Dentistry Journal

13 pages, 2092 KB

Open AccessArticle

From Images to Specimens: The Impact of Tactile, Three-Dimensional Learning in Dental Anatomy

by Anna Tostrup Kristensen, Noora Helene Thune, Hugo Lewi Hammer, Qalbi Khan, Tor Paaske Utheim, Camilla Sofia Miranda Kristoffersen, Camilla Elise Øxnevad Ziesler and Amer Sehic

Dent. J. 2026, 14(4), 245; https://doi.org/10.3390/dj14040245 - 21 Apr 2026

Cited by 1 | Viewed by 541

Abstract

Background: A solid understanding of dental and craniofacial anatomy is essential for reliable clinical practice, yet long-term retention of anatomical knowledge is known to decline as students progress through their training. Although digital- and image-based resources are widely used in anatomy education, it [...] Read more.

Background: A solid understanding of dental and craniofacial anatomy is essential for reliable clinical practice, yet long-term retention of anatomical knowledge is known to decline as students progress through their training. Although digital- and image-based resources are widely used in anatomy education, it remains unclear whether two-dimensional (2D) representations support durable recognition of complex anatomical structures. This study investigated whether tactile engagement with real three-dimensional (3D) anatomical specimens enhances long-term identification accuracy compared with standardized 2D images. Materials and Methods: Eighty-nine fifth-year dental students at the University of Oslo were assessed approximately 2.5 years after completing their formal anatomy course. All students completed two sequential identification tests on the same day: a 2D image-based test followed immediately by an equivalent test using real extracted human teeth and real skull bones. The assessments comprised 28 osteology structures and 14 teeth. Performance between conditions was compared using mixed-effects logistic regression with test modality as a fixed effect and participant and anatomical item as crossed random effects. Results: Overall identification accuracy increased from 52% in the 2D condition to 74% in the 3D tactile condition (p < 0.0001). Mean accuracy for osteology improved from 0.519 (SD = 0.074) to 0.708 (SD = 0.072) (p < 0.0001), while tooth morphology scores increased from 0.535 (SD = 0.097) to 0.795 (SD = 0.110) (p < 0.0001). All individual teeth and nearly all osteological structures showed significantly higher identification accuracy in the 3D condition. The largest gains were observed for structures with low 2D recognition. Conclusions: Tactile interaction with real 3D anatomical specimens substantially enhances long-term recognition of dental and craniofacial anatomy. These findings support the continued integration of hands-on, three-dimensional learning alongside digital resources in dental anatomy education to promote durable anatomical understanding and clinical preparedness. Full article

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

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9 pages, 2384 KB

Open AccessCase Report

Large Oral Lipomas: Uncommon Neoplasms in Two Case Reports

by Juraj Brozović, Bruno Vidaković, Barbara Mikulić and Matej Tomas

Dent. J. 2026, 14(4), 244; https://doi.org/10.3390/dj14040244 - 20 Apr 2026

Viewed by 917

Abstract

Background: Oral lipomas are uncommon benign tumors composed of mature adipocytes, accounting for roughly 1% of benign intraoral lesions. Common predilection sites are buccal mucosa, lips, and tongue, presenting as slow-growing, nodular masses, often with a yellow hue. As the size of [...] Read more.

Background: Oral lipomas are uncommon benign tumors composed of mature adipocytes, accounting for roughly 1% of benign intraoral lesions. Common predilection sites are buccal mucosa, lips, and tongue, presenting as slow-growing, nodular masses, often with a yellow hue. As the size of most lesions does not exceed 10 mm, particularly larger lipomas may be misdiagnosed. We present two cases of large oral lipomas. Case reports: Case 1: A 58-year-old male with a painless, sessile nodular mass of approximately 2.5 cm in the left cheek, increasing in size and causing discomfort during mastication. After excision, histopathology revealed mature adipocytes with delicate fibrous septa. Case 2: A 47-year-old female with a tender yellow growth of approximately 2 cm in her lower lip, increasing in size and causing aesthetic problems with functional discomfort. After sharp dissection, the specimen presented acanthotic and parakeratotic epithelium with adipocytic tumorous tissue, permeated by collagenous cords. Conclusions: Oral lipomas are uncommon, mostly asymptomatic benign lesions. Mostly found in the buccal mucosa and lower lip, they can mimic more common growths. When located superficially, a conservative surgical excision leads to resolution with rare recurrences. Histopathological inspection is necessary to confirm the benign nature of the lesion. Full article

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10 pages, 3914 KB

Open AccessCase Report

Regeneration Versus Granulation Tissue Healing in a Hopeless Mature Mandibular Molar Post-Endodontic Management: A 40-Month Follow-Up Case Report

by Elhassan Hassanein, Petra Gierthmuehlen, Almaha S. Algazlan, Dalia Kaisarly and Moataz Elgezawi

Dent. J. 2026, 14(4), 243; https://doi.org/10.3390/dj14040243 - 20 Apr 2026

Viewed by 1580

Abstract

Objective: To report a rare case of pulp space tissue growth in a mature mandibular molar with severe endo-periodontal involvement after conservative endodontic treatment and to discuss the possible biological explanations, including regeneration and granulation tissue healing. Severe endo-periodontal lesions are challenging, particularly [...] Read more.

Objective: To report a rare case of pulp space tissue growth in a mature mandibular molar with severe endo-periodontal involvement after conservative endodontic treatment and to discuss the possible biological explanations, including regeneration and granulation tissue healing. Severe endo-periodontal lesions are challenging, particularly as endodontic regeneration is usually observed in immature teeth, while revascularization in mature teeth, especially in cases of advanced periodontal disease, is rare, as demonstrated in this case. Methods: This study reports a rare case of tissue regeneration versus granulation tissue healing in the pulp space, occurring alongside periodontal healing, in a mature mandibular molar with necrotic pulp and severe periodontal involvement. A 52-year-old patient presented with a mature mandibular molar (tooth #19) exhibiting necrotic pulp with severe endo-periodontal involvement, including grade-3 mobility, tenderness to percussion, a 12 mm probing depth, and extensive periradicular radiolucency. The tooth was diagnosed with necrotic pulp and symptomatic apical periodontitis and was deemed hopeless, with extraction planned. Results: Following patient refusal, endodontic treatment was initiated, including cleaning, shaping, and placement of the intracanal medicament, Ledermix. The patient canceled the extraction due to symptom resolution and disappeared for 12 months. On return, the patient presented with spontaneous pain exacerbated by thermal stimuli, consistent with symptoms of irreversible pulpitis. Clinical examination revealed significant clinical and radiographic improvements, including reduced probing depth (3 mm), no mobility, resolution of apical translucency, radiographic findings suggestive of canal narrowing, and a positive pulp sensibility response. Re-entry elicited profuse bleeding with newly formed vital tissue beneath the medicament. Sodium hypochlorite irrigation failed to achieve hemostasis; inflamed tissue was removed; root canals were cleaned, shaped and obturated; and treatment was completed with placement of a permanent coronal resin composite restoration. A forty-month follow-up showed an asymptomatic tooth with clinical and radiographic healing. Conclusions: This case demonstrates that conservative endodontic management may result in favorable clinical and radiographic outcomes in mature teeth with severe endo-peroidontal involvement, influencing extraction decisions. It provides clinical evidence suggestive of tissue regeneration and periodontal healing in a mature tooth with necrotic pulp and severe periodontal compromise, challenging conventional prognosis. The observed pulp space tissue growth may be suggestive of regeneration; however, alternative explanations, including granulation tissue healing or repair processes, cannot be excluded. Healing by granulation tissue in the pulp space remains possible. Root canal treatment in advanced endo-perio lesions can yield favorable outcomes and may influence extraction decisions. Further clinical and histological studies are needed to clarify underlying mechanisms and optimize treatment strategies. Full article

(This article belongs to the Special Issue Advances in Regenerative Endodontics)

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30 pages, 1063 KB

Open AccessArticle

GUM: Gum Understanding Mission—A Serious Game to Improve Periodontitis Literacy Among University Students

by Franklin Parrales-Bravo, Hugo Arias-Flores, Luis Caguana-Alvarez, Miguel Dávila-Medina, Carolina Parrales-Bravo and Leonel Vasquez-Cevallos

Dent. J. 2026, 14(4), 242; https://doi.org/10.3390/dj14040242 - 18 Apr 2026

Viewed by 902

Abstract

Background/Objectives: Periodontitis represents a significant global health burden, yet preventive health literacy remains critically low among emerging adults—a developmental stage where lifelong health behaviors crystallize. This study evaluated the effectiveness of the GUM (an acronym of Gum Understanding Mission) game, an interactive gamified [...] Read more.

Background/Objectives: Periodontitis represents a significant global health burden, yet preventive health literacy remains critically low among emerging adults—a developmental stage where lifelong health behaviors crystallize. This study evaluated the effectiveness of the GUM (an acronym of Gum Understanding Mission) game, an interactive gamified digital tool incorporating AI-informed or manual feedback, for improving periodontitis literacy among tenth-semester Software Engineering students at the University of Guayaquil. Methods: In a controlled pre-test/post-test experiment, 50 participants were randomly assigned to either the GUM game intervention or a traditional lecture. Both groups completed identical knowledge assessments immediately before and after their respective 50-min instructional sessions. The GUM game featured adaptive questioning, immediate elaborated feedback, and comprehensive performance analytics, while the control group received instructor-led didactic instruction with a subsequent question-and-answer session. Results: The GUM group improved from a baseline of 21% to 94% correct responses, while the lecture group increased from 22% to 67% (

p < 0.001

). Error reduction was 74% in the GUM group versus 45% in the control group. However, the study’s scope is currently limited to a single, digitally literate cohort, and knowledge retention over time was not assessed. Conclusions: These findings suggest that a self-directed, feedback-driven serious game can substantially outperform traditional methods in fostering periodontitis literacy within this population. Further research is needed across diverse populations with extended follow-up periods to assess knowledge retention and generalizability. Full article

(This article belongs to the Section Dental Education)

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13 pages, 853 KB

Open AccessArticle

Assessment of Orofacial Function After Mandibular Angle Harmonization with Hyaluronic Acid: A Longitudinal Observational Study

by Nicole Barbosa Bettiol, Franciele Aparecida de Carvalho, Selma Siessere, Giovana Dornelas Azevedo Romero, Márcio de Menezes, Catia Cristina Janjacomo Martini, Jardel Francisco Mazzi-Chaves, Laís Valencise Magri, Simone Cecilio Hallak Regalo and Marcelo Palinkas

Dent. J. 2026, 14(4), 241; https://doi.org/10.3390/dj14040241 - 17 Apr 2026

Cited by 1 | Viewed by 731

Abstract

Background: The relationship between facial aesthetic procedures and changes in the stomatognathic system has attracted increasing interest, motivating investigations into their functional and structural impacts. This longitudinal observational study analyzed molar bite force and orofacial tissue pressure in adults who underwent hyaluronic acid [...] Read more.

Background: The relationship between facial aesthetic procedures and changes in the stomatognathic system has attracted increasing interest, motivating investigations into their functional and structural impacts. This longitudinal observational study analyzed molar bite force and orofacial tissue pressure in adults who underwent hyaluronic acid injections in the mandibular angle. Methods: Ten adults (eight women and two men; mean age 34.3 ± 11.2 years) with normal occlusion and no temporomandibular disorders were included. The MD Codes guided injection points of 2 mL of hyaluronic acid in the mandibular angle. Maximum right and left molar bite force was measured using a digital dynamometer, and tongue, lip, and cheek pressures were measured with a Pro-Fono Biofeedback device. Assessments occurred before and at 15, 30, and 60 days. Repeated measures ANOVA with Bonferroni correction was applied (p < 0.05), and effect sizes and 95% confidence intervals were calculated. Results: No statistically significant differences were observed in maximum molar bite force throughout the follow-up period. Regarding orofacial pressures, a significant main effect of time was observed for tongue pressure (p = 0.03); however, the effect size was moderate-to-large, and values showed considerable variability across participants. Lip and cheek pressures remained stable over time. Conclusions: Hyaluronic acid injection in the mandibular angle did not show clinically detectable changes in maximum molar bite force, suggesting short-term preservation of masticatory function within the 60-day follow-up period. These findings are limited to short-term observations and specific sample characteristics. The observed variation in tongue pressure may reflect adaptive functional adjustments, although variability across participants was considerable. Full article

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12 pages, 958 KB

Open AccessArticle

Treatment Predictability of Two Clear Aligner Systems: A Retrospective Assessment of Invisalign Versus Eon Aligner

by Raghad Abdullah Algarni, Saeed N. Asiri and Abdallah Al-Ani

Dent. J. 2026, 14(4), 240; https://doi.org/10.3390/dj14040240 - 15 Apr 2026

Viewed by 1218

Abstract

Background/Objectives: To compare the efficacy of two aligner systems (Invisalign and Eon Aligner) across multiple linear and angular movements. Methods: A total sample of 80 patient cases (n = 40 in each group) was recruited retrospectively. Per case, 3 digital models [...] Read more.

Background/Objectives: To compare the efficacy of two aligner systems (Invisalign and Eon Aligner) across multiple linear and angular movements. Methods: A total sample of 80 patient cases (n = 40 in each group) was recruited retrospectively. Per case, 3 digital models were retrieved in the form of stereolithography (STL) files. Predicted and achieved tooth movements were measured using the 3Shape Clear Aligner Studio. Initial models were aligned on the predicted and achieved models to create superimposition. Differences in measurement between pre-treatment, predicted, and post-treatment scans were measured. Agreement between the two, Invisalign and Eon, was measured using the interclass correlation coefficient (ICC). Results: Both Invisalign (ICC = 0.82; 95% CI 0.66, 0.9) and Eon Aligner (ICC = 0.75; 95% CI 0.53, 0.87) have shown good agreement when calculating the average differences between the achieved and predicted interpremolar width values. Similar results were found for both intercanine width values (Invisalign: ICC = 0.96; 95% CI = 0.93, 0.98 vs. Eon Aligner: ICC = 0.98; 95% CI = 0.97, 0.99). In Eon cases, good to excellent agreement between the achieved and predicted models was observed for lateral (ICC = 0.89; 95% CI = 0.79, 0.94) and central (ICC = 0.93; 95% CI = 0.87, 0.96) mesiodistal rotations. Conversely, Invisalign displayed moderate strength of agreement for the lateral (ICC = 0.68; 95% CI = 0.40, 0.83) and central (ICC = 0.70; 95% CI = 0.44, 0.84) mesiodistal readings. While both aligners demonstrated some level of predictive capacity towards horizontal movements, they were unreliable in predicting vertical movements. Differences in magnitude of change between initial and achieved values between Eon and Invisalign were noted only for certain teeth in the case of horizontal and vertical movements. Conclusions: Both clear aligner therapy systems were able to achieve satisfactory outcomes in terms of inter-premolar and intercanine width changes. Eon Aligner, on the other hand, outperformed Invisalign in terms of rotational accuracy and horizontal movement precision. Notably, both systems demonstrated poor predictability for vertical movements and suffer from significant systemic bias requiring over-correction. Full article

(This article belongs to the Special Issue Digital Orthodontics: 3D Planning and Customized Appliance Design)

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10 pages, 1136 KB

Open AccessArticle

Comparison of Shear Bond Strength and Failure Modes of Transbond XT and Orthomite LC After Thermal Cycling: An In Vitro Study

by Tomoyo Okazaki, Hirohide Kurashina, Yoshinori Ishida, Hitoshi Kawanabe and Kazunori Fukui

Dent. J. 2026, 14(4), 239; https://doi.org/10.3390/dj14040239 - 15 Apr 2026

Viewed by 649

Abstract

Background/Objectives: Bond reliability is essential in orthodontic treatment, as temperature fluctuations in the oral environment can weaken adhesive interfaces and increase the risk of bracket failure. However, direct comparison of the long-term durability of commonly used orthodontic resin cements under [...] Read more.

Background/Objectives: Bond reliability is essential in orthodontic treatment, as temperature fluctuations in the oral environment can weaken adhesive interfaces and increase the risk of bracket failure. However, direct comparison of the long-term durability of commonly used orthodontic resin cements under thermocycling conditions is limited. Therefore, the present study aimed to evaluate and compare the shear bond strength (SBS) and failure modes of Transbond™ XT and Orthomite™ LC before and after thermal cycling (Tc). Methods: A total of 60 bovine enamel specimens were used in this study. Specimens were bonded with either Transbond XT or Orthomite LC under standardized conditions. SBS was measured at 24 h (Tc0) and after 5000 thermal cycles (Tc5000). Failure modes were classified as adhesive (A), enamel cohesive (B), or bracket cohesive (C) failure. Statistical analyses included the Mann–Whitney U test for SBS and Fisher’s exact test for failure mode distribution. Results: At Tc0, there was no significant difference in SBS between the two cements (p > 0.05). After Tc5000, Orthomite LC showed significantly higher SBS than Transbond XT (p = 0.00368). Failure mode analysis revealed that, after Tc, Transbond XT exhibited a higher incidence of adhesive failures (A), whereas Orthomite LC predominantly demonstrated bracket cohesive failures (C) (p = 0.00020). Conclusions: Orthomite LC demonstrated greater resistance to thermal cycling–induced bond degradation compared with Transbond XT, likely due to differences in resin monomer composition and interface stability. Full article

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15 pages, 583 KB

Open AccessArticle

Evaluating Undergraduate Dental Curricula on Oral Health Care for Autistic Persons in Australia and New Zealand—A Cross-Sectional Study

by Jayne Jones, Dileep Sharma, Kuang-Yin Chu, Elysa Roberts and Deborah Cockrell

Dent. J. 2026, 14(4), 238; https://doi.org/10.3390/dj14040238 - 15 Apr 2026

Viewed by 878

Abstract

Introduction: Persons diagnosed with Autism Spectrum Disorder (ASD) require adaptations to dental care that many undergraduate programmes may not explicitly treat. This cross-sectional pilot study assessed the extent of ASD-related content in Australia and New Zealand (ANZ) dental and oral health curricula [...] Read more.

Introduction: Persons diagnosed with Autism Spectrum Disorder (ASD) require adaptations to dental care that many undergraduate programmes may not explicitly treat. This cross-sectional pilot study assessed the extent of ASD-related content in Australia and New Zealand (ANZ) dental and oral health curricula and explored Oral Health Therapy students’ knowledge and self-efficacy. Methods: Online surveys of academic staff across ANZ programmes and Bachelor of Oral Health Therapy students at the University of Newcastle were conducted. Quantitative data was summarised descriptively, and free text responses underwent thematic analysis. Results: Fifteen educator responses (8% of 178 invitees) suggest limited ASD-specific teaching and minimal use of simulation-based education. Among 38 student responses (from one institution), knowledge was generally foundational, but misconceptions persisted and no respondents reported high confidence in providing oral health care for Autistic patients. Interest in further training was high. Conclusions: Within the constraints of low response rates and a single institution student sample, these preliminary findings suggest opportunities to strengthen Autism-related teaching, particularly sensory adaptations, communication strategies, and experiential learning. Inferences should be considered exploratory and hypothesis generating. Limitations: Low educator responses and potential response bias due to limited external validity from a single student cohort. Full article

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

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26 pages, 1611 KB

Open AccessReview

Three-Dimensional Printing and Personalized Bioceramic Scaffolds for Dental and Maxillofacial Applications: A Narrative Review

by Seyed Ali Mostafavi Moghaddam, Hamid Mojtahedi, Amirhossein Bahador, Lotfollah Kamali Hakim and Hamid Tebyaniyan

Dent. J. 2026, 14(4), 237; https://doi.org/10.3390/dj14040237 - 15 Apr 2026

Cited by 1 | Viewed by 1395

Abstract

Background/Objectives: Bioceramic scaffolds with complex geometries and customized mechanical and biological properties can now be produced via 3D printing, revolutionizing dental and maxillofacial tissue engineering. This review discusses the recent progress in 3D printing technologies applied to bioceramic scaffolds for dental and maxillofacial [...] Read more.

Background/Objectives: Bioceramic scaffolds with complex geometries and customized mechanical and biological properties can now be produced via 3D printing, revolutionizing dental and maxillofacial tissue engineering. This review discusses the recent progress in 3D printing technologies applied to bioceramic scaffolds for dental and maxillofacial reconstruction. Methods: A comprehensive literature search was conducted across major electronic databases, including Scopus, PubMed, ScienceDirect, and Web of Science. Peer-reviewed articles published between 2015 and 2026 were considered for inclusion. Several 3D printing methods can be used to create bioceramic or composite scaffolds for the regeneration of dental, oral, or maxillofacial tissues. Results: Additive manufacturing enables customization of bioceramic scaffolds. This report emphasizes the osteoconductive properties, biodegradability, and compatibility of calcium phosphate, bioactive glass, and calcium silicate ceramics. Conclusions: This review helps to determine how 3D-printed bioceramics can be optimized for dental and maxillofacial applications tailored to specific patients. Full article

(This article belongs to the Special Issue 3D Printing in Dentistry: Materials, Devices and Technologies)

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14 pages, 537 KB

Open AccessReview

Emergence Angle and Emergence Profile in Implant-Supported Restorations: A Scoping Review

by Vladimir Prpic, Sven Gojsovic, Petar Kosec, Stanko Skec and Amir Catic

Dent. J. 2026, 14(4), 236; https://doi.org/10.3390/dj14040236 - 15 Apr 2026

Cited by 2 | Viewed by 1700

Abstract

Background/Objectives: Prosthodontic restoration design plays a key role in the long-term success of implant-supported treatments and in maintaining peri-implant tissue health. Inadequate emergence angles and profiles can compromise tissue stability and negatively influence clinical outcomes. Generative design, as an algorithm-driven optimization approach, [...] Read more.

Background/Objectives: Prosthodontic restoration design plays a key role in the long-term success of implant-supported treatments and in maintaining peri-implant tissue health. Inadequate emergence angles and profiles can compromise tissue stability and negatively influence clinical outcomes. Generative design, as an algorithm-driven optimization approach, requires the definition of key parameters in advance to guide the process and determine the final shape of the hybrid implant abutment. Methods: A detailed literature review of the PubMed and Scopus databases was performed to find appropriate studies published up to 1 December 2025. Studies that investigated the emergence angle and emergence profile of implant-supported restorations were included. Seventeen studies fulfilled criteria and were included in the final analysis. Results: While the optimal emergence angle is still debatable, the literature suggests that an angle less than 30° may be beneficial. However, a concave emergence profile of implant-supported restoration has a significant role in improving stability and maintaining peri-implant health. Conclusions: Careful characterization and evaluation of the included parameters provide useful insights for generative design workflows, enabling the creation of implant abutment designs that maintain a balance between mechanical performance and biological compatibility. Full article

(This article belongs to the Special Issue Recent Progress in Digital Technology in Prosthodontics and Implantology)

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19 pages, 4462 KB

Open AccessArticle

Agreement in Subjective Periodontal Findings in Undergraduate Dental Training: A Retrospective Observational Study of Bleeding on Probing and Tooth Mobility

by Patrick Jansen, Felix Krause, Andreas Braun and Ellen E. Jansen

Dent. J. 2026, 14(4), 235; https://doi.org/10.3390/dj14040235 - 14 Apr 2026

Viewed by 748

Abstract

Background/Objectives: Accurate assessment of periodontal parameters such as bleeding on probing (BoP) and tooth mobility is essential for diagnosis and treatment planning. In contrast to metric measures, these findings represent more subjective clinical parameters, potentially increasing examiner-related variability, particularly among less experienced examiners. [...] Read more.

Background/Objectives: Accurate assessment of periodontal parameters such as bleeding on probing (BoP) and tooth mobility is essential for diagnosis and treatment planning. In contrast to metric measures, these findings represent more subjective clinical parameters, potentially increasing examiner-related variability, particularly among less experienced examiners. This study evaluated agreement patterns between student recordings and educator verification recordings and assessed the influence of educational level and anatomical factors. Methods: BoP and tooth mobility data recorded by undergraduate dental students (ICC1, ICC4, state examination) and verified by licensed dental educators were retrospectively analyzed, comprising 6504 BoP sites and 1084 mobility recordings. Agreement and directional disagreement (under-/over-rating) were analyzed. Statistical analyses evaluated the effects of training stage, anatomical site, and periodontal severity. Associations with probing depth deviations and patient age were also examined. Results: Overall agreement was high for both parameters (BoP: 86%; mobility: 91%). Nevertheless, statistically significant differences were observed across educational levels (global Chi² tests p < 0.001). ICC1 students predominantly underestimated findings, whereas ICC4 students more frequently overestimated them; results stabilized in the state examination. Anatomical location significantly influenced disagreement patterns, with anterior and distal sites showing higher variability. BoP deviations were significantly associated with probing depth inaccuracies (r = 0.6; p < 0.001) and patient age (r = 0.187; p < 0.05). Conclusions: Within the limitations of this retrospective study, student recording accuracy for subjective periodontal parameters appears to be influenced by training stage and anatomical site. These findings may highlight the importance of structured calibration and targeted training strategies to improve diagnostic reliability in undergraduate periodontal education. Full article

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

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26 pages, 1270 KB

Open AccessReview

A Multidimensional Analysis of Shade Selection Difficulty for Indirect Restorations Among Dental Students and Professionals

by Roxana-Ionela Vasluianu, Andreas Katsonis, Monica Silvia Tatarciuc, Anca Mihaela Vitalariu, Adina Oana Armencia, Andrea-Simoni Katsoni, Panagiotis Perperidis, Catalina Cioloca Holban, Irina Gradinaru, Ovidiu Stamatin and Magda Ecaterina Antohe

Dent. J. 2026, 14(4), 234; https://doi.org/10.3390/dj14040234 - 14 Apr 2026

Cited by 1 | Viewed by 1347

Abstract

Despite advances in dental materials and digital color registration systems, esthetic matching remains a clinical challenge for both dental students and experienced professionals. A comprehensive narrative review was conducted through bibliographic searches in PubMed, Scopus, Web of Science, and PsycINFO databases from January [...] Read more.

Despite advances in dental materials and digital color registration systems, esthetic matching remains a clinical challenge for both dental students and experienced professionals. A comprehensive narrative review was conducted through bibliographic searches in PubMed, Scopus, Web of Science, and PsycINFO databases from January 2015 to January 2026. The evidence was synthesized using a four-dimensional analytical framework encompassing technological, cognitive–psychological, educational, and clinical-contextual factors. Quantitative synthesis revealed substantial variability in shade matching success rates, with intraoral scanners demonstrating pass rates ranging from 31.3% to 78.2% across devices, while spectrophotometers achieved superior repeatability (ICC > 0.9) but faced interpretive barriers. Cognitive load theory explains the performance deterioration, with novices being particularly susceptible to retinal fatigue and metamerism under non-standardized lighting conditions. The proposed paradigm shift involves redefining shade selection from a purely technical task to a cognitive skill that requires deliberate perceptual calibration, structured educational protocols, and hybrid digital visual workflows. To improve esthetic predictability, educational programs need to integrate longitudinal training in color science with objective feedback mechanisms. Clinical workflows should adopt hybrid calibration-centric protocols that position technology as a verification tool, rather than a replacement for clinical judgment. Understanding the multidimensional nature of shade matching difficulty enables the development of evidence-based educational protocols and clinical workflows, ultimately improving esthetic outcomes. Full article

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

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11 pages, 1450 KB

Open AccessArticle

Post and Core for Telescopic Crown-Retained Dentures—An In Vitro Comparison of Different Materials Using Chewing Simulation

by Jonas Adrian Helmut Vogler, Milan Rachold, Bernd Wöstmann, Peter Rehmann and Kay-Arne Walther

Dent. J. 2026, 14(4), 233; https://doi.org/10.3390/dj14040233 - 14 Apr 2026

Viewed by 1150

Abstract

Objectives: Due to extra-axial forces, post and core (PC) treatment has the worst survival probability in abutment teeth for telescopic crown-retained dentures (TCDs). The reason for this is a mismatch regarding the mechanical properties between PC material and dentin or a poor accuracy [...] Read more.

Objectives: Due to extra-axial forces, post and core (PC) treatment has the worst survival probability in abutment teeth for telescopic crown-retained dentures (TCDs). The reason for this is a mismatch regarding the mechanical properties between PC material and dentin or a poor accuracy of fit of PC, resulting in tooth fracture or decementation. However, the inclusion of severely damaged endodontically treated teeth needing PC is often mandatory in order to achieve a stable situation for TCD. Thus, an advancement of PC treatment for TCD is of high clinical interest. Recently it has become possible to fabricate customized PC with favourable mechanical properties by using CAD/CAM technology. Methods: Thus, the aim of this investigation was to compare the performance of these PC types (CAD/CAM PC) to customized cast PC (CPC) and prefabricated fibre-reinforced PC (PFPC) in a TCD set-up using a chewing simulator. Results: The investigation group with CAD/CAM PC showed neither tooth fracture nor decementation, in contrast to the CPC and PFPC groups, in which both types of failure were recorded. Thus, CAD/CAM PC showed significantly better performance than CPC and PFPC. Conclusions: Within the limitations, CAD/CAM PCs are therefore recommendable for PC treatment with TCD. Full article

(This article belongs to the Section Digital Technologies)

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8 pages, 11824 KB

Open AccessCase Report

Voice Change Following Third Molar Alveolectomy: A Rare and Preventable Complication

by Lara Majcen, Marko Tarle, Mario Raos, Josip Biočić, Berisav Perić, Davor Brajdić, Petar Đanić and Ivan Salarić

Dent. J. 2026, 14(4), 232; https://doi.org/10.3390/dj14040232 - 14 Apr 2026

Viewed by 1072

Abstract

Background: Emphysema is a rare complication of dental procedures. The highest incidence has been associated with the use of air turbine handpieces. If not recognized and treated promptly, this complication can lead to serious outcomes. Methods: We present a case of a 43-year-old [...] Read more.

Background: Emphysema is a rare complication of dental procedures. The highest incidence has been associated with the use of air turbine handpieces. If not recognized and treated promptly, this complication can lead to serious outcomes. Methods: We present a case of a 43-year-old man who developed deep cervicofacial and subcutaneous emphysema of the face, neck and chest along with the specific voice change due to nose blowing shortly after alveolectomy of the lower right third molar. Results: The patient was hospitalized, conservatively treated, monitored and treated with intravenous antibiotic therapy. After two weeks he made a full recovery. Conclusions: It is essential to recognize and adequately manage emphysema, and to inform patients postoperatively not to blow their nose after third molar alveolectomy to prevent this rare but potentially serious complication. To our knowledge, this is the first reported case of voice alteration caused by nasopharyngeal emphysema following third molar alveolectomy. Full article

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

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23 pages, 2133 KB

Open AccessSystematic Review

Clinical Efficacy and Safety of Photobiomodulation Therapy for Orofacial Conditions in Older Adults: A Systematic Review of Randomized Controlled Trials

by Suwat Tanya and Patcharawan Srisilapanan

Dent. J. 2026, 14(4), 231; https://doi.org/10.3390/dj14040231 - 13 Apr 2026

Cited by 1 | Viewed by 1887

Abstract

Background/Objectives: Photobiomodulation therapy (PBMT) is a non-invasive therapeutic modality that enhances tissue healing, modulates inflammation, and reduces pain. Despite increasing clinical use, evidence regarding PBMT in geriatric oral conditions has not been comprehensively synthesized. This systematic review aimed to evaluate the clinical [...] Read more.

Background/Objectives: Photobiomodulation therapy (PBMT) is a non-invasive therapeutic modality that enhances tissue healing, modulates inflammation, and reduces pain. Despite increasing clinical use, evidence regarding PBMT in geriatric oral conditions has not been comprehensively synthesized. This systematic review aimed to evaluate the clinical efficacy and safety of PBMT in managing orofacial conditions in older adults. Methods: A systematic search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify randomized controlled trials (RCTs) published between January 2000 and March 2025. Eligible studies included patients aged ≥60 years receiving PBMT for orofacial conditions. Study selection followed predefined criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and findings were narratively synthesized. Results: Twenty-three RCTs were included. Evidence for PBMT was most frequently reported in cancer therapy-induced oral mucositis (n = 8), with consistent reductions in lesion severity and pain. Studies on burning mouth syndrome (n = 7) and hyposalivation (n = 2) generally reported improvements in symptoms, although placebo effects were noted. Fewer studies evaluated postoperative pain (n = 2), oral lichen planus (n = 1), peri-implant conditions (n = 1), and implant osseointegration (n = 2). No clinically significant adverse events were reported. However, heterogeneity in PBMT parameters and outcome measures limited comparability. Conclusions: PBMT is a safe and clinically effective adjunctive therapy for managing orofacial conditions in older adults, particularly oral mucositis. These findings support its integration into geriatric oral care. Standardized protocols and well-designed RCTs are needed to determine optimal treatment parameters and long-term effectiveness. Full article

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

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15 pages, 7035 KB

Open AccessArticle

Influence of Operating Temperature on the Properties and Performance of Two Heat-Treated Reciprocating NiTi Instruments: An In Vitro Study

by Tahreer Almutairi, Rashid El Abed, Anas Al-Jadaa, Amar H. Khamis and Amre R. Atmeh

Dent. J. 2026, 14(4), 230; https://doi.org/10.3390/dj14040230 - 13 Apr 2026

Viewed by 558

Abstract

Introduction: Advancements in thermo-mechanical surface treatment of endodontic nickel–titanium (NiTi) instruments introduced another aspect of variation. Particularly related to their metallurgy, which influences their behaviour in relation to temperature. This is clinically significant, considering the variation in the temperatures inside the root [...] Read more.

Introduction: Advancements in thermo-mechanical surface treatment of endodontic nickel–titanium (NiTi) instruments introduced another aspect of variation. Particularly related to their metallurgy, which influences their behaviour in relation to temperature. This is clinically significant, considering the variation in the temperatures inside the root canal during instrumentation. This study aimed to compare the effects of different temperatures on the bending stiffness, cyclic fatigue resistance, and cutting efficiency of two reciprocating heat-treated NiTi files: R-Motion (RM) and WaveOne Gold (WOG). Methodology: Bending stiffness was examined in a temperature-controlled water bath, measuring the maximum force in Newtons during a 3 mm tip horizontal displacement. The cyclic fatigue resistance was tested in a simulated stainless-steel canal (35° curvature, 6 mm radius) in dynamic mode at 22 °C, 37 °C, and 45 °C. Time to fracture (TTF) and length of fractured fragment were recorded, and representative samples were examined using scanning electron microscopy. The cutting efficiency was assessed using bovine bone slabs measuring 1.5 mm in thickness and 15 mm in width. The files were activated in reciprocation mode for three minutes while resting on the upper surface of the slab, while submerged in a water bath maintained at 22 °C, 37 °C, or 45 °C. The maximum cutting depth was measured in millimetres under magnification. Additionally, Differential Scanning Calorimetry (DSC) analysis was performed for three specimens of each file type. Results: RM exhibited significantly higher TTF, longer fractured fragments, and smaller cutting depths than WOG across all temperatures. The RM was significantly stiffer at 37 °C and 45 °C only. For each file type, increasing the temperature was associated with a significant increase in stiffness (p < 0.01), except for WOG between 22 °C and 37 °C (p = 0.199). The TTF was significantly higher in RM at 22 °C, while the TTF in WOG increased significantly with lower temperatures. No effect was observed on the length of the fractured fragment. Lower temperatures were also associated with reduced cutting efficiency in both files. Conclusions: Temperature has a significant impact on the properties and performance of RM and WOG and should be considered during instrumentation. File design has a greater influence on their strength and cutting ability than their transformation behaviour related to heat treatment. Full article

(This article belongs to the Section Dental Materials)

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21 pages, 312 KB

Open AccessArticle

Measuring Digital Oral Health Literacy in the Social Media Era: Psychometric Validation of the Romanian Version of the Social Media Oral Health Literacy Questionnaire (SMOHLQ)

by Adina Oana Armencia, Andrei Nicolau, Laurian Lucian Francu, Galina Pancu, Roxana-Ionela Vasluianu, Georgiana Macovei, Alexandra Boloṣ, Dragos Catalin Ghica, Monica Mihaela Scutariu and Lucian Stefan Burlea

Dent. J. 2026, 14(4), 229; https://doi.org/10.3390/dj14040229 - 13 Apr 2026

Cited by 1 | Viewed by 1101

Abstract

Background/Objectives: Online environment and social media platforms have become major sources of health information, influencing behaviors and decision-making related to oral health. The Aim of This Study was to culturally adapt and psychometrically validate the Romanian version of the Social Media Oral [...] Read more.

Background/Objectives: Online environment and social media platforms have become major sources of health information, influencing behaviors and decision-making related to oral health. The Aim of This Study was to culturally adapt and psychometrically validate the Romanian version of the Social Media Oral Health Literacy Questionnaire (SMOHLQ) and to assess oral health literacy levels among dental students. Material and Methods: An observational cross-sectional study was conducted among 304 fourth- and fifth-year dental students. The Romanian version of the SMOHLQ underwent cultural adaptation and psychometric evaluation using descriptive statistics, exploratory factor analysis (principal axis factoring with oblimin rotation), Cronbach’s alpha coefficient, intraclass correlation coefficient (ICC), Pearson correlations, and ANOVA analysis. Results: Exploratory factor analysis confirmed a three-dimensional structure consisting of access and understanding, critical appraisal, and behavioral impact domains. Internal consistency was high for the overall scale (Cronbach’s α = 0.856) and good across subscales (α = 0.744–0.836). Pearson correlations showed significant associations between dimensions (r = 0.162–0.603, p < 0.001). ICC values indicated good score stability. ANOVA analyses revealed significant differences across demographic subgroups (p < 0.05). Mean scores were higher for cognitive dimensions (MS = 4.20–4.54) compared with behavioral impact (MS = 2.87). Conclusions: The Romanian version of the SMOHLQ demonstrated satisfactory psychometric properties, supporting its reliability and construct validity as a tool for assessing digital oral health literacy in the context of social media use. Full article

(This article belongs to the Section Dental Education)

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20 pages, 4211 KB

Open AccessArticle

A Pan-Cancer Transcriptomic Signature for Conserved Molecular Programs Underlying Premalignant–Malignant Progression Across Common Carcinomas

by Kimia Sadat Kazemi, Marta Miyazawa, João Adolfo Costa Hanemann, Marisa Ionta, Pollyanna Francielli de Oliveira, Andrew Leask, Cristiane Miranda Franca and Felipe Fornias Sperandio

Dent. J. 2026, 14(4), 228; https://doi.org/10.3390/dj14040228 - 13 Apr 2026

Cited by 1 | Viewed by 1194

Abstract

Background/Objectives: Oral squamous cell carcinoma (OSCC) commonly arises from oral potentially malignant disorders (OPMDs), yet reliable molecular biomarkers that predict malignant transformation remain scarce. Because epithelial carcinogenesis follows similar multistep trajectories across multiple organs, pan-cancer transcriptional analyses may reveal conserved pathways relevant to [...] Read more.

Background/Objectives: Oral squamous cell carcinoma (OSCC) commonly arises from oral potentially malignant disorders (OPMDs), yet reliable molecular biomarkers that predict malignant transformation remain scarce. Because epithelial carcinogenesis follows similar multistep trajectories across multiple organs, pan-cancer transcriptional analyses may reveal conserved pathways relevant to early oral tumorigenesis. This study aimed to identify shared transcriptional signatures across carcinomas and evaluate their applicability to precancerous-to-carcinoma progression. Methods: Bulk RNA-seq data from five carcinomas (lung, colon, breast, prostate, and head and neck squamous cell carcinoma, HNSCC) were obtained from TCGA to identify shared differentially expressed genes (DEGs) (|log₂FC| ≥ 2; FDR < 0.05). Functional enrichment, clustering, and gene–pathway network analyses characterized conserved biological processes. Independent GEO datasets containing premalignant and malignant samples, including OPMD and OSCC cohorts, were examined to assess early-stage relevance. Results: A conserved 45-gene signature was identified, enriched for transcriptional regulation, chromatin organization, and RNA polymerase II-mediated processes. Regulatory hubs, including ZIC5, MYBL2, ONECUT2, POU4F1, and PDX1, and strong upregulation of cancer-testis antigens (MAGEA3, MAGEA6, MAGEC2) were notable. Integration with premalignant datasets revealed 13 genes consistently dysregulated across early lesions, involving pathways such as cell differentiation, apoptosis, and lipid transport. Several genes remained altered from normal tissue through OPMD to OSCC, supporting their potential as stable biomarkers. Conclusions: This study identifies conserved transcriptional programs shared across epithelial cancers and detectable in OPMDs. These findings highlight promising biomarker and regulatory candidates for improving early detection and risk stratification of oral precancer, addressing a critical unmet need in OSCC prevention and clinical management. Full article

(This article belongs to the Special Issue Advances in Oral Pathology: From Molecular Mechanisms to Clinical Diagnosis)

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13 pages, 1673 KB

Open AccessReview

Dental Anxiety as a Potential Bottleneck in Oral–Systemic Health Pathways: A Conceptual Mapping Review of Review Articles

by Mika Kajita, Vesa Pohjola, Gerald Humphris and Satu Lahti

Dent. J. 2026, 14(4), 227; https://doi.org/10.3390/dj14040227 - 10 Apr 2026

Viewed by 1368

Abstract

Background/Objectives: Although many studies have examined the determinants and management of dental anxiety (DA), its broader placement as a potential bottleneck along oral–systemic health pathways, from the determinants of DA to consequences through dental avoidance, oral outcomes, psychosocial impacts, and possible systemic health [...] Read more.

Background/Objectives: Although many studies have examined the determinants and management of dental anxiety (DA), its broader placement as a potential bottleneck along oral–systemic health pathways, from the determinants of DA to consequences through dental avoidance, oral outcomes, psychosocial impacts, and possible systemic health outcomes, has not been mapped across the review literature. This review aimed to conceptually map how existing DA reviews are distributed across this pathway, whether this broad framing changed across 5-year periods, and how systemic health outcomes were framed. Methods: We conducted a conceptual mapping review of DA-focused review articles published between 2005 and 2025. PubMed and Scopus were searched for English-language narrative, systematic, scoping and umbrella reviews and meta-analyses addressing the determinants or consequences of DA. One reviewer screened records, extracted review characteristics, and classified each review into predefined domains using binary framed/not framed coding rules. A structured AI-assisted prompt was used only to support full-text evaluation across domains; all final coding decisions were made by the reviewer. Results: The search identified 851 records; after removing 426 duplicates, 425 unique records were screened, and 39 reviews met the inclusion criteria. Framing concentrated on environmental and psychological determinants and on the pathway from DA to avoidance and poor oral health, whereas broader consequences, including shame, OHRQoL, and systemic health outcomes, were less consistently framed. Across 5-year periods, the broad pattern of framing remained relatively stable. Systemic health outcomes were framed in only a minority of reviews. Conclusions: Future research should test hypothesized pathways from DA to broader health consequences using clearly specified bridge mechanisms and appropriate temporal designs. Full article

(This article belongs to the Special Issue Dental Anxiety: The Current Status and Developments)

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20 pages, 3774 KB

Open AccessArticle

Layer-Matched A2 Shade Compatibility Across 3Y/4Y/5Y Multilayer Zirconia: CIEDE2000 Color Differences Correlated with Y₂O₃ Content (EDS), Phase Constitution (XRD), and Grain Size (FE-SEM)

by Carlos Roberto Luna-Dominguez, Suria Sarahi Oliver-Rivas, Omaika Victoria Criollo-Barrios, Gerardo Alberto Salvador Gomez-Lara, Ricardo de Jesús Figueroa-Lopez and Jorge Humberto Luna-Dominguez

Dent. J. 2026, 14(4), 226; https://doi.org/10.3390/dj14040226 - 10 Apr 2026

Viewed by 722

Abstract

Objective: This in vitro study aimed to compare the layer-matched color compatibility of three 3Y/4Y/5Y multilayer zirconia grades marketed in shade A2. Materials and Methods: Disc specimens (18 mm × 1.5 mm) were milled from pre-shaded multilayer zirconia blanks (Katana™ Multi-Layered Zirconia; Kuraray [...] Read more.

Objective: This in vitro study aimed to compare the layer-matched color compatibility of three 3Y/4Y/5Y multilayer zirconia grades marketed in shade A2. Materials and Methods: Disc specimens (18 mm × 1.5 mm) were milled from pre-shaded multilayer zirconia blanks (Katana™ Multi-Layered Zirconia; Kuraray Noritake Dental Inc., Tokyo, Japan) in three grades: UTML (5Y), STML (4Y), and HTML (3Y). Twelve discs per grade were polished and measured on a neutral-gray background (Munsell N7) using a dental spectrophotometer (VITA Easyshade Advance 4.0; VITA Zahnfabrik, Bad Säckingen, Germany) at the incisal, middle, and cervical thirds. Color differences were calculated using CIEDE2000 (ΔE₀₀). Yttria content (wt%) was determined using EDS (JSM-7800F; JEOL Ltd., Tokyo, Japan), and phases were assessed using XRD (X’Pert PRO; Malvern Panalytical, Almelo, The Netherlands); microstructure and grain size were examined using FE-SEM after thermal etching. Statistics: A two-way mixed-design ANOVA with Bonferroni adjustment (α = 0.05) was conducted. Results: A significant incisal-to-cervical gradient was observed within each grade (p < 0.001), whereas layer-matched inter-material differences were small (all ΔE00 < 1.0), i.e., below the commonly accepted perceptibility threshold. EDS confirmed the expected stepwise decrease in Y₂O₃ from UTML to HTML, accompanied by corresponding changes in phase constitution and grain size. Conclusions: Despite compositional and microstructural differences, the three multilayer zirconia grades showed no clinically perceptible layer-matched color differences, supporting their combined use in extended rehabilitations while maintaining the natural-like color gradient across the multilayer blank. Full article

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16 pages, 842 KB

Open AccessArticle

Orthodontic Appliance Type and Oral Malodor Burden: Cross-Sectional Comparison of Clear Aligners, Fixed Braces, and Untreated Controls

by Romina Georgiana Bita, Daniel Breban-Schwarzkopf, Magda Mihaela Luca, Edida Maghet and Alexandra Ioana Danila

Dent. J. 2026, 14(4), 225; https://doi.org/10.3390/dj14040225 - 9 Apr 2026

Viewed by 710

Abstract

Background and Objectives: Halitosis can impair psychosocial well-being, and orthodontic appliances may modify plaque retention and oral ecology. We compared patient-perceived halitosis burden, clinician-rated malodor, and oral health-related quality of life (OHRQoL) among clear aligner users, fixed-brace patients, and untreated controls, and explored [...] Read more.

Background and Objectives: Halitosis can impair psychosocial well-being, and orthodontic appliances may modify plaque retention and oral ecology. We compared patient-perceived halitosis burden, clinician-rated malodor, and oral health-related quality of life (OHRQoL) among clear aligner users, fixed-brace patients, and untreated controls, and explored oral and salivary correlates of worse malodor severity. Methods: This cross-sectional study (March 2024–November 2025) enrolled 184 participants aged 15–35 years (aligners n = 62; fixed braces n = 64; controls n = 58). Outcomes were HALT (0–100), organoleptic score (0–5), and OHIP-14 (0–56). Plaque index, gingival inflammation, tongue coating, and unstimulated salivary flow were recorded; low flow was defined as <0.25 mL/min. Organoleptic score ≥ 2 was used descriptively for clinically relevant malodor prevalence, whereas organoleptic score ≥3 defined a moderate-to-severe malodor phenotype for secondary exploratory internal modeling. Multivariable robust linear models (HALT) and proportional-odds ordinal logistic regression (organoleptic severity) were used. Results: Fixed braces showed higher HALT (53.7 ± 6.2) than controls (46.3 ± 6.4) and aligners (41.7 ± 7.4) (p < 0.001), higher organoleptic scores (2.9 ± 0.4 vs. 2.4 ± 0.6 vs. 2.2 ± 0.6; p < 0.001), and worse OHIP-14 (18.6 ± 4.7 vs. 15.9 ± 4.3 vs. 13.8 ± 4.8; p < 0.001). Clinically relevant malodor prevalence (organoleptic ≥ 2) was 96.9% in fixed braces, 79.3% in controls, and 66.1% in aligners (p < 0.001); because ≥2 was used as a broad descriptive threshold, these values should be interpreted as descriptive rather than diagnostic prevalence estimates. In adjusted models, greater tongue coating, higher plaque, and low salivary flow were associated with worse organoleptic severity, whereas appliance category did not remain independently associated with HALT once concurrent clinical correlates were included. Conclusions: Fixed braces showed higher unadjusted malodor burden and worse OHRQoL than aligners and untreated controls, but appliance category should be interpreted as a contextual exposure linked to plaque-retentive conditions rather than as a standalone causal determinant. Plaque accumulation, tongue coating, and lower salivary flow showed the strongest associations with worse malodor severity. These findings should be interpreted in light of the cross-sectional design, possible observer and selection bias, and residual confounding. Full article

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13 pages, 1418 KB

Open AccessArticle

Aging-Simulation Experience in Dental Education: Impact on Attitude and Empathy of Dental Students Towards Older People

by Martina Frigerio, Nattida Charadram, Mohammad Qurashi, Najla Chebib and Frauke Müller

Dent. J. 2026, 14(4), 224; https://doi.org/10.3390/dj14040224 - 9 Apr 2026

Viewed by 781

Abstract

Background: Empathy and a positive attitude are essential competencies in healthcare, particularly when caring for older adults. Their development is therefore a critical component of undergraduate dental education. This study evaluates whether using aging simulation suits can enhance empathy and improve attitudes toward [...] Read more.

Background: Empathy and a positive attitude are essential competencies in healthcare, particularly when caring for older adults. Their development is therefore a critical component of undergraduate dental education. This study evaluates whether using aging simulation suits can enhance empathy and improve attitudes toward older adults among dental students. Methods: Third- to fifth-year dental students from the University Clinics of Dental Medicine in Geneva, Switzerland, participated in an aging-simulation experience using the GERonTologic age simulation suit (GERT^®), which replicates age-related physical impairments. Students performed tasks in four predefined scenarios, both with and without the suit. Changes in empathy and attitudes were measured using the Jefferson Scale of Empathy-Health Profession Students’ version (JSE-HPS) and the Geriatric Attitudes Scale (GAS) questionnaires. Perceptions of the intervention were evaluated using a 5-point Likert scale questionnaire. Results: Sixty-three undergraduate students (45 women, 18 men), aged 20–53 years, participated. The suit significantly impaired their physical abilities (p < 0.001). Empathy improved post-intervention (p = 0.038), particularly in the third-year group. Attitude towards older adults improved significantly post-intervention (p = 0.001), mainly among fourth- and fifth-year students. All participants endorsed the positive value of the intervention. Conclusions: The intervention’s impact varied by clinical experience: empathy increased mainly in less experienced students, while attitudes improved in those with more exposure to elderly care. This suggests that the timing of simulation within the curriculum influences outcomes. Aging simulation represents a promising educational approach to enhance empathy, improve attitudes toward older adults, and prepare dental students for the clinical and psychosocial aspects of geriatric care. Full article

(This article belongs to the Section Dental Education)

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31 pages, 848 KB

Open AccessArticle

Psychological and Social Trajectories During Dental Treatment: A Prospective Cohort Study on Oral Health-Related Quality of Life

by Marius Moroianu, Lavinia-Alexandra Moroianu, Oana-Maria Isailă, Cătălin Pleșea-Condratovici, Simona-Dana Mitincu-Caramfil and Mădălina Nicoleta Matei

Dent. J. 2026, 14(4), 223; https://doi.org/10.3390/dj14040223 - 9 Apr 2026

Cited by 1 | Viewed by 865

Abstract

Background: Patients undergoing dental treatment often experience psychological distress and social discomfort, yet longitudinal data on these changes are limited. Existing studies rely on cross-sectional designs or lengthy tools, reducing feasibility in routine practice. This study explored psychological and social trajectories during [...] Read more.

Background: Patients undergoing dental treatment often experience psychological distress and social discomfort, yet longitudinal data on these changes are limited. Existing studies rely on cross-sectional designs or lengthy tools, reducing feasibility in routine practice. This study explored psychological and social trajectories during dental care, highlighting challenges and implications for patient wellbeing and care delivery. Methods: A prospective cohort study with repeated measures across three dental visits (V1–V3) was conducted. Participants completed a 21-item binary (yes/no) questionnaire assessing psychological (Q1–Q6) and social dimensions (Q7–Q14 at all visits; extended social domain Q7–Q21 at V2–V3). Composite scores were calculated, and longitudinal changes were analyzed using generalized estimating equations or mixed-effects models. Item-level trajectories were examined with multiple comparison adjustments. Results: Of 120 enrolled patients, 100 completed all visits. Psychological well-being consistently improved, while social outcomes showed more complex, domain-specific patterns. Item-level analyses revealed gains in appearance and satisfaction, whereas stigma, fear, and social integration remained relatively stable, underscoring the need to monitor multiple psychosocial dimensions. Conclusions: Psychosocial monitoring during dental care is feasible and potentially beneficial. The 21-item questionnaire was practical and well-accepted, with composite scores serving as simple indicators for tracking patient wellbeing and supporting a holistic, patient-centered approach. Further validation in larger and more diverse populations is needed. Full article

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

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15 pages, 627 KB

Open AccessReview

PEEK Intraoral Scan Bodies—A Scoping Review

by Ioulianos Rachiotis, Aspasia Pachiou, Daniel S. Thoma, Nadja Naenni and Christos Rahiotis

Dent. J. 2026, 14(4), 222; https://doi.org/10.3390/dj14040222 - 9 Apr 2026

Viewed by 905

Abstract

Background: Accurate digital impressions are crucial for the long-term success of implant-supported prostheses, with scan bodies playing a pivotal role in transferring the implant position into the virtual model. Recent work has focused on PEEK (polyether-etherketone) scan bodies because their optical behavior [...] Read more.

Background: Accurate digital impressions are crucial for the long-term success of implant-supported prostheses, with scan bodies playing a pivotal role in transferring the implant position into the virtual model. Recent work has focused on PEEK (polyether-etherketone) scan bodies because their optical behavior may facilitate intraoral scanning; however, the breadth and quality of supporting evidence remain unclear. Methods: This scoping review followed PRISMA-ScR reporting guidelines and was registered in the Open Science Framework (OSF; Registration DOI 10.17605/OSF.IO/CU3V8). Pub-Med/MEDLINE, Embase, and Scopus were searched through September 2025. Eligible designs included in vitro studies, randomized trials, observational studies, and technical reports evaluating PEEK scan bodies in implant dentistry. Screening and data extraction were performed in duplicate, and findings were synthesized descriptively. Results: The search identified 227 records, and after screening, 31 studies met the inclusion criteria. Most studies were in vitro, with limited clinical evidence, and only one prospective clinical study was identified. Outcomes commonly addressed trueness, precision, scan time, and handling. Comparators varied (e.g., titanium, resin; splinted vs. unsplinted), and the results on accuracy were heterogeneous, with deviations typically within clinically acceptable limits (<100 µm). Conclusions: PEEK scan bodies are applicable for digital implant impressions. Clinical data are sparse, though, and methods vary. Controlled clinical studies are necessary to confirm the accuracy, reliability, and indications of this approach compared to titanium ISBs. Full article

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

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19 pages, 4426 KB

Open AccessArticle

Clinical Performance and Patients’ Satisfaction of Digitally Versus Conventionally Fabricated Dentures: A Randomized Controlled Pilot Study

by Jonas Rechlin, Florian Beuer, Robert Nicic, Rebecca Noetzel, Wolfgang Hannak and Elisabeth Prause

Dent. J. 2026, 14(4), 221; https://doi.org/10.3390/dj14040221 - 9 Apr 2026

Cited by 1 | Viewed by 1108

Abstract

Background/Objectives: Although digital workflows for complete denture fabrication are increasingly implemented in clinical practice, randomized controlled pilot trials directly comparing their clinical performance and patient satisfaction with conventional complete dentures (CCDs) remain scarce. This study aimed to compare patient satisfaction and clinical [...] Read more.

Background/Objectives: Although digital workflows for complete denture fabrication are increasingly implemented in clinical practice, randomized controlled pilot trials directly comparing their clinical performance and patient satisfaction with conventional complete dentures (CCDs) remain scarce. This study aimed to compare patient satisfaction and clinical effectiveness between conventionally and digitally fabricated complete dentures (DCDs). Methods: In the present exploratory randomized controlled clinical pilot study using a cross-over design, 15 edentulous patients received both a conventionally fabricated and a digitally fabricated complete denture in randomized order. Each denture was worn for a three-month adaptation period. Patients were blinded to the fabrication method. Oral health-related quality of life was assessed using the OHIP-G49 questionnaire, and clinical performance was evaluated using standardized criteria at baseline, after three months with the first denture, and after three months with the second denture. Results: Both fabrication methods yielded satisfactory clinical outcomes in all patients. All 15 patients rated the DCDs as highly satisfactory, while 14 patients rated the CCDs equally favorably; one patient was unable to tolerate the conventional denture. DCDs demonstrated a slight but consistent advantage in oral health-related quality of life (OHRQoL) scores. Conclusions: Both conventional and digital complete dentures are clinically effective and well accepted by edentulous patients. However, DCDs offer a modest improvement in patient satisfaction and OHRQoL. Digitally fabricated complete dentures provide comparable clinical results to conventional methods while offering potential advantages in patient comfort and perceived quality of life. Given the exploratory nature of the study and the limited sample size, the results should be interpreted with caution and primarily serve to inform future, adequately powered randomized clinical trials. Full article

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

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11 pages, 960 KB

Open AccessArticle

Dimensional Accuracy and Short-Term Stability of Orthodontic Resin-Printed Models: A Closed Dental System Compared with Commercial Desktop Workflows

by Pilar España-Pamplona, Davide Gentile, Adrian Curto-Aguilera, Riccardo Aiuto, Milagros Adobes-Martin and Daniele Garcovich

Dent. J. 2026, 14(4), 220; https://doi.org/10.3390/dj14040220 - 9 Apr 2026

Viewed by 683

Abstract

Background/Objectives: Resin 3D printing is widely used to fabricate orthodontic diagnostic models, but the practical performance of commercial desktop workflows compared to dental-certified workflows is still debated. This study compared the dimensional accuracy and 7-day stability of maxillary orthodontic models printed from the [...] Read more.

Background/Objectives: Resin 3D printing is widely used to fabricate orthodontic diagnostic models, but the practical performance of commercial desktop workflows compared to dental-certified workflows is still debated. This study compared the dimensional accuracy and 7-day stability of maxillary orthodontic models printed from the same master STL file using a dental-certified workflow versus two commercial desktop workflows. Methods: An ISO 20896-1:2019-based reference cast with four 6 mm calibration spheres was used to generate a master STL file. Fifteen models were printed (n = 5 per workflow) using Primeprint™ (dental-certified workflow) and two commercial desktop printers (Anycubic Photon Mono M5s; Phrozen Sonic Mighty 14K REVO). The models were digitized at baseline (T0, ≤48 h) and after 7 days (T7) using a laboratory scanner. Surface superimposition in CloudCompare^® calculated the RMS (root mean square) surface deviation and mean signed deviation, and two calibrated operators performed independent extractions. Results: The mean RMS deviations were <0.10 mm for all workflows at both time points. No between-workflow differences were detected at T0 (H = 2.000; p = 0.368) or T7 (H = 1.520; p = 0.468), no within-workflow T0–T7 changes were significant (all p > 0.05), and the inter-operator agreement was excellent (ICC 0.991–0.999). Conclusions: Under the tested workflows, dental-certified and commercial desktop resin printing produced orthodontic models with a comparable global surface accuracy and short-term dimensional stability. Full article

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13 pages, 677 KB

Open AccessArticle

Domain-Specific vs. General-Purpose Large Language Models in Orthodontics: A Blinded Comparison of AlimGPT, GPT-4o, Gemini, and Llama

by Sertaç Aksakallı, Bilgin Giray and Çağrı Temel

Dent. J. 2026, 14(4), 219; https://doi.org/10.3390/dj14040219 - 8 Apr 2026

Viewed by 906

Abstract

Objective: The application of artificial intelligence (AI) in orthodontics has evolved rapidly in recent years, encompassing areas such as diagnosis, treatment planning, and patient management, and AlimGPT is an AI-based tool that provides treatment options based on data and algorithms. Methods: [...] Read more.

Objective: The application of artificial intelligence (AI) in orthodontics has evolved rapidly in recent years, encompassing areas such as diagnosis, treatment planning, and patient management, and AlimGPT is an AI-based tool that provides treatment options based on data and algorithms. Methods: Fourteen different orthodontic questions were asked to each model, and answers were analyzed. This study aimed to compare AlimGPT with GPT-4o, Gemini, and Llama using standardized tests to evaluate the quality of information provided, including the Likert scale, modified DISCERN (mDISCERN), and modified Global Quality Score (mGQS). Results: Significant differences were detected for reliability (χ² = 15.267, p = 0.0016) and usefulness (χ² = 20.557, p = 0.0001). Post hoc tests showed AlimGPT > Gemini and Llama for reliability and AlimGPT > GPT-4o, Gemini, and Llama for usefulness. mDISCERN was significant overall (χ² = 11.047, p = 0.0115), but no pairwise contrast met adjusted significance; mGQS showed no significant differences (χ² = 7.071, p = 0.0697). Inter-rater agreement was moderate-to-good for reliability (ICC = 0.710, 95% CI 0.60–0.80) and usefulness (ICC = 0.729, 95% CI 0.63–0.82), moderate for mGQS (ICC = 0.596, 95% CI 0.47–0.71), and poor-to-moderate for mDISCERN (ICC = 0.435, 95% CI 0.30–0.58). Conclusions: In this blinded, within-subjects experiment, the domain-specific model (AlimGPT) received higher clinician ratings for usefulness and, for reliability, exceeded two general baselines. Differences in mGQS were not detected. Expanding the number of raters, increasing item diversity or integrating updated baselines would be beneficial. Full article

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

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13 pages, 3007 KB

Open AccessArticle

Comparative Evaluation of Bovine- and Porcine-Derived Xenografts in Rabbit Calvarial and Canine Mandibular Dehiscence Models

by Na Ri Seo, Hee Jeong Jang, Sung-Ho Lee, Bongju Kim and Dong-Wook Han

Dent. J. 2026, 14(4), 218; https://doi.org/10.3390/dj14040218 - 8 Apr 2026

Cited by 1 | Viewed by 1007

Abstract

Background: This study compared two xenogeneic bone graft materials, A-Oss (bovine-derived) and The Graft (porcine-derived), using a rabbit calvarial defect model and a canine mandibular dehiscence-type defect model. Methods: Healing was evaluated at 6 and 12 weeks in rabbits and at 24 weeks [...] Read more.

Background: This study compared two xenogeneic bone graft materials, A-Oss (bovine-derived) and The Graft (porcine-derived), using a rabbit calvarial defect model and a canine mandibular dehiscence-type defect model. Methods: Healing was evaluated at 6 and 12 weeks in rabbits and at 24 weeks in mongrel dogs. Micro-computed tomography quantified mineralized tissue fill (defect closure) in rabbits and, in dogs, the compartments classified as new bone and residual graft, together with vertical and horizontal volumetric maintenance. Hematoxylin and eosin (H&E) sections provided complementary qualitative observations. Results: In rabbits, defect closure did not differ between materials at 6 weeks (67.1 ± 12.7% vs. 70.2 ± 15.1%, p = 0.090) or 12 weeks (78.6 ± 5.9% vs. 72.3 ± 0.9%, p = 0.124). In dogs, new bone was similar between groups (43.5 ± 3.2% vs. 45.9 ± 1.1%, p = 0.208), whereas residual graft showed a numerical trend toward higher values with A-Oss (20.2 ± 3.5% vs. 13.3 ± 4.5%, p = 0.069). Vertical volume maintenance also trended higher with A-Oss (91.1 ± 1.6% vs. 87.8 ± 1.3%, p = 0.056), while horizontal maintenance was comparable (94.5 ± 1.8% vs. 91.4 ± 2.8%, p = 0.241). Histology in both models showed graft particles within the defect/augmented regions with surrounding eosinophilic matrix and intervening tissue spaces. Conclusions: Overall, both materials produced similar healing profiles across models, with small between-material differences most apparent in the canine dehiscence setting. Full article

(This article belongs to the Special Issue Bone Regeneration and Tissue Reconstruction in Dentistry)

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14 pages, 3409 KB

Open AccessSystematic Review

Malignant Transformation in Extraoral Lichen Planus: A Systematic Review and Meta-Analysis in the Context of the Risk in Oral Lichen Planus

by Ana Carolina Evangelista Colafemina, Caique Mariano Pedroso, Maria Eduarda Perez-de-Oliveira, Ana Gabriela Costa Normando, Katherine France, Rafael Tomaz Gomes, Marcelo Henrique Napimoga, Marcio Ajudarte Lopes and Alan Roger Santos-Silva

Dent. J. 2026, 14(4), 217; https://doi.org/10.3390/dj14040217 - 8 Apr 2026

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Abstract

Objectives: This systematic review aimed to evaluate malignant transformation (MT) in extraoral lichen planus to help contextualize the debated malignant potential of oral lichen planus in a mucocutaneous disease model. Methods: A comprehensive literature search was conducted across five databases and [...] Read more.

Objectives: This systematic review aimed to evaluate malignant transformation (MT) in extraoral lichen planus to help contextualize the debated malignant potential of oral lichen planus in a mucocutaneous disease model. Methods: A comprehensive literature search was conducted across five databases and gray literature sources, without date restrictions. Observational studies reporting MT in cutaneous or genital LP were included. Data extraction, risk of bias assessment using Joanna Briggs Institute (JBI), and meta-analysis of proportions were performed. Subgroup analyses by anatomical site were conducted where possible. Results: Ten studies (15,829 patients) were included, with a predominance of women (93.1%). The pooled MT rate of extraoral LP was 1% (95% CI: 0.00–0.03). Subgroup analysis revealed a significantly higher rate in vulvar LP (2%; 95% CI: 0.02–0.03) compared to cutaneous LP (0%; 95% CI: 0.00–0.01) (p < 0.0001). Squamous cell carcinoma was the most frequent malignancy. The erosive and hypertrophic subtypes of LP were more commonly associated with cancer development. Conclusions: MT of extraoral LP appears to be rare, particularly in cutaneous forms. However, the risks observed in the genital mucosa reinforce the need for accurate diagnosis and long-term follow-up, especially in erosive presentations. Full article

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

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15 pages, 3434 KB

Open AccessArticle

Cyclic Fatigue of Rotary Versus Reciprocating Endodontic Files: An In Vitro Study of Engine-Driven Endodontic Files

by Sverre Brun, Andrine Rebni Kristoffersen, Malene Nerbøberg Solsvik, Marit Øilo and Inge Fristad

Dent. J. 2026, 14(4), 216; https://doi.org/10.3390/dj14040216 - 8 Apr 2026

Viewed by 1214

Abstract

Background/Objectives: Instrument fracture remains a significant complication in endodontics. This study compared the resistance to cyclic fatigue failure between rotary and reciprocating nickel–titanium file systems, as well as differences related to file size and taper. Methods: Nineteen rotary and reciprocating file types (n [...] Read more.

Background/Objectives: Instrument fracture remains a significant complication in endodontics. This study compared the resistance to cyclic fatigue failure between rotary and reciprocating nickel–titanium file systems, as well as differences related to file size and taper. Methods: Nineteen rotary and reciprocating file types (n = 10 per group) were evaluated in three independent test series, harmonized according to file size and system. Cyclic fatigue testing was conducted using a static model with a stainless-steel artificial canal, with an internal diameter of 0.9 mm, a 75° curvature angle, and a fixed radius for each series. Files were operated using preset programs on the X-Smart Plus, Rooter X3000, and Sendoline Endo torque-controlled motors. Time to fracture was recorded digitally, and the total number of full rotations to failure was calculated. The fractured fragments were examined with scanning electron microscopy and fractographic analysis. The data were analyzed using linear models in Stata version 19, with significance set at p ≤ 0.05. Results: Reciprocating file systems demonstrated greater time-to-fracture fatigue resistance than rotary systems. However, these differences were diminished or, in some cases, eliminated when normalized to the number of complete rotations. Fractographic analysis indicated that fractures predominantly resulted from tensile stress rather than shear forces. Conclusions: Reciprocating kinematics generally enhanced fatigue resistance compared with continuous rotation. The results suggest that fatigue resistance in machine-driven nickel–titanium instruments cannot be predicted by motion type or file design alone but reflects a complex interaction between alloy composition, heat treatment, and cross-sectional geometry. Full article

(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)

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Dent. J., Volume 14, Issue 4 (April 2026) – 56 articles

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