Dentistry Journal

14 pages, 10329 KiB

Open AccessArticle

SEM and Bacteriological Evidence of Laser-Activated Irrigation Compared to Ultrasonic-Activated Irrigation: A Pilot Study

by David E. Jaramillo, Ji W. Jeong, Zhen Shen and Enrico Divito

Dent. J. 2025, 13(5), 195; https://doi.org/10.3390/dj13050195 - 29 Apr 2025

Abstract

Background: Pulp tissue debridement and the eradication of microorganisms from an infected root canal system before obturation is a primary focus of endodontic treatment and the best predictor for the long-term success of endodontic treatment. Objective: The purpose of this in vitro laboratory [...] Read more.

Background: Pulp tissue debridement and the eradication of microorganisms from an infected root canal system before obturation is a primary focus of endodontic treatment and the best predictor for the long-term success of endodontic treatment. Objective: The purpose of this in vitro laboratory study was to evaluate pulp tissue debridement and the disinfection efficacy of two different Er;Cr:YSGG laser units, with a 2790 nm wavelength, compared to ultrasonic-activated irrigation (UAI) in root canals infected with Enterococcus faecalis. Methods: Human non-infected mandibular first molars were extracted, disinfected, and cultured with Enterococcus faecalis. Different types of Er;Cr:YSGG laser irrigation and UAI were performed according to the manufacturers’ protocols. The teeth were then processed for bacteriological and SEM analyses. Results: The different laser-activated irrigation protocols showed multiple areas of remaining bacteria, biofilm, tissue, and thermal ablation. The laser fiber tips also displayed significant tip degradation after use, which might affect efficacy. Conclusions: In this in vitro study, laser-activated irrigation using Er;Cr:YSGG technology and UAI were inefficient in eliminating pulp tissue from difficult-to-reach areas and Enterococcus faecalis from infected root canals. Full article

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

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16 pages, 1130 KiB

Open AccessArticle

Comparative Analysis of Salivary Tumor Marker CA-125 Among Oral Squamous Cell Carcinoma Patients and Healthy Individuals

by Riham Mohammed, Mariam El Sheikh, Nada Tawfig Hashim, Nallan CSK Chaitanya and Ahmed Suleiman

Dent. J. 2025, 13(5), 194; https://doi.org/10.3390/dj13050194 - 29 Apr 2025

Abstract

Background/Objectives: In Sudan, oral cancer is one of the top ten most common cancers, with OSCC representing the majority of the cases. To date, despite the fact that saliva can be collected simply and non-invasively, there is no approved salivary tumor marker [...] Read more.

Background/Objectives: In Sudan, oral cancer is one of the top ten most common cancers, with OSCC representing the majority of the cases. To date, despite the fact that saliva can be collected simply and non-invasively, there is no approved salivary tumor marker for OSCC. This study aimed to investigate the reliability of salivary CA-125 as a tumor marker for OSCC by measuring and comparing its level among OSCC and healthy individuals as well as its level across different histopathological grades. Methods: A total of 100 subjects were enrolled; 50 were patients with OSCC, while the other 50 were matched healthy individuals. Non-stimulated whole saliva was collected before the administration of definitive treatment, and the concentration of salivary CA-125 was quantified using an automated immunoassay analyzer that employs a one-step sandwich fluorescent enzyme immunoassay (FEIA). Results: The level of salivary CA-125 was 342.65 U/mL in the cases group, which was significantly increased compared with 203.65 U/mL in the healthy controls (p = 0.017). Statistically significant differences in the level of salivary CA-125 among different histopathological grades were observed (p = 0.014). The sensitivity, specificity, accuracy, and positive and negative predictive values were 48%, 78%, 63%, 68.6%, and 60%, respectively. Conclusions: This study suggests that salivary CA-125 could serve as a potential tumor marker for OSCC. However, its clinical application requires further validation. Full article

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9 pages, 717 KiB

Open AccessArticle

Crestal Hydraulic Sinus Lift with Simultaneous Implant Insertion: A Retrospective Case Series

by Francesco Mattia Ceruso, Aurea Immacolata Lumbau, Francesco Pernice, Alessandro Mastroianni, Michele Miranda, Silvio Mario Meloni, Marco Gargari, Marco Tallarico and Milena Pisano

Dent. J. 2025, 13(5), 193; https://doi.org/10.3390/dj13050193 - 28 Apr 2025

Abstract

Objectives: This retrospective study aimed to evaluate the increase in vertical bone height following sinus lift procedures using the CAS (Crestal Approach Sinus) kit technique in combination with tissue-level implants. Additionally, the quantity of bone between the implant apex and the Schneiderian [...] Read more.

Objectives: This retrospective study aimed to evaluate the increase in vertical bone height following sinus lift procedures using the CAS (Crestal Approach Sinus) kit technique in combination with tissue-level implants. Additionally, the quantity of bone between the implant apex and the Schneiderian membrane was assessed to determine the effectiveness and safety of this minimally invasive approach. Methods: The study included 15 patients (20 implants) who underwent sinus lift procedures with the CAS kit technique and tissue-level implants in the posterior maxilla between September 2021 and October 2024. Inclusion criteria required a minimum residual bone height (RBH) of 2 mm. Cone-beam computed tomography (CBCT) scans were used for initial screening, and panoramic radiography evaluated outcomes at implant placement and nine months postoperatively. Primary outcomes included implant and prosthetic survival rates, as well as biological and technical complications. Secondary outcomes were vertical bone height and the amount of bone above the implant tip. Statistical analyses were conducted using the Wilcoxon signed-rank test with a significance level of 0.05. Results: All implants achieved successful osseointegration, with no implant or prosthetic failures and no biological or technical complications reported. The mean RBH at implant placement was 4.2 ± 1.4 mm, which increased to an overall membrane elevation of 13.8 ± 1.8 mm. At the 9-month follow-up, the overall membrane elevation was slightly reduced to 13.0 ± 1.6 mm (p = 0.000), with a mean bone gain of 9.6 ± 2.4 mm. The amount of bone above the implant tip was 3.4 ± 1.7 mm at placement, decreasing to 3.0 ± 1.2 mm at follow-up (p = 0.007). Conclusions: The CAS kit technique combined with tissue-level implants demonstrated significant vertical bone gain and high implant survival rates without complications. This minimally invasive approach proved effective and safe for sinus augmentation in patients with limited residual bone height. The findings support the CAS kit’s potential as a preferred technique for maxillary sinus elevation. Further research with larger cohorts and long-term follow-up is needed to validate these results. Full article

(This article belongs to the Special Issue Oral Implantology and Bone Regeneration)

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17 pages, 3956 KiB

Open AccessFeature PaperArticle

Minimally Invasive Root Canal Cleaning: Evaluating Supplementary Irrigation Techniques

by Alissa Tiscareño, P. S. Ortolani-Seltenerich, Ana Ramírez-Muñoz, Omar Pérez-Ron, Pedro M. Mendez S, Carmen Leal-Moya, Giulia Malvicini, Gaya C. S. Vieira and Alejandro R. Pérez

Dent. J. 2025, 13(5), 192; https://doi.org/10.3390/dj13050192 - 27 Apr 2025

Abstract

Objectives: This study aimed to evaluate the efficacy of cleaning in minimally shaped mesial and oval distal canals of 3D models of mandibular molars, focusing on positive pressure irrigation, wireless and conventional passive ultrasonic irrigation (PUI), and diode laser (DL) at 980 nm. [...] Read more.

Objectives: This study aimed to evaluate the efficacy of cleaning in minimally shaped mesial and oval distal canals of 3D models of mandibular molars, focusing on positive pressure irrigation, wireless and conventional passive ultrasonic irrigation (PUI), and diode laser (DL) at 980 nm. Methods: Forty-four 3D-printed resin models, based on eleven natural mandibular molars (each with mesial and distal canals), were divided into four groups (n = 11 per group) to evaluate different irrigation methods. A total of 22 mesial canals (size 20/.04) and 11 oval distal canals (size 25/.04) were analyzed per group. Each root canal was uniformly filled with an artificial hydrogel to simulate a biofilm mixture. Following this preparation, the specified irrigation techniques were applied to the respective groups. Quantitative evaluations of pre- and post-irrigation images were performed to assess the efficiency of tissue removal along the entire length of the canal and in the apical, middle, and coronal thirds. Results: The findings revealed no significant differences in the initial amount of tissue between the samples, indicating uniform filling. In the apical region of mesial canals, conventional PUI showed the highest cleaning efficiency (14.1% residual tissue), significantly outperforming the other methods (p < 0.05). Cordless PUI and DL also surpassed positive pressure irrigation, leaving 30.4% and 29.3% residual tissue, respectively, compared to 42.2% with positive pressure. In the middle third, all methods tested performed better than needle irrigation (p < 0.05), but there were no significant differences in the coronal third or over the full canal length. Distal oval canals showed no significant differences in cleaning effectiveness among methods. Conclusions: Although no single method was superior regarding the full canal length, supplementary techniques such as PUI and DL offer potential benefits over conventional irrigation methods, particularly in the apical third of the canal. Complementary approaches such as conventional PUI and diode laser at 980 nm showed superior cleaning efficiency, particularly in the apical third. These results suggest their integration could improve the effectiveness of cleaning in minimally instrumented mesial canals. Full article

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

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17 pages, 2167 KiB

Open AccessArticle

Pediatric Dentists’ Practice Patterns in the Management of Permanent Teeth Needing Endodontic Treatment

by Nuha Ashraf, Linda Sangalli, Jackson Seagroves and Caroline M. Sawicki

Dent. J. 2025, 13(5), 191; https://doi.org/10.3390/dj13050191 - 26 Apr 2025

Abstract

Background/Objectives: The objective of this study was to evaluate practice patterns among pediatric dentists for the management of permanent teeth needing endodontic treatment. Methods: An electronic nationwide survey was sent to all members of the American Academy of Pediatric Dentistry (AAPD). [...] Read more.

Background/Objectives: The objective of this study was to evaluate practice patterns among pediatric dentists for the management of permanent teeth needing endodontic treatment. Methods: An electronic nationwide survey was sent to all members of the American Academy of Pediatric Dentistry (AAPD). The survey assessed provider training on and confidence (0–100, with 100 = “most confident”) in treating pediatric patients needing endodontic treatment on permanent teeth, referral patterns, and preferred educational resources. A logistic regression identified significant predictors of confidence levels. Results: The final sample included 259 respondents, with 71% having over 10 years of experience in practice. A total of 47% of respondents reported performing endodontic treatments on permanent teeth in pediatric patients, with direct pulp capping (70%) and partial or full pulpotomy (62%) being the most common procedures. Although the respondents moderately agreed (53 ± 32) that they received sufficient training during their residency to perform endodontic treatment on permanent teeth, their reported comfort levels with performing these procedures were low (0.001 ± 33). The adequacy of the training received during their residency was identified as a significant predictor of a higher level of confidence (p < 0.001, 95% CI 0.437, 0.667). The respondents highlighted additional continuing education courses and training, dedicated lectures at the AAPD Annual Session, and annual joint symposia or meetings between the AAPD and the American Association of Endodontists as the most valuable educational resources for the endodontic management of permanent teeth in pediatric patients. Conclusions: The findings suggest that enhancing residency training and expanding access to targeted continuing education opportunities are critical for improving pediatric dentists’ confidence and competence in the endodontic management of permanent teeth in pediatric patients. Full article

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

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14 pages, 3030 KiB

Open AccessArticle

Effect of Vascular Photobiomodulation in the Postoperative Period of Alveolar Bone Grafting

by Nicole Rosa de Freitas, Luisa Belluco Guerrini, Denise Sabbagh Haddad, Roberta Martinelli de Carvalho, Renato Yassutaka Faria Yaedú and Ana Lúcia Pompéia Fraga de Almeida

Dent. J. 2025, 13(5), 190; https://doi.org/10.3390/dj13050190 - 26 Apr 2025

Abstract

Background/Objectives: This study evaluated the effects of vascular photobiomodulation (VPBM) on pain intensity, edema, and facial temperature variation in patients undergoing alveolar bone grafting (ABG) surgery. Methods: A total of 42 patients with cleft lip and palate (aged 9–25 years) scheduled for ABG [...] Read more.

Background/Objectives: This study evaluated the effects of vascular photobiomodulation (VPBM) on pain intensity, edema, and facial temperature variation in patients undergoing alveolar bone grafting (ABG) surgery. Methods: A total of 42 patients with cleft lip and palate (aged 9–25 years) scheduled for ABG using iliac crest bone were randomly assigned in equal numbers (14 per group) to one of three groups: control (ABG only), test (ABG + VPBM), and placebo (ABG + simulated VPBM). Iliac and facial pain and edema were clinically evaluated 24 h post-surgery, along with thermographic facial analysis. Follow-up was conducted via phone calls for one week. Results: No statistically significant differences were observed among the groups regarding facial pain and edema at 24 h post-surgery. However, iliac pain significantly differed between the placebo and control groups (p = 0.045). A significant time-related effect on both facial and iliac pain outcomes was noted during follow-up, irrespective of the group. The need for rescue medication and self-perception of reduced edema did not differ significantly. Thermographic analysis reveals a significantly lower temperature variation in the test group (2.36 °C) compared to the other groups (p = 0.007). Conclusions: Overall, VPBM therapy influenced postoperative pain in the early recovery phase and temperature in the immediate postoperative period but did not significantly affect edema. Full article

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

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11 pages, 1279 KiB

Open AccessArticle

Evaluation of Color Stability and Marginal Integrity in Provisional Restorations: A Study of Milling, 3D Printing, and Conventional Fabrication Methods

by Austin Galbraith, Mai Doan, Tyson Galbraith and Neamat Hassan Abubakr

Dent. J. 2025, 13(5), 189; https://doi.org/10.3390/dj13050189 - 25 Apr 2025

Abstract

Background: The quality of a provisional restoration, especially its color and marginal integrity, can play a critical role in its survival and overall patient satisfaction. This study aims to evaluate the color stability and marginal fit differences between provisional restorations fabricated by non-traditional [...] Read more.

Background: The quality of a provisional restoration, especially its color and marginal integrity, can play a critical role in its survival and overall patient satisfaction. This study aims to evaluate the color stability and marginal fit differences between provisional restorations fabricated by non-traditional methods compared to manual fabrication. Methods: A total of 80 extracted teeth were prepared for ceramic crowns and randomly divided into four groups: acrylic, 3D printing, computer-aided design/computer-aided manufacturing (CAD/CAM), and bis-acryl. The examined teeth were subjected to artificial aging using a thermocycling machine dwelling for 5000 cycles (simulating 6 clinical months). Color stability and marginal integrity were measured before and after thermal aging using a VITA Easyshade V spectrophotometer and 3D surface non-contact profilometer. ANOVA was used to determine whether the mean value difference was significantly different. Results: The 3D-printed and bis-acryl provisional crowns displayed the lowest change in marginal integrity, while the acrylic provisional crowns showed the greatest change in marginal integrity (p = 0.0001). Additionally, the acrylic provisional material revealed a significantly greater color change. Conclusions: The 3D-printed provisional crowns demonstrated the best marginal integrity and color stability. Full article

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

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17 pages, 2994 KiB

Open AccessSystematic Review

The Association Between Periodontal Disease and Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

by Vincenzo Bitonti, Tiziana Perri, Lorenzo Cigni, Domenico Familiari, Giuseppe Vazzana and Rocco Franco

Dent. J. 2025, 13(5), 188; https://doi.org/10.3390/dj13050188 - 25 Apr 2025

Abstract

Background: Periodontal disease (PD) and polycystic ovary syndrome (PCOS) are two prevalent conditions that have been independently associated with systemic inflammation and hormonal dysregulation. Emerging evidence suggests a potential bidirectional relationship between these conditions, but the nature and strength of this association remain [...] Read more.

Background: Periodontal disease (PD) and polycystic ovary syndrome (PCOS) are two prevalent conditions that have been independently associated with systemic inflammation and hormonal dysregulation. Emerging evidence suggests a potential bidirectional relationship between these conditions, but the nature and strength of this association remain unclear. Objective: This systematic review aimed to evaluate and synthesize the existing evidence on the association between periodontal disease and polycystic ovary syndrome, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods: A comprehensive literature search was conducted in multiple databases, including PubMed, Scopus, and Web of Science, from 1990 to 2025. Studies investigating the association between PD and PCOS in terms of prevalence, severity, and shared pathophysiological mechanisms were included. Two independent reviewers screened studies for eligibility, extracted data, and assessed methodological quality using validated tools. Discrepancies were resolved through consensus. Meta-analysis was conducted where appropriate. Results: A total of nine studies were included. Most studies reported a higher prevalence and severity of periodontal disease among women with PCOS compared to controls. Shared mechanisms, including systemic inflammation, insulin resistance, and hormonal dysregulation, were frequently proposed as underlying factors. However, heterogeneity in study designs, diagnostic criteria, and confounding adjustments limited the comparability of findings. Conclusions: This systematic review supports a potential association between periodontal disease and polycystic ovary syndrome, likely mediated by common inflammatory and metabolic pathways. However, the evidence is limited by heterogeneity and methodological biases. Further well-designed longitudinal studies are needed to clarify causal relationships and explore the clinical implications of integrating periodontal health management into PCOS care. Full article

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

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11 pages, 1708 KiB

Open AccessSystematic Review

General Dentists and Dental Specialists’ Knowledge of Treatment, Diagnosis, Referral, and Risk Factors of Obstructive Sleep Apnea: A Systematic Review

by Shahad A. Alkharouby, Sumayyah L. Alkhudhayri, Shahad L. Alhassani, Hamed S. Alghamdi, Rashed A. Alsahafi, Nivetha Mariappan, Mohammed A. Barashi and Hesham A. Alhazmi

Dent. J. 2025, 13(5), 187; https://doi.org/10.3390/dj13050187 - 24 Apr 2025

Abstract

Objectives: This systematic review aimed to evaluate general dentists and dental specialists’ knowledge regarding obstructive sleep apnea (OSA) diagnosis, referral, risk factors, and treatment. Methods: A systematic search of databases, including Web of Science, PubMed, and ProQuest, was conducted for studies published up [...] Read more.

Objectives: This systematic review aimed to evaluate general dentists and dental specialists’ knowledge regarding obstructive sleep apnea (OSA) diagnosis, referral, risk factors, and treatment. Methods: A systematic search of databases, including Web of Science, PubMed, and ProQuest, was conducted for studies published up to 25 September 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included cross-sectional studies that assessed the knowledge of general dentists or dental specialists. A quality assessment was performed using the Newcastle–Ottawa Quality Assessment Scale. Results: The seven included studies demonstrated varied knowledge levels among respondents regarding polysomnography as the gold standard for diagnosing OSA, with percentages ranging from 40.18% to 90%. While recognition of craniofacial structure as a risk factor for OSA was consistently high, knowledge about body weight as a risk factor varied. Additionally, the understanding of continuous positive airway pressure as the standard treatment showed discrepancies across the studies. Conclusions: Given that some of the included articles displayed a moderate to high risk of bias, the results highlight the varying levels of OSA knowledge among dentists and specialists across the studies. This indicates a potential need for targeted educational programs to improve their understanding and management of OSA. Full article

(This article belongs to the Section Dental Education)

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17 pages, 831 KiB

Open AccessReview

Culture and Behaviour Management of Children in the Dental Clinic: A Scoping Review

by Adebola Oluyemisi Ehizele, Love Bukola Ayamolowo, Adeyinka Ishola and Moréniké Oluwátóyìn Foláyan

Dent. J. 2025, 13(5), 186; https://doi.org/10.3390/dj13050186 - 24 Apr 2025

Abstract

Cultural norms, beliefs, and practices influence parental expectations, children’s responses, and the acceptance of behaviour management techniques (BMTs) in paediatric dentistry. Despite this, the existing guidelines often adopt a standardized approach, overlooking critical cultural differences. This scoping review maps the links between culture [...] Read more.

Cultural norms, beliefs, and practices influence parental expectations, children’s responses, and the acceptance of behaviour management techniques (BMTs) in paediatric dentistry. Despite this, the existing guidelines often adopt a standardized approach, overlooking critical cultural differences. This scoping review maps the links between culture and behaviour management strategies in paediatric dental settings. A scoping review following PRISMA guidelines was conducted across PubMed, Cochrane Library, Web of Science, Google Scholar, and hand-searched sources from the inception of the databases to 31 January 2025. A total of 671 studies were identified, with 15 meeting the inclusion criteria. Data on the key findings were inductively analyzed to assess cultural influences on parental acceptance, child behavior, and communication. The findings show that non-invasive BMTs such as TellShow–Do and positive reinforcement were the most accepted across cultures, while passive and active restraints were least accepted, especially in Western populations. Parental preferences varied; Jordanian parents were more accepting of passive restraint than German parents, while general anaesthesia was preferred in Bahrain. Cultural norms shaped communication styles—Latino families emphasized warm interpersonal interactions, whereas Pakistani families exhibited limited parental involvement due to language barriers. Black and Hispanic Medicaid-enrolled mothers in the U.S. reported lower satisfaction with pain management, highlighting disparities in culturally competent care. In conclusion, cultural factors significantly influence paediatric behaviour management in dental clinics. Integrating cultural competence into practice can enhance communication, improve patient compliance, and promote equitable care. Further research is needed, particularly in Africa and South America, to inform globally inclusive behaviour management guidelines. Full article

(This article belongs to the Special Issue Preventive Dental Care, Chairside and Beyond)

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12 pages, 4768 KiB

Open AccessCase Report

Immediate Implants in Extraction Sockets with Deficient Buccal Walls in the Maxillary Aesthetic Zone

by Sorin Boeriu, Timothy Hottel, Cris Chirla and Phillip Chirla

Dent. J. 2025, 13(5), 185; https://doi.org/10.3390/dj13050185 - 24 Apr 2025

Abstract

Background: Immediate implant placement in fresh extraction sockets has become an accepted treatment in dentistry as a predictable procedure to restore failing teeth. One prerequisite for this immediate procedure in the anterior maxillary region is an intact facial wall. Unfortunately, the presence of [...] Read more.

Background: Immediate implant placement in fresh extraction sockets has become an accepted treatment in dentistry as a predictable procedure to restore failing teeth. One prerequisite for this immediate procedure in the anterior maxillary region is an intact facial wall. Unfortunately, the presence of fenestrations and dehiscences is very common. These defects occur due to the pathology responsible for the extraction of the teeth. Traditionally, hard and soft tissue grafting is necessary to repair these large bony defects before implant placement. However, there are many defects with facial wall deficiencies. Methods: This report reflects procedures used to provide successful functional outcomes using grafting techniques in conjunction with immediate implant placement in defective sockets. This clinical research study followed a qualitative methodology, and the results are based on observational outcomes of four patient surgical implant procedures. Each patient received the same protocol in an attempt to reach similar results. Results: Proper diagnosis, treatment planning, and clinical skills are key factors in achieving predictable results. With each of these four patients, the clinical soft tissue outcomes revealed that the midfacial gingival margin had minimal or no recession at two years with minimal pocket depths less than 3 mm. Conclusions: Although the procedure presented in this article has yet to be clinically validated, it is an available technique that can be used in the hands of an experienced practitioner and can provide excellent results for the patient. Full article

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

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12 pages, 235 KiB

Open AccessArticle

Mandibular Kinematics on an Orthodontic Population Assessed with an Optical Jaw Tracking System: A Comparative Study

by Joana Silva, Ariana Azevedo, Eugénio Martins, Alberto Canabez, Domingo Martin and Conchita Martin

Dent. J. 2025, 13(5), 184; https://doi.org/10.3390/dj13050184 - 23 Apr 2025

Abstract

Objective: To evaluate mandibular kinematics in an orthodontic population using the Modjaw^® optical jaw tracking system. Materials and methods: A total of 154 orthodontic patients underwent mandibular kinematic analysis using the Modjaw^® system. ANB values determined skeletal classification, while [...] Read more.

Objective: To evaluate mandibular kinematics in an orthodontic population using the Modjaw^® optical jaw tracking system. Materials and methods: A total of 154 orthodontic patients underwent mandibular kinematic analysis using the Modjaw^® system. ANB values determined skeletal classification, while dental classification was assessed on digital casts. The Modjaw^® records were taken as instructed by the manufacturer, and data collected from the readings included the discrepancy between centric occlusion and maximum intercuspation, maximum opening, Bennett angles, and sagittal condylar guidance. The presence or absence of temporomandibular disorders was determined by the DC-TMD questionnaires. Non-parametric tests and Spearman correlations were applied for the statistical analysis. Results: Significant differences in mandibular kinematics were observed between skeletal classes, particularly in CO-MI discrepancies, Bennett angles, and maximum opening (p < 0.05). TMD symptoms were associated with higher absolute CO-MI discrepancies but did not significantly alter other kinematic parameters. Weak correlations were found between sagittal condylar guidance and anterior guidance variables. Conclusions: Mandibular kinematics differ by skeletal classification, with Class III patients demonstrating distinct patterns. While TMD symptoms impact CO-MI discrepancies, overall mandibular dynamics remain consistent. Full article

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

16 pages, 2826 KiB

Open AccessReview

Micro- and Macroabrasion in the Esthetic Zone: A Narrative Review and Case Study

by Jose Villalobos-Tinoco, Carlos A. Jurado, Silvia Rojas-Rueda, Nechama S. Citrin, Staley Colvert, Jose Luis Gutierrez-Quintero and Salwa Mekled

Dent. J. 2025, 13(5), 183; https://doi.org/10.3390/dj13050183 - 23 Apr 2025

Abstract

Background: Micro- and macroabrasion represent a minimally invasive treatment approach for stained teeth in the esthetic zone. Diagnosing the type of stain is crucial for selecting the appropriate treatment approach. These clinical procedures involve several meticulous steps that may be confusing for less [...] Read more.

Background: Micro- and macroabrasion represent a minimally invasive treatment approach for stained teeth in the esthetic zone. Diagnosing the type of stain is crucial for selecting the appropriate treatment approach. These clinical procedures involve several meticulous steps that may be confusing for less experienced clinicians. Methods: The objective of this article is to provide an updated review of the literature on the clinical procedures for micro- and macroabrasion and to present a clinical case in which a minimally invasive macroabrasion procedure was applied to treat a female patient seeking to remove stains from her anterior teeth. Preliminary reviews were conducted of existing case reports and reviews evaluating the clinical procedures and outcomes of micro- and macroabrasion. Results: A review of the literature reveals minor differences in how stains on anterior teeth are addressed. Depending on the depth of the stain, microabrasion is typically used for superficial stains, while macroabrasion is employed for deeper stains. Clinicians often combine micro- or macroabrasion with tooth whitening procedures. Literature reviews agree that micro- and macroabrasion techniques are effective minimally invasive approaches that yield high esthetic results. The case study demonstrated each clinical step of microabrasion, achieving results that fully satisfied the patient’s esthetic demands. Conclusions: Micro- and macroabrasion can be effective and minimally invasive methods for treating stained anterior teeth. Superficial stains can be treated with microabrasion, while deeper stains may require macroabrasion. In some clinical scenarios, tooth whitening can also be combined with these treatments. Full article

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

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9 pages, 1799 KiB

Open AccessFeature PaperArticle

The Outcome of Old-School Indirect Pulp Capping over 40 Years: A Practice-Based Retrospective Evaluation

by Roland Frankenberger, Andreas Koch, Lina Plohmann, Benedicta Beck-Broichsitter and Stephan Becker

Dent. J. 2025, 13(5), 182; https://doi.org/10.3390/dj13050182 - 22 Apr 2025

Abstract

(1) Background: The aim of this in vitro study was to evaluate the success of indirect pulp capping (IPC) procedures over a period of 40 years. (2) Methods: The investigation of 1412 dental records included 159 patients with 366 IPC teeth having been [...] Read more.

(1) Background: The aim of this in vitro study was to evaluate the success of indirect pulp capping (IPC) procedures over a period of 40 years. (2) Methods: The investigation of 1412 dental records included 159 patients with 366 IPC teeth having been treated from 1969 to 1980. The teeth revealed caries within the inner third of dentin, were symptom-free, and showed no pulp exposure. The caries were excavated thoroughly and teeth with accidentally exposed pulp were excluded. Zinc–oxide–eugenol was used for the IPC procedures. The posterior teeth were restored with amalgam, and the anterior teeth received direct resin composite fillings. The gathered parameters with possible influences on survival rates were age, gender, tooth locations/positions, dates of vital therapy, the number of filled surfaces, types of primary restoration material, successional treatments on each tooth, and the last dates of surveillance. Data collection and statistical analysis were performed using Excel sheets and DataTab. Significant differences among groups were computed by cox regression analysis and the significance level was set at p = 0.05. Kaplan–Meier curves were utilized to illustrate the survival rates. (3) Results: Treatment success was measured by the maintenance of vitality beyond 365 days. The loss of vitality within 365 days was determined as treatment failure. Treatment outcomes were assessed after different time periods (1 and 6 months; 1, 2, 5, 10, 20, and 40 years). Pulp vitality dropped from 95% after 3 months to 32% after 40 years. Cavity size had a significant influence on the survival of pulp, but tooth position did not; however, third molars at least initially showed a better outcome. Beyond the 1-year recall, no differences for the evaluated parameters were present. (4) Conclusions: IPC showed excellent long-term success rates, revealing a 1.7% annual failure rate after 40 years of clinical service. Larger defects suffer more pulp damage in the long run. Full article

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

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15 pages, 1249 KiB

Open AccessArticle

The Effect of Low-Level Laser Therapy to Reduce Pain Caused by Orthodontic Separators: A Randomized, Double-Blind Placebo-Controlled, Split-Mouth Study

by Alireza Khandan Dezfully, Márió Gajdács, Aliz Eperke Pató, Krisztina Kárpáti and Melinda Madléna

Dent. J. 2025, 13(5), 181; https://doi.org/10.3390/dj13050181 - 22 Apr 2025

Abstract

Background: During the initiation of routine orthodontic treatment with fixed appliances, placing elastic separators (ESs) may lead to the patient experiencing considerable pain. Earlier studies evaluating the effects of low-level laser therapy (LLLT) on reducing pain caused by orthodontic ESs have reported contradictory [...] Read more.

Background: During the initiation of routine orthodontic treatment with fixed appliances, placing elastic separators (ESs) may lead to the patient experiencing considerable pain. Earlier studies evaluating the effects of low-level laser therapy (LLLT) on reducing pain caused by orthodontic ESs have reported contradictory results. The aim of our study was to evaluate the effect of a single application of LLLT on the experience of pain following ES placement. Methods: A double-blind, placebo-controlled randomized controlled trial was performed—with implementation of the split-mouth technique—where n = 33 volunteers (12 male and 21 female; aged between 19 and 36 years) were enrolled. ESs were placed at the mesial and distal surfaces of the first permanent molars in the upper or lower jaws. Jaws were divided into two quadrants; the treatment group received LLLT (using a GaAlAs diode laser, at a 980 nm wavelength, with 100 mW producing 6 J of energy; continuous wave), while the other quadrant served as the placebo side receiving a similar treatment, but without laser irradiation, immediately after separation. A questionnaire with a visual analogue scale (VAS; 0–100) was used for the assessment of pain (spontaneous pain and pain on mastication) scored for each first permanent molar directly after separation and after 6, 24, 48 and 72 h of both laser and placebo treatment application. Results: Mean VAS values were lower, but not significantly different, between the treatment vs. placebo groups for spontaneous pain at either measurement point (p > 0.05). Mean VAS values were significantly lower in the treatment groups for pain on mastication at the 6 (9.29 ± 12.65 vs. 19.07 ± 20.99; p = 0.025), 24 (21.96 ± 21.11 vs. 37.19 ± 26.35; p = 0.012) and 48 h (28.01 ± 21.40 vs. 42.60 ± 26.29; p = 0.016) measurement points. The analgetic effect of LLLT was most effective after 6 h, both in the resting position (−49% decrease) and during mastication (−51% decrease). Conclusions: A single application of LLLT with 6 J of energy may have beneficial effects on reducing the pain caused by orthodontic ESs used at the initiation of treatment with fixed appliances, especially during mastication, after 6–48 h following the separation procedure. Trial registration: clinicaltrials.gov ID NCT06816537 (date of registration: 7 February 2025, retrospectively registered). Full article

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11 pages, 231 KiB

Open AccessReview

True Allergies to Articaine: A 25-Year Analysis

by Frank Halling, Andreas Neff and Axel Meisgeier

Dent. J. 2025, 13(5), 180; https://doi.org/10.3390/dj13050180 - 22 Apr 2025

Abstract

Background: Although allergic reactions to amide local anesthetics (LA) are rare, it is important for medical professionals to be aware of their potential occurrence. Despite the fact that articaine is one of the most commonly used LA in dentistry, a survey of [...] Read more.

Background: Although allergic reactions to amide local anesthetics (LA) are rare, it is important for medical professionals to be aware of their potential occurrence. Despite the fact that articaine is one of the most commonly used LA in dentistry, a survey of documented cases of allergies to articaine is absent from the literature. The objective of this review was to ascertain how often true allergies to articaine, verified by standard allergological procedures, have been reported over the last 25 years. Methods: A comprehensive review of the literature from 1 January 2000 to 31 December 2024 was conducted using the PubMed-MEDLINE database. The search was limited to articles investigating suspected allergy to articaine. The search strategy encompassed indexing terms, keywords, and free-text words, complemented by an extensive manual search. The final determination was based on the application of skin and/or challenge tests as the gold standard for identifying articaine as the causative agent. Results: During the investigation period, 10 case reports and six case series, encompassing 29 patients with a confirmed true allergy to articaine, were identified. The age of the patients ranged from 8 to 65 years, with a median age of 34 years. Of these patients, 20 were diagnosed with an immediate type I allergy, while 5 patients exhibited a delayed type IV allergy. In four cases the specific type of allergy was not mentioned. In the majority of cases an intradermal test (IDT) was employed to ascertain the specific type of allergy. Cross-reactivity with other amide LA was reported in three cases. Conclusions: True allergies to articaine are exceedingly rare. Investigation strategies should include a combination of a thorough clinical history and a standardized allergological procedure entailing skin tests and challenge. Only a comprehensive approach ensures the accurate identification of affected patients and facilitates the selection of a tolerated LA. Full article

20 pages, 1017 KiB

Open AccessReview

Biomaterials for Guided Tissue Regeneration and Guided Bone Regeneration: A Review

by Nathália Dantas Duarte, Paula Buzo Frigério, Gloria Estefania Amaya Chica, Roberta Okamoto, Rogério Leone Buchaim, Daniela Vieira Buchaim, Michel Reis Messora and João Paulo Mardegan Issa

Dent. J. 2025, 13(4), 179; https://doi.org/10.3390/dj13040179 - 21 Apr 2025

Abstract

This review aims to provide an overview of the types of membranes, bone substitutes, and mucosal substitutes used for GTR and GBR and briefly explores recent innovations for tissue regeneration and their future perspectives. Since this is a narrative review, no systematic search, [...] Read more.

This review aims to provide an overview of the types of membranes, bone substitutes, and mucosal substitutes used for GTR and GBR and briefly explores recent innovations for tissue regeneration and their future perspectives. Since this is a narrative review, no systematic search, meta-analysis, or statistical analysis was conducted. Using biomaterials for GTR and GBR provides a reduction in postoperative morbidity, as it contributes to less invasive clinical procedures, serving as an alternative to autogenous grafts. Moreover, randomized clinical trials (RCTs) and systematic reviews are essential for the evaluation of new biomaterials. These studies provide more robust evidence and help guide clinical practice in the selection of safer and more effective biomaterials, allowing for the personalization of treatment protocols for each patient. Full article

(This article belongs to the Special Issue Innovations and Challenges in Dental Implantology)

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14 pages, 1280 KiB

Open AccessReview

Effects of Vitamin D, Melatonin, and Omega-3 Fatty Acids on Periodontal Health: A Narrative Review

by Dora Dragičević Tomičić, Nikolina Lešić, Ivana Škrlec, Larissa Steigmann, Kristina Tseneva, Martina Čalušić Šarac, Tin Crnić, Igor Tomičić, Željka Perić Kačarević and Marija Čandrlić

Dent. J. 2025, 13(4), 178; https://doi.org/10.3390/dj13040178 - 20 Apr 2025

Abstract

Periodontitis is a chronic inflammatory disease characterized by the destruction of tooth-supporting structures, influenced by immune system dysregulation, oxidative stress, and imbalances in bone metabolism. Given its multifactorial pathogenesis, bioactive compounds such as vitamin D, melatonin, and omega-3 fatty acids have emerged as [...] Read more.

Periodontitis is a chronic inflammatory disease characterized by the destruction of tooth-supporting structures, influenced by immune system dysregulation, oxidative stress, and imbalances in bone metabolism. Given its multifactorial pathogenesis, bioactive compounds such as vitamin D, melatonin, and omega-3 fatty acids have emerged as potential adjuncts to periodontal therapy due to their immunomodulatory, anti-inflammatory, and antioxidative properties. This narrative review explores the role of these three supplements in periodontal health, their potential in synergistic effects, and existing research gaps, providing a foundation for future studies on their clinical applications. Vitamin D is essential for calcium homeostasis, bone remodeling, and immune function. It modulates both innate and adaptive immune responses, enhancing antimicrobial peptide production and reducing inflammatory cytokine expression. Omega-3 fatty acids reduce the production of pro-inflammatory eicosanoids while promoting the synthesis of pro-resolving lipid mediators, contributing to bone preservation and immune balance. Melatonin, known for its antioxidant and osteogenic properties, supports bone remodeling by stimulating osteoblast proliferation and inhibiting osteoclast activity, while also regulating circadian rhythms, which may influence oral health. Although these bioactive compounds show promising effects in preclinical and clinical studies, significant knowledge gaps remain regarding optimal dosages, long-term efficacy, combined use, and standardized treatment protocols. Further clinical trials are necessary to elucidate their therapeutic value in periodontal disease management, especially those focused on their potential synergistic mechanisms. Understanding their synergistic mechanisms may open new avenues for adjunctive strategies in periodontal therapy. Full article

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

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12 pages, 1509 KiB

Open AccessArticle

Effect of a Recombinant Human Basic Fibroblast Growth Factor 2 (rhFGF-2)-Impregnated Atelocollagen Sponge on Vertical Guided Bone Regeneration in a Rat Calvarial Model

by Keisuke Kogure, Akira Hasuike, Risa Kurachi, Yasuyuki Igarashi, Masataka Idesawa and Shuichi Sato

Dent. J. 2025, 13(4), 177; https://doi.org/10.3390/dj13040177 - 20 Apr 2025

Abstract

Background/Objectives: Achieving a sufficient volume of augmented bone, particularly for vertical bone regeneration, remains challenging. This study investigated the use of basic fibroblast growth factor 2 (FGF-2) to promote bone augmentation beyond the skeletal envelope in the rat calvarium. Methods: Seven [...] Read more.

Background/Objectives: Achieving a sufficient volume of augmented bone, particularly for vertical bone regeneration, remains challenging. This study investigated the use of basic fibroblast growth factor 2 (FGF-2) to promote bone augmentation beyond the skeletal envelope in the rat calvarium. Methods: Seven rats were included in the study, with bilateral experimental sites in the calvarium. Two plastic caps were placed in the calvarium, containing either 0.3% FGF-2 with an atelocollagen sponge or an atelocollagen sponge alone as a control. Bone augmentation within the plastic caps was evaluated using micro-computed tomography (micro-CT) scans and histological sections. Micro-CT measurements, including bone volume measurements, were obtained at 1 week to 12 weeks after surgery. At 12 weeks, the area and height of the newly formed bone were evaluated using histological sections. Results: Starting at 8 weeks after surgery, the volume of the newly formed bone in the 0.3% FGF-2 group was significantly greater than that in the control group. At 12 weeks, histomorphometric analyses revealed that the area and height of the newly augmented bone were 35.6% and 41.9%, respectively, in the FGF-2 group, compared with 9.1% and 13.4%, respectively, in the control group. Conclusions: The inclusion of 0.3% FGF-2 in atelocollagen sponge enhanced vertical bone augmentation beyond the skeletal envelope in the rat calvarium. These findings have potential applications for improving bone regeneration outcomes in dental implant procedures. Full article

(This article belongs to the Special Issue Bone Augmentation in Dentistry)

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