Oral — Health, Diseases, Therapies, and Technologies

Background: Excessive gingival display is frequently associated with upper lip hypermobility and represents a common aesthetic concern. Several therapeutic approaches have been proposed, including botulinum toxin type A injections, lip repositioning surgery (LRS), and combined techniques; however, no clear consensus exists regarding the most effective and stable treatment option. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) guidelines. A comprehensive search of multiple electronic databases was performed, leading to the inclusion of 17 human studies that met predefined PICOS criteria. The review protocol was registered in PROSPERO (CRD420261281920). Results: Most included studies reported favorable outcomes in terms of reduction in gingival display, improvement in smile aesthetics, and patient satisfaction. No major adverse effects were reported, suggesting acceptable safety profiles for all therapeutic modalities. Outcomes varied depending on the type of intervention, surgical technique, botulinum toxin dosage and injection protocol, and the initial severity of upper lip hypermobility. Conclusions: Both botulinum toxin injections and LRS demonstrated effectiveness in reducing excessive gingival display. Botulinum toxin provided a rapid but temporary improvement, whereas modified LRS showed greater stability over time. Combined approaches appeared to offer the most consistent long-term results by limiting postoperative relapse. Further standardized protocols and long-term clinical studies are needed to confirm these findings and support evidence-based clinical decision-making. Full article

Background: Quality-of-life (QoL) assessment has become an essential component of outcome evaluation in oral and maxillofacial surgery (OMFS), particularly in interventions with functional implications for breathing, sleep, and oro-facial performance. Existing instruments often lack specificity for the postoperative OMFS population. This study aimed to develop and psychometrically validate the OMFS-QoL-18 questionnaire, a condition-oriented patient-reported outcome measure designed for postoperative assessment. Methods: A cross-sectional validation study was conducted on 226 adult patients evaluated 6–12 months after orthognathic or function-oriented OMFS procedures. Internal consistency was assessed using Cronbach’s alpha, and reproducibility using the intraclass correlation coefficient (ICC) based on a two-way random-effects model with absolute agreement. The internal structure of the instrument was explored through an exploratory dimensionality analysis using Principal Component Analysis (PCA), including Kaiser–Meyer–Olkin (KMO) testing and Bartlett’s test of sphericity. Descriptive statistics were calculated for item and domain scores. Results: The OMFS-QoL-18 demonstrated good internal consistency (Cronbach’s α = 0.789; standardized α = 0.783) and satisfactory reproducibility (ICC = 0.81; 95% CI: 0.74–0.87). The exploratory dimensionality analysis suggested a multidimensional structure, with five components explaining 67.1% of the total variance. Item clustering was broadly consistent with the predefined conceptual domains, including respiratory comfort, sleep quality, daytime function, oro-maxillofacial function, and global satisfaction. Given the use of PCA as a component-based method, these findings are interpreted as preliminary evidence of dimensional organization rather than confirmation of latent constructs. Conclusions: The OMFS-QoL-18 demonstrated good internal consistency and preliminary evidence of a coherent factor structure. These findings support its use as a promising condition-specific instrument, pending further validation studies. Further multicenter and longitudinal validation studies are warranted to confirm structural stability and responsiveness over time. Full article

Background/Objectives: The uprighting of mesially tipped mandibular second molars following first molar loss is a complex surgical and orthodontic challenge. Conventional methods often result in reciprocal anchorage loss. Mini-implants (MIs) have emerged as essential temporary anchorage devices (TADs) that provide absolute anchorage and enable more predictable tooth movements. Methods: Numerical simulations were performed to evaluate the forces required for mandibular second molar uprighting under two conditions: first, only with the second molar present, and second, with both the second and the third molars present. Although the periodontal ligament exhibits nonlinear and viscoelastic behavior in vivo, a linear elastic approximation was adopted to allow for a reliable evaluation of comparative stress distribution and initial displacement patterns within the scope of this exploratory biomechanical study. Stress distribution in the roots, periodontal ligament, and alveolar bone was assessed for each scenario. Two three-dimensional (3D) models of the left mandibular segment were created from scans of a human mandible and its teeth. The first model included the canine, the first and second premolars, and the second molar. A second model additionally incorporated the third molar. A retromolar MI was placed in both models. Molar uprighting was simulated using a spring connecting the implant to a button bonded on the mesial surface of the second molar. A force of 200 g was applied because in clinical orthodontic practice, forces that exceed approximately 2 N may cause pain or undesirable tooth mobility. Displacements along the X, Y, and Z axes, as well as regions of peak stress, were analyzed. Results: Model 1 showed maximum displacements at the furcation/mid-root, distal root apex, and distal crown, with von Mises stresses of 0.470 to 0.371 MPa. In Model 2, peak displacements occurred at the mesial root and crown, with stresses of 0.185 and 0.149 MPa, respectively. The magnitude of displacements was in the order of 10⁻⁵ mm. Such values represent initial mechanical responses rather than clinically observable tooth movements. However, the differences between models (e.g., the stress reduction) are expected to be clinically meaningful. Conclusions: Since clinical measurements regarding the stress distribution on teeth and surrounding tissues during orthodontic molar uprighting movements are impossible to perform, the finite element method (FEM) can offer insight into these aspects. The presence of the third molar significantly modulates the biomechanics of second molar uprighting via retromolar MIs. When the third molar is present, the second molar exhibits a reduced tendency for deformation during distalization, although this leads to a slower displacement. This FEM provides biomechanical insights but does not support direct clinical decision-making. The present findings should be viewed as theoretical biomechanical tendencies that require confirmation through clinical, experimental, and longitudinal studies before translation into clinical practice. Full article

Background/Objectives: Burning mouth syndrome (BMS) is a chronic idiopathic orofacial pain disorder characterized by persistent intraoral burning in the absence of detectable mucosal alterations. Diagnosis is challenging due to the lack of specific biomarkers and the need to exclude numerous systemic and local conditions that can mimic oral burning. This literature review aims to summarize current and emerging therapeutic strategies for BMS. Methods: A structured and filtered search of PubMed, Scopus, and Web of Science identified studies evaluating pharmacological, phytotherapeutic, and non-pharmacological interventions. Results: Various antidepressants, anticonvulsants, benzodiazepines, H2 receptor antagonists, and low-dose naltrexone have demonstrated varying degrees of symptom reduction, while alpha lipoic acid (ALA) and phytomedicines such as capsaicin, Hypericum perforatum, Catuama, lycopene, crocin, and melatonin show mixed clinical benefits. Non-pharmacological approaches, including photobiomodulation (PBM), oral cryotherapy, neuromodulation techniques, and cognitive behavioral therapy, also provide meaningful symptom improvement in many patients. Conclusions: Across all modalities, therapeutic responses remain heterogeneous and generally incomplete, underscoring the absence of a universally effective treatment. Current evidence supports an individualized and multidisciplinary approach that integrates pharmacological, psychological, and adjunctive therapies to address the multifactorial nature of BMS. Full article

Objectives: To retrospectively evaluate the survival rate and complications of immediately loaded implant-supported restorations in atrophic mandibles of patients subjected to inferior alveolar nerve relocation for the placement of dental implants. Methods: Consecutively treated patients having a follow-up of four years after loading of implants immediately placed after inferior alveolar nerve repositioning were included. Outcome measures were implant and prothesis survival rates and any type of complications related to the surgery, in particular related to post-operative neurosensory disturbance. Results: Data from 14 consecutive patients rehabilitated with 51 implants were analyzed. All provisional prosthetic restorations could be immediately placed after implant placement, none failed, and no patient dropped out over the four years after definitive loading. Only one implant failed. One day postoperatively, all patients experienced dysesthesia or paresthesia. At two weeks, nine patients had a total neurological recovery and one had partial recovery, while the remaining four patients did not recover. One mandible fractured three weeks after implant placement. At one-year post-loading, one patient was still affected by neurosensory dysfunction and three partially recovered (one of these had it preoperatively). After three years, two patients still presented partial recovery. After four years, no further changes were recorded, and no patients reported total neurosensory dysfunction. The patient with the fractured mandible recovered completely with no neurosensory disturbances. Conclusions: Implant placement in atrophic mandibles following inferior alveolar nerve transposition or lateralization may represent a viable alternative to vertical ridge augmentation, with the added advantage of allowing immediate fixed provisional prothesis. Although severe complications and neurosensory disturbances are not uncommon, all patients experience gradual recovery within one to three years. Full article

Background/Objectives: Superficial oral mucosal (SOM) lesions are prevalent among patients with Sjögren’s disease (SjD) due to mucosal dryness. Given the limited evidence on screening and referral for SOMs, and the presence of relevant information only in dental clinical notes, a natural language processing (NLP) pipeline was developed to screen for SOMs among SjD patients. This retrospective study analyzed dental clinical notes from 180 linked electronic dental and health records, including both with and without a diagnosis of SjD. Materials and Methods: An annotation schema with four classes (SOMs, signs and symptoms of dry mouth, treatment for xerostomia, referral to specialists) was inductively created using the Extensible Human Oracle Suite of Tools (eHOST) to manually annotate clinical notes. Relevant keyterms were retrieved using a rule-based approach with Python’s Natural Language Toolkit (NLTK). SjD and control groups were compared using Fisher’s Exact tests. Four annotators reviewed ninety-three records. Results: SjD patients (mean age 54.8 ± 11.7 years) had fewer total visits across 15 years but had more dental visits per year (10.2 ± 13.3) than controls. SjD patients were more likely to have oral candidiasis (p = 0.041), exhibit signs and symptoms of dry mouth (p = 0.004), receive treatments for xerostomia (p < 0.001), be treated with cholinergic agonists (p = 0.005), and be referred to a specialist (p = 0.046), but findings were not significant for all SOMs. Additionally, SjD patients had a higher proportion of sialadenitis (p = 0.045), rheumatoid arthritis (p = 0.001), systemic lupus erythematosus (p < 0.001), myalgia/myositis/fibromyalgia (p = 0.010), and anxiety/nervousness (p = 0.004). Conclusions: These findings encourage the feasibility of using text mining from dental clinical notes for screening and management of oral conditions. Full article

Background/Objectives: This study aimed to describe and quantify facial soft tissue changes in two patients who underwent radiotherapy (RT) for head and neck cancers, using three-dimensional (3D) stereophotogrammetry and surface deviation analysis. The aims were (i) to assess the progression of morphological alterations over time (ii) and to evaluate the clinical potential of 3D surface mapping in documenting RT-related aesthetic changes. Methods: Two patients with head and neck cancer undergoing RT were analyzed using three-dimensional stereophotogrammetry (3dMD Trio-system, Atlanta, GA, USA) at three timepoints: before RT (T0), 45 days after the start of RT (T1), and 6 months after the start of RT (T2). Facial 3D scans were processed using Geomagic Control 2014 software (v.3D Systems, Morrisville, NC, USA) to perform standardized alignments and calculate volumetric deviations, create colorimetric deviation maps, and conduct Root Mean Square (RMS) analysis. Results: Between T0 and T1, both patients showed soft tissue volume reduction, primarily in the mandibular and submental regions, likely reflecting acute treatment effects and weight loss. Between T0 and T2, an increase in soft tissue volume was observed, especially in the lower face and neck, consistent with late radiation effects such as lymphedema and post-treatment weight gain. RMS values ranged from 5.53 mm to 6.87 mm across patients and time points, indicating measurable morphological changes. The upper third of the face remained stable and served as a reliable reference region for alignment. Conclusions: RT may be associated with significant, region-specific changes in facial and cervical soft tissues in HNC patients, but these preliminary observations must always be correlated with weight loss and confirmed by further studies. 3D stereophotogrammetry is a reliable, non-invasive method for detecting and quantifying these alterations over time. This technique can offer valuable insights for clinical monitoring and could promote better patient counseling and potentially mitigate the psychological burden associated with facial changes. Full article

Objectives: This study aimed to compare the retention and fit precision of removable partial denture circumferential clasps fabricated from cast cobalt–chromium, 3D-printed cobalt–chromium, and polyether ether ketone. Methods: A maxillary right first premolar abutment was prepared. Eighty circumferential clasps were allocated into three material groups: cast Co–Cr (n = 20), 3D-printed Co–Cr (n = 20), and PEEK (n = 40). The terminal third of metal retentive clasps was designed to engage 0.25 mm and 0.50 mm undercuts. PEEK clasps were fabricated with two designs: partial (two-thirds) and full-arm undercut engagement. Each group was examined for retentive forces after 1440 cycles (simulating 1 year). Initial and final retentive forces were recorded. Clasp deformation was assessed by measuring inter-arm distance before and after cycling using digital photography and ImageJ software. Results: All clasp groups demonstrated a statistically significant reduction in retention after 1440 cycles (p < 0.05). At both undercut depths, cast and 3D-printed Co–Cr clasps exhibited significantly higher retentive forces than PEEK (p < 0.001). Within the PEEK group, full-arm engagement showed significantly higher retention than partial engagement at the 0.25 mm undercut (p < 0.001), whereas no significant difference was observed between designs at the 0.50 mm undercut (p = 0.406). Fit precision revealed a significant increase in inter-arm distance after cycling (p < 0.05). PEEK clasps exhibited significantly smaller dimensional changes than Co–Cr clasps (p < 0.02). Conclusions: Clasp material, undercut depth, and design significantly influenced retention and fit precision. Co–Cr clasps maintained higher retentive forces, whereas PEEK clasps demonstrated reduced deformation after cycling. Full article

Objectives: Variations in composite resin composition and aging time remain one of the main reasons for replacing esthetic restorations. This in vitro study aimed to evaluate the microtensile bond strength of a low-shrinkage composite resin on a demineralized dentin surface following adhesive interface degradation. Methods: Seventy-eight extracted human molars were prepared, and artificial caries lesions were induced. For microtensile bond strength (μTBS) testing, 60 teeth were randomly assigned to six experimental subgroups (n = 10 per subgroup) based on restorative system and thermal cycling condition. An additional 18 teeth were randomly assigned to six experimental subgroups (n = 3 each) for SEM analysis. Three restorative systems were evaluated, Z250 (conventional resin), K (Kalore resin), and P90 (Filtek P90 resin), each subjected to two thermal cycling conditions: without thermal cycling (NTC) and 12,000 thermal cycles (TC). Results: In the NTC groups, Z250 exhibited a significantly higher bond strength (25.29 ± 10.91 MPa) compared to K (9.69 ± 11.63 MPa) and P90 (9.81 ± 8.49 MPa) (p < 0.05). Following TC, a numerical decrease in bond strength was observed across all groups. Z250 (13.00 ± 10.76 MPa) maintained a significantly higher bond strength compared to K (4.30 ± 6.40 MPa) and P90 (0 ± 0 MPa) (p = 0.001). Notably, the P90 group showed a near-complete loss of bond strength after TC (0 ± 0 MPa), which was a statistically significant reduction compared to its NTC condition (p = 0.002). SEM analysis revealed a predominance of mixed failures in most experimental groups, while the P90 TC group showed a clear predominance of adhesive failures. Conclusions: This study demonstrates that the conventional Bis-GMA resin (Z250) consistently exhibited superior bond strength to demineralized dentin compared to the low-shrinkage resins (Kalore and Filtek P90) under both non-aged and aged conditions. While all materials experienced a reduction in bond strength after thermal cycling, the Filtek P90 system showed a catastrophic loss of adhesion after aging, indicating its particular susceptibility to degradation. These results emphasize the critical roles of resin chemistry and adhesive system selection in long-term bond durability in compromised dentin. Full article

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by systemic inflammation, synovial hyperplasia, and progressive joint destruction. Periodontitis, a chronic inflammatory disease affecting the supporting structures of teeth, has been increasingly recognized as a potential contributor to RA pathogenesis. Evidence suggests that both conditions share common immunological mechanisms and microbial triggers. This review summarizes the data linking RA with periodontitis, with particular focus on shared pathogenic pathways, microbial triggers, immune system alterations, and clinical relevance. Methods: Experimental, epidemiological, and clinical studies were evaluated to explore biological and clinical links between periodontitis and RA. Special emphasis was placed on the mucosal origins of RA, bacterial-mediated citrullination, autoantibody formation, and the role of the complement system. Results: Available epidemiological data indicate that individuals with RA present higher prevalence and greater severity of periodontitis. Periodontal pathogens, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, contribute to immune dysregulation through citrullination, and subsequent production of anti-citrullinated protein antibodies (ACPAs), a hallmark of RA. Both diseases are characterized by chronic, uncontrolled inflammation, amplified by complement activation and neutrophil hyperactivity. Clinical evidence suggests that non-surgical periodontal therapy may reduce systemic inflammatory markers and improve RA disease activity. Conclusions: The relationship between RA and periodontitis appears to be bidirectional and the recognition of this interaction supports closer collaboration between rheumatologists and dental professionals. Future studies are required to clarify causality and determine whether management strategies can influence patient outcomes. Full article

Background: The Mediterranean diet (MD) represents a nutritionally balanced eating pattern characterized by high consumption of fruits, vegetables, legumes, nuts, whole grains, olive oil, fish, and extra-virgin olive oil as the principal fat source and limited intake of red meat and refined sugars. Emerging evidence indicates that the MD’s anti-inflammatory and antioxidant properties extend beyond systemic health, potentially reducing the risk and severity of periodontitis. This narrative review aimed to synthesize current evidence on the relationship between adherence to the MD and periodontal health outcomes. Methods: A comprehensive electronic literature search was conducted in PubMed without restrictions on publication date. Fourteen studies, ranging from 2019 to 2025, were included, encompassing human, clinical, experimental, and review designs that examined MD adherence and its effects on periodontal parameters. Eligible studies included cross-sectional, cohort, randomized controlled trials; systematic reviews; and animal models assessing clinical periodontal indices, inflammatory biomarkers, or microbial composition. Extracted data included study design, population characteristics, dietary assessment methods, and primary periodontal findings. Results: Most studies demonstrated that greater adherence to the MD was associated with improved periodontal parameters, including reduced probing pocket depth, clinical attachment loss, and bleeding on probing. Interventional trials showed significant reductions in systemic inflammatory markers such as IL-1β, TNF-α, and CRP, along with decreased counts of periodontopathogenic bacteria. Experimental studies further revealed the protective role of oleic acid and polyphenols in regulating macrophage activity, suppressing osteoclastogenesis, and enhancing IL-10 expression via epigenetic modulation. However, heterogeneity in dietary scoring systems, sample characteristics, and follow-up duration limited direct comparison, and not all associations reached statistical significance. Conclusions: Current evidence supports a beneficial association between MD adherence and periodontal health, mediated through anti-inflammatory, antioxidant, and microbiome-stabilizing mechanisms. Further standardized longitudinal and interventional studies are needed to confirm causality and refine nutritional strategies for periodontal disease prevention and management. Full article

Introduction: Smoking is a major modifiable risk factor for periodontal disease, while perceptions, knowledge, and attitudes may influence smoking-related behaviors and preventive practices. The aim of this study was to develop and perform an exploratory validation of a questionnaire assessing these dimensions in relation to periodontal health. Methods: A cross-sectional survey was conducted using a structured, self-administered online questionnaire comprising 31 items. Internal consistency was evaluated using Cronbach’s alpha coefficient, and construct validity was assessed through exploratory factor analysis using principal component analysis with Varimax rotation. Results: Sixty-six complete questionnaires were included in the analysis. The overall internal consistency of the instrument was good (Cronbach’s alpha = 0.770). Reliability across individual domains ranged from acceptable to good. The Kaiser–Meyer–Olkin measure and Bartlett’s Test of Sphericity confirmed the suitability of the data for factor analysis. Conclusions: The questionnaire demonstrates acceptable psychometric properties for exploratory use and may serve as a preliminary tool for assessing smoking-related perceptions, knowledge, and attitudes in relation to periodontal health. Full article

Takotsubo cardiomyopathy (TCM) is characterized by contractile impairment of the left ventricular apex and excessive contraction of the base of the heart, resulting in transient cardiac dysfunction. Here, we report a case of an implantable cardioverter defibrillator (ICD) that was activated for ventricular fibrillation (VF) caused by TCM one day after removal of maxillomandibular exostoses. The patient was a 53-year-old female who underwent removal of maxillomandibular exostoses in the mid-palate area, bilateral molars of the maxilla, and bilateral mandibular premolars under general anesthesia. Because the patient had a history of VF, an ICD was implanted. Removal was performed without any problems, but VF occurred on the following day, and the ICD was frequently required. Ultrasound examination suggested contractile impairment of the ventricular apex and excessive contraction of the base. Examinations led to a diagnosis of TCM using the Mayo Clinic diagnostic criteria. VF was resolved by administration of amiodarone hydrochloride. The wound in the oral cavity healed favorably, and the patient was discharged from hospital on day 33 without further occurrence of VF. This case highlights important perioperative risk assessment and anesthesia considerations for oral and maxillofacial surgeons managing medically compromised patients undergoing oral surgery. Full article

Background: Patients with diabetes mellitus exhibit increased susceptibility to peri-implant inflammation and implant failure due to systemic metabolic dysfunction, impaired immunity, and delayed tissue healing. The oral microbiome is increasingly recognized as a key intermediary in these pathogenic processes. Aims: This review aims to systematically evaluate the available literature examining the relationships among the oral microbiome, biomaterial biocompatibility, and inflammatory changes in peri-prosthetic tissues in insulin-dependent diabetic patients. Methods: A systematic search of PubMed and Scopus databases identified studies published between January 2000 and July 2025. Eligible studies (25 in total) included clinical, histological, microbiological, or immunohistochemical investigations involving diabetic patients rehabilitated with dental implants or prostheses. Study selection and reporting followed PRISMA 2020 guidelines. Results: Diabetic cohorts showed consistent microbial alterations, including a higher relative abundance of periopathogenic species (P. gingivalis, T. forsythia, and F. nucleatum), lower microbial diversity, and greater biofilm-forming potential. Histological analyses frequently described increased inflammatory infiltrates, higher cytokine expression, and reduced soft-tissue integration. Biomaterial surface characteristics were also associated with differences in microbial adhesion, while hyperglycemia was linked to microbial and host-response patterns suggestive of greater pathogenicity and inflammation. Collectively, these findings suggest that diabetes-associated dysbiosis may be associated with increased peri-implant inflammatory changes and altered peri-implant homeostasis. Conclusions: The oral microbiome may be involved in inflammatory activity and biocompatibility at the tissue–implant interface in diabetic patients. A better understanding of host–microbe–material interactions may support risk assessment and help inform future personalized management strategies, such as targeted antimicrobial approaches, probiotic modulation, and biomaterial surface optimization, although these implications should be interpreted cautiously given the predominantly observational and heterogeneous nature of the available evidence. Full article

Background: Cone-beam computed tomography (CBCT) is increasingly applied for the assessment of periodontal bone levels. However, its measurement reliability and consistency depend strongly on image quality parameters such as voxel size, noise, and reconstruction sharpness. With the growing use of CBCT datasets for artificial intelligence (AI)-based diagnostics, it is essential to understand how image degradation conditions affect examiner-derived measurement outcomes and the reliability of reference data used for AI training. Methods: An anonymized CBCT dataset containing one periodontally healthy tooth (31) and one tooth with pronounced periodontal bone loss (41) was analyzed. The original DICOM data were systematically degraded using controlled voxel enlargement (double and triple voxel size) and simulated image blur (Gaussian and median filtering). Six dentists (n = 6) independently performed standardized linear bone-level measurements, with three repeated measurements per tooth and image condition. Data were analyzed using the Shapiro–Wilk test for normality assessment, the Kruskal–Wallis H test for group comparisons, Bonferroni-adjusted Mann–Whitney U tests for post hoc pairwise comparisons, and intraclass correlation coefficients (ICC (2,1)) for inter-examiner reliability assessment. Results: A total of 180 measurements were evaluated. Image degradation conditions were associated with statistically significant differences in bone-level measurements for both teeth (tooth 31: p = 0.017; tooth 41: p = 0.0049). Significant pairwise differences were primarily observed between the original dataset and specific degraded conditions involving blur and reduced spatial resolution, while several comparisons remained non-significant. Inter-examiner reliability varied across image groups and decreased notably with pronounced voxel enlargement, particularly in the periodontally compromised tooth. Conclusions: Controlled image degradation conditions of CBCT image quality significantly affect measurement outcomes and inter-examiner reproducibility of periodontal bone measurements. These findings demonstrate that image quality is a critical determinant of measurement reliability and examiner-dependent interpretation. From both a clinical and AI-development perspective, maintaining adequate CBCT resolution may contribute to more consistent measurement behavior and more reliable training datasets. Full article

Background/Objectives: Behavior management is a major challenge in pediatric dentistry, particularly during the first dental visit, when anxiety, fear, and negative expectations can compromise cooperation and clinical outcomes. While evidence-based behavior guidance techniques are well established, their effectiveness depends on early identification of behavioral risk and individualized planning. This study aimed to develop and clinically evaluate a parent-completed digital pre-visit tool to support individualized behavior management and targeted use of digital distraction in pediatric dentistry. Methods: A web-based application was developed using HTML, CSS, and JavaScript. It was applied to a prospective observational cohort of 90 pediatric patients aged 4–8 years (mean 6.1 ± 1.2), including 48 girls and 42 boys. Parents completed a pre-visit questionnaire covering four domains: child’s age, previous dental experiences, reactions to unfamiliar situations, and individual interests, including stimuli to avoid. Based on predefined decision rules, the tool generated recommended clinical approaches, including behavior guidance techniques, digital distraction, and inhalation sedation. Results: Over 90% of children were successfully managed during their first visit. Children in low- and moderate-risk groups had significantly higher odds of treatment success compared to high-risk children. Low-risk children almost universally completed treatment at the first visit, while a substantial portion of moderate-risk children were successfully managed without an adaptation visit. Digital distraction, particularly when tailored to individual interests, enhanced cooperation and tolerance of procedures. Conclusions: The digital pre-visit tool enables early identification of behavioral risk and supports targeted application of digital distraction and sedation. This approach can improve child cooperation, reduce anxiety, optimize clinical efficiency, and contribute to positive early dental experiences. Full article

Background/Objectives: Root canal procedures on multi-rooted teeth, including first molars, depend on experience, tactile perception, and anatomical knowledge to avoid perforation in the furcation region. Studies using various methodologies and populations have reported discrepant findings on pulpal floor thickness. No study using micro-computed tomography (Micro-CT), the gold standard, has been conducted on a Black South African sample to evaluate pulpal floor thickness. Methods: In this cross-sectional, descriptive, quantitative study, Micro-CT scans of 91 maxillary and 77 mandibular first molars were reconstructed in 3D and oriented according to a reference plane along the cemento-enamel junction using Avizo software. Measurements were taken from the midpoint of the pulpal chamber floor to the perpendicular point on the furcation. In maxillary molars, an additional measurement between the mesiobuccal and distobuccal roots was taken. The effects of arch, side, age, and sex were assessed. Results: Neither sex, arch, nor side had a significant influence on the pulpal floor thickness. The central mandibular and maxillary pulpal floor thicknesses increased significantly with aging, while the effect on the buccal maxillary pulpal floor thickness was not significant. The mean central mandibular and maxillary pulpal floor thicknesses were 2.66 and 2.83 mm, respectively, while the buccal maxillary pulpal floor thickness was significantly smaller at 2.37 mm. Conclusions: More accurate and repeatable findings compared to the literature could be attributed to the use of Micro-CT, which provides higher resolution images, and to Avizo, which enables precise localization of 3D points. Variations from the literature might also be explained by differences in the age and geographical origin of the samples. Full article

Background: Oral complications are common in cancer patients, especially those with head and neck cancers. Patients who have been exposed to radiotherapy for their head and neck cancers endure considerable short- and long-term complications. Methods: A scoping review following the ScR and OSF registries protocol was conducted in MEDLINE/PubMed, Embase, Cochrane, Scopus, LILACS, and Web of Science to identify relevant articles from 1993 to 30 June 2025. Inclusion criteria covered clinical trials, case series, prospective and retrospective studies, and diagnostic investigations. Figures were taken from the treated patients after their consent. Results: Radiotherapy-induced oral complications include, but are not limited to, periodontitis, oral mucositis, xerostomia, fibrosis and trismus, dental caries, oropharyngeal candidiasis, burning mouth syndrome, and osteoradionecrosis. Conclusions: An integrated, collaborative, multidisciplinary approach to managing these patients should be implemented to reduce these toxicities and their impact on patients’ vitality and quality of life. This review discusses the main oral complications of radiotherapy in patients with head and neck cancers and summarizes the updated management approaches for these complications. Full article

Objective: This study evaluates the pre–post changes in dental knowledge, attitudes, skills, and behaviors following a community health worker (CHW)-led intervention. Methods: Adult caregivers from migrant worker families living near the United States–Mexico border participated in the five-week, in-person, CHW-led intervention program. The two-hour once/week interactive sessions were held in Spanish and included oral health education, skill-building, and goal-setting. Participants completed pre- and post-surveys about dental knowledge, attitudes, skills, and oral hygiene behaviors (N = 117). Participants self-reported frequency of brushing and flossing in the prior week, which was dichotomized to reflect meeting the American Dental Association (ADA) guidelines of brushing twice/day and flossing once/day. Mean group comparisons and paired t-tests were conducted to assess pre- and post-intervention differences. Intervention feedback was also evaluated. Results: Pre-intervention, most adults met hygiene guidelines, and in the overall sample, there were no significant differences post-intervention. However, there were meaningful behavior change differences observed among subgroups not meeting ADA guidelines at baseline. Among the 32% of adults who did not meet ADA brushing guidelines and the 61% that did not meet ADA flossing guidelines at baseline, there were significant improvements post-intervention and increased weekly frequency for brushing (p < 0.001) and flossing (p < 0.001). Pre-intervention, 30% reported not being taught to properly brush or floss; post-intervention, only 3% reported not being taught this skill (p < 0.001). Knowledge (p < 0.001) and some attitudes, including self-efficacy (p < 0.001), significantly increased post-intervention. Program feedback from participants and CHWs was positive, and 81% of participants shared materials. Conclusions: After the CHW-led intervention, there were increases in the adults’ self-reported dental knowledge, some attitudes, and hygiene skills. Toothbrushing and flossing frequency increased post-intervention among the subgroups of adults that were not already meeting ADA guidelines at baseline. Full article