Search Results (431)

Background/Objectives: The functionalization of various forms of graphene, such as graphene nanoplatelets, graphene oxide, and reduced graphene oxide, in biomaterials is a promising strategy in dentistry, particularly regarding their antimicrobial potential. However, conclusive studies on the toxicity and biocompatibility of graphene-based materials remain limited, and standardized guidelines for their production, handling, and dental applications are still lacking. This scoping review aims to map the available studies on various types of graphene, synthesize evidence on their antimicrobial effectiveness, and describe the main biological responses when functionalized in dental biomaterials. Methods: An electronic search was conducted in the Clarivate, PubMed, and Scopus databases using the descriptors as follows: ‘graphene’ AND ‘antimicrobial effect’ AND ‘bactericidal effect’ AND (‘graphene oxide’ OR ‘dental biofilm’ OR ‘antibacterial properties’ OR ‘dental materials’). Article screening and eligibility assessment were performed based on predefined inclusion and exclusion criteria, following the PRISMA-ScR guidelines. Results: The search identified 793 articles. After removing duplicates, applying the eligibility criteria, and performing a full-text analysis of 64 articles, 21 studies were included in the review. Graphene oxide, particularly at low concentrations, was the most commonly studied graphene variant, demonstrating significant antimicrobial efficacy against S. mutans, S. faecalis, E. coli, P. aeruginosa, and C. albicans. Both mechanical and chemical mechanisms have been linked to the biological responses of graphene-doped biomaterials. The biocompatibility and cytotoxicity of these compounds remain controversial, with some studies reporting favorable outcomes, while others raise significant concerns. Conclusions: Graphene shows great promise as an antimicrobial agent in dental biomaterials. Despite encouraging results, more in vitro and in vivo studies are needed to better understand its biocompatibility and cytotoxicity in dental applications. Additionally, standardized production protocols, clearly defined clinical applications in dentistry, and regulatory guidelines from the World Health Organization concerning handling procedures and occupational risks remain necessary. Full article

Objectives: Digitalization has revolutionized dentistry, introducing advanced technological tools that improve diagnostic accuracy and access to healthcare. This study aims to examine the effects of integrating digital technologies into the dental field, analyzing the associated benefits and risks, with particular paid attention to the therapeutic relationship and decision-making autonomy. Materials and Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, complemented by Google Scholar for non-indexed studies. The selection criteria included peer-reviewed studies published in English between 2014 and 2024, focusing on digital dentistry, artificial intelligence, and medical ethics. This is a narrative review. Elements of PRISMA guidelines were applied to enhance transparency in reporting. Results: The analysis highlighted that although digital technologies and AI offer significant benefits, such as more accurate diagnoses and personalized treatments, there are associated risks, including the loss of empathy in the dentist–patient relationship, the risk of overdiagnosis, and the possibility of bias in the data. Conclusions: The balance between technological innovation and the centrality of the dentist is crucial. A human and ethical approach to digital medicine is essential to ensure that technologies improve patient care without compromising the therapeutic relationship. To preserve the quality of dental care, it is necessary to integrate digital technologies in a way that supports, rather than replaces, the therapeutic relationship. Full article

Three-dimensional printing is commonly used to fabricate provisional dental restorations. Studies have reported that changes in printing orientation affect the physical and mechanical properties of 3D-printed polymeric provisional restorations; however the findings have been inconsistent. Therefore, this systematic review and meta-analysis aims to analyze the articles evaluating the influence of printing orientation on the physical and mechanical properties of 3D-printed polymeric provisional dental restorations. Recommendations provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to structure and compose the review. The PICO (Participant, Intervention, Comparison, Outcome) question ordered was: ‘Do 3D-printed provisional dental restorations (P) printed at various orientations (except 0°) (I) exhibit similar physical and mechanical properties (O) when compared to those printed at a 0° orientation (C)?’. An electronic search was conducted on 28 and 29 April 2025, by two independent researchers across four databases (MEDLINE/PubMed, Scopus, Cochrane Library, and Web of Science) to systematically collect relevant articles published up to March 2025. After removing duplicate articles and applying predefined inclusion and exclusion criteria, twenty-one articles were incorporated into this review. Self-designed Performa’s were used to tabulate all relevant information. For the quality analysis, the modified CONSORT scale was utilized. The quantitative analysis was performed on only fifteen out of twenty-one articles. It can be concluded that the printing orientation affects some of the tested properties, which include fracture strength (significantly higher for specimens printed at 0° when compared to 90°), wear resistance (significantly higher for specimens printed at 90° when compared to 0°), microhardness (significantly higher for specimens printed at 90°and 45° when compared to 0°), color stability (high at 0°), and surface roughness (significantly higher for specimens printed at 45° and 90° when compared to 0°). There were varied outcomes in terms of flexural strength and elastic modulus. Full article

Background: Mesenchymal stem cells (MSCs), multipotent and immune-regulatory cells derived from tissues such as bone marrow, dental pulp, and periodontal ligament, emerged as promising agents in regenerative dentistry. Their clinical applications include endodontic tissue regeneration, periodontal healing, and alveolar bone repair, addressing critical challenges in dental tissue restoration. Methods: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO. We searched PubMed, Scopus, and Web of Science databases for open-access, English-language clinical trials and observational studies published from 2015 to 2025. Studies focusing on the application of MSCs in dental tissue regeneration were included based on predefined eligibility criteria. Results: Out of 2400 initial records, 13 studies met the inclusion criteria after screening and eligibility assessment. Most studies investigated MSCs derived from dental pulp and periodontal ligament for regenerating periodontal tissues and alveolar bone defects. The majority reported improved clinical outcomes; however, variations in MSC sources, delivery methods, sample sizes, and follow-up periods introduced methodological heterogeneity. Conclusions: MSCs show significant potential in enhancing bone and periodontal regeneration in dental practice. Nonetheless, the current evidence is limited by small sample sizes, short follow-up, and inconsistent methodologies. Future large-scale, standardized clinical trials are required to validate MSC-based regenerative therapies and optimize treatment protocols. Full article

Background: The rising demand for aesthetic dental treatments has spurred interest in peroxide-free color correctors as alternatives to traditional hydrogen peroxide formulations, which are associated with tooth sensitivity and potential enamel demineralization. This systematic review evaluates the whitening efficacy and safety profile of hydrogen peroxide-free color corrector (HPFCC) products, focusing on color change metrics, enamel and dentin integrity, and adverse effects. Methods: Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Science throughout January 2025 for randomized controlled trials, observational studies, and in vitro experiments comparing HPFCC to placebo or peroxide-based agents. The data extraction covered study design, sample characteristics, intervention details, shade improvement (ΔE00 or CIE Lab), enamel/dentin mechanical properties (microhardness, roughness, elastic modulus), and incidence of sensitivity or tissue irritation. Risk of bias was assessed using the Cochrane tool for clinical studies and the QUIN tool for in vitro research. Results: Six studies (n = 20–80 samples or subjects) met the inclusion criteria. In vitro, HPFCC achieved mean ΔE00 values of 3.5 (bovine incisors; n = 80) and 2.8 (human molars; n = 20), versus up to 8.9 for carbamide peroxide (p < 0.01). Across studies, HPFCC achieved a mean ΔE00 of 2.8–3.5 surpassing the perceptibility threshold of 2.7 and approaching the clinical acceptability benchmark of 3.3. Surface microhardness increased by 12.9 ± 11.7 VHN with HPFCC (p < 0.001), and ultramicrohardness rose by 110 VHN over 56 days in prolonged use studies. No significant enamel erosion or dentin roughness changes were observed, and the sensitivity incidence remained below 3%. Conclusions: These findings derive from one clinical trial (n = 60) and five in vitro studies (n = 20–80), encompassing violet-pigment serums and gels with differing concentrations. Due to heterogeneity in designs, formulations, and outcome measures, we conducted a narrative synthesis rather than a meta-analysis. Although HPFCC ΔE00 values were lower than those of carbamide peroxide, they consistently exceeded perceptibility thresholds while maintaining enamel integrity and causing sensitivity in fewer than 3% of subjects, supporting HPFCCs as moderate but safe alternatives for young patients. Full article

Background: The development of antimicrobial resistance is a major public health issue, in which dentists play a significant role by prescribing 7–11% of worldwide antibiotics. The aim of this study is to evaluate the self-perception and knowledge of antibiotic therapy in fifth-year undergraduate dental students. Methods: This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 18 questions was conducted with fifth-year students enrolled in the 2022/23 and 2023/24 academic years. The data were analyzed using descriptive and inferential statistical methods. Results: A total of 139 students (76.4%) completed the questionnaire. A total of 71.9% of students considered that they had received adequate education in antibiotic therapy, particularly in Oral Surgery (89.2%) and Periodontics (86.3%). The theoretical classes (3.50 ± 0.98) and practical sessions (3.18 ± 1.29) provided the knowledge that had the greatest influence on their education. They showed high self-confidence in diagnosing an infection (3.49 ± 0.73) and in choosing the appropriate antibiotic and dosage (3.26 ± 0.73). Over 76% of students answered correctly regarding the need for antibiotic prescriptions in various practical scenarios, except in the replantation of avulsed permanent teeth (54%). Conclusions: Dental students’ knowledge of antibiotics should be reinforced, as a high percentage answered correctly regarding the indications for antibiotics in pulpal and periapical diseases, but students performed less well regarding the choice of antibiotic and dosage in patients without sensitivity to β-lactams. Full article

Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, at the Department of Dental Prosthetics at the University of Medicine and Pharmacy in Cluj-Napoca. All patients had complete bimaxillary edentulism and received removable dentures as treatment. Clinical and cephalometric analyses were performed before and after prosthetic treatment to compare changes. The cephalometric analysis was based on the guidelines of Tweed and Rocabado for evaluation. Quantitative data were described using the mean and standard deviation for normal distribution and represented by bar graphs with error bars. A paired samples t-test was used to determine differences between groups, with a significance threshold of 0.05 for the bilateral p-value. Results: When analyzing changes in cranial base inclination, the corresponding angles exhibited an increase, indicating cephalic extension. A statistically significant difference in the anteroposterior diameter of the oropharyngeal lumen with and without bimaxillary complete dentures was identified (p < 0.05). For hyperdivergent patients, modifications in the position of anatomical features on cephalometry slightly reduced the VDO and had a slight compensatory effect on skeletal typology. In contrast, for hypodivergent patients, modifications to the position of anatomical landmarks also had a compensatory effect on skeletal typology, increasing the VDO. Conclusion: Changes in the position of anatomical features on cephalometry generally have a compensatory effect on skeletal typology after complete denture placement. Complete prosthetic treatment with removable dentures can significantly influence respiratory function by reducing the oropharyngeal lumen and body posture by cephalic extension and attenuation of the lordotic curvature of the cervical spine. Full article

Autogenous tooth transplantation offers a biologically favorable approach to tooth replacement, preserving the periodontal ligament, promoting alveolar development, and maintaining proprioception. Background/Objectives: Its broader clinical applicability is limited by variability in techniques and outcome definitions. This systematic review and meta-analysis evaluated the clinical success of autogenous tooth transplantation across donor tooth types, developmental stages, surgical techniques, and fixation methods. Methods: Following PRISMA 2020 guidelines and a PROSPERO-registered protocol (CRD42024625550), five databases and the gray literature were searched through July 2025. Eligible studies reported clinical outcomes for autogenous tooth transplantation. Risk of bias was assessed using the Newcastle–Ottawa Scale. A random-effects meta-analysis of logit-transformed proportions was conducted, with subgroup and sensitivity analyses by tooth type, root development stage, surgical technique, and fixation method. Results: Twenty studies involving 1366 transplanted teeth were included. The pooled success rate was 94.0% (95% CI: 22.5–99.9%) across follow-up periods ranging from one month to twenty-nine years. However, interpretation is limited by distinct heterogeneity (I² = 99.8%) and the wide confidence interval. Subgroup analyses by tooth type, root maturity, surgical technique, and fixation method are, therefore, emphasized to support clinical interpretation. Conclusions: Autogenous tooth transplantation achieves consistently high success across clinical contexts when biologic handling is respected. These findings support its broader use in dental and orthodontic practice and underscore the need for standardized outcome reporting and prospective research. Interpretation is limited by heterogeneity and variation in reporting standards. Full article

Background/Objectives: The main purpose of the present scoping review was to map and explore the efficacy of computer-controlled intraosseous anesthesia (CCIA) in comparison with conventional dental anesthesia in pediatric dental patients. Secondarily, this study aimed to compare the acceptance and preference factors between CCIA and conventional dental anesthesia in children. Given the limited and heterogeneous nature of the available literature, this review aimed to identify gaps and scope the extent of research conducted in this area, providing a foundation for future, more targeted studies. Methods: The search was conducted in 19 electronic databases, and the appropriate studies were identified according to PRISMA-ScR guidelines. Only split-mouth randomized controlled clinical trials that reported on the clinical outcomes of CCIA in children were included. Two reviewers worked independently on the screening and selection of the studies. The same two reviewers carried out the data extraction and the risk of bias assessment, using the Cochrane risk of bias tool. Due to the exploratory nature, this review focused on mapping the characteristics, outcomes, and research trends rather than synthesizing effect sizes. Results: Out of 841 papers, 2 randomized clinical trials were ultimately included in the scoping review. The outcomes were categorized as primary (including results that answered the focus question) and secondary (relating to additional quality characteristics). Regarding the primary outcomes, in both studies, intraosseous anesthesia was efficacious in achieving the adequate level of anesthesia. One of the secondary outcomes was the acceptance and preference of CCIA in comparison with conventional dental anesthesia in children. The limited number and the high risk of bias in existing studies highlight the necessity for more comprehensive and high-quality research. Conclusions: The selected studies support the assertion that CCIA is a promising technique since it results in less pain perception and is preferred by patients compared to conventional local anesthesia. However, the existing literature is limited and at high risk of bias. Thus, further targeted investigations are needed to evaluate and yield more definitive results regarding the superiority of CCIA. Full article

Background: Dynamic computer-aided navigation systems are a real-time motion tracking technology widely applied in oral implantology and endodontics to enhance precision and reduce complications. However, their reliability, accuracy, and usability in dentoalveolar surgery and maxillary bone augmentation remain underinvestigated. Methods: A systematic review following PRISMA guidelines was conducted and registered on PROSPERO (CRD42024610153). PubMed, Scopus, Web of Science, and Cochrane Library databases were searched until October 2024 to retrieve English eligible studies, without restrictions on the publication year, on dynamic computer-assisted navigation systems in dentoalveolar and bone augmentation surgeries. Exclusion criteria were surgery performed without dynamic computer-assisted navigation systems; dental implant placement; endodontic surgery; and maxillo-facial surgery. The outcomes were reliability, accuracy, post-operative course, surgical duration, complications, patient- and clinician-reported usability, acceptability, and satisfaction. Included studies were qualitatively synthetized and judged using dedicated tools for the different study designs. Results: Twenty-nine studies with 214 patients were included, showing high reliability in dentoalveolar and bone augmentation surgeries comparable to or superior to freehand surgeries, higher accuracy in dentoalveolar surgery compared to maxillary bone augmentation, and reduced complication rates across all surgeries. While overall surgical duration slightly increased due to technology installation, operative time was reduced in third molar extractions. Patient-reported outcomes were poorly investigated. Clinician-reported outcomes were mixed, but difficulties in the differentiation of soft tissue from hard tissue were recorded, especially in sinus floor elevation. Conclusions: Dynamic computer-assisted navigation systems enhance accuracy and safety in dentoalveolar and bone augmentation surgery. Further studies are needed to assess the underinvestigated patient-reported outcomes and standardize protocols. Full article

Background and Objectives: Cyanoacrylate (CA) tissue adhesives have gained increasing attention as alternatives to sutures in oral surgery and periodontology. The objective of this scoping review is to assess their clinical applications and effectiveness in wound closure and postoperative management. Materials and Methods: The review was conducted following the JBI methodology and PRISMA-ScR guidelines. A comprehensive search was performed in PubMed, Scopus, and Web of Science to identify randomized controlled trials published between 2015 and 2025 evaluating the use of CAs in oral surgery and periodontal procedures. Results: A total of 19 studies were included. Cyanoacrylate adhesives demonstrated comparable or superior outcomes to other wound healing strategies in terms of operative time, postoperative pain reduction, and early wound healing. Their use was particularly beneficial in free gingival grafts and palatal donor site management. However, the findings across studies were not always consistent, and some trials did not report statistically significant differences. The use of long-chain CA formulations is associated with minimal toxicological risk, though these adhesives demonstrate intrinsic hemostatic and antimicrobial effects. Conclusions: Cyanoacrylate tissue adhesives represent a valid alternative to sutures in several dental surgical contexts, especially in procedures involving mucogingival grafts. Further high-quality clinical studies are needed to clarify their long-term outcomes and broaden their indications in dentistry. Full article

Background: Burnout syndrome (BS) is an occupational condition resulting from chronic stress, characterized by three dimensions, emotional exhaustion (EE), depersonalization (DE), and diminished personal accomplishment (PA), particularly prevalent in caregiving professions such as healthcare. The aim of this study is to analyse the prevalence of BS among Spanish dental implantology specialists, along with the impact of demographic, educational, and professional aspects. Methods: This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines and was open to respondents from May to December 2024. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was sent to members of the Spanish Society of Implants. The data were analysed using descriptive analysis. Results: A total of 305 participants (20.9%) (31.5% females and 68.5% males) completed the questionnaire. The prevalence of BS was 4.3%; however, 61.0% of the dentists showed signs of suffering from the syndrome. The mean values of EE were “average” (20.3 ± 13.8) and of DE and EE “low” (5.1 ± 5.9, and 32.5 ± 14.5, respectively). The factors significantly associated with suffering from BS were being female and having more than 20 years of experience in dental implant treatments. Conclusions: It is advisable to conduct instructive and awareness-raising initiatives among dental professionals to promote an awareness of their mental health, ultimately aiming at preserving their physical and emotional well-being while delivering optimal care to their patients. Full article

Background and Objectives: Bone regeneration (BR) is a cornerstone technique in reconstructive dental surgery, traditionally using either barrier membranes, titanium meshes, or perforated non-resorbable membranes to facilitate bone regeneration. Recent advancements in 3D technology, including CAD/CAM and additive manufacturing, have enabled the development of customized scaffolds tailored to patient needs, potentially overcoming the limitations of conventional methods. Materials and Methods: A scoping review was conducted according to the PRISMA guidelines. Electronic searches were performed in MEDLINE (PubMed), the Cochrane Library, Scopus, and Web of Science up to January 2025 to identify studies on digital technologies applied to bone augmentation. Eligible studies encompassed randomized controlled trials, cohort studies, case series, and case reports, all published in English. Data regarding digital workflows, software, materials, printing techniques, and sterilization methods were extracted from 23 studies published between 2015 and 2024. Results: The review highlights a diverse range of digital workflows, beginning with CBCT-based DICOM to STL conversion using software such as Mimics and Btk-3D^®. Customized titanium meshes and other meshes like Poly Ether-Ether Ketone (PEEK) meshes were produced via techniques including direct metal laser sintering (DMLS), selective laser melting (SLM), and five-axis milling. Although titanium remained the predominant material, studies reported variations in mesh design, thickness, and sterilization protocols. The findings underscore that digital customization enhances surgical precision and efficiency in BR, with several studies demonstrating improved bone gain and reduced operative time compared to conventional approaches. Conclusions: This scoping review confirms that 3D techniques represent a promising advancement in BR. Customized digital workflows provide superior accuracy and support for BR procedures, yet variability in protocols and limited high-quality trials underscore the need for further clinical research to standardize techniques and validate long-term outcomes. Full article

This study aimed to evaluate and compare the performance of four advanced artificial intelligence-powered chatbots—ChatGPT-4 Omni (ChatGPT-4o), DeepSeek, Gemini Advanced, and Claude 3.7 Sonnet—in responding to questions related to traumatic dental injuries (TDIs) in the primary dentition. The assessment focused on accuracy, completeness, readability, and response time, aligning with the 2020 International Association of Dental Traumatology guidelines. Twenty-five open-ended TDI questions were submitted to each model in two separate sessions. Responses were anonymized and evaluated by four pediatric dentists. Accuracy and completeness were rated using Likert scales; readability was assessed using five standard indices; and response times were recorded in seconds. ChatGPT-4o demonstrated significantly higher accuracy than Gemini Advanced (p = 0.005), while DeepSeek outperformed Gemini Advanced in completeness (p = 0.010). Response times differed significantly (p < 0.001), with DeepSeek being the slowest and ChatGPT-4o and Gemini Advanced being the fastest. DeepSeek produced the most readable outputs relatively, though none met public readability standards. Claude 3.7 generated the most complex texts (p < 0.001). A strong correlation existed between accuracy and completeness (ρ = 0.701, p < 0.001). These findings emphasize the cautious integration of artificial intelligence chatbots into pediatric dental care due to varied performance. Clinical accuracy, completeness, and readability are critical when offering information aligned with guidelines to support decisions in dental trauma management. Full article

Background/Objectives: Diabetes mellitus is defined as a group of metabolic diseases characterized by chronically elevated blood glucose levels. This condition influences the course of orthodontic treatment, as it affects various clinical aspects of the patient that must be taken into consideration prior to initiation. Therefore, achieving adequate control and management of diabetic patients undergoing orthodontic therapy is essential. This article presents a qualitative synthesis of studies addressing how diabetes affects orthodontic treatments, emphasizing the importance of understanding the necessary considerations prior to initiating treatment and how to manage potential complications. Methods: This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A database search was performed on 5 May 2025, in PubMed, Scopus, Scielo, and The Cochrane Library, using terms related to “diabetes mellitus” and “orthodontic treatments”. Studies meeting the search criteria were included, particularly those that were published in the past ten years and reported on the influence of diabetes on orthodontic treatment. The quality of the case–control studies was assessed using the Newcastle–Ottawa Scale (NOS); for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used; and for experimental studies, the SYRCLE’s Risk of Bias Tool was applied. Results: Fourteen studies ultimately met the inclusion criteria. The evidence showed that diabetes increases gingival bleeding due to elevated levels of advanced glycation end-products (AGEs) and pro-inflammatory cytokines; reduces the efficiency of tooth movement; increases root resorption and affects bone remodeling; and compromises both periodontal and pulpal responses, thereby hindering tissue regeneration. It was also observed that the use of insulin or antidiabetic agents such as metformin may partially mitigate these adverse effects. Conclusions: This systematic review reveals a clear relationship between diabetes and various clinical aspects that influence the progression of orthodontic treatments. Nonetheless, further studies are needed to better understand the impact of this systemic condition on dental treatment outcomes. Full article