Search Results (452)

Background: Local anesthesia is essential for most dental procedures, but its parenteral administration is often painful. Topical anesthetics are commonly used to minimize local anesthesia pain; however, commercial formulations fail to fully prevent the discomfort of local anesthetic injection. Methods: We developed and characterized a novel lidocaine and epinephrine co-loaded liquid crystalline precursor system (LCPS) for topical anesthesia. The formulation was structurally characterized using polarized light microscopy (PLM) and small-angle X-ray scattering (SAXS). Rheological behavior was assessed through continuous and oscillatory rheological analyses. Texture profile analysis, in vitro mucoadhesive force evaluation, in vitro drug release and permeation studies, and an in vivo toxicity assay using the chicken chorioallantoic membrane (CAM) model were also conducted. Results: PLM and SAXS confirmed the transition of the LCPS from a microemulsion to a lamellar liquid crystalline structure upon contact with artificial saliva. This transition enhanced formulation consistency by over 100 times and tripled mucoadhesion strength. The LCPS also provided controlled drug release, reducing permeation flow by 93% compared to the commercial formulation. Importantly, the CAM assay indicated that the LCPS exhibited similar toxicity to the commercial product. Conclusions: The developed LCPS demonstrated promising physicochemical and biological properties for topical anesthesia, including enhanced mucoadhesion, controlled drug delivery, and acceptable biocompatibility. These findings support its potential for in vivo application and future clinical use to reduce pain during dental anesthesia procedures. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

A novel macrodesign for a dental implant characterized by a non-monotonic variation in core diameter and thread shape has been described to produce lower stress levels during insertion as compared to conventional tapered implants. Two finite element models resembling the lower left molar region with preformed osteotomies were created based on a cone beam computed tomography (CBCT) scan. Insertion of both the novel and the conventional, tapered implant type were simulated using Standard for the Exchange of Product model data (STEP) files of both implant types. Von Mises equivalent stress, strain development, and amount of redistributed bone were recorded. The conventional implant demonstrated a continuous increase in strain values and reaction moment throughout the insertion process, with a brief decrease observed during the final stages. Stress levels in the cortical bone gradually increased, followed by a reduction when the implant was finally positioned subcrestally. The novel implant achieved the maximum magnitude of reaction moment and cortical bone strain values when the implant’s maximum core diameter passed the cortical bone layer at around 60% of the insertion process. Following a notable decrease, both the reaction moment and stress started to rise again as the implant penetrated further. The novel implant removed more bones in the trabecular region while the conventional implant predominantly interacted with cortical bone. Overall, the novel design seems to be less traumatic to alveolar bone during the insertion process and hence may lead to reduced levels of initial peri-implant bone loss. Full article

Background: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. Clinical Case: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. Results: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. Conclusions: The continuity of cost-free dental care effectively addressed the participant’s oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system. Full article

Resin-based restorative materials are widely used for direct dental restorations due to their versatility and esthetic appeal. However, selecting the most appropriate material involves multifactorial considerations, including clinical demands, practitioner preferences, and professional background. This pilot study aimed to investigate the factors influencing the selection of resin-based restorative materials among dental clinicians at the National and Kapodistrian University of Athens. A structured questionnaire comprising 23 closed-ended and 5 open-ended items was administered to 87 clinicians between October 2023 and January 2025. The survey assessed material preferences for anterior and posterior restorations, along with demographic, economic, and environmental influences. Data were analyzed using descriptive statistics, Spearman correlations, and Mann–Whitney U tests (SPSS v29). Findings revealed that clinicians with over five years of experience demonstrated significantly greater knowledge of material composition (r = 0.230) and shelf life (r = 0.223). These practitioners favored specialized materials, whereas those with less experience emphasized anatomical and esthetic attributes. For posterior restorations, 75.9% of respondents preferred packable composites. Involvement in procurement processes correlated positively with familiarity with ISO specifications (r = 0.254). While environmental concerns were noted, they were generally secondary, with gender-based differences observed in prioritization. These results underline the importance of targeted continuing education to enhance evidence-based material selection in restorative dentistry. Full article

Background/Objectives: The effective management of dental practices is increasingly recognized as a key factor in ensuring high-quality care, efficient operations, and interdisciplinary collaboration. While many dentists assume managerial responsibilities, formal training in healthcare or dental practice management may influence the quality of these practices. This study aims to evaluate the differences in organization, efficiency, and quality of care between dental clinics managed by dentists who have completed management training and those who have not. It also explores dentists’ knowledge and attitudes regarding dental practice management. Methods: A cross-sectional, observational, case–control study was conducted between 14 April and 14 May 2023, using an online questionnaire distributed to licensed dental practitioners in Romania. A total of 136 dentists participated, divided into a study group (n = 60), who had completed management courses and a control group (n = 76) who had not. Descriptive statistics and comparative analyses (t-tests, Chi-square tests) were performed using SPSS version 24, with significance set at p < 0.05. Results: Dentists with managerial training demonstrated greater implementation of strategic planning, financial performance monitoring, quality management, and use of digital tools. They also reported higher collaboration with interdisciplinary professionals—orthodontist 76.7% in the study group vs. 63.2% in the control group, medical assistant 78.3% in the study group vs. 47.4% in the control group, front desk 43.3% in the study group vs. 18.4% in the control group; better delegation of tasks—61.7% in the study group vs. 27.6% in the control group; and greater concern for team development—95% in the study group vs. 71% in the control group; and patient rights—81.7% in the study group vs. 75% in the control group. Significant differences (p < 0.05) were noted in management practices, opinions about the optimal manager for a dental practice, and the use of software tools. Conclusions: Managerial training equips dentists with critical skills for enhancing operational efficiency and care quality. Integrating management education into dental curricula and continuing professional development can substantially improve the sustainability and performance of dental practices. Full article

Oral diseases such as periodontitis and dental caries, as well as conditions related to oral health such as halitosis, are closely associated with dysbiosis of the oral microbiota and continue to pose significant public health challenges worldwide. With the increasing resistance to existing antibiotics and side effects of chemical disinfectants, probiotics have emerged as promising alternatives for oral healthcare. This study aimed to evaluate the oral health efficacy and probiotic properties of Limosilactobacillus fermentum (L. fermentum) MG4717 isolated from the human oral cavity. L. fermentum MG4717 showed notable antimicrobial activity against the key oral pathogens Streptococcus mutans (S. mutans), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Fusobacterium nucleatum (F. nucleatum) and effectively inhibited biofilm formation. Additionally, L. fermentum MG4717 significantly downregulated methionine gamma-lyase (mgl) mRNA expression in P. gingivalis, which is implicated in halitosis and pathogenicity. L. fermentum MG4717 strongly adhered to the KB and HT-29 epithelial cells and exhibited good resilience under simulated gastrointestinal conditions. Whole-genome sequencing (WGS) and average nucleotide identity (ANI) analysis confirmed strain identity (98.73% average nucleotide identity with L. fermentum DSM20052) and the absence of transferable antibiotic resistance genes. Safety assessments revealed no cytotoxicity, hemolytic activity, or bile salt hydrolase activity. These findings suggest that L. fermentum MG4717 has the potential to be used as a safe and effective oral probiotic beneficial for oral health. Full article

This study aimed to evaluate the cytotoxicity of two resin materials, Tera Harz TC-85 DAC and Clear-A, along with the effects of two different post-printing protocols applied to Clear-A. Samples were produced using the Ackuretta Sol printer. The following three groups were formed based on the resins used and the post-curing methods applied: Group 1: Tera Harz TC-85 DAC resin + Tera Harz Cure; Group 2: Clear-A resin + Curie machine; and Group 3: Clear-A resin + Tera Harz Cure. All samples were sterilized in 70% ethanol for 5 min, rinsed with sterile deionized water, and incubated in Dulbecco’s Modified Eagle Medium at 37 °C for 72 h. Cytotoxicity assessment was performed by the XTT and RTCA methods using the human gingival fibroblast cell line. According to the XTT assay, undiluted resin extracts exhibited approximately 75–80% cell viability at 24 h, while further dilutions resulted in a viability exceeding 90%. No significant differences in viability were observed among the groups at any dilution at 48 and 72 h. The xCELLigence RTCA results aligned with the XTT findings, showing a transient decrease in cell viability within the first 24 h, followed by continued cell growth. This study demonstrated that extracts from all tested 3D-printed resins exhibited biocompatibility with human gingival fibroblasts. These findings support their potential for further applications in the dental and biomedical fields. Full article

Child and adolescent health plays a critical role in shaping future public health and intergenerational outcomes. In China, rising rates of myopia, obesity, mental health issues, and other common conditions highlight the need for continuous monitoring. Since 2016, the Chinese National Surveillance on Students’ Common Diseases and Risk Factors (CNSSCDRF) has provided comprehensive, nationwide data on student health. By 2022, the system had expanded to nearly all counties, tracking key indicators such as vision problems, overweight/obesity, dental caries, and health-risk behaviors across multiple administrative levels. This review outlines the surveillance methodology, including sampling, data collection, and analysis. Findings have directly informed school health policies and technical guidelines, supporting national goals such as those in the Healthy China 2030 Plan. Full article

Background: The dentin–pulp complex plays a vital role in tooth health. Dentin forms the main body the tooth and continues to form throughout life to maintain homeostasis and provide protection against deleterious external stimuli. However, the detailed mechanism of dentin formation remains poorly understood, and there is a need for new regenerative therapies. This study therefore investigated whether primary dental pulp cells from mice could be used to establish a new culture system. Methods: Mouse mandibles were divided along the ramus to extract dental pulp tissue containing cervical loops. The extracted tissue was cultured in an incubator to promote cell out-growth and increase the number of cells available for experimentation. Results: Cultured cells formed mineralized nodules, confirmed by Alizarin red S staining. The expression levels of dentin sialo protein, bone gamma-carboxyglutamate protein, and type I collagen mRNAs in cultured dental pulp cells on day 15 were lower than those in intact mouse dental pulp tissue, and the expression of all mRNAs was confirmed through electrophoresis. Conclusions: This study established a primary culture system using dental pulp tissue extracted from mouse mandibular incisors. The results demonstrated that dental pulp cells can differentiate into odontoblast-like cells and form dentin-like mineralized nodules, thereby offering a useful system for studying dentin formation and odontoblast differentiation. Full article

Background: The digital transformation in dentistry is increasingly reshaping treatment procedures, offering new opportunities and advancements. While digitalization promises enhanced efficiency and quality of care through the standardization, acceleration, and simplification of workflows, it also introduces challenges related to mental health. Studies investigating digitization-associated stressors and resources, as well as health- and work-related outcomes, in the dental sector are still rare. In the context of ongoing digitalization, further studies are needed to examine the need for and the current status of the implementation of measures preventing techno-stress and stress-related outcomes. This study explores the use of digital tools in dental practices and their relationship to the techno-stress among German dentists. It identifies key stressors and resources associated with digital technologies, aiming to inform preventive measures, as well as training and support strategies to mitigate digital stress. Methods: A qualitative study was employed, involving ten problem-centered, guideline-based expert interviews with German dentists. The interviews were analyzed using MAXQDA software, following the focused interview analysis framework by Kuckartz and Rädiker. Coding and thematic analysis adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist and qualitative research quality criteria by Mayring. Results: This study identified a dual impact of digitalization in dentistry. On the one hand, digital tools significantly enhance workflow efficiency, diagnostic accuracy, and patient outcomes. On the other hand, they pose challenges like technostress, high financial costs, and the need for continuous learning. Findings reveal that the perceived usefulness of digital technologies is closely linked to the level of techno-stress experienced, while the amount, intuitiveness, and ease of use significantly influence stress levels. Conclusions: Digital transformation offers substantial benefits for dental practices but requires a balanced approach to implementation. Participants highlighted the need for proactive measures, such as targeted training, technical support, and stress-reducing interventions to reduce techno-stress levels. The digital transformation must be supported by coordinated efforts across academia, industry, and policy to strengthen digital competencies—creating a healthier, more resilient digital work environment. Future research should focus on the causal relationship between techno-stress and adverse long-term consequences, such as burnout or mental disorders, among dentists. Full article

Background/Objectives: Cancer patients undergoing chemotherapy (CT) or radiotherapy (RT) are at increased risk of oral complications. Preventive dental care has been proposed to mitigate these risks, yet its effectiveness is not sufficiently evaluated. This systematic review and meta-analysis aimed to assess the impact of preventive oral health interventions on key clinical outcomes in oncology patients. Methods: A systematic search of MEDLINE, Embase, and CENTRAL databases was conducted (March 2025), adhering to PRISMA guidelines with a PROSPERO-registered protocol (CRD 420251006799). Eligible studies included randomized trials, cohort studies, and pre–post intervention studies evaluating preventive dental care in patients receiving CT or RT. The outcomes included gingival index (GI), dental caries (DMFT), plaque levels, and periodontal health. Meta-analyses were performed on GI and DMFT outcomes using random-effects models. Results: Eleven studies were included in the qualitative synthesis and four in the meta-analyses. Preventive interventions, such as fluoride applications, oral hygiene education, and regular professional cleanings, were associated with stabilization or improvement of gingival health. The pooled estimate for GI showed no significant deterioration over time (MD = −0.05, 95% CI: −0.34 to 0.24, p = 0.72). For DMFT, a slight but significant increase was observed (MD = 1.07, 95% CI: 0.08 to 2.05, p = 0.03), suggesting a continued risk of caries despite intervention. Conclusions: Preventive dental care interventions appear to support the maintenance of gingival health in cancer patients undergoing CT or RT. However, despite these interventions, a slight increase in dental caries was still observed, indicating that preventive strategies may not fully eliminate the risk of caries. These findings highlight the importance of sustained and individualized oral health programs as part of comprehensive oncology care. Future studies using standardized protocols and longer follow-up periods are needed to better evaluate their long-term effectiveness across diverse cancer populations. Full article

Flourishing in children is an indicator of positive development in the areas of emotional, social, and cognitive development. Using a recent dataset from the US National Survey of Children’s Health, this study investigates the association between access to a quality healthcare system and flourishing indicators in school-aged children with autism. The outcome variable describes the proportion of children aged 6–17 with autism meeting the flourishing criteria, which include measures related to learning, resilience, and self-regulation. The main independent variable includes six core indicators for school-aged children and adolescents, which assess whether the family feels like a partner in their child’s care, the child has a medical home, receives regular medical and dental preventive care, has adequate insurance, has no unmet needs or barriers to accessing services, and has prepared for transition to adult healthcare. Multivariable logistic regression models were used to examine the relationships between various independent variables and the outcome of interest. The results show that children with autism who receive comprehensive and coordinated care are more likely to flourish compared to those without such care for five of these six indicators, while controlling for sex, race, parental education, household income, self-reported autism severity, general health status, and the number of adverse childhood experiences. Children with autism are more likely to flourish when their families and healthcare providers work together effectively. Addressing gaps in the quality care system is essential for developing holistic approaches that empower children with autism to thrive and reach their full potential. Supportive health policies and effective coordination between families and healthcare providers are crucial for fostering the flourishing of children with autism, ensuring comprehensive, individualized, and continuous care. Full article

Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread’s crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone–implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS’s cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, p = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (p = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density. Full article

Background: In recent years, thanks to the improvement of adhesive techniques, patients affected by tooth wear, related to erosion and/or parafunctional habits, can undergo restoration by adding only what has been lost of their dentition (additive approach). However, since not all clinicians are convinced that dental rehabilitation should be proposed in the early stages of exposed dentin, several treatments are often postponed. It is important to emphasize that, in the early stages, the clinical approach should remain conservative, focusing on dietary counseling, the modification of harmful habits, fluoride application, and risk factor management. Only when these preventive and non-invasive strategies prove insufficient, and the condition continues to progress, should invasive restorative treatments be considered. Unfortunately, epidemiological studies are reporting an increase in the number of young patients affected by erosive tooth wear, and not intercepting these cases earlier could lead to a severe degradation of the affected dentition. In addition, parafunctional habits are also becoming more frequent among patients. The combination of erosion and attrition can be very destructive, and may progress rapidly once dentin is exposed and the risk factors remain unaddressed. The aim of this report was to present a conservative full-mouth rehabilitation approach for severe erosive lesions and to provide a 10-year follow-up assessing the biological, functional, and esthetic outcomes. Methods: In this article, the postponed restorative treatment of a patient, suffering from severe tooth wear, is illustrated. The patient had sought dental treatment in the past; however, due to the already very compromised dentition, a conventional but very aggressive treatment was proposed and refused. Four years later, when the patient finally accepted an alternative conservative therapy, the tooth degradation was very severe, especially at the level of the maxillary anterior teeth. The combination of three different approaches, Speed-Up Therapy, BOPT (Biologically-Oriented Preparation Technique), and the 3 Step Technique, however, improved the capacity to successfully complete the difficult therapeutic task. Results: The biological goals (maintenance of the pulp vitality of all of the teeth and the minimal removal of healthy tooth structure) were accomplished, relying only on adhesive techniques. Conclusions: The overall treatment was very comfortable for the patient and less complicated for the clinician. At 10-year follow-up, biological, functional, and esthetic success was still confirmed. Full article