Dentistry Journal

14 pages, 974 KB

Open AccessArticle

Digital Accuracy of Closed-Tray Implant Impressions: Influence of Polyvinyl Siloxane Viscosity and Subgingival Posterior Implant Angulation

by Yousra Ahmed, Shereen Moselhy Abdul Hameed, Zainab Refaey El Sharkawy, Faris A. Alshahrani, Tarek AbdAllah Mahmoud, Inas M. Mohamed and Noha Taymour

Dent. J. 2025, 13(9), 421; https://doi.org/10.3390/dj13090421 - 12 Sep 2025

Abstract

Objectives: To assess the impact of PVS impression material viscosity and implant angulation on the three-dimensional accuracy of implant casts in a partially edentulous situation using the closed-tray technique. Materials and Methods: Three epoxy resin mandibular partially edentulous models (Kennedy Class I) [...] Read more.

Objectives: To assess the impact of PVS impression material viscosity and implant angulation on the three-dimensional accuracy of implant casts in a partially edentulous situation using the closed-tray technique. Materials and Methods: Three epoxy resin mandibular partially edentulous models (Kennedy Class I) were fabricated, each with four implant analogues placed at teeth positions 35, 37, 45, and 47. The anterior analogues were positioned parallel (0), while the posterior analogues were placed at different angulations: Group 1, 30° mesiodistal; Group 2, 20° mesiodistal; Group 3, 20° buccolingual. All analogues were placed 2 mm subgingivally. Closed-tray impressions (n = 8 per subgroup) were made using either heavy + light body PVS or monophase PVS. Resulting stone casts were scanned, and STL files were processed and analyzed using reverse engineering software (Geomagic Control X). Three-dimensional deviations (root mean square, RMS) between reference and test models were calculated by superimposition and best-fit algorithm. Results: With monophase PVS, implant angulation significantly influenced cast accuracy (p < 0.001). The 30° MD group exhibited the highest deviation (96 ± 7 µm), followed by the 20° BL group (81 ± 6 µm), then the 20° MD group (75 ± 6 µm). In contrast, no statistically significant difference in accuracy was observed among angulation groups when using heavy + light body PVS (77 ± 3 µm, 82 ± 13 µm, and 79 ± 8 µm for 30° MD, 20° BL, and 20° MD, respectively; p = 0.550). Conclusions: Both monophase and heavy + light body PVS impression materials produced clinically acceptable accuracy for closed-tray implant impressions. However, the heavy + light body PVS demonstrated greater consistency across various implant angulations and is recommended for multiple angulated subgingival posterior implants when using the closed-tray technique. Full article

► Show Figures

Figure 1

14 pages, 903 KB

Open AccessArticle

Comparison of Narrow (<3.75 mm) and Standard (≥3.75 mm) Diameter Implants Supporting the Same Multiple Fixed Prostheses and Mirroring Real-World Clinical Scenarios: Non-Randomized Clinical Trial

by Eduardo Anitua, Ander Alcaine and Mohammad Hamdan Alkhraisat

Dent. J. 2025, 13(9), 420; https://doi.org/10.3390/dj13090420 - 12 Sep 2025

Abstract

Objective: To compare the survival of narrow (<3.75 mm) implants and standard diameter (≥3.75 mm) implants supporting the same multiple fixed prostheses and mirroring real-world clinical scenarios. Methods: This is a controlled clinical trial where both test (diameter < 3.75 mm) and control [...] Read more.

Objective: To compare the survival of narrow (<3.75 mm) implants and standard diameter (≥3.75 mm) implants supporting the same multiple fixed prostheses and mirroring real-world clinical scenarios. Methods: This is a controlled clinical trial where both test (diameter < 3.75 mm) and control (diameter ≥ 3.75 mm) implants supported the same prosthesis. The principal variable was implant survival and the secondary variables included demographic, surgical and prosthetic variables. Statistical analyses were conducted to compare these variables between the study groups. Results: A total of 42 patients participated in this study, with an age range of 39 to 92 years. The follow-up period was 36 months. Narrow diameter implants (NDIs) were predominantly placed in the premolar region and more frequently in bone types I and II compared to wider diameter implants. No implant failures were recorded during the study period. Marginal bone level remodeling showed statistically significant differences between the study groups at 12-month follow-up. However, these differences were no longer significant after 3 years of follow-up (Test: median −0.2 mm, range −1.5 to 0.8 mm; Control: median 0.0 mm, range −1.3 to 0.8 mm; p = 0.119). None of the prostheses failed, and all remained free of technical complications throughout the study. Conclusions: Within the limitations of this study, narrow-diameter implants demonstrated comparable clinical outcomes to standard-diameter implants when supporting the same prostheses. Full article

► Show Figures

Figure 1

12 pages, 613 KB

Open AccessArticle

Crown–Root Ratio as a Predictive Morphometric Indicator in Mandibular First Molars with Occlusal Trauma and Periodontitis: A Radiographic and Clinical Modeling Study

by Lidya Irani Nainggolan, Bramma Kiswanjaya, Menik Priaminiarti, Sri Lelyati Chaidar Masulili, Hanna H. Bachtiar-Iskandar, Yuniarti Soeroso, Pitu Wulandari, Eha Renwi Astuti and Akihiro Yoshihara

Dent. J. 2025, 13(9), 419; https://doi.org/10.3390/dj13090419 - 12 Sep 2025

Abstract

Background/Objectives: Trauma from occlusion (TFO) is a modifying factor in periodontal disease progression, yet its morphometric impact on mandibular molars remains underexplored. The crown–root ratio (CRR), traditionally used in prosthodontic prognosis, may also serve as a diagnostic marker for structural changes in periodontally [...] Read more.

Background/Objectives: Trauma from occlusion (TFO) is a modifying factor in periodontal disease progression, yet its morphometric impact on mandibular molars remains underexplored. The crown–root ratio (CRR), traditionally used in prosthodontic prognosis, may also serve as a diagnostic marker for structural changes in periodontally compromised teeth. This study evaluated the relationship between crown and root dimensions and clinical/radiographic parameters in mandibular first molars with TFO and developed predictive models emphasizing the role of CRR. Methods: This retrospective cross-sectional study included 99 periodontitis patients clinically and radiographically diagnosed with TFO. Digitized periapical radiographs of mandibular first molars (tooth 36 or 46) were analyzed to measure clinical and radiographic CRR, crown and root length, tooth inclination, alveolar bone loss, and root morphology. Correlation and stepwise multiple regression analyses identified predictors of crown and root length. Results: Males had significantly greater crown length (7.6 vs. 7.2 mm), root length (13.3 vs. 12.3 mm), and radiographic CRR (1.2 vs. 1.0) (p = 0.008). Clinical CRR showed a moderate positive correlation with crown length (r = 0.526) and a strong inverse correlation with root length (r = −0.735) (p < 0.001). Regression models revealed that clinical CRR, root length, and sex significantly predicted crown length (R² = 0.955), while CRR and crown length predicted root length (R² = 0.958). Conclusions: This study demonstrated that the clinical crown–root ratio (CRR) is a strong predictor of both crown and root lengths in mandibular first molars affected by trauma from occlusion (TFO) in periodontitis patients. Full article

► Show Figures

Graphical abstract

12 pages, 605 KB

Open AccessArticle

Comparative Usability Evaluation of Three Digital Smile Design Software Tools Using the System Usability Scale

by Andrei Macris, Sergiu Drafta, Ștefania Martiniuc and Alexandru E. Petre

Dent. J. 2025, 13(9), 418; https://doi.org/10.3390/dj13090418 - 12 Sep 2025

Abstract

Background/Objectives: Digital Smile Design software tools facilitates aesthetic planning and improves communication between clinicians, patients, and dental laboratories. These software tools have been developed to support facial and dental analysis and to assist users in creating an ideal smile integrated with the patient’s [...] Read more.

Background/Objectives: Digital Smile Design software tools facilitates aesthetic planning and improves communication between clinicians, patients, and dental laboratories. These software tools have been developed to support facial and dental analysis and to assist users in creating an ideal smile integrated with the patient’s appearance. This study aimed to compare the usability of three DSD software tools—Preteeth AI Pro (version 6.0.0), SmileCloud, and Medit Link (version 3.4.3)—using the System Usability Scale. Methods: Twenty-three prosthodontists and prosthodontics residents evaluated each tool following a standardized usage protocol. After completing Digital Smile Designs in each application, participants filled out a 10-item System Usability Scale questionnaire (score 0–100). Descriptive statistics were calculated, and intergroup comparisons were performed using one-way ANOVA (p < 0.05). Results: Mean System Usability Scale scores were 74.24 (Preteeth AI Pro), 80.33 (SmileCloud), and 73.15 (Medit Link). SmileCloud obtained the highest score (A−grade, Curved Grading Scale), indicating “good to very good” usability. No statistical significances were found between the three software tools (F = 1.04, p = 0.36). Conclusions: All three Digital Smile Design software tools achieved System Usability Scale scores above the usability benchmark of 68, with SmileCloud demonstrating the most favorable user experience. These findings may assist clinicians in selecting intuitive and efficient Digital Smile Design platforms to optimize aesthetic treatment workflows. Full article

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

► Show Figures

Figure 1

14 pages, 858 KB

Open AccessArticle

Synergistic Effect of Sodium Hypochlorite and Carbon Dioxide Against Enterococcus faecalis Biofilm

by Júlia Guerra de Andrade, Ana Flávia Folhas Natali, Caroline Loureiro, Gladiston William Lobo Rodrigues, Ana Paula Fernandes Ribeiro, Rayara Nogueira de Freitas, Renan Jose Barzotti, Laura Cesário Oliveira, Yuri Gabriel Chamorro de Moraes, Natália Amanda Gomes, Antônio Hernandes Chaves-Neto, Frederico Canato Martinho and Rogério de Castilho Jacinto

Dent. J. 2025, 13(9), 417; https://doi.org/10.3390/dj13090417 - 10 Sep 2025

Viewed by 61

Abstract

Objectives: This study aimed to evaluate whether the addition of pressurized carbon dioxide (PCD) influences the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) against Enterococcus faecalis biofilm in root canals and dentinal tubules. Methods: Forty extracted human mandibular premolars with single canals were [...] Read more.

Objectives: This study aimed to evaluate whether the addition of pressurized carbon dioxide (PCD) influences the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) against Enterococcus faecalis biofilm in root canals and dentinal tubules. Methods: Forty extracted human mandibular premolars with single canals were contaminated with E. faecalis for 10 days and randomly assigned to four groups (n = 10): 2.5% NaOCl, 2.5% NaOCl + CO₂, sterile saline, and sterile saline + CO₂. The pH and temperature of the NaOCl solution were measured before and after CO₂ incorporation. Microbial load was assessed by CFU counts before and after irrigation, and in dentin samples from the cervical, middle, and apical thirds. Oxidative stress was evaluated via lipid peroxidation (TBARS), protein carbonyl content, and total protein quantification. Biofilm metabolic activity was analyzed using the XTT reduction assay. Data were analyzed using one-way ANOVA on ranks and two-way repeated measures ANOVA (α = 0.05), a very large effect size (Cohen’s d) ≈ 1.756 was assumed. Results: All irrigation protocols significantly reduced bacterial load (p < 0.05). Both NaOCl groups outperformed the saline controls (p = 0.009). The addition of CO₂ to NaOCl slightly enhanced disinfection in the main canal but did not improve antimicrobial action in dentinal tubules. CO₂ incorporation reduced the pH of NaOCl from ~13.4 to 7.4 and slightly increased the temperature, making the solution more chemically reactive. However, both oxidative stress markers and the XTT assay showed that the combination with CO₂ impaired the antimicrobial effectiveness of NaOCl. Conclusions: Despite the improvement in bacterial reduction in the root canal lumen, the combination of PCD with NaOCl failed to enhance intratubular disinfection and reduced the oxidative damage and metabolic inactivation of the biofilm. CO₂ pressurization appears to limit the antimicrobial action of NaOCl. Full article

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

► Show Figures

Graphical abstract

23 pages, 806 KB

Open AccessSystematic Review

Laser Therapy for Vascular Malformations of the Oral Cavity: A Systematic Review

by Matteo Pellegrini, Martina Bosisio, Federica Pulicari, Carmen Darinca Todea and Francesco Spadari

Dent. J. 2025, 13(9), 416; https://doi.org/10.3390/dj13090416 - 9 Sep 2025

Viewed by 157

Abstract

Objectives: to compare the clinical effectiveness, safety, and aesthetic outcomes of different laser systems used for the treatment of oral vascular malformations. Materials and Methods: This review followed JBI guidelines and adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews [...] Read more.

Objectives: to compare the clinical effectiveness, safety, and aesthetic outcomes of different laser systems used for the treatment of oral vascular malformations. Materials and Methods: This review followed JBI guidelines and adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. The research was performed through the databases PubMed, Scopus, and Web of Science using MeSH (Medical Subject Headings) terms for MEDLINE (PubMed), while equivalent free-text terms were applied to Scopus and Web of Science. The initial database search was performed on 20 May 2024. Studies published from 2014 to 2024 focusing on laser therapy for oral vascular lesions were included. Data quality was assessed using NHLBI and ROBINS-I V2 tools. Results: Of the 139 articles identified, 11 met inclusion criteria, assessing Nd:YAG, diode, Er,Cr:YSGG, and CO₂ lasers. The Nd:YAG laser was effective for deep vascular lesions with strong thermal effects. The diode laser provided excellent coagulation and minimal postoperative discomfort. The Er,Cr:YSGG laser offered faster healing and better cosmetic results. The CO₂ laser showed effective results with low recurrence rates. Most studies reported reduced bleeding, pain, and recovery time following laser treatment. Conclusions: Laser therapy, particularly Nd:YAG, diode, and CO₂ lasers, offers a safe, effective alternative for oral vascular malformations, providing improved outcomes and fewer complications. Future studies should include larger sample sizes and comparisons with traditional therapies. Full article

(This article belongs to the Special Issue Editorial Board Members’ Collection Series: Laser in Oral Surgery, Diagnosis and Oncology)

► Show Figures

Graphical abstract

19 pages, 4393 KB

Open AccessArticle

Bond Strength of an Epoxy Resin Root Canal Sealer Prototype

by Matthias J. Roggendorf, Hubert C. Roggendorf, Markus Müller-Krott, Franz-Josef Faber and Roland Frankenberger

Dent. J. 2025, 13(9), 415; https://doi.org/10.3390/dj13090415 - 9 Sep 2025

Viewed by 165

Abstract

Background/Objectives: We aimed to assess the bond strength of AH Plus Jet (AH) and an epoxy resin-based root canal sealer prototype (K-0189) adhered to three different obturation points. Methods: A total of 120 single-rooted teeth were selected after radiographic analysis, and [...] Read more.

Background/Objectives: We aimed to assess the bond strength of AH Plus Jet (AH) and an epoxy resin-based root canal sealer prototype (K-0189) adhered to three different obturation points. Methods: A total of 120 single-rooted teeth were selected after radiographic analysis, and their root canals were instrumented with ProTaper Next files (PTN) up to size X5. The teeth were randomly assigned to two sealer groups (G) (G1: AH, G2: K-0189, each n = 60) and further divided into three subgroups: (A) ConformFit X5 points (PTN) cold obturation (CO), (B) ProTaper Universal F5 points (PTU) (CO), (C) GuttaCore X5 (GC) warm obturation (WO). After final irrigation (NaOCl 3%, EDTA 17%, NaOCl 3%) and drying, root canals were obturated and stored for 30 days at 37 °C in Simulated Body Fluid (SBF). The specimens were embedded in acrylate and sectioned horizontally; then, push-out bond strength (POBS) analysis was performed. Results: The median POBS values [MPa] were G1A: 2.03; G1B: 2.12; G1C: 3.2; G2A: 1.91; G2B: 2.56; and G2C: 3.36. WO showed significantly higher POBS (p < 0.001 *) than CO. The POBS was not significantly different between the two WO groups (p = 0.508). The POBS of G2B was significantly higher compared to all other CO groups. Conclusions: The epoxy resin sealer prototype demonstrated POBS values comparable to AH Plus when used with WO and PTU points, indicating significantly higher POBS values compared to all other CO points. Full article

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

► Show Figures

Figure 1

10 pages, 674 KB

Open AccessReview

Timing of Treatment for Patients with Hypertrophic Maxillary Labial Frena

by Veronica Lexa Marr, Lauren Grace Stewart, Man Hung and Val Joseph Cheever

Dent. J. 2025, 13(9), 414; https://doi.org/10.3390/dj13090414 - 8 Sep 2025

Viewed by 208

Abstract

Background/Objectives: The maxillary labial frenum (MLF) is a connective tissue structure attaching the upper lip to the maxillary alveolar process. Its morphology varies significantly among individuals and is often most prominent during early childhood. While hypertrophic or low-attaching frena have been associated [...] Read more.

Background/Objectives: The maxillary labial frenum (MLF) is a connective tissue structure attaching the upper lip to the maxillary alveolar process. Its morphology varies significantly among individuals and is often most prominent during early childhood. While hypertrophic or low-attaching frena have been associated with diastemas, feeding issues, and speech impairments, there is no causal evidence supporting early surgical intervention. This review aims to examine current evidence regarding the timing and necessity of frenectomy procedures and to evaluate the implications of early versus delayed intervention. Methods: A narrative review was conducted using twenty peer-reviewed articles published in the past 10 years, with one additional article from 2012 included for its ongoing relevance. Databases searched included PubMed, the NIH database, the Reference Manual of Pediatric Dentistry, and journals from the American Academy of Pediatrics. Inclusion criteria were English-language, peer-reviewed studies that addressed the morphology, classification, diagnosis, management, and outcomes of MLFs across age groups. Excluded were studies focusing solely on mandibular, buccal, or lingual frena; non-English publications; case reports; and articles lacking full-text availability. Results: The literature suggests that premature frenectomy, prior to the eruption of permanent maxillary canines, typically between 9 and 12 years of age, is associated with frenum regrowth, surgical complications, and orthodontic relapse. Additionally, a lack of standardized diagnostic criteria contributes to inconsistent clinical decision-making. Conservative management, including monitoring, is strongly recommended as the frenum often migrates apically as the maxilla develops. Factors such as airway obstruction and developmental delays should be ruled out before considering surgery. Conclusions: There is insufficient evidence to support early surgical intervention for MLF-related concerns. A conservative, individualized approach, delaying frenectomy until after permanent canine eruption, may minimize complications, improve long-term outcomes, and allow the frenum to migrate apically as the patient develops. Standardized diagnostic tools are urgently needed to guide clinical decision-making. Full article

► Show Figures

Figure 1

19 pages, 595 KB

Open AccessSystematic Review

Automated Detection of Periodontal Bone Loss in Two-Dimensional (2D) Radiographs Using Artificial Intelligence: A Systematic Review

by Alin M. Iacob, Marta Castrillón Fernández, Laura Fernández Robledo, Enrique Barbeito Castro and Matías Ferrán Escobedo Martínez

Dent. J. 2025, 13(9), 413; https://doi.org/10.3390/dj13090413 - 8 Sep 2025

Viewed by 238

Abstract

Artificial intelligence is an emerging tool that is being used in multiple fields, including dentistry. An example of this is the diagnosis of periodontal bone loss by analyzing two-dimensional (2D) radiographs (periapical, bitewing, and panoramic). Objectives: The objectives of this systematic review [...] Read more.

Artificial intelligence is an emerging tool that is being used in multiple fields, including dentistry. An example of this is the diagnosis of periodontal bone loss by analyzing two-dimensional (2D) radiographs (periapical, bitewing, and panoramic). Objectives: The objectives of this systematic review are to bring together the existing evidence and evaluate the effectiveness of the different artificial intelligence architectures that have been used in recent studies. Materials and Methods: This work has been carried out following the PRISMA criteria and has been recorded in PROSPERO (ID = CRD 42025640049). We searched six different databases, and the results were filtered according to previously established inclusion and exclusion criteria. We extracted data independently by three review authors and analyzed the risk of bias of the studies using the QUADAS-2 test, calculating Cohen’s kappa index (κ) to measure the agreement between assessors. Results: We included 20 diagnostic accuracy studies according to the inclusion and exclusion criteria, published between 2019 and 2024. All included studies described the detection of periodontal bone loss on radiographs. Limitations: One of the main limitations identified was heterogeneity in the indices used to assess the accuracy of models, which made it difficult to compare results between studies. In addition, many works use different imaging protocols and X-ray equipment, introducing variability into the data and limiting reproducibility. Conclusions: Artificial intelligence is a promising technique for the automated detection of periodontal bone loss, allowing the accurate measurement of bone loss, identifying lesions such as apical periodontitis and stage periodontitis, in addition to reducing diagnostic errors associated with fatigue or inexperience. However, improvements are still required to optimize its accuracy and clinical applicability. Full article

► Show Figures

Figure 1

12 pages, 973 KB

Open AccessArticle

Patient Satisfaction with Anterior Bite Turbos: A Prospective Clinical Trial

by Fady Hussein Fahim, Donald Lloyd Baumann, Ahmed Othman, Reham M. Abdelsalam, Hamada Ahmed Deyab, Constantin von See and Dina Osman ElAbbasy

Dent. J. 2025, 13(9), 412; https://doi.org/10.3390/dj13090412 - 8 Sep 2025

Viewed by 169

Abstract

Background: Bonded composite bite turbos are an efficient tool in the treatment of deep bite malocclusion. Patient satisfaction with orthodontic appliances has been correlated with treatment success. The aim of this study is to evaluate the level of patient satisfaction associated with [...] Read more.

Background: Bonded composite bite turbos are an efficient tool in the treatment of deep bite malocclusion. Patient satisfaction with orthodontic appliances has been correlated with treatment success. The aim of this study is to evaluate the level of patient satisfaction associated with bonded composite anterior bite turbos in deep bite treatment. Materials and Methods: This study was a one-arm prospective clinical study. Sixty patients, younger than 25 years old with permanent dentition and increased anterior overbite were treated with composite bite turbos bonded to the maxillary central incisors. A questionnaire form using the Likert scale with five responses (Very Unpleasant, Unpleasant, Acceptable, Pleasant, and Very Pleasant) was used by patients to document their satisfaction and feedback regarding the bite turbos after 1 week and 1 month. Statistical analyses with the chi-squared test was used to analyze the data for statistical significance. Results: Spearman’s correlation coefficient was used to determine the correlation between age and satisfaction score, while the Mann–Whitney U test was used to compare the satisfaction scores between males and females. There was a statistically significant difference between all patient responses after 1 week and 1 month. A significant decline occurred in the unpleasant response from 10% after 1 week to 0% after 1 month; acceptable response from 36.7% after 1 week to 3.3% after 1 month. There was a statistically significant increase in the pleasant and very pleasant responses. Minor speech and eating difficulties were reported during the first week by 46.7% of patients. Conclusions: Anterior bite turbos made from Triad Gel and bonded to palatal surfaces of both maxillary central incisors using a Mini-Mold tip with 5 mm depth tip will most likely lead to an acceptance rate of 90% after 1 week and 100% acceptance rate after 1 month, without any problems in 53.3% of the patients. Short follow-up periods and lack of control group are the main limitations in this study. Trial registration: Registered at ClinicalTrials.gov (NCT07143916). Full article

► Show Figures

Figure 1

18 pages, 1593 KB

Open AccessArticle

Determinants of Severe Oral Mucositis Development Despite Photobiomodulation Therapy in Stem Cell Transplant Patients

by Sandra Bastos Rezende, Luana Campos, Maria Clara de Souza, Marcos Schoenmann, Maria Cristina Martins de Almeida Macedo, Roberto Luiz da Silva and Alyne Simões

Dent. J. 2025, 13(9), 411; https://doi.org/10.3390/dj13090411 - 8 Sep 2025

Viewed by 234

Abstract

Background/Objectives: Oral mucositis (OM) is an extremely common and debilitating side effect in patients undergoing Hematopoietic Stem Cell Transplantation (HSCT). As such, managing this condition is an obligatory component for their supportive care. Among the available treatment options, photobiomodulation therapy has long [...] Read more.

Background/Objectives: Oral mucositis (OM) is an extremely common and debilitating side effect in patients undergoing Hematopoietic Stem Cell Transplantation (HSCT). As such, managing this condition is an obligatory component for their supportive care. Among the available treatment options, photobiomodulation therapy has long since established itself as the most promising approach, with consistent evidence supporting its efficacy. Despite this, the clinical results of this therapy are still influenced by the chosen dosimetry parameters, as well as patient-specific factors. Therefore, this study aimed to assess which factors can continue to influence the severity and onset of OM despite the protective effect provided by the ongoing photobiomodulation therapy. Methods: To achieve this, a retrospective analysis was conducted on the medical records of 171 patients who underwent PBMT during HSCT over a two-year period at the Brazilian Institute of Cancer Control. These files were used to review clinical and laboratorial parameters, such as OM grade, serum CRP, creatinine, urea, OGT, PGT, pain levels, presence of microorganisms in cultures, type of transplant, and conditioning regimens. All of these were evaluated at two different time points: the first day of conditioning and the day of highest OM degree. The statistical analysis was then conducted to evaluate the correlation between the variables and OM grade. Results: Results showed that type of conditioning regimens, use of MTX during conditioning, presence of microorganisms in cultures, and increased serum CRP, PGT, and initial urea levels were associated with severe OM. Conclusions: Among these, the type of conditioning regimens, MTX usage, positive results in cultures, and increased PGT levels on the first day of conditioning could be considered predictive for severe OM and the worst PBMT results. Consequently, in patients exposed to additional risk factors, adjustments in dosimetry paraments of PBMT or employment of adjuvant therapies should be considered to achieve better results. Full article

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

► Show Figures

Figure 1

25 pages, 2829 KB

Open AccessReview

Maxillary Expansion in the Management of Obstructive Sleep Apnea: A Comprehensive Review

by Roqaya Alrumaih, Ali Alterki and Mohammad Qali

Dent. J. 2025, 13(9), 410; https://doi.org/10.3390/dj13090410 - 5 Sep 2025

Viewed by 204

Abstract

Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by partial or complete blockage of the upper airway during sleep, leading to disrupted airflow and fragmented sleep. Maxillary expansion has emerged as a promising treatment option, as widening the maxilla can increase [...] Read more.

Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by partial or complete blockage of the upper airway during sleep, leading to disrupted airflow and fragmented sleep. Maxillary expansion has emerged as a promising treatment option, as widening the maxilla can increase nasal airway volume and improve airflow. The treatment options for maxillary expansion include rapid maxillary expansion (RME) for pediatric patients, mini-screw-assisted rapid palatal expansion (MARPE) for adolescents and adults, surgically assisted rapid palatal expansion (SARPE) for skeletally mature individuals, and distraction osteogenesis maxillary expansion (DOME) for adults with severe maxillary constriction and nasal obstruction. This comprehensive review explores the role of maxillary expansion in the management of OSA, examining its clinical applications and potential effectiveness as a therapeutic intervention. Full article

► Show Figures

Figure 1

11 pages, 902 KB

Open AccessArticle

Comparison of Dentoalveolar Trauma Patterns Between E-Scooter and Bicycle Accidents in a German Urban Area: A Retrospective Study

by Anna Aydin, Johannes Schunk, Manfred Giese, Oliver Schuck and Florian Dudde

Dent. J. 2025, 13(9), 409; https://doi.org/10.3390/dj13090409 - 5 Sep 2025

Viewed by 162

Abstract

Objectives: The increasing popularity of electric scooters (E-scooters) has led to a rise in trauma-related injuries, particularly in the craniofacial region. This study aims to compare dentoalveolar trauma (DT) patterns between E-scooter and bicycle accidents in a German urban area to identify differences [...] Read more.

Objectives: The increasing popularity of electric scooters (E-scooters) has led to a rise in trauma-related injuries, particularly in the craniofacial region. This study aims to compare dentoalveolar trauma (DT) patterns between E-scooter and bicycle accidents in a German urban area to identify differences in injury characteristics, risk factors, and treatment approaches. Materials and Methods: This retrospective study analyzed 178 patients treated for DT following E-scooter (n = 56) or bicycle (n = 122) accidents between January 2022 and December 2022 at a single oral and maxillofacial surgery department in a German urban area. Demographic, clinical, temporal, and therapeutic data were collected and statistically compared. Results: E-scooter patients were significantly younger (mean age: 33.6 vs. 47.0 years, p < 0.001) and predominantly female (85.7% vs. 26.2%, p < 0.001) compared to bicycle patients. E-scooter accidents more frequently occurred at night (69.6%) and on weekends (62.5%) and were significantly associated with alcohol consumption (55.4%) and low helmet use (8.9%). Clinically, E-scooter accidents resulted in more complex dental injuries, including a higher incidence of root fractures (14.3% vs. 0%, p < 0.001), complicated crown fractures (25.0% vs. 9.0%, p = 0.004), and crown-root fractures (32.1% vs. 9.8%, p < 0.001). Mandibular injuries were more prevalent in the E-scooter group, and concomitant facial fractures (excluding alveolar) were also more common (28.6% vs. 19.7%, p = 0.018). Conclusion: E-scooter accidents are associated with a distinct DT pattern involving younger, often alcohol-intoxicated, and helmetless patients, typically presenting with more severe and complex DT-injuries. These findings highlight the urgent need for targeted prevention strategies, legislative measures on helmet use, and clinician awareness of specific trauma profiles linked to E-scooter use. Full article

(This article belongs to the Section Oral and Maxillofacial Surgery)

► Show Figures

Figure 1

19 pages, 5697 KB

Open AccessArticle

Biomechanical and Morphological Analyses of Enamel White Spot Lesions Treated by Different Therapeutic Approaches (In Vitro Comparative Study)

by Lamis Abdul Hammed Al-Taee, Mohammad Talal Al-Hyazaie, Rabeia J. Khalil and Avijit Banerjee

Dent. J. 2025, 13(9), 408; https://doi.org/10.3390/dj13090408 - 5 Sep 2025

Viewed by 447

Abstract

Background/Objectives: Within the minimum intervention oral care (MIOC) delivery framework, the management and improvement in the esthetics of enamel white spot lesions (WSLs) are recommended. This study evaluated the chemomechanical and morphological characteristics of WSLs treated by four therapeutic approaches using Raman [...] Read more.

Background/Objectives: Within the minimum intervention oral care (MIOC) delivery framework, the management and improvement in the esthetics of enamel white spot lesions (WSLs) are recommended. This study evaluated the chemomechanical and morphological characteristics of WSLs treated by four therapeutic approaches using Raman spectroscopy, Knoop microhardness (KH), and field-emission scanning electron microscopy (FESEM). Methods: Sixty human enamel slabs were divided into six groups: non-treated (baseline), WSLs (8% methylcellulose gel with 0.1 M lactic acid, pH 4.6 at 37 °C for 21 days), and four treated groups, namely bovine collagen supplement (Nutravita Ltd., Maidenhead, Berkshire, UK), Regenerate system (NR-5, Bordeaux, France), Sylc air abrasion (AquaCare, Denfotex Research Ltd., Edinburgh, UK), and CO₂ laser (JHC1180, Jinan, China). Treatment lasted 28 days, followed by four weeks of storage in artificial saliva (pH = 7.0, 37 °C). Bovine collagen was analyzed using Fourier-Transform Infrared Spectroscopy (FTIR). The mineral content, including the phosphate peak intensities (PO₄ ν₁, ν₂, and ν₄) and carbonate (CO₃), as well as tissue microhardness, were assessed at varying depths (50–200 µm), followed by morphological assessment. Results: The FTIR spectrum of bovine collagen powder confirms the presence of amide I, II, and III. It produced a statistically significant enhancement in the phosphate content and KHN compared to WSLs of up to 150 µm in depth (p < 0.001). Regenerate-treated surfaces recorded the highest phosphate content among groups at the superficial layer. All treatment interventions enhanced the morphology of lesions by covering the exposed prisms and inter-prismatic structure. Conclusions: Bovine collagen supplements can enhance the phosphate content and surface properties of enamel white spot lesions (WSLs) and could be considered a potential modality comparable to other micro-invasive approaches for addressing incipient enamel lesions. This could significantly impact dental care management. Full article

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

► Show Figures

Graphical abstract

15 pages, 345 KB

Open AccessArticle

A Survey of Oral Health-Related Quality of Life for Adults with Cerebral Palsy in Australia

by Karen Lansdown, Kim Bulkeley, Margaret McGrath, Michelle Irving, Claudia Zagreanu and Hayley Smithers-Sheedy

Dent. J. 2025, 13(9), 407; https://doi.org/10.3390/dj13090407 - 4 Sep 2025

Viewed by 287

Abstract

Objective: Our aim was to investigate the oral health-related quality of life (OHRQoL) and dental care experiences of adults with Cerebral Palsy (CP). Methods: In 2023, adults with CP and their caregivers from four Australian states completed questionnaires, including the Oral Health Impact [...] Read more.

Objective: Our aim was to investigate the oral health-related quality of life (OHRQoL) and dental care experiences of adults with Cerebral Palsy (CP). Methods: In 2023, adults with CP and their caregivers from four Australian states completed questionnaires, including the Oral Health Impact Profile-14 (OHIP-14). Non-parametric tests were conducted to analyze associations between demographic and CP-related variables and OHRQoL. Results: A total of 69 respondents participated, including n = 22 adults with CP and n = 47 caregivers of adults with CP. Most adults with CP were diagnosed with a spastic motor type (46/69, 66%), with bilateral spasticity being the most common (30/46, 65%). The mean OHIP-14 score was 10.3 ± 9.3 (mean ± SD). Nearly 70% reported challenges cleaning their teeth, over 25% lacked a dentist, more than 60% found dental exams challenging, and nearly 50% required specialized dental care. In bivariate analysis, OHIP-14 was associated with daily oral care routines (p = 0.012) and “simple dental check-up” (p = 0.017). There was a statistically significant relationship between socio-economic status and scores for the handicap dimension (p = 0.040). Higher OHIP-14 scores were associated with greater levels of impairment regarding gross motor (p = 0.199), manual functioning limitations (p = 0.001), speech (p = 0.123), and communication function scales (p = 0.319). Conclusion: Adults with CP reported challenges participating in and maintaining oral health and accessing dental care, influenced by physical, functional, and socio-economic factors. These findings indicate the need for inclusive care and strategies to support access to services. Full article

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

► Show Figures

Figure 1

13 pages, 2024 KB

Open AccessArticle

Qualitative Enhancement of the Tooth–Filling Interface Using Cold Atmospheric Plasma

by Madline Priska Gund, Jusef Naim, Muhammad al Muhammad, Antje Lehmann, Axel Schindler, Matthias Hannig and Stefan Rupf

Dent. J. 2025, 13(9), 406; https://doi.org/10.3390/dj13090406 - 4 Sep 2025

Viewed by 299

Abstract

Objective: To evaluate the effects of cold atmospheric plasma (CAP) on adhesive bonding in Class II composite restorations in vitro. Methods: Forty-eight standardized Class II cavities were assigned to six groups (n = 8), varying in phosphoric acid conditioning, CAP [...] Read more.

Objective: To evaluate the effects of cold atmospheric plasma (CAP) on adhesive bonding in Class II composite restorations in vitro. Methods: Forty-eight standardized Class II cavities were assigned to six groups (n = 8), varying in phosphoric acid conditioning, CAP treatment (1.5 W or 3 W), composite filling, and thermo-mechanical loading (TML). Evaluations included dye penetration, adhesive layer morphology, resin tag length, and hybrid layer thickness. Results: CAP combined with phosphoric acid (H₃PO₄) significantly increased hybrid layer thickness and resin tag length (p < 0.006). The lowest dye penetration was observed in Groups 1 and 4. Conclusions: CAP in combination with phosphoric acid improved the adhesive interface in Class II cavities. CAP alone showed limited benefits, and higher power levels may negatively affect bonding. Full article

(This article belongs to the Section Dental Materials)

► Show Figures

Figure 1

18 pages, 2393 KB

Open AccessArticle

Four-Week Evaluation of the Interaction Pattern Among Saccharibacteria, Nitrate-Reducing Bacteria, and Periodontopathogens in Orthodontic Miniscrew Implants

by Boy M. Bachtiar, Endang W. Bachtiar, Nicholas S. Jakubovics, Turmidzi Fath, Sariesendy Sumardi, Nada Ismah, Natalina Haerani, Fatimah Maria Tadjoedin and Zamri Radzi

Dent. J. 2025, 13(9), 405; https://doi.org/10.3390/dj13090405 - 4 Sep 2025

Viewed by 387

Abstract

Background/Objective: Orthodontic mini-implants (MI) create new niches that may alter the oral microbiota and modulate host immune responses. While clinical inflammation is not always evident, microbial and molecular changes may precede visible signs of peri-implant infection. This study investigated microbial shifts and [...] Read more.

Background/Objective: Orthodontic mini-implants (MI) create new niches that may alter the oral microbiota and modulate host immune responses. While clinical inflammation is not always evident, microbial and molecular changes may precede visible signs of peri-implant infection. This study investigated microbial shifts and inflammatory responses following MI placement, with a focus on Saccharibacteria, nitrate-reducing bacteria (NRB), and periodontopathogens. Methods: Saliva and peri mini-implant crevicular fluid (PMICF) samples were collected from eight orthodontic patients at baseline (T0), one week (T1), and one month (T2) after mini-implant placement. DNA was extracted from each saliva and PMICF sample and pooled across the eight patients for each time point. The pooled DNA were then subjected to 16S rRNA gene sequencing using the Oxford Nanopore MinION platform. Statistical analysis was performed to determine shifts in bacterial abundance, diversity, and co-occurrence patterns across the different sample types (saliva vs. PMICF) and time points. Results: Alpha diversity decreased in PMICF at T2, while it remained stable in saliva samples. Periodontopathogens (Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum) increased in PMICF at T2, while NRB and Saccharibacteria, along with a representative host bacterium (Schaalia odontolytica), remained relatively stable. Co-occurrence analysis showed antagonistic relationships between Saccahribacteria/NRB and periodontopathogens. IL-6 significantly decreased from T1 to T2, while CRP showed a non-significant downward trend. The expression of nitrate reductase genes narG and napA remained stable across time intervals. Conclusions: Despite no clinical inflammation, MI placement led to localized microbial shift and mild inflammatory responses. NRB and Saccharibacteria’s stability and antagonistic relationship to periodontopathogens may indicate that they could be involved in maintaining microbial homeostasis. These findings highlight possible early biomarkers and ecological strategies to support oral health in MI patients. Full article

► Show Figures

Graphical abstract

20 pages, 2104 KB

Open AccessArticle

Effectiveness of Individually Trained Oral Prophylaxis (iTOP) Education on Long-Term Oral Health in Medical and Dental Students: A Two-Year Prospective Cohort Study

by Zvonimir Lukac, Brigita Maric, Josip Kapetanovic, Mislav Mandic, Ivona Musa Leko and Andrija Petar Bosnjak

Dent. J. 2025, 13(9), 404; https://doi.org/10.3390/dj13090404 - 3 Sep 2025

Viewed by 361

Abstract

Background/Objectives: Preventive oral health education plays a key role in preparing future healthcare professionals to promote and maintain good oral hygiene. Individually Trained Oral Prophylaxis (iTOP) is a structured, personalized educational program that emphasizes correct brushing techniques and interdental cleaning. This study [...] Read more.

Background/Objectives: Preventive oral health education plays a key role in preparing future healthcare professionals to promote and maintain good oral hygiene. Individually Trained Oral Prophylaxis (iTOP) is a structured, personalized educational program that emphasizes correct brushing techniques and interdental cleaning. This study aimed to evaluate the long-term effectiveness of a single-session iTOP intervention on clinical oral health outcomes among medical and dental students. Methods: A 2-year prospective cohort study included 82 first- and fourth-year medical and dental students at the University of Mostar, Bosnia and Herzegovina. The researchers randomly assigned participants to an iTOP intervention group or a control group. The primary analysis used multivariable linear mixed-effects models for repeated measures, adjusted for study program, academic year, smoking status, and baseline oral-hygiene habits, with effect sizes reported alongside 95% confidence intervals. Clinical periodontal parameters—plaque index, bleeding on probing, and probing depth—were assessed at baseline, three months, and two years. All participants received professional cleaning and oral hygiene kits. Only the intervention group received personalized iTOP training, consisting of a single session with brief reinforcement at the 3-month follow-up. This study was registered at ClinicalTrials.gov (NCT07085013). Results: Seventy-six students completed the follow-up. The iTOP group had significantly lower plaque index and bleeding scores at both follow-up points (p < 0.001) compared to the control group. Baseline differences were observed between subgroups (medical vs. dental; younger vs. older students), but these diminished over time. At the 2-year follow-up, only the plaque index remained significantly improved, while other clinical parameters returned to values comparable to baseline. Conclusions: The iTOP program resulted in significant short-term improvements in oral health among medical and dental students. For sustained long-term outcomes, iTOP or similar structured oral health education programs should be integrated into medical and dental curricula. Enhancing oral health awareness among healthcare providers may ultimately contribute to improved public oral health outcomes. Given the single-center design and the single-session nature of the intervention, the results should be interpreted with caution. Full article

(This article belongs to the Special Issue Oral Pathology: Current Perspectives and Future Prospects)

► Show Figures

Figure 1

10 pages, 857 KB

Open AccessArticle

Material-Dependent Microhardness Response to Preheating in Nanoparticulate Composite Resins Cured with High-Intensity Light

by Jorge I. Fajardo, César A. Paltán, Ana Armas-Vega, Camila Campanella-Maldonado and Silvio Requena-Cisneros

Dent. J. 2025, 13(9), 403; https://doi.org/10.3390/dj13090403 - 2 Sep 2025

Viewed by 301

Abstract

Background/Objectives: Composite resins are widely used in restorative dentistry due to their aesthetic properties and ease of handling. Preheating prior to light polymerization has been proposed to improve flowability, degree of conversion, and mechanical properties. This in vitro study aimed to evaluate the [...] Read more.

Background/Objectives: Composite resins are widely used in restorative dentistry due to their aesthetic properties and ease of handling. Preheating prior to light polymerization has been proposed to improve flowability, degree of conversion, and mechanical properties. This in vitro study aimed to evaluate the effect of preheating on the microhardness of three nanoparticulate composite resins—IPS Empress Direct (Ivoclar), Filtek Z350 XT (3M-ESPE), and Forma (Ultradent)—when cured with a high-power LED light. Methods: Sixty disc-shaped samples (n = 20 per material) were fabricated and divided into preheated and non-preheated groups. After polishing and 24 h storage in distilled water at 37 °C, samples were subjected to Knoop microhardness testing under a 300 g load for 15 s. Statistical analysis was conducted using R software. Results: Preheating produced a significant increase in surface microhardness for IPS Empress Direct (32.8%) and Filtek Z350 XT (5.8%) (p < 0.05 for both), whereas Forma showed no significant change. Conclusions: Under the conditions of this in vitro study, preheating can enhance the mechanical performance of specific composite resins by increasing microhardness; however, the effect is material-dependent. Full article

► Show Figures

Figure 1

25 pages, 3974 KB

Open AccessFeature PaperArticle

Modular Deep-Learning Pipelines for Dental Caries Data Streams: A Twin-Cohort Proof-of-Concept

by Ștefan Lucian Burlea, Călin Gheorghe Buzea, Florin Nedeff, Diana Mirilă, Valentin Nedeff, Maricel Agop, Dragoș Ioan Rusu and Laura Elisabeta Checheriță

Dent. J. 2025, 13(9), 402; https://doi.org/10.3390/dj13090402 - 2 Sep 2025

Viewed by 372

Abstract

Background: Dental caries arise from a multifactorial interplay between microbial dysbiosis, host immune responses, and enamel degradation visible on radiographs. Deep learning excels in image-based caries detection; however, integrative analyses that combine radiographic, microbiome, and transcriptomic data remain rare because public cohorts are [...] Read more.

Background: Dental caries arise from a multifactorial interplay between microbial dysbiosis, host immune responses, and enamel degradation visible on radiographs. Deep learning excels in image-based caries detection; however, integrative analyses that combine radiographic, microbiome, and transcriptomic data remain rare because public cohorts are seldom aligned. Objective: To determine whether three independent deep-learning pipelines—radiographic segmentation, microbiome regression, and transcriptome regression—can be reproducible implemented on non-aligned datasets, and to demonstrate the feasibility of estimating microbiome heritability in a matched twin cohort. Methods: (i) A U-Net with ResNet-18 encoder was trained on 100 annotated panoramic radiographs to generate a continuous caries-severity score from a predicted lesion area. (ii) Feed-forward neural networks (FNNs) were trained on supragingival 16S rRNA profiles (81 samples, 750 taxa) and gingival transcriptomes (247 samples, 54,675 probes) using randomly permuted severity scores as synthetic targets to stress-test preprocessing, training, and SHAP-based interpretability. (iii) In 49 monozygotic and 50 dizygotic twin pairs (n = 198), Bray–Curtis dissimilarity quantified microbial heritability, and an FNN was trained to predict recorded TotalCaries counts. Results: The U-Net achieved IoU = 0.564 (95% CI 0.535–0.594), precision = 0.624 (95% CI 0.583–0.667), recall = 0.877 (95% CI 0.827–0.918), and correlated with manual severity scores (r = 0.62, p < 0.01). The synthetic-target FNNs converged consistently but—as intended—showed no predictive power (R² ≈ −0.15 microbiome; −0.18 transcriptome). Twin analysis revealed greater microbiome similarity in monozygotic versus dizygotic pairs (0.475 ± 0.107 vs. 0.557 ± 0.117; p = 0.0005) and a modest correlation between salivary features and caries burden (r = 0.25). Conclusions: Modular deep-learning pipelines remain computationally robust and interpretable on non-aligned datasets; radiographic severity provides a transferable quantitative anchor. Twin-cohort findings confirm heritable patterns in the oral microbiome and outline a pathway toward future clinical translation once patient-matched multi-omics are available. This framework establishes a scalable, reproducible foundation for integrative caries research. Full article

► Show Figures

Figure 1

14 pages, 252 KB

Open AccessArticle

Oral Health Status, Behavior, and Knowledge of Patients with Cardiovascular Disease and Associated Risk Factors in Odisha: A Cross-Sectional Survey

by Lora Mishra, Muskan Sharma, Naomi Ranjan Singh, Gathani Dash, Satya Ranjan Misra, Krzysztof Sokolowski, Manoj Kumar, Rupsa Das, Suresh Kumar Behera and Barbara Lapinska

Dent. J. 2025, 13(9), 401; https://doi.org/10.3390/dj13090401 - 1 Sep 2025

Viewed by 375

Abstract

Background: Cardiovascular diseases (CVDs) are linked with poor oral health outcomes, yet data on oral health status, behaviors, and awareness among CVD patients in Odisha remain scarce. This study aimed to assess the self-reported oral health status, behaviors, and knowledge among patients with [...] Read more.

Background: Cardiovascular diseases (CVDs) are linked with poor oral health outcomes, yet data on oral health status, behaviors, and awareness among CVD patients in Odisha remain scarce. This study aimed to assess the self-reported oral health status, behaviors, and knowledge among patients with CVD and associated risk factors. Methods: A cross-sectional survey was conducted among 391 patients aged 40–80 years attending dental and cardiology OPDs at a tertiary care center in Bhubaneswar. Participants were grouped into control, at-risk, and established CVD categories. A 24-item questionnaire and panoramic radiographic examination were used to assess oral health. Data were analyzed using the chi-squared test and Kappa statistics. Results: Patients with established CVD reported significantly higher prevalence of oral health problems, poor oral hygiene behaviors, and lower awareness compared to controls. Clinical findings revealed higher rates of periodontal bone loss, caries, and periapical radiolucency in the CVD group. Agreement between radiographic examiners was high. Conclusions: There is a substantial burden of oral disease and poor oral health awareness among patients with CVD in Odisha. These findings emphasize the need for integrated oral health education and care protocols in cardiovascular patient management. Full article

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

12 pages, 360 KB

Open AccessReview

Role of Myokines on the Bone Metabolism of Craniofacial Region: A Scoping Review

by Ahana S. Rajan and Eiji Tanaka

Dent. J. 2025, 13(9), 400; https://doi.org/10.3390/dj13090400 - 31 Aug 2025

Viewed by 367

Abstract

Background: The craniofacial region is functionally unique, with close interaction between muscles and bones during mastication, speech, and facial expression. Although myokines, muscle-derived signaling molecules, are increasingly being studied in relation to bone metabolism, most studies have focused on limb muscles and long [...] Read more.

Background: The craniofacial region is functionally unique, with close interaction between muscles and bones during mastication, speech, and facial expression. Although myokines, muscle-derived signaling molecules, are increasingly being studied in relation to bone metabolism, most studies have focused on limb muscles and long bones. Given the developmental and functional specificity of craniofacial structures, this article aims to map the current evidence on myokines involved in craniofacial bone metabolism and to identify gaps in order to guide future research. Methods: We conducted a literature search in PubMed and Scopus (January 2000–July 2025), combining both free-text keywords and MeSH terms to ensure comprehensive retrieval of relevant articles. Results: Nine articles from the extensive search were included in this review that adhered to the eligibility criteria. The myokines that were reported include interleukin-6, insulin like growth factor-1, and myostatin and irisin. Conclusions: Further research is required into the mechanism by which craniofacial muscle-derived myokines regulate local bone metabolism, as this knowledge could pave the way for novel therapeutic strategies that leverage myokine signaling, which could be applied in the context of orthodontic and orthognathic treatments, maxillofacial reconstruction, or age-related bone loss. Full article

► Show Figures

Figure 1

14 pages, 1135 KB

Open AccessArticle

The Role of Five Prognostic Factors in the Eruption of Palatally Impacted Canines Following Diode Laser Disinclusion: A Case Series Study

by Martina Horodynski, Francesca Crocamo, Adriana Assunta De Stefano, Gerardo La Monaca, Nicola Pranno, Gaspare Palaia, Umberto Romeo and Gabriella Galluccio

Dent. J. 2025, 13(9), 399; https://doi.org/10.3390/dj13090399 - 31 Aug 2025

Viewed by 298

Abstract

Background: This case series study aims to evaluate the spontaneous eruption of impacted canines following diode laser disinclusion surgery without orthodontic traction, and to analyze the correlation with five prognostic factors: age, sex of the patient, angle α, sector, and height of inclusion [...] Read more.

Background: This case series study aims to evaluate the spontaneous eruption of impacted canines following diode laser disinclusion surgery without orthodontic traction, and to analyze the correlation with five prognostic factors: age, sex of the patient, angle α, sector, and height of inclusion of the canine. Methods: The sample included 15 patients aged 13–30 years and 20 palatally impacted canines. The patients’ records were collected, and prognostic factors were assessed. All patients underwent disinclusion surgery using a diode laser (K-Laser, Eltech, Blue Derma) and post-surgery, canines were monitored with intraoral scans and photos at 1 week, 8 weeks (T1), and 16 weeks (T2). The STL files were superimposed with the open-source software MeshLab (MeshLab 2023.12, Visual Computing Lab, Pisa, Italy), and the eruption values were measured. Through multiple linear regression analysis, the relationships between the five prognostic factors and the total spontaneous eruption value were analyzed. Results: The canines treated in this study responded with an average eruption of 4.70 mm. For the prognostic factors sex (p = 0.94) and angle α (p = 0.12), no statistically significant relationship with eruption was found. The variables age (p < 0.001), sector II (p = 0.02), sector III (p = 0.03), sector IV (p = 0.06), and inclusion height (p < 0.001) had negative linear coefficients. Consequently, as the values of these three prognostic factors increased, a lower eruption of the included element measured in millimeters was obtained. Conclusions: All canines successfully erupted following the disinclusion procedure, avoiding the use of orthodontic traction. Patient sex and the α angle of impaction were not reliable predictors of eruption outcomes. In contrast, age, sector, and inclusion height measured via CBCT showed high statistical significance and could be used as prognostic factors to predict the eruptive response following disinclusion surgery. Full article

(This article belongs to the Special Issue Photobiomodulation Research and Applications in Dentistry)

► Show Figures

Figure 1

15 pages, 2152 KB

Open AccessArticle

An International Online Survey on Oral Hygiene Issues in Patients with Epidermolysis Bullosa

by Giovanna Garuti, Giacomo Setti, Chiara Lucia Guidetti, Gaela Barbieri, Ugo Consolo and Pierantonio Bellini

Dent. J. 2025, 13(9), 398; https://doi.org/10.3390/dj13090398 - 30 Aug 2025

Viewed by 328

Abstract

Background: Inherited epidermolysis bullosa (EB) includes a group of rare genetic disorders affecting the skin and mucous membranes. These disorders are characterized by extreme fragility and blister formation after minimal or no trauma. Oral and systemic manifestations vary by subtype; the more [...] Read more.

Background: Inherited epidermolysis bullosa (EB) includes a group of rare genetic disorders affecting the skin and mucous membranes. These disorders are characterized by extreme fragility and blister formation after minimal or no trauma. Oral and systemic manifestations vary by subtype; the more severe forms often present with extensive intra-oral blistering, scarring, microstomia, vestibular obliteration, ankyloglossia, and—in some cases—oral cancer. This study aims to collect data on oral-health practices and challenges in people with EB to inform preventive strategies and dental care. Methods: An international, structured online questionnaire with 31 items was distributed to individuals with a confirmed diagnosis of EB. The survey explored clinical and oral manifestations, home-care routines (oral hygiene and diet), experiences with dental professionals, and the impact of oral health on quality of life. Results: Eighty-two questionnaires were completed. Dystrophic EB was the most often reported subtype (69.5%). Most respondents (67.1%) experienced recurrent oral blisters and/or erosions. Many reported relying exclusively on soft foods and struggling with mechanical plaque removal because of microstomia and pseudo-syndactyly. Severe oral pain hindered effective brushing in 17% of participants. Hand contractures and microstomia interfered with oral hygiene in 74% and 31% of participants, respectively. Nearly 30% sought dental care only when in pain. Among those who did not attend regular check-ups or hygiene sessions (44.6%), the most cited reason was that dental clinics were inadequately equipped or trained to manage EB. Conclusions: Because dental procedures carry significant risks for patients with EB, preventive care should begin in early childhood. Yet many patients are still insufficiently informed about essential preventive measures and lack access to dental professionals trained in EB management. Full article

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

► Show Figures

Graphical abstract

17 pages, 1673 KB

Open AccessArticle

Absorption, Thermal Relaxation Time, and Beam Penetration Depth of Laser Wavelengths in Ex Vivo Porcine Gingival Tissues

by Mayssaa Ismail, Thibault Michel, Daniel Heysselaer, Saad Houeis, Andre Peremans, Alain Vanheusden and Samir Nammour

Dent. J. 2025, 13(9), 397; https://doi.org/10.3390/dj13090397 - 29 Aug 2025

Viewed by 412

Abstract

Background/Objectives: The laser beam absorption and thermal relaxation time (TRT) in oral tissues are key to optimizing treatment parameters. The aim of this study is to (1) evaluate, in an ex vivo study, the percentage of attenuation and transmittance of each wavelength [...] Read more.

Background/Objectives: The laser beam absorption and thermal relaxation time (TRT) in oral tissues are key to optimizing treatment parameters. The aim of this study is to (1) evaluate, in an ex vivo study, the percentage of attenuation and transmittance of each wavelength as a function of tissue thickness; (2) determine the global absorption coefficient, α, of pig gingival tissue for the most commonly used wavelengths in dentistry; (3) calculate the thermal relaxation time (TRT) of oral tissue for these wavelengths; and (4) determine their corresponding penetration depths. Methods: We measured the transmission of different laser wavelengths through pig oral gingival tissues (Mandibular labial gingiva). We placed each tissue sample between two glass slides with minimal light attenuation. The input and output powers were measured after irradiating the tissue at different specific wavelengths: 450 nm, 480 nm, 532 nm, 632 nm, 810 nm, 940 and 980 nm, 1064 nm, 1341, 2780 nm and 2940 nm. After calculating the transmittance values, we plotted transmittance curves for each wavelength. Using the Beer–Lambert law, we then calculated the absorption coefficient (α) of each wavelength in the oral gingival tissue. Absorption coefficients were then used to calculate the TRT and penetration depth for each wavelength. Results: Among the tested wavelengths, 810 nm exhibited the lowest absorption in ex vivo porcine gingival tissue (α = 9.60 cm⁻¹). The 450 nm blue laser showed moderate absorption (α = 26.8 cm⁻¹), while the Er:YAG laser at 2940 nm demonstrated the highest absorption (α = 144.8 cm⁻¹). We ranked the wavelengths from most absorbed to least absorbed by porcine oral gingival mucosa as follows: 2940 nm > 2780 nm > 450 nm > 480 nm > 532 nm > 1341 nm > 632 nm > 940 nm > 980 nm > 1064 nm > 810 nm. Conclusions: Absorption and the TRT vary significantly across wavelengths. Erbium lasers are characterized by the highest absorption and minimal light penetration. Infrared diodes, particularly the 810 nm wavelength, showed the lowest absorption and deepest tissue penetration and exhibited the highest thermal relaxation time. The 480 nm laser demonstrated greater absorption by porcine gingival tissue compared to the 532 nm laser. These findings provide evidence-based guidance for wavelength selection in dental treatments and photobiomodulation, enabling improved precision, safety, and therapeutic efficacy in clinical practice. Full article

(This article belongs to the Special Issue Photobiomodulation Research and Applications in Dentistry)

► Show Figures

Graphical abstract

27 pages, 2300 KB

Open AccessReview

Collagen-Composite Scaffolds for Alveolar Bone and Dental Tissue Regeneration: Advances in Material Development and Clinical Applications—A Narrative Review

by Natesan Thirumalaivasan

Dent. J. 2025, 13(9), 396; https://doi.org/10.3390/dj13090396 - 29 Aug 2025

Viewed by 617

Abstract

Background/Objectives: The use of collagen-based scaffolds in dentition tissue engineering has gained significance and importance in the field as they are structurally equivalent and biologically compatible with the native extracellular matrix (ECM). In this review, collagen-composite scaffolds for pulp, alveolar bone, and periodontal [...] Read more.

Background/Objectives: The use of collagen-based scaffolds in dentition tissue engineering has gained significance and importance in the field as they are structurally equivalent and biologically compatible with the native extracellular matrix (ECM). In this review, collagen-composite scaffolds for pulp, alveolar bone, and periodontal regeneration are analyzed in terms of materials, fabrication techniques, and clinical outcomes. Methods: Recent developments in collagen scaffolds are highlighted in this review, with a focus on type I collagen due to its structural strength and arginine–glycine–aspartic acid (RGD) motifs, which promote cell adhesion and differentiation. Composite materials, freeze-drying, electrospinning, and 3D bioprinting, which are used to improve the functionality of the scaffold, are key developments. Results: This review shows progress in collagen-based scaffolds for restoring dental tissues, such as dentin, gingival tissue, or bone, in humans. Electrospinning and 3D bioprinting are new manufacturing techniques that enhance the functionality of scaffold devices, and incorporating bioactive molecules increases the regenerative capacity; however, stability and long-term efficacy are still problems. Conclusions: Although they have a lot of potential, collagen-composite scaffolds face challenges like rapid degradation and limited mechanical strength. To make long-lasting, tailored dental regeneration therapies feasible, future research needs to improve smart biomaterials, gene delivery, and personalized designs for dental regenerative therapy. Full article

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

► Show Figures

Graphical abstract

15 pages, 1023 KB

Open AccessArticle

Precision in Facial Measurements: Comparative Analysis Between a Digital 3D Scanner and an Analog Instrument

by Francesco Puleio, Giorgio Lo Giudice, Angela Alibrandi, Ilenia Campione, Federica Di Spirito and Roberto Lo Giudice

Dent. J. 2025, 13(9), 395; https://doi.org/10.3390/dj13090395 - 29 Aug 2025

Viewed by 545

Abstract

Background: Accurate facial proportion analysis is essential for therapeutic planning in dentistry. This study aimed to evaluate the Planmeca ProFace 3D scanner’s accuracy by comparing its digital measurements to analog caliper measurements. Methods: A comparative cross-sectional study included seven patients. Fourteen standardized facial [...] Read more.

Background: Accurate facial proportion analysis is essential for therapeutic planning in dentistry. This study aimed to evaluate the Planmeca ProFace 3D scanner’s accuracy by comparing its digital measurements to analog caliper measurements. Methods: A comparative cross-sectional study included seven patients. Fourteen standardized facial landmarks were measured digitally and with an analog caliper. Distances were grouped as small (≤6.5 cm, Group A) or large (>6.5 cm, Group B). Paired t-tests, Cronbach’s Alpha, and Bland–Altman analysis assessed differences, reliability, and agreement. Results: The results showed a statistically significant difference between the two methods of measurements in group A (p = 0.016) and high statistical significance was obtained in group B (p = 0.001). Cronbach’s Alpha showed high reliability for Group A (α = 0.982) but low for Group B (α = 0.270). The mean difference between the caliper and software measurements was 0.24 ± 0.9 SD (min 0.16 max 2.92) in group A and 0.71 ± 2.8 SD (min 0.02 max 4.17). Bland–Altman analysis revealed a consistent positive proportional bias, with differences increasing for larger measurements. Conclusions: Facial point measurements by the means of digital scanning technique show measurements overlapping with analog technique for measurements less than or equal to 6.5 cm, with significant deviation for points with a distance greater than 6.5 cm. A hybrid approach or compensatory strategies are needed to ensure clinical precision. Full article

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

► Show Figures

Figure 1

13 pages, 743 KB

Open AccessArticle

Evaluating the Effectiveness of Nasoalveolar Molding in the Management of Children with Unilateral Cleft Lip and Palate: A Cohort Study

by Alba España-Guerrero, Enrique España-Guerrero, Esther Liceras-Liceras, Elena Bullejos-Martínez, Adoración Martínez-Plaza, Miguel Alaminos, Ricardo Fernández-Valadés and Antonio España-López

Dent. J. 2025, 13(9), 394; https://doi.org/10.3390/dj13090394 - 28 Aug 2025

Viewed by 373

Abstract

Background: Children affected by unilateral cleft lip and palate (UCLP) represent a therapeutic challenge requiring the development of novel therapies, such as the implant of a bioengineered tissue—BIOCLEFT—or the use of nasoalveolar molding (NAM). The objective of this work was to evaluate [...] Read more.

Background: Children affected by unilateral cleft lip and palate (UCLP) represent a therapeutic challenge requiring the development of novel therapies, such as the implant of a bioengineered tissue—BIOCLEFT—or the use of nasoalveolar molding (NAM). The objective of this work was to evaluate the effects of NAM on the surgical and aesthetic outcomes of children with UCLP. Methods: A total of 36 children with UCLP treated at a craniofacial malformations management unit were evaluated, including 23 patients treated with presurgical NAM followed by palate surgical correction (NAM group) and 13 patients treated surgically without previous NAM (non-NAM group). Measurements were obtained from each patient immediately before palate surgery, including four linear measurements: nasal ala projection length (NAPL), nasal dome height (NDH), superoinferior alar groove position (S-I AGP), and nasal dome position (M-L NDP), and two angular measurements: columellar deviation (CD) and nasal bridge deviation (NBD). Results: When NAM was used, a significant improvement of the basilar view linear measurements of the patient’s nose was found, including the NAPL and NDH, and the frontal view linear measurement M-L NDP, but not S-I AGP. Significant improvements were also observed in the angular measurements of nasal symmetry CD and NBD. All these variables, except the S-I AGP, significantly correlated with the treatment group, and two variables—NAPL and CD—significantly contributed to generate a predictive model developed using binary logistic regression. Conclusions: These findings support the use of NAM to efficiently improve the nasal symmetry and the presurgical outcomes of patients with UCLP. Full article

(This article belongs to the Special Issue Trends in Orofacial Cleft Research)

► Show Figures

Graphical abstract

22 pages, 3603 KB

Open AccessArticle

Computer Simulation of the Mechanical Behavior of the ‘Zygomatic Bones–Implants–Splinting Bar–Removable Overdenture’ Dental Structure Under Operational Loads

by Magomed Magomedov, Alexander Kozulin, Sergey Arutyunov, Alexey Drobyshev, Timur Dibirov, Eduard Kharazyan, Magomet Mustafaev, Artem Drobyshev and Sergey Panin

Dent. J. 2025, 13(9), 393; https://doi.org/10.3390/dj13090393 - 28 Aug 2025

Viewed by 355

Abstract

Background/Objectives: When solving the problems of installing zygomatic implants after partial or full maxillectomy with subsequent attachment of a removable overdenture (ROD), computer simulation based on the finite element method (FEM) is an effective tool for treatment planning. In this study, stress-strain states [...] Read more.

Background/Objectives: When solving the problems of installing zygomatic implants after partial or full maxillectomy with subsequent attachment of a removable overdenture (ROD), computer simulation based on the finite element method (FEM) is an effective tool for treatment planning. In this study, stress-strain states of the ‘zygomatic bones–implants–splinting bar–ROD’ dental structure were evaluated under various loading conditions. Methods: A 3D FEM computer simulation was carried out to estimate stress-strain states of the elements of the dental structure and to study the effect of redistribution of the loads transferred from the ROD to the zygomatic bones through four implants. Results: That successive insertion and removal of the ROD caused identical stresses in the elements of the dental structure. Given the accepted level of critical stress of about 13 MPa, their values may be exceeded in the zygomatic bones during both processes. In the ROD, the equivalent stresses did not exceed the critical levels upon alternate loading of 50 N on the posterior teeth (both molars and premolars) under all biting and mastication. Taking into account the linear dependence of the applied load and the stresses in the ROD, it can be stated that its integrity is maintained until 118 N (or the generally accepted typical value of 100 N). Under the 90° biting angle, the equivalent stresses are below the critical level in all the studied cases; thus, the acceptable value increases to 213 N, but it is only 63 N at a biting angle of 45°. Conclusions: It has been established that the equivalent stresses in the zygomatic bones can exceed the critical stress level of 13 MPa. In addition, some practical recommendations and prospects of the study have been formulated. Full article

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

► Show Figures

Figure 1

28 pages, 1016 KB

Open AccessReview

Sustainable Dental and Periodontal Practice: A Narrative Review on the 4R-Framework—Reduce, Reuse, Rethink, Recycle—And Waste Management Rationalization

by Federica Di Spirito, Francesco Giordano, Maria Pia Di Palo, Giuseppina De Benedetto, Leonardo Aulisio and Giovanni Boccia

Dent. J. 2025, 13(9), 392; https://doi.org/10.3390/dj13090392 - 28 Aug 2025

Viewed by 582

Abstract

Background/Objectives: While dentistry plays a critical role in promoting oral health, it also contributes significantly to environmental degradation through high energy consumption, water usage, and reliance on disposable, non-recyclable materials. Periodontology, in particular, involves resource-intensive procedures such as full-mouth disinfection, frequent surgical [...] Read more.

Background/Objectives: While dentistry plays a critical role in promoting oral health, it also contributes significantly to environmental degradation through high energy consumption, water usage, and reliance on disposable, non-recyclable materials. Periodontology, in particular, involves resource-intensive procedures such as full-mouth disinfection, frequent surgical interventions, and aerosol-generating instrumentation. The aim of the present narrative review is to synthesize current knowledge and delineate feasible, evidence-informed strategies to operationalize sustainability across the full spectrum of periodontal treatment settings. Methods: The electronic search of the present narrative review was performed across PubMed/MEDLINE, Web of Science, BioMed Central, Scopus, CINAHL, and Cochrane Library databases. Results: The review identified actionable sustainability strategies across pre-workplace (e.g., eco-conscious procurement and transport reduction), workplace (e.g., energy- and water-saving technologies, digital workflows, and pollution control), and waste management (e.g., reuse protocols, recycling, and sustainable material selection). Particular emphasis was placed on the role of dental education, life cycle assessments, and digital innovations. Conclusions: The transition toward sustainable periodontology requires the adoption of evidence-based practices and leveraging digital innovation to reduce the environmental impact while maintaining high standards of care. Full article

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

► Show Figures

Figure 1

Journal Menu

Journal Browser

Dent. J., Volume 13, Issue 9 (September 2025) – 40 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI