Search Results (2,239)

Background: Panoramic radiography is one of the most widely used imaging examinations in dental practice, providing a broad view of the jaws and adjacent head and neck structures. Although primarily prescribed for odontogenic assessment, its field of view may reveal non-odontogenic findings with potential clinical significance. Methods: A structured narrative review was conducted according to SANRA criteria. A literature search was performed in PubMed/MEDLINE, Embase, Scopus, and Web of Science for English-language publications from January 2010 to May 2026. Backward and forward citation tracking of relevant articles, key reviews, and reference textbooks was also performed. Eligible studies and authoritative sources addressing non-odontogenic findings detectable on panoramic radiographs were qualitatively synthesized. Results: The review focuses on carotid artery calcifications, maxillary sinus abnormalities, mandibular radiomorphometric signs related to low skeletal bone mineral density, elongation or calcification of the stylohyoid complex, sialoliths, tonsilloliths, calcified lymph nodes, phleboliths, and laryngeal cartilage calcifications. These findings range from benign anatomical variants to radiographic indicators that may require medical or specialist evaluation. Conclusions: Panoramic radiography should be regarded as a tool for recognition and clinical suspicion rather than definitive diagnosis of extraoral or systemic disease. Dentists play a central role in systematically assessing the entire image, documenting relevant abnormalities, correlating them with patient history and risk factors, and initiating appropriate referral when indicated. Full article

Background: Childhood oral hygiene behaviors are crucial to preventing oral diseases and can influence the development and progression of malocclusions. The World Health Organization (WHO) Oral Health Questionnaire is a standardized tool for assessing oral hygiene behaviors, oral health-related behaviors, and preventive dental awareness in children. Aim: This study aimed to assess oral hygiene behaviours and examine associations between WHO Oral Health Questionnaire variables and Angle malocclusion classes among children aged 6–9 years. Materials and Methods: This cross-sectional study included 90 children aged 6–9 years from the Pristina region, Kosovo. Data were collected using the WHO Oral Health Questionnaire for Children, which assessed oral hygiene habits, toothbrushing frequency, fluoride awareness, dental attendance, dietary behaviors, oral symptoms, and oral-health-related quality of life. Malocclusion was classified according to Angle classification into Class I, II, and III malocclusions with 3D intraoral scanners, Aerolscan 3. Descriptive statistical analysis, Chi-square (χ²) test, Spearman correlation analysis, and reliability analysis using Cronbach’s Alpha were performed using SPSS Statistics 23.0 (IBM Corp., Armonk, NY, USA) and Statistica 7.1 (StatSoft Inc., Tusla, OK, USA). Results: Most participants reported regular oral hygiene practices, with 46.7% brushing their teeth two or more times daily. However, limited awareness regarding fluoride-containing toothpaste was observed, as most children answered “don’t know” regarding fluoride use. Occasional toothache or oral discomfort was reported by 33.3% of participants, while 23.3% reported dissatisfaction with dental appearance. Difficulty biting hard foods was present in 34.4% of children. Reliability analysis of the Q10 section demonstrated moderate internal consistency (Cronbach’s Alpha = 0.500). Chi-square analysis demonstrated no statistically significant association between Angle malocclusion classes and WHO questionnaire variables (p > 0.05). The highest χ² value was observed for tooth-cleaning frequency (Q7) (χ² = 11.97; p = 0.152), although the association remained statistically non-significant. Psychosocial impact questions and oral health-related quality of life questions also demonstrated no statistically significant association with malocclusion classes. Conclusions: oral hygiene practices, preventative oral health practices, and oral health-related experiences were comparatively similar among children in different Angle malocclusion classes. Although there were no statistically significant correlations found between malocclusion classes and WHO questionnaire variables, the results show that some children have psychosocial concerns about their dental appearance and insufficient awareness of preventive oral health. The WHO Oral Health Questionnaire is a useful epidemiological tool for evaluating pediatric oral health behaviors and may help build youth orthodontic and preventive oral health policies. Full article

Dental caries is a biofilm-mediated dysbiotic disease characterized by ecological shifts within the oral microbiome and progressive demineralization of dental hard tissues. The microbiological composition of carious dentin and the impact of minimally invasive excavation techniques on residual microbial communities remain subjects of ongoing investigation due to methodological heterogeneity and inconsistencies among published studies. This narrative review aimed to summarize current evidence regarding the microbial ecology of carious dentin, compare culture-based and molecular methods for microbiological assessment, and evaluate the microbiological outcomes associated with contemporary approaches to managing minimally invasive caries. The relevant literature on dentinal caries microbiology, microbial detection methods, and excavation techniques was analyzed. The available evidence indicates that carious dentin contains a highly diverse polymicrobial community composed of acidogenic, aciduric, anaerobic, and proteolytic microorganisms. Culture-based methods primarily detect viable and cultivable taxa, whereas molecular approaches reveal substantially greater microbial diversity, including uncultivable and low-abundance species. Comparative studies demonstrate that minimally invasive excavation techniques significantly reduce microbial load but rarely achieve complete microbial elimination. The available evidence suggests that successful caries management is associated with a reduction in and ecological modulation of the residual microbiota within a sealed environment. The integration of culture-based and molecular findings provides a more comprehensive understanding of the microbiology of carious dentin and supports biologically oriented, minimally invasive strategies for caries management. Full article

Obesity and dental caries are highly prevalent chronic conditions with significant global health impact. Although an association between these diseases has been suggested, the nature of this relationship remains unclear. This state-of-the-art review aims to synthesize current evidence on the interplay between obesity and dental caries, focusing on shared risk factors, salivary alterations and underlying biological mechanisms. Evidence indicates that obesity and dental caries share common behavioral and socioeconomic determinants, namely unhealthy dietary patterns with high intake of free sugars, poor oral hygiene habits and social disadvantage. Salivary alterations observed in obesity may also create a more cariogenic oral environment. Additionally, inflammatory mediators, oxidative stress markers and changes in the oral microbiome suggest biologically plausible links between both conditions. However, current data does not support a direct causal relationship, but rather a complex multifactorial interaction between obesity and dental caries driven by shared risk factors and modifiable behaviors. Preventive strategies should adopt an integrated approach targeting shared determinants, particularly diet, oral hygiene habits and socioeconomic status. Nevertheless, the predominance of cross-sectional evidence limits causal inference, highlighting the need for longitudinal studies that simultaneously assess obesity and dental caries, and that address salivary biomarkers using standardized methodologies across different age groups to clarify underlying mechanisms and assess their clinical relevance. Full article

Chronic periapical periodontitis is a persistent inflammatory disease characterized by progressive bone destruction around the tooth apex. Manual radiographic detection of these lesions is subjective and time-consuming, highlighting the need for automated diagnostic tools. This paper presents a unified deep learning framework for joint tooth segmentation and periapical lesion detection in panoramic radiographs. Our approach employs a joint process: first, a deep learning model identifies and segments individual teeth according to standard dental numbering systems, while a second one detects periapical lesions within the tooth regions obtained from the segmentation outputs in the first stage. The framework incorporates an advanced loss function (Powerful IoU v2) to improve bounding-box regression accuracy and a spatial association mechanism to map detected lesions to specific teeth based on geometric overlap analysis. Our proposed tooth segmentation model achieves an mAP@50 of 97.7% and a mean Dice coefficient of 93.5%, while the periapical lesion detector reaches an mAP@50 of 91.9%. Furthermore, our region-of-interest approach yields a 3.49× computational speedup, averaging 0.1589 s per radiograph when compared to full-image processing. Trained exclusively on open-source datasets, this reproducible framework achieves explicit tooth-to-lesion mapping, providing an efficient and practical tool for periapical lesion screening. Full article

Untreated dental caries in permanent teeth is the most frequent disease of all 371 diseases and traumas assessed by the Global Burden of Disease Study in 2021, and there are reported to be 2.24 billion cases worldwide. Demineralization is a disintegration process of minerals and apatite crystals in hard tissue, provoked by biofilm activities, dietary factors, and the micro-oral environment—the three main mechanisms of dental caries. Restoration of mineral ions in the crystal structure is defined as remineralization. Remineralization enables the deposition of new minerals within the crystal structure of demineralized enamel, aiming to increase mineral production. Environments suitable for remineralization and inhibiting demineralization could be created by using a caries prevention agent. Objectives: Providing scientific evidence regarding Aloe vera as an alternative agent for caries prevention. Materials and Method: The method used in this study is a scoping review, utilizing the PRISMA-ScR as a guideline to conduct article screening and further analysis, following a thematic analysis approach. Database searches were conducted in PubMed, EBSCOhost, and ScienceDirect, based on the keywords generated. Results: A total of 13 articles were gathered for further analysis. Conclusions: Aloe vera shows promising preliminary potential, but further standardized in vivo and randomized clinical studies are necessary to confirm its remineralizing efficacy and clarify its mechanisms of action as a cavity prevention agent. Clinical Relevance: Using Aloe vera as an alternative caries prevention agent. Full article

Dental calculus is a highly prevalent oral condition in dogs and is widely recognized as an important risk factor for gingival inflammation and periodontal disease. Effective strategies for its prevention and treatment remain limited, highlighting the significance of exploring novel mechanisms underlying its formation. Neutrophil extracellular traps (NETs), a key component of innate immunity, have been found in various diseases. To investigate the relationship between NETs and canine dental calculus formation, NET-associated markers were assessed in the oral cavities of dogs with dental calculus and healthy controls. Based on previously published full-length 16S rRNA amplicon sequencing data of canine dental calculus, Porphyromonas gulae was selected as a candidate NET-inducing bacterium for subsequent validation experiments. Subsequent neutrophil stimulation experiments were conducted to explore the effects of NETs and related factors on dental calculus formation. Collectively, our findings demonstrate the presence of NETs within canine dental calculus and reveal that P. gulae present in canine dental calculus is capable of inducing NET formation. The level of myeloperoxidase–DNA complex in gingival crevicular fluid was significantly elevated in dogs with dental calculus. NETs promoted aggregation and microcrystal formation from calcium and phosphate ions under both physiological and supersaturated concentrations. By adhering to the surface of dental calculus, NETs facilitated calculus accumulation. This effect showed positive correlation with neutrophil counts and administration frequency, but was independent of the concentration of administered calcium and phosphate solutions. IL-1β promoted the formation of aggregated NETs but did not enhance calculus accumulation. DNase I inhibited this process by degrading NET-DNA. In conclusion, dental calculus and the calculus-inhabiting P. gulae could stimulate oral neutrophils to release NETs, which participate in and facilitate the initial formation, aggregation, and subsequent accumulation of canine dental calculus. Full article

Dental diseases have long been taught and treated as separate entities: cariology, operative dentistry, endodontics, and periodontology, each working within its own boundaries. However, increasing biological and clinical evidence suggests that this classified view does not fully reflect how disease progresses in the mouth. Instead, dental disease should be understood as a continuum within the interconnected tooth–pulp–periodontium complex. This review provides current evidence showing how dental caries can serve as the starting point of a process that can progress through pulpitis and apical periodontitis and eventually affect surrounding periodontal tissues. Caries is now widely known as a biofilm-driven and host-influenced condition shaped by ecological imbalance rather than specific pathogens alone. As lesions penetrate deeper into dentin, the structure becomes more permeable, permitting diffusion of microbial metabolites and signaling molecules toward the pulp. This initiates a multifaceted inflammatory reaction within the pulp tissue. At this stage, pulpitis becomes a critical turning point, where the outcome depends on microbial load, lesion activity, host response, and quality of clinical intervention. If the disease is not well controlled, it may lead to pulp necrosis, allowing infection to spread beyond the root canal and initiate periapical inflammation. Through anatomical pathways such as apical foramina and lateral canals, these processes can extend further, sometimes resembling or overlapping with periodontal disease. This overlap creates diagnostic challenges, as conventional tests may not always distinguish between conditions. A structured, pathway-based diagnostic approach is therefore essential. From a treatment perspective, this continuum model highlights early intervention, minimally invasive care, preservation of pulp vitality when possible, and maintenance of a strong coronal seal. Ultimately, stronger integration across dental disciplines can improve diagnosis, guide treatment decisions, support long-term tooth preservation, and promote unified dental education. This article presents a narrative review supported by a structured literature search and proposes a clinically actionable framework that extends established endodontic–periodontal concepts upstream to include caries initiation and restorative modulation. Full article

The success of dental implantation depends on both mechanical stability and the host’s immune response to the implanted biomaterials. Osteoimmunology emphasizes that early immune responses at the implant-tissue interface are critical for bone healing and long-term osseointegration. The immune response primarily consists of immune cells, particularly macrophages, neutrophils, and lymphocytes, which interact with osteogenic cells through cytokine networks and signalling pathways, such as RANK/RANKL/OPG. Additionally, it modulates both bone formation and resorption. This review focuses on summarizing the mechanisms that shape the immune response around implants by dental implant materials. It describes mechanisms related to bulk composition, surface topography, and mechanical properties, and highlights macrophage polarization and the transition from inflammation to regeneration. The review discusses current immunomodulatory strategies, including bioactive surfaces, ion doping, nanopatterning, drug-releasing surfaces, and responsive materials, as well as advances enabled by additive manufacturing. The review also discusses experimental models used to study osteoimmunological interactions and the clinical significance of immune dysregulation in peri-implant diseases. The design of biomaterials based on osteoimmunology represents a shift toward immune-compatible implants that aim to improve regenerative outcomes and long-term implant success. Full article

Background/Objectives: Endodontic perforation repair requires biomaterials that balance sealing ability with minimal cellular injury. AH Plus (epoxy resin-based) remains widely used despite cytotoxicity concerns. CeraSeal (calcium silicate-based bioceramic) is a potentially more biocompatible alternative. However, comparative data on sealer-induced cytotoxicity and inflammatory responses remain limited. This study compared the cytotoxicity and inflammatory profiles of CeraSeal and AH Plus using in vitro and in vivo approaches. Methods: Human periodontal ligament stem cells (hPDLSCs) were exposed to sealer extracts (1:4 AH Plus, 1:8 CeraSeal) for 120 h. Cell death was assessed by MTT, Live/Dead, LDH release, and Annexin V/PI flow cytometry. Oxidative stress was quantified via ROS generation (DCFH-DA). In a rat furcation perforation model (n = 8 teeth/group), inflammatory markers (TNF-α, IL-1β, CD68), osteogenic activity (ALP), and osteoclasts (TRAP) were evaluated. Results: AH Plus was associated with significantly greater necrotic cell death (357.6 ± 47.6% LDH release vs. CeraSeal 128.8 ± 37.5%; p = 0.0079) and reduced hPDLSC viability at all time points (p < 0.0001). ROS generation was comparable between sealers (~32–35%, p > 0.05). In vivo, IL-1β was higher in AH Plus-treated tissues (52.25 vs. 24.88 cells/mm²; p = 0.0002), while TNF-α and CD68 were greater in CeraSeal (p ≤ 0.0011). ALP was higher in AH Plus (median 6.15 vs. 3.68; p = 0.0002), with no difference in TRAP-positive osteoclasts. Morphometric analysis showed superior cellular preservation with CeraSeal (p = 0.0079), while inflammatory infiltration was higher in CeraSeal (p = 0.0002). Conclusions: AH Plus was associated with a necrotic-inflammatory profile with elevated IL-1β and higher ALP expression. CeraSeal demonstrated better cellular preservation, lower LDH release, and a distinct inflammatory signature (higher TNF-α and CD68). These findings establish comparative response profiles for the two sealers and support CeraSeal as a potentially biocompatible alternative, though further mechanistic studies are warranted. Full article

Background: The association between oral health and gastrointestinal (GI) cancers has been primarily investigated within a periodontitis-centered framework. However, the potential contribution of cumulative oral disease burden, including dental caries and apical pathology, remains insufficiently explored. The Decayed, Missing, and Filled Teeth (DMFT) index reflects lifetime exposure to oral microbial dysbiosis and chronic inflammation. Methods: This retrospective exploratory study included patients with GI cancers referred for perioperative oral screening and management at a tertiary care center between 2015 and 2025. Oral health was evaluated using the DMFT index, periodontal probing depth, and radiographically diagnosed apical periodontitis. Age-stratified DMFT and periodontal parameters were compared with national reference data, while apical periodontitis prevalence was descriptively assessed. Results: Patients with GI cancers demonstrated higher DMFT values than national averages across most adult age groups. The prevalence of periodontal pockets (≥4 mm and ≥6 mm) was also elevated. Apical periodontitis was common, affecting 46.3% of patients, with some age groups exceeding 50%. Overall, these findings indicate oral disease clustering with coexisting chronic oral conditions. Conclusions: Patients with GI cancers exhibit substantial oral disease burden, including increased caries experience, periodontal pathology, and apical lesions. These findings suggest that the oral–gastrointestinal cancer relationship may extend beyond a periodontitis-centered paradigm, and that cumulative oral disease burden—including cariogenic processes—may represent an underrecognized component of this axis. The DMFT index may serve as a surrogate marker of lifelong oral inflammatory exposure. While causal relationships cannot be established, this study provides a basis for future mechanistic and longitudinal investigations. Full article

The increasing flow of documents in digital libraries, archives and electronic document management systems makes the standardization, adaptation and automation of the process of creating metadata an urgent scientific problem. Metadata directly affects the efficiency of document search, identification, semantic interpretation, long-term storage and intersystem exchange. However, while standardized description based on MARC21, a flexible approach to creating a dynamic field, and intelligent methods based on deep learning, cover these requirements separately, the issue of their full integration into a single methodological system has not been sufficiently resolved. In this study, an integrated hybrid model for describing electronic documents based on standardized, flexible, and intelligent metadata was proposed. A mixed electronic document corpus of 1500 documents was formed for evaluation. The corpus consisted of books, dissertations, scientific articles, archival documents, and heterogeneous electronic documents, with 300 samples selected from each group. Key metadata elements for each document were manually identified and used as ground truth. According to experimental results, the MARC21-based constructor achieved 96.8% structural compatibility and 95.6% metadata completeness, but the average description time was 6.8 min. The dynamic field approach achieved 93.4% structural compatibility and 94.1% metadata completeness, and reduced the description time to 4.1 min. The deep learning-based intelligent module achieved a structural matching score of 91.7%, a metadata extraction score of 93.8% F1, and reduced the processing time to 1.9 min. The proposed hybrid model achieved a structural matching score of 95.9%, a metadata F1 score of 95.1%, and an average description time of 2.3 min. The results showed that the hybrid model is a balanced solution between metadata quality, flexibility, and automation. Full article

Dental caries remains the most prevalent chronic disease worldwide, yet early enamel lesions are reversible if managed with appropriate remineralizing agents. This narrative review synthesizes current evidence on remineralizing agents, their mechanisms of action, and clinical applications, with a focus on dental materials used in preventive and minimally invasive dentistry. Traditional fluoride-based approaches enhance remineralization through fluorapatite formation; however, their effectiveness is limited when calcium and phosphate bioavailability is insufficient. Biomimetic agents, including casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), bioactive glasses, tricalcium phosphate, and nano-hydroxyapatite, provide these bioavailable ions and demonstrate superior performance under challenging clinical conditions. Emerging therapies such as probiotics, photodynamic therapy, and laser-assisted mineralization show promise but require further clinical validation. Based on the primary mechanism of action, an original classification of remineralizing agents is proposed, grouping them into fluoride-based agents, calcium-phosphate systems, nanotechnology-based systems, biofilm modifiers, biomimetic and emerging systems, and adjunctive antimicrobial therapies. The review concludes that bioavailable calcium represents a critical limiting factor in remineralization under certain conditions, and that combination protocols incorporating multiple remineralizing agents, tailored to individual patient risk profiles, achieve superior outcomes compared to single-agent approaches. Clinicians are encouraged to adopt minimally invasive, patient-tailored remineralization strategies that arrest lesions before cavitation, preserving natural tooth structure and reducing the lifelong restorative burden. Full article

Background: Dental caries is a chronic disease mediated by biofilm, which is caused by Streptococcus mutans, and enamel genetics modulates susceptibility. The variants of ENAM might alter the adhesion of enamel and bacteria. One important anti-viral target is sortase A (SrtA), which restricts colonization but does not have an impact on bacterial survival. Aim: The aim of this study was to find out the relationship between ENAM rs3796704 and dental caries vulnerability among adult Iraqi Arab females and to assess the antibiofilm capacity of eugenol and cinnamic acid against S. mutans SrtA using molecular docking, ADMET prediction, and molecular dynamics modeling. Methods: A case–control study was done on 240 women (aged 25–30 years; 120 caries, 120 controls). HRM real-time PCR was done to genotype ENAM rs3796704. An analysis of allelic and genotypic distributions was done using chi-square tests and odds ratios (p < 0.05). An in silico docking analysis aimed at SrtA (PDB: 4TQX) was performed in AutoDock Vina, and this was followed by ADMET profiling and a 50 ns molecular dynamics simulation (OPLS4/TIP3P, NPT 300 K/1 atm). Results: The level of the G allele was found to be lower in the cases than in the controls (60% vs. 70; OR = 0.6429; p = 0.02), but the level of the A allele was found to be higher in the cases (40% vs. 30; OR = 1.5556; p = 0.02). Docking showed a minor difference in binding affinities with eugenol (−4.961 kcal/mol) and cinnamic acid (−4.939 kcal/mol) as compared with chlorhexidine (−4.692 kcal/mol). Both compounds showed stable binding for more than 50 ns as well as desirable predicted pharmacokinetics. Conclusions: The caries vulnerability in this sample was associated with ENAM rs3796704. Eugenol and cinnamic acid undergo stable dissociative interactions with SrtA and were found to have favorable safety profiles in silico. Therefore, they may be considered as adjunctive anti-virulence agents in the prevention of caries. Full article

Sinonasal malignancies are rare, accounting for fewer than 3% of head and neck cancers, but their early presentation often overlaps with benign rhinosinusitis. Unilateral nasal obstruction, rhinorrhoea, facial pressure, and intermittent epistaxis may initially appear inflammatory, which contributes to diagnostic delay and late-stage presentation. Recent clinical guidance emphasizes that persistent unilateral symptoms, especially when accompanied by bleeding, focal endoscopic abnormalities, or orbital, dental, or neurologic features, should prompt specialist assessment rather than repeated empiric treatment. This commentary argues that the central clinical problem is not failure to recognize advanced disease, but failure to reconsider a benign working diagnosis when “sinusitis” stops behaving like sinusitis. This commentary proposes a pragmatic triage framework for unilateral or refractory sinonasal disease that prioritizes pattern recognition, focused nasal endoscopy, appropriate imaging, and timely biopsy where indicated. Its contribution is to connect three clinically relevant observations: sinonasal malignancy is rare and therefore easily deprioritized; unilateral, progressive, refractory, bleeding, orbital, dental, or neurologic features should prompt earlier cancer exclusion; and emerging AI-assisted endoscopy should currently be viewed only as a triage adjunct, not a substitute for imaging, histopathology, or multidisciplinary assessment. Full article