Search Results (243)

This preliminary clinical study investigated the microbial composition of dental biofilms on healthy root surfaces and cavitated root caries lesions in two age cohorts: adults under 65 years and those aged 65 and older. The goal was to assess how aging and caries status influence root surface biofilm diversity and structure. For that, forty adults (23 women, 17 men) were enrolled. Biofilm samples were collected directly from clinically healthy and cavitated root surfaces. Microbial profiling was performed using 16S rRNA gene sequencing to evaluate diversity metrics and community composition. The results show that cavitated root surfaces harbored significantly higher microbial diversity compared to healthy root surfaces, as indicated by the Shannon diversity index. In contrast, healthy surfaces exhibited lower diversity and greater species dominance, confirmed by Simpson’s index. Age-related differences in biofilm composition were also evident, with older adults showing distinct microbial communities compared to younger participants. In conclusion, both age and cavitation presence significantly influence biofilm composition on root surfaces. These differences in microbial diversity and dominance may inform future clinical strategies for managing root caries, particularly in older adults. Further research is needed to assess the implications of these microbial patterns on treatment outcomes. Full article

Background/Objectives: Mobile health (mHealth) technologies are increasingly used to support preventive oral care and patient self-management. CarieCheck is a Portuguese app intended to improve oral health literacy and support caries-risk self-assessment. This prospective pilot study focused on users’ perceived app quality and usability, assessed with uMARS-PT. Methods: Thirty participants from the academic community of Egas Moniz School of Health and Science used the app for 30 days and completed the uMARS-PT questionnaire. Descriptive statistics were used to calculate mean scores for Engagement, Functionality, Aesthetics, Information Quality, Subjective Quality, and Perceived Impact. Results: The overall mean uMARS-PT score was 4.22, indicating excellent perceived quality. The highest domain scores were Functionality (4.51), Aesthetics (4.45), and Information Quality (4.22). Engagement (3.71) and Subjective Quality (3.05) were moderate. Perceived Impact (3.85) reflected self-reported perception of increased awareness and motivation regarding oral health behaviors. Conclusions: CarieCheck was rated highly in usability, aesthetics, and information quality. These findings suggest that CarieCheck may be considered as a digital tool for preventive education and user-supported caries-risk self-assessment. Larger, longer-term studies in diverse populations using objective behavioral and clinical outcomes are warranted. Full article

Background: Cervical restorations remain clinically challenging due to complex anatomy, limited enamel availability, and difficulties in achieving reliable adhesion at dentin or cementum margins. Polymerization shrinkage and marginal leakage are frequent causes of failure. Although the Closing Gap Technique has been proposed to improve marginal adaptation in cervical restorations, evidence supporting its medium- to long-term clinical performance is limited. The aim of this case report was to evaluate the clinical effectiveness of the Closing Gap Technique in the restoration of carious and non-carious cervical lesions. Materials and Methods: Two patients presenting with cervical lesions were treated using the Closing Gap Technique. One case involved carious cervical lesions, while the second included multiple non-carious cervical lesions. Restorations were performed following an enamel-anchored incremental layering protocol with resin composite. Clinical evaluations were conducted at 8 years (case #1) and 2 years (case #2) post-treatment, respectively. Results: Both cases demonstrated favorable clinical outcomes at follow-up. The restorations exhibited good marginal integrity, satisfactory esthetics, absence of marginal discoloration, no secondary caries, and no signs of debonding. The only minor defect observed was slight chipping of one of the restorations. Conclusions: Within the limitations of this case report, the Closing Gap Technique showed stable and predictable medium- and long-term clinical performance, supporting its use as a viable restorative approach for managing cervical lesions in daily clinical practice. Full article

Objectives: Despite the increasing scientific evidence regarding the application of Cranberries in dentistry, a comprehensive understanding of their potential benefits, active constituents, and mechanisms of action remains lacking. Consequently, this narrative review aims to meticulously analyze and consolidate the existing scientific literature on the utilization of Cranberries for the prevention and treatment of oral diseases. Materials and Methods: Electronic databases (PubMed, Scopus, and Web of Science) were searched up to October 2025. This review included in vitro, in vivo, and clinical research studies. A two-phase selection process was carried out. In phase 1, two reviewers independently screened titles and abstracts to identify potentially eligible studies. In phase 2, the same reviewers performed the full-text assessments of the eligible articles. Results: Among the 93 eligible articles, most assessed Cranberry use in Cariology (n = 28) and Periodontics (n = 26). Biofilm and microbial virulence factors (n = 46) were the most frequently studied topics. Cranberry extract (n = 32) and high-molecular-weight non-dialyzable material (NDM) (n = 23) were the most evaluated Cranberry fractions. Overall, Cranberry-derived compounds were identified as non-toxic and demonstrated promising antimicrobial activity against dental caries-related microorganisms in preclinical studies (n = 20). Regarding periodontal and peri-implant diseases, Cranberry demonstrated host immune modulator effects, counteracting the inflammatory and destructive mechanisms (n = 8). Additionally, Cranberries presented benefits in reducing the inflammation associated with periodontal disease and temporal mandibular joint lesions (n = 1). Regarding dental erosion, Cranberry inhibited dentin erosion (n = 4); however, no effect was observed on enamel lesions (n = 2). As an antioxidant agent, Cranberry showed effectiveness in preventing dental erosion (n = 18). Beyond that, Cranberry neutralized reactive oxygen species generated immediately after dental bleaching, enhancing bond strength (n = 2) and counteracting the oxygen ions formed on the tooth surface following bleaching procedures (n = 3). In osteoclastogenesis assays, A-type proanthocyanidins inhibited bone resorption (n = 1). In osteogenic analysis, preservation of hydroxycarbonate apatite deposition and an increase in early and late osteogenic markers were observed (n = 2). Conclusions: Cranberry bioactive compounds, both individually and synergistically, exhibit substantial potential for diverse applications within dentistry, particularly in the prevention and management of oral and maxillofacial diseases. This review provides insights into the plausible incorporation of Cranberries in contemporary dentistry, offering readers an informed perspective on their potential role. Full article

The intra- and intercellular signaling molecule nitric oxide (NO) is produced in endothelial cells by the activity of endothelial NO synthase (eNOS). Upon formation, NO diffuses into the underlying vascular smooth muscle cells, where it activates NO-sensitive guanylyl cyclase (NO-GC) resulting in the production of cyclic guanosine 3′,5′-monophosphate (cGMP) from guanosine 5′-triphosphate (GTP). Inducing vasodilatation, inhibiting platelet aggregation and leukocyte adhesion, and inhibiting the proliferation and migration of vascular smooth muscle cells, the NO-cGMP signaling leads to a number of anti-inflammatory processes. Inflammation-dependent elevated concentrations of reactive oxygen species (ROS) and reactive nitrogen species (RNS) in blood vessels of inflamed dental pulp induce an uncoupling of eNOS and oxidized NO-GC, leading to a disruption of NO-cGMP signaling. Endothelial dysfunction in inflamed dental pulp alters cell–cell and cell–matrix interactions, reducing the regenerative and reparative potential of the dentin–pulp complex in response to carious lesions. In the therapeutic management of caries, it is essential to consider the presence of endothelial dysfunction in the inflamed dental pulp. The utilization of NO-GC stimulators and activators in indirect and direct pulp capping materials may enhance the regeneration and repair potential of inflamed dental pulp. Full article

Background: X-linked hypophosphatemic rickets (XLH) is a rare hereditary disorder characterized by renal phosphate wasting and impaired bone mineralization. Oral manifestations such as spontaneous periapical lesions and dental abscesses in the absence of caries or trauma may precede systemic features in XLH due to underlying dentin hypomineralization and enamel–dentin junction defects, and could serve as early diagnostic indicators. Case Report: We report on the case of a 4-year-old boy referred to our pediatric dental unit with recurrent intraoral fistulas persisting over the past year. Clinical examinations and an orthopantomogram revealed extensive root resorption and periapical pathology affecting multiple primary molars without evident caries or trauma. Laboratory investigations showed hypophosphatemia, elevated renal phosphate loss, and raised inflammatory markers (CRP (C-reactive protein) and granulocytes). Genetic testing of the child and his mother confirmed a diagnosis of X-linked hypophosphatemic rickets. Management: Due to behavioral challenges, treatment proceeded with difficulty over multiple visits. Endodontic treatment was initiated using a formalin–resorcinol technique; however, several primary molars developed progressive necrosis and required extraction. Orthodontic space maintainers were placed to preserve arch integrity and support future eruption. The patient remains under follow-up and is currently awaiting Burosumab therapy. Despite systemic management, spontaneous necroses of the primary molars persist, highlighting the refractory nature of dental involvement in XLH. Conclusions: This case underscores the pivotal role of pediatric dentists in recognizing systemic diseases through oral findings and demonstrates the challenges of managing XLH-related dental pathology, even under targeted systemic therapy. Early interdisciplinary collaboration is essential to optimize both dental and systemic outcomes in affected children. Full article

Background and Objectives: Sjögren’s syndrome (SS) causes destructive salivary gland dysfunction with substantial oral morbidity. To synthesize practical, evidence-based approaches for early recognition, initial oral management, and timely referral to dental care. Materials and Methods: Narrative review of English-language literature from the Web of Science Core Collection and PubMed, prioritizing systematic reviews, randomized trials, and consensus guidelines. Results: Early oral signs include rapid multifocal root and cervical caries, burning sensations, and rising dental treatment needs. Unstimulated whole saliva ≤ 0.1 mL/min supports significant hypofunction and complements the 2016 ACR/EULAR criteria. Preventive care should combine dietary counseling, salivary stimulation, and topical remineralization. Adjuncts include high-fluoride toothpaste, biomimetic hydroxyapatite dentifrices, and casein phosphopeptide–amorphous calcium phosphate (CPP-ACP). However, evidence for fluoride varnish in SS remains mixed. Pharmacologic sialogogues require screening for contraindications. Conclusions: Embedding oral screening, simple salivary metrics, and a structured referral pathway into rheumatology visits can reduce preventable tooth loss and improve comfort, function, and treatment adherence. Full article

Background: Antimicrobial photodynamic therapy (aPDT) is a useful adjunct for managing oral biofilm diseases. Natural photosensitizers may be safer and more biocompatible than synthetic ones, but their dental effectiveness is still unclear. Methods: A PRISMA compliant review (PROSPERO ID: CRD420251233910) searched PubMed, Embase, Scopus, and the Cochrane Library for randomized controlled trials published from 2015 to 2025 that used natural photosensitizers for aPDT in dental settings. Three reviewers screened studies, extracted data, and assessed bias with a nine-domain tool adapted for photodynamic therapy. Results: Eleven of 249 records met the established criteria. Natural photosensitizers included curcumin, riboflavin, phycocyanin, chlorophyll derivatives, and plant extracts, tested in periodontitis, peri-implant mucositis, denture stomatitis, caries-related biofilms, and general oral decontamination. Most trials showed short-term microbial reductions and modest clinical gains, with performance comparable to chlorhexidine, methylene blue, or standard care. Adverse effects were minimal. Study quality was generally good, but wide variation in photosensitizer type, light settings, and outcomes, and short follow-up periods hindered meta-analysis and limited conclusions about long-term effectiveness. Conclusions: Natural photosensitizer-based aPDT appears effective and safe as an adjunct, offering consistent short-term microbiological improvements. Current evidence does not support replacing established antimicrobial approaches. Larger, well-controlled trials with standardized methods and longer follow-up periods are needed to define best practice and clarify the role of aPDT in routine dentistry. Full article

Bioactive glasses (BGs) are promising materials for enamel remineralization and caries management due to their ion-releasing ability and capacity to promote apatite formation. However, their clinical translation remains limited. Conventional BGs, such as 45S5, exhibit excellent bioactivity but are mechanically weak, prone to rapid ion burst release, and lack long-term stability. Recent advances—including secondary oxide incorporation (e.g., B₂O₃, ZnO), polymer–glass hybrids, and nanostructured systems like mesoporous BGs and RegeSi have improved reactivity, mechanical performance, and remineralization depth, though their durability under oral conditions is not yet established. BGs also display antibacterial activity by elevating local pH and releasing ions that inhibit cariogenic bacteria, but their broader ecological impact on the oral microbiome remains poorly understood. Emerging approaches such as halogen-modified BGs, particularly fluoride- and chloride-doped formulations, show dual benefits for remineralization and antimicrobial action, though supporting evidence is largely confined to in vitro studies. The absence of standardized protocols for assessing remineralization, ion release, and biofilm interaction further complicates cross-study comparisons and slows clinical adoption. Future progress will require interdisciplinary collaboration, standardized evaluation methods, and rigorous clinical validation to ensure that next-generation BGs can be safely and effectively integrated into dental practice. Full article

Background: The aim of this study was to investigate the effects of chronic graft-versus-host disease (cGVHD) and its treatment with cyclosporine and extracorporeal photopheresis (ECP) on salivary caries risk factors. Methods: In this exploratory single-centre cross-sectional pilot study, saliva samples from 22 cGVHD patients were analysed for flow rate, pH, buffering capacity, and counts of Streptococcus mutans and Lactobacillus. A detailed dental examination assessed plaque, carious lesions, and their progression. Caries risk was determined based on general health and diet questionnaires and clinical findings. Results: Patients receiving a combination of cyclosporine and ECP had significantly fewer carious teeth, affected tooth surfaces, and non-cavitated carious lesions compared with those treated with ECP alone (Bonferroni test, p = 0.004, p = 0.002, and p < 0.001, respectively). Patients treated with ECP had more carious teeth and affected surfaces than those who did not receive either ECP or cyclosporine (p = 0.008 and p = 0.002), whereas patients treated with cyclosporine only had more non-cavitated lesions than those receiving both cyclosporine and ECP (p < 0.001). A negative correlation was observed between cyclosporine dose and stimulated salivary flow (R = −0.672, p = 0.0486), and a positive correlation between cyclosporine dose and caries risk (R = 0.640, p = 0.0461). Conclusions: The disease and its treatment were associated with reduced salivary flow and increased caries risk. Patients’ oral health should be monitored regularly and managed with care to prevent further deterioration. Full article

Background/Objectives: Visual examination remains the standard for caries detection, but its subjectivity limits reproducibility. Adjunctive methods may support objectivity, yet many require costly equipment or extensive training. BlueCheck (BC) liquid is a hemoglobin-based dye that binds reversibly to porous hydroxyapatite, producing a visible blue discoloration in demineralized enamel. This study aimed to evaluate the ability of BC liquid to detect initial occlusal caries lesions and assess lesion activity. Methods: An in vitro study was performed on 54 extracted permanent posterior teeth. Caries detection and lesion activity assessment were performed visually (International Caries Classification and Management System) and with BC liquid. Histology, including methyl red staining, served as the reference standard for lesion depth and activity. Agreement, sensitivity, specificity, and ROC analyses were calculated. Results: BC liquid showed almost perfect intra- and inter-examiner reproducibility (κ = 0.86). Overall agreement with visual examination was 92.6%, and agreement with histological activity assessment was 79.6%. For detection of initial lesions, BC liquid achieved sensitivity of 81.8% and specificity of 100%, with an AUC of 0.909. For activity assessment, BC liquid showed higher sensitivity than visual examination (89.5% vs. 60.5%), but lower specificity (75% vs. 100%), yielding an AUC of 0.822. Conclusions: Within the limitations of this in vitro study, BC liquid demonstrated good diagnostic accuracy and agreement with visual criteria for both detection and activity assessment of occlusal caries lesions. BC liquid may serve as an adjunctive tool for caries diagnosis, but further in vivo and longitudinal studies are required to validate its clinical applicability. Full article

Background/Objectives: Although the relationship between prolonged breastfeeding and early childhood caries remains unclear, dentists must manage children’s oral health while respecting mothers’ chosen feeding practices and providing information on maintaining oral health as long as possible. This longitudinal study was performed to investigate the occurrence of dental caries and identify associated factors, with particular attention to maternal condition and oral-health-related support in long-term breastfed children. Methods: Of 6746 children aged 42 months in Toyonaka City, Japan, 1210 who had been breastfed for at least the first 18 months were enrolled. Participants underwent oral examinations and anthropometric measurements at 18 and 42 months of age. In addition, a self-administered questionnaire was distributed to families when the child was 18 months old. Logistic regression analysis was used to evaluate risk factors for dental caries, with caries occurrence at 42 months as the dependent variable. Results: Overall, 24.3% of the children had experienced dental caries at 42 months. Logistic regression analysis identified several significant factors associated with caries occurrence: birth order (p < 0.001), snacking frequency (p = 0.038), Cariostat^® caries-risk test results (p < 0.001), and wake-up time (p = 0.015) among child factors, and parental exhaustion (p = 0.041) and participation in postnatal oral health classes (p = 0.005) among maternal factors. Conclusions: Waking habits in early childhood, maternal psychological condition, and participation in postnatal oral health instruction were significantly associated with dental caries occurrence over time among long-term breastfed children. Full article

Minimally invasive treatment is increasingly successful in managing carious lesions in primary teeth, owing to the regenerative capacity of the dental pulp and the possibility to influence the pulp–dentin complex. Chemo-mechanical caries excavation (CME) with Brix 3000, a papain-based enzymatic agent, allows selective removal of infected dentin while preserving affected dentin for potential remineralization. Fluorescence-aided caries excavation (FACE) enables visualization of porphyrins produced by cariogenic microorganisms, guiding selective dentin removal. In this study, 42 children aged 4–7 years with ICDAS II code 05–06 lesions in primary molars were treated, and the correlation between fluorescence intensity and cariogenic microbial load was evaluated. CME was performed using Brix 3000, and residual dentin was categorized by fluorescence as red, red with pale-pink areas, pale-pink, or non-fluorescent. Microbiological samples were collected pre- and post-excavation, cultured under standardized laboratory conditions, and quantitatively analyzed. Results showed that higher fluorescence intensity corresponded to increased presence of S. mutans (ρ = 0.945, p < 0.001), while other species were present in lower quantities. CME with Brix 3000 significantly reduced microbial load, and fluorescence reliably indicated areas requiring removal. These findings demonstrate that combining FACE with Brix 3000 allows precise, minimally invasive caries removal in primary teeth, providing an objective method to guide tissue-preserving excavation while effectively controlling cariogenic microorganisms. Full article

Objectives: This cross-sectional observational and epidemiological study aimed to collect data on the oral health conditions of the prison population in Rio de Janeiro, Brazil. Methods: The Penitentiary Moniz Sodré, part of the Penitentiary Complex of Bangu, houses 1385 male inmates of different nationalities. They were divided into groups according to age: Group 1, prisoners aged 18 to 27 years; Group 2, from 28 to 37 years; Group 3, from 38 to 47 years; and Group 4, from 48 and older. A survey was performed, and the Decayed, Missing, Filled Teeth (DMFT) index was applied. A statistical analysis was conducted, considering a p-value of less than 0.05 as significant. Then, multiple linear regression was implemented to verify correlations among the studied parameters, to adjust for confounders, and to examine predictors of DMFT scores. Results: The average age was 26.95 ± 6.72 years, with 57.7% smokers (n = 720) and 7.7% (n = 96) former smokers. Lung diseases were also relatively common (20.9%). The most frequently reported oral issue was bleeding on probing (37.7%, n = 470), with 100% presenting visible dental plaque and 71.3% dental calculus. Oral hygiene habits showed moderate adherence, with 20.1% brushing their teeth at least once daily and 20.3% flossing; however, only 10.3% reported using fluoride mouthwash. The average DMFT score progressively increased across age groups: Group 1 (age: 18–27): 6.89; Group 2 (age: 28–37): 10.87; Group 3 (age: 38–47): 16; and Group 4 (age ≥ 48): 22.5 (p < 0.0001). Decayed (D) teeth scores showed a moderate increase: Group 1: 2.94 ± 2.74; Group 2: 3.38 ± 2.65; Group 3: 3.11 ± 2.56; Group 4: 3.75 ± 3.1 (p = 0.0029). Missing (M) teeth scores demonstrated a significant increase with age, from 2.74 (±2.84) in group 1 to 18.12 (±7.71) in group 4 (p < 0.0001), whereas Filled (F) teeth scores were highest in group 3 (mean 1.92 ± 4.13), followed by a decline in the oldest group (mean 0.62 ± 1.18) (p < 0.0001). These findings indicate a strong age-related increase in the total DMFT score, primarily driven by the number of missing teeth. Conclusions: High levels of caries and its sequelae exist, demonstrating a correlation with age, as well as a low level of previous periodontal treatment or intervention. As the treatments performed did not manage to reduce the incidence of caries and periodontal diseases, a high number of extractions were observed in patients in confinement. Full article

Background: Dental caries is currently the most common chronic disease affecting the Spanish pediatric population. Therefore, the main objective of this study was to assess Caries Management by Risk Assessment (CAMBRA) in children attending a university dental clinic between the ages of 6 and 12 and establish the DMFT (decayed, missing, and filled teeth index for permanent teeth) of the sample. In addition, the study calculated the plaque index, salivary pH level, buffering capacity, and the quantity and quality of saliva in the sample and determined if there were statistical differences between sexes and between subgroups with DMFT = 0 (control) and DMFT > 0 (cases). Methods: A case–control study was conducted with 89 patients aged 6 to 12 years. Clinical and salivary indicators were measured. Caries risk was also assessed using the CAMBRA protocol, and the sample was also divided into control and case groups for further analysis. Results: The CAMBRA questionnaire showed that 65.2% of participants presented a high risk of caries. The sample showed an average DMFT of 0.65 with a plaque index of 57.2%. The mean salivary pH was 7.35 (±0.30). The average volume of stimulated saliva was 6.83 mL (±3.68), and the buffering capacity was classified as normal in 57% of cases. No statistically significant differences were found between sexes or in the evaluated risk factors. In the control group, the mean salivary pH value was 7.35, and the amount of stimulated saliva was 6.5 mL. The buffering capacity was classified as normal in 67% of cases. In contrast, the case group presented a mean pH value of 7.15 and a salivary volume of 5 mL, with a normal buffer capacity in 50% of cases. Conclusions: The CAMBRA protocol indicated that more than half of the participants presented a high risk of caries, indicating the need to customize treatment plans for each patient. The salivary pH showed statistic differences between the control and case groups, indicating the importance of incorporating salivary biomarkers into routine clinical practice. Full article