Authors: Ionuț Tărăboanță Irina-Georgeta Șufaru Ionuț Luchian Nicanor Cimpoeșu Florinel Cosmin Bida Andra Claudia Tărăboanță-Gamen Costin Iulian Lupu Bogdan Constantin Vasiliu Magda Călina Bârlean Irina Nica
Background/Objectives: In vitro simulation of dental wear is essential for preclinical evaluation of dental materials, but available devices differ widely in operating principles and simulated oral conditions. This scoping review mapped devices used to reproduce dental wear and oral aging and classified them according to the dominant wear mechanism. Methods: Searches were conducted in PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase, and Google Scholar for records published between 1985 and 2026. Eligible sources reported an identifiable in vitro device or setup, a dental material or hard-tissue substrate, and extractable device-level data on operating principles, parameters, environment, antagonist, or outcomes. Results: Sixty-eight reports were retained and consolidated into 19 devices or device families. The systems included two-body chewing simulators, three-body wear machines, robotic or multiaxial masticatory platforms, tribometers, toothbrushing abrasion devices, erosion and pH-cycling systems, tribocorrosion setups, and multifunctional oral aging simulators. Device development showed a transition from mainly mechanical wear testing toward integrated platforms combining load, sliding, thermocycling, saliva or electrolyte exposure, pH control, chemical challenge, biofilm-related conditions, and electrochemical monitoring. Reporting remained heterogeneous, particularly for load, cycle number, frequency, sliding distance, antagonist material, medium, temperature, pH, and outcome measurement. Conclusions: Device selection should be based on the dominant wear mechanism, material type, and research objective. More complete source-level reporting is needed to improve reproducibility and comparability.
]]>Authors: Nermine Joumaa Liam Rebetez Tommaso Lombardi Alexandre Perez
A 66-year-old female patient was referred to the oral surgery unit for the enucleation of a radicular cyst centered at the apex of the necrotic tooth 12. Initial panoramic and intraoral periapical radiographs suggested a persistent periapical cystic lesion despite previous root canal treatment. However, cone-beam computed tomography (CBCT) revealed the coexistence of two distinct lesions within the same anatomical region: a periapical lesion associated with tooth 12, radiographically suggestive of a radicular cyst, and a second well-defined lesion centered within the nasopalatine canal, consistent with a nasopalatine duct cyst and not detectable on conventional radiographs. This unusual association represented a significant diagnostic challenge, as the clinical and two-dimensional radiographic findings initially suggested a single persistent endodontic lesion. Surgical enucleation of both lesions was performed. Histopathological examination confirmed the diagnosis of a nasopalatine duct cyst for the lesion located within the incisive canal, whereas the periapical lesion was confirmed as a radicular cyst. Postoperative follow-up at 10 days, 3 months, 6 months, and 1 year demonstrated satisfactory healing without recurrence or complications. This case highlights the diagnostic value of CBCT in the identification of coexisting odontogenic and non-odontogenic lesions of the anterior maxilla, particularly when conventional radiography is insufficient to distinguish separate pathologies.
]]>Authors: Besian Abazi Etleva Qeli Silvana Bara Çeljana Toti Gerta Kaçani Aida Meto
Background: Type 2 diabetes mellitus (T2DM) and periodontitis are chronic inflammatory conditions. Periodontitis may amplify low-grade systemic inflammation in people with T2DM. High-sensitivity C-reactive protein (hsCRP) reflects this inflammatory burden, but the effect of non-surgical periodontal therapy (NSPT) on hsCRP in T2DM remains uncertain. Objective: To evaluate whether NSPT changes hsCRP at 3 and 6 months compared with oral hygiene instructions alone in patients with T2DM and periodontitis. Methods: Predefined secondary analysis of a 1:1 parallel-group randomized trial with assessments at baseline, 3 months, and 6 months. Participants received scaling and root planing plus oral hygiene instructions (intervention) or oral hygiene instructions only (control). Fasting hsCRP (mg/L) was analyzed on the log scale using mixed-effects models; effects are presented as exponentiated ratios with 95% confidence intervals. Sensitivity analyses included baseline-adjusted analysis of covariance (ANCOVA) and covariate-adjusted mixed models. An exploratory group-adjusted regression examined associations between periodontal changes and hsCRP change. Results: Eighty-nine participants were randomized (45 control, 44 intervention), with hsCRP available for most participants through 6 months. There was no between-group difference at 3 months (ratio 0.958; 95% CI 0.875–1.049; p = 0.358). At 6 months, hsCRP was lower in the NSPT group than in controls (ratio 0.809; 95% CI 0.738–0.887; p < 0.001), corresponding to ~19% lower hsCRP; the model-based geometric mean hsCRP at 6 months was 2.66 mg/L versus 3.26 mg/L. Periodontal measures improved more with NSPT, but changes in periodontal measures were not independently associated with hsCRP change after group adjustment. Conclusions: In patients with T2DM and periodontitis, NSPT was associated with lower hsCRP at 6 months compared with oral hygiene instructions alone. These biomarker findings suggest a potential systemic anti-inflammatory effect, but should be interpreted as hypothesis-generating and confirmed in adequately powered trials.
]]>Authors: Mahsa Moannaei Mojdeh Mehdizadeh Farnaz Mirrashidi Mohammad Hossein Manouchehri Sepehr Naghdi Amirhossein Moaddabi Nima Malek Hosseini Gianrico Spagnuolo Francesco Giordano Parisa Soltani
Background/Objectives: Metal artifacts from dental implants degrade CBCT image quality and may impair detection of peri-implant bone defects. Zirconia implants produce stronger artifacts than titanium due to its higher atomic number. This study evaluated the impact of a native MAR algorithm (SMARF) on CBCT detection of buccal fenestration and dehiscence of varying sizes adjacent to zirconia versus titanium implants. Methods: In this ex vivo pilot study, two 4 mm × 12 mm implants (one titanium and one zirconia) were implanted in a dry human mandible. Artificial fenestration and dehiscence defects were created at the buccal surface of right and left premolar regions, in three sizes (small 2 mm × 2 mm× 1 mm; medium 2 mm × 4 mm× 1 mm; large 2 mm × 6 mm× 1 mm). Scans were acquired with a Papaya 3D (Genoray) CBCT using a single-tooth FOV (4 cm× 4 cm × 5 cm), 83 kVp, 10 mA, 0.1 mm voxel; each condition was imaged with MAR on and off (six repeats each). Two trained observers scored defect presence on a five-point Likert scale. Sensitivity, specificity, inter- and intraobserver agreement (Cohen’s kappa), and comparisons across conditions were calculated. Results: Interobserver κ = 0.65 (substantial); intraobserver κ = 0.87–1.00 (excellent). For titanium implants, sensitivity and specificity were 100% across all defect types, sizes, and MAR settings. For zirconia implants, fenestration sensitivity with MAR off increased with size (small 50%, medium 75%, large 100%); MAR on raised sensitivity to 100% for all sizes, with a significant improvement for small fenestrations (p = 0.005). Dehiscence sensitivity for zirconia was 100% across sizes and MAR conditions. Specificity for zirconia defects was 83.3% with MAR off and decreased to 66.6% with MAR on (p = 0.07). Conclusions: With the Papaya 3D system used in this pilot study, MAR was unnecessary for defect detection adjacent to titanium implants but affected performance for zirconia implants: MAR increased sensitivity for small fenestrations while reducing specificity (although not statistically significant). Clinicians should weigh the sensitivity–specificity trade off when applying MAR around zirconia implants.
]]>Authors: Nevena Todorović Vukotić Neda Đorđević Andrijana Stanisavljević Ilić Snežana Pejić Slobodan Janković Ivana Perić
Background/Objectives: The critical role of oral hygiene in overall health has driven efforts to improve oral hygiene practices. Novel devices employing electric-based technologies have emerged as powerful allies to conventional mechanical approaches for plaque control. NeoPill is a novel electric oral hygiene device designed to assist individuals with fixed orthodontic appliances in maintaining oral hygiene efficiently. The device utilizes direct current (DC) to facilitate bacterial removal from tooth surfaces and gingival tissues. Although the antimicrobial effects of electric-based devices, including NeoPill, are recognized, evidence concerning their impact on salivary biochemical parameters is scarce, especially in relation to oxidative stress. This pilot study aimed to evaluate the effects of NeoPill-derived DC on the redox status of saliva samples obtained from smokers. Methods: Saliva samples were analyzed after a 30-s exposure to NeoPill-derived DC and compared with untreated samples. Salivary pH, buffering capacity, and total protein concentration were measured, along with key salivary biomarkers of oxidative stress and antioxidant capacity. Results: The applied treatment did not significantly affect salivary pH, buffering capacity, or total protein content. Furthermore, NeoPill-derived DC treatment did not induce reactive oxygen species production or lipid peroxidation. No changes were observed in reducing power, glutathione-dependent defense, or the activities of antioxidant enzymes, including catalase and superoxide dismutase. Conclusions: These findings suggest that NeoPill-derived DC does not alter the redox status of smokers’ saliva under the applied conditions. However, it should be noted that this is a preliminary study with a small sample size, which represents a key limitation.
]]>Authors: Maryam Safar Maha Al-Sane Hana Drobiova Maribasappa Karched
Background/Objectives: Aggregatibacter actinomycetemcomitans is an important periodontal pathogen whose biofilm formation and bacterial aggregation contribute to colonization and persistence within the oral cavity. This study aimed to generate random transposon mutants of A. actinomycetemcomitans and screen for alterations in biofilm- and aggregation-related phenotypes. Methods: A transposon mutagenesis library was created in the serotype d strain SA269 using the EZ-Tn5 transposon system. Transformants were screened in vitro for biofilm formation, autoaggregation, and coaggregation with Fusobacterium nucleatum. Biofilm biomass was quantified using a standardized microtiter plate assay, while aggregation assays were performed by optical density measurements. Results: Among 44 transformants, 12 exhibited a markedly reduced ability to form biofilms compared with the wild-type strain, indicating that disruption of certain loci compromises surface adherence and biofilm biomass accumulation. Five representative mutants were selected for aggregation studies. Three mutants showed reduced autoaggregation, suggesting impaired intraspecies cell–cell interactions, whereas four mutants demonstrated enhanced coaggregation with F. nucleatum, reaching approximately 50% coaggregation after 120 min. These findings indicate that insertional inactivation of genes in A. actinomycetemcomitans can differentially affect biofilm formation, autoaggregation, and interspecies coaggregation. Conclusions: This preliminary study demonstrates the utility of random transposon mutagenesis for identifying mutants with altered adhesion- and biofilm-related phenotypes. Although the disrupted genes were not identified, the mutant library provides a foundation for future molecular characterization of genetic determinants involved in biofilm development and microbial community interactions.
]]>Authors: Efsun Somay Doğa Topkan Erkan Topkan Sibel Bascil Melis Selek Ugur Selek
Radiation-induced periodontitis represents an underrecognized and mechanistically complex toxicity of head and neck radiotherapy, arising from the interplay of oxidative stress, inflammatory dysregulation, impaired bone remodeling, and epithelial barrier disruption. Despite its clinical relevance, the molecular determinants underlying inter-individual susceptibility remain poorly defined. Heat shock protein 27 (HSP27), a stress-inducible molecular chaperone, has emerged as a candidate mediator potentially linking biological pathways relevant to radiation-induced tissue injury, including redox regulation, cytoskeletal stability, DNA repair, and apoptosis control. However, no clinical or experimental study has directly evaluated HSP27 in radiation-induced periodontitis. Therefore, the proposed involvement of HSP27 in this setting should be interpreted as a biologically plausible, hypothesis-generating framework rather than evidence of a proven causal mechanism. Convergent but indirect evidence from periodontal biology, radiation-response models, inflammatory disease, and cellular stress systems suggests that HSP27 may plausibly influence periodontal tissue resilience and injury responses after radiotherapy. Therapeutic modulation of HSP27 may represent a potential investigational strategy to mitigate radiation-induced periodontitis, but this concept requires direct validation in periodontal cell-based, animal, organoid, and prospective clinical studies. This review synthesizes current mechanistic and translational evidence to evaluate HSP27 as a candidate mediator, biomarker, and investigational therapeutic target in radiation-induced periodontitis.
]]>Authors: Mohammed Sabah Jumaah Constance Sewani-Rusike Hussein Ali Nayyef Nayyf Gabriel Tchuente Kamsu Sameer A. Awad Ekram R. Aldelaimi Cromwel Tepap Zemnou Ahmed A. Al-Kubaisi
Background/Objectives: Polycystic ovary syndrome (PCOS) is a prevalent endocrine condition in women. The impacts on oral and dental health have not been explicitly articulated. This study aimed to ascertain the association between serum asprosin levels, DMFT, and periodontitis in women with polycystic ovary syndrome (PCOS). Methods: The study included 100 participants: 60 women with PCOS and 40 healthy individuals. Clinical attachment loss (CAL), probing pocket depth (PPD), plaque index (PI), and gingival bleeding index (GBI) were documented. An enzyme-linked immunosorbent assay (ELISA) was used to measure serum asprosin and HOMA-IR concentrations. Results: An individual diagnosed with DMFT and periodontitis in women with PCOS had a markedly elevated concentration of asprosin (5.67 ± 3.55 ng/mL) compared to the control group (3.23 ± 2.25 ng/mL; p < 0.0001). The correlation between serum asprosin levels and clinical periodontal markers was found to be significantly positive. Conclusions: This case-control study suggests that elevated serum asprosin levels in women with polycystic ovary syndrome (PCOS) may be associated with poor periodontal sensitivity to proinflammatory stimuli.
]]>Authors: Federica Guglielmi Francesca Colacino Anna Maria Raguso Giulio Solimene Beatrice Cognigni Patrizia Gallenzi
Background: Gorlin–Goltz syndrome is a rare autosomal dominant condition with characteristic craniofacial and odontogenic anomalies. Orofacial alterations in childhood may precede dermatological findings, highlighting the relevance of early orthodontic and functional evaluation. Objective: This case describes a multidisciplinary orthodontic and Home Sleep Apnea Testing (HSAT)-based approach for the assessment of craniofacial morphology and sleep-disordered breathing (SDB) risk in a pediatric patient with Gorlin–Goltz syndrome. Methods: A 12-year-old male with a genetically confirmed PTCH1 mutation underwent digital intraoral scanning, orthodontic evaluation, and SDB screening using the Pediatric Sleep Questionnaire (PSQ). Following a positive screening score, HSAT with the Philips Alice NightOne® system was performed under specialist supervision. Results: The patient showed recurrent odontogenic cysts, a lateral open bite, and unilateral Class II canine relationship. The PSQ score was 0.579, exceeding the validated cut-off of 0.33 and indicating an elevated SDB risk. HSAT findings were suggestive of mild obstructive sleep apnea based on Respiratory Event Index (REI) values (REI 4.7/h), with an isolated SpO2 nadir of 77% and a maximum recorded apnea duration of 425 s, warranting cautious specialist interpretation and follow-up assessment. Conclusions: Integrating orthodontic assessment, digital documentation, validated screening tools, and objective HSAT-based evaluation may support the early recognition of functional compromise in syndromic pediatric patients. Positive screening results should prompt specialist referral and objective sleep assessment, while attended polysomnography remains indicated when comprehensive sleep architecture evaluation or definitive characterization is required.
]]>Authors: Haoxiang Zhang Donghao Wei Yunhan Tan Ping Di Ye Lin Chun Yi Xi Jiang
Objectives: To quantitatively evaluate soft tissue dimensional changes after immediate implant placement and provisionalization (IIPP) in the esthetic zone with or without connective tissue grafting (CTG). Methods: In this prospective clinical trial, 44 patients requiring a single maxillary anterior immediate implant were randomly allocated to a test group (IIPP + CTG) or a control group (IIPP alone). At baseline and 6 months postoperatively, buccal soft tissue height (STH) and soft tissue thickness (STT) at various levels were recorded. Measurements were obtained through three-dimensional superimposition of cone-beam computed tomography (CBCT) and intraoral scanning data. Results: Forty-three patients completed the 6-month follow-up. From baseline to 6 months, buccal soft tissue height increased 2.14 ± 0.74 mm and 1.71 ± 0.81 mm in the test and control groups, respectively, without statistically significant differences between groups (p = 0.078). Buccal soft tissue thickness increased at most measured levels in both groups (p < 0.05), except at 1 mm apical to the crest in the control group (p = 0.11). However, thickness augmentation was consistently greater in the test group at all levels (p < 0.001). Conclusions: Within the 6-month follow-up period, both soft tissue height and thickness increased after IIPP. CTG performed simultaneously with IIPP was associated with significantly thicker buccal soft tissue compared with IIPP alone.
]]>Authors: Angela Mirea Bellocchio Ludovica Ciraolo Maria Fazio Riccardo Nucera
Background: Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep-related breathing disorder associated with significant systemic complications and reduced quality of life. Mandibular advancement devices (MADs) represent an established alternative therapy for patients who cannot tolerate continuous positive airway pressure (CPAP). However, concerns remain regarding their potential effects on temporomandibular disorders (TMD). Materials and Methods: This retrospective exploratory study analyzed clinical records of 26 patients (mean age 55.4 ± 5.8 years) with polysomnography-confirmed OSAS and baseline TMD-related symptoms treated with a custom-made monobloc MAD. Clinical parameters were evaluated at baseline (T0) and after approximately 6 months of therapy (T1). Outcomes included apnea–hypopnea index (AHI), Epworth Sleepiness Scale (ESS), Fonseca Anamnestic Index, and health-related quality of life assessed using the SF-36 questionnaire. Repeated measures ANOVA and linear regression analyses were performed. Results: After six months of MAD therapy, a significant reduction in AHI was observed (30 ± 13.76 vs. 10.87 ± 3.9; p < 0.00001). Daytime sleepiness significantly decreased (ESS: 9.31 ± 3.53 vs. 3.38 ± 1.77; p < 0.00001). TMD symptom severity also decreased significantly according to the Fonseca Index (33.85 ± 17.74 vs. 10.00 ± 8.94; p < 0.00001). Quality of life scores improved significantly (SF-36: 41.15 ± 9.52 vs. 65.38 ± 5.82; p < 0.00001). Linear regression analysis showed no significant association between changes in AHI and changes in TMD symptoms, ESS scores, or quality of life. Conclusions: Within the limitations of this retrospective study, MAD therapy was not associated with symptom aggravation of temporomandibular disorders in patients with pre-existing TMD symptoms. Significant improvements in respiratory parameters, daytime sleepiness, and quality of life were observed after six months of therapy.
]]>Authors: Hend Mohamed ElSayed Rania E. Bayoumi Salah A. Yousief Ali Barakat Galia Aljefri Noor Aldossari Maram Alqahtani Fahd Alkhaldi Ahmed Ali Alghamdi Faisal Khalid Almohaya Alhanouf Alsamari Faisal Musaad Almobarak Abdulrahman Salem Alghuraymil Yazeed Alarjani Maha Sherif Othman Shaimaa F. K. Habib Waleed Nasir Saeed Asiri
Objective: The current investigation aims to assess the clinical efficacy of intraoral photographic assessment in detecting dental caries of varying severity and to assess different variables, such as the type of dentition, examiner experience, and the type of imaging equipment, on evaluative clarity. Methods: This meta-analysis of the PRISMA-DTA systematic review and diagnostic test accuracy was conducted. They searched electronic databases such as PubMed, Web of Science, Scopus, Embase, and Cochrane Library from the beginning of time up to January 2025. The studies had to have evaluated intraoral photographic caries because they were required to have compared it with clinical intraoral examination and provide extractable tooth-level 2 × 2 data. Enamel (ICDAS 1 3), dentine (ICDAS 4 6), and any caries (ICDAS 1 6) were analyzed separately in a meta-analysis. A random-effects model was used to compute pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves. Subgroup analysis was done on a pre-specified basis according to dentition, type of examiner, and imaging device. This study has been registered in PROSPERO with reference number 2026 CRD420261330820. Results: Twenty-three studies were retrieved through a comprehensive search and were stratified by severity into three categories. In the case of enamel caries, sensitivity was 0.65 (95% CI: 0.62–0.68), specificity was 0.95 (95% CI: 0.94–0.95), DOR was 36.74 (95% CI: 12.44–108.49), and the AUC was 0.87. In the case of dentine caries, the pooled sensitivity and specificity were 0.86 (95% CI: 0.85–0.87) and 0.96 (95% CI: 0.96–0.97), respectively, which produced the DOR of 176 (95% CI: 91.2–339.6) and the AUC of 0.94. Any caries had a pooled sensitivity of 0.81 (95% CI: 0.80–0.83), specificity of 0.97 (95% CI: 0.96–0.97), DOR of 64.04 (95% CI: 11.65–351.94), and AUC of 0.888. Subgroup analyses revealed that diagnostic accuracy was greater when the lesions were severe. Conclusions: Intraoral photographic assessment has a moderate level of accuracy in detecting enamel lesions and has a clinically acceptable level of accuracy in detecting dentine caries. The clinical efficacy increased with the severity of lesions and was consistent with high specificity at all levels of threshold. Imaging on smartphones could be a promising method for caries screening.
]]>Authors: Rodrigo Lozano-Rosado Eusebio Torres-Carranza Alberto Garcia-Perla-Garcia Jose-Luis Gutierrez-Perez Pedro Infante-Cossio
Background and objectives: Sentinel lymph node biopsy (SLNB) has become the standard approach for cervical staging in patients with early-stage oral cavity squamous cell carcinoma (OCSCC). Although it demonstrates diagnostic accuracy exceeding 90% in referral centres, the occurrence of false-negative (FN) results undermines oncological safety and adversely impacts patient prognosis. This scoping review aims to synthesise and evaluate the scientific evidence regarding the risk factors and technical errors that underpin FN incidence. Methods: A systematic search was conducted across MEDLINE (PubMed), Scopus and Web of Science for studies published between 2000 and 2025, adhering to PRISMA-ScR guidelines. Primary clinical and observational studies specifically addressing the variables and aetiology of diagnostic failure in SLNB for early-stage OCSCC (cT1-T2 N0) were included. Results: Twenty-seven studies were included in the final qualitative synthesis. Four critical domains characterising FN risk were elucidated, facilitating risk-stratified selection and surveillance strategies: (1) Clinical and tumour factors: Depth of invasion >4–5 mm, T3–T4 tumour size, and prior cervical anatomical disruption. (2) Surgical factors: Insufficient sentinel lymph node (SLN) harvest (≤2 SLNs), lack of exhaustive lymphatic basin exploration, the initial learning curve, and the exclusive use of non-isotopic tracers. (3) Anatomical factors: Floor of the mouth tumours and the radioactive shine-through effect. (4) Histopathological protocol: Suboptimal ultrastaging, insufficient frozen section biopsy, and limitations in rapid molecular techniques. Overall, studies using standardised protocols report a false-negative rate between 5% and 15%. Conclusions: FN events in SLNB are multifactorial and predictable phenomena, arising from cumulative vulnerabilities along the diagnostic continuum. The technique achieves an optimal diagnostic yield in cT1–T2 N0 cases without prior cervical treatment when applied under optimal conditions. However, methodological heterogeneity in the literature limits the interpretation of the results and partially constrains their clinical application.
]]>Authors: Mohanprasanth Aruchamy Natesan Thirumalaivasan
Background: The oral squamous cell carcinoma (OSCC) is a very aggressive cancer that is the product of tumor cell interactions with the microenvironment. The tumor microenvironment (TME) has a severe impact on OSCC progression, metastasis, and resistance to treatment by altering gene expression via various cellular and molecular signal transductions. Aim: This review systematizes the information on gene regulation in the OSCC TME (cellular components, signaling pathways that regulate tumor progression and resistance). Methods: We used PRISMA guidelines to search PubMed, Scopus, Web of Science, and Google Scholar (up to April 2025) with OSCC studies addressing the subject of gene regulation and tumor microenvironment. The quality of human or experimental models was evaluated using the Newcastle–Ottawa Scale and the qualitative synthesis was performed because of heterogeneity. Results: The significant regulatory functions of tumor-associated macrophages, cancer-associated fibroblasts, immune cells, and non-coding RNAs were found, especially in the pathways like JAK/STAT, EGFR, Wnt/ -β catenin, and PI3K/AKT/mTOR. Conclusions: The conceptualization of gene regulatory networks in the OSCC TME identifies the emerging biomarkers and targets of therapy. Merging multimodal omics and single-cell studies can further contribute to the precision strategies to enhance the outcomes of OSCC.
]]>Authors: Jaime Jamett Marjorie Borgeat Karina Cordero-Torres Patricio Meléndez Ximena Collao-Ferrada María Guerra Zúñiga Alejandro Veloz
Background/Objectives: Tooth loss reflects cumulative biological and social processes across the life course. However, population-level causal evidence on the influence of structural social vulnerability and multimorbidity on tooth-loss severity remains limited in middle-income contexts. This study evaluated the causal impacts of social vulnerability and multimorbidity on tooth-loss severity in Chilean adults under explicit potential-outcomes assumptions. Methods: We analyzed nationally representative data from the Chilean National Health Survey 2016–2017 (N=5165 adults aged ≥20 years with oral examination; analytic sample n=4521). Outcomes comprised ordinal severity (y1: functioning dentition, moderate loss, severe loss, edentulism) and continuous tooth count (y2). Exposures included a Social Vulnerability Index (SVI, 0–1) and Multimorbidity Score (MS, 0–1). We estimated confounder-adjusted proportional-odds and survey-weighted linear regression models. Population-averaged causal contrasts were obtained via g-computation comparing 75th and 25th exposure percentiles, with 95% confidence intervals from probability-proportional-to-size bootstrap (1000 replications). Age-dependent edentulism trajectories were generated using discrete-time Markov projections. Results: In the weighted population, 72.6% retained functional dentition, whereas 5.5% were edentulous. Increasing SVI from 0.091 to 0.345 was associated with a 0.110-point severity increase and 1.95 fewer teeth. Increasing MS from 0.00 to 0.20 was associated with a 0.062-point severity increase and 1.20 fewer teeth. SVI showed larger population-averaged effects than multimorbidity. Conclusions: Within a potential-outcomes framework and under the stated identifying assumptions, structural social vulnerability and multimorbidity each exerted independent effects on tooth-loss severity, with socioeconomic disadvantage showing the stronger distributional gradient across the life course. Because the data are cross-sectional, this causal interpretation is conditional on those assumptions rather than established by the design.
]]>Authors: Marco Colombo Gaetano Scaramozzino Giuseppe Cota Maurizio Pascadopoli Giacomo Budelli Simonemaria Domenico Gatti Andrea Scribante
Background/Objectives: Cephalometric analysis is essential in orthodontics and for studying conditions such as obstructive sleep apnea syndrome (OSAS). However, manually identifying anatomical landmarks and segmenting the pharyngeal airway on lateral cephalograms can be time-consuming and prone to errors. This study evaluates the CEPH_2D system, an AI-based tool designed to automate cephalometric landmark detection and pharyngeal airway segmentation from 2D lateral cephalometric radiographs. Methods: The system was evaluated on 35 anonymized lateral cephalograms obtained from patients aged 6–65 years, including mixed and permanent dentition cases. Two experienced clinicians generated and reviewed the ground truth annotations for cephalometric landmark localization and pharyngeal airway segmentation. System performance was assessed using mean radial error (MRE), successful detection rate (SDR), mean average precision (mAP), Dice similarity coefficient (DSC), precision, recall, and inference time. Results were compared with manual methods and existing automated tools. Results: The system reached a mean radial error (MRE) of 0.740 ± 0.793 mm for the key point detection task and a mean Dice Score (mDSC) of 0.935 ± 0.040 with an average processing time of 2.557 ± 0.504 s. Conclusions: CEPH_2D appears to be a promising adjunctive tool for automatic cephalometric landmark detection and pharyngeal airway segmentation on lateral cephalograms, although clinician verification remains advisable before clinical interpretation or treatment planning, particularly for landmarks showing higher detection errors.
]]>Authors: Mihai Oprea Allma Roxana Pitru Ion Rogoveanu Dorin Nicolae Gheorghe Alexandra Roman Dora Maria Popescu Flavia Mirela Nicolae Andreea Cândea Claudiu-Marinel Ionele Adina Turcu-Stiolica Sergiu Ciobanu Petra Surlin
Background/Objectives: Systemic diseases such as diabetes mellitus and hepatitis C virus infection are increasingly recognized as important modifiers of oral health. However, their combined impact, as well as the role of behavioral confounders such as smoking, remains insufficiently explored. This study aimed to evaluate oral health parameters in patients with diabetes and/or hepatitis C virus infection, to investigate the prevalence of oral mucosal conditions, and to identify independent predictors of xerostomia, with particular emphasis on glycemic control and smoking. Methods: A cross-sectional study was conducted on 66 patients, including 33 systemically affected individuals and 33 healthy controls. Clinical parameters included the number of teeth, tooth mobility, bleeding on brushing, xerostomia, and oral lichen planus. Glycemic control was defined by using glycated hemoglobin thresholds (controlled < 7%, uncontrolled ≥ 7%). Statistical analyses included non-parametric tests, Spearman correlation, and multivariate logistic regression. Results: Patients with diabetes exhibited significantly fewer teeth (p = 0.001), increased tooth mobility (p = 0.001), and a higher prevalence of gingival bleeding (p = 0.042). Hepatitis C virus infection was strongly associated with oral lichen planus (p = 0.009). Xerostomia was more prevalent in hepatitis C virus infection patients, but in multivariate analysis, smoking emerged as the only independent predictor (OR = 5.73; p = 0.014). Glycemic control was not independently associated with xerostomia after adjustment. Conclusions: Diabetes primarily influences periodontal destruction, while hepatitis C virus infection is associated with mucosal pathology. Smoking plays a dominant role in xerostomia and may confound associations attributed to systemic disease. These findings highlight the importance of integrated oral-systemic assessment and behavioral risk management.
]]>Authors: Mahmoud M. Bakr Mohamed Shamel Nourhan Taha Sara Moataz Mahmoud Al Ankily
Background/Objectives: Methods of smoking have evolved over the years, including heated tobacco products. The impact of exposure to traditional tobacco smoke and heated/electronic tobacco products (IQOS) on biofilm formation has not been previously compared in vitro. Aims and objectives: The present study aimed to evaluate the impact of tobacco and electronic smoking on microbial biofilm formation on dental hard tissues. Materials and Methods: Thirty premolars were randomly assigned to six groups (n = 10 per group) according to tissue type and smoking exposure: Six experimental groups were defined: Group 1, non-exposed enamel; Group 2, enamel subjected to conventional cigarette smoke (CS); Group 3, enamel subjected to heated tobacco (HT); Group 4, non-exposed cementum; Group 5, cementum subjected to conventional cigarette smoke; and Group 6, cementum exposed to heated tobacco. Enamel and root discs were then immersed in 2 mL of an adjusted, standardized bacterial suspension of Streptococcus mutans (S. mutans) to allow bacterial biofilm adhesion after incubation for 48 h at 37 °C. The mean colony-forming unit (CFU) count was calculated, and the surface topography and roughness were assessed using scanning electron microscopy and ImageJ software with the SurfCharJ plugin, respectively. Results: Conventional cigarette smoking showed significantly higher S. mutans adhesion on the enamel and root discs compared with IQOS and control groups. Both IQOS and cigarette smoking increased roughness on enamel and root versus the control group, and cigarette smoking produced significantly higher roughness on the enamel surface when compared to IQOS; however, there were no significant differences in the roughness between the two smoking methods on the root surface. SEM analysis showed the most extensive enamel and root microtopography change in IQOS smoking. Conclusions: Aerosols from heated tobacco products (IQOS) alter the surface topography and roughness of enamel and root, while traditional cigarette smoking significantly increases bacterial colonization. Further in vivo studies are warranted to simulate the dynamic nature of the oral cavity.
]]>Authors: Giovana Dornelas Azevedo Romero Nicole Barbosa Bettiol Selma Siessere Franciele Aparecida de Carvalho Márcio de Menezes Jardel Francisco Mazzi-Chaves Laís Valencise Magri Simone Cecilio Hallak Regalo Marcelo Palinkas
Objectives: Hyaluronic acid augmentation of the mandibular angle has become a widely performed procedure for improving lower facial contour and definition; however, because of its anatomical proximity to the masseter muscle, concerns remain regarding possible functional effects on the stomatognathic system. This longitudinal study investigated whether hyaluronic acid injection in the mandibular angle could affect neuromuscular recruitment patterns of the masseter and temporalis muscles through surface electromyography assessment. Methods: Ten adults were assessed at baseline and at 15, 30, and 60 days after injection. Electromyographic activity was recorded during mandibular tasks and chewing conditions. Repeated measures ANOVA with Bonferroni correction was used for statistical analysis (p < 0.05). Effect sizes were calculated using partial eta squared (η2p), and pairwise comparisons were explored using Cohen’s d. Data are presented as means with 95% confidence intervals (95% CIs), and individual trajectories were analyzed to characterize temporal patterns and within-subject variability. Results: Most variables did not show significant changes over time (p > 0.05), with small-to-moderate effect sizes. Significant reductions were observed in the right masseter during left laterality (p = 0.03; η2p = 0.17) and in the left masseter during maximum voluntary contraction with and without parafilm (p = 0.02–0.04; η2p = 0.19–0.22). These findings were temporary and were not consistently identified among subjects. Chewing conditions remained stable across all time points (p > 0.05). Conclusions: Hyaluronic acid injection in the mandibular angle was not associated with clinically relevant electromyographic changes. The observed variations were transient, showed small-to-moderate effect sizes, and demonstrated interindividual variability, suggesting preservation of neuromuscular function and physiological adaptive responses.
]]>Authors: Karolyne de Melo Soares Vânia Vieira Reis José Nunes de Queiroz Neto Darlene Camati Persuhn Eutília Andrade Medeiros Freire Sabrina Garcia de Aquino Cristina Wide Pissetti Naila Francis Paulo de Oliveira
Objective: To investigate the association between genetic polymorphisms of the vitamin D receptor (VDR: rs1544410, rs2228570, rs731236), methylenetetrahydrofolate reductase (MTHFR: rs1801131), and DNA methyltransferase (DNMT1: rs2228611, DNMT3A: rs7590760, DNMT3B: rs6087990) genes and the coexistence of periodontitis and systemic lupus erythematosus (SLE). Methods: Systematically healthy individuals and patients with SLE of both sexes, aged over 20 years, were recruited and divided into four groups: healthy, periodontitis, SLE, and SLE with periodontitis. Seven polymorphisms in the VDR, MTHFR, DNMT1, DNMT3A, and DNMT3B genes were analyzed. Results: The frequency of the rs1801131 (MTHFR) AA genotype was higher in the healthy group than in the periodontitis group. The B allele of rs1544410 (VDR) was more frequent in patients with SLE, regardless of the presence of periodontitis. The t allele of rs731236 (VDR) was more frequent in patients with SLE without periodontitis. Conclusions: The polymorphisms studied do not show an exclusive association with the coexistence of periodontitis and SLE. However, the MTHFR rs1801131 polymorphism may be a protective factor against periodontitis, but not when it coexists with SLE. VDR rs1544410 is associated with SLE regardless of the presence of periodontitis, and rs731236 is associated with SLE, but not in coexistence with periodontitis. These data provide insights into the genetics of periodontitis and lupus; however, they are currently exploratory, as they were obtained from a single-center study in which it was not possible to adjust for demographic variables (age and sex) between groups due to the modest sample size.
]]>Authors: Dilshad Umar Rohan Mascarenhas Shreyaskar Rakshit Salwa Bm
Background: An exaggerated curve of Spee is a common finding in malocclusions with a deep overbite and requires correction to achieve functional occlusion and long-term stability. Leveling of the curve of Spee using continuous archwire mechanics generates complex force systems, the biomechanical effects of which depend on archwire material properties, cross-sectional dimensions, and the depth of the curvature being corrected. Quantitative data describing stress distribution within the teeth and periodontal ligament during this process remain limited. Objective: To evaluate and compare the stresses generated in the mandibular teeth and periodontal ligament during leveling of the curve of Spee using orthodontic archwires of different materials and dimensions through three-dimensional finite element analysis. Materials and Methods: A three-dimensional finite element model of the mandibular dentition, periodontal ligament, and supporting alveolar bone was constructed from computed tomography data. Orthodontic brackets and archwires of stainless steel, nickel–titanium, and titanium–molybdenum alloy were modeled in four dimensions: 0.014-inch, 0.016-inch, 0.016 × 0.022-inch, and 0.019 × 0.025-inch. Leveling of the curve of Spee was simulated at incremental depths ranging from 2 mm to 6 mm using displacement-controlled activation. Von Mises stresses generated within the teeth and periodontal ligament were recorded and compared across all simulations. Results: Stress magnitudes increased with increasing depth of the curve of Spee, larger archwire dimensions, and greater wire stiffness. Stainless steel archwires produced the highest stresses, followed by titanium–molybdenum alloy, while nickel–titanium archwires consistently generated the lowest stresses in both teeth and periodontal ligament. Conclusions: Archwire material and dimension significantly influence stress generation during leveling of the curve of Spee. Flexible archwires produce lower stress levels and may be advantageous during early correction of deeper curves.
]]>Authors: Marija Obradović Olivera Dolić Nataša Knežević Željka Kojić Predrag Kaurin Dragana Radić-Karaulac Zorica Živak-Topalović Snežana Burgić-Pejić Marija Ostojić Nikolina Spasojević Nikolina Damjanović Dijana Đuza Marijana Arapović-Savić Mirjana Umićević-Davidović Renata Josipović
The primary objective of this research was to evaluate the oral health habits, dietary practices, and knowledge regarding cariogenic diet among University Dental students. Materials and methods: A cross-sectional, questionnaire-based study was conducted among students attending the integrated undergraduate and graduate Dental Medicine (DM) program. Data analysis was performed by stratifying students according to the year of study. In total, 114 questionnaires were collected. Three questionnaires were subsequently excluded, resulting in a final sample size of 111 students for analysis. Results: Over 75% of students from the 2nd (83.3%) to 6th (91.3%) year used a combination of a toothbrush and fluoride toothpaste, whereas 50% of 1st-year students reported using fluoride-free toothpaste (p < 0.05). The majority of senior students (34.8–100%) correctly identified xylitol and sorbitol as non-cariogenic (p < 0.05). However, a notable knowledge gap persisted in the final year, with over 30% of sixth-year students failing to identify them. Furthermore, over 60.0% of third-year and 90.0% of fifth-year students recognized the protective dental effects of hard cheese, cranberry, and green tea (p < 0.05). Regarding cariogenic potential, 45.8% of first-year and 57.1% of second-year students were unable to identify the most cariogenic saccharide (p < 0.05). Conclusions: The study reveals an improvement in oral health habits and knowledge, particularly regarding the use of fluoride toothpaste and the identification of cariogenic saccharides. However, significant knowledge gaps persist across all years, most notably the high prevalence of fluoride-free toothpaste use among first-year students and the inability of a substantial portion of senior students to identify non-cariogenic sugar substitutes and protective foods.
]]>Authors: Panagiota Chatzidou Charalampos Souvatzoglou John Fanourgiakis Georgia Kalaitzaki Anastasia Karagergou Olga Naka
Background-Objectives: Edentulism remains a major global health problem, and implant-supported overdentures (ISODs) are widely used to restore oral function and improve quality of life in edentulous patients. Among the available attachment systems, bar configurations play an important role in determining biomechanical behaviour, retention, stability, and maintenance requirements. This scoping review aimed to map and evaluate the influence of key bar attachment parameters—such as cross-sectional geometry, material, splinting configuration, and distal extension—on the clinical performance of overdenture therapy. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) framework. A comprehensive search was conducted in PubMed, Scopus, and the Cochrane Library. Eligible studies included clinical investigations, in vitro mechanical studies, and finite element analyses addressing bar-retained implant-supported overdentures. Extracted data included bar configuration characteristics, implant distribution, and reported outcomes such as retention forces, stress distribution, prosthetic complications, and patient-reported measures. Results: The available evidence indicated a recurring balance between increased retention and higher peri-implant stress, particularly in association with Hader bar designs. Material selection also appeared to influence performance. CAD/CAM-milled titanium bars demonstrated favourable mechanical durability, whereas alternative materials such as PEEK and zirconia were associated with improved stress distribution and potential biological advantages, although concerns regarding long-term durability remain. Differences related to arch type were also observed, with splinted bars supported by four implants generally favoured in the maxilla, while two-implant bar overdentures appear to provide satisfactory outcomes in the mandible. Conclusions: Bar selection should be individualised according to anatomical conditions, biomechanical demands, and patient-specific factors. Longer-term clinical studies and more standardised testing protocols are still required, particularly for newer materials and digitally fabricated bar systems, to support more consistent evidence-based decision-making.
]]>Authors: Panagiota Chatzidou Vasileios Botskaris Vassiliki Anastassiadou
Background/Objectives: Mastication is a complex sensorimotor function involving coordination between the brainstem central pattern generator and supraspinal systems, particularly the primary motor cortex (M1). Evidence suggests a link between masticatory activity and corticomotor plasticity, but findings remain fragmented. This scoping review aimed to synthesise the human evidence on the relationships among mastication, tooth loss, dental rehabilitation, ageing, and corticomotor plasticity, with emphasis on M1 mechanisms. Methods: Following PRISMA-ScR guidelines, systematic searches were conducted in MEDLINE/PubMed, Scopus, and Web of Science using terms related to mastication, neuroplasticity, motor cortex, ageing, and rehabilitation. Eligible studies included human experimental, clinical, and observational research employing neuroimaging or neurophysiological methods. Data were extracted and synthesised using a Population–Concept–Context framework across eight conceptual domains. Results: Twenty-two heterogeneous studies (fMRI, TMS, EMG, psychophysical, histological) were included. Mastication consistently activated distributed sensorimotor networks, including M1 and the primary somatosensory cortex (S1). Peripheral sensory input and dental mechanoreception were linked to structural and functional adaptations. Corticomotor excitability was modulated by chewing, oral-motor learning, and rehabilitative interventions. Ageing was associated with altered but preserved cortical responsiveness. Associations between mastication and cognition were reported, though largely cross-sectional. Overall, findings suggested a relationship linking peripheral input, sensorimotor integration, and corticomotor plasticity, but methodological variability limited causal inference. Conclusions: Mastication is linked to modifiable corticomotor activity and supports experience-dependent neuroplasticity. However, the evidence remains largely associative and methodologically heterogeneous. Neural adaptations appear to be preserved with ageing but are influenced by systemic and environmental factors. Longitudinal, multimodal research is needed to clarify the mechanisms, causality, and clinical relevance, particularly in rehabilitation contexts.
]]>Authors: Giuseppina Campisi Martina Coppini Vittorio Fusco Alberto Bedogni Francesco Bertoldo Rodolfo Mauceri
Prevention of medication-related osteonecrosis of the jaw (MRONJ) associated with low-dose bone-modifying agents (LD-BMAs) remains a clinically relevant challenge, particularly due to the heterogeneity of recommendations and the growing number of patients exposed to these therapies. Unlike high-dose regimens, LD-BMAs are associated with a lower incidence and longer latency of MRONJ, generating uncertainty regarding the optimal timing and scope of dental interventions. This commentary critically compares four major international position papers and consensus documents (AAOMS 2022, SIPMO–SICMF 2020/2024, Chinese Expert Consensus 2024, and SIOT–SIdP 2023) through four pragmatic questions concerning patient stratification, timing of dental assessment, speed of risk reduction, and the role of prescriber-oriented screening tools. The analysis highlights substantial discrepancies among preventive models, particularly regarding whether pre-treatment dental treatments should be mandatory or whether early post-initiation assessment may be acceptable in selected low-risk patients.
]]>Authors: Enrico M. Strappa Charlotte Gemelli Marisa Roncati Francesco Zuffetti Massimo Del Fabbro Tiziano Testori
Objectives: This systematic review and meta-analysis aimed to evaluate the role of diode and Nd:YAG lasers as adjuncts to scaling and root planing (SRP) in the non-surgical treatment of moderate-to-severe periodontitis. Methods: The protocol was registered in PROSPERO (CRD420250603025) and conducted following PRISMA guidelines. A comprehensive search in Scopus, PubMed, and Cochrane CENTRAL (up to October 2024) identified randomized controlled trials (RCTs), prospective, and retrospective controlled clinical studies comparing SRP alone versus SRP plus adjunctive laser therapy. The primary outcome was probing pocket depth (PPD); secondary outcomes were bleeding on probing (BoP) and the clinical attachment level (CAL). Risk of bias was assessed using Cochrane RoB 2.0 tool for RCTs and Newcastle–Ottawa Scale for non-RCTs. Meta-analysis was undertaken when at least three studies presenting the same outcome at the same follow-up were found. Results: Nine studies with follow-ups from 3 to 120 months were included, representing a total of 423 participants. Both groups showed PPD reduction at all time points, with pooled analyses revealing no statistically significant differences (mean difference −0.12 to −0.35 mm; p > 0.05), although point estimates often favored laser-treated sites, particularly when baseline PPD ≥ 6 mm. Subgroup analysis showed significantly greater PPD reduction in laser-treated sites compared to SRP alone at 12 months in deep pockets (p = 0.001). These findings should be interpreted with caution, given their exploratory nature, limited sample size, and high heterogeneity. Similar patterns were observed for CAL and BoP, with substantial heterogeneity (I2 > 70% at several time points). No adverse events were reported. Conclusions: Within the limitations of the available evidence, adjunctive diode and Nd:YAG laser therapy does not demonstrate consistent statistically significant differences compared to SRP alone in non-surgical periodontal treatment. While a potential adjunctive effect may be observed under specific clinical conditions, particularly in deeper pockets, current evidence is insufficient to support its superiority.
]]>Authors: Arin Ismael Omer Trefa M. Ali Mahmood
Background/Objectives: Anterior open bite (AOB) is a multifactorial malocclusion often associated with dysfunctional orofacial habits, such as tongue thrusting and lip incompetence. Early functional interventions aim to restore muscular balance; however, evidence supporting orofacial exercise therapy as a preventive measure remains limited. This pilot study evaluated the effectiveness of targeted orofacial physical exercises in reducing anterior open bite and improving tongue and lip function in school-aged children. Methods: A controlled clinical trial was conducted following ethical approval (COD-EC-24-0036). A total of 1531 children were screened, of whom 24 presented with AOB; 14 consented to participate. Participants were allocated to a tongue exercise group, a lip exercise group, or a control group receiving verbal advice only. Orofacial exercises focused on tongue posture, swallowing function, and lip seal. Measurements were obtained at baseline and 6 months using intraoral scans and clinical assessments. Treatment adherence was monitored using monthly exercise charts. Data were analyzed using repeated measures ANOVA (α = 0.05). Results: AOB prevalence among screened children was 1.57%. Descriptive analysis showed that both intervention groups demonstrated numerical reductions in anterior open bite over 6 months, whereas minimal changes were observed in the control group. However, no statistically significant differences were detected between groups (p > 0.05). Children with higher cooperation exhibited greater improvement, suggesting adherence may influence treatment response. Conclusions: Orofacial physical exercises demonstrated a trend toward improving anterior open bite and orofacial function; however, changes were not statistically significant. These exercises may serve as supportive early therapeutic management, but larger, adequately powered trials are needed to clarify their therapeutic potential.
]]>Authors: Daniela Argatu Andrei Georgescu Ionut Luchian Florin Razvan Curca Monica Mihaela Scutariu Dana Gabriela Budala Nicoleta Tofan Vlad Constantin Cristian Cojocaru Florinel Cosmin Bida
Hydroxyapatite-based biomaterials are widely investigated for oral-tissue-healing applications; however, the available literature is heterogeneous in terms of material design, experimental models, and reported outcomes. This narrative review synthesizes peer-reviewed studies published between 2014 and 2024 that investigate hydroxyapatite-based biomaterials in the context of oral soft and hard tissue healing. The literature was identified through targeted searches of major scientific databases and selected based on relevance to material characteristics, biological response, and oral regenerative applications. The analysis reveals substantial heterogeneity in material formulation, experimental design, and outcome assessment, limiting direct comparison between studies and translational interpretation. While modified and nano-sized hydroxyapatite systems often demonstrate enhanced biological responses, supporting evidence is predominantly preclinical. Greater standardization of methodologies and outcome measures is required to strengthen clinical relevance.
]]>Authors: Jovana Lovric Sanja Gnjato Saša Zeljković Tijana Adamovic Jana Ilic Ljubica Skrbic Predrag Jovicic Ognjenka Jankovic Olivera Dolic
Backround: The aim of this study was to evaluate the effects of probiotic yogurt containing Lactobacillus rhamnosus (LGG) on the microhardness and surface roughness of restorative dental materials commonly used in pediatric dentistry. Methods: Three materials were tested: conventional glass ionomer cement Fuji II, high-viscosity glass ionomer cement Fuji IX, and microhybrid composite resin Te Econom. The samples were prepared according to the manufacturers’ instructions, initially stored in distilled water, and subsequently immersed in probiotic yogurt. Microhardness was measured by the Vickers hardness test, and surface roughness was assessed by 3D profilometers. Results: Statistical analysis was performed using the Wilcoxon signed-rank test and the Kruskal–Wallis test. Exposure to probiotic yogurt resulted in increased microhardness for the resin-modified and high-viscosity glass ionomer cements, whereas the microhardness of the microhybrid composite resin decreased. The surface roughness increased for all the tested materials, with statistically significant differences observed in most groups (p < 0.05). Conclusions: These findings indicate that probiotic yogurt can alter the physical properties of restorative dental materials and highlight the importance of careful selection of preventive agents in pediatric dental practice. Further research is needed to clarify the long-term effects of probiotic preparations on dental restorations.
]]>Authors: Željka Lovrić Bruno Špiljak Asja Čelebić Stjepanka Lešić Boris Labar Marinka Mravak-Stipetić
Objective: This study aimed to assess practicing dentists’ knowledge, attitudes, and self-confidence regarding knowledge about oral manifestations of haematological disorders and interpretation of blood count (BC) tests. Materials and Methods: An online survey was sent to all practicing dentists via email addresses registered with the Dental Chamber. The questionnaire collected sociodemographic data and assessed knowledge of hematological diseases, their oral manifestations, and BC interpretation, as well as dentists’ attitudes toward interdisciplinary collaboration and perceived need for continuing education. In the knowledge section, some questions required a single correct answer, while most allowed multiple selections. For multiple-choice items, any incorrect choice made the response incorrect; responses were partially correct if accurate but incomplete and fully correct only when all correct options were selected. Statistical analysis was performed with p < 0.05. Descriptive statistics, Shapiro–Wilk, Kruskal–Wallis H, Mann–Whitney U, and independent-samples t-tests were used. Results: A total of 308 dentists responded, representing only 7.6% of the national dental workforce. While most recognized the relevance of BC tests and systemic disease indicators in oral health, knowledge gaps were substantial. The mean score on knowledge items was low (2.81 ± 1.52 out of 11), with only 1.3% dentists achieving seven or more correct answers. Interestingly, dentists with higher self-reported confidence in interpreting BC tests had lower knowledge scores, suggesting a potential Dunning-Kruger effect. Knowledge did not differ by specialization or postgraduate education, likely reflecting limited curricular coverage, but was more strongly associated with clinical experience, practice location, and patient load. Most respondents (96.1%) expressed strong interest in further education on the topic. Conclusions: Targeted education and interdisciplinary collaboration are essential to overcome gaps and enhance knowledge and diagnostic accuracy in oral manifestations of blood diseases and BC interpretation.
]]>Authors: Matiss Salms Martins Namikis Matiss Dambergs Oskars Radzins
Background: Temporary dental crowns are an essential component of fixed prosthodontic treatment, protecting prepared teeth and maintaining occlusal function and aesthetics until delivery of the definitive restoration. Their clinical performance is strongly influenced by their internal microstructure, which directly affects mechanical behavior. Therefore, the aim of this study was to compare the internal porosity and fracture resistance of temporary dental crowns fabricated using conventional and 3D-printing techniques. Materials and Methods: This in vitro study compared the porosity and fracture resistance of three materials for provisional restorations: a bis-acrylic resin (ProtempTM 4), an autopolymerizing resin (Success CD), and a 3D-printed light-curing resin (V-Print c&b temp). Thirty-six standardized single-unit crowns (n = 12 per group) were fabricated. All specimens were analyzed using high-resolution micro-computed tomography to determine total crown volume, pore volume, and relative porosity. Fracture resistance was evaluated under monotonic compressive loading in a universal testing machine. Data were analyzed using appropriate parametric or non-parametric statistical tests (α = 0.05). Results: The 3D-printed material exhibited the lowest mean porosity (0.0029%), whereas ProtempTM 4 and Success CD showed substantially higher porosity values. However, ProtempTM 4 demonstrated the highest mean fracture resistance, followed by the 3D-printed resin and Success CD. No direct correlation between porosity and fracture resistance was observed, indicating that material chemistry and internal bonding play a more decisive role than void content alone. Conclusions: These findings suggest that 3D printing improves structural homogeneity, while bis-acrylic materials provide superior load-bearing capacity, and that each fabrication method offers distinct advantages depending on clinical requirements.
]]>Authors: Noora Al Matani Abubaker Qutieshat
Background/Objectives: Photobiomodulation (PBM) is a biologically plausible adjunct for modulating orthodontic tissue response, but its role in conventional clear aligner therapy remains uncertain. This narrative review summarises the mechanistic rationale and clinical evidence on PBM used with clear aligners, focusing on treatment efficiency, predictability, patient-centred outcomes, and biological safety. Methods: Scopus was searched using PBM/low-level laser terms combined with orthodontics and clear aligners. Titles and abstracts were screened for human studies evaluating PBM as an adjunct to conventional staged clear aligner therapy and reporting treatment duration or alignment efficiency, tracking/predictability (for example, additional aligners, refinements, or fit-related outcomes), pain, or biological safety. Eight aligner-based clinical studies formed the core set. Results: The included studies comprised case reports, retrospective cohorts, pilot investigations, and one historical prospective nonrandomized comparison. Most evaluated short daily sessions of home-use near-infrared LED PBM, while some used external laser-based or combined adjunct protocols. Some studies reported shorter treatment duration, faster alignment, or fewer finishing aligners in PBM users, but these findings were difficult to attribute to PBM alone because altered tray-change intervals and close monitoring were common co-interventions. Aligner-specific pain outcomes were inconsistently reported. Limited safety data, based mainly on one retrospective pilot cohort assessing anterior teeth, found no statistically significant difference in root-volume change between PBM users and controls. Conclusions: PBM has been investigated as a potential adjunct in clear aligner orthodontics, but the available evidence remains preliminary, heterogeneous, and largely non-randomised. No high-quality randomized clinical evidence currently supports the clinical effectiveness or routine use of PBM in clear aligner orthodontics. At present, PBM should be regarded as an investigational adjunct rather than an established clinical recommendation, pending larger and better-designed trials with standardised device-specific protocols, objective adherence measures, movement-specific analyses, and longer follow-up for safety and patient benefit.
]]>Authors: Antony Chidiac Christia Akl Richard M. Sadaka Stephanie Mrad José de Jesús Navarrete-Hernández Rim Bourgi Horacio Islas-Granillo Carlos Enrique Cuevas-Suárez Joseph Bassil
Background: Antihyperlipidemic medications are widely prescribed for the management of dyslipidemia and prevention of cardiovascular disease and may also influence bone metabolism, formation, and repair. However, their impact on peri-implant bone remodeling and dental implant survival remains insufficiently investigated. Objectives: The aim of this study was to evaluate the influence of antihyperlipidemic therapy on dental implant survival and failure rates over a ten-year period. Methods: A retrospective cohort study included 552 patients receiving 1680 dental implants between 2012 and 2022. Patients were divided into a control group (512 patients; 1581 implants) and a study group receiving antihyperlipidemic monotherapy (40 patients; 99 implants). Clinical, radiographic, and demographic data were collected and analyzed, and implant failure was assessed according to the established clinical criteria of the International Congress of Oral Implantologists. Results: Kaplan–Meier analysis demonstrated significantly better dental implant survival in patients receiving antihyperlipidemic therapy (log-rank p = 0.046). The failure rate was lower in the study group (1.01%) compared with the control group (5.12%). Cox regression analysis, adjusted for age, sex, implant diameter and length, insertion torque, and bone quality, showed that antihyperlipidemic therapy was associated with a markedly reduced risk of implant failure (HR = 0.16). Overall, the use of antihyperlipidemic medications was associated with a significantly lower risk of implant failure (p < 0.05), suggesting a beneficial effect on long-term dental implant survival. Conclusions: The present findings indicate that antihyperlipidemic therapy may be associated with improved dental implant survival and enhanced osseointegration. These results should be interpreted as hypothesis-generating and necessitate confirmation in future prospective randomized controlled studies with expanded and more balanced cohorts.
]]>Authors: Salma Sadia Israt Jahan Trina Wakar Mahmud Umme Habiba Samiul Haque Golam Sharower Atsushi Tomokiyo Rafiqul Islam
Background/Aim: This study aims to assess the prevalence of self-reported oral ulcers and their associated factors among patients with type 2 diabetes mellitus (T2DM) in Bangladesh. Materials and Methods: A hospital-based cross-sectional study was conducted among 260 patients with T2DM attending outpatient dental services at three tertiary hospitals in Dhaka. Data were collected using a semi-structured questionnaire covering sociodemographic characteristics, behavioral and dietary factors, medical history, and self-reported oral mucosal conditions. Associations between oral ulcers and potential risk factors were analyzed using Chi-square and Fisher’s exact tests. Results: Most participants were middle-aged (50–59 years), female, of low educational status and married, with a high prevalence of regular tooth-brushing but low use of oral hygiene aids such as mouthwash. Traumatic ulcers (21.5%) and oral lichen planus (19.6%) were the most frequently observed oral mucosal lesions followed by recurrent aphthous ulcers, oral lichenoid reactions, and oral candidiasis. Traumatic ulcers and oral lichenoid reactions showed associations with sharp teeth, dentures or braces, and amalgam restorations, while lichen planus and aphthous ulcers were significantly associated with smoking, systemic conditions such as hypertension, and coexisting oral lesions such as oral candidiasis. Multivariable logistic regression showed that sharp teeth, denture or brace use, amalgam restorations, and tobacco-related habits were associated with oral lesions. Conclusions: Oral ulcers and related mucosal lesions were found to be common among patients with T2DM in Bangladesh, with traumatic ulcers being most frequent and several local and behavioral factors showing significant associations.
]]>Authors: Bruna Cristina de Freitas Ribeiro Juliana Jendiroba Faraoni Amanda Cristina de Almeida Rodrigo Silveira Tosta Figueiredo Enir Rabêlo da Silva Regina Guenka Palma-Dibb
Objective: To evaluate the ability of an experimental propolis/chitosan varnish to inhibit the erosive process in primary tooth enamel. Materials and Methods: Forty-two primary incisors were selected and divided into three groups (n = 14): control/no treatment, Duraphat® varnish, and propolis/chitosan varnish. The varnishes were applied to the experimental area and left in place for 4 h. After varnish removal, the specimens were subjected to erosive challenges with Coca-Cola®. The quantitative outcome variables were mineral loss assessed by longitudinal microhardness, surface roughness, and wear profile. The data were analyzed using ANOVA and Tukey’s test (p < 0.05). Results: Wear profile and surface roughness analyses showed no significant differences among the groups (p > 0.05). In the microhardness analysis, the control and experimental groups showed significant differences between the control and demineralized areas and between the control and experimental areas (p < 0.05). In the Duraphat group, a significant difference was observed between the control and experimental areas (p < 0.05). Conclusions: The experimental propolis/chitosan varnish was unable to prevent the progression of mineral loss in the enamel of primary teeth subjected to erosive challenge. Duraphat® fluoride varnish was also unable to protect the enamel. Clinical relevance: Several studies have investigated the use of propolis and chitosan in dentistry, and promising results have been reported when these agents are used individually; however, the propolis/chitosan combination remains poorly explored. To the best of our knowledge, this is the first study to investigate this combination for dental erosion in primary teeth.
]]>Authors: Luigi Sardellitti Alessio Pirino Armando Di Palma Enrica Filigheddu Egle Patrizia Milia
Background/Objectives: Vascular complications associated with dermal filler injections are rare but potentially severe, particularly when ocular or neurological structures are involved. Current evidence on pathophysiology, clinical management, and prevention remains heterogeneous. This systematic review aimed to synthesize available clinical evidence on vascular occlusion related to dermal filler injections, focusing on clinical presentation, management strategies, and preventive approaches. Methods: This systematic review was conducted and reported according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (ID: CRD420261323578). PubMed/MEDLINE, Scopus, and the Cochrane Library were searched for studies published between January 2015 and February 2025. Clinical trials, observational studies, case series, and case reports describing vascular complications following facial dermal filler injections were included. Study selection and data extraction were performed independently by two reviewers. Risk of bias was assessed using RoB 2.0 for randomized trials, the Newcastle–Ottawa Scale for observational studies, and Joanna Briggs Institute checklists for case reports and case series. Due to methodological heterogeneity, results were synthesized qualitatively. Results: A total of 1922 records were identified, and 91 studies met the inclusion criteria. Vascular complications were primarily related to intravascular embolization or external vascular compression. Hyaluronic acid fillers accounted for most reported events and were associated with more favorable outcomes owing to enzymatic reversibility with hyaluronidase. Cutaneous ischemia represented the most frequent complication and generally resolved with early high-dose hyaluronidase administration, whereas ocular and neurological events were less common but frequently resulted in permanent deficits. Imaging-guided approaches, particularly ultrasound-assisted techniques, emerged as promising tools for both prevention and targeted management. Conclusions: Vascular occlusion following dermal filler injections represents a time-critical clinical emergency requiring prompt recognition and intervention. The available evidence supports a time-dependent therapeutic model in which early treatment appears to improve cutaneous outcomes, whereas ocular complications remain associated with poor prognosis despite aggressive rescue strategies. Complications related to non-hyaluronic or permanent fillers and autologous fat appear to be associated with more limited therapeutic options and a higher risk of irreversible damage. The certainty of evidence is limited by heterogeneity of study designs and the predominance of descriptive and observational reports. Registration: PROSPERO (ID: CRD420261323578).
]]>Authors: Mustafa F. Abd Al-Hussein Nada E. Shafiq Anas F. Mahdee Mohammed Taha Ahmed Baban Sarhang S. Gul
Objectives: The primary objective of vital pulp therapy (VPT) is to induce the formation of tertiary dentin bridge through the application of bioactive materials to maintain pulp vitality. This study aimed to evaluate the odontogenic potential of Moringa oleifera ethanolic and aqueous extracts as sustainable herbal pulp capping materials in comparison to mineral trioxide aggregate (MTA) and a bioceramic putty. The evaluation was conducted in vitro on human dental pulp stem cells (DPSCs) and in vivo using a rat model of direct pulp capping. Methods: Moringa leaf extracts were prepared and the cytotoxicity assessed using MTT assay to measure the IC50, and their odontogenic potential was further evaluated in vitro by measuring alkaline phosphatase (ALP) activity and performing Alizarin Red staining for mineralization in comparison to MTA. For the in vivo study, the exposed rat pulps were capped with the extracts, MTA, the bioceramic putty, or a plain collagen sponge (control). Histological analysis was performed to evaluate inflammation and tertiary dentin bridge formation. Results: The ethanolic, aqueous extracts and MTA showed low cytotoxicity, though the ethanolic extract had significantly enhanced ALP expression (p < 0.05) and mineralized nodule formation (p < 0.05) compared to the other groups. In the in vivo study, the plain collagen sponges failed, resulting in necrosis. Conversely, MTA and the ethanolic extract exhibited the best outcomes, inducing the lowest inflammatory response (mainly score 1 and 2) and the successful formation of an irregular dentin bridge by odontoblast-like cells, whereas the aqueous extract and bioceramic putty showed intermediate results, with higher inflammation levels. Conclusions: Ethanolic Moringa oleifera extract is a highly biocompatible material with potent odontogenic induction capabilities, primarily driven by its flavonoid content. It is a promising, novel, and cost-effective material for use in the VPT as an effective alternative to MTA.
]]>Authors: Marie Siano Rosana Costa Marta Relvas Ana Sofia Vinhas Cátia Reis Cristina Cabral
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.
]]>Authors: Petrică-Florin Sava Ionuț Tărăboanță Daniela Șulea Ilie-Cristian Drochioi Bogdan Radu Dragomir Mihai Ciofu Ștefan Gherasimescu Otilia Boișteanu Victor-Vlad Costan
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.
]]>Authors: Diana Florina Nica Stefania Dinu Doina Chioran Adrian Nicoara Mircea Rivis Virgil-Florin Duma Cosmin Sinescu Meda Lavinia Negrutiu Cristina Langa Cristian Zaharia
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.
]]>Authors: Pierangelo Burdo Roberta Pasqualone Amar Ferati Mattia Sozzi Cristina Meuli Giuseppe Varvara
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.
]]>Authors: Raffaele Vinci Saverio Cosola Gian Luca Pancrazi Marco Esposito
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.
]]>Authors: Jose Ramon Herrera Balaji Kolasani Sandeepkumar Gaddam Aishwarya Kunam Devon Roese George J. Eckert Grace Gomez Felix Gomez Thankam P. Thyvalikakath
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.
]]>Authors: Anna Schiavelli Romeo Patini Davide Guerrieri Carlo Lajolo Carmen Chiara Nacca Cosimo Rupe Edoardo Staderini Gioele Gioco
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.
]]>Authors: Mohammed Mudher Mohammed Neda Mohammed Al-Kaisy
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.
]]>Authors: Maria Cristina Borsatto Barbara Jarreta Jaciara Miranda Gomes-Silva Patricia Gatón-Hernández Carolina Paes Torres Rodrigo Galo
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.
]]>Authors: Michaela Stoupi Myrto Telopoulou Vasileios Zisis Nikolaos Shinas Elpida-Niki Emmanouil-Nikoloussi
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.
]]>Authors: Filippos Fytros Vasileios Zisis Petros Papadopoulos Thomas Chontos Konstantinos Poulopoulos Christina Charisi Andreas Yiannouras Vasiliki Arsoudi Athanasios Poulopoulos Smaragda Diamanti
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.
]]>Authors: Florinel Cosmin Bida Andrei Georgescu Ionut Taraboanta Claudiu Gabriel Palamaru Ionut Luchian Dana Gabriela Budala Nicoleta Tofan Carina Balcos Oana Maria Butnaru Dragos Ioan Virvescu
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.
]]>Authors: Ryo Shiraishi Chonji Fukumoto Shuma Yagisawa Toshiki Hyodo Aya Koike Amu Fujiwara Yosuke Kunitomi Yuske Komiyama Shigeru Toyoda Takahiro Wakui Hitoshi Kawamata
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.
]]>Authors: Teodor Chioasca Sorin Deacu Emma Gheorghe Mihaela Cezarina Mehedinți Felicia Mihailuta Lenuta Ambrose Madalina Matei Maria Andrada Hincu
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.
]]>Authors: Michael Moncher Vera Zimprich Jonathan von See Jörg Philipp Tchorz Theodor von See Constantin von See
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.
]]>Authors: Rasa Mladenovic Katarina Kalevski Marko Milosavljevic Nikola Prodanovic Tanja Lukovic Zecevic Tijana Prodanovic Kristina Mladenovic Dejan Dimitrijevic
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.
]]>Authors: Marisca Meyer Casper Hendrik Jonker Sandeepa Rajbaran-Singh Federico Foschi Anna Catherina Oettlé
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.
]]>Authors: Ahmed A. Al-Kubaisi Sarah Adnan Khalaf Rosull Saadoon Abbood Dhuha D. M. Alrawi Fadhela Nafea Kafe Layth Mula-Hussain Sameer Ahmed Awad
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.
]]>Authors: Tracy L. Finlayson Martin Riegels Padideh Asgari Nannette Stamm Ana Palomo-Zerfas Arcela Nunez-Alvarez
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.
]]>Authors: Islam E. Ali Mariko Hattori Yuka Sumita Kirstin Vach Ralf-Joachim Kohal Noriyuki Wakabayashi
Background/Objectives: This in vitro study investigated the trueness of digital impressions (DIs) obtained using an intraoral scanner (IOS) compared to conventional impressions (CIs) on resin model replicas of mandibulectomy defects. Methods: Mandibulectomy resin models from 20 patients were used, including 10 partially edentulous (PE) and 10 completely edentulous (CE) patients. All models were scanned using an industrial scanner to obtain reference datasets. For CIs, silicone impressions were made in custom trays, poured into stone models, and subsequently scanned with the industrial scanner to create the test groups (n = 10 each): CI-PE and CI-CE. For the DI, an IOS (True Definition; TD) was used to directly scan the 20 models, yielding the groups DI-PE and DI-CE (n = 10 each). All test scans were superimposed on their corresponding reference scans, and trueness was assessed by calculating the mean absolute deviations (µm). Statistical analysis was performed to compare trueness across groups. Results: The mean deviations (µm) in CI-PE, CI-CE, DI-PE, and DI-CE were 26.49 ± 6.39, 23.10 ± 8.94, 76.64 ± 31.75, and 80.93 ± 33.21, respectively. Impression technique significantly affected the trueness results, with DIs showing higher overall deviations (78.78 ± 31.69 µm) than the CIs (25.24 ± 7.67 µm). No significant difference in trueness was found between partially and completely edentulous models. Conclusions: Digital impressions of mandibulectomy models made with a TD scanner had significantly lower trueness than CIs. However, the observed deviations remained within clinically acceptable limits (around 300 µm in 99.5% of the model scans), demonstrating the feasibility of TD for scanning mandibulectomy models.
]]>Authors: Dominik Niklas Elvers Marius Meier Dritan Turhani Sebastian Fitzek Philipp Johann Poxleitner Jörg Philipp Tchorz
Background/Objectives: Cone beam computed tomography (CBCT) is vital in endodontics but suffers from beam-hardening artifacts caused by metallic restorations, which can obscure diagnostic details. This study evaluated a novel patient positioning protocol—a controlled head tilt—designed to mitigate these artifacts by moving contralateral metallic structures outside the primary X-ray path in small field of view (FoV) CBCTs. Methods: Using a skull phantom with metallic restorations CBCT scans were acquired in three positions: standard alignment, a 12° tilt toward the region of interest (ROI), and a 12° tilt to the opposite side. Fifty experienced dentists, blinded to the protocol, subjectively compared image quality and artifact severity between the tilted and reference images. Results: The tilt away from the ROI was rated as providing better image quality significantly more often than the tilt towards the side of the ROI (442 of 585 non-tied comparisons; p < 0.001). A complementary rater-clustered GEE analysis adjusted for slide confirmed higher odds of “better” ratings under head tilt away from the ROI for image quality (OR = 4.16, 95% CI 3.12–5.56) and artefacts (OR = 2.87, 95% CI 1.93–4.26). An individual head tilt significantly improves subjective small-FoV CBCT image quality, most evidently in the longitudinal plane, by reducing artifact interference from contralateral metals, and should be considered a practical strategy for clinical use, and may serve as a practical chairside strategy, pending clinical validation.
]]>Authors: Ana Baptista Sandra Gavinha Maria Conceição Manso
Background: Oral health (OH) is integral to general health, well-being, and quality of life; however, in long-term care (LTC) settings, it is often neglected due to residents’ functional limitations, high care dependency, and the prioritization of underlying medical conditions by healthcare staff. Previous studies have highlighted this issue and identified multiple barriers to OH promotion in institutional settings. Objectives: To assess OH practices among nurses (NUR) and nursing assistants (NA) in LTC units and to identify barriers compromising effective oral care delivery. Methods: An observational, cross-sectional, descriptive study was conducted across five LTC facilities in Porto, Portugal. A structured survey was administered to 145 healthcare workers out of a total of 259 eligible participants, yielding a response rate of 55.98%. Data were collected via Google Forms and analyzed using IBM SPSS Statistics v.26. Descriptive statistics, analysis of variance, the Mann–Whitney U test, and Chi-square tests were applied, with a significance level of 0.05. Results: The main primary barriers to OH promotion included poor patient cooperation (74.6%), lack of dentists (74.6%), insufficient material (62.7%), limited time (45.8%) and inadequate staffing (40.7%). Chlorhexidine (94.50%) and oral sponges (70%) were the most frequently used resources, whereas other methods were underutilized. No statistically significant differences were observed between professional groups, irrespective of prior training. Although 48.5% of NUR and 51.5% of NA reported not perceiving barriers, substantial gaps in practice were identified. Only 1.9% of untrained NA reported consulting evidence-based scientific sources, compared with 44.7% of untrained NUR. Conclusions: Despite limited perceived barriers, significant deficiencies in OH practices persist in LTC settings, highlighting the need for structured, interdisciplinary training programs to improve oral care delivery.
]]>Authors: Luis Alain Lara Espinosa Ximena Alejandra Checa Caratachea Álvaro Edgar González-Aragón Pineda Gustavo Castillo Salazar
Background/Objectives: Interproximal reduction (IPR), also known as dental stripping, is a commonly used orthodontic technique to gain space, avoid extractions, and correct tooth size discrepancies, particularly in contemporary orthodontics and clear aligner therapy. The aim of this systematic review was to update the evidence from the last 10 years regarding the dental and periodontal effects associated with IPR. Methods: A systematic review of the literature was conducted including studies published between January 2015 and July 2025. Searches were performed in PubMed, SciELO, LILACS, Cochrane Library, and Google Scholar. Primary studies reporting dental and/or periodontal outcomes related to IPR were included. Study selection and data extraction were performed following PRISMA guidelines. Results: Twelve studies met the inclusion criteria, comprising in vitro and in vivo designs. The available evidence indicates that IPR is associated with transient changes in enamel surface roughness and minimal increases in pulp temperature, which remains below critical thresholds when appropriate techniques and cooling measures are used. No consistent evidence of increased caries risk, periodontal deterioration, or tooth sensitivity was reported. Surface polishing and fluoride application were frequently associated with more favorable outcomes. Conclusions: Based on the available evidence from the last decade, IPR appears to be a clinically safe orthodontic procedure when performed with proper technique, adequate case selection, and appropriate finishing protocols. However, heterogeneity among study designs highlights the need for further well-designed clinical studies to strengthen the evidence base.
]]>Authors: Lucia Giannini Antonino Manti Rosanna Mazzeo Benedetta Zunino Luca Esposito
Background/Objectives: Temporomandibular disorders (TMDs) are a group of multifactorial conditions affecting the temporomandibular joints (TMJs), masticatory muscles, and associated structures. TMDs are identified as the main cause of non-dental orofacial pain in children and adolescents. This scoping review aims to explore recent evidence on prevalence, clinical presentation, associated factors, and treatment approaches of TMDs in children and adolescents. Methods: A systematic search was conducted across PubMed, Scopus and Embase for studies published between 2015 and 2025, following PRISMA-ScR guidelines. Results: Thirty-eight studies were included. TMD prevalence in children and adolescents ranged from 16.9% to 40% through clinical examination, with painful TMD rates ranging from 16.2% to 25.5%, while symptom-based surveys reported prevalences of 9–35.3%. The most frequent diagnoses were myofascial pain, myalgia, arthralgia and disc displacement with reduction. Female sex and increasing age were consistent risk factors. Psychosocial variables, such as anxiety and depression, showed strong associations with pain-related TMDs. Structural and systemic conditions such as musculoskeletal alterations, joint hypermobility, respiratory conditions and headaches/migraines were also frequently reported. Evidence on treatment appears to be limited. In juvenile idiopathic arthritis (JIA), TMJ involvement is prevalent (32.6–64%), particularly in the persistent oligoarticular subtype. Conclusions: TMDs in children and adolescents are prevalent and multifactorial conditions, mainly of muscular origin, presenting more frequently in adolescents and females. Psychosocial factors, functional habits, clenching, mouth breathing and systemic conditions may be associated with TMD presence or severity. Substantial heterogeneity persists in diagnostic criteria, assessment tools and outcome measures. Research on therapeutic interventions is scarce and often limited to small samples. Standardized diagnostic protocols, improvements in research consistency, longitudinal cohorts and RCTs are needed to clarify etiological pathways, validate diagnostic criteria and establish effective, evidence-based strategies for the management of TMDs in children and adolescents.
]]>Authors: Cristin Coman Gheorghiu Petronica Caraș Iuliana Diana-Larisa Ancuța
Objectives: The present study evaluated the efficacy of a preparation based on bacterial lysates of Streptococcus oralis, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum in the treatment of experimental periodontitis in rats, compared to metronidazole. Methods: Twenty female Wistar rats were used, divided into three groups: control, bacterial lysates and metronidazole, administered for 10 days by oral lavage/gavage. Periodontitis was induced by ligatures contaminated with bacterial suspensions (109 CFU/mL) for 4 weeks. Lysates were obtained by culturing bacterial strains, centrifugation, washing, heat inactivation, ultrasonication and filtration. The evaluations included biocompatibility on HGF-1 fibroblasts, microbiological stability, clinical parameters, hematological, biochemical and histopathological analyses. Results: The lysates demonstrated the absence of cytotoxicity (cell viability 90–100%) and significant antimicrobial effect at the optimal concentration (2 × 109 CFU/mL equivalent). Both treatments significantly reduced periodontal inflammation, with no statistical differences between them. Systemic immunoinflammatory indices (SII, SIRI, AISI) increased comparably, demonstrating controlled immune mobilization, and ALT was maintained within physiological limits. Histopathological examination revealed a reduction in inflammatory infiltrate, connective tissue reorganization and bone regeneration in both treated groups. Conclusions: Bacterial lysates represent a viable therapeutic alternative with comparable efficacy to metronidazole, favorable safety profile and immunomodulatory potential in the treatment of periodontitis.
]]>Authors: Eliakym Arámbula Meraz Andrea Ross Orozco Maricela Ramírez Álvarez Noemi García Magallanes América Yazmín Torres Moreno Gloria Elena Guzmán Celaya Valeria Ibarra Villanueva Jesús Armando Beltrán León Adriana Koratzy Ochoa García Fred Luque Ortega
Background: Periodontal disease is a chronic inflammatory condition characterized by progressive destruction of the supporting tissues of the teeth. MicroRNAs (miRNAs) have emerged as key post-transcriptional regulators of immune and inflammatory responses; however, their coordinated expression patterns in periodontal disease remain incompletely understood. Objective: This study aimed to evaluate the expression of miR-141-3p, miR-146a-5p, and miR-148b-3p in periodontal disease and to explore their potential co-regulation in relation to periodontal inflammation. Methods: Gingival samples were collected from individuals with periodontal disease and periodontally healthy controls. miRNA expression levels were quantified by real-time quantitative PCR using TaqMan assays and normalized to miR-191-5p. Relative expression was calculated using the ΔΔCt method. Statistical analyses included group comparisons and correlation analyses to assess relationships among miRNA expression levels. Results: miR-146a-5p expression was significantly reduced in periodontal disease compared with healthy controls (p < 0.05), while miR-141-3p showed a consistent downward trend without reaching statistical significance. No significant differences were observed for miR-148b-3p expression between groups. Notably, strong positive correlations were identified among the three miRNAs, indicating coordinated expression patterns independent of disease stage or grade. Conclusions: The findings demonstrate altered expression of miR-146a-5p and coordinated regulation of miR-141-3p, miR-146a-5p, and miR-148b-3p in periodontal disease. These results support the concept that miRNAs act within regulatory networks rather than as isolated markers and contribute to a more nuanced understanding of miRNA-mediated regulation in periodontal inflammation.
]]>Authors: Leopoldo Mauriello Giuseppe Trapanese Vitolante Pezzella Graziano Zappalà Elio Ramaglia Vincenzo Iorio-Siciliano Luca Ramaglia Andrea Blasi
Background: Periodontitis is a disease characterized by the destruction of periodontal tissue and tooth loss. The molecular mechanisms behind this disease, however, are not clearly understood. Ferroptosis is an iron-dependent, lipid peroxidation-driven form of regulated cell death that seems to play a role in periodontal pathogenesis by increasing oxidative stress and reducing tissue regeneration. Objective: The current narrative review aims to summarize current knowledge of the involvement of ferroptosis in periodontal tissue destruction and potentially to identify new targets of therapy. Methods: A comprehensive search of PubMed, Embase, and Web of Science databases was conducted. Original human, animal, and in vitro studies published in English were selected. Data on experimental models, molecular markers, and key outcomes were extracted and synthesized in the review. Results: After screening, four studies were identified and selected. Ferroptosis activation in periodontal ligament fibroblasts, stem cells, and gingival tissues was associated with increased ACSL4 and decreased GPX4 expression, iron accumulation, and oxidative stress. The administration of Ferrostatin-1 or antioxidants like curcumin seemed to reduce inflammation and alveolar bone loss in vivo. Transcriptomic analyses further revealed immune-related ferroptosis gene signatures in human periodontitis tissues. Conclusions: Ferroptosis represents a crucial mechanism in periodontal tissue destruction through not yet completely understood. Understanding these molecular pathways could be the key to developing new therapeutic strategies for periodontal treatment.
]]>Authors: Benedikta Kamdem Anthony S. de Buys Roessingh
Objective: Bilateral cleft lip and palate (BCLP) is a craniofacial malformation often associated with anatomical and functional impairments, including a shallow oral vestibule in the premaxillary region. This condition requires a vestibuloplasty to restore the space between the teeth and upper lip, also improving aesthetics. Traditional techniques frequently require autologous grafts, leading to increased morbidity. Tissue bioengineering provides suitable alternatives. Methods: We present the case of a 19-year-old female, who had undergone several surgeries for BCLP management, complaining of a lack of upper lip projection and an insufficient vestibular dept in the premaxilla region. We reported short-term follow-up using Acellular Fish Skin Graft (AFSG, Kerecis™) as a substitute to autologous graft to perform a vestibuloplasty. Outcome assessment was based on clinical measurements. Results: The graft showed early signs of vascularization. Clinical outcomes included improved vestibular depth, from 1 mm preoperatively to 8 mm, upper lip projection, and functional mobility after a six-month follow-up period. The patient experienced an uneventful recovery and was satisfied with the aesthetic result. Conclusions: This case, presenting the first application of AFSG in vestibuloplasty, tends to reassure us about its safety. AFSG might be an effective biocompatible alternative to autologous grafts in vestibuloplasty, offering promising results in mucogingival reconstruction. Further studies are needed to confirm long-term stability and integration in oral tissues.
]]>Authors: Yang Yang Miao Yu Xiaoming Zhu Qian Ding
Objective: This study was intended to evaluate the effects of the case-based learning (CBL) and Sandwich teaching methods in clinical practice of prosthodontics. Methods: 82 fifth-year students who were undertaking clinical practice of prosthodontics in Peking University School and Hospital of Stomatology (PKUSS) were included in this study. The CBL–Sandwich courses using typical esthetic cases were applied in the experimental group (40 students), while the control group (42 students) used a traditional teaching method during clinical practice. No significant differences were observed in the responses in age or pre-internship theoretical scores between the two groups (p > 0.05). After 10 months of training, clinical skills assessment and anonymous questionnaires were conducted. Results: The scores of clinical skills in the experimental group were all significantly higher than in the control group (p < 0.01). The former also showed significantly higher scores (p < 0.01) in three questionnaire items, while study burden was nearly the same between the two groups. Conclusions: The CBL–Sandwich teaching method can improve students’ clinical skills during prosthodontic internship and enhance their interest in learning.
]]>Authors: Fabio Massimo Sciarra Giovanni Caivano Emanuele Di Vita Mario Palermiti Pietro Messina Enzo Maria Cumbo Luigi Caradonna Salvatore Nigliaccio Davide Alessio Fontana Antonio Scardina Giuseppe Alessandro Scardina
Background: Infective endocarditis (IE) is a severe and multifactorial condition historically linked to dental procedures. Current evidence shows that most cases arise from complex host–microbe interactions and biofilm colonization on damaged endothelium or intracardiac/prosthetic material, while the inappropriate use of antibiotics in dentistry promotes antimicrobial resistance. Objectives: To provide a narrative synthesis of contemporary evidence on (i) the relative contribution of dental procedures versus daily oral inflammatory burden to bacteremia and IE risk, (ii) the role of periodontal disease and the oral resistome in AMR, and (iii) the clinical and medico-legal implications of antibiotic prescribing and guideline adherence in dental practice. Materials and Methods: A narrative review was conducted using PubMed, Scopus, ResearchGate, and Google Scholar, complemented by manual screening of reference lists and relevant guideline documents. The search covered approximately the last decade (2015–2025) and included ESC 2023 and AHA 2021 guidance on IE prevention. Search terms combined concepts related to “infective endocarditis”, “antibiotic prophylaxis”, “dentistry/dental procedures”, “periodontitis/periodontal disease”, “bacteremia”, “biofilm”, “oral microbiome/oral resistome”, and “antimicrobial stewardship/antibiotic resistance”, using Boolean operators. Eligible sources included clinical studies, systematic reviews/meta-analyses, consensus statements and guidelines, and selected medico-legal literature relevant to dental decision-making and documentation. Editorials and non-peer-reviewed items without retrievable full text were not considered for evidence synthesis. Results: The reviewed evidence supports that spontaneous bacteremia associated with active periodontitis and daily oral activities may be more frequent than procedure-related bacteremia, suggesting that inflammation control and biofilm management represent a major preventive lever. Antibiotic prophylaxis should be reserved for a limited subset of high-risk cardiac patients as per contemporary ESC/AHA recommendations, whereas routine “defensive” prescribing in low-risk contexts provides minimal expected benefit and carries individual and societal harms (adverse events, microbiome disruption, AMR selection). Integrating periodontal care pathways with risk stratification and targeted antibiotic stewardship can improve patient safety and support public health. Conclusions: Dentistry plays a strategic preventive role in IE and AMR primarily through periodontal inflammation control, asepsis, and prudent antibiotic use. From a medico-legal standpoint, professional liability should be assessed on a process-based standard (risk assessment, adherence to updated guidelines, causal local treatment, informed consent, and traceable follow-up) rather than on outcome-driven hindsight.
]]>Authors: Luigi Sardellitti Francesca Luisa Floris Marco Bonardi Giovanni Landi Anna Di Marzio Matteo Caviglia Chiara Ciacciarelli Elisa Deidda Enrica Filigheddu Egle Patrizia Milia
Background/Objectives: Dental caries remains one of the most prevalent chronic diseases in early childhood, and traditional preventive strategies often fail to achieve sustained risk reduction without individualized management. The Caries Management by Risk Assessment protocol (CAMBRA) provides a structured, risk-based preventive approach integrating clinical and behavioral indicators. This study evaluated the two-year effectiveness of a CAMBRA-based prevention program in preschool children. Methods: A prospective observational cohort study was conducted in a university-affiliated pediatric dentistry clinic in Italy. A total of 296 children aged 4–6 years were enrolled and classified into caries risk categories according to CAMBRA criteria. Personalized preventive plans included oral hygiene education, dietary counselling, fluoride applications, and sealants where indicated. Clinical outcomes were assessed over a 24-month follow-up period. Results: Over two years, a substantial shift toward lower caries risk categories was observed, with the proportion of children classified as High/ Very High risk markedly reduced. Improvements were also recorded in caries experience (dmft) and oral hygiene status (OHI-S). Greater adherence to scheduled follow-up visits was associated with a higher likelihood of clinical improvement. Conclusions: A CAMBRA-based, risk-guided preventive program implemented in a public pediatric dental setting was associated with meaningful improvements in caries risk profiles and oral health parameters over 24 months. Regular follow-up and caregiver engagement appear to be key factors in sustaining preventive benefits in high-risk preschool populations.
]]>Authors: Prabhleen Kaur Alexander Milosevic
Studies on links between Oral Health-Related Quality of Life (OHRQoL) and use of dental services among UK children are lacking. This study aimed to assess the relationship between OHRQoL and dental attendance in 12- and 15-year-old children in the UK using secondary data from the UK Child Dental Health Survey (CDHS, 2013). Methods: OHRQoL was measured as the exposure using the Child-OIDP (Oral Impacts on Daily Performances), and dental attendance was the outcome in this analysis. Dental attendance was measured by asking children whether they visited the dentist regularly, only when in trouble, or never. Logistic regression models analysed the relationship between OHRQoL and dental attendance accounting for potential confounding factors such as socio-demographic characteristics, health behaviours, and anxiety. Results: Data from 4136 children aged 12 and 15 years found that the prevalence of dental attendance ‘only when in trouble or never’ was 20.5% among children who reported at least one impact, compared to 13.6% among children reporting no impacts. A social gradient was apparent, as 28% of children living in deprived areas exhibited problem-oriented dental attendance compared with 8.6% in affluent areas. Logistic regression unadjusted estimates of children who reported at least one impact on QoL had 1.64 times greater likelihood of visiting the dentist ‘only when in trouble or never’ compared to children reporting no impacts (OR: 1.64, 95%CI: 1.24, 2.17). Adjusting for confounders reduced this to OR 1.39 (95% CI: 1.10, 1.77). Furthermore, the greater the number of negative impacts that were reported, the higher the odds of visiting a ‘dentist only when in trouble or never’. In the fully adjusted model, children who reported either two or more impacts had higher odds of visiting the dentist ‘only when in trouble’. Children who reported only one impact were as likely to seek dental treatment ‘only when in trouble’ as children reporting no impacts. Conclusions: Both poorer OHRQoL and problem-oriented attendance were more evident in children from lower-socio-economic backgrounds. Barriers to regular dental attendance affecting children from disadvantaged backgrounds should be addressed and dental care prioritised.
]]>Authors: Tomasz Marecik Krzysztof Gąsiorowski Jakub Bargiel Grażyna Wyszyńska-Pawelec Michał Gontarz
Iatrogenic maxillary sinusitis accounts for a significant proportion of unilateral sinus infections. This report describes a 36-year-old HIV-positive patient with Serratia marcescens chronic left maxillary sinusitis and ethmoiditis caused by migration of a dental implant into the maxillary sinus. The implant was successfully removed endoscopically via functional endoscopic sinus surgery. Histopathological examination revealed polypoid mucosa with chronic inflammation, while microbiological culture grew Serratia marcescens, an uncommon and opportunistic pathogen. Targeted antibiotic therapy with trimethoprim/sulfamethoxazole was administered for 20 days. Six-month follow-up revealed complete remission without recurrence of sinusitis.
]]>Authors: Andrei Vorovenci Viorel Ștefan Perieanu Mihai Burlibașa Mihaela Romanița Gligor Mădălina Adriana Malița Mihai David Camelia Ionescu Ruxandra Stănescu Mona Ionaș Radu Cătălin Costea Oana Eftene Cristina Maria Șerbănescu Mircea Popescu Andi Ciprian Drăguș
Objectives: To compare artificial intelligence (AI) crown design with expert or non-AI computer-aided (CAD) design for single-unit tooth and implant-supported crowns across efficiency, marginal and internal fit, morphology and occlusion, and mechanical performance. Materials and Methods: This systematic review was conducted and reported in accordance with PRISMA 2020. PubMed MEDLINE, Scopus, Web of Science, IEEE Xplore, and Dentistry and Oral Sciences Source were searched from 2016 to 2025 with citation chasing. Eligible studies directly contrasted artificial intelligence-generated or artificial intelligence-assisted crown designs with human design in clinical, ex vivo, or in silico settings. Primary outcomes were design time, marginal and internal fit, morphology and occlusion, and mechanical performance. Risk of bias was assessed with ROBINS-I for non-randomized clinical studies, QUIN for bench studies, and PROBAST + AI for computational investigations, with TRIPOD + AI items mapped descriptively. Given heterogeneity in settings and endpoints, a narrative synthesis was used. Results: A total of 14 studies met inclusion criteria, including a clinical patient study, multiple ex vivo experiments, and in silico evaluations. Artificial intelligence design reduced design time by between 40% and 90% relative to expert computer-aided design or manual workflows. Marginal and internal fit for artificial intelligence and human designs were statistically equivalent in multiple comparisons. Mechanical performance matched technician designs in load-to-fracture testing, and modeling indicated stress distributions similar to natural teeth. Overall risk of bias was judged as some concerns across tiers. Conclusions: Artificial intelligence crown design delivers efficiency gains while showing short-term technical comparability across fit, morphology, occlusion, and strength for single-unit crowns in predominantly bench and in silico evidence, with limited patient-level feasibility data. Prospective clinical trials with standardized, preregistered endpoints are needed to confirm durability, generalizability, and patient-relevant outcomes, and to establish whether short-term technical advantages translate into clinical benefit.
]]>Authors: Francisco Javier Silvestre Cecilia Fabiana Márquez-Arrico Javier Silvestre-Rangil Belén García-López
Background: The progressive aging of the population has led to an increased prevalence of chronic diseases and polypharmacy, with arterial hypertension representing one of the most frequent conditions. Consequently, the management of vital signs during dental interventions, such as tooth extractions, has acquired particular clinical relevance. The present study aimed to analyze the hemodynamic impact of vasoconstrictors (VAs) used in local anesthesia (LA) at different procedural stages in patients with pharmacologically controlled hypertension, as well as to compare these effects with those observed in normotensive individuals. Additionally, the study evaluated the influence of antihypertensive medication on hemodynamic responses during dental extraction. Methods: A case–control study was conducted at Dr. Peset University Hospital (Valencia, Spain), including 254 patients—148 hypertensive (controlled with type 1 and 2 antihypertensive therapy) and 106 normotensive controls. Hemodynamic parameters—systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and oxygen saturation (SO2)—were recorded at four time points: baseline (T1), five minutes post anesthesia with 4% articaine and epinephrine (T2), upon completion of extraction (T3), and one week postoperatively (T4). Results: The SBP remained more stable in normotensive patients, while both groups exhibited a slight DBP decrease at T2, with recovery by T3. In hypertensive patients treated with angiotensin receptor blockers (ARBs), DBP decreased further. Tooth extraction under controlled hypertension conditions caused a mild, clinically insignificant increase in HR. Conclusions: Significant fluctuations in SBP, DBP, and SO2 occurred during dental extraction, underscoring the necessity for vigilant intraoperative monitoring and individualized management of hypertensive patients.
]]>Authors: Maria Fostiropoulou Eftychia Pappa Konstantinos Tzimas Efstratios Papazoglou
Background/Objectives: This article presents a novel approach that combines the Palatal Silicone Key and Injection Molding techniques as a viable alternative for complex anterior cases with high esthetic demands, where layering multiple shades is essential to achieve a natural appearance, rather than using a single monochromatic composite. Methods: The Palatal Silicone Key technique utilizes a silicone index to transfer palatal and incisal anatomy from a diagnostic wax-up, allowing freehand layering of proximal and buccal surfaces with multiple composite shades. The Injection Molding technique provides a simpler and more predictable workflow by using a transparent silicone index to replicate the wax-up. However, the original injection technique relies on a single-shade composite, limiting the esthetic outcomes. In the presented case canines and first premolars were reshaped to replace congenitally missing lateral incisors. Palatal surfaces were built with medium-viscosity enamel shade composite using the silicone key, and dentin anatomy was sculpted freehand with dentin shade composite. Buccal anatomy was restored by injecting enamel shade flowable composite into the transparent index. Results: This combined protocol facilitated the precise transfer of the wax-up, minimizing adjustments, while the use of multiple composite shades reproduced the natural translucency of adjacent teeth, resulting in highly esthetic restorations. Conclusions: Handling traditional composites in complex anterior cases can be time-consuming and technique-sensitive. The presented combination of techniques, while requiring a high level of skill and precision, integrates the strengths of both approaches, enabling a minimally invasive, additive workflow with reduced clinical time and more predictable esthetic outcomes.
]]>Authors: Karl M. Lyons Robert M. Love John Beumer Mahmoud M. Bakr Richard D. Cannon
Objectives: This study aimed to investigate the influence of saliva on the adhesion of C. albicans to various obturator prosthetic materials. Methods: This in vitro study investigated C. albicans adherence using clinical isolates, including one isolated from an obturator. The adherence of C. albicans cells to heat-cured acrylic, self-cured acrylic, a tissue conditioner, and silicone was measured using static and flow adhesion assays. The effect of pooled saliva from patients receiving radiotherapy or healthy volunteers on C. albicans adherence was determined. The adsorption of salivary proteins to acrylic coupons was investigated using SDS-polyacrylamide gel electrophoresis, Western blotting, and mass spectrometry. Results: It was found that C. albicans adhered to all obturator materials. Saliva was found to approximately double the adhesion of C. albicans to obturator materials, with saliva from patients who had received radiotherapy as part of their cancer treatment tending to increase adhesion more than saliva from healthy volunteers. The protein SPLUNC2 was found to be selectively concentrated by heat- and self-cured acrylic and may contribute to the adhesion of C. albicans to acrylic. Conclusions: This study found that saliva promotes the adhesion of C. albicans, and salivary proteins may play a role in facilitating this process. Adhesion was lower to acrylic-based prosthetic materials than to other materials. This suggests that interim obturators should be made from self-cured acrylic, and definitive obturators should be made from heat-cured acrylic.
]]>Authors: Florina Titihazan Tareq Hajaj Andreea Codruța Novac Daniela Maria Pop Cosmin Sinescu Meda Lavinia Negruțiu Mihai Romînu Cristian Zaharia
Objectives: The aim of this study was to present and describe a digital workflow integrating Digital Smile Design (DSD) with computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing technologies for the fabrication of dental preparation guides, focusing on workflow feasibility, design reproducibility, and clinical handling. Materials and Methods: A digital workflow was implemented using intraoral scanning and Exocad DentalCAD 3.1 Elefsina software to design dental preparation guides based on digitally planned restorations. Preparation margins, insertion paths, and minimal material thickness were defined virtually. The guides were fabricated using both subtractive (PMMA milling) and additive (stereolithographic-based 3D printing) manufacturing techniques. Post-processing included chemical cleaning, support removal, additional light curing, and manual finishing. The evaluation was qualitative and descriptive, based on visual inspection, workflow performance, and guide adaptation to printed models. Results: The proposed digital workflow was associated with consistent fabrication of preparation guides and predictable transfer of the virtual design to the manufactured guides. Digital planning facilitated clear visualization of preparation margins and insertion axes, supporting controlled and minimally invasive tooth preparation. The workflow demonstrated good reproducibility and efficient communication between clinician and dental technician. No quantitative measurements or statistical analyses were performed. Conclusions: Within the limitations of this qualitative feasibility study, the integration of DSD with CAD/CAM and 3D printing technologies represents a viable digital approach for designing and fabricating dental preparation guides. The workflow shows potential for improving predictability and communication in restorative dentistry.
]]>Authors: Marija Badrov Petra Franov Antonija Tadin
Objectives: This cross-sectional study aimed to evaluate oral health knowledge, self-perceived oral status, hygiene behaviors, prevalence of dental injuries, and mouthguard use among Croatian basketball players and coaches. Materials and Methods: A total of 414 participants of both sexes, spanning various levels of basketball participation in Croatia, completed an anonymous online questionnaire assessing oral health knowledge, hygiene habits, trauma history, and preventive practices. Data was analyzed using descriptive statistics, Chi-square, Mann–Whitney, and Kruskal–Wallis tests. Results: Participants demonstrated generally poor oral health knowledge, with coaches scoring significantly higher than players (p < 0.05), and knowledge levels varying according to education and socioeconomic status (p ≤ 0.001). A majority reported no prior dental trauma (69.6%), and mouthguard use was notably low (20.8%). While regular toothbrushing was prevalent (87%), the use of dental floss was limited (39.9%). The most reported oral health problems included gingival bleeding (37.9%), dental calculus (35.0%), and tooth sensitivity (34.3%). Conclusions: Despite relatively good hygiene habits, Croatian basketball players demonstrated low oral health knowledge and insufficient preventive practices, particularly regarding mouthguard use. These findings indicate the need for targeted education and preventive strategies within the basketball community.
]]>Authors: Yashaswini Jagadeesh Nubaira Rizvi Madhu Nair
Objectives: To assess the utility of Microsoft Copilot, a generative AI tool, in providing meaningful differential diagnosis and management strategies comparable with those generated by a board-certified radiologist using cone beam computed tomography (CBCT) studies in maxillofacial disease and thus assess its potential utility to help with the initial provisional diagnostic process. Study Design: A pilot project designed as a single-center, retrospective study using a convenient sample was conducted. De-identified data collected from patient charts in a consistent format was fed to Microsoft 365 Copilot (MCP) to generate a list of meaningful differential diagnosis (DD) and management protocols. Scores ranging of 0–3 were given for 0–3 matches in DD and management protocols, respectively. Results: Proportional analysis showed that the radiologist and Copilot agreed on the DD in 75.2% of cases and 94.6% of cases in management protocols. For biopsy recommendations, the radiologist and Copilot advised biopsy in 33 (89.2%) cases while they did not recommend biopsy in 23 (41.8%) cases. Conclusions: Generative AI platforms at this point may have value in generating DD and management protocols based on maxillofacial CBCT findings. However, the radiologist’s judgement based on clinical context, feature recognition, and critical analysis seemed to outperform MCP. Larger studies with statistical validation are warranted.
]]>Authors: Yasushi Mitani Yuko Okai-Kojima Mohammad Moshfeghi Morio Tonogi Shouhei Ogisawa Bumkyoo Choi
Objectives: This study aimed to comprehensively evaluate and compare the therapeutic effects of Right Angle Maxillary Protraction Appliance (RAMPA) therapy on nasal airway volume in pediatric patients, specifically differentiated by their baseline radiological paranasal sinus status. The objective was to quantify airway volume changes (absolute and percentage) in clear and opacified sinus groups, investigate the influence of age, sex, and treatment duration on these changes, and elucidate potential differences in the underlying mechanisms of airway expansion between groups. Study Design: A retrospective comparative cohort study design was employed. This study includes a “clear sinus group” of 26 patients (mean age: 6.6 years) with radiologically clear sinuses at baseline and an “opacified sinus group” of 20 patients (mean age: 6.8 years) diagnosed with rhinosinusitis and exhibiting significant sinus opacification on baseline CBCT scans. Upper airway volumetric measurements were performed using CBCT scans acquired pre- (T1) and post-treatment (T2), with data analyzed using Invivo 5 software. Results: RAMPA therapy significantly increased upper airway volume in both cohorts. The clear sinus group showed an approximate 18% mean increase (4886.9 mm3 absolute), while the opacified sinus group demonstrated a remarkably greater 61% mean increase (11,192.8 mm3 absolute). This difference was statistically significant. In the clear sinus group, airway volume gain positively correlated with treatment duration (p = 0.0303). Conversely, no significant correlation was found in the opacified sinus group (p = 0.288), suggesting rapid obstruction relief as a dominant mechanism. Sex did not significantly influence outcomes, and age was not a strong independent predictor of volume change magnitude. Conclusions: RAMPA therapy effectively increases upper airway volume in pediatric patients, with a substantially greater effect in those with baseline sinus opacification due to rapid obstruction resolution complementing skeletal changes. The mechanism of action differs by sinus status, with clear sinus patients showing gradual, duration-dependent skeletal adaptation and opacified sinus patients exhibiting immediate, duration-independent gains primarily from sinus clearance. These findings provide crucial insights for tailored clinical decision-making.
]]>Authors: Norma Cruz-Fierro Myriam Angélica de la Garza-Ramos Sara Sáenz-Rangel María Concepción Treviño Tijerina Guillermo Cano-Verdugo Víctor Hugo Urrutia Baca
Background: Cognitive aging is a physiological process that involves gradual and mild changes in mental functions. When these changes significantly affect cognitive performance, it is considered cognitive decline. Objective: This analytical cross-sectional pilot study examined the association between periodontal status, systemic conditions, and cognitive performance in middle-aged and older adults. Methods: Forty adults aged 35–59 years (n = 20) and ≥60 years (n = 20) from northeastern Mexico were evaluated. Oral assessments included the Modified Gingival Index and detection of Porphyromonas gingivalis and Fusobacterium nucleatum using qPCR. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE), and frailty with the Clinical Frailty Scale (CFS) and Oral Frailty Checklist (OF-5). Systemic medical history and oral hygiene habits were determined using a questionnaire. Results: MMSE scores were lower in older adults compared with middle-aged adults, and the magnitude of the difference was small. The presence of P. gingivalis or F. nucleatum was similar between groups. Frailty indicators were more prevalent in older adults. Logistic regression identified age and frailty-related variables as the strongest predictors of lower cognitive performance, whereas microbiological findings were not significant predictors. Conclusions: Age and frailty indicators, rather than bacterial presence alone, were associated with reduced cognitive performance in this pilot sample. Although no microbiological differences were observed, the findings highlight the need for larger analytical studies incorporating quantitative bacterial load and additional confounders to better understand the oral–systemic–cognitive interactions.
]]>Authors: Ben J. Smith Louis George Duman Davari Jeremy Collins Jordan Orth Mahmoud M. Bakr Santosh Kumar Tadakamadla Andrew B. Cameron
Background/Objectives: The purpose of this in vitro study is to evaluate the effect varying palatal vault depths have on the accuracy of complete maxillary denture bases fabricated using additive manufacturing technology. Methods: One hundred complete maxillary denture bases were manufactured on two different digital light processing (DLP) dental 3D printers at five different palatal depths. After manufacturing, the denture bases were post-cured, scanned, and then analyzed in metrology software. Statistically significant differences were determined using two-way ANOVA tests for normally distributed data and the Kruskal–Wallis test for non-normally distributed data. Color deviation maps were used to give clinical relevance to the results. Results: Significant differences were found for both printers among some groups for the different palatal depths. In relation to the negative mean deviation, the data revealed that the NextDent printers were the least accurate (0.047 ± 0.004) in the group with the deepest palate. The positive mean deviation revealed the most deviation (0.077 ± 0.009) in the group with the deepest palate, which was also mirrored in the Asiga printer (0.050 ± 0.002). The color deviation maps revealed areas of positive and negative average deviation in all groups. The effect of the printer model (p = 0.007) and palatal depth (p = 0.04) on negative average deviation was significant. The effect of the interaction of printer and palatal depth was also significant (p = 0.001). Conclusion: Deeper palatal vaults are associated with higher deviation in DLP 3D-printed complete maxillary denture bases manufactured through additive manufacturing.
]]>Authors: Tomoya Saito Jun Aida
Objective: This is the first population-based study to separately examine whether preventive and treatment dental visits modify the association between stressful life events and toothache. Psychological stress may alter health-seeking behaviors and pain perception, potentially leading to symptom-driven rather than preventive dental visits. Methods: Cross-sectional data were obtained and analyzed from the 2019 wave of the Japan Gerontological Evaluation Study (JAGES), including 19,314 community-dwelling adults aged 65 years and older. Poisson regression analyses were conducted to examine the associations between stressful life events, dental visit history, and self-reported toothache. Results: Higher stressful life events were associated with greater toothache prevalence (PR = 1.189; 95% CI: 1.117–1.264). Preventive dental visits within the past six months were linked to the lowest risk, whereas recent treatment visits were associated with higher risk. Conclusion: Promoting regular preventive dental visits, particularly among individuals under high stress, may help reduce the likelihood of experiencing toothache among older adults.
]]>Authors: Ichizo Morita Koji Hara Kanae Kondo Yusuke Matsumoto Iwane Sugiura Yujo Inagawa Seiji Nakashima Taketsugu Nomura Yoshikazu Abe Yoshikazu Nagase Satomi Maruyama
Background: The time from mastication to swallowing is used as an indicator of masticatory and swallowing functions. However, there have been no reports on reasonable eating times associated with eating satisfaction. Clarifying the reasonable time for eating and drinking to achieve eating satisfaction will indicate the level of mastication and swallowing functions that contributes to maintaining an individual’s quality of life. Objective: This study aimed to determine the time from food intake to the end of swallowing that is associated with eating satisfaction. Methods: A cross-sectional survey of 437 community-dwelling older people was conducted. Mastication and swallowing times (SST-MST) were measured using the Saku-Saku Test with a 2 g rice cracker. Food intake difficulty and eating satisfaction were evaluated using a questionnaire. The association between the SST-MST and the difficulty in eating food or eating satisfaction was assessed by sensitivity, specificity, Youden index, sensitivity–specificity ratio, positive likelihood ratio, negative likelihood ratio, odds ratio, and 95% confidence interval. Results: Most indices indicated that a cutoff point of 25 s on the SST-MST was associated with not having difficulty in eating food items. Moreover, when the SST-MST cutoff was set to 25 s, all indices showed a favorable association with eating satisfaction. Conclusions: In community-dwelling older people in their 70s and 80s, an SST-MST of about 25 s for 2 g of rice crackers was modestly associated with eating satisfaction.
]]>Authors: Youssouf Ouédraogo Abdoul Karim Sakira Soumaïla Kindo Abdoul Azize Zallé Moussa Ouédraogo Ahia Monique Lydie Beugré-Kouassi Jean Bertin Beugré
Background/Objectives: Dental malocclusions are often treated with appliances made of metal alloys. These alloys biodegrade in oral cavity and release toxic metals such as nickel and chromium. This study aimed to assess nickel and chromium content in the saliva of patients with and without fixed metallic orthodontic appliances. Methods: This was a descriptive cross-sectional study aiming to assess nickel and chromium content in saliva. A survey was conducted to record socio-demographic characteristics and clinical signs due to the wearing of fixed metallic orthodontic appliances. A 10 mL saliva sample was used to measure salivary pH and assess nickel and chromium concentrations using atomic emission spectrophotometry. A Student’s t-test compared saliva metal levels in non-wearers and wearers of metal orthodontic appliances. A Chi-square test was used to assess the influence of pH on metal release in patients. Results: A total of 92 participants, divided in two groups; 46 without appliance and 46 wearing appliance were received during the study period. Their mean age was 17.05 ± 6.46 years. Patients’ mean saliva pH was 6.97 ± 0.44. The mean nickel concentration was 4.39 ± 4.01 µg/L in the saliva of non-appliance wearers and 20.41 ± 18.56 µg/L in the saliva of appliance wearers, respectively. The chromium mean concentration was 1.3 ± 1.33 µg/L for non-appliance wearers and 9.38 ± 19.49 µg/L and for appliance wearers. Metal release is influenced by the pH of foods. Conclusions: Metal orthodontic appliances increase the release of nickel and chromium in saliva. It is necessary to monitor the risk of intolerance and optimize treatment duration.
]]>Authors: George N. Romanos Dimitrios Deligiannidis Dimosthenis Igoumenakis Eleni Konsolaki Chrysostomos Zioudas Georgios Karakinaris Athanassios Kyrgidis Sofia Aggelaki
Background/Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive and antiangiogenic drugs with no consensus on optimal treatment. This study aimed to evaluate the clinical outcomes of MRONJ patients managed at a tertiary referral center over a 15-year period. Methods: We conducted a retrospective cohort study of 130 patients diagnosed with MRONJ (per AAOMS criteria) at a single tertiary hospital between 2006 and 2021. Data on demographics, underlying disease, drug history, MRONJ stage, triggering events, and treatment (conservative vs. surgical) were collected from medical records. Treatment outcomes were categorized as complete resolution, stable disease, or progression. Univariate and multivariate logistic regression analyses were performed to identify predictors of resolution. Results: Most patients (84.6%) had an underlying malignancy. The primary causative agents were zoledronic acid (47.7%) and denosumab (30.0%), the most frequent site was the mandible (66.2%), and the main trigger was dental extraction (59.2%). Crude resolution rates were 20.3% for conservative management versus 83.6% for surgical management. Treatment was stage-driven, with surgery common in advanced stages. At 12 months, 43.1% of all patients achieved complete resolution, and 52.3% remained stable. Multivariate analysis confirmed surgical treatment as the only independent predictor of complete resolution (OR = 20.1, 95% CI: 8.1–50). Conclusions: In this cohort, conservative care was generally sufficient for Stage I disease, while surgical intervention was the strongest predictor of healing and provided reliable outcomes for advanced MRONJ. These findings support an individualized, stage-appropriate treatment strategy.
]]>Authors: Sezai Erginbas Andrea Boggio Nur Ozel Erginbas Sara Iadecola Giorgio Gastaldi Mauro Cozzani
Introduction: This study aimed to evaluate the educational value of YouTube videos presenting information on pediatric orthodontic treatments, specifically clear aligners, fixed braces, and lingual braces. Methods: A cross-sectional analysis was conducted on 150 of the most-viewed English-language YouTube videos (50 per treatment type). Videos were assessed for accuracy, depth of explanation, source type (expert, commercial, or general user), and viewer engagement metrics. Statistical comparisons were made using the Kruskal–Wallis test and Dunn’s post hoc tests with Bonferroni correction. Results: Fixed brace videos demonstrated more accuracy (average score 4.2/5), than both clear aligners (p = 0.03) and lingual braces (p < 0.001), with 60% originating from expert sources. Clear aligner and lingual brace videos had lower accuracy scores (3.8 and 3.5, respectively), reflecting higher proportions of commercial influence (50% and 55%). The findings highlighted the predominance of promotional content in clear aligner and lingual brace videos, raising concerns about potential misinformation. Conclusions: YouTube provides accessible but variable-quality information on pediatric orthodontics. Fixed brace videos offer more reliable educational content, while clear aligner and lingual brace videos are more susceptible to commercial bias. Efforts to promote expert-driven content and implement content verification systems are needed to improve the quality of online orthodontic information for parents and caregivers.
]]>Authors: Sonja Žarković Gjurin Katja Povšič Tom Kobe Borut Žužek Rok Gašperšič Čedomir Oblak
Background/objectives: Zirconia dental implants are increasingly recognised as an alternative to titanium implants due to their biocompatibility and aesthetics. Initially developed as one-piece systems, zirconia implants have evolved into two-piece designs with different platform levels; however, comparative data on their primary and secondary stability– particularly as assessed by resonance frequency analysis (RFA)—and marginal bone dynamics remain limited. This case series aimed to evaluate the implant stability and marginal bone changes of two-piece zirconia implants with bone-level (BL) and tissue-level (TL) platforms in patients missing maxillary premolars. Methods: Thirteen zirconia implants (n = 13; 7 BL, 6 TL; Z5-TL/Z5-BL, Z-Systems, Switzerland) were placed in 11 patients with healed ridges. The implant stability quotient (ISQ) was measured immediately after insertion and before prosthetic loading. Lithium disilicate crowns were cemented after four months, and follow-ups were conducted for an average of 35 months (SD = 12). Results: Initial ISQ values ranged from 73 to 79, increasing to 76–84 at 3–4 months, indicating high implant stability for both BL and TL implants. The extent of marginal bone loss (MBL) after two years was greater around BL implants (mean 0.46 mm) compared to TL implants (mean 0.2 mm), although probing depths and bleeding on probing remained minimal in both groups, with only one TL implant showing gingival recession. Conclusions: Over a short observation period, two-piece zirconia implants with tissue-level platforms appeared to demonstrate superior marginal tissue stability. Further, larger-scale controlled studies are required to confirm these preliminary observations.
]]>Authors: Carolina Díaz-Hernández Gloria Saavedra-Marbán Nuria Esther Gallardo-López Manuel Joaquín de Nova-García Nere Zurro-Arrazola Antonia María Caleya
Molar incisor hypomineralisation (MIH) is a developmental defect affecting permanent first molars and often the incisors too. Hypomineralised second primary molars (HSPM) have been proposed as potential early indicators of MIH. Aim: The aim was to identify potential aetiological factors associated with MIH and assess their relationship with HSPM in a pilot study. Methods: A cross-sectional case–control study was conducted with 120 patients (60 cases and 60 controls), aged 7–15 years, from the Paediatric Dentistry Postgraduate Programme. MIH was diagnosed following European Academy of Paediatric Dentistry (EAPD) guidelines. Parents completed a structured questionnaire on potential aetiological factors. Results: MIH was significantly associated with maternal smoking during pregnancy (p = 0.013), birth hypoxia (p = 0.013) and the use of amoxicillin and inhalation therapy during infancy (p < 0.001). It was also associated with tonsillitis (p = 0.022), bronchiolitis (p = 0.005) and other respiratory disorders (p = 0.049). HSPM was associated with anaemia and hypotension during pregnancy (p = 0.001), bottle-feeding (p = 0.044) and urinary tract infections (p = 0.003). No statistically significant association was found between MIH and HSPM. Conclusions: This pilot study has identified specific prenatal, perinatal, and postnatal factors associated with MIH and HSPM. The findings emphasise the clinical relevance for early diagnosis and management and highlight the need for studies with larger sample sizes to validate these associations.
]]>Authors: Edoardo Staderini Gioele Gioco Federica Guglielmi Francesca Cazzato Licia Leccese Carmen Chiara Nacca Patrizia Gallenzi
Introduction: Infantile Refsum disease (IRD) is considered one of the milder phenotypes within the Zellweger Spectrum Disorders (ZSDs), a group of peroxisomal biogenesis disorders characterized by a generalized impairment of peroxisomal function. Pathognomonic features of IRD are growth retardation, hearing and cognitive impairment, neuromuscular problems, and craniofacial anomalies. Due to the relatively short lifespan, severe dental anomalies have not been previously reported in association with this disorder. This case report describes a rare manifestation of multiple impacted teeth and near complete edentulism in an adult patient diagnosed with Infantile Refsum disease (IRD). Material and Methods: The patient, a 24-year-old female, presented with a skeletal Class III malocclusion, severe maxillary hypoplasia, and complete impaction of the permanent dentition. The diagnosis of Infantile Refsum disease (IRD) was genetically confirmed and was associated with both neurological and dermatological manifestations. Conclusions: This case underscores that severe disturbances in tooth eruption and impaction may represent underrecognized manifestations of metabolic and genetic disorders such as Infantile Refsum disease (IRD). Dental professionals should remain vigilant to the potential association between systemic conditions and delayed or failed tooth eruption, emphasizing the need for interdisciplinary management and further investigation.
]]>Authors: Patricio Meléndez Rojas Macarena Rodríguez Luengo Marcelo Durán Anrique Sven Niklander María F. Villalobos Dellafiori Jaime Jamett Rojas Alejandro Veloz Baeza
Background/Objectives: Despite decades of technological progress, the diagnosis of dental caries still depends largely on subjective, operator-dependent assessment, leading to inconsistent detection of early lesions and delayed intervention. Artificial intelligence (AI) has emerged as a transformative approach capable of standardizing diagnostic performance and, in some cases, surpassing human accuracy. This scoping review critically synthesizes the current evidence on AI for caries detection and examines its true translational readiness for clinical practice. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science (WoS), covering studies published from January 2019 to June 2024, in accordance with PRISMA-ScR guidelines. Eligible studies included original research evaluating the use of AI for dental caries detection, published in English or Spanish. Review articles, editorials, opinion papers, and studies unrelated to caries detection were excluded. Two reviewers independently screened, extracted, and charted data on imaging modality, sample characteristics, AI architecture, validation approach, and diagnostic performance metrics. Extracted data were summarized narratively and comparatively across studies using tabulated and graphical formats. Results: Thirty studies were included from an initial pool of 617 records. Most studies employed convolutional neural network (CNN)-based architectures and reported strong diagnostic performance, although these results come mainly from experimental settings and should be interpreted with caution. Bitewing radiography dominated the evidence base, reflecting technological maturity and greater reproducibility compared with other imaging modalities. Conclusions: Although the reported metrics are technically robust, the current evidence remains insufficient for real-world clinical adoption. Most models were trained on small, single-source datasets that do not reflect clinical diversity, and only a few underwent external or multicenter validation. Until these translational and methodological gaps are addressed, AI for caries detection should be regarded as promising yet not fully clinically reliable. By outlining these gaps and emerging opportunities, this review offers readers a concise overview of the current landscape and the key steps needed to advance AI toward meaningful clinical implementation.
]]>Authors: Antonio Belmonte Ylenia Leanza Alessandro Polizzi Alessandra Romano Alessandro Allegra Rosalia Leonardi Cristina Panuzzo Gaetano Isola
The interplay between the oral and gut microbiota and systemic health has garnered significant attention in recent years, particularly concerning hematological malignancies. Multiple myeloma and other hematological cancers are characterized by immune dysfunction, creating a bidirectional relationship with microbial communities. Dysbiosis, defined as an imbalance in microbial composition, may influence disease progression, treatment response, and overall prognosis. This narrative review is based on a non-systematic search of PubMed and Scopus (2010–2024) using terms related to oral microbiota, gut microbiota, dysbiosis, hematological malignancies, multiple myeloma, immune modulation, and treatment-related complications. Studies were selected for relevance to pathogenesis, immune regulation, clinical implications, and therapeutic interactions. As this is a narrative review, no quantitative synthesis or formal grading of evidence strength was performed; findings are therefore interpreted qualitatively based on the available literature. The role of microbial-derived metabolites, their effects on immune modulation, and their potential as biomarkers for disease and treatment outcomes have been explored. Specific attention is given to the implications of dysbiosis in chemotherapy-induced complications, such as mucositis and infections, and emerging therapeutic strategies, including probiotics, prebiotics, and fecal microbiota transplantation. Additionally, the influence of anticancer therapies on microbial ecosystems has been highlighted and the bidirectional impact of host–microbe interactions in shaping disease trajectory has been discussed. Understanding these complex interactions could lead to novel diagnostic and therapeutic approaches, ultimately improving patient outcomes. This review aims to provide clinicians and researchers with a comprehensive overview of current knowledge and future perspectives on the role of oral and gut microbiota in the context of hematological malignancies.
]]>Authors: Andrea Scribante Matteo Pellegrini Alessandro Chiesa Stefania Crea Andrea Butera
Background/Objectives: Dentin hypersensitivity (DH) is associated with gingival recession and dentin exposure. Biomimetic hydroxyapatite (HAp) reduces DH by occluding dentinal tubules, with conventional toothpaste formulations showing benefits. High-density HAp mouthwashes may enhance bioavailability, but comparative evidence is scarce. This trial assessed the immediate desensitizing efficacy of a conventional HAp toothpaste and a high-density HAp mouthwash after professional oral hygiene. Methods: One hundred participants were randomized 1:1 to Biorepair® (Coswell S.p.A., Funo, BO, Italy) Total Protection Toothpaste (Control) or Biorepair® (Coswell S.p.A., Funo, BO, Italy) High-Density Mouthwash (Test). Assessments were performed at baseline (T0), post-debridement (T1), and after product use (T2). The primary endpoint was patient-level Schiff Air Index (SAI). Secondary endpoints included tooth-level SAI, Visual Analog Scale (VAS) scores, and gingival recession (GR). The trial was registered at ClinicalTrials.gov (NCT07057141) and followed CONSORT 2025 guidelines. Friedman and Dunn’s tests and regression models were applied. Results: Both groups showed significant reductions in hypersensitivity. Patient-level mean SAI decreased from 1.47 to 0.66 in the Control and from 1.48 to 0.45 in the Test group, while VAS declined from 3.66 to 1.57 (Control) and from 4.15 to 1.37 (Test). Post hoc analyses showed significant intragroup reductions between T0/T1 and T2 in both groups, with no significant differences between groups at any timepoint. GR remained stable across the study. Regression analyses identified follow-up time and GR as significant predictors, whereas treatment allocation was not, indicating that the acute advantage of the mouthwash at T2 did not persist once longitudinal trends were considered. Conclusions: Both HAp formulations effectively reduced dentin hypersensitivity 30 s after application. The high-density mouthwash exhibited slightly lower mean values at T2, although these differences were not statistically significant.
]]>Authors: Aliza Tithphit Benedikt Schneider Ahmed Othman Veasna Phit Hong Yoeu Tith Constantin von See
Background/Purpose: The study aimed to analyze the dimensions and width-to-length ratios of the maxillary anterior teeth in young native Cambodian adults and to assess their relationship with the golden proportion, symmetry, and sexual dimorphism. Materials and Methods: Maxillary study casts of 193 eligible Cambodian subjects, aged 18 to 25 years, were retrospectively evaluated. The width and length of their maxillary anterior teeth were measured using a digital caliper. Descriptive statistics, independent-samples t-test at 95% confidence intervals, Kolmogorov-Smirnov, Shapiro-Wilk, and Kruskal-Wallis tests were performed to analyze the data. Results: There was a high level of similarity between first and second quadrant measurements. Females showed slightly higher standard deviations for central incisors and lateral incisors than males across most ratios, indicating more variability in the width-in-length ratios for females. Males exhibited significantly greater tooth dimensions than females. The following results showed statistical significance with p < 0.05 and 95% confidence intervals. The mean crown width of the central incisors was 8.16 mm in males (CI: 8.03–8.29) and 7.87 mm in females (CI: 7.78–7.96). For the lateral incisors, the mean crown width was 6.69 mm in males (CI: 6.53–6.85) and 7.64 mm in females (CI: 7.43–7.85). The width-to-length ratio of the central incisors was higher in females (mean = 0.88; CI: 0.86–0.91) compared with males (mean = 0.87; CI: 0.84–0.89). Overall, proportional relationships remained consistent across genders. The golden proportion guideline was not applicable, as observed ratios ranged from 0.90 to 1.67 (all below 1.618), and RED values exceeded 80%. The null hypothesis was rejected due to the significant gender differences found in tooth dimensions and width-to-length ratios. Conclusions: There was no significant difference in maxillary anterior tooth dimensions for the right and left sides among the Cambodian population. Males had statistically larger teeth than females. Width-to-length ratios were greater in females for central incisors; however, the proportional relationships between the genders remained relatively consistent. The golden proportion and RED proportions did not exist within this population. A smaller size characterizes Cambodian dentition compared to that of other ethnic groups. Finally, these results can serve as an indicator for planning customized esthetic treatment in Cambodians. Future studies with larger sample sizes are needed to ensure the representation of the whole Cambodian population.
]]>Authors: Martin Major Melinda Polyák Tamás Würsching Gábor Kammerhofer Éva Kocsis Zsolt Németh György Szabó
Background: Periapical surgery is indicated for persistent periapical lesions that do not respond to conventional endodontic therapy, yet postoperative recovery is often hindered by pain, swelling, and delayed healing. Platelet-rich fibrin (PRF) membranes are autologous biomaterials with regenerative potential, capable of modulating inflammation and promoting tissue repair. Methods: This preliminary randomized controlled trial evaluated the effectiveness of PRF membranes in improving postoperative outcomes—specifically pain, swelling, and quality of life—after apicoectomy. Twenty patients requiring periapical surgery were randomly allocated to a PRF group (n = 10) or a control group (n = 10). In the PRF group, autologous PRF membranes were applied over the resected root-end and into the osteotomy cavity before flap closure. In the control group, no PRF membranes or any additional biomaterial were applied, apart from the standard root-end filling material (MTA), which was identically used in both groups as part of the routine apicoectomy protocol. All patients were blinded to allocation, and outcomes were assessed by an independent blinded evaluator. Facial swelling was quantified by 3D facial scanning, pain was recorded daily using a visual analog scale (VAS), and quality of life was evaluated with the PROMIS-29+2 Profile. Results: The PRF group showed significantly reduced swelling (mean volume difference, 7.12 cm3; p = 0.025), lower pain scores (VAS: 1.80 ± 1.22 vs. 3.80 ± 2.44; p = 0.034), and improved quality-of-life domains, including higher Physical Function (p = 0.032) and lower Sleep Disturbance (p = 0.008) scores. Conclusions: Within the limitations of this pilot study, PRF membranes enhanced postoperative recovery after periapical surgery by reducing swelling and pain while improving patient-reported outcomes. Larger multicenter trials are needed to confirm these preliminary findings.
]]>Authors: Francesco Puleio Fabio Salmeri Ettore Lupi Ines Urbano Roberta Gasparro Simone De Vita Roberto Lo Giudice
Background: The precision of intraoral scanners (IOSs) is a key factor in ensuring the reliability of digital impressions, particularly in full-arch workflows. Although proprietary metrology tools are generally employed for scanner validation, open-source platforms could provide a cost-effective alternative for clinical research. Methods: This in vivo study compared the precision of two IOSs—3Shape TRIOS 3 and Planmeca Emerald S—using an open-source analytical workflow based on Autodesk Meshmixer and CloudCompare. A single healthy subject underwent five consecutive full-arch scans per device. Digital models were trimmed, aligned by manual landmarking and iterative closest-point refinement, and analyzed at six deviation thresholds (<0.01 mm to <0.4 mm). The percentage of surface points within clinically acceptable limits (<0.3 mm) was compared using paired t-tests. Results: TRIOS 3 exhibited significantly higher repeatability than Planmeca Emerald S (p < 0.001). At the <0.3 mm threshold, 99.3% ± 0.4% of points were within tolerance for TRIOS 3 versus 92.9% ± 6.8% for Planmeca. At the <0.1 mm threshold, values were 89.6% ± 5.7% and 47.3% ± 13.7%, respectively. Colorimetric deviation maps confirmed greater spatial consistency of TRIOS 3, particularly in posterior regions. Conclusions: Both scanners achieved clinically acceptable precision for full-arch impressions; however, TRIOS 3 demonstrated superior repeatability and lower variability. The proposed open-source workflow proved feasible and reliable, offering an accessible and reproducible method for IOS performance assessment in clinical settings.
]]>Authors: Iulia Muntean Laura-Cristina Rusu Lavinia Cosmina Ardelean Codruta Victoria Tigmeanu Alexandra Roi Stefania Dinu Adina Andreea Mirea
Background/Objectives: As antimicrobial dental treatments, based on chemical products, long tested for their efficacy, have been lately associated with developing antimicrobial resistance, there is a growing interest to identify and develop efficient alternatives. The aim of this paper is to assess the antimicrobial potential of eight selected essential oils (EOs): Cinnamon (Cinnamomum verum), Tea tree (Melaleuca alternifolia), Spearmint (Mentha spicata), Rosemary (Rosmarinus officinalis), Clove (Eugenia caryophyllata), Eucalyptus (Eucalyptus radiata), Cedarwood (Juniperus virginiana), and Lemongrass (Cymbopogon flexuosus), more or less recognized and investigated for this particular therapeutic effect, on Streptococcus mutans (S. mutans), a key pathogen involved in oral pathology. Materials and methods: The chemical constituents of the EOs were identified and quantified by Gas Chromatography-Mass Spectrometry (CG-MS) method. Saliva samples, collected from nine patients with active dental caries, were tested in vitro. To assess the bacterial susceptibility of the selected EOs against S. mutans, the inhibition zones (IZ), minimum inhibitory concentrations (MIC), and minimum bactericidal concentrations (MBC) were determined. Results: All EOs tested showed antimicrobial activity against S. mutans, with IZs over 20 mm. The highest antimicrobial efficacy was observed for spearmint, followed by Eucalyptus, Tea tree, and Lemongrass. The next in descending order were Cinnamon Bark, Clove, Rosemary, and Cedarwood. Considering the mean MIC and MBC values, the spearmint EO proved to be the most effective in inhibiting the growth of S. mutans, as well as in annihilating it, followed by the Eucalyptus EO, Tea tree EO and Lemongrass EO. The less effective were determined to be Cinnamon, Clove, Rosemary and Cedarwood EOs. Conclusions: The eight selected EOs demonstrated antimicrobial activity against S. mutans, with Spearmint and Eucalyptus showing the most significant effects, advocating for their potential in dental caries prevention and treatment, and their potential role in oral hygiene applications.
]]>Authors: Adelaide Mensah Lyndsey McMullan Leonard Maguire Charles Benneh Ahmed Abuelhana Rosalina Intan Saputri Aaron J. Courtenay
Background/Objectives: Early diagnosis of periodontal disease is vital for preventing disease progression and improving patient outcomes. This study explored healthcare professionals’ perspectives on a novel minimally invasive biofluid sampling device intended for periodontal disease diagnosis. Methods: A co-design approach was used to engage end users during early device development. Two focus group discussions were conducted with dentists, followed by an online questionnaire completed by dentists and other oral healthcare professionals. The aim was to gather opinions, preferences, and suggestions regarding the proposed device’s design and clinical application. Results: The innovation was well received by survey respondents (n = 54) and participants of the focus group discussions, who also provided insightful comments on aspects including physical features, diagnostic value, usability, and integration with clinical workflow. Conclusions: The co-design process revealed that there is a need for the novel biofluid sampling device. Suggestions from the participants helped improve an early internal Target Product Profile and bring the device closer to clinical requirements and expectations.
]]>Authors: Leonardo Ariza-Cabello Ximena Lucar-Dueñas Jorge Noriega-Castañeda Jose Antonio Gil-Montoya Ximena Alejandra León-Ríos
Objective: This study aimed to determine the association between periodontal disease and dementia in older adults in Lima Centro. Materials and methods: A cross-sectional analytical study was conducted in 112 institutionalized older adults, who were clinically evaluated using the Periodontal Screening and Recording (PSR) system. Bivariate analyses were performed using the chi-square test, Mann–Whitney U test, and Student’s t-test. Logistic regression was used to estimate the crude and adjusted odds ratios with 95% confidence intervals, with p < 0.05 considered statistically significant. Results: The results showed that 49.11% of the participants scored a code 3 in the PSR system, indicating periodontal pockets of 3 to 5 mm, bleeding, and bacterial plaque, while 79.46% exhibited the presence of bacterial plaque. Likewise, older adults with dementia were observed to have clinical plaque upon probing, whereas 40.35% of older adults without a dementia diagnosis did not have plaque; this association was statistically significant. In the multivariate analysis, an association between periodontal disease and dementia was observed in the crude analysis (OR = 4.43; 95% CI: 2.20–8.93; p = 0.000) and the adjusted analysis (OR = 4.69; 95% CI: 2.32–9.48; p = 0.000). Conclusions: In conclusion, a significant relationship was identified between periodontal disease (assessed using the PSR system), the presence of bacterial plaque, and gingival bleeding with dementia in the evaluated older adults. This finding highlights the importance of periodontal health not only for oral well-being but also as a potentially modifiable risk factor for dementia prevention. Integrating oral health interventions into broader geriatric care may contribute to delaying or reducing the risk of neurodegenerative diseases, underscoring the need for interdisciplinary approaches in public health strategies.
]]>Authors: Marija Buotić Darija Bubalo Tina Poklepović Peričić Antea Trgo Ivana Medvedec Mikić
Objectives: This study aimed to evaluate dentists’ knowledge in Split-Dalmatia County regarding bisphosphonates and their oral side effects. Methods: An anonymous, 20-item questionnaire assessing demographics, knowledge of indications, mechanisms of action, and complications of bisphosphonates was electronically distributed via email to dentists in Split-Dalmatia County between March and April 2025. Descriptive statistical analysis was performed, and the results are presented as absolute numbers and percentages. The Chi-square test was used to compare proportions between groups, with a significance level set at p < 0.05. Results: A total of 172 dentists from Split-Dalmatia County participated (response rate was 71.36%). The mean total knowledge score was 7.3 ± 1.4 out of 9 items. The results indicated that most respondents correctly answered questions about indications for bisphosphonate use (95.9%), mechanism of action (93.6%), and the most common complication—osteonecrosis of the jaw (92.4%). The lowest correct response rate (38.4%) was for procedures before invasive dental treatments. Only 18.6% of participants answered all nine knowledge questions correctly. No significant differences in knowledge were found based on gender, age, year of graduation, or educational level. Nearly all dentists (95.3%) expressed interest in further education on this topic. Conclusions: Although dentists demonstrated satisfactory general knowledge regarding bisphosphonates, important gaps remain, particularly in practical application, including recommendations for managing patients on bisphosphonates undergoing invasive dental procedures. Given the rising use of bisphosphonates and the potential severity of their side effects, additional education is warranted to enhance prevention, promote early detection, and ensure appropriate clinical management of related complications.
]]>Authors: Alberto Gasbarri Sofia Rastelli Giulia Caporro Giulia Ciciarelli Mauro Arcangeli Antonio Capogreco Maurizio D'Amario
Background and Objectives: Stereolithography (SLA) enables the creation of physical replicas of digital models, offering surgeons a realistic representation of patient anatomy. This technology improves diagnostics and surgical planning, facilitates communication within the medical team, and enhances the doctor–patient relationship by promoting compliance. This study aims to place the intervention addressed in a broader context and highlight the utility of SLA models in complex surgical scenarios. Case Presentation: The study presents two cases of patients with severe maxillary atrophy: a 67-year-old healthy male (with well-controlled hypertension) and a 72-year-old female patient (with hypercholesterolemia). Intervention and Outcome: Zygomatic implant procedures with immediate loading were performed to resolve the bone atrophy in both cases. These procedures heavily leveraged preoperative planning using stereolithographic models. Both interventions resulted in a positive outcome, which was confirmed at the 6-month follow-up. Conclusions: The integration of stereolithographic models into the preoperative planning process improved the prognosis of these complex cases, confirming their value in managing severe maxillary atrophy.
]]>Authors: Saki Mizutani Sachie Nakao Rikako Sato Akira Tada Kota Amano Mana Oshio Atsuko Otsuka Yoko Iwase Hiroshige Taniguchi
Background: Intraoral pressure contributes significantly to bolus transport during swallowing, along with tongue and pharyngeal pressures. However, conventional assessment methods (e.g., manometry, tongue pressure measurement) have limitations, including invasiveness, difficulty in capturing pressure gradients, and reliance on cognitive function. Objective: This study aimed to examine differences in intraoral pressure between patients with dysphagia and healthy controls using a newly developed, noninvasive intraoral pressure sensor. Methods: Sixteen individuals with dysphagia were categorized into two groups based on the Dysphagia Severity Scale (DSS): eight with mild dysphagia (DSS6-5) and eight with moderate dysphagia (DSS4-3). Seven healthy young adults (DSS7) were included as controls. Intraoral pressure was measured using a sensor enclosed in a silicone balloon placed in a standardized position. Three thickened liquids (mildly, moderately, and extremely thick) were tested, and intraoral pressure duration, peak pressure, and area were analyzed. Results: Pressure duration and area significantly increased with higher-viscosity samples in participants with dysphagia. Both parameters were significantly higher in the dysphagia groups than in controls (p < 0.001). For the extremely thick sample, pressure area was significantly greater in the mild dysphagia group than in controls (p = 0.031), and in the moderate group across all viscosities (p = 0.036; mildly thick, p = 0.010; moderately thick, p = 0.006; extremely thick, respectively). Conclusions: Intraoral pressure measurement may be a valuable supplementary screening tool, particularly for identifying moderate or more severe dysphagia.
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