

Dent. J. 2025, 13(7), 326; https://doi.org/10.3390/dj13070326 - 18 Jul 2025

Viewed by 287

Abstract

Background/Objectives: The main purpose of the present scoping review was to map and explore the efficacy of computer-controlled intraosseous anesthesia (CCIA) in comparison with conventional dental anesthesia in pediatric dental patients. Secondarily, this study aimed to compare the acceptance and preference factors [...] Read more.

Background/Objectives: The main purpose of the present scoping review was to map and explore the efficacy of computer-controlled intraosseous anesthesia (CCIA) in comparison with conventional dental anesthesia in pediatric dental patients. Secondarily, this study aimed to compare the acceptance and preference factors between CCIA and conventional dental anesthesia in children. Given the limited and heterogeneous nature of the available literature, this review aimed to identify gaps and scope the extent of research conducted in this area, providing a foundation for future, more targeted studies. Methods: The search was conducted in 19 electronic databases, and the appropriate studies were identified according to PRISMA-ScR guidelines. Only split-mouth randomized controlled clinical trials that reported on the clinical outcomes of CCIA in children were included. Two reviewers worked independently on the screening and selection of the studies. The same two reviewers carried out the data extraction and the risk of bias assessment, using the Cochrane risk of bias tool. Due to the exploratory nature, this review focused on mapping the characteristics, outcomes, and research trends rather than synthesizing effect sizes. Results: Out of 841 papers, 2 randomized clinical trials were ultimately included in the scoping review. The outcomes were categorized as primary (including results that answered the focus question) and secondary (relating to additional quality characteristics). Regarding the primary outcomes, in both studies, intraosseous anesthesia was efficacious in achieving the adequate level of anesthesia. One of the secondary outcomes was the acceptance and preference of CCIA in comparison with conventional dental anesthesia in children. The limited number and the high risk of bias in existing studies highlight the necessity for more comprehensive and high-quality research. Conclusions: The selected studies support the assertion that CCIA is a promising technique since it results in less pain perception and is preferred by patients compared to conventional local anesthesia. However, the existing literature is limited and at high risk of bias. Thus, further targeted investigations are needed to evaluate and yield more definitive results regarding the superiority of CCIA. Full article

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

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14 pages, 15062 KiB

Open AccessArticle

Short-Term Effects of Visceral Manual Therapy on Autonomic Nervous System Modulation in Individuals with Clinically Based Bruxism: A Randomized Controlled Trial

by Cayetano Navarro-Rico, Hermann Fricke-Comellas, Alberto M. Heredia-Rizo, Juan Antonio Díaz-Mancha, Adolfo Rosado-Portillo and Lourdes M. Fernández-Seguín

Dent. J. 2025, 13(7), 325; https://doi.org/10.3390/dj13070325 - 16 Jul 2025

Viewed by 1448

Abstract

Background/Objectives: Bruxism has been associated with dysregulation of the autonomic nervous system (ANS). Visceral manual therapy (VMT) has shown beneficial effects on the vagal tone and modulation of ANS activity. This study aimed to evaluate the immediate and short-term effects of VMT [...] Read more.

Background/Objectives: Bruxism has been associated with dysregulation of the autonomic nervous system (ANS). Visceral manual therapy (VMT) has shown beneficial effects on the vagal tone and modulation of ANS activity. This study aimed to evaluate the immediate and short-term effects of VMT in individuals with clinically based bruxism. Methods: A single-blind randomized controlled trial was conducted including 24 individuals with clinically based bruxism. Participants received two sessions of either VMT or a sham placebo technique. Outcome measures included heart rate variability (HRV), both normal-to-normal intervals (HRV-SDNN), and the root mean square of successive normal-to-normal intervals (HRV-RMSSD), as well as muscle tone and stiffness and pressure pain thresholds (PPTs). Measurements were made at T1 (baseline), T2 (post-first intervention), T3 (pre-second intervention), T4 (post-second intervention), and T5 (4-week follow-up). Results: A significant time*group interaction was observed for HRV-SDNN (p = 0.04, η² = 0.12). No significant changes were found for muscle tone or stiffness. PPTs significantly increased at C4 after the second session (p = 0.049, η² = 0.16) and at the left temporalis muscle after the first session (p = 0.01, η² = 0.07). Conclusions: The findings suggest that two sessions of VMT may lead to significant improvements in HRV-SDNN compared to the placebo, suggesting a modulatory effect on autonomic function. No consistent changes were observed for the viscoelastic properties of the masticatory muscles. Isolated improvements in pressure pain sensitivity were found at C4 and the left temporalis muscle. Further research with larger sample sizes and long-term follow-up is needed to determine the clinical relevance of VMT in the management of signs and symptoms in individuals with bruxism. Full article

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

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24 pages, 9660 KiB

Open AccessArticle

Effect of Mouth Rinsing and Antiseptic Solutions on Periodontitis Bacteria in an In Vitro Oral Human Biofilm Model

by Jan Tinson Strenge, Ralf Smeets, Maria Geffken, Thomas Beikler and Ewa Klara Stuermer

Dent. J. 2025, 13(7), 324; https://doi.org/10.3390/dj13070324 - 16 Jul 2025

Viewed by 410

Abstract

Background/Objectives: The formation of oral biofilms in periodontal pockets and around dental implants with induction of periodontitis or peri-implantitis is an increasing problem in dental health. The intelligent design of a biofilm makes the bacteria embedded in the biofilm matrix highly tolerant [...] Read more.

Background/Objectives: The formation of oral biofilms in periodontal pockets and around dental implants with induction of periodontitis or peri-implantitis is an increasing problem in dental health. The intelligent design of a biofilm makes the bacteria embedded in the biofilm matrix highly tolerant to antiseptic therapy, often resulting in tooth or implant loss. The question therefore arises as to which mouthwashes have eradication potential against oral biofilm. Methods: A human oral biofilm model was developed based on donated blood plasma combined with buffy coats, inoculated with oral pathogenic bacterial species found in periodontal disease (Actinomyces naeslundii, Fusobacterium nucleatum, Streptococcus mitis, and Porphyromonas gingivalis). Over a span of 7 days, we tested different mouth rinsing and antiseptic solutions (Chlorhexidine, Listerine^®, NaOCl, Octenisept^®, and Octenident^®) covering the matured biofilm with 24 h renewal. Phosphate-buffered saline (PBS) was used as a control. Bacterial growth patterns were detected via quantitative polymerase chain reaction (qPCR) after 2, 4, and 7 days of treatment. Results: While all groups showed initial bacterial reduction, the control group demonstrated strong regrowth from day 2 to 4. Listerine showed a near-significant trend toward bacterial suppression. Additionally, strain-specific efficacy was observed, with Octenisept^® being most effective against Streptococcus mitis, Octenident^® and NaOCl showing superior suppression of Actinomyces naeslundii, and Listerine^® outperforming other solutions in reducing Fusobacterium nucleatum. Donor-specific, individual variability further influenced treatment outcomes, with distinct trends in bacterial suppression and regrowth observed across donors. Conclusions: These findings underscore the complexity of biofilm-associated infections and highlight the importance of targeted therapeutic approaches for managing bacterial biofilms. In this experiment, the donor-specific outcomes of the antimicrobial effects of the solutions may indicate that genetic predisposition/tolerance to oral infections appears to play a critical role in the control of oral biofilms. Full article

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

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17 pages, 2879 KiB

Open AccessArticle

The Impact of Integrating 3D-Printed Phantom Heads of Newborns with Cleft Lip and Palate into an Undergraduate Orthodontic Curriculum: A Comparison of Learning Outcomes and Student Perception

by Sarah Bühling, Jakob Stuhlfelder, Hedi Xandt, Sara Eslami, Lukas Benedikt Seifert, Robert Sader, Stefan Kopp, Nicolas Plein and Babak Sayahpour

Dent. J. 2025, 13(7), 323; https://doi.org/10.3390/dj13070323 - 16 Jul 2025

Viewed by 312

Abstract

Background/Objectives: This prospective intervention study examined the learning effect of using 3D-printed phantom heads with cleft lip and palate (CLP) and upper jaw models with CLP and maxillary plates during a lecture for dental students in their fourth year at J. W. [...] Read more.

Background/Objectives: This prospective intervention study examined the learning effect of using 3D-printed phantom heads with cleft lip and palate (CLP) and upper jaw models with CLP and maxillary plates during a lecture for dental students in their fourth year at J. W. Goethe Frankfurt University. The primary aim was to evaluate the impact of 3D-printed models on students’ satisfaction levels along with their understanding and knowledge in dental education. Methods: Six life-sized phantom heads with removable mandibles (three with unilateral and three with bilateral CLP) were designed using ZBrush software (Pixologic Inc., Los Angeles, CA, USA) based on MRI images and printed with an Asiga Pro 4K 3D printer (Asiga, Sydney, Australia). Two groups of students (n = 81) participated in this study: the control (CTR) group (n = 39) attended a standard lecture on cleft lip and palate, while the intervention (INT) group (n = 42) participated in a hands-on seminar with the same theoretical content, supplemented by 3D-printed models. Before and after the session, students completed self-assessment questionnaires and a multiple-choice test to evaluate knowledge improvement. Data analysis was conducted using the chi-square test for individual questions and the Wilcoxon rank test for knowledge gain, with the significance level set at 0.05. Results: The study demonstrated a significant knowledge increase in both groups following the lecture (p < 0.001). Similarly, there were significant differences in students’ self-assessments before and after the session (p < 0.001). The knowledge gain in the INT group regarding the anatomical features of unilateral cleft lip and palate was significantly higher compared to that in the CTR group (p < 0.05). Conclusions: The results of this study demonstrate the measurable added value of using 3D-printed models in dental education, particularly in enhancing students’ understanding of the anatomy of cleft lip and palate. Full article

(This article belongs to the Special Issue Dental Education: Innovation and Challenge)

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15 pages, 1266 KiB

Open AccessReview

Comparison of Oral Microbial Profile Among Patients Undergoing Clear Aligner and Fixed Orthodontic Therapies for the Treatment of Malocclusions: An Updated Review

by Emilie Ponton, Paul Emile Rossouw and Fawad Javed

Dent. J. 2025, 13(7), 322; https://doi.org/10.3390/dj13070322 - 16 Jul 2025

Viewed by 280

Abstract

Objective: The present review aims to compare the oral microbial profile (OMP) of patients undergoing fixed orthodontic therapy (OT) versus clear aligner therapy (CAT) for the treatment of malocclusions. Methods: Clinical studies were included. Case-reports/-series, letters to the editor, reviews, perspectives, [...] Read more.

Objective: The present review aims to compare the oral microbial profile (OMP) of patients undergoing fixed orthodontic therapy (OT) versus clear aligner therapy (CAT) for the treatment of malocclusions. Methods: Clinical studies were included. Case-reports/-series, letters to the editor, reviews, perspectives, and expert opinions were excluded. Indexed databases (MEDLINE/PubMed, Embase, Scopus, and Web of Science) were searched up to the end point of May 2025, without time and language barriers. The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias (RoB) and quality of evidence were assessed. Results: Three randomized clinical trials (RCTs) and seven non-RCTs were included. In all RCTs and five non-RCTs, OMP was assessed using subgingival plaque samples. Periodontopathogenic bacteria and Gram-negative anaerobic microbes were more often identified in patients undergoing fixed OT than CAT. The biofilm mass was higher in patients undergoing fixed OT than CAT. In two RCTs, periodontopathogenic bacteria were dominant among patients undergoing fixed OT than CAT. All RCTs and two non-RCTs had a high RoB. The certainty of evidence was “moderate” in 70% of the studies. Conclusions: Due to a high RoB, variability in study designs, and lack of power analysis, direct comparisons remain limited. Full article

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

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14 pages, 1213 KiB

Open AccessArticle

Development of a Microfluidic Paper-Based Analytical Device for Myeloperoxidase Detection in Periodontitis

by Juliane Caroline Leão, Thiago Mazzu, Vitor Leão, Paola Gomes Souza, Nathalya Maria Vilela Moura, Emanuel Carrilho and Mario Taba, Jr.

Dent. J. 2025, 13(7), 321; https://doi.org/10.3390/dj13070321 - 15 Jul 2025

Viewed by 319

Abstract

Objectives: To develop a microfluidic paper-based analytical device (μPAD) that identifies myeloperoxidase (MPO) levels in the saliva of healthy patients and those with periodontal disease. Materials and Methods: A platform similar to a 96-well plate was printed on Watman^® chromatography paper to [...] Read more.

Objectives: To develop a microfluidic paper-based analytical device (μPAD) that identifies myeloperoxidase (MPO) levels in the saliva of healthy patients and those with periodontal disease. Materials and Methods: A platform similar to a 96-well plate was printed on Watman^® chromatography paper to run the experimental analysis with unstimulated saliva samples were collected from two groups of patients: those with periodontal health (H, n = 15) and established periodontitis (PD, n = 15). Then, three types of chromophore substrates were pipetted into the wells of the prototype: (1) Guaiacol; (2) Guaiacol, 4,4 ′-diaminodifenilsulfon (DAB) and hydrogen peroxide in Tris-HCl buffer; and (3) 3,3′,5,5′-Tetramethylbenzidine (TMB), followed by saliva samples. The reaction images were analyzed by numbering according to the intensity scale. Results: The comparative results of the reactions using μPAD demonstrated that both the H and PD groups were compatible with each other without differences among the chromophore substrates (p > 0.05). However, the protocol with TMB showed a faster reaction and better color difference when comparing 15.62 ng/mL and 7.81 ng/mL of MPO in the plate embedded with Guaiacol; 1000 ng/mL and 62.5 ng/mL on the Guaiacol and DAB plate; and 62.5 ng/mL of TMB. The average detectable concentrations of MPO in saliva using TMB were H = 21.2 ± 10.4 ng/mL and PD = 28.9 ± 12.8 ng/mL (p = 0.08). Conclusions: The developed microfluidic paper-based analytical device has been tested for identifying the myeloperoxidase saliva levels of healthy patients and those with periodontal disease. This rapid test demonstrated its possible applicability mainly when associated with the TMB chromophore, but further studies are required with different biomarkers to explore this promising diagnostic platform. Full article

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

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17 pages, 618 KiB

Open AccessSystematic Review

Clinical Performance of Bulk-Fill Versus Incremental Composite Restorations in Primary Teeth: A Systematic Review of In Vivo Evidence

by Maria Sarapultseva, Desheng Hu and Alexey Sarapultsev

Dent. J. 2025, 13(7), 320; https://doi.org/10.3390/dj13070320 - 15 Jul 2025

Viewed by 369

Abstract

Background and Objectives: This is the first systematic review to focus exclusively on in vivo randomized controlled trials that compare bulk-fill and conventional incremental composite restorations in primary teeth. Our aim was to synthesize current evidence on their clinical performance, including retention, [...] Read more.

Background and Objectives: This is the first systematic review to focus exclusively on in vivo randomized controlled trials that compare bulk-fill and conventional incremental composite restorations in primary teeth. Our aim was to synthesize current evidence on their clinical performance, including retention, two-year survival rates, marginal integrity, and procedural efficiency. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and the Elicit AI platform up to March 2025. Eligible studies were in vivo randomized controlled trials involving children aged 3–12 years with carious primary teeth, directly comparing bulk-fill and incremental composite restorations. Primary outcomes included retention rates, two-year survival, and marginal integrity, while secondary outcomes were postoperative sensitivity, secondary caries, and aesthetic outcomes. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessments using the Cochrane RoB 2.0 tool. A narrative synthesis was undertaken due to substantial heterogeneity in study design and outcome reporting. The review protocol was registered in PROSPERO (CRD420251021433). Results: Thirteen randomized controlled trials met the inclusion criteria. Both restoration techniques demonstrated high short-term retention rates (>90%) and comparable two-year survival (85–90%). Marginal integrity was generally equivalent, though incremental techniques showed modest advantages in complex cavities. Secondary outcomes were inconsistently reported, with no significant group differences. Bulk-fill restorations consistently reduced the procedural time by 2–4 min per restoration, representing a meaningful advantage in pediatric clinical settings. Conclusions: Bulk-fill composites offer a clinically effective and time-efficient alternative to incremental layering in the restoration of primary teeth. This focused synthesis addresses a gap in existing reviews by concentrating solely on primary dentition and in vivo evidence. Despite similar clinical outcomes, the time savings associated with bulk-fill techniques may enhance their utility in pediatric dentistry. Further standardized and long-term trials are warranted to confirm these findings and inform clinical guidelines. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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19 pages, 406 KiB

Open AccessReview

Pacifier Use and Its Influence on Pediatric Malocclusion: A Scoping Review of Emerging Evidence and Developmental Impacts

by Man Hung, Jacob Marx, Corban Ward and Connor Schwartz

Dent. J. 2025, 13(7), 319; https://doi.org/10.3390/dj13070319 - 14 Jul 2025

Viewed by 680

Abstract

Background/Objectives: Pacifier use is a widespread soothing practice during infancy, but extended use has been linked to adverse dental outcomes, particularly malocclusion. This review aimed to evaluate the association between pacifier use and dental developmental issues in infants and toddlers and to [...] Read more.

Background/Objectives: Pacifier use is a widespread soothing practice during infancy, but extended use has been linked to adverse dental outcomes, particularly malocclusion. This review aimed to evaluate the association between pacifier use and dental developmental issues in infants and toddlers and to identify key influencing factors. Methods: A scoping review using PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source was performed. Peer-reviewed, full-text articles published in English between 2014 and 2024 were screened by two independent reviewers using predefined criteria. Eligible studies were thematically analyzed. Results: From 262 records, 35 studies met the inclusion criteria. Pacifier use was consistently associated with an increased prevalence of malocclusions, including anterior open bite, posterior crossbite, and overjet. The risk and severity of dental issues were strongly influenced by the duration, frequency, and intensity of pacifier use. Prolonged use beyond three years significantly increased the likelihood of structural changes requiring intervention. Conclusion: There is strong evidence linking pacifier use to negative dental developmental outcomes, particularly when use is prolonged or frequent. Early intervention, caregiver education, and timely weaning are critical to minimizing long-term oral health risks. Future research should explore pacifier design, objective measures of use, and how socioeconomic factors may influence pacifier use patterns and oral health outcomes. Understanding these relationships can support the development of more targeted and equitable prevention strategies. Full article

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20 pages, 6738 KiB

Open AccessFeature PaperArticle

Biocompatible Inorganic PVD MeSiON Thin Films (Me = Cr or Zr) Used to Enhance the Bond Strength Between NiCr-Based Metallic Frameworks and Ceramic in Dental Restorations

by Mihaela Dinu, Cosmin Mihai Cotrut, Alina Vladescu (Dragomir), Florin Baciu, Anca Constantina Parau, Iulian Pana, Lidia Ruxandra Constantin and Catalin Vitelaru

Dent. J. 2025, 13(7), 318; https://doi.org/10.3390/dj13070318 - 14 Jul 2025

Viewed by 234

Abstract

Background/Objectives: The increasing demand for aesthetics in dentistry has driven significant advancements in both materials and techniques. The primary cause of ceramic detachment in dental restorations is extensive mechanical stress, which often results in detachment and clinical complications. This study aims to improve [...] Read more.

Background/Objectives: The increasing demand for aesthetics in dentistry has driven significant advancements in both materials and techniques. The primary cause of ceramic detachment in dental restorations is extensive mechanical stress, which often results in detachment and clinical complications. This study aims to improve the bond strength between NiCr-based metal frameworks and ceramic coatings by introducing biocompatible inorganic MeSiON thin films (Me = Cr or Zr) as interlayers. Methods: MeSiON coatings with a thickness of ~2 μm were deposited on NiCr alloy using cathodic arc evaporation. To tailor the stoichiometry, morphology, and mechanical properties of the coatings, the substrate bias voltage was varied: −50 V, −100 V, −150 V, −200 V. Structural and surface characterization was performed using SEM/EDS, XRD, profilometry, and contact angle analysis. The coating adhesion was evaluated by using standardized scratch testing, while the bond strength was evaluated using a three-point bending test. Results: The NiCr alloy exhibited a dendritic microstructure, and the ceramic layer consisted mainly of quartz, feldspar, kaolin, and ZrO₂. ZrSiON coatings showed superior roughness, elemental incorporation, and adhesion compared to Cr-based coatings, these properties being further improved by increasing the substrate bias. The highest bond strength was achieved with a ZrSiON coating deposited at −200 V, a result we attributed to increased surface roughness and mechanical interlocking at the ceramic-metal interface. Conclusions: CrSiON and ZrSiON interlayers enhanced ceramic-to-metal adhesion in NiCr-based dental restorations. The enhancement in bond strength is primarily ascribed to substrate bias-induced modifications in the coating’s stoichiometry, roughness, and adhesion. Full article

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

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9 pages, 3737 KiB

Open AccessArticle

The Prevalence of Supernumerary Teeth in a Sample of Non-Syndromic Young Patients from Greece

by Nefeli Katanaki, Miltiadis A. Makrygiannakis and Eleftherios G. Kaklamanos

Dent. J. 2025, 13(7), 317; https://doi.org/10.3390/dj13070317 - 14 Jul 2025

Viewed by 479

Abstract

Background/Objectives: Supernumerary teeth, or hyperdontia, refer to a developmental anomaly defined by the presence of additional teeth beyond the normal dentition. Hyperdontia may result in clinical complications including delayed eruption, crowding, and malocclusion. Despite its prevalence having been studied in various populations, [...] Read more.

Background/Objectives: Supernumerary teeth, or hyperdontia, refer to a developmental anomaly defined by the presence of additional teeth beyond the normal dentition. Hyperdontia may result in clinical complications including delayed eruption, crowding, and malocclusion. Despite its prevalence having been studied in various populations, data from geographically isolated or peripheral groups remain limited. This study aimed to investigate the prevalence and distribution of supernumerary teeth in a sample of children and adolescents from the island of Lesvos, Greece. Methods: A retrospective cross-sectional study was conducted using panoramic radiographs from 621 Caucasian children aged 9–16 years who attended orthodontic or general/pediatric dental clinics in Mytilini, Lesvos island, Greece. Radiographs were examined for the presence, number, type, and location of supernumerary teeth. The analysis included data to explore gender and arch distribution. Results: Supernumerary teeth were identified in 15 individuals, corresponding to a prevalence of 2.4%. A slightly higher occurrence was observed in males (1.4%) than in females (1%). The majority of supernumerary teeth were situated in the maxillary arch (1.9%). Mesiodens represented the most frequently observed type, followed by supernumerary lateral incisors, paramolars, and a single supernumerary central incisor. Conclusions: The prevalence of supernumerary teeth in this population is consistent with reported findings. Mesiodens was the most frequently observed type, with a predominance in the maxillary arch. Early detection of supernumerary teeth is crucial for accurate diagnosis and effective management. Full article

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12 pages, 2053 KiB

Open AccessArticle

Distalization with Clear Aligners: Accuracy, Impact of Mini-Screws, and Clinical Outcomes

by Teresa Pinho, Diana Melo, Sofia Ferreira and Maria Gonçalves

Dent. J. 2025, 13(7), 316; https://doi.org/10.3390/dj13070316 - 14 Jul 2025

Viewed by 313

Abstract

Background: Distalization is a fundamental orthodontic strategy for correcting Class II and Class III malocclusions, particularly in cases where specific dental or skeletal conditions favor its application. Recent technological advances have enabled complex dental movements to be performed using clear aligners, aided by [...] Read more.

Background: Distalization is a fundamental orthodontic strategy for correcting Class II and Class III malocclusions, particularly in cases where specific dental or skeletal conditions favor its application. Recent technological advances have enabled complex dental movements to be performed using clear aligners, aided by digital planning platforms such as ClinCheck^®. Methods: This retrospective study aimed to evaluate the accuracy of ClinCheck^® in predicting molar and canine distalization outcomes with the Invisalign^® system and to identify clinical factors influencing treatment predictability. Thirty patients with complete permanent dentition and at least 2 mm of programmed distalization were selected. Planned movements were extracted from the Invisalign^® Doctor Site and compared to achieved outcomes using Geomagic^® Control X™ software. Occlusal improvements were assessed using the Peer Assessment Rating (PAR) index. Results: The results revealed significant discrepancies between the programmed and achieved distalization, with mean deviations greater than 1 mm in both arches. Skeletal anchorage with mini-screws significantly improved distalization outcomes in the maxillary arch; however, no significant effect was observed in the mandibular arch. Additionally, no significant associations were found between distalization outcomes and skeletal pattern (ANB angle) or facial biotype. Conclusions: Clear aligners are effective in achieving substantial occlusal improvements, particularly when combined with personalized digital planning and supplementary strategies such as skeletal anchorage. Mandibular cases demonstrated greater reductions in PAR scores, emphasizing the potential of aligners in complex distalization treatments. Full article

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14 pages, 1172 KiB

Open AccessArticle

Laser-Mediated Hemostasis for Older Patients Receiving Routine Dental Treatment

by Suwat Tanya, Saengsome Prajaneh, Piyachat Patcharanuchat and Sajee Sattayut

Dent. J. 2025, 13(7), 315; https://doi.org/10.3390/dj13070315 - 11 Jul 2025

Viewed by 312

Abstract

Background/Objective: Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. Methods: A prospective [...] Read more.

Background/Objective: Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. Methods: A prospective observational study was conducted across research networks between October 2023 and August 2024, involving 60 patients aged 50 years and older (average = 63.35 years) at risk of postoperative bleeding following dental treatments. Additionally, laser therapy for hemostasis was selected and provided among calibrated operators. A single researcher performed data collection. Before statistical analysis, data verification and clinical assessment were conducted by the operators and researcher. A clinical cut-off for hemostasis was set at 5 min. Two diode laser machines were used namely, an 810 nm and dual wavelengths of 635 nm and 980 nm. Results: There were 94 extraction sockets, 28 procedures of scaling and root planing and 18 procedures of minor oral surgery. Combining laser ablating sulcular fiber and photobiomodulation initiating blood clot formation was a preferable hemostatic technique for extraction socket, while photobiomodulation alone was a preferred technique for soft tissue hemostasis (p < 0.001). All operators confirmed that 97.86 percent of bleeding events achieved more rapid hemostasis. 61.43 percent of bleeding events clinically achieved hemostasis within 5 min by using laser-mediated hemostasis alone (p = 0.092). Full recovery of the extraction socket was significantly observed during the 2- to 4-week follow-up period (p = 0.005). No clinical complications were reported. Conclusions: Laser-mediated hemostasis effectively reduced hemostatic duration, prevented postoperative bleeding and promoted wound healing in older patients undergoing routine dental treatment. Full article

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

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14 pages, 520 KiB

Open AccessReview

Activation of the Nrf2 Signaling Pathway as a Therapeutic Strategy Against Periodontal Disease: A Narrative Review

by Sarmistha Saha, Nadezhda Sachivkina, Ekaterina Lenchenko, Olga Pilshchikova and Alexandr Muraev

Dent. J. 2025, 13(7), 314; https://doi.org/10.3390/dj13070314 - 11 Jul 2025

Viewed by 296

Abstract

Periodontitis (PD), is a chronic inflammatory disease of the periodontal system, which includes gingiva, periodontal ligament, alveolar bone, and tooth cement. It is becoming increasingly prevalent globally, and its implications for oral health are profound. The Nrf2 signaling pathway is crucial in managing [...] Read more.

Periodontitis (PD), is a chronic inflammatory disease of the periodontal system, which includes gingiva, periodontal ligament, alveolar bone, and tooth cement. It is becoming increasingly prevalent globally, and its implications for oral health are profound. The Nrf2 signaling pathway is crucial in managing the relationship between inflammation and oxidative stress, making it vital for understanding this disease. Nrf2 interacts with key redox-sensitive inflammatory pathways, playing a vital role in the development of periodontitis. Acknowledging these dynamics underscores the importance of proactively addressing the complex aspects of periodontal disease. This review emphasizes its intricate interactions with redox-sensitive transcription factors vital for sustaining the self-perpetuating inflammatory processes underlying the disease. Additionally, it explores promising therapeutic strategies aimed at Nrf2 activation and encourages more effective management of PD. Full article

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

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15 pages, 1454 KiB

Open AccessArticle

A Thermal Imaging Camera as a Diagnostic Tool to Study the Effects of Occlusal Splints on the Elimination of Masticatory Muscle Tension

by Danuta Lietz-Kijak, Adam Andrzej Garstka, Lidia Szczucka, Roman Ardan, Monika Brzózka-Garstka, Piotr Skomro and Camillo D’Arcangelo

Dent. J. 2025, 13(7), 313; https://doi.org/10.3390/dj13070313 - 11 Jul 2025

Viewed by 411

Abstract

Medical Infrared Thermography (MIT) is a safe, non-invasive technique for assessing temperature changes on the skin’s surface that may reflect pathological processes in the underlying tissues. In temporomandibular joint disorders (TMDs), which are often associated with reduced mobility and muscle overactivity, tissue metabolism [...] Read more.

Medical Infrared Thermography (MIT) is a safe, non-invasive technique for assessing temperature changes on the skin’s surface that may reflect pathological processes in the underlying tissues. In temporomandibular joint disorders (TMDs), which are often associated with reduced mobility and muscle overactivity, tissue metabolism and blood flow may be diminished, resulting in localized hypothermia. Aim: The purpose of this study was to evaluate muscle tone in the masseter, suprahyoid, and sternocleidomastoid muscles following the application of two types of occlusal splints, a Michigan splint and a double repositioning splint, based on temperature changes recorded using a Fluke Ti401 PRO thermal imaging camera. Materials and Methods: Sixty dental students diagnosed with TMDs were enrolled in this study. After applying the inclusion and exclusion criteria, participants were randomly assigned to one of two groups. Group M received a Michigan splint, while group D was treated with a double repositioning splint. Results: The type of occlusal splint influenced both temperature distribution and muscle tone. In the double repositioning splint group, temperature decreased by approximately 0.8 °C between T1 and T3, whereas in the Michigan splint group, temperature increased by approximately 0.7 °C over the same period. Conclusions: Occlusal splint design has a measurable impact on temperature distribution and muscle activity. The double repositioning splint appears to be more effective in promoting short-term muscle relaxation and may provide relief for patients experiencing muscular or myofascial TMD symptoms. Full article

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

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37 pages, 438 KiB

Open AccessReview

Three-Dimensionally Printed Splints in Dentistry: A Comprehensive Review

by Luka Šimunović, Samir Čimić and Senka Meštrović

Dent. J. 2025, 13(7), 312; https://doi.org/10.3390/dj13070312 - 10 Jul 2025

Viewed by 682

Abstract

Three-dimensional (3D) printing has emerged as a transformative technology in dental splint fabrication, offering significant advancements in customization, production speed, material efficiency, and patient comfort. This comprehensive review synthesizes the current literature on the clinical use, benefits, limitations, and future directions of 3D-printed [...] Read more.

Three-dimensional (3D) printing has emerged as a transformative technology in dental splint fabrication, offering significant advancements in customization, production speed, material efficiency, and patient comfort. This comprehensive review synthesizes the current literature on the clinical use, benefits, limitations, and future directions of 3D-printed dental splints across various disciplines, including prosthodontics, orthodontics, oral surgery, and restorative dentistry. Key 3D printing technologies such as stereolithography (SLA), digital light processing (DLP), and material jetting are discussed, along with the properties of contemporary photopolymer resins used in splint fabrication. Evidence indicates that while 3D-printed splints generally meet ISO standards for flexural strength and wear resistance, their mechanical properties are often 15–30% lower than those of heat-cured PMMA in head-to-head tests (flexural strength range 50–100 MPa vs. PMMA 100–130 MPa), and study-to-study variability is high. Some reports even show significantly reduced hardness and fatigue resistance in certain resins, underscoring material-specific heterogeneity. Clinical applications reviewed include occlusal stabilization for bruxism and temporomandibular disorders, surgical wafers for orthognathic procedures, orthodontic retainers, and endodontic guides. While current limitations include material aging, post-processing complexity, and variability in long-term outcomes, ongoing innovations—such as flexible resins, multi-material printing, and AI-driven design—hold promise for broader adoption. The review concludes with evidence-based clinical recommendations and identifies critical research gaps, particularly regarding long-term durability, pediatric applications, and quality control standards. This review supports the growing role of 3D printing as an efficient and versatile tool for delivering high-quality splint therapy in modern dental practice. Full article

(This article belongs to the Special Issue Digital Dentures: 2nd Edition)

20 pages, 3348 KiB

Open AccessArticle

Influence of the Processing Method on the Nano-Mechanical Properties and Porosity of Dental Acrylic Resins Fabricated by Heat-Curing, 3D Printing and Milling Techniques

by Marina Imre, Veaceslav Șaramet, Lucian Toma Ciocan, Vlad-Gabriel Vasilescu, Elena Iuliana Biru, Jana Ghitman, Mihaela Pantea, Alexandra Ripszky, Adriana Lucia Celebidache and Horia Iovu

Dent. J. 2025, 13(7), 311; https://doi.org/10.3390/dj13070311 - 10 Jul 2025

Viewed by 345

Abstract

Background: Acrylic resin-based materials are a versatile category used extensively in various dental applications. Processed by current modern technologies, such as CAD/CAM technologies or 3D printing, these materials have revolutionized the field of dentistry for the efficient creation of dental devices. However, [...] Read more.

Background: Acrylic resin-based materials are a versatile category used extensively in various dental applications. Processed by current modern technologies, such as CAD/CAM technologies or 3D printing, these materials have revolutionized the field of dentistry for the efficient creation of dental devices. However, despite their extensive use, a limited number of comparative studies exist that investigate how different processing methods—such as traditional techniques, 3D printing, and CAD/CAM milling—impact the nano-mechanical behavior and internal porosity of these materials, which are critical for their long-term clinical performance. Objectives: The purpose of this study is to evaluate the nanomechanical properties (hardness, elasticity, and stiffness) and micro-porosity of acrylic resin-based materials indicated for temporary prosthodontic appliances manufactured by new technologies (milling, 3D printing) compared to traditional methods. Methods: The hardness, elasticity, and stiffness measurements were performed by the nano-metric indentation method (nanoindentation), and the quantitative morphological characterization of the porosity of the acrylic resin samples obtained by 3D printing and CAD/CAM milling was performed by micro-computed tomography. Results: According to nanomechanical investigations, CAD/CAM milling restorative specimens exhibited the greatest mechanical performances (E~5.233 GPa and H~0.315 GPa), followed by 3D printed samples, while the lowest mechanical properties were registered for the specimen fabricated by the traditional method (E~3.552 GPa, H~0.142 GPa). At the same time, the results of porosity studies (micro-CT) suggested that 3D printed specimens demonstrated a superior degree of porosity (temporary crown—22.93% and splints—8.94%) compared to CAD/CAM milling restorative samples (5.73%). Conclusions: The comparative analysis of these results allows for the optimal selection of the processing method in order to ensure the specific requirements of the various clinical applications. Full article

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15 pages, 1865 KiB

Open AccessSystematic Review

Complexities of Candida Colonization and Oral Microbiome in Oral Lichen Planus: A Systematic Review and Meta-Analysis

by Israyani, Christine Anastasia Rovani, Erni Marlina and Chung-Ming Liu

Dent. J. 2025, 13(7), 310; https://doi.org/10.3390/dj13070310 - 10 Jul 2025

Viewed by 348

Abstract

Background/objectives: Oral lichen planus (OLP) is a chronic autoimmune disorder affecting various age groups and is associated with multiple factors. Conventional therapies often encounter complications from opportunistic infections, particularly oral candidiasis. This study examines the relationships between Candida colonization and oral microbiome composition [...] Read more.

Background/objectives: Oral lichen planus (OLP) is a chronic autoimmune disorder affecting various age groups and is associated with multiple factors. Conventional therapies often encounter complications from opportunistic infections, particularly oral candidiasis. This study examines the relationships between Candida colonization and oral microbiome composition in OLP patients. Through meta-analysis, we clarify these interactions and their implications for OLP progression. Methods: The PICOS is a systematic research strategy, following PRISMA 2020 and MeSH descriptors: oral lichen planus, oral microbiome, oral fungal, and non-Candida oral fungal. Results: A search of CINAHL, EMBASE, PubMed, Science Direct, and Web of Science identified 313 studies. Twelve studies were suitable for a systematic review, with four appropriate for meta-analysis. Findings showed a significant association between OLP and oral microbiota, with an OR of 4.155 (95% CI: 1.278–13.511, p = 0.024). Although analyses of C. albicans and non-albicans species lacked significance, particular non-albicans species were noted. The subgroup analysis of oral microbiota approached significance, indicated by an OR of 11.739 (95% CI: 0.654–210.713, p = 0.059). Conclusions: This study highlights the roles of Candida species and the oral microbiota in OLP, revealing a complex interaction between Candida colonization and the oral microbiome. Full article

(This article belongs to the Special Issue Oral Microbiology and Immunology: Present Research, Challenges and Development)

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29 pages, 2331 KiB

Open AccessReview

Therapeutic Potential of Tanshinones in Osteolytic Diseases: From Molecular and Cellular Pathways to Preclinical Models

by Rafael Scaf de Molon

Dent. J. 2025, 13(7), 309; https://doi.org/10.3390/dj13070309 - 9 Jul 2025

Viewed by 497

Abstract

Tanshinones are a class of lipophilic diterpenoid quinones extracted from Salvia miltiorrhiza (Dan shen), a widely used herb in traditional Chinese medicine. These compounds, particularly tanshinone IIA (T-IIA) and sodium tanshinone sulfonate (STS), have been acknowledged for their broad spectrum of biological activities, [...] Read more.

Tanshinones are a class of lipophilic diterpenoid quinones extracted from Salvia miltiorrhiza (Dan shen), a widely used herb in traditional Chinese medicine. These compounds, particularly tanshinone IIA (T-IIA) and sodium tanshinone sulfonate (STS), have been acknowledged for their broad spectrum of biological activities, including anti-inflammatory, antioxidant, anti-tumor, antiresorptive, and antimicrobial effects. Recent studies have highlighted the potential of tanshinones in the treatment of osteolytic diseases, characterized by excessive bone resorption, such as osteoporosis, rheumatoid arthritis, and periodontitis. The therapeutic effects of tanshinones in these diseases are primarily attributed to their ability to inhibit osteoclast differentiation and activity, suppress inflammatory cytokine production (e.g., tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, and IL-6), and modulate critical signaling pathways, including NF-kB, MAPK, PI3K/Akt, and the RANKL/RANK/OPG axis. Additionally, tanshinones promote osteoblast differentiation and mineralization by enhancing the expression of osteogenic markers such as Runx2, ALP, and OCN. Preclinical models have demonstrated that T-IIA and STS can significantly reduce bone destruction and inflammatory cell infiltration in arthritic joints and periodontal tissues while also enhancing bone microarchitecture in osteoporotic conditions. This review aims to provide a comprehensive overview of the pharmacological actions of tanshinones in osteolytic diseases, summarizing current experimental findings, elucidating underlying molecular mechanisms, and discussing the challenges and future directions for their clinical application as novel therapeutic agents in bone-related disorders, especially periodontitis. Despite promising in vitro and in vivo findings, clinical evidence remains limited, and further investigations are necessary to validate the efficacy, safety, and pharmacokinetics of tanshinones in human populations. Full article

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

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11 pages, 584 KiB

Open AccessArticle

Efficacy of Oral Midazolam for Sedation and Amnesia in Preschool Children with Dental Anxiety: A Double-Blind, Randomized Controlled Trial

by Nguyen Quang Binh, Vo Truong Nhu Ngoc, Pham Quoc Khanh, Nguyen Phuong Huyen, Trinh Khanh Linh, Pham Phuc Khanh and Le Kha Anh

Dent. J. 2025, 13(7), 308; https://doi.org/10.3390/dj13070308 - 9 Jul 2025

Viewed by 711

Abstract

Background: Dental anxiety often poses a significant barrier to effective dental care in pediatric patients. This study evaluated the efficacy and safety of oral midazolam at two different doses for sedation and amnesia in preschool children undergoing dental procedures under 30 min, [...] Read more.

Background: Dental anxiety often poses a significant barrier to effective dental care in pediatric patients. This study evaluated the efficacy and safety of oral midazolam at two different doses for sedation and amnesia in preschool children undergoing dental procedures under 30 min, including primary teeth extraction, root canal treatment, dental filling, and stainless-steel crown. Methods: This prospective, double-blind, randomized controlled trial included 80 children aged 3–6 years with dental anxiety (Types 1 and 2 of the Frankl Behavior Rating Scale) at the National Hospital of Odonto-Stomatology, Hanoi. following the CONSORT guidelines. Participants were randomly assigned to receive oral midazolam at 0.3 mg/kg or 0.6 mg/kg. Sedation efficacy, onset time, procedure duration, cooperation level (Houpt Behavior Rating Scale), recovery time, and amnesia at 12 h, 24 h, and 1 week, as well as adverse events, were recorded and analyzed. Results: Both midazolam doses were effective for sedation (0.3 mg/kg: 95% vs. 0.6 mg/kg: 100%, p = 0.49). The higher dose (0.6 mg/kg) provided significantly longer effective procedural time (27.3 ± 4.1 min vs. 20.3 ± 4.0 min, p < 0.001) and better patient cooperation (95% vs. 78.9%, p = 0.045), but slightly prolonged recovery time (34.6 ± 4.6 min vs. 31.8 ± 4.4 min, p = 0.008). Both doses produced similar amnesic effects, with approximately 90% anterograde amnesia at 12 h post-procedure. Adverse events were minimal and mild. Conclusions: Both 0.3 mg/kg and 0.6 mg/kg doses of oral midazolam are safe and effective for sedation and amnesia in preschool children undergoing dental procedures. While the 0.6 mg/kg dose provides better procedural cooperation and prolonged sedation, it also requires a slightly longer recovery time. Full article

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14 pages, 1886 KiB

Open AccessArticle

Comparative Evaluation of Tooth Discoloration Induced by an Experimental Antibiotic Paste Modified with Nano Chitosan: An In Vitro Study

by Mohamed Ahmed Elsayed, Md Sofiqul Islam, Safiya Ali, Zainab Hussain, Muhammed Mustahsen Rahman and Okba Mahmoud

Dent. J. 2025, 13(7), 307; https://doi.org/10.3390/dj13070307 - 9 Jul 2025

Viewed by 735

Abstract

Background/Objectives: Tooth discoloration is a common concern associated with the use of intra-canal medicaments, particularly those containing antibiotics. This study aims to evaluate the tooth discoloration potential of an experimental antibiotic paste modified with Nano Chitosan (APNC) and compare it with two antibiotic [...] Read more.

Background/Objectives: Tooth discoloration is a common concern associated with the use of intra-canal medicaments, particularly those containing antibiotics. This study aims to evaluate the tooth discoloration potential of an experimental antibiotic paste modified with Nano Chitosan (APNC) and compare it with two antibiotic pastes and two calcium hydroxide-based pastes over different time intervals. Methods: Fifty bovine incisors were standardized and prepared up to size 60. The teeth were randomly assigned into five groups based on the medicament applied: Metapaste, Metapex, modified Triple Antibiotic Paste (mTAP), Double Antibiotic Paste (DAP), and APNC. A digital spectrophotometer was used to measure the color parameters (L*, a*, and b*) at two zones, above and below the cemento-enamel junction (CEJ), across four-time points: before application (T0- baseline), immediately after application (T1), after two weeks (T2), and after one month (T3). The color changes (ΔE) were calculated and statistically analyzed using repeated-measure ANOVA. Results: Statistically significant differences in discoloration were observed between the tested medicaments after one month (p < 0.05). mTAP caused the highest ΔE values both above and below the CEJ at all time points, particularly after one month (p < 0.05). Conversely, APNC, Metapaste, and DAP demonstrated the least discoloration, with no significant differences among them. The degree of discoloration was time-dependent and more pronounced below the CEJ in all groups. Conclusions: After one month, the experimental APNC paste induced tooth discoloration comparable to that of Metapaste, indicating minimal esthetic compromise. APNC may be a promising alternative to traditional antibiotic pastes with minimal discoloration effects. Full article

(This article belongs to the Section Dental Materials)

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20 pages, 19379 KiB

Open AccessArticle

The Success of Endodontic Treatments Performed by Dental Residents in Advanced Education in General Dentistry Program: A 10-Year Retrospective Study

by Nisreen Al Jallad, Eli Sun, Tongtong Wu, Shasha Cui, Amer Basmaji, Radhika Thakkar, Shahenda Aboelmagd, Neha Naik, Konstantina Tzouma, Jin Xiao and Hans Malmstrom

Dent. J. 2025, 13(7), 306; https://doi.org/10.3390/dj13070306 - 8 Jul 2025

Viewed by 1117

Abstract

Objectives: This study aimed to evaluate the success rates of NSRCT performed by AEGD residents and to identify predictive factors associated with clinical outcomes and patient satisfaction. Methods: A retrospective chart review was conducted on cases treated between 2012 and 2021. Eligible cases [...] Read more.

Objectives: This study aimed to evaluate the success rates of NSRCT performed by AEGD residents and to identify predictive factors associated with clinical outcomes and patient satisfaction. Methods: A retrospective chart review was conducted on cases treated between 2012 and 2021. Eligible cases included fully developed permanent teeth that underwent NSRCT and received a final restoration by general dentistry residents, with a minimum of 12 months of follow-up. Data collected included demographic information, medical history, clinical symptoms, radiographic findings, instrumentation, type and timing of final restorations, and patient satisfaction scores. Treatment success was defined as the absence of symptoms and either the resolution or stability of periapical radiolucency. Patient satisfaction and pain levels were also analyzed. Results: AEGD residents achieved radiographic and clinical RCT success rates of 93.3% and 91.5%, respectively. Multivariate logistic regression showed that the presence of an intact restoration was significantly associated with increased odds of tooth retention (odds ratio [OR] = 3.4, p < 0.001), while post placement in a straight root was also a significant predictor of survival (OR = 4.2, p = 0.02). Conversely, pre-existing radiolucency (OR = 0.37, p = 0.018) and the use of a metal post (OR = 0.23, p = 0.012) were significantly associated with lower odds of tooth retention. Worse periodontal health was significantly associated with increased odds of pain on percussion, with a 74.19% increase in odds per worsening category (OR = 1.74, p = 0.002). Patient satisfaction was significantly higher when restorations remained intact, with esthetic satisfaction increasing by a factor of 3.08 (OR = 3.08, p < 0.001) and functional satisfaction increasing by a factor of 3.9 (OR = 3.9, p < 0.001). Conclusions: Endodontic treatments performed by AEGD residents demonstrated high success rates and favorable patient-reported outcomes. Restoration integrity, periodontal health, and post and final restoration selection play critical roles in treatment success and patient satisfaction. Full article

(This article belongs to the Special Issue Dental Education: Innovation and Challenge)

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22 pages, 2988 KiB

Open AccessReview

Impact of Optical Coherence Tomography (OCT) for Periodontitis Diagnostics: Current Overview and Advances

by Pietro Rigotti, Alessandro Polizzi, Anna Elisa Verzì, Francesco Lacarrubba, Giuseppe Micali and Gaetano Isola

Dent. J. 2025, 13(7), 305; https://doi.org/10.3390/dj13070305 - 4 Jul 2025

Viewed by 489

Abstract

Optical coherence tomography (OCT) is a non-invasive imaging technique that provides high-resolution, real-time visualization of soft and hard periodontal tissues. It offers micrometer-level resolution (typically ~10–15 μm) and a scan depth ranging from approximately 0.5 to 2 mm, depending on tissue type and [...] Read more.

Optical coherence tomography (OCT) is a non-invasive imaging technique that provides high-resolution, real-time visualization of soft and hard periodontal tissues. It offers micrometer-level resolution (typically ~10–15 μm) and a scan depth ranging from approximately 0.5 to 2 mm, depending on tissue type and system configuration. The field of view generally spans a few millimeters, which is sufficient for imaging gingiva, sulcus, and superficial bone contours. Over the past two decades, its application in periodontology has gained increasing attention due to its ability to detect structural changes in gingival and alveolar tissues without the need for ionizing radiation. Various OCT modalities, including time-domain, Fourier-domain, and swept-source OCT, have been explored for periodontal assessment, offering valuable insights into tissue morphology, disease progression, and treatment outcomes. Recent innovations include the development of three-dimensional (3D) OCT imaging and OCT angiography (OCTA), enabling the volumetric visualization of periodontal structures and microvascular patterns in vivo. Compared to conventional imaging techniques, such as radiography and cone beam computed tomography (CBCT), OCT offers superior soft tissue contrast and the potential for dynamic in vivo monitoring of periodontal conditions. Recent advancements, including the integration of artificial intelligence (AI) and the development of portable OCT systems, have further expanded its diagnostic capabilities. However, challenges, such as limited penetration depth, high costs, and the need for standardized clinical protocols, must be addressed before widespread clinical implementation. This narrative review provides an updated overview of the principles, applications, and technological advancements of OCT in periodontology. The current limitations and future perspectives of this technology are also discussed, with a focus on its potential role in improving periodontal diagnostics and personalized treatment approaches. Full article

(This article belongs to the Special Issue Optical Coherence Tomography (OCT) in Dentistry)

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11 pages, 696 KiB

Open AccessReview

Role of Brain Networks in Burning Mouth Syndrome: A Narrative Review

by Takahiko Nagamine

Dent. J. 2025, 13(7), 304; https://doi.org/10.3390/dj13070304 - 4 Jul 2025

Viewed by 354

Abstract

Objective: Burning mouth syndrome (BMS) is a chronic and often debilitating orofacial pain condition characterized by a burning sensation in the oral mucosa without clear abnormal lesions. While its etiology is considered multifactorial, the underlying pathophysiology remains unclear. This narrative review aims [...] Read more.

Objective: Burning mouth syndrome (BMS) is a chronic and often debilitating orofacial pain condition characterized by a burning sensation in the oral mucosa without clear abnormal lesions. While its etiology is considered multifactorial, the underlying pathophysiology remains unclear. This narrative review aims to synthesize existing functional magnetic resonance imaging (fMRI) studies to shed light on the central neural mechanisms contributing to BMS. Methods: A focused electronic search was conducted across the PubMed and J-STAGE databases for relevant articles published in English from January 2000 to May 2025. The review prioritized studies investigating brain structure and function using fMRI in individuals with BMS. Results: Our synthesis of the literature consistently demonstrated that the brains of individuals with BMS exhibit augmented connectivity within the medial pain system and a diminished gray matter volume in the medial prefrontal cortex (mPFC). These findings suggest a crucial role for altered brain circuitry, particularly a reduction in the output of the basal ganglia dopamine system, in the experience of BMS pain. Conclusions: The consistent fMRI findings strongly indicate that BMS involves significant functional and structural brain alterations. The observed changes in the mPFC and its connections to the basal ganglia dopamine system highlight this pathway as a potential target for both pharmacological and non-pharmacological neurological interventions for individuals with BMS. Full article

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

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15 pages, 715 KiB

Open AccessSystematic Review

Oral Health and Healthy Ageing: A Systematic Review of Longitudinal Studies

by Lujain Sahab, Jonathon Timothy Newton and Wael Sabbah

Dent. J. 2025, 13(7), 303; https://doi.org/10.3390/dj13070303 - 4 Jul 2025

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Abstract

Background: The global rise in life expectancy and the resulting shift toward ageing populations pose significant public health and socioeconomic challenges. As healthy ageing becomes a priority, understanding the factors that support well-being in older age is essential. Oral health is increasingly [...] Read more.

Background: The global rise in life expectancy and the resulting shift toward ageing populations pose significant public health and socioeconomic challenges. As healthy ageing becomes a priority, understanding the factors that support well-being in older age is essential. Oral health is increasingly recognised as a critical determinant of overall health and has been linked to chronic conditions. Objectives: To conduct a systematic review of longitudinal studies examining the relationship between oral health and healthy ageing. Materials and Methods: Two independent reviewers conducted searches in three databases (MEDLINE, EMBASE, and LILACS) up to April 2025, following a defined search strategy. Grey literature was explored using Open Grey and Google Scholar. The quality and the risk of bias of the included studies were evaluated using the Newcastle Ottawa Quality Assessment Scale (NOS) for longitudinal studies. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251029090). Results: Four longitudinal studies reporting the association between oral health and healthy ageing were recognised and included. All selected studies were considered of good quality according to the NOS. The studies varied in defining and measuring healthy ageing, the follow-up period, the sample size, and the measure of oral health; therefore, it was not possible to perform a meta-analysis. The studies included in the review demonstrated a positive relationship between the number of natural teeth and healthy ageing. Discussion: Despite variations in the definition of healthy ageing and the application of different oral health indicators, the review identified significant associations between the number of natural teeth and trajectories of healthy ageing. Conclusions: This review recognised significant longitudinal associations between oral health measures (number of teeth) and trajectories of healthy ageing. The findings emphasise the need to incorporate oral health into research and policy related to healthy ageing. Full article

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

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13 pages, 1790 KiB

Open AccessArticle

Longitudinal Assessment of Dental Erosion in a Romanian Cohort of Young Adults: A Ten-Year Follow-Up Pilot Study

by Andrea Bors, Felicia Gabriela Beresescu and Melinda Szekely

Dent. J. 2025, 13(7), 302; https://doi.org/10.3390/dj13070302 - 3 Jul 2025

Viewed by 306

Abstract

Background: Dental erosion is the irreversible loss of tooth structure from acid exposure. Its prevalence is rising globally, making it an important oral health concern. However, longitudinal data from Eastern Europe are scarce, especially in Romania. This pilot study aimed to assess the [...] Read more.

Background: Dental erosion is the irreversible loss of tooth structure from acid exposure. Its prevalence is rising globally, making it an important oral health concern. However, longitudinal data from Eastern Europe are scarce, especially in Romania. This pilot study aimed to assess the 10-year incidence of dental erosion in Romanian young adults and to compare clinical index scoring with digital scanning. Methods: A 10-year prospective study followed 540 Romanian adults (aged 18–30) selected with no erosive lesions at baseline (Basic Erosive Wear Examination BEWE = 0). Erosive wear was assessed at the 10-year follow-up using BEWE, with 40 participants also undergoing digital intraoral scanning to measure enamel loss (μm). Gender differences were analyzed. Chi-square tests, relative risk, and correlation analyses were performed. Results: After 10 years, 23.2% of participants developed dental erosion. Males exhibited a higher incidence than females (29.9% vs. 17.2%; RR = 1.74, p < 0.001). Among the scanned subset (n = 40), the mean enamel loss was 137 ± 79 µm, with greater wear on palatal vs. buccal surfaces (p = 0.002). BEWE scores were moderately correlated with digital enamel loss (r = 0.58, p < 0.001). Conclusions: Erosion progressed over time in this cohort, with males at higher risk. Digital scanning detected subtle enamel loss not captured by BEWE, indicating greater sensitivity to early changes. BEWE and digital methods provided complementary information; their combined use offers a more comprehensive assessment. Full article

(This article belongs to the Special Issue Studies on Dental Enamel)

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Dent. J., Volume 13, Issue 7 (July 2025) – 57 articles

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