Journal Description
Dentistry Journal
Dentistry Journal
is an international, peer-reviewed, open access journal on dentistry published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: JCR - Q1 (Dentistry, Oral Surgery and Medicine) / CiteScore - Q2 (General Dentistry)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 21.5 days after submission; acceptance to publication is undertaken in 3.5 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
3.1 (2024);
5-Year Impact Factor:
3.3 (2024)
Latest Articles
Evaluation of Smile Aesthetics in Dental Students: Perceptions of Tooth Colour Changes Due to Incisor Inclination and Micro- and Mini-Aesthetic Characteristics Assessed by Professionals and Laypersons
Dent. J. 2025, 13(8), 380; https://doi.org/10.3390/dj13080380 - 20 Aug 2025
Abstract
Background: The present study investigated the relation between dental inclination, colorimetric variation, and aesthetic perception according to the modification of incisor inclination. Smile aesthetics, shaped by morphological factors and patient perception, are vital for social attractiveness and treatment success. This study aimed to
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Background: The present study investigated the relation between dental inclination, colorimetric variation, and aesthetic perception according to the modification of incisor inclination. Smile aesthetics, shaped by morphological factors and patient perception, are vital for social attractiveness and treatment success. This study aimed to assess the effect of varying head tilt on the perceived colour of upper central incisors by simulating changes in torque of the tooth, as well as evaluate factors influencing the perception of an aesthetic smile, including morphological characteristics and gingival aesthetic parameters. Methods: The study was comprised of three stages: colour analysis, evaluation of micro- and mini-aesthetic smile features, and an image-based assessment to determine evaluator perceptions and overall smile attractiveness. A sample of 50 students with complete, lesion-free anterior dentition was analysed. To simulate the effect of orthodontic torque changes during colour analysis, subjects tilted their heads downward and upward, representing palatal and buccal crown torque, respectively. Standardized macro-intraoral photographs were captured under controlled lighting conditions using a DSLR camera stabilized on a tripod in the different positions: the neutral head position (p0), 15° upward (p + 15), and 15° downward (p − 15). Digital colour analysis was conducted in the CIELAB colour space (L*, a*, b*). In the next stage, focusing on micro- and mini-aesthetic evaluation, an additional 50 smiles were generated using artificial intelligence via the SmileCloud program—one digitally enhanced smile per subject—complementing the initial set of 50 spontaneous smiles. These 100 smile images were evaluated by 50 laypersons and 50 dentists using a visual analogue scale via an online questionnaire, in order to assess perceptions, determine smile attractiveness, and quantify gingival aesthetic parameters. Results: The statistically significant regression results are as follows: those for the L* values in all three head inclinations: downward (−15 degrees), upward (+15 degrees), and total tilting (−15 to +15 degrees), as well as for the a* values for downward tilting and the b* values for total tilting. When the head is tilted downwards, the central incisors are positioned retrusively, and the L* b* values reveal a darker and more yellowish appearance, whereas, with the head tilted upwards, the central incisors protrude, and L* a* values indicate a brighter and more greenish appear. In the evaluation stage of the smile aesthetics study, no significant differences were observed in the judgments between laypersons and dentists or between males and females. Smiles with a high or average anterior line, parallel arc, upward lip curvature, visible first/second premolars, a smile index of 5.08–5.87, and symmetry score of 1.04 were rated as more attractive. Significant asymmetries were observed between upper dental hemi-quadrants in gingival contour and interdental papilla height, highlighting subtle morphological variations relevant to smile aesthetics. Conclusions: Aesthetic assessment revealed that the findings suggest a measurable impact of head position on dental colour perception and aesthetic evaluation. Evaluator variables including profession and gender exerted negligible effects on aesthetic perception, whereas smile attractiveness features and gingival aesthetic parameters demonstrate significant clinical applicability in patient management.
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(This article belongs to the Special Issue Advances in Esthetic Dentistry)
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Open AccessArticle
Evaluation of Compatibility of Different Attachment Types Used in Orthodontic Clear Aligners with Electron Microscopy
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Can Sever and Can Arslan
Dent. J. 2025, 13(8), 379; https://doi.org/10.3390/dj13080379 - 20 Aug 2025
Abstract
Background/Objectives: The effectiveness of clear aligner therapy depends significantly on the precision of force delivery through the aligner–attachment interface. This study aimed to evaluate the microscopic compatibility between different orthodontic clear aligner materials (Duran+ and Zendura FLX) and attachment designs (rectangular and
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Background/Objectives: The effectiveness of clear aligner therapy depends significantly on the precision of force delivery through the aligner–attachment interface. This study aimed to evaluate the microscopic compatibility between different orthodontic clear aligner materials (Duran+ and Zendura FLX) and attachment designs (rectangular and optimized) using scanning electron microscopy (SEM). Methods: Fifty-six samples were divided into four groups: rectangular attachments with Duran+ aligners (n = 14), rectangular attachments with Zendura FLX aligners (n = 14), optimized attachments with Duran+ aligners (n = 14), and optimized attachments with Zendura FLX aligners (n = 14). Attachments were bonded to bovine incisors using standardized protocols. Clear aligners were thermoformed at 220 °C for 40 s. Cross-sectional samples were analyzed using SEM at 250× magnification. Gap measurements were taken at seven points for rectangular attachments and five points for optimized attachments. Results: Gap measurements ranged from 14.75 ± 1.41 µm to 91.07 ± 3.11 µm. Zendura FLX demonstrated significantly better adaptation than Duran+ with rectangular attachments (42.10 ± 1.07 µm vs. 44.52 ± 1.51 µm, p < 0.001). Optimized attachments showed better overall adaptation than rectangular attachments. All combinations showed regional variation with the largest gaps at gingival borders (67.18–91.07 µm) and the smallest at flat buccal surfaces (14.75–20.98 µm). Conclusions: Perfect adaptation was not achieved with any material–attachment combination tested. Material selection and attachment design significantly influence microscopic adaptation, with multi-layer materials and optimized geometries showing superior performance. These findings provide mechanical explanations for clinical limitations in clear aligner therapy.
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(This article belongs to the Special Issue Malocclusion: Treatments and Rehabilitation)
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Open AccessArticle
A Digital Workflow for Virtual Articulator Mounting Using Face Scan and Facebow Capture: A Proof-of-Concept
by
Giuseppe D’Albis, Marta Forte, Laura Stef, Diana Ramona Feier, Victor Diaz-Flores García, Massimo Corsalini and Saverio Capodiferro
Dent. J. 2025, 13(8), 378; https://doi.org/10.3390/dj13080378 - 20 Aug 2025
Abstract
Purpose: This article introduces a digital technique for virtual articulator mounting by employing the scan of a facebow worn by the patient as a virtual reference. Methods: The digital technique enables the transfer of the maxillary arch orientation relative to the cranial base
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Purpose: This article introduces a digital technique for virtual articulator mounting by employing the scan of a facebow worn by the patient as a virtual reference. Methods: The digital technique enables the transfer of the maxillary arch orientation relative to the cranial base into a CAD-CAM environment (Ceramill Mind; AmannGirrbach), without the need for ionizing radiation or identification of facial landmarks. By digitally aligning the intraoral scans of the dental arches (Trios 4; 3Shape) with a 3D facial scan and the scanned facebow in position (Artex; AmannGirrbach), clinicians can reproduce the cranium-to-maxilla spatial relationship accurately and intuitively. Results: This radiation-free protocol provides virtual cross-mounting and allows for the use of a semi-adjustable articulator within common CAD-CAM software. Conclusions: Given that intraoral scanners, facial scanners, and design software with articulator simulation are becoming more available in modern clinical workflows, this method introduced here could be a viable radiation-free and easy-to-use alternative. However, larger cohorts and standardized testing protocols are needed to determine its clinical reproducibility and reliability.
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(This article belongs to the Special Issue New Trends in Digital Dentistry)
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Shear Bond Strengths of Composite Resin Bonded to MIH-Affected Hard Tissues with Different Adhesives and Pre-Treatments
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Cia Solanke, Hassan Shokoohi-Tabrizi, Andreas Schedle and Katrin Bekes
Dent. J. 2025, 13(8), 377; https://doi.org/10.3390/dj13080377 - 20 Aug 2025
Abstract
Background: Reduced bond strengths in hypmineralised enamel have been reported with increased restorative failures. This study aimed to investigate the shear bond strengths of resin composite to hypomineralised enamel and dentin bonded with two different adhesive systems and pre-treatments. Methods: Thirty-six
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Background: Reduced bond strengths in hypmineralised enamel have been reported with increased restorative failures. This study aimed to investigate the shear bond strengths of resin composite to hypomineralised enamel and dentin bonded with two different adhesive systems and pre-treatments. Methods: Thirty-six freshly extracted first permanent molars with MIH and 17 sound third molars were used for shear bond strength tests in enamel and dentin. Specimens of control groups were bonded to resin composite using ScotchbondTM Universal Plus and AdperTM Scotchbond 1XT. MIH-affected enamel specimens of six test groups were pre-treated with various chemical agents, such as 35% phosphoric acid, 5% NaOCl, resin infiltration with ICON®, or a combination of these agents prior to bonding with composite resin using ScotchbondTM Universal Plus. Bonded specimens were subsequently sheared at a crosshead speed of 1.0 mm/min, after which their fracture modes were recorded. The mean bond strengths of all groups were compared using a one-way analysis of variance test (ANOVA) and a Bonferroni–Holm analysis was performed for pairwise comparison between the groups. The association between modes of failure was examined with Pearson’s chi-square test. Results: Mean shear bond strength values were highest for sound dentin specimens (Group SD 2) bonded with ScotchbondTM Universal Plus (23.76 ± 7.68 MPa). Sound enamel specimens (Group SE 2) exhibited significantly higher mean bond strength values than MIH-enamel specimens (Group HE 2) when bonded with ScotchbondTM Universal Plus (19.68 ± 6.25 vs. 11.53 ± 3.29 MPa, p < 0.001). Oxidative pre-treatment followed by resin infiltration significantly improved bond strengths to hypomineralised enamel (Group HE 6) (17.84 ± 2.98 MPa, p < 0.05). Bond strengths to sound and hypomineralised enamel and dentin did not differ significantly for both adhesives. Conclusions: Within the limitations of an in vitro study, oxidative pre-treatment in combination with resin infiltration seems to be beneficial when planning adhesive restorations with composite in hypomineralised enamel. Both ScotchbondTM Universal Plus and AdperTM Scotchbond 1XT can be used for bonding of resin composite to MIH-affected enamel and dentin.
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(This article belongs to the Special Issue Dental Materials Design and Innovative Treatment Approach)
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Open AccessArticle
Microscopic and Crystallographic Analysis of Increased Acid Resistance of Melted Dental Enamel Using 445 nm Diode Laser: An Ex-Vivo Study
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Samir Nammour, Marwan El Mobadder, Aldo Brugnera, Praveen Arany, Mireille El Feghali, Paul Nahas and Alain Vanheusden
Dent. J. 2025, 13(8), 376; https://doi.org/10.3390/dj13080376 - 19 Aug 2025
Abstract
Background/Objectives: This study aimed to evaluate the efficacy of a 445 nm diode laser in enhancing enamel resistance to acid-induced demineralization and to investigate the associated compositional and structural modifications using scanning electron microscopy (SEM), electron spectroscopy for chemical analysis (ESCA), and
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Background/Objectives: This study aimed to evaluate the efficacy of a 445 nm diode laser in enhancing enamel resistance to acid-induced demineralization and to investigate the associated compositional and structural modifications using scanning electron microscopy (SEM), electron spectroscopy for chemical analysis (ESCA), and X-ray diffraction (XRD) crystallographic analysis. Methods: A total of 126 extracted human teeth were used. A total of 135 (n = 135) enamel discs (4 × 4 mm) from 90 teeth were assigned to either a laser-irradiated group or an untreated control group for SEM, ESCA, and XRD analyses. Additionally, 24 mono-rooted teeth were used to measure pulp temperature changes during laser application. Laser irradiation was performed using a 445 nm diode laser with a pulse width of 200 ms, a repetition rate of 1 Hz, power of 1.25 W, an energy density of 800 J/cm2, a power density of 3980 W/cm2, and a 200 µm activated fiber. Following acid etching, SEM was conducted to assess microstructural and ionic alterations. The ESCA was used to evaluate the Ca/P ratio, and XRD analyses were performed on enamel powders to determine changes in phase composition and crystal lattice parameters. Results: The laser protocol demonstrated thermal safety, with minimal pulp chamber temperature elevation (0.05667 ± 0.04131 °C). SEM showed that laser-treated enamel had a smoother surface morphology and reduced acid-induced erosion compared with controls. Results of the ESCA revealed no significant difference in the Ca/P ratio between groups. XRD confirmed the presence of hydroxyapatite structure in laser-treated enamel and detected an additional diffraction peak corresponding to a pyrophosphate phase, potentially enhancing acid resistance. Results of the spectral analysis showed the absence of α-TCP and β-TCP phases and a reduction in the carbonate content in the laser group. Furthermore, a significant decrease in the a-axis lattice parameter suggested lattice compaction in laser-treated enamel. Conclusions: Irradiation with a 445 nm diode laser effectively enhances enamel resistance to acid demineralization. This improvement may be attributed to chemical modifications, particularly pyrophosphate phase formation, and structural changes including prism-less enamel formation, surface fusion, and decreased permeability. These findings provide novel insights into the mechanisms of laser-induced enhancement of acid resistance in enamel.
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(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)
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A New Method for the Digital Assessment of the Relative Density of Bone Tissue in Dentistry Using the ImageJ Software Package
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Mariya Ebrakhim, Denis Moiseev, Valery Strelnikov, Alaa Salloum, Ekaterina Faustova, Aleksandr Ermolaev, Yulianna Enina, Ellina Velichko and Yuriy Vasil’ev
Dent. J. 2025, 13(8), 375; https://doi.org/10.3390/dj13080375 - 19 Aug 2025
Abstract
Backgroud: The aim of this study was to create an accessible, simple and reliable method for assessing the relative density of bone tissue in dentistry based on the analysis of digital panoramic radiographs. Methods: Measurement of average gray values on orthopantomograms
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Backgroud: The aim of this study was to create an accessible, simple and reliable method for assessing the relative density of bone tissue in dentistry based on the analysis of digital panoramic radiographs. Methods: Measurement of average gray values on orthopantomograms was carried out using ImageJ Version 1.54i software. To estimate the relative bone density, functions for selecting regions of interest (ROI), calculating the area of selection, and statistics of the selected area were used. Statistical characteristics of samples and testing of hypotheses using statistical criteria were performed using Microsoft Excel. Results: we found that when manually selecting the reference and comparison areas for areas without signs of pathological changes in bone tissue, the average standard deviation was 0.058, and the coefficient of variation was 0.055 ± 0.011%, which makes the choice of the jaw angle as a reference more preferable. The average relative bone density of the assessed defective areas to the jaw angle was 0.64 ± 0.11, and the average relative bone density of the areas without pathology to the jaw angle was 1.052 ± 0.058. Conclusions: a research protocol was developed and justified using the ImageJ software package, which establishes a strict procedure for quantitative assessment of relative bone density based on the results of digital panoramic radiography. The proposed protocol can be used to monitor the condition of bone tissue after all types of dental treatment over time.
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(This article belongs to the Special Issue Digital Implantology in Dentistry)
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Fatigue Behavior of Multi/Unit-Supported Dental Restorations: Implant Platform vs. Prosthetic Platform
by
Eduardo Anitua, Mikel Armentia, Ernest Mallat and Beatriz Anitua
Dent. J. 2025, 13(8), 374; https://doi.org/10.3390/dj13080374 - 18 Aug 2025
Abstract
The increasing popularity of Multi/Unit abutments in dental restorations is attributed to their clinical advantages, yet little is known about their mechanical behavior, particularly in terms of fatigue performance. Background/Objectives: This study aimed to evaluate the mechanical behavior of Multi/Unit abutments with a
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The increasing popularity of Multi/Unit abutments in dental restorations is attributed to their clinical advantages, yet little is known about their mechanical behavior, particularly in terms of fatigue performance. Background/Objectives: This study aimed to evaluate the mechanical behavior of Multi/Unit abutments with a focus on the impact of implant and prosthetic platform diameters on fatigue performance. Methods: Five dental restoration models were analyzed using Finite Element Analysis by incorporating implants of identical length and body diameter but varying implant platform size (3.5 and 4.1 mm) and prosthetic platform size (3.5, 4.1, and 5.5 mm). Mechanical stresses on critical sections of the screws were assessed under cyclic loads. Results: The results revealed that the implant platform diameter had minimal influence on the fatigue performance of the prosthetic screw, while a wider prosthetic platform significantly improved its mechanical behavior by reducing stress and allowing the use of larger screw metrics. These findings emphasize that the prosthetic platform diameter plays a crucial role in protecting the prosthetic screw, which is often the critical component in dental restorations that use Multi/Unit abutments. Conclusions: The study highlights the importance of carefully selecting platform dimensions to optimize the mechanical performance and longevity of dental restorations utilizing Multi/Unit abutments.
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(This article belongs to the Special Issue Innovations and Challenges in Dental Implantology)
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The Correlations Between Diabetes Mellitus and Oro-Maxillofacial Disorders: A Statistical Perspective
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Ionut Catalin Botezatu, Mihaela Salceanu, Ana Emanuela Botez, Cristina Daniela Dimitriu, Oana Elena Ciurcanu, Claudiu Topoliceanu, Elena-Carmen Cotrutz and Maria-Alexandra Martu
Dent. J. 2025, 13(8), 373; https://doi.org/10.3390/dj13080373 - 18 Aug 2025
Abstract
Background/Objectives: The goal of this research was to determine the prevalence and distribution of the oro-maxillofacial pathologies in patients with diabetes mellitus and to determine the correlation between diabetes mellitus and oro-maxillofacial disorders. Methods: The retrospective study group consisted of 6868 patients
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Background/Objectives: The goal of this research was to determine the prevalence and distribution of the oro-maxillofacial pathologies in patients with diabetes mellitus and to determine the correlation between diabetes mellitus and oro-maxillofacial disorders. Methods: The retrospective study group consisted of 6868 patients (mean age 49.84 ± 22.79 years) admitted in Oral and Maxillofacial Surgery Department between 2018 and 2024. Qualitative data were analyzed by Chi-square (χ2) test. Odds Ratio (OR) and Relative Risk (RR) were measured for each oro-maxillofacial pathology. Quantitative data were analyzed by Student’s T-test. Results: Among patients with diabetes mellitus (DM), the estimated risk of malignant tumors was 5.29 times higher (RR = 5.29; p = 0.001) compared to the non-DM group, with 15.0% of diabetic patients affected, versus 1.4% in the non-diabetic group. The probability of periodontal disease in diabetic patients was 4.66 times higher (RR = 4.66; p = 0.001), affecting 5.5% of the DM group, compared to only 0.6% in the non-DM group. Diabetic patients had a likelihood 3.53 times higher (RR = 3.53; p = 0.001) of developing apical periodontitis, with 5.3% of the DM group affected, in contrast to 1.0% of the non-DM group. The presence of root remnants was 1.43 times more likely (RR = 1.43; p = 0.001) in diabetic patients, with 9.0% of the DM group affected, compared to 6.1% in the non-DM group. Conclusions: The strong correlation between diabetes and oral pathologies, particularly malignancies and periodontal disease, underscores the need for early screening, preventive care, and targeted management strategies for diabetic patients.
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(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management: 2nd Edition)
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Quorum-Quenching AHL-Lactonase Est816 Inhibits Polymicrobial Subgingival-Plaque-Derived Biofilm Formation
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Zelda Ziyi Zhao, Wenwen Shan, Xiaoyu Sun, Tianfan Cheng, Jing Zhang and Chun Hung Chu
Dent. J. 2025, 13(8), 372; https://doi.org/10.3390/dj13080372 - 15 Aug 2025
Abstract
Objectives: This study aimed to investigate the effects of the quorum-quenching enzyme N-acyl-homoserine lactone (AHL)-lactonase Est816 on biofilm formation in subgingival plaque microbiota from participants with advanced periodontitis. Methods: Subgingival plaque samples were collected from 30 adults with untreated Stage
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Objectives: This study aimed to investigate the effects of the quorum-quenching enzyme N-acyl-homoserine lactone (AHL)-lactonase Est816 on biofilm formation in subgingival plaque microbiota from participants with advanced periodontitis. Methods: Subgingival plaque samples were collected from 30 adults with untreated Stage III or higher periodontitis and cultured anaerobically. Est816 was applied in vitro, with phosphate-buffered saline (PBS) serving as the control. Biofilm composition was analyzed via 16S rRNA sequencing, and alpha diversity metrics were assessed. Differential taxa abundance was assessed with the multivariate statistical software MaAsLin3. Biofilm morphology, biomass, and thickness were evaluated using scanning electron microscopy (SEM), crystal violet staining, and confocal laser scanning microscopy (CLSM). Results: Est816 significantly reduced microbial richness (Chao1 Index, p = 0.031), biofilm biomass (64% reduction, p < 0.001), and thickness (76% reduction, p < 0.001) compared to controls. SEM revealed fragmented biofilm architecture in Est816-treated samples. Conclusions: AHL-lactonase Est816 inhibited polymicrobial subgingival-plaque-derived biofilm formation while reducing species richness, phylogenetic diversity, and community evenness. These findings demonstrate Est816’s potential as an adjunctive therapy for disrupting pathogenic biofilms in periodontitis.
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(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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Comparative Evaluation of Customized CAD/CAM vs. Stock Titanium Abutments for Immediate Implant Placement in Class II Extraction Sockets: A Randomized Controlled Trial
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Ali Robaian, Mohamed Mofreh Hamed, Yousra Ahmed and Fatma E. A. Hassanein
Dent. J. 2025, 13(8), 371; https://doi.org/10.3390/dj13080371 - 15 Aug 2025
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Background: Immediate implant placement in the esthetic zone, particularly in Class II extraction sockets with partial facial bone loss, presents challenges in achieving soft and hard tissue stability. Customized computer-aided design/computer-aided manufacturing (CAD/CAM) titanium abutments may offer advantages over prefabricated stock abutments. This
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Background: Immediate implant placement in the esthetic zone, particularly in Class II extraction sockets with partial facial bone loss, presents challenges in achieving soft and hard tissue stability. Customized computer-aided design/computer-aided manufacturing (CAD/CAM) titanium abutments may offer advantages over prefabricated stock abutments. This study compared the clinical, radiographic, and patient-reported outcomes of customized CAD/CAM titanium abutments versus stock Laser-Lok stock abutments. Materials and methods: In a single-center, double-blind randomized clinical trial, 48 patients received immediate maxillary anterior implants restored with either customized CAD/CAM titanium abutments (n = 24) or stock titanium abutments (n = 24). Primary outcomes included peri-implant probing depth (PD), mucosal height, Pink Esthetic Score (PES), crestal bone level changes, and patient satisfaction assessed at baseline, 6, and 12 months post-loading. Statistical analysis included effect sizes and 95% confidence intervals. Results: At 12 months, the customized abutment group showed significantly shallower PD (mean difference: −0.54 mm; 95% CI: −0.72 to −0.35; p < 0.001), higher PES (12.21 ± 0.35 vs. 10.41 ± 1.17; p < 0.0001; Cohen’s d = 2.08), and less crestal bone loss (1.75 ± 0.36 mm vs. 2.33 ± 0.52 mm; p < 0.0001). Patient satisfaction scores were also higher in the customized group (p = 0.003). Within-group improvements were observed in both groups over time. No implant failures occurred. Conclusions: At 1-year follow-up, customized CAD/CAM titanium abutments demonstrated improved peri-implant soft tissue parameters, esthetics, and patient satisfaction compared to stock abutments. While these findings support their use in esthetically demanding immediate implant cases, the short-term duration and single-center design warrant further long-term multicenter studies to confirm durability. Trial registration: Registered at ClinicalTrials.gov on 19/01/2025 (NCT06791655).
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Effect of Thermal Ageing on Flexural Strength and Microhardness of Novel High-Performance Polymer (Nanoksa G-Plus) in Comparison to a Widely Used Bio-HPP/PEEK
by
Ramy Abdallah Abdelrahim, Ahmed Ali Ezzeldine, Mahmoud Abdellah and SaadEldein Sadeq Elghazawi
Dent. J. 2025, 13(8), 370; https://doi.org/10.3390/dj13080370 - 15 Aug 2025
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Background/Objectives: The dental industry is continuously developing high-performance polymer (HPP) materials with different qualities for denture frameworks. The aim of this in vitro study was to assess how thermal ageing (TA) affects the flexural strength (FS) and microhardness of two different HPP materials:
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Background/Objectives: The dental industry is continuously developing high-performance polymer (HPP) materials with different qualities for denture frameworks. The aim of this in vitro study was to assess how thermal ageing (TA) affects the flexural strength (FS) and microhardness of two different HPP materials: Nanoksa G-plus and Bio-HPP/PEEK. Methods: The TA process was carried out for 5000 cycles at 5 °C and 55 °C in distilled water. To assess FS, a total of 40 bar-shaped specimens measuring 65.0 mm × 10.0 mm × 2.5 mm (20 per group) were obtained; TA and No-TA (NTA) subgroups were prepared for each material group (10 per subgroup); and a three-point bending test was conducted using an Instron universal testing machine. Each specimen that fractured during the FS test was subjected to microhardness measurement using a Vickers hardness tester. The mean FS and microhardness of the TA and NTA specimens were statistically examined using the t-test. Results: Both the TA and NTA Bio-HPP/PEEK specimens exhibited significantly greater (p < 0.0001) microhardness and FS qualities than the Nanoksa G-Plus specimens. The FS and microhardness of the Bio-HPP/PEEK and Nanoksa G-Plus materials significantly decreased (p < 0.05) after TA. Conclusions: The Bio-HPP/PEEK material showed better FS and microhardness properties than the Nanoksa G-Plus material. TA considerably decreased the FS and microhardness of the Bio-HPP/PEEK and Nanoksa G-Plus materials.
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Open AccessArticle
Comparison of Herbal and Potassium Nitrate Toothpastes in Managing Dentin Hypersensitivity: A Randomized Controlled Trial
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La-ongthong Vajrabhaya, Supranee Benjasupattananan, Kraisorn Sappayatosok, Papatpong Sirikururat, Suwanna Korsuwannawong and Vittawin Dechosilpa
Dent. J. 2025, 13(8), 369; https://doi.org/10.3390/dj13080369 - 15 Aug 2025
Abstract
Background/Objectives: This study evaluates the effectiveness of a toothpaste containing Java Tea and Little Ironweed in alleviating tooth sensitivity compared to a conventional potassium nitrate toothpaste. Methods: A total of 90 healthy patients aged 18–70 with up to two teeth exhibiting
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Background/Objectives: This study evaluates the effectiveness of a toothpaste containing Java Tea and Little Ironweed in alleviating tooth sensitivity compared to a conventional potassium nitrate toothpaste. Methods: A total of 90 healthy patients aged 18–70 with up to two teeth exhibiting gingival recession were recruited into this study. All selected teeth had a visual analog scale (VAS) score ≥ 4 in response to tactile or air blast stimuli. Excluded teeth included those requiring restoration or participants undergoing treatments affecting sensitivity or taking pain medication/anti-sensitivity agents. Participants were randomly divided into three groups and instructed to brush twice daily with different toothpastes. The S1 group was prescribed toothpaste containing Java Tea and Little Ironweed extract, the S2 group was prescribed toothpaste containing Java Tea and Little Ironweed extract with 0.7% potassium nitrate, and the S3 group was prescribed toothpaste containing potassium nitrate. VAS scores were recorded at baseline, 2 weeks, and 4 weeks. Data were then compared and statistically analyzed between the groups. Results: For the tactile test, the final number of included teeth was 47 in the S1 group, 46 in the S2 group, and 22 in the S3 group. For the air blast test, the number of teeth included was 38 in the S1 group, 30 in the S2 group, and 27 in the S3 group. At baseline, mean VAS scores were comparable across groups for both tactile (S1: 6.89 ± 0.98; S2: 6.65 ± 1.52; S3: 6.82 ± 1.99) and air blast tests (S1: 7.39 ± 1.15; S2: 7.53 ± 1.31; S3: 6.89 ± 2.12). All groups showed significant reductions in VAS scores from baseline at both 2 and 4 weeks. A Kruskal–Wallis test indicated significant between-group differences in VAS scores at 2 and 4 weeks (p = 0.001). Post hoc analysis (Dunn’s test with Bonferroni correction) at 2 weeks revealed that the S1 group had significantly higher VAS scores than those of S2 (tactile p = 0.001, air blast p = 0.001) and S3 (tactile p = 0.002, air blast p = 0.018). By 4 weeks, the S2 group demonstrated superior efficacy, with significantly lower VAS scores compared to those of S1 (tactile p < 0.001, air blast p = 0.030) and S3 (tactile p = 0.035, air blast p = 0.001). Conclusions: All tested toothpastes effectively reduced dentin hypersensitivity over the study period. Potassium nitrate toothpaste provided more rapid initial relief, when compared to the herbal formulation alone; however, both achieved similar outcomes by 4 weeks. The herbal toothpaste supplemented with potassium nitrate demonstrated superior efficacy and may offer a promising natural alternative for managing dentin hypersensitivity.
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(This article belongs to the Topic Oral Health Management and Disease Treatment)
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Multimodal Evaluation of Three NiTi Rotary Systems: Clinical Simulation, Mechanical Testing, and Finite Element Analysis
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Jesus A. Aparicio, Pedro M. Mendez S, Giulia Malvicini, Simone Grandini, Carlo Gaeta, Ana Paula García Guerrero, Kristel Lidice Miranda Robles, José Aranguren and Alejandro R. Pérez
Dent. J. 2025, 13(8), 368; https://doi.org/10.3390/dj13080368 - 15 Aug 2025
Abstract
Objectives: This study aimed to compare the clinical durability, mechanical performance, and stress behavior of three NiTi rotary systems—BlueShaper (Blue), BlueShaper Pro (Dual Wire), and BlueShaper Gold (fully gold-treated NiTi)—through a multimodal evaluation that included simulated instrumentation in 3D-printed replicas, mechanical testing, and
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Objectives: This study aimed to compare the clinical durability, mechanical performance, and stress behavior of three NiTi rotary systems—BlueShaper (Blue), BlueShaper Pro (Dual Wire), and BlueShaper Gold (fully gold-treated NiTi)—through a multimodal evaluation that included simulated instrumentation in 3D-printed replicas, mechanical testing, and finite element analysis (FEA). Methods: Sixty instruments (n = 20 per group) were tested. Simulated canal preparation was conducted in standardized 3D-printed mandibular molars with a 40° mesial root curvature until fracture occurred. Mechanical tests included torsional and flexural loading using a universal testing machine and stainless steel blocks with a standardized 40° curvature. FEA simulations evaluated von Mises stress, shear stress, total deformation, cyclic fatigue behavior, and contact pressure between the instrument and canal wall. Results: BlueShaper Gold prepared an average of 7.5 canals before fracture, followed by BlueShaper Pro (5.67 canals) and Blue (5.00 canals) (p < 0.001). Gold exhibited the highest torsional resistance (6.08 ± 3.08 N) and the longest fatigue life (325 ± 55.7 cycles), with the lowest von Mises stress and damage factor in FEA. BlueShaper Pro showed the longest time to fracture in mechanical testing (73.85 ± 7.10 s) and balanced mechanical behavior. Blue demonstrated the lowest performance across most parameters, including the shortest fatigue life and highest stress concentration. Conclusions: BlueShaper Gold exhibited the highest mechanical strength and fatigue resistance. BlueShaper Pro demonstrated the longest fatigue life and balanced mechanical behavior. Blue showed the lowest performance across most parameters. The strong correlation among clinical, mechanical, and FEA data reinforces the critical role of alloy composition in determining instrument durability, even when design remains constant.
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(This article belongs to the Special Issue Endodontics and Restorative Sciences: 2nd Edition)
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Evaluation of Internal and Marginal Shrinkage Stress in Adhesive Class III Cavities Restored with Different Resin Composite Combinations—A 3D-FEA Study
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Elisa Donaria Aboucauch Grassi, Guilherme Schmitt de Andrade, Ana Beatriz Gomes de Carvalho, Roberta Gasparro, Mauro Mariniello, Angelo Aliberti, Pietro Ausiello and Alexandre Luiz Souto Borges
Dent. J. 2025, 13(8), 367; https://doi.org/10.3390/dj13080367 - 14 Aug 2025
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Objectives: To study the effects of internal and marginal polymerization shrinkage stress and distribution in different resin composite class III dental restorations in relation to the restorative technique using numerical finite element analysis (FEA). Methods: A 3D model of a human hemi-maxilla with
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Objectives: To study the effects of internal and marginal polymerization shrinkage stress and distribution in different resin composite class III dental restorations in relation to the restorative technique using numerical finite element analysis (FEA). Methods: A 3D model of a human hemi-maxilla with a sound maxillary central incisor were created. Four class III distal cavities were shaped and differently restored. Four groups of resin composite combinations were analyzed: group C (three increments of conventional composite); group B (two increments of bulk-fill composite); group FC (flowable base + three increments of conventional composite); and group FB (flowable bulk-fill base + two increments of conventional composite). The resulting four models were exported to FEA software for static structural analysis. Polymerization shrinkage was simulated using thermal analogy, and stress distribution was analyzed using the Maximum Principal Stress criterion at the marginal and internal cavity interfaces. Results: Group FC showed the highest stress at the level in the proximal region (9.05 MPa), while group FB showed the lowest (4.48 MPa). FB also exhibited the highest internal dentin stress, indicating potential risks for long-term bond degradation. In the cavo-surface incisal angle, the average peak stress across all groups was 3.76 MPa. At the cervical cavo-surface angle, stress values were 3.3 MPa (C), ~3.36 MPa (B), 3.41 MPa (FC), and 3.27 MPa (FB). Conclusions: Restorative technique did not significantly influence marginal stress distribution in class III composite restorations. However, the bevel area at the cervical margin showed the highest concentration of shrinkage stress.
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Open AccessSystematic Review
Charting New Territory: AI Applications in Dental Caries Detection from Panoramic Imaging
by
Man Hung, Daniel Yevseyevich, Milan Khazana, Connor Schwartz and Martin S. Lipsky
Dent. J. 2025, 13(8), 366; https://doi.org/10.3390/dj13080366 - 12 Aug 2025
Abstract
Introduction: Dental caries remains a public health concern, and early detection prevents its progression and complications. Panoramic radiographs are essential diagnostic tools, yet the interpretation of panoramic X-rays varies among practitioners. Artificial intelligence (AI) presents a promising approach to enhance diagnostic accuracy in
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Introduction: Dental caries remains a public health concern, and early detection prevents its progression and complications. Panoramic radiographs are essential diagnostic tools, yet the interpretation of panoramic X-rays varies among practitioners. Artificial intelligence (AI) presents a promising approach to enhance diagnostic accuracy in detecting dental caries. This scoping review examines the current literature on the use of AI programs to analyze panoramic radiographs for the diagnosis of dental caries. Methods: This scoping review searched PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source, adhering to PRISMA guidelines. The review included peer-reviewed, original research published in English that investigated the use of AI to diagnose dental caries. Data were extracted on the AI model characteristics, advantages, disadvantages, and diagnostic performance. Results: Seven studies met the inclusion criteria. The Deep Learning Model achieved the highest performance (specificity 0.9487, accuracy 0.9789, F1 score 0.9245), followed by Diagnocat and Tooth Type Enhanced Transformer. Models such as CranioCatch and CariSeg showed moderate performance, while the Dental Caries Detection Network demonstrated the lowest. Benefits included improved diagnostic support and workflow efficiency, while limitations involved dataset biases, interpretability challenges, and computational demands. Conclusions: Applying AI technologies to panoramic X-rays demonstrates the potential for enhancing caries diagnosis, with some models achieving near-expert performance. However, future research must address the generalizability, transparency, and integration of AI models into clinical practice. Future research should focus on diverse training datasets, explainable AI development, clinical validation, and incorporating AI training into dental education and training.
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(This article belongs to the Special Issue Updates and Highlights in Cariology)
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Open AccessReview
Evaluating the Success of Immediate Implants in the Esthetic Zone: A Narrative Review with Case Illustration
by
Carlos A. Jurado, Francisco Garcia-Torres, Silvia Rojas-Rueda, Kiarash Karimi and Mark Adam Antal
Dent. J. 2025, 13(8), 365; https://doi.org/10.3390/dj13080365 - 12 Aug 2025
Abstract
Background: Immediate implant therapy is a highly effective solution for replacing non-restorable teeth, particularly in the esthetic zone, where achieving optimal results can be challenging. In this area, even small imperfections can significantly affect a patient’s satisfaction due to the high visibility
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Background: Immediate implant therapy is a highly effective solution for replacing non-restorable teeth, particularly in the esthetic zone, where achieving optimal results can be challenging. In this area, even small imperfections can significantly affect a patient’s satisfaction due to the high visibility of the teeth involved. This narrative review provides an overview of findings from case reports and systematic reviews that highlight the success of immediate implant therapy in the esthetic zone. Additionally, it includes a case illustration to emphasize how meticulous planning, combined with advanced techniques, can achieve successful outcomes. Methods: A comprehensive literature review was conducted to evaluate the effectiveness of immediate implant placement and loading for non-restorable teeth in the esthetic zone. Key factors identified for success include atraumatic tooth extraction, precise implant placement, and effective soft tissue management to achieve natural esthetics and long-term stability. To illustrate these principles, the review features a clinical case involving the replacement of a maxillary right central incisor rendered non-restorable due to trauma. Treatment incorporated advanced digital planning, atraumatic extraction, immediate implant placement, and provisionalization. The final restoration involved soft tissue contouring and ceramic veneers on adjacent teeth, enhancing the patient’s overall smile and confidence. Results: Evidence from the literature indicates that well-planned immediate implant therapy achieves high success rates and long-term stability. In the clinical case presented, the workflow met the patient’s esthetic and functional needs, resulting in a natural, harmonious smile, and improved patient satisfaction. Conclusions: Immediate implant therapy in the esthetic zone is highly effective when critical considerations—such as bone preservation, guided implant placement, soft tissue shaping, and appropriate restoration—are meticulously addressed. Advanced techniques and careful planning are essential for fulfilling both esthetic and functional patient needs, ultimately delivering predictable and successful outcomes.
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(This article belongs to the Section Dental Implantology)
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The Areca Nut and Oral Submucosal Fibrosis: A Narrative Review
by
Kimia Kazemi, Asmaa Fadl, Felipe F. Sperandio and Andrew Leask
Dent. J. 2025, 13(8), 364; https://doi.org/10.3390/dj13080364 - 12 Aug 2025
Abstract
The areca nut (AN) is chewed by approximately 600 million people worldwide. Among AN chewers, ~5% develop oral submucosal fibrosis (OSF), a progressive fibrotic disorder of the oral cavity. OSF is characterized by subepithelial fibrosis and mucosal rigidity, leading to restricted mouth opening,
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The areca nut (AN) is chewed by approximately 600 million people worldwide. Among AN chewers, ~5% develop oral submucosal fibrosis (OSF), a progressive fibrotic disorder of the oral cavity. OSF is characterized by subepithelial fibrosis and mucosal rigidity, leading to restricted mouth opening, difficulty in mastication, deglutition, and speech. These impairments severely compromise oral hygiene and routine dental care, diminishing patients’ quality of life. At least 4% of OSF patients develop oral cancer. The prevalence of OSF correlates with AN chewing, particularly when accompanied by other risk factors such as tobacco use. The International Agency for Research on Cancer has identified chronic chemical and mechanical irritation of the oral mucosa from AN chewing as a major cause of OSF. The active chemical ingredients of AN include alkaloids such as arecoline, flavonoids, and tannins. Of these, arecoline is considered the most potent fibrogenic agent. In vitro, arecoline induces cultured fibroblasts to differentiate into highly contractile α-smooth muscle actin (α-SMA)-expressing myofibroblasts, the effector cells of fibrosis, and to express profibrotic markers and mediators, including transforming growth factor-β 1 (TGF-β1) and cellular communication network factor 2 (CCN2), which is associated with malignant progression of OSF. In vivo, mice exposed to AN extract or arecoline show submucosal collagen accumulation and myofibroblast differentiation, concomitant with upregulated pro-fibrotic gene (TGF-β1, Col1A1, α-SMA) expression. Although myofibroblasts can be seen in OSF patient-derived samples, substantial disease heterogeneity exists, which has thus far hindered the generation of high-quality data necessary to gain insights into underlying mechanisms and disease progression. Consequently, treatment options for OSF are limited and primarily symptomatic. Collectively, evidence from human and animal studies establishes OSF as an AN-induced fibrotic disorder and underscores the urgent need for mechanism-focused research to identify reliable diagnostic markers and therapeutic targets to address its growing global burden.
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(This article belongs to the Special Issue Dentistry in the 21st Century: Challenges and Opportunities)
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Optimizing Preclinical Skill Assessment for Handpiece-Naïve Students: A Strategic Approach
by
Reinhard Chun Wang Chau, Szabolcs Felszeghy, Maria F. Sittoni-Pino, Santiago Arias-Herrera, Sompop Bencharit, Margrit Maggio, Murat Mutluay, David P. Rice, Walter Yu Hang Lam, Sıla Nur Usta, Barry F. Quinn, Jorge Tricio, Masako Nagasawa, Mihaela Pantea, Marina Imre, Ana Maria Cristina Tancu, Amitha Ranauta, Arzu Tezvergil-Mutluay, Satu Korpisaari, Kaisa Leinonen, Mikko Liukkonen, Outi S. Huhtela, Ulf T. Örtengren and Peter Lingströmadd
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Dent. J. 2025, 13(8), 363; https://doi.org/10.3390/dj13080363 - 11 Aug 2025
Abstract
Background: Preclinical dental training requires simulation-based tools to develop fine motor skills, but traditional models like plastic teeth often lack realistic tactile feedback, and systematic evaluations of multi-layered drilling plates are scarce. This study aimed to evaluate the educational utility and perceived
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Background: Preclinical dental training requires simulation-based tools to develop fine motor skills, but traditional models like plastic teeth often lack realistic tactile feedback, and systematic evaluations of multi-layered drilling plates are scarce. This study aimed to evaluate the educational utility and perceived realism of a novel multi-layered drilling plate designed to simulate enamel, dentin, and pulp, with null hypotheses that it would not differ in realism from natural dental tissues or in educational utility from existing tools. Methods: Seventy dental educators (mean preclinical teaching experience: 112.9 ± 116.7 months) from 14 institutions across four continents assessed the plates using standardized protocols. Statistical analysis (Mann–Whitney U Test) was performed to analyze the results. Results: Quantitative ratings (1–10 scale) showed high mean scores for drilling quality (enamel: 7.80 ± 1.55, dentin: 7.27 ± 1.94, pulp: 7.48 ± 2.33), surface smoothness (enamel: 8.17 ± 1.55, dentin: 8.17 ± 1.57), and ergonomic visibility (8.56 ± 1.58), with 90% passing grades, rejecting the null hypothesis of no difference in educational utility. Tissue transition scores (enamel/dentin: 7.09 ± 2.56; dentin/pulp: 6.86 ± 2.46) showed significant differences (p < 0.05) in realism from natural tissues, rejecting the null hypothesis of no difference. Inter-rater reliability was poor (Krippendorff’s alpha: 0.449 for failing scores, 0.211 for passing scores). Qualitative feedback praised ease of use but noted limitations in dentin haptic simulation. Conclusions: The drilling plate shows promise for skill development, though without controlled comparisons to existing tools, its relative efficacy remains preliminary. Further research on student outcomes and tool refinement is needed to validate its use in dental education.
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(This article belongs to the Special Issue Advancing Dental Education: Synergizing Virtual Reality, Haptics, AI, and Conventional Training for Green Clinical and Community Competence and Sustainability)
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Oral Manifestations, Dental Interventions, and Clinical Outcomes in Hospitalized COVID-19 Patients: A Two-Year Cohort Study in São Paulo, Brazil
by
Marcelo Ivander Andrade Wanderley, Leticia Rodrigues-Oliveira, Teresa Cristina Dias Cunha Nascimento, Luiz Francisco Cardoso, Thaís Bianca Brandão, Alan Roger Santos-Silva and Ana Carolina Prado-Ribeiro
Dent. J. 2025, 13(8), 362; https://doi.org/10.3390/dj13080362 - 11 Aug 2025
Abstract
Objectives: To investigate the demographic, epidemiological, and medical profiles of hospitalized COVID-19 patients who received dental care, and to identify their main oral health needs. Methods: This retrospective, descriptive cohort study analyzed medical and dental records of patients hospitalized with COVID-19 at a
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Objectives: To investigate the demographic, epidemiological, and medical profiles of hospitalized COVID-19 patients who received dental care, and to identify their main oral health needs. Methods: This retrospective, descriptive cohort study analyzed medical and dental records of patients hospitalized with COVID-19 at a private tertiary hospital in São Paulo, Brazil, from January 2020 to March 2022. The data collected included demographic variables, comorbidities, length of hospitalization, need for respiratory support, clinical outcomes, dental diagnoses, and procedures performed. Results: A total of 129 medical records were reviewed. The sample included 93 males (72%) and 36 females (28%), with a mean age of 72 years. Comorbidities were present in 92% of cases, most frequently a prior COVID-19 infection (59%), diabetes (36%), and depression (31%). The mean hospital stay was 51 days, with a median of 33 days. Most patients (91%) required ICU care; among these, 87% received invasive mechanical ventilation. Dental consultations were most commonly requested for oral assessments (88%), lesions (58%), and opportunistic infections (8%). The most frequent diagnoses were trauma-related lesions from orotracheal intubation (63%), opportunistic infections (45%), and odontogenic or periodontal infections (15%). Primary treatments included oral hygiene procedures (89%), photobiomodulation therapy (67%), and tooth extractions (6%). Patients received an average of eight dental consultations. The overall mortality rate was 26%. Conclusions: Older male patients with COVID-19 frequently required intensive dental care during hospitalization. Oral trauma and opportunistic infections were common, highlighting the need for specialized dental management in critically ill populations.
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(This article belongs to the Special Issue Preventive Dental Care, Chairside and Beyond)
Open AccessFeature PaperReview
The 2018 Classification of Periodontitis: Challenges from Clinical Perspective
by
Marek Chmielewski, Andrea Pilloni, Alessandro Cuozzo, Giuseppe D’Albis, Gerarda D’Elia, Piero Papi and Lorenzo Marini
Dent. J. 2025, 13(8), 361; https://doi.org/10.3390/dj13080361 - 8 Aug 2025
Abstract
Objectives: The objective of this narrative review was to evaluate the clinical challenges encountered in the application of the 2018 AAP/EFP Classification of Periodontitis. Methods: Electronic and manual searches were conducted to identify studies reporting diagnostic accuracy and inter- and intra-examiner
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Objectives: The objective of this narrative review was to evaluate the clinical challenges encountered in the application of the 2018 AAP/EFP Classification of Periodontitis. Methods: Electronic and manual searches were conducted to identify studies reporting diagnostic accuracy and inter- and intra-examiner agreement when using the 2018 Classification, both with and without the aid of implementation tools. Results: Eleven studies were included, encompassing a total of 459 clinical cases. Overall, 852 examiners participated, with 31 gold-standard examiners providing the reference diagnoses. General dentists often exhibited lower diagnostic accuracy and consistency compared to students and periodontal experts. Diagnostic challenges were observed in staging, particularly distinguishing between Stage III/IV and gingivitis/Stage I. Grading reliability was reduced in the absence of longitudinal data and high-level modifying factors. This review also explored difficulties in reporting ‘hopeless teeth’ and assigning the extent of periodontitis. Education, training, and implementation tools substantially improved diagnostic accuracy and consistency, increasing the agreement with reference diagnosis and strengthening inter- and intra-examiner agreement. Conclusions: The application of the 2018 Classification showed notable variability in diagnostic accuracy and inter- and intra-examiner agreement. Improving clinician experience and training and incorporating diagnostic aids and emerging AI technologies has the potential to enhance diagnostic accuracy and consistency, which are essential for precisely estimating periodontitis prevalence, interpreting research findings, and determining prognosis and treatment needs.
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(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management: 2nd Edition)
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