Oral, Volume 5, Issue 4 (December 2025) – 27 articles

Background/Purpose: The study aimed to analyze the dimensions and width-to-length ratios of the maxillary anterior teeth in young native Cambodian adults and to assess their relationship with the golden proportion, symmetry, and sexual dimorphism. Materials and Methods: Maxillary study casts of 193 eligible Cambodian subjects, aged 18 to 25 years, were retrospectively evaluated. The width and length of their maxillary anterior teeth were measured using a digital caliper. Descriptive statistics, independent-samples t-test at 95% confidence intervals, Kolmogorov-Smirnov, Shapiro-Wilk, and Kruskal-Wallis tests were performed to analyze the data. Results: There was a high level of similarity between first and second quadrant measurements. Females showed slightly higher standard deviations for central incisors and lateral incisors than males across most ratios, indicating more variability in the width-in-length ratios for females. Males exhibited significantly greater tooth dimensions than females. The following results showed statistical significance with p < 0.05 and 95% confidence intervals. The mean crown width of the central incisors was 8.16 mm in males (CI: 8.03–8.29) and 7.87 mm in females (CI: 7.78–7.96). For the lateral incisors, the mean crown width was 6.69 mm in males (CI: 6.53–6.85) and 7.64 mm in females (CI: 7.43–7.85). The width-to-length ratio of the central incisors was higher in females (mean = 0.88; CI: 0.86–0.91) compared with males (mean = 0.87; CI: 0.84–0.89). Overall, proportional relationships remained consistent across genders. The golden proportion guideline was not applicable, as observed ratios ranged from 0.90 to 1.67 (all below 1.618), and RED values exceeded 80%. The null hypothesis was rejected due to the significant gender differences found in tooth dimensions and width-to-length ratios. Conclusions: There was no significant difference in maxillary anterior tooth dimensions for the right and left sides among the Cambodian population. Males had statistically larger teeth than females. Width-to-length ratios were greater in females for central incisors; however, the proportional relationships between the genders remained relatively consistent. The golden proportion and RED proportions did not exist within this population. A smaller size characterizes Cambodian dentition compared to that of other ethnic groups. Finally, these results can serve as an indicator for planning customized esthetic treatment in Cambodians. Future studies with larger sample sizes are needed to ensure the representation of the whole Cambodian population. Full article

Background: Periapical surgery is indicated for persistent periapical lesions that do not respond to conventional endodontic therapy, yet postoperative recovery is often hindered by pain, swelling, and delayed healing. Platelet-rich fibrin (PRF) membranes are autologous biomaterials with regenerative potential, capable of modulating inflammation and promoting tissue repair. Methods: This preliminary randomized controlled trial evaluated the effectiveness of PRF membranes in improving postoperative outcomes—specifically pain, swelling, and quality of life—after apicoectomy. Twenty patients requiring periapical surgery were randomly allocated to a PRF group (n = 10) or a control group (n = 10). In the PRF group, autologous PRF membranes were applied over the resected root-end and into the osteotomy cavity before flap closure. In the control group, no PRF membranes or any additional biomaterial were applied, apart from the standard root-end filling material (MTA), which was identically used in both groups as part of the routine apicoectomy protocol. All patients were blinded to allocation, and outcomes were assessed by an independent blinded evaluator. Facial swelling was quantified by 3D facial scanning, pain was recorded daily using a visual analog scale (VAS), and quality of life was evaluated with the PROMIS-29+2 Profile. Results: The PRF group showed significantly reduced swelling (mean volume difference, 7.12 cm³; p = 0.025), lower pain scores (VAS: 1.80 ± 1.22 vs. 3.80 ± 2.44; p = 0.034), and improved quality-of-life domains, including higher Physical Function (p = 0.032) and lower Sleep Disturbance (p = 0.008) scores. Conclusions: Within the limitations of this pilot study, PRF membranes enhanced postoperative recovery after periapical surgery by reducing swelling and pain while improving patient-reported outcomes. Larger multicenter trials are needed to confirm these preliminary findings. Full article

Background: The precision of intraoral scanners (IOSs) is a key factor in ensuring the reliability of digital impressions, particularly in full-arch workflows. Although proprietary metrology tools are generally employed for scanner validation, open-source platforms could provide a cost-effective alternative for clinical research. Methods: This in vivo study compared the precision of two IOSs—3Shape TRIOS 3 and Planmeca Emerald S—using an open-source analytical workflow based on Autodesk Meshmixer and CloudCompare. A single healthy subject underwent five consecutive full-arch scans per device. Digital models were trimmed, aligned by manual landmarking and iterative closest-point refinement, and analyzed at six deviation thresholds (<0.01 mm to <0.4 mm). The percentage of surface points within clinically acceptable limits (<0.3 mm) was compared using paired t-tests. Results: TRIOS 3 exhibited significantly higher repeatability than Planmeca Emerald S (p < 0.001). At the <0.3 mm threshold, 99.3% ± 0.4% of points were within tolerance for TRIOS 3 versus 92.9% ± 6.8% for Planmeca. At the <0.1 mm threshold, values were 89.6% ± 5.7% and 47.3% ± 13.7%, respectively. Colorimetric deviation maps confirmed greater spatial consistency of TRIOS 3, particularly in posterior regions. Conclusions: Both scanners achieved clinically acceptable precision for full-arch impressions; however, TRIOS 3 demonstrated superior repeatability and lower variability. The proposed open-source workflow proved feasible and reliable, offering an accessible and reproducible method for IOS performance assessment in clinical settings. Full article

Background/Objectives: As antimicrobial dental treatments, based on chemical products, long tested for their efficacy, have been lately associated with developing antimicrobial resistance, there is a growing interest to identify and develop efficient alternatives. The aim of this paper is to assess the antimicrobial potential of eight selected essential oils (EOs): Cinnamon (Cinnamomum verum), Tea tree (Melaleuca alternifolia), Spearmint (Mentha spicata), Rosemary (Rosmarinus officinalis), Clove (Eugenia caryophyllata), Eucalyptus (Eucalyptus radiata), Cedarwood (Juniperus virginiana), and Lemongrass (Cymbopogon flexuosus), more or less recognized and investigated for this particular therapeutic effect, on Streptococcus mutans (S. mutans), a key pathogen involved in oral pathology. Materials and methods: The chemical constituents of the EOs were identified and quantified by Gas Chromatography-Mass Spectrometry (CG-MS) method. Saliva samples, collected from nine patients with active dental caries, were tested in vitro. To assess the bacterial susceptibility of the selected EOs against S. mutans, the inhibition zones (IZ), minimum inhibitory concentrations (MIC), and minimum bactericidal concentrations (MBC) were determined. Results: All EOs tested showed antimicrobial activity against S. mutans, with IZs over 20 mm. The highest antimicrobial efficacy was observed for spearmint, followed by Eucalyptus, Tea tree, and Lemongrass. The next in descending order were Cinnamon Bark, Clove, Rosemary, and Cedarwood. Considering the mean MIC and MBC values, the spearmint EO proved to be the most effective in inhibiting the growth of S. mutans, as well as in annihilating it, followed by the Eucalyptus EO, Tea tree EO and Lemongrass EO. The less effective were determined to be Cinnamon, Clove, Rosemary and Cedarwood EOs. Conclusions: The eight selected EOs demonstrated antimicrobial activity against S. mutans, with Spearmint and Eucalyptus showing the most significant effects, advocating for their potential in dental caries prevention and treatment, and their potential role in oral hygiene applications. Full article

Background/Objectives: Early diagnosis of periodontal disease is vital for preventing disease progression and improving patient outcomes. This study explored healthcare professionals’ perspectives on a novel minimally invasive biofluid sampling device intended for periodontal disease diagnosis. Methods: A co-design approach was used to engage end users during early device development. Two focus group discussions were conducted with dentists, followed by an online questionnaire completed by dentists and other oral healthcare professionals. The aim was to gather opinions, preferences, and suggestions regarding the proposed device’s design and clinical application. Results: The innovation was well received by survey respondents (n = 54) and participants of the focus group discussions, who also provided insightful comments on aspects including physical features, diagnostic value, usability, and integration with clinical workflow. Conclusions: The co-design process revealed that there is a need for the novel biofluid sampling device. Suggestions from the participants helped improve an early internal Target Product Profile and bring the device closer to clinical requirements and expectations. Full article

Objective: This study aimed to determine the association between periodontal disease and dementia in older adults in Lima Centro. Materials and methods: A cross-sectional analytical study was conducted in 112 institutionalized older adults, who were clinically evaluated using the Periodontal Screening and Recording (PSR) system. Bivariate analyses were performed using the chi-square test, Mann–Whitney U test, and Student’s t-test. Logistic regression was used to estimate the crude and adjusted odds ratios with 95% confidence intervals, with p < 0.05 considered statistically significant. Results: The results showed that 49.11% of the participants scored a code 3 in the PSR system, indicating periodontal pockets of 3 to 5 mm, bleeding, and bacterial plaque, while 79.46% exhibited the presence of bacterial plaque. Likewise, older adults with dementia were observed to have clinical plaque upon probing, whereas 40.35% of older adults without a dementia diagnosis did not have plaque; this association was statistically significant. In the multivariate analysis, an association between periodontal disease and dementia was observed in the crude analysis (OR = 4.43; 95% CI: 2.20–8.93; p = 0.000) and the adjusted analysis (OR = 4.69; 95% CI: 2.32–9.48; p = 0.000). Conclusions: In conclusion, a significant relationship was identified between periodontal disease (assessed using the PSR system), the presence of bacterial plaque, and gingival bleeding with dementia in the evaluated older adults. This finding highlights the importance of periodontal health not only for oral well-being but also as a potentially modifiable risk factor for dementia prevention. Integrating oral health interventions into broader geriatric care may contribute to delaying or reducing the risk of neurodegenerative diseases, underscoring the need for interdisciplinary approaches in public health strategies. Full article

Objectives: This study aimed to evaluate dentists’ knowledge in Split-Dalmatia County regarding bisphosphonates and their oral side effects. Methods: An anonymous, 20-item questionnaire assessing demographics, knowledge of indications, mechanisms of action, and complications of bisphosphonates was electronically distributed via email to dentists in Split-Dalmatia County between March and April 2025. Descriptive statistical analysis was performed, and the results are presented as absolute numbers and percentages. The Chi-square test was used to compare proportions between groups, with a significance level set at p < 0.05. Results: A total of 172 dentists from Split-Dalmatia County participated (response rate was 71.36%). The mean total knowledge score was 7.3 ± 1.4 out of 9 items. The results indicated that most respondents correctly answered questions about indications for bisphosphonate use (95.9%), mechanism of action (93.6%), and the most common complication—osteonecrosis of the jaw (92.4%). The lowest correct response rate (38.4%) was for procedures before invasive dental treatments. Only 18.6% of participants answered all nine knowledge questions correctly. No significant differences in knowledge were found based on gender, age, year of graduation, or educational level. Nearly all dentists (95.3%) expressed interest in further education on this topic. Conclusions: Although dentists demonstrated satisfactory general knowledge regarding bisphosphonates, important gaps remain, particularly in practical application, including recommendations for managing patients on bisphosphonates undergoing invasive dental procedures. Given the rising use of bisphosphonates and the potential severity of their side effects, additional education is warranted to enhance prevention, promote early detection, and ensure appropriate clinical management of related complications. Full article

Background and Objectives: Stereolithography (SLA) enables the creation of physical replicas of digital models, offering surgeons a realistic representation of patient anatomy. This technology improves diagnostics and surgical planning, facilitates communication within the medical team, and enhances the doctor–patient relationship by promoting compliance. This study aims to place the intervention addressed in a broader context and highlight the utility of SLA models in complex surgical scenarios. Case Presentation: The study presents two cases of patients with severe maxillary atrophy: a 67-year-old healthy male (with well-controlled hypertension) and a 72-year-old female patient (with hypercholesterolemia). Intervention and Outcome: Zygomatic implant procedures with immediate loading were performed to resolve the bone atrophy in both cases. These procedures heavily leveraged preoperative planning using stereolithographic models. Both interventions resulted in a positive outcome, which was confirmed at the 6-month follow-up. Conclusions: The integration of stereolithographic models into the preoperative planning process improved the prognosis of these complex cases, confirming their value in managing severe maxillary atrophy. Full article

Background: Intraoral pressure contributes significantly to bolus transport during swallowing, along with tongue and pharyngeal pressures. However, conventional assessment methods (e.g., manometry, tongue pressure measurement) have limitations, including invasiveness, difficulty in capturing pressure gradients, and reliance on cognitive function. Objective: This study aimed to examine differences in intraoral pressure between patients with dysphagia and healthy controls using a newly developed, noninvasive intraoral pressure sensor. Methods: Sixteen individuals with dysphagia were categorized into two groups based on the Dysphagia Severity Scale (DSS): eight with mild dysphagia (DSS6-5) and eight with moderate dysphagia (DSS4-3). Seven healthy young adults (DSS7) were included as controls. Intraoral pressure was measured using a sensor enclosed in a silicone balloon placed in a standardized position. Three thickened liquids (mildly, moderately, and extremely thick) were tested, and intraoral pressure duration, peak pressure, and area were analyzed. Results: Pressure duration and area significantly increased with higher-viscosity samples in participants with dysphagia. Both parameters were significantly higher in the dysphagia groups than in controls (p < 0.001). For the extremely thick sample, pressure area was significantly greater in the mild dysphagia group than in controls (p = 0.031), and in the moderate group across all viscosities (p = 0.036; mildly thick, p = 0.010; moderately thick, p = 0.006; extremely thick, respectively). Conclusions: Intraoral pressure measurement may be a valuable supplementary screening tool, particularly for identifying moderate or more severe dysphagia. Full article

Background: Artificial intelligence technologies are increasingly integrated into dental practice, offering potential improvements in diagnostic accuracy, treatment planning, and patient outcomes. However, the extent and quality of evidence supporting these applications remain unclear. Methodology: We conducted a systematic literature search using PubMed, Cochrane Library, Embase, and IEEE Xplore databases from January 2015 to December 2024. Search terms included combinations of “artificial intelligence,” “machine learning,” “deep learning,” “dentistry,” “diagnosis,” and “treatment planning.” Studies evaluating AI systems in clinical or laboratory settings with measurable outcomes were included. Data extraction followed PRISMA guidelines, and methodological quality was assessed using the QUADAS-2 tool. Results: Twenty-three studies met the inclusion criteria. Most focused on diagnostic accuracy (n = 21), with few addressing treatment planning (n = 1) or outcome prediction (n = 1). Reported accuracies ranged from 82–94% for caries detection, 85–92% for periodontal disease assessment, and 88–96% for oral lesion identification. Orthodontic applications achieved 95–98% accuracy in cephalometric landmark identification, while implant planning studies demonstrated up to 96% agreement with expert strategies. Despite promising technical performance, 79% of studies were retrospective and conducted in controlled research settings, with limited external or prospective clinical validation. Risk of bias was highest in patient selection due to frequent use of case–control designs and archived imaging datasets. Conclusions: AI shows significant promise for enhancing dental diagnostics and treatment planning. However, most applications require further clinical validation before routine implementation. The disconnect between laboratory performance and real-world clinical validation represents a critical gap that must be addressed. Current AI systems should be viewed as diagnostic aids rather than replacements for clinical judgment. Practitioners considering AI adoption should understand current limitations and evidence quality, particularly the lack of prospective clinical validation in diverse populations. Full article

Background: Commercial oral care products commonly incorporate synthetic antimicrobials such as cetylpyridinium chloride (Cetyl Cl.), L-Arginine (L-arg.), and stannous fluoride (SnF₂). Although effective against oral pathogens, these agents are often associated with adverse effects including mucosal irritation, taste alteration, and disruption of the oral microbiome. These limitations have spurred growing interest in safer, plant-based alternatives. In this study, we present a two-pronged in vitro oral care testing model that integrates cell assays with machine-guided quantitative microscopy analyses to assess both antibacterial efficacy and host biocompatibility of botanical extracts. Methods: Using Miswak (Salvadora persica) and Neem (Azadirachta indica) as representative natural products, we conducted antibacterial and antibiofilm testing including the evaluation of the minimum inhibitory concentration (MIC), minimum biofilm inhibitory concentration (MBIC), and minimum biofilm eradication concentration (MBEC), alongside biocompatibility assessments via MTT cell viability assays on probiotic bacteria and mammalian oral cells. To evaluate biofilm structure and disruption, we employed scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM), augmented with machine-guided Weka segmentation and automated image analysis. Results: Our findings show that Miswak and Neem extracts exhibited 75–100% antibacterial and antibiofilm efficacy against all tested bacteria, as demonstrated by cell assays and microscopy analyses, comparable to synthetic oral care agents. They also maintained ~100% viability toward commensal microbes and mammalian oral cells, whereas Cetyl Cl. and SnF₂ showed dose-dependent cytotoxicity. Conclusions: This dual-assessment oral care testing model provides a comprehensive and biologically relevant framework for the discovery and screening of safe and effective natural herbal extracts in oral care applications. Full article

Background/Objectives: Angiotensin-converting enzyme (ACE) inhibitors are commonly prescribed anti-hypertensive agents. However, one of their effects is reducing the breakdown of a number of pro-inflammatory mediators, including bradykinin and substance P. Given the role of inflammation in periodontal disease, the aim of this study was to see whether ACE inhibitors may have an influence on the severity of periodontal disease, as assessed by clinical attachment loss. Methods: A case–control retrospective study was undertaken through analysis of patient records from a specialist periodontic practice. Data regarding the loss of clinical attachment was collected from patients who were non-smokers and grouped according to patients prescribed ACE inhibitors, those taking other antihypertensive medication, and those taking no antihypertensive medication. Results: No statistically significant difference was observed between the three treatment groups in terms of mild to moderate loss of attachment (1–3 mm; 4–5 mm). However, a significantly higher incidence of severe attachment loss (>6 mm) was observed in patients prescribed ACE inhibitors, as compared to another antihypertensive or no antihypertensive medication. Conclusions: The incidence of severe loss of clinical attachment in this study was highest in those patients being prescribed ACE inhibitors. This effect would appear to be independent of the effects of the medication on blood pressure, since this was not observed with other antihypertensive medications, and hence may potentially relate to the known pro-inflammatory action of ACE inhibitors. Full article

Background: Antimicrobial resistance in oral pathogens drives interest in natural alternatives such as essential oils (EOs). Methods: The chemical composition and in vitro antimicrobial activity of Origanum vulgare, Thymus vulgaris, and Lavandula angustifolia EOs were investigated. Oils were profiled by gas chromatography–mass spectrometry (GC-MS) and tested against Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922, and Candida albicans ATCC 10231 using the disc diffusion method (triplicate, 1 µL/disc, ~850–950 µg). Results: O. vulgare oil produced the strongest inhibition against C. albicans (18.4 ± 0.5 mm), T. vulgaris was most active E. coli (13.0 ± 0.5 mm), while L. angustifolia showed negligible activity (6–7 mm). All EO inhibition zones were smaller than those of antibiotics. Conclusions: At clinically relevant doses, Oregano and Thyme oils showed modest antimicrobial effects, whereas Lavender was inactive. However, these findings are limited by the use of ATCC strains, small sample size, and reliance on the disc diffusion method, which provides only qualitative data and does not capture biofilm or host interactions. Future studies should include minimum inhibitory concentrations (MIC)/minimum bactericidal concentrations (MBC) assays, biofilm models, and cytotoxicity testing. AI-assisted GC-MS analysis and automated inhibition zone measurement should be considered as future perspectives to improve reproducibility and translational potential. Full article

Background/Objectives: Dental anxiety has been demonstrated to exert a significant influence on the frequency of treatment, the degree of patient compliance, and the long-term implications for oral health. The objective of this study was to evaluate the extent of dental anxiety experienced by patients attending an oral surgery practice in Germany. In addition, the study sought to assess their preventive dental behaviour and to explore any potential associations between anxiety levels and the utilisation of preventive care services. Methods: The present study comprised 102 consecutive adult outpatients from a private oral surgery practice. The assessment of dental anxiety was conducted using the Corah’s Dental Anxiety Scale (DAS). The behaviour of the subjects in relation to preventative dental care was measured using a series of six standardised items, including the frequency of tooth brushing, tartar removal, and professional tooth cleaning. The data analysis comprised descriptive statistics, chi-square (χ²) tests, multiple linear regression, and one-way analysis of variance (ANOVA). Results: The mean DAS score was 12.69 (SD = 3.36). According to the DAS classification system, 28.4% of patients reported low anxiety, 50.0% moderate anxiety, and 21.6% high dental anxiety. Regression analysis explained 10% of the variance in DAS scores (R² = 0.128, adj. R² = 0.100). The analysis revealed that age (β = −0.218, p = 0.035) and lower educational level (β = −0.357, p < 0.001) were associated with higher anxiety scores, whereas sex was not a significant predictor. Preventive dental behaviour, encompassing practices such as tooth brushing, professional tooth cleaning, and tartar removal, did not exhibit significant disparities across anxiety groups (all p > 0.05). Conclusions: While dental anxiety was prevalent among the patient sample, it did not exert a significant influence on preventive dental behaviours. However, patients with lower levels of education and younger age exhibited higher dental anxiety scores. These findings underscore the necessity for targeted educational and preventive strategies in patients with elevated dental anxiety. Full article

Acrylic resin is widely used in removable dental prostheses due to its biocompatibility, low cost, and ease of handling; however, it presents mechanical limitations and a high susceptibility to microbial colonization, particularly by Candida albicans. The incorporation of nanoparticles into polymethyl methacrylate (PMMA) has been investigated as a strategy to mitigate these drawbacks. This scoping review evaluated the impacts of incorporating chitosan (CTS) nanoparticles into PMMA on antimicrobial activity and mechanical properties. A comprehensive search of the PubMed, Scopus, Web of Science, and BVS databases resulted in the retrieval of 1912 records. After removing 557 duplicates and applying the eligibility criteria, 9 in vitro studies were included. Despite methodological heterogeneity, most studies reported enhanced antifungal activity against C. albicans and improvements in mechanical properties, such as microhardness and overall strength, when CTS was incorporated. Thus, CTS appears to be a promising additive for denture base resins, with the potential to reduce denture-associated infections and increase the longevity of prostheses. Nevertheless, standardized methodologies and well-designed in vivo and clinical investigations remain essential to determine optimal concentrations, incorporation techniques, and long-term clinical performance before implementation. A scoping review design was selected due to the exploratory nature of the study and the heterogeneity of available evidence, which precludes direct comparisons and quantitative synthesis. Full article

The rapid digitization of dentistry is significantly transforming fixed prosthodontics, a discipline highly dependent on technical precision. This narrative review, incorporating a structured literature search, provides a critical overview of how digital tools—including computer-aided design and manufacturing (CAD/CAM), intraoral scanners (IOS), and additive manufacturing—are influencing clinical protocols and production methods. A database-guided selection process was employed to identify relevant studies published between 2000 and 2024, spanning in vitro research, observational studies, and clinical trials. While digital workflows offer promising benefits, such as increased accuracy, efficiency, and patient comfort, supporting evidence remains preclinical or short-term in nature. The review highlights areas of innovation as well as ongoing limitations in clinical validation, standardization, and adoption. A more cautious interpretation of the current evidence is warranted, especially regarding long-term clinical outcomes and cost-effectiveness. This review aims to inform clinicians, researchers, and educators about both the potential and the present limitations of digital fixed prosthodontics. Full article

This study aimed to explore the added value and usage of laser Doppler flowmetry (LDF) in conjunction with continuous tissue (arterial) oxygen saturation (SO₂) monitoring, electrical pulp testing (EPT), cold stimulation (CS) testing, and apical X-rays (RX). LDF data were evaluated in relation to three different scenarios. LDF records of all four upper incisors from 30 randomly selected patients aged 21–40 were analysed in relation to the following scenarios: (a) simultaneous SO₂ measurements using a pre-manufactured splint handled by an experienced LDF dentist, (b) EPT, and (c) CS. A total of 120 teeth were analysed, of which 11 were non-vital (7 denervated and 4 traumatised). Data assessment showed the following mean LDF values: vital teeth: 23.6 Perfusion Units (PU), SD 6.3 and SaO₂ of 88.7%, SD 17.1. For non-vital teeth, the mean LDF value was 16.1 PU (SD 11.8) and the mean SO₂ value was 70.8% (SD 31.9). The standard deviation was found to be twice as high for non-vital teeth as for vital teeth. No direct relationship was found between LDF and SO₂ values at low SO₂. For vitality discrimination, the ROC curves showed an area under the curve of 0.799 for LDF and 0.643 for SO₂. EPT data assessment showed a mean value of 18.1 (SD 19.7) out of a possible score of 0–80. This was distributed as follows: seven non-vital teeth (80/80); 109 vital teeth; and four undecided teeth. This was compared to the LDF and SO₂ results. The data assessment showed nine non-vital teeth, 108 vital teeth, and three undecided teeth in comparison to LDF and SO₂ results. Conclusion: LDF and SO₂ do not complement each other sufficiently in detecting non-vital teeth when the selection criteria are applied. While LDF clearly contributes, the vital or non-vital classification still depends on a combination of X-ray, sensitivity, and vitality tests. Full article

Background: Early childhood caries (ECC) is a common chronic disease in young children, influenced by multiple factors, including the activity of bacteria and other microorganisms, diet, and immune response. Pro-inflammatory cytokines like interleukin-8 (IL-8) and anti-inflammatory cytokines like interleukin-10 (IL-10) play crucial roles in the inflammatory process of caries. However, their relationship with ECC severity remains unclear. This study aimed to compare salivary IL-8 and IL-10 levels in children with and without ECC and analyze their association with caries severity using the International Caries Detection and Assessment System (ICDAS). Children with and without central obesity were included to evaluate the potential influence of nutritional status on cytokine expression. Methods: A cross-sectional study was conducted from March 2022 to December 2023 in San Luis Potosí, México, including 76 children aged 3 to 5 years (40 with ECC and 36 caries-free). Anthropometric measurements were taken to classify children as centrally obese or non-centrally obese. Unstimulated saliva samples were collected, and IL-8 and IL-10 levels were measured using ELISA. Statistical analysis included the Mann–Whitney U test, Spearman’s rank correlation coefficient, and binary logistic regression analysis, considering p < 0.05 as statistically significant. Results: IL-8 levels were higher in the ECC group (85 ± 119 pg/mL) than in the control group (45 ± 74 pg/mL), but this difference was not significant (p = 0.3613). IL-10 levels were lower in the ECC group (3 ± 2 pg/mL) than in the control group (11 ± 44 pg/mL; p = 0.6481). The difference between IL-8 and IL-10 levels was greater in the ECC group (27 ± 41 pg/mL) than in the control group (17 ± 33 pg/mL; p = 0.1709). No significant correlation was found between cytokine levels and ICDAS scores (p > 0.05), and binary logistic regression did not show an association between IL-8, IL-10, WHtR, and cavitated caries lesions. Conclusions: Although IL-8 tended to be elevated and IL-10 reduced in children with ECC, the differences were not statistically significant. The observed trend suggests a possible local immunological imbalance in children with caries, which may contribute to disease progression independently of bacterial activity or behavioral influences. Full article

Objective: The purpose of this study was to compare the flexural strength, flexural modulus, hardness, and surface roughness of one brand each of 3D-printed and heat-cured acrylic resin materials after they were immersed in various disinfection solutions. Methods: The study included 160 specimens, consisting of 80 heat-cured and 80 3D-printed specimens. Forty specimens of each resin material type were prepared for flexural testing, while an additional forty specimens were designated for hardness and surface roughness assessments. Each collection of 40 specimens was subsequently randomized into four subgroups (n = 10) for immersion in either distilled water (control), 1% sodium hypochlorite, Superdent, or Kin Oro denture cleansers. Flexural test, hardness, and surface roughness assessments were performed. Data analysis was conducted using SPSS, with a level of significance set at p < 0.05. Results: Flexural strength and surface roughness did not differ significantly between the two resin types. Flexural modulus was significantly higher in the heat-cured resin among all the disinfectants (p = 0.000). The heat-cured resin had significantly higher microhardness than the 3D-printed resin among the disinfectants except for the Kin Oro group, and both resins showed a significant reduction in hardness after immersion in disinfectants compared to distilled water (p < 0.05). Conclusions: The heat-cured resin demonstrated higher flexural modulus and surface hardness compared to the 3D-printed resin. Flexural strength and surface roughness were comparable between the two materials. Both resins had their highest mechanical properties in distilled water. Full article

Background: Peri-implantitis is an inflammatory condition caused by bacterial plaque and several factors like diabetes, smoking, titanium bio-tribocorrosion, implant–abutment micromovements, occlusal overload, cement remnants, and poor oral hygiene, resulting in bone resorption. The aim of this review was to evaluate the relationship between titanium metal particles and the development of peri-implantitis, specifically the characterisation of the inflammatory response regarding cytokine profile, immune cell infiltration, and transcription factors up-regulated in the peri-implant sites. Methods: A systematic review was conducted following the PRISMA guidelines, from January 2004 to January 2025, in three databases: PubMed, Web of Science, and Wiley Library. The inclusion criteria included in vivo human studies and in vitro studies with a focus on bio-tribocorrosion of titanium particles in peri-implant tissues, and their immunological and cellular implications. Quality assessment of in vivo transversal and case–control studies used Joanna Briggs Institute Critical Appraisal Tools, and, for in vitro studies, the modified CONSORT checklist. Results: A total of 27 studies were included, 20 in vitro and 7 in vivo. Titanium particles induced the secretion of IL-1β, IL-6, and TNF-α by peri-implant cells, activation of the NLRP3 inflammasome, and RANKL/OPG bone resorption, further stimulating an exacerbated inflammatory response, LPS independent. There was a significant increase in IL-33, an alarmin, possibly associated with implant–pillar micromovements. IL-8 production by gingival stromal cells and fibroblasts, and downregulation of CCR7 can explain an altered leukocyte migration and the mixture of M1/M2 macrophage populations in peri-implantitis. Conclusions: Titanium particle bio-tribocorrosion stimulates a chronic inflammatory response impacting immune cell composition and cytokine secretion in peri-implant tissue, leading, ultimately, to osteolysis. Modulation of the immune response may contribute to the development of therapeutic strategies and the prevention of implant failure. Full article

Background/Objectives: This study evaluates students’ awareness and perceptions of interdisciplinary education. It focuses specifically on digital dentistry among students in the Department of Dental Technology. The findings aim to support the development of interdisciplinary courses and programs to enhance students’ skills in response to the growing digitalization of dental healthcare. Methods: A cross-sectional survey was conducted using a 23-item online questionnaire administered to a total of 203 students to collect data on general characteristics, perceptions of interdisciplinary education, the perceived necessity of such education, and the demand for interdisciplinary training, including topics related to CAD/CAM and 3D printing technologies. A t-test was performed to analyze grade-level differences in perceptions. Correlation analysis was conducted between perceptions and digital dental laboratory technology skills. Results: Despite the relatively low level of awareness regarding interdisciplinary education, students expressed a strong perceived need for it. A total of 76.6% of respondents preferred to collaborate with the Department of Dental Hygiene. No clear link exists between students’ perceptions of interdisciplinary education and their digital dental competencies. Practical training is more important than awareness. A significant difference in competencies was seen between lower- and higher-year students, indicating that advanced programs for higher-year students may be effective. Conclusions: Clear guidance on interdisciplinary education can enhance student understanding and acceptance. Interdisciplinary education with the dental hygiene department may increase engagement. Full article

Background/Objectives: Disinfection of removable prostheses is essential for controlling oral infections, yet the methods employed may compromise the mechanical reliability of denture base materials. This study evaluated the effect of microwave irradiation and immersion in 0.2% chlorhexidine solution on the fracture strength of three commonly used acrylic denture bases. Methods: Forty-five standardised maxillary palatal denture bases were fabricated from cross-linked conventional, high-impact, and light-cured acrylic resins. The specimens were divided equally into three treatment groups: water storage (control), immersion in 0.2% chlorhexidine solution for 30 min twice weekly, and microwave disinfection at 650 W for three minutes, each continued for four weeks. Fracture strength was determined by using the Universal testing machine. The data were analysed with one-way ANOVA followed by Bonferroni post hoc testing. Results: Cross-linked and high-impact acrylic resins exhibited significantly greater fracture strength than light-cured acrylics (p < 0.001). The overall ANOVA showed no statistically significant differences among disinfection methods (p = 0.069); however, post hoc comparisons revealed significant reductions in fracture strength within specific material groups following microwave disinfection. This effect was most pronounced in the light-cured group, whereas immersion in chlorhexidine produced no significant changes. Notably, the fracture strength of all groups remained above clinically acceptable thresholds. Conclusions: Microwave disinfection negatively influences the mechanical integrity of acrylic denture bases, particularly those fabricated from light-cured resins. In contrast, immersion in 0.2% chlorhexidine preserves fracture strength, supporting its use as a safe and effective protocol for routine disinfection in dental practice. Full article

This narrative review addresses the complexities of managing the vertical dimension of occlusion (VDO) in restorative dentistry, focusing on predictability in prosthetic reconstructions. Altering VDO impacts biological, biomechanical, esthetic, and functional aspects, making it a controversial topic. While VDO naturally evolves throughout life, interventions require careful consideration due to potential complications. Various techniques guide VDO determination, including facial proportions, physiological methods, phonetics, and cephalometric analysis. Clinicians must understand these principles and adapt them to individual patient needs. Materials and Methods: A narrative literature review was conducted using PubMed, Scopus, Google Scholar, and the Cochrane Library, searching keywords like “vertical dimension of occlusion”, “dental”, “diagnosis”, “management” and “complications”. In addition to the literature review, two case reports with extensive prosthodontic restorations were included to illustrate the diagnostic challenges and treatment considerations in a clinical setting. Results: Increasing VDO aids restorative treatments, re-establishing morphology, and facilitating additive procedures. Minimally invasive approaches, provisional restorations, and fixed restorations with functional contours are favored. Individualized, patient-centered care is critical, recognizing unique anatomical and functional needs. This approach optimizes stomatognathic system rehabilitation while preventing adverse effects on body posture and airway dimensions. Conclusions: To ensure predictable results and minimize risks, changes in VDO should be kept to a minimum to achieve dentofacial aesthetic harmony and secure adequate space for the planned restorations The two case reports presented, with different clinical approaches, underline the importance of understanding the potential risks and benefits of VDO alteration which is crucial for achieving predictable and successful outcomes in complex restorative cases. Full article

Obstructive sleep apnea (OSA) is a chronic disorder associated with serious health consequences, yet many cases remain undiagnosed due to limited access to standard diagnostic tools such as polysomnography. Recent advances in artificial intelligence (AI) have enabled the development of deep convolutional neural networks that analyze craniofacial radiographs, particularly lateral cephalograms, to detect anatomical risk factors for OSA. The goal of this approach is not to replace polysomnography but to identify individuals with a high suspicion of OSA at the primary care or dental level and to guide them toward timely and appropriate diagnostic evaluation. Current studies have demonstrated that AI can recognize patterns of oropharyngeal crowding and anatomical imbalance of the upper airway with high accuracy, often exceeding manual assessment. Furthermore, interpretability analyses suggest that AI focuses on clinically meaningful regions, including the tongue, mandible, and upper airway. Unexpected findings such as predictive signals from outside the airway also suggest AI may detect subtle features associated with age or obesity. Ultimately, integrating AI with cephalometric imaging may support early screening and referral for polysomnography, improving care pathways and reducing delays in OSA treatment. Full article

Mucins are a family of heavily glycosylated proteins that form the main organic component of the oral mucosal barrier complex. Transmembrane mucin 1 (tMUC1) is anchored at the superficial epithelial surface to provide a protective function. The interaction of tMUC1 with oral microbes provides nutrients and physicochemical protection, promotes adhesion, and increases the microbe residence time in the oral cavity. Mucin-degrading microorganisms in the consortia also offer some advantages to oral microbes. The high molecular weight of mucin glycoproteins is hard to study because of their size, complexity, and heterogeneity. This review discusses how mucin facilitates oral microbiome colonization and how mucin–microbial interactions influence the development of oral cancer, mainly oral squamous cell carcinoma. Full article

Objective: The material properties of craniofacial sutures significantly influence the outcomes of orthodontic treatment, particularly with newer appliances. This study specifically investigates how the Young’s modulus of craniofacial sutures impacts the anterosuperior protraction achieved using a recently developed extraoral appliance. Our goal is to identify the patterns by which suture properties affect skull deformation induced by this device. Materials and Methods: We conducted four finite element (FE) simulations to evaluate the Right Angle Maxillary Protraction Appliance (RAMPA) when integrated with an intraoral device (gHu-1). We tested Young’s moduli of 30 MPa, 50 MPa, and 80 MPa for the sutures, drawing on values reported in previous research. To isolate RAMPA’s effects on craniofacial deformation, we also performed an additional simulation with rigid sutures and a separate model that included only the intraoral device. Results: Simulations with flexible sutures showed consistent displacement and stress patterns. In contrast, the rigid suture model exhibited substantial deviations, ranging from 32% to 76%, especially in the maxillary palatine suture and orbital cavity. Both displacements and von Mises stresses were proportional to the Young’s modulus, with linear variations of approximately 15%. Conclusions: Our findings demonstrate that RAMPA effectively achieves anterosuperior protraction across a broad spectrum of suture material properties. This positions RAMPA as a promising treatment option for patients with long-face syndrome. Furthermore, the observed linear relationship (with a fixed slope) between craniofacial deformation and the Young’s modulus of sutures provides a crucial foundation for predicting treatment outcomes in various patients. Full article

The global demographic transition toward an ageing population has necessitated substantive reforms in dental education, particularly within the field of geriatric prosthodontics. Conventional curricula have frequently prioritized technical competencies while insufficiently addressing the integration of biological, psychosocial, and ethical complexities inherent in the care of older adults. This scoping review critically examined these curricular deficiencies by synthesizing evidence from 34 peer-reviewed studies, employing Bloom’s Taxonomy as a conceptual framework to inform a systematic and pedagogically grounded curriculum redesign. The primary aim was to identify existing gaps in undergraduate and postgraduate education, evaluate the efficacy of active and simulation-based learning modalities, assess the utility of reflective practices and standardised assessment tools, and formulate strategic, taxonomy-aligned pedagogical guidelines. Following the PRISMA-ScR methodology, the included studies were thematically analysed and categorized across the six cognitive levels of Bloom’s Taxonomy. Findings highlighted the effectiveness of integrated educational strategies, including Case-Based Learning, interprofessional education, virtual simulations, and structured assessments such as Objective Structured Clinical Examinations (OSCE). Furthermore, reflective models such as “What? So What? Now What?” fostered higher-order cognitive processes, ethical reasoning, and self-directed learning. By aligning cognitive levels—from foundational knowledge recall to innovative creation—ten evidence-based educational guidelines were developed. These guidelines are pedagogically sound, empirically supported, and adaptable to diverse curricular contexts. The proposed framework ensures a deliberate, progressive trajectory from theoretical comprehension to clinical expertise and ethical leadership. Future research should explore longitudinal outcomes and develop scalable, culturally responsive models to support the broader implementation of curricular reform in geriatric dental education. Full article