Dentistry Journal

Research

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

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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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16 pages, 2467 KiB

Open AccessArticle

Micro-Computed Tomography Analysis of Reciprocating Systems in Three-Dimensional Models of Mandibular Premolars with Two Canals

by María Medina-Gil, Ana Martín-Díaz, Natalia Navarrete, José Aranguren, P. S. Ortolani-Seltenerich, Giulia Malvicini, Gaya C. S. Vieira and Alejandro R. Pérez

Dent. J. 2025, 13(4), 175; https://doi.org/10.3390/dj13040175 - 19 Apr 2025

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Abstract

Objective: This study investigated the shaping efficiency of four reciprocating systems—WaveOne Gold, Reciproc Blue, Excalibur, and One Reci—in three dimensional (3D) resin models of natural mandibular premolar teeth with two canals. Methods: Forty 3D-printed mandibular premolars (Vertucci configuration type V) were divided into [...] Read more.

Objective: This study investigated the shaping efficiency of four reciprocating systems—WaveOne Gold, Reciproc Blue, Excalibur, and One Reci—in three dimensional (3D) resin models of natural mandibular premolar teeth with two canals. Methods: Forty 3D-printed mandibular premolars (Vertucci configuration type V) were divided into four groups, each of which was assigned one of the reciprocating systems. According to the manufacturer’s protocols, each canal was prepared, with pre- and post-instrumentation micro computed tomography (micro-CT) scans evaluating canal volume, surface area, percentage of unprepared canal walls, and resin reduction in the pericervical area. Instrumentation time and screw-in sensation were recorded as qualitative performance indicators. Statistical analysis was performed using one-way ANOVA and chi-square tests with a significance of (p < 0.05). Results: All systems increased canal volume and surface area, primarily in the apical third, with Reciproc Blue and One Reci achieving the largest volume. WaveOne Gold had the highest percentage of unprepared walls (27.03%) and Reciproc Blue the lowest (19.65%), though these differences were not statistically significant (p > 0.05). Reciproc Blue caused the highest pericervical resin loss (22.24%), significantly higher than Excalibur (15.09%) and One Reci (15.17%) (p = 0.035). Reciproc Blue exhibited the highest incidence of screw-in sensation (70%), while WaveOne Gold achieved the shortest instrumentation time (86.7 s), although neither variable showed statistical significance. Conclusions: All systems effectively shaped complex canal anatomies, with Reciproc Blue demonstrating the highest dentin removal and WaveOne Gold proving the most time efficient. Clinically, these findings suggest that instrument selection should balance shaping efficiency with dentin preservation. Minimizing unprepared areas and preserving pericervical dentin are essential for enhancing disinfection and reducing the risk of root fractures, ultimately contributing to the long-term success of endodontic treatment. Full article

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

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10 pages, 841 KiB

Open AccessArticle

Assessing Discrimination and Acceptance for Lightness and Chroma During Shade Selection: A Comparison of Dental and Non-Dental Professionals

by Haruna Konishi, Yuichi Ishida, Takaharu Goto and Tetsuo Ichikawa

Dent. J. 2025, 13(4), 163; https://doi.org/10.3390/dj13040163 - 11 Apr 2025

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Abstract

Background/Objectives: Tooth color is key in determining aesthetic appearance during restorative and prosthodontic treatments. To establish a more reliable methodology for shade selection, this study investigated differences in the discrimination and acceptance of tooth color between dental and non-dental professionals, focusing on [...] Read more.

Background/Objectives: Tooth color is key in determining aesthetic appearance during restorative and prosthodontic treatments. To establish a more reliable methodology for shade selection, this study investigated differences in the discrimination and acceptance of tooth color between dental and non-dental professionals, focusing on color attributes such as lightness and chroma. Methods: This study included 30 dentists, 30 dental technicians, 30 patients, and 30 dental students. They were asked to compare pairs of shade tabs with different lightness and chroma from the VITA Toothguide 3D-MASTER^® (VITA Zahnfabrik, Bad Säckingen, Germany). The number of answers in which participants could discriminate color differences (discrimination numbers) and answers in which they could not accept color differences (non-acceptance numbers) were recorded. Statistical analysis was performed using Spearman’s rank correlation coefficient, the Mann–Whitney U test, the Kruskal–Wallis test, and multiple regression analysis (p < 0.05). Results: Significant factors influencing lightness discrimination were participant group and age, while those influencing acceptance were subject group and sex. Conclusions: This study revealed differences in the discrimination and acceptance of lightness and chroma between dental and non-dental professionals, particularly concerning lightness. Dental technicians exhibited a higher discrimination ability and stricter acceptance of lightness and chroma, regardless of age. Based on an understanding of these characteristics, appropriate shade selection and adequate communication will be important. Full article

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

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16 pages, 3242 KiB

Open AccessArticle

Characterization of Fibronectin-Adherent, Non-Fibronectin-Adherent, and Explant-Derived Human Dental Pulp Stem Cell Populations

by Heoijin Kim, Shelley J. Williams and John S. Colombo

Dent. J. 2025, 13(4), 159; https://doi.org/10.3390/dj13040159 - 2 Apr 2025

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Abstract

Background/Objectives: Dental pulp stem cells (DPSCs) are of significant interest due to their mesenchymal lineage and relative availability from extracted teeth. This study aims to examine the relationship between fibronectin-adherent, non-fibronectin-adherent, and explant-derived DPSC populations in terms of the population doubling rate in [...] Read more.

Background/Objectives: Dental pulp stem cells (DPSCs) are of significant interest due to their mesenchymal lineage and relative availability from extracted teeth. This study aims to examine the relationship between fibronectin-adherent, non-fibronectin-adherent, and explant-derived DPSC populations in terms of the population doubling rate in culture and the expression of mesenchymal cell surface markers and their capacity for osteodifferentiation. Methods: Human pulp tissue was removed from healthy extracted human teeth, enzymatically digested prior to seeding onto fibronectin-coated plates, and left to adhere for 20 min, yielding a fibronectin-adherent population. The remaining non-adherent cells were transferred and designated ‘non-fibronectin-adherent.’ Intact pulp was placed on uncoated plastic for 5 days, with the migrated cells designated ‘explant-derived’. DPSCs from these populations were examined in terms of population doubling rates, the expression of CD90, CD44, CD105, and CD73, and the expression of RUNX2, SPP1, and BGLAP after 7 days in osteoinductive media. Results: The fibronectin-adherent cells had the greatest population doubling over time. All populations demonstrated comparable percentages of cells positive for mesenchymal markers, though individual marker expression varied slightly. The explant-derived cells showed increased expression of RUNX2 after 7 days in osteoinductive media, while the treated single-cell-suspension-derived populations showed increased expression of SPP1 mRNA. Conclusions: Fibronectin enrichment resulted in a population with the greatest rate of population doubling over extended culture compared to the other two populations. The proportion of cells positive for all four mesenchymal surface markers was the same between populations. The fibronectin-adherent and non-adherent cultures may have responded more rapidly to osteoinductive media than the explant-derived cells. Full article

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

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13 pages, 1431 KiB

Open AccessArticle

Prevalence and Morphology of C-Shaped Canals in Mandibular Second Molars: A Cross-Sectional Cone Beam Computed Tomography Study in an Ecuadorian Population

by Josué Fernández Laplace, Jenny Guerrero Ferreccio, Giulia Malvicini, Catalina Mendez de la Espriella and Alejandro R. Pérez

Dent. J. 2025, 13(4), 147; https://doi.org/10.3390/dj13040147 - 28 Mar 2025

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Abstract

Background/Objectives: C-shaped canals represent a challenge in endodontic procedures. The present study aimed to investigate the prevalence and characteristics of C-shaped canals in mandibular second molars in Guayaquil, Ecuador. Methods: CBCT records from two radiology centers were examined (2020–2022). A total [...] Read more.

Background/Objectives: C-shaped canals represent a challenge in endodontic procedures. The present study aimed to investigate the prevalence and characteristics of C-shaped canals in mandibular second molars in Guayaquil, Ecuador. Methods: CBCT records from two radiology centers were examined (2020–2022). A total of 400 CBCT scans (800 mandibular second molars) were analyzed using Fan’s classification. Data on the presence or absence of C-shaped canals, gender, and bilateral occurrence were collected. Statistical analysis included the test for differences in proportions and the chi-squared test to assess the significance of correlations between variables. Results: C-shaped canals were found in 28% of mandibular second molars, affecting 33.75% of the patient sample. The prevalence was significantly higher in females (42.9%) compared to males (20.4%). Bilateral occurrences were observed in 63% of affected patients. Morphologic variability was pronounced, with Fan C1 and C4 dominating in the coronal and apical thirds, respectively, while a shift toward Fan C2 and C3 was observed in the middle third. Only 19.2% of the teeth maintained a consistent morphology. Conclusions: C-shaped canals were found in 28% of mandibular second molars and occurred predominantly in females. Notably, most cases were bilateral, highlighting the importance of effectively adapting endodontic techniques to treat this unique anatomical variation. Further research into genetic and environmental influences could deepen our understanding and help develop refined diagnostic and therapeutic strategies. Full article

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

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15 pages, 2196 KiB

Open AccessArticle

Phenotypic Craniofacial and Upper Spine Characteristics in Patients with Obstructive Sleep Apnoea

by Anne Marie Aavang Arvidson and Liselotte Sonnesen

Dent. J. 2025, 13(3), 136; https://doi.org/10.3390/dj13030136 - 20 Mar 2025

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Abstract

Background/Objectives: This study investigates differences in craniofacial morphology including skull thickness, sella turcica morphology, nasal bone length, and posterior cranial fossa dimensions, as well as differences in head posture and deviations in upper spine morphology, in adult OSA patients compared to healthy [...] Read more.

Background/Objectives: This study investigates differences in craniofacial morphology including skull thickness, sella turcica morphology, nasal bone length, and posterior cranial fossa dimensions, as well as differences in head posture and deviations in upper spine morphology, in adult OSA patients compared to healthy controls with neutral occlusion. Methods: 51 OSA patients (34 men, 17 women, mean age 51.9 ± 11.3 years) and 74 healthy controls (19 men, 55 women, mean age 38.7 years ± 14.0 years) with neutral occlusion were included. Craniofacial morphology and head posture were investigated using cephalometric measurements on lateral cephalograms and morphological deviations in sella turcica and upper spine were assessed through visual description of lateral cephalograms. Results: OSA patients had significantly more retrognathic maxilla (p = 0.02) and mandible (p = 0.032 and p = 0.009), significantly larger beta-angle (p = 0.006), and significantly smaller jaw angle (p = 0.045) compared to controls. OSA patients had significantly larger length (p = 0.003, p = 0.001, p = 0.044) and depth of the posterior cranial fossa (p < 0.001) compared to controls. OSA patients had a significantly more extended (p < 0.001) and forward-inclined head posture (p < 0.001) and morphological deviations in the upper spine occurred significantly more often in OSA patients compared to controls (p = 0.05). No significant differences in skull thickness, nasal bone length, and morphological deviations in the sella turcica (p = 0.235) were found between the groups. Conclusions: Significant deviations were found in craniofacial morphology, head posture, and morphological deviations in the upper spine. The results may prove valuable in the diagnostics of OSA patients and in considerations regarding etiology and the phenotypic differentiation of OSA patients. Full article

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

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10 pages, 240 KiB

Open AccessArticle

Impact of High-Intensity Sports Practice on Stomatognathic System Function: An Observational Study

by Evandro Marianetti Fioco, Marcelo Palinkas, Natália de Moraes Barbosa, Edson Donizetti Verri, Luciano Maia Alves Ferreira, Danilo Henrique Lattaro, Gabriella Simi Gariba Silva, Selma Siéssere and Simone Cecilio Hallak Regalo

Dent. J. 2025, 13(3), 126; https://doi.org/10.3390/dj13030126 - 13 Mar 2025

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Abstract

Background: Physical activity improves quality of life, but competitive sports emphasize performance, leading to intense training and restrictive diets that increase injury risk. This affects the stomatognathic system, underscoring the role of sports dentistry in preventing injuries and orofacial functional changes. This observational [...] Read more.

Background: Physical activity improves quality of life, but competitive sports emphasize performance, leading to intense training and restrictive diets that increase injury risk. This affects the stomatognathic system, underscoring the role of sports dentistry in preventing injuries and orofacial functional changes. This observational study analyzed the stomatognathic system’s functionality in male high-intensity athletes (n = 18) compared to a sedentary group (n = 18). Methods: Functional parameters were analyzed: electromyographic activity during mandibular tasks, masseter and temporal muscles thickness, and molar bite force. Results: Student’s t-test was used for analysis. At mandibular rest, male high-performance athletes showed lower electromyographic activity in the right and left masseter muscles, suggesting adaptation to training. During maximum voluntary contraction, activity was higher in the temporal and masseter muscles, especially in the left masseter, indicating hypertrophy. Electromyographic activity increased during protrusion and lateral movements, particularly in the masseter and temporal muscles, demonstrating a greater functional efficiency group of athletes. They also exhibited greater masseter muscle thickness and thinner temporal muscle thickness, with a significant difference in the right masseter muscle at rest. The group of athletes showed greater molar bite force, with significant differences, indicating greater muscle capacity. Conclusions: Sports practice promotes adaptations in the stomatognathic system, improving its functionality. Full article

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

11 pages, 236 KiB

Open AccessArticle

Oral Hygiene Management of Hematologic Patients Undergoing Auto-Transplantation: An Observational Study

by Marco Miceli, Elisabetta Carli, Enrico Orciolo, Maria Rita Giuca and Rossana Izzetti

Dent. J. 2025, 13(3), 115; https://doi.org/10.3390/dj13030115 - 5 Mar 2025

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Abstract

Background/Objectives: The present study evaluated the effectiveness of a prevention protocol involving oral hygiene, instructions, and motivation in patients eligible for hematopoietic stem cell transplantation (HSCT). Methods: Consecutive patients scheduled for HSCT were enrolled. All patients received a complete dental examination aimed at [...] Read more.

Background/Objectives: The present study evaluated the effectiveness of a prevention protocol involving oral hygiene, instructions, and motivation in patients eligible for hematopoietic stem cell transplantation (HSCT). Methods: Consecutive patients scheduled for HSCT were enrolled. All patients received a complete dental examination aimed at assessing periodontal health status through periodontal charting and registration of the levels of plaque and inflammation. Subsequently, patients received professional oral hygiene care and were instructed on and motivated toward oral prophylaxis prior to HSCT. Upon engraftment, patients received dedicated instructions to improve oral hygiene maneuvers. After HSCT, patients were re-evaluated for periodontal clinical parameters. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was also administered to evaluate perceived oral health status. Results: Thirty-five patients (18 males and 17 females, with a mean age of 43.28 ± 11.73 years) were enrolled. An overall improvement was noted in periodontal parameters. However, despite plaque reduction, inflammation was still present because of the treatment. The OHIP-14 score slightly worsened after HSCT. Conclusions: Professional oral hygiene and prophylaxis proved effective in improving the oral health status of patients undergoing HSCT, potentially impacting post-treatment outcomes. Further assessment is needed to validate these results. Full article

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

12 pages, 1451 KiB

Open AccessArticle

Does the Phase-One Functional Therapy Increase the Risk of an External Apical Root Resorption Following the Phase-Two Fixed Orthodontic Treatment? A Pilot Study

by Sara Eslami, Jakob Stuhlfelder, Suh-In Rhie, Sarah Bühling, Mauricio Gonzalez Balut, Ludovica Nucci, Abdolreza Jamilian and Babak Sayahpour

Dent. J. 2025, 13(3), 95; https://doi.org/10.3390/dj13030095 - 24 Feb 2025

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Abstract

Background: This retrospective study aimed to analyze the frequency and extent of apical root resorptions (EARR) during orthodontic treatment in the upper and lower incisors, as well as lower molars, using orthopantomograms (OPG). Potential influencing factors such as age, gender, root shape, [...] Read more.

Background: This retrospective study aimed to analyze the frequency and extent of apical root resorptions (EARR) during orthodontic treatment in the upper and lower incisors, as well as lower molars, using orthopantomograms (OPG). Potential influencing factors such as age, gender, root shape, type of orthodontic appliance, and treatment duration were examined as well. Methods: A total of 57 patients who completed their treatment at the orthodontic department of the Goethe University of Frankfurt between 2011 and 2018 were included in the study. These patients had a combined total of 570 teeth, which were divided into two groups. Group 1 consisted of 20 patients (average age at T0: 10.1 ± 1.2 years old) received a one-phase fixed orthodontic treatment using passive self-ligating Damon bracket system (average duration of 2.1 years ± 6 months), while group 2 consisted of 37 patients (average age at T0: 12.4 ± 2.8 years old) underwent a two-phase therapy, which involved a phase-one functional therapy (average duration of 1.7 years ± 6 months) prior to the phase-two fixed orthodontic treatment with the Damon system (average duration of 1.5 ± 4 months) with a total treatment time of 3.2 years ± 7 months. To determine the extent of post-treatment root resorption of the upper and lower incisors, as well as the first lower molars, crown–root ratio was calculated for each tooth using the pre- and post-treatment OPGs. Additionally, each tooth was assigned a degree of resorption according to the Levander and Malmgren classification. The inter-group comparisons were conducted using the Wilcoxon Mann–Whitney U test. Spearman’s correlation analysis was used to assess the relationship between age, treatment duration, and EARR. The association between gender, root morphology, and EARR was evaluated using the Wilcoxon Mann–Whitney U test. For nominally scaled variables, the Chi-square test was used. The statistical significance was set at p < 0.05. Results: No statistically significant differences were seen between groups 1 and 2 regarding the degree of root resorption (p = 0.89). The study found that the average root resorption for all examined teeth was −5.14%, indicating a slight reduction in the length of the tooth roots after orthodontic treatment. However, no significant differences were observed concerning gender, age, type of orthodontic appliance or treatment duration. Comparisons between upper and lower jaws also did not yield statistically significant differences. The majority of teeth in the study exhibited a normal root shape. The short root length and a pipette formed roots were significantly associated with a higher risk of root resorption (p = 0.001). Conclusions: The study’s findings suggest that the two-phase orthodontic treatment does not increase the risk of EARR compared to one-phase therapy significantly. Some degree of root resorption occurred as a result of orthodontic treatment in both groups. Notably, abnormal root forms were identified as influential factors that could help predict the likelihood of root resorption following orthodontic treatment. Full article

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

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17 pages, 2231 KiB

Open AccessArticle

Bone Remodeling Around Implants with Different Macro-Design Placed in Post-Extraction Sockets: A Cone-Beam Computed Tomography (CBCT) Randomized Controlled Clinical Trial (RCT)

by Roberta Grassi, Fábio França Vieira e Silva, Gennaro Musella, Francesco Pettini, Gisela Cristina Vianna Camolesi, Martina Coppini and Stefania Cantore

Dent. J. 2025, 13(2), 78; https://doi.org/10.3390/dj13020078 - 11 Feb 2025

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Abstract

Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two [...] Read more.

Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two implant designs, System 2P and Dura-Vit 3P, which feature semi-conical microgeometry and apical self-tapping portions for improved stability and bone regeneration. Methods: With a 1:1 allocation ratio, the current investigation was a two-arm parallel group randomized clinical trial. Patients qualified if they required immediate dental replacements with adequate buccal bone support. Two types of implants were placed: System 2P (cylindrical shape) and Dura-Vit 3P (more conical shape, with a particular architecture of threads). Following the intervention, CBCT was performed both immediately (T1) and six months later (T2). Measurements of CBCT horizontal bone level at apical, medial, and bevel height on the palatal/lingual and vestibular sides as well as the buccal vertical gap were the primary results. Complications, implant stability quotient (ISQ), and torque insertion were evaluated. The Mann–Whitney test was used to determine time-based differences within each group, while the Wilcoxon test was used to estimate differences between groups. The impact of baseline marginal gap dimension and gingival biotype was estimated using multiple regressions. Results: Thirty patients were recruited and randomized to treatments, with two lost to follow-up. One System 2P implant failed and two patients of the Dura-Vit 3P group dropped out. At T1, the Dura-Vit 3P group exhibited a lower mean insertion torque and a higher ISQ than the System 2P group. Furthermore, the Dura-Vit 3P group showed lower bone reduction compared to System 2P at horizontal and vertical measurements with significant differences for the vestibular and palatal base and medial level (p-values < 0.05). Regression models indicated a positive effect of thick biotypes on gap filling and dimensional bone reduction. No complications were observed in both groups. Conclusions: The Dura-Vit 3P implant exhibits high primary stability when inserted in post-extraction sites. Furthermore, this kind of implant stimulates higher bone stability on both the palatal and buccal side when compared to the System 2P implant. The present findings support the evidence that the macro-design of the Dura-Vit 3P implant promotes increased primary stability and reduces bone loss. Full article

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

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13 pages, 6436 KiB

Open AccessArticle

Topical Oxygenation Improves Microvascularity in a Human Ex Vivo Palatal Tissue Model: A Histological Analysis

by Andrea Pilloni, Cira Rosaria Tiziana Di Gioia, Raffaella Carletti, Gerarda D’Elia, Michaela Di Mario, Angela Molendini, Umberto Romeo and Lorenzo Marini

Dent. J. 2025, 13(2), 77; https://doi.org/10.3390/dj13020077 - 10 Feb 2025

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Abstract

Background: Several therapies involving the use of oxygen have been developed; however, the literature to date has poorly addressed the effects of Topical Oxygen Therapy (TOT) on oral tissues. The aim of the present pilot study was to histologically evaluate the response to [...] Read more.

Background: Several therapies involving the use of oxygen have been developed; however, the literature to date has poorly addressed the effects of Topical Oxygen Therapy (TOT) on oral tissues. The aim of the present pilot study was to histologically evaluate the response to TOT in epithelial–connective samples harvested from the palate. Methods: In eight patients selected for a free gingival graft (FGG) procedure, the lateral portions of the graft were randomly assigned to receive TOT (test) or no treatment (control). Both the portions were stained with hematoxylin–eosin for the evaluation of histomorphological changes and with Picrosirius for the study of collagen. Immunohistochemical staining was performed with antibodies for the characterization of the inflammatory infiltrate and neoangiogenesis. Results: The analysis failed to show morphological variations in both groups, demonstrating that there was no tissue damage due to TOT. The prevalence of type I collagen in both samples supported this finding. Immune cells were present in low levels and mainly consisted of CD3+ T lymphocytes. The histomorphometric analysis showed an increased average vessel area (7607.95 μm² ± 3983.24 vs. 4038.42 μm² ± 1823.52), an increased number and caliber of vessels (49.82 ± 20.55 vs. 32.35 ± 16.64), and a higher microvessel density (7.89 ± 3.25 vessels/0.26 mm² vs. 5.13 ± 2.63 vessels/0.26 mm²) in the test group. Conclusions: Although further investigations are needed, TOT could improve and speed up oral wound healing through the local condition of hyperoxia. Full article

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

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25 pages, 5099 KiB

Open AccessArticle

Pathophysiological Responses of Oral Keratinocytes After Exposure to Flavored E-Cigarette Liquids

by Abrar Shamim, Hannah Herzog, Raivat Shah, Sara Pecorelli, Virginia Nisbet, Ann George, Giancarlo A. Cuadra and Dominic L. Palazzolo

Dent. J. 2025, 13(2), 60; https://doi.org/10.3390/dj13020060 - 29 Jan 2025

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Abstract

Background: Electronic cigarettes (ECIGs) have grown in popularity, particularly among adolescents and young adults. Flavored ECIG-liquids (E-liquids) are aerosolized by these ECIGs and inhaled into the respiratory system. Several studies have shown detrimental effects of E-liquids in airway tissues, revealing that flavoring agents [...] Read more.

Background: Electronic cigarettes (ECIGs) have grown in popularity, particularly among adolescents and young adults. Flavored ECIG-liquids (E-liquids) are aerosolized by these ECIGs and inhaled into the respiratory system. Several studies have shown detrimental effects of E-liquids in airway tissues, revealing that flavoring agents may be the most irritating component. However, research on the effects of E-liquids on biological processes of the oral cavity, which is the first site of aerosol contact, is limited. Hence, this study focuses on the effects of E-liquid flavors on oral epithelial cells using the OKF6/TERT-2 cell line model. Methodology: E-liquid was prepared with and without flavors (tobacco, menthol, cinnamon, and strawberry). OKF6/TERT-2 oral epithelial cells, cultured at 37 °C and 5% CO₂, were exposed to 1% E-liquid ± flavors for 24 h. Outcomes determined include cell morphology, media pH, wound healing capability, oxidative stress, expression of mucin and tight junction genes, glycoprotein release, and levels of inflammatory cytokines (TNFα, IL-6, and IL-8). Results: Exposure to 1% flavored E-liquids negatively affect cellular confluency, adherence, and morphology. E-liquids ± flavors, particularly cinnamon, increase oxidative stress and production of IL-8, curtail wound healing recovery, and decrease glycoprotein release. Gene expression of muc5b is downregulated after exposure to E-liquids. In contrast, E-liquids upregulate occludin and claudin-1. Conclusions: This study suggests that ECIG use is not without risk. Flavored E-liquids, particularly cinnamon, result in pathophysiological responses of OKF6/TERT-2 cells. The dysregulation of inflammatory responses and cellular biology induced by E-liquids may contribute to various oral pathologies. Full article

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

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11 pages, 1719 KiB

Open AccessArticle

The Protective Effects of Silver Fluoride Solution and Fluoride Varnish on Dental Erosion—An In Vivo Study

by Julie Marie Haabeth Brox, Amela Tulek, Amer Sehic, Aida Mulic, Tor Paaske Utheim and Qalbi Khan

Dent. J. 2025, 13(2), 46; https://doi.org/10.3390/dj13020046 - 22 Jan 2025

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Abstract

Objectives: Dental erosion has evolved into a common condition with growing concern in the dental community. The aim of this study was to explore the protective effects of two highly fluoridated products, silver fluoride solution (silver diamine fluoride-potassium iodide solution, SDF-KI) and fluoride [...] Read more.

Objectives: Dental erosion has evolved into a common condition with growing concern in the dental community. The aim of this study was to explore the protective effects of two highly fluoridated products, silver fluoride solution (silver diamine fluoride-potassium iodide solution, SDF-KI) and fluoride varnish, on dental erosion in mouse. Methods: Two groups of ten young CD-1 mouse were given a cola drink ad libitum over a 6-week period. A prophylactic treatment with a silver fluoride solution (38% SDF 48,000 ppm F with a silver concentration of 253,900 ppm) and a fluoride varnish (NaF, 22,600 ppm F) were applied on the mandibular molars, performed under sedation twice a week during the whole experiment. Furthermore, two control groups of ten mice were included, a positive (cola drink) and a negative (distilled water) control. A terminal procedure was followed by dissection of mandibular molars and analysis of them using scanning electron microscopy (SEM). The first molars were transversely ground, further analyzed by SEM, and measured for tooth height and tooth tissue loss. Results: Analyses of mandibular molars treated with a fluoride varnish indicated a 5% decreased tooth tissue loss, compared to the molars which served as a positive control. The best effect was achieved with the application of silver fluoride solution, displaying a 35% decreased tooth tissue loss compared to the positive control group. Conclusions: Preventive treatment with a solution of silver fluoride solution exhibits greater protection against dental erosion compared to a traditional fluoride varnish. This study indicates that silver fluoride solution is an effective fluoride compound and is highly beneficial in a clinical setting with the aim of preventing dental erosion. Full article

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

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10 pages, 943 KiB

Open AccessArticle

Exploring the Association Between Third Molar Agenesis and Carabelli Traits: A Cross-Sectional Study

by Isabela Ribeiro Madalena, Heloisa Guimarães Resende, Ariane Beatriz Blancato, Maria Angélica Hueb de Menezes-Oliveira, Flares Baratto-Filho, Poliana Ferreira Santos, Camila Paiva Perin, Thais Vilalba Paniagua Machado do Nascimento, Peter Proff, Christian Kirschneck, César Penazzo Lepri and Erika Calvano Küchler

Dent. J. 2025, 13(1), 23; https://doi.org/10.3390/dj13010023 - 6 Jan 2025

Viewed by 717

Abstract

Background/Objectives: Dental agenesis is the congenital absence of at least one tooth and has been associated with several other developmental dental conditions, such as morphological dental alterations and Carabelli trait. This study sought to investigate whether third molar agenesis is associated with Carabelli [...] Read more.

Background/Objectives: Dental agenesis is the congenital absence of at least one tooth and has been associated with several other developmental dental conditions, such as morphological dental alterations and Carabelli trait. This study sought to investigate whether third molar agenesis is associated with Carabelli traits in permanent molars. Methods: This was a cross-sectional study that used a convenience sample obtained from the orthodontic records of German patients. Patients with syndromes, oral clefts, congenital alterations including dental agenesis (except agenesis of third molars), and severe cases of bruxism with a loss of tooth tissue were excluded. Teeth with cavitated lesions of dental caries, occlusal wear, restorations, and evident dental deformities were not included in the evaluation. The Carabelli trait was evaluated in the permanent maxillary molars. The Carabelli trait was classified according to its expression for each tooth as either absent, negative, and positive expressions. Third molar agenesis was evaluated only in patients older than 10 years old (based on when initial tooth formation should be visible in the panoramic radiographs). The two-sided Chi-squared test was used to investigate the association between the conditions, using an alpha of 5% (p < 0.05). Results: A total of 155 patients (74 females and 81 males) were investigated; 39 had third molar agenesis and 75 had the Carabelli trait. There was no statistical significance difference between patients with third molar agenesis and those with Carabelli traits in relation to sex (p > 0.05). The Carabelli trait was more common in first molars than in second molars. There was no statistical significant association between third molar agenesis and Carabelli traits (p > 0.05). Conclusions: Third molar agenesis was not associated with the Carabelli trait in the permanent molars in this population. Full article

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

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12 pages, 1508 KiB

Open AccessArticle

Assessment of Exercise-Induced Dehydration Status Based on Oral Mucosal Moisture in a Field Survey

by Gen Tanabe, Tetsuya Hasunuma, Yasuo Takeuchi, Hiroshi Churei, Kairi Hayashi, Kaito Togawa, Naoki Moriya and Toshiaki Ueno

Dent. J. 2025, 13(1), 5; https://doi.org/10.3390/dj13010005 - 25 Dec 2024

Viewed by 793

Abstract

Background/Objective: Conventional techniques for evaluating hydration status include the analysis of blood, urine, and body weight. Recently, advancements in dentistry have introduced capacitance sensor-based oral epithelial moisture meters as promising avenues for assessment. This study aimed to examine the correlation between oral mucosal [...] Read more.

Background/Objective: Conventional techniques for evaluating hydration status include the analysis of blood, urine, and body weight. Recently, advancements in dentistry have introduced capacitance sensor-based oral epithelial moisture meters as promising avenues for assessment. This study aimed to examine the correlation between oral mucosal moisture content, as determined using a capacitance sensor, and exercise-induced dehydration. Methods: A total of 21 participants engaged in a 120 min slow distance exercise session. A series of measurements were taken before and after the exercise session, including body weight, sweat rate, secretory immunoglobulin A (s-IgA) concentration in saliva samples, saliva flow rate, and oral mucosal moisture content, which were assessed using a capacitance sensor. The relationship between physical dehydration and oral mucosal moisture content was investigated using statistical analysis. Receiver operating characteristic curves were constructed to ascertain whether variations in oral mucosal moisture content could discern body mass losses (BMLs) of 1.5% and 2%. Results: A significant correlation was observed between the sweat rate during exercise and the change in oral mucosal moisture content before and after exercise (Spearman’s rank correlation coefficient: ρ = −0.58, p < 0.001). The salivary flow and s-IgA secretion rates were lower after the exercise period than before, whereas the s-IgA concentration was higher. Oral mucosal moisture decreased during the exercise period. Receiver operating characteristic curve analysis revealed that differences in oral mucosal moisture content exhibited discriminative capabilities, with area under the curve values of 0.79 at 1.5% BML and 0.72 at 2% BML. Conclusions: The measurement of oral mucosal moisture using capacitance sensors represents a promising noninvasive approach for the assessment of exercise-induced dehydration. Full article

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

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Review

Jump to: Research, Other

18 pages, 574 KiB

Open AccessReview

Prevention of White Spot Lesions Induced by Fixed Orthodontic Therapy: A Literature Review

by Francesco Saverio Ludovichetti, Edoardo Stellini, Andrea Zuccon, Patrizia Lucchi, Niccolò Dessupoiu, Sergio Mazzoleni and Roberta Gaia Parcianello

Dent. J. 2025, 13(3), 103; https://doi.org/10.3390/dj13030103 - 27 Feb 2025

Viewed by 865

Abstract

Objectives: This study aims to review the scientific literature on the prevention of white spot lesions (WSLs) associated with fixed orthodontic treatment. WSLs result from enamel demineralization and pose aesthetic and functional challenges. The study evaluates the effectiveness of various preventive interventions [...] Read more.

Objectives: This study aims to review the scientific literature on the prevention of white spot lesions (WSLs) associated with fixed orthodontic treatment. WSLs result from enamel demineralization and pose aesthetic and functional challenges. The study evaluates the effectiveness of various preventive interventions to reduce the risk of WSLs during orthodontic care. Methods: A comprehensive literature search was conducted using MeSH terms such as “white spot”, “fixed orthodontic treatment”, “CPP-ACP”, “topical fluoride”, and “demineralized lesion”, combined with the Boolean operator ‘AND’. Databases searched included PubMed, EMBASE, Scopus, and OpenGrey, focusing on studies published between January 2014 and September 2024. The inclusion criteria required studies to evaluate interventions aimed at reducing WSL risk in patients undergoing fixed orthodontic treatment. A total of 41 articles were screened, with 17 selected based on relevance and methodological rigor. Results: The review identified several effective strategies for preventing WSLs. Topical fluoride applications, particularly high-concentration varnishes, significantly reduced WSL prevalence, with some studies favoring fluoride varnish over other interventions. CPP-ACP and CPP-ACPF formulations demonstrated potential for remineralizing demineralized enamel, especially when combined with fluoride toothpaste. High-fluoride toothpaste and acidulated phosphate fluoride mouthwash were effective in reducing lesion incidence, emphasizing the importance of patient compliance in daily oral hygiene routines. Professional interventions, such as fluoride varnish applications, showed enhanced outcomes when re-applied periodically. Conclusions: Preventing WSLs during orthodontic treatment is crucial for ensuring the aesthetic and functional success of therapy. Strategies combining fluoride-based interventions with casein phosphopeptide formulations offer significant benefits. However, patient education and adherence to recommended oral hygiene practices remain critical. Further research is needed to compare the long-term effectiveness of these interventions and to explore new technologies for WSL prevention. Full article

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

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13 pages, 611 KiB

Open AccessReview

Permanent Maxillary Lateral Incisors’ Agenesis Managed by Mini-Screw Implant-Supported Pontics: A Scoping Review

by Elena Caramaschi, Elisabetta Lalli, Valentino Garau, Alessio Verdecchia and Enrico Spinas

Dent. J. 2025, 13(3), 96; https://doi.org/10.3390/dj13030096 - 24 Feb 2025

Cited by 1 | Viewed by 320

Abstract

Background/Objectives: The Agenesis of maxillary lateral incisors occurs with a variable prevalence in different ethnic groups, and there is a need for a temporary replacement until maturity has been reached in patients for whom the replacement solution has been chosen. This study aims [...] Read more.

Background/Objectives: The Agenesis of maxillary lateral incisors occurs with a variable prevalence in different ethnic groups, and there is a need for a temporary replacement until maturity has been reached in patients for whom the replacement solution has been chosen. This study aims to analyze the scientific evidence available to date concerning the use of mini-screw implant (MSI)-supported pontics for the transitional management of permanent maxillary lateral incisors’ agenesis in developmental age subjects. Methods: Electronic research was conducted using four databases: PubMed, Clarivate Analytics/Web of Science Core Collection, Scopus, and the Wiley/Cochrane Library. Six studies were included in the final review. Data were extracted based on the first and second author, year of publication, study design, sample characteristics, mini-screw implant (MSI) characteristics, MSI insertion and loading protocol, characteristics of the prosthetic component, and outcomes during the follow-up time. Results: Clinical outcomes were proven positive in all studies. In only one study did MSIs show mobility and consequent failure after one month. Discoloration of the prosthetic part proved to be the main complication. Conclusions: The comparison with conventional removable prostheses and fixed dental prostheses revealed that MSI-supported pontics are a viable alternative and a promising temporary solution until the end of growth. Further studies to standardize protocols and assess long-term outcomes are needed. Full article

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

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16 pages, 2178 KiB

Open AccessReview

Revolutionizing Dentistry: Preclinical Insights and Future Applications of mRNA Vaccines in Dentistry—A Narrative Review

by Luciana Koren, Andro Koren, Robert Likić and Tomislav Katanec

Dent. J. 2025, 13(2), 79; https://doi.org/10.3390/dj13020079 - 13 Feb 2025

Cited by 1 | Viewed by 1355

Abstract

Background: Recent advances in mRNA vaccine technology, accelerated by the global COVID-19 pandemic, have generated significant interest in their applications beyond infectious diseases. Dentistry has emerged as a promising field for exploring the potential of mRNA-based therapies in preventing and treating oral diseases. [...] Read more.

Background: Recent advances in mRNA vaccine technology, accelerated by the global COVID-19 pandemic, have generated significant interest in their applications beyond infectious diseases. Dentistry has emerged as a promising field for exploring the potential of mRNA-based therapies in preventing and treating oral diseases. Objectives: This narrative review aims to evaluate the current status of mRNA vaccine development and its preclinical applications in oral health, focusing on periodontal disease, dental caries, regenerative medicine, implantology, and oral cancer. Methods: The review synthesizes findings from preclinical studies, including research conducted in animal models and in vitro, to assess the potential of mRNA-based therapies to modulate immune responses and promote tissue regeneration in the oral cavity. Clinical trials were only mentioned in the context of broader areas of mRNA vaccine implementation such as oncology and immunotherapy. Results: The preclinical studies highlight the capacity of mRNA vaccines to enhance the body’s immune response and facilitate tissue repair processes. Despite these promising results, challenges persist in delivering mRNA vaccines effectively within the complex oral environment. These challenges include vaccine stability, delivery mechanisms, and the modulation of immune responses. Conclusions: While mRNA vaccines offer significant promise for revolutionizing oral health care, they face notable limitations concerning safety, efficacy, and clinical feasibility. Overcoming these obstacles through further research is essential to unlock their full translational potential and ensure their safe and effective integration into dental practice. Full article

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

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Other

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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

Viewed by 132

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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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

Viewed by 114

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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13 pages, 2228 KiB

Open AccessOpinion

Identifying Key Factors in Papilla Growth Around Implants: Focus on Intraoral Negative Pressure

by Daniele Botticelli, Ivo Agabiti, Rihito Yamada, Nozomi Maniwa, Karol Alí Apaza Alccayhuaman and Yasushi Nakajima

Dent. J. 2025, 13(3), 124; https://doi.org/10.3390/dj13030124 - 13 Mar 2025

Viewed by 939

Abstract

The absence of interdental papillae in dental prosthetics often leads to unsatisfactory esthetic outcomes, such as black triangles and elongated clinical crowns. While previous research has demonstrated that papillae can regenerate in a coronal direction, the underlying mechanisms remain incompletely understood. Several theories [...] Read more.

The absence of interdental papillae in dental prosthetics often leads to unsatisfactory esthetic outcomes, such as black triangles and elongated clinical crowns. While previous research has demonstrated that papillae can regenerate in a coronal direction, the underlying mechanisms remain incompletely understood. Several theories have been proposed to explain this phenomenon, but no clear cause–effect relationship has been established among the various factors involved in spontaneous papilla growth around implants. This study aims to identify and classify the factors influencing this process. Various potential contributors were analyzed, including adjacent elements, buccal–lingual papilla width, contact point position, convergent neck design, crown overcontour, intraoral negative pressure, and others. To systematically organize these factors, a modified Overton Window and a mind map were employed. The factors were categorized as cause-related, essential, or influencing based on the collective opinion of the research group following a comprehensive review of the relevant literature. In the absence of clear evidence supporting a definitive cause–effect relationship, Occam’s Razor (the principle of parsimony) was applied to identify the most plausible cause-related factors. Full article

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

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17 pages, 1363 KiB

Open AccessSystematic Review

Antibiotic Prescription for the Prevention of Postoperative Complications After Third-Molar Extractions: A Systematic Review

by Nicola De Angelis, Lorenzo Denegri, Ioana Cristina Miron, Catherine Yumang, Paolo Pesce, Domenico Baldi, Francesca Delucchi, Francesco Bagnasco and Maria Menini

Dent. J. 2025, 13(3), 107; https://doi.org/10.3390/dj13030107 - 28 Feb 2025

Viewed by 803

Abstract

Background: Third-molar extractions are common procedures often complicated by infections and alveolitis. The use of antibiotics as prophylaxis to prevent these complications is debated due to potential risks and side effects. Therefore, the aim of the present systematic review was to determine the [...] Read more.

Background: Third-molar extractions are common procedures often complicated by infections and alveolitis. The use of antibiotics as prophylaxis to prevent these complications is debated due to potential risks and side effects. Therefore, the aim of the present systematic review was to determine the efficacy of antibiotic prescription for the prevention of these complications. Methods: A comprehensive literature search was conducted in MEDLINE/PubMed, Cochrane, and SCOPUS databases up until June 2024. The focused question was “Does the antibiotic prescription influence the incidence of postoperative complications following third-molar extractions in healthy patients?” Systematic reviews assessing complications after third-molar extractions were included. Results: A total of 16 studies were included, revealing that antibiotic use significantly reduces infection risk and dry socket incidence compared to no prescription. Amoxicillin–clavulanic acid was particularly effective. Conclusions: Antibiotics, especially amoxicillin–clavulanic acid, are effective in preventing postoperative infections and alveolitis after third-molar extraction. However, their administration should be carefully considered to balance benefits against potential risks. Evidence supports the judicious use of antibiotics in dental surgery to optimize patient outcomes, minimizing possible adverse effects and the risk of developing antibiotic resistance. Full article

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

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15 pages, 3756 KiB

Open AccessCase Report

Combined Surgical and Orthodontic Treatment of Complex Odontoma in Growing Patients: Presentation of Two Cases

by Natalia Muczkowska, Ewa Czochrowska, Klaudia Masłowska, Andrzej Wojtowicz and Wojciech Popowski

Dent. J. 2025, 13(2), 82; https://doi.org/10.3390/dj13020082 - 14 Feb 2025

Viewed by 713

Abstract

Background/Objectives: Odontomas are the most common mixed odontogenic tumors and may cause impaction of adjacent teeth and masticatory disorders. Treatment of tooth impaction caused by the presence of odontomas is related to their stages of root development and their positions in the alveolar [...] Read more.

Background/Objectives: Odontomas are the most common mixed odontogenic tumors and may cause impaction of adjacent teeth and masticatory disorders. Treatment of tooth impaction caused by the presence of odontomas is related to their stages of root development and their positions in the alveolar bone. The aim of this case report is to present the combined surgical and orthodontic treatment in growing patients with odontomas and to discuss the treatment outcomes. Methods: Two growing patients, an 8-year-old boy and a 17-year-old girl, with large odontomas in the posterior maxillary region of the maxilla were presented. The tumors were found during a radiological examination, and the first molars on the affected sides were impacted due to the presence of odontomas. Results: The treatment plans included the surgical removal of the tumors. In the case of the younger patient, the impacted developing molar erupted spontaneously in the oral cavity one year and two months after surgery. An orthodontic traction of the impacted molar was successfully applied in the older patient. Conclusions: The presence of a large odontoma in the posterior segments may lead to a displacement and impaction of neighboring molars and malformation of their roots. Spontaneous eruption of the affected molar can be expected if the tumor is diagnosed and removed early before its root formation is completed; otherwise, an orthodontic extrusion is needed. Interdisciplinary cooperation is important to diagnose and plan the dental treatment in young patients with odontomas. Full article

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

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18 pages, 1030 KiB

Open AccessSystematic Review

Evaluation of the Efficacy of Corticotomy and Piezocision on Canine Retraction: A Systematic Review

by Erica Lipani, Elisa Pisani, Mariagrazia Verrone, Federica Bitonto, Alessio Verdecchia and Enrico Spinas

Dent. J. 2025, 13(2), 57; https://doi.org/10.3390/dj13020057 - 27 Jan 2025

Viewed by 876

Abstract

Background: In order to reduce the prolonged duration of orthodontic treatment, several surgical techniques have been proposed over the years. Corticotomy and piezocision are the two most widely used techniques, and, given the lack of consensus in the literature, along with the renewed [...] Read more.

Background: In order to reduce the prolonged duration of orthodontic treatment, several surgical techniques have been proposed over the years. Corticotomy and piezocision are the two most widely used techniques, and, given the lack of consensus in the literature, along with the renewed interest in these approaches in recent years, the primary objective of this study is to evaluate their effectiveness in accelerating canine retraction in patients requiring extraction of the upper first premolar and, as a secondary objective, to assess if there is a worsening of periodontal health and how the surgical approach is perceived by the patient. Methods: An electronic search was performed on PubMed, Scopus, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to 30 November 2024. The PRISMA statement was adopted for the realization of the review, and the Cochrane Collaboration’s risk of bias assessment tool (RoB 2) was used to assess the studies’ quality. Results: After full text assessment, fifteen randomized clinical trials (14 split mouth design, 1 single-blind, single-center design) covering 326 patients (mean age 20, 19 years) were included. The data collected reveal that corticotomy accelerates canine retraction by 1.5 to 4 times, while piezocision achieves retraction 1.5 to 2 times faster, making corticotomy the most effective technique. No statistically significant adverse effects on periodontal ligament, molar anchorage loss, or root resorption were observed following the two surgical techniques. In addition, patients reported experiencing mild to moderate pain. Conclusions: Corticotomy and piezocision are effective techniques for accelerating upper canine retraction in extraction cases, significantly reducing the overall duration of orthodontic treatment. Full article

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

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