Search Results (33)

Background: Dental patient-centred outcomes are essential in clinical practice and research. To enhance feasibility, Oral Health-Related Quality of Life (OHRQoL) instruments often need to reduce administration time. In Serbia, longer OHIP versions exist (OHIP-14, OHIP-EDENT), but the ultrashort OHIP-5 has not yet been available. Aim: This cross-sectional study aimed to translate, culturally adapt, and evaluate the psychometric properties of the five-item Serbian version of the Oral Health Impact Profile (OHIP5-Srb). Materials and Methods: The OHIP5-Srb was translated using a standard forward–backward procedure. Participants were recruited between June and September 2025 using a convenience sampling approach. Psychometric testing—including internal consistency, exploratory (EFA), confirmatory factor analysis (CFA), and convergent and known-groups validity—was conducted on 236 participants (mean age 47.4 years). Test–retest reliability was evaluated in 35 dental students, and responsiveness in 45 patients undergoing dental treatment. Results: Cronbach’s alpha was 0.784, indicating adequate internal consistency. Test–retest reliability was excellent (mean ICC = 0.96; all inter-item correlations > 0.20). Convergent validity was supported by a strong negative correlation between OHIP5-Srb summary scores and a single-item measure of overall oral/dental health (Spearman’s rho = −0.861, p < 0.01). Known-group validity was confirmed by significant differences between removable denture wearers and individuals with natural teeth (and/or fixed partial dentures), after adjusting for age, and between participants perceiving a need for dental treatment and those who did not. EFA indicated a one-factor structure explaining 55.1% of variance. The one-factor model was confirmed by CFA and showed good fit (χ² = 15.08, df = 5; CFI = 0.97; TLI = 0.94; RMSEA = 0.092; SRMR = 0.04). Responsiveness analysis demonstrated significant decreases in OHIP5-Srb scores following various dental treatments. Conclusions: The OHIP5-Srb is unidimensional, reliable, valid, and responsive. Its brevity and robust psychometric properties make it suitable for assessing self-perceived oral health-related quality of life in the Serbian urban population, particularly when minimizing respondent burden is critical. Full article

Background: The interaction between prosthetic restorations and periodontal health is a critical factor for the long-term success of dental treatments. A biologically compatible prosthetic design supports periodontal stability, whereas neglecting periodontal principles can compromise treatment outcomes. This study aimed to validate a questionnaire designed to assess dentists’ perceptions regarding the influence of prosthetic restorations on the periodontium. Material and Methods: An observational cross-sectional study was conducted using a self-administered questionnaire distributed to licensed dentists across Romania. The questionnaire underwent expert review, pilot testing (n = 50), and statistical validation, including the Content Validity Index (CVI), Cronbach’s alpha for internal consistency, and Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA) with Varimax rotation. The final sample included 39 respondents. Data was analyzed using SPSS v26.0. Results: The questionnaire demonstrated excellent internal consistency (Cronbach’s alpha = 0.900; standardized alpha = 0.917). Most items had corrected item-total correlations > 0.40. EFA revealed eight coherent factors explaining 81.68% of total variance, with high communalities (0.549–0.966), strong Kaiser–Meyer–Olkin test (KMO) values, and significant Bartlett’s test values, confirming construct validity. Descriptive statistics showed predominantly positive attitudes among dentists regarding the periodontal considerations in prosthetic treatment. The highest-rated items emphasized oral hygiene, periodontal stability, and biological adaptation of restorations. Lower scores were associated with routine use of periodontal indices and recognition of failures due to insufficient evaluation. Conclusions: The validated instrument proved reliable and demonstrated strong psychometric properties in this exploratory validation, supporting its use in research and education. Romanian dentists demonstrated a favorable perception of the role of periodontal health in prosthetic success. This tool can inform curriculum development and interdisciplinary clinical protocols in prosthodontics and periodontology. Full article

Objectives: To evaluate the psychometric properties of the Spanish version of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire among dental professionals in Colombia. Methods: A cross-sectional study was conducted in Manizales, Colombia, between January and June 2024. A total of 120 dental professionals, including general dentists, specialists, residents, and academic clinicians, were selected through stratified random sampling. Participants completed the Spanish-adapted OSAKA questionnaire and a structured sociodemographic survey. Internal consistency was assessed using Cronbach’s alpha (α) and McDonald’s Omega (Ω). Construct validity was examined through exploratory factor analysis (EFA), with Kaiser Meyer Olkin (KMO) values and Bartlett’s test. Results: The knowledge subscale (18 items) showed good reliability (α = 0.83; Ω = 0.83), while the attitude subscale (5 items) showed near-acceptable reliability (α = 0.68; Ω = 0.59). KMO values were 0.79 for knowledge and 0.57 for attitudes; Bartlett’s test was significant in both cases (p ≤ 0.001). EFA supported structural validity: six components with eigenvalues >1 explained 61.66% of the variance for knowledge, and two components explained 79.49% for attitudes. Significant differences in attitude scores were found among professional groups (p ≤ 0.001, η² = 0.13), with specialists scoring highest ($\overline{X}$ = 17.66) and general dentists lowest ($\overline{X}$ = 14.62). Knowledge scores did not significantly differ between groups (p = 0.47). Conclusions: The Spanish OSAKA questionnaire is a valid and reliable tool to assess knowledge and attitudes toward obstructive sleep apnea in Colombian dental professionals. Its use may support improved education, screening, and interdisciplinary collaboration in dental settings. Full article

Dens invaginatus is a developmental dental anomaly characterized by the infolding of the enamel organ into the dental papilla during early odontogenesis. This process leads to a broad spectrum of anatomical variations, ranging from minor enamel-lined pits confined to the crown to deep invaginations extending through the root, occasionally communicating with periodontal or periapical tissues. The internal complexity of affected teeth presents diagnostic and therapeutic challenges, particularly in severe forms that mimic root canal systems or are associated with pulpal or periapical pathology. Maxillary lateral incisors are most frequently affected, likely due to their unique developmental timeline and morphological susceptibility. Although various classification systems have been proposed, Oehlers’ classification remains the most clinically relevant due to its simplicity and correlation with treatment complexity. Recent advances in diagnostic imaging, especially cone beam computed tomography (CBCT), have revolutionized the identification and classification of these anomalies. CBCT-based adaptations of Oehlers’ classification allow for the precise assessment of invagination extent and pulpal involvement, facilitating improved treatment planning. Contemporary therapeutic strategies now include calcium-silicate-based cement sealing materials, endodontic microsurgery for inaccessible anatomy, and regenerative endodontic procedures for immature teeth with necrotic pulps. Emerging developments in artificial intelligence, genetic research, and tissue engineering promise to further refine diagnostic capabilities and treatment options. Early detection remains critical to prevent complications such as pulpal necrosis or apical disease. A multidisciplinary, image-guided, and patient-centered approach is essential for optimizing clinical outcomes in cases of dens invaginatus. Full article

Purpose: The aim of this study was to compare the effect of rotary (air-driven, electric-driven) and oscillating (piezoelectric ultrasonic) handpieces on the quality of crown preparation, marginal integrity, and internal adaptation of monolithic zirconia crowns. Materials and Methods: Seventy-two standardized premolar preparations were performed using the air-driven handpiece with a guide pin-ended tapered fissure diamond bur on a modified dental surveyor. The finishing process utilized three handpiece types (n = 24/group) with fine/superfine diamond burs under controlled force with a fixed number of rotations and controlled advancement time. Marginal/internal adaptation was evaluated via the triple-scan technique; defects (marginal, axial, and occlusal) were quantified based on predefined criteria through the inspection of the Standard Tessellation Language (STL) file. Results: One-way ANOVA with Tukey HSD and Kruskal–Wallis with Dunn–Bonferroni tests were utilized. The marginal gap showed no significant differences (p > 0.05, η² = 0.04). The electric handpiece outperformed the ultrasonic (p = 0.023, η² = 0.105) in internal adaptation, while the air-driven showed no differences (p > 0.05). The ultrasonic handpiece produced fewer marginal defects than the air-driven (p = 0.039, ε² = 0.132), but more axial defects (median 9 vs. 6, p = 0.014, ε² = 0.168) than the electric handpiece and occlusal defects (5 vs. 3, 4 p = 0.007, p = 0.015, ε² = 0.227) than rotary handpieces. The air-driven handpiece exhibited comparable defect numbers to the electric handpiece without statistical significance (p > 0.05). Conclusions: Handpiece selection had a small effect on marginal adaptation but more pronounced effects on overall defect formations and internal adaptation. The ultrasonic handpiece’s decreased marginal defects but variable axial/occlusal results reveal technological constraints, whereas rotary handpieces’ consistency reflects their operator-dependent nature. Full article

Objectives: To introduce a novel method for apical lesion sampling using a protected paper point device and to evaluate its effectiveness and robustness during the sampling process in vitro. Methods: A prototype for apical sample collection was developed as an adaptation of the Micro-Apical Placement System—the device features a highly tapered screw head with a thin, hollow, stainless-steel tube and an internal wire piston. Standardized 5 mm paper points (ISO 10; PD Dental, Switzerland) served as carrier material. The prototype was tested using 30 × 3D-printed, single-rooted tooth models inoculated using two bacterial strains (Staphylococcus epidermidis and Escherichia coli) to simulate apical and intraradicular bacterial infections, respectively. The sampling process involved collecting and analyzing samples at specific timepoints, focusing on the presence or absence of E. coli contamination. Following sample collection, cultural detection of bacterial presence was performed by incubating the samples on agar plates to confirm the presence of E. coli. Samples were collected as follows: S0 (sterility control of the prototype), P0 (sterility control of the tooth model), P1 (apical sample collected with the CAPS (controlled apical sampling) device, and P2 (contamination control sample to check for the presence of E. coli inside the root canal). Results: Handling of the CAPS prototype was straightforward and reproducible. No loss of paper points or complications were observed during sample collection. All sterility samples (P0, S0) were negative for tested microorganisms, confirming the sterility of the setup. P2 samples confirmed the presence of E. coli in the root canal in all trials. The P1 samples were free from contamination in 86.67% of trials. Conclusions: The CAPS method for apical sampling demonstrated advances in the successful and precise sample collection of apically located S. epidermidis and will be a useful tool for endodontic microbiological analysis. Its user-friendly design and consistent performance highlight its potential for clinical application, contributing to more accurate microbial diagnostics and later patient-specific therapeutic approaches in endodontic treatments. Full article

This study investigated the feasibility and effectiveness of a commercial top-down stereolithography (SLA)-based system for the additive manufacturing of zirconia dental prostheses. Yttria-stabilized zirconia–resin slurries were prepared, and zirconia objects were fabricated using a top-down SLA system. Thermogravimetric–differential thermal analysis was used to examine the resin, while X-ray fluorescence spectroscopy and X-ray diffraction were used to analyze the printed samples. The microstructures of additively manufactured and subtractively manufactured zirconia were compared using field emission scanning electron microscopy (FE-SEM) before and after sintering. Biaxial flexural strength tests were also conducted to evaluate mechanical properties. The green bodies obtained via additive manufacturing exhibited uniform layering with strong interlayer adhesion. After sintering, the structures were dense with minimal porosity. However, compared to subtractively manufactured zirconia, the additively manufactured specimens showed slightly higher porosity and lower biaxial flexural strength. The results demonstrate the potential of SLA-based additive manufacturing for dental zirconia applications while also highlighting its current mechanical limitations. The study also showed that using a blade to evenly spread viscous slurry layers in a top-down SLA system can effectively reduce oxygen inhibition at the surface and relieve internal stresses during the layer-by-layer printing process, offering a promising direction for clinical adaptation. Full article

Three-dimensional (3D) printing represents a pivotal technological advancement in dental prosthetics, fundamentally transforming the fabrication of provisional crowns and bridges through innovative vat photopolymerization methodologies, specifically stereolithography (SLA) and digital light processing (DLP). This comprehensive scholarly review critically examines the technological landscape of 3D-printed resin-based dental provisional crowns and bridges, systematically analyzing their material performance, clinical applications, and prospective developmental trajectories. Empirical investigations demonstrate that these advanced restorations exhibit remarkable mechanical characteristics, including flexural strength ranging from 60 to 90 MPa and fracture resistance of 1000–1200 N, consistently matching or surpassing traditional manufacturing techniques. The digital workflow introduces substantial procedural innovations, dramatically reducing fabrication time while simultaneously achieving superior marginal adaptation and internal architectural precision. Despite these significant technological advancements, critical challenges persist, encompassing material durability limitations, interlayer bonding strength inconsistencies, and the current paucity of longitudinal clinical evidence. Contemporary research initiatives are strategically focused on optimizing resin formulations through strategic filler incorporation, enhancing post-processing protocols, and addressing fundamental limitations in color stability and water sorption characteristics. Ultimately, this scholarly review aims to provide comprehensive insights that will inform evidence-based clinical practices and delineate future research trajectories in the dynamically evolving domain of digital dentistry, with the paramount objective of advancing patient outcomes through technological innovation and precision-driven methodological approaches. Full article

Background/Objectives: This study tested a method for evaluating the internal fit of indirect resin-based composite (RBC) restorations, as well as the influence of different combinations of impression and die materials on the reproducibility of the topography of teeth prepared for indirect RBC restoration. Methods: Bovine incisors received flattened and cavitated areas at the cervical and middle thirds of the buccal surface, respectively. The samples were randomly assigned to two groups according to the material used for impression taking (n = 5): irreversible hydrocolloid and polyvinyl siloxane (PVS). Die replicas were obtained with Type IV gypsum or elastomeric material. RBC restorations were fabricated through an indirect technique (test) and a direct-indirect technique as the control. The internal fit of restorations was assessed by measuring the cementation line thickness with a digital caliper (simulated cementation protocol with ultra-light PVS) and validated using scanning electron microscopy (SEM). Surface topography (Sa, Sq, and Sz) was analyzed via optical profilometry, and wettability was assessed through the water contact angle method. The data were analyzed using t-test, ANOVA, and Pearson correlation tests (α = 5%). Results: The simulated cementation resulted in internal gap values positively correlated to the values from SEM (R² = 0.958; p = 0.0102). The internal gap of restorations was not significantly correlated with the discrepancies between the topography of the die and tooth substrate (p ≥ 0.067). The combination of irreversible hydrocolloid and gypsum resulted in restorations with the lowest cementation line thickness, although in terms of roughness, this combination was the only one that resulted in significant differences from the control (p ≤ 0.028). The internal mean gap values of restorations were significantly correlated to the cumulative wettability difference of materials used during impression taking, fabrication of die replica, and restoration build-up (R² = 0.981; p = 0.003). Conclusions: The reproducibility of topographical characteristics of the tooth in the die replica did not affect the internal adaptation of indirect RBC restorations, whereas surface wettability of materials presented a more relevant effect on the overall gap formation. The simulated cementation technique tested in the study shows potential as a simpler, cost-effective, and non-destructive method for evaluating the adaptation of indirect RBC restorations. Full article

This study aimed to evaluate the marginal and internal adaptation of CAD/CAM crowns milled using two different milling protocols (fine or extra-fine) within a 4-axis milling machine. The crowns were fabricated from lithium disilicate ceramic (IPS e.max CAD) and resin composite (Tetric CAD), assessing their fit in various regions. The crowns (N = 40, n = 10) were milled from lithium disilicate and resin composite using a CEREC Primemill unit. Four groups were formed based on the material and milling protocol: EFLD (extra-fine lithium disilicate), FLD (fine lithium disilicate), EFRC (extra-fine resin composite), and FRC (fine resin composite). The crowns were measured using the replica technique, evaluating internal and marginal adaptation in 18 measuring points per specimen. Data were statistically analyzed using ANOVA and Tukey’s test. Resin composite crowns demonstrated a significantly better internal fit compared to lithium disilicate (p < 0.001). Marginal and internal measurements for resin composites were consistently smaller across regions compared to lithium disilicate. No significant differences were found between milling protocols except for the axial wall region (p = 0.001), where extra-fine milling resulted in smaller values. Resin composite crowns exhibited superior internal fit compared to lithium disilicate, regardless of milling protocol. Both the fine and extra-fine milling protocols had minimal impact on adaptation, except at the axial wall region, with both protocols promoting adequate results overall. Full article

This in vitro investigation aimed to compare the trueness, precision, internal fit, and marginal adaptation of Varseo Smile Crown Plus (VSCP), CROWNTEC (C), and milled Enamic crowns (E) using a 5-axis dental milling machine (prograMill PM7). 39 crowns (VSCP, E, C; n = 13) were designed and fabricated. Internal/marginal adaptation, precision, and trueness were assessed via die scans with/without a fit checker. Dimensional discrepancies were determined by superimposing the scans. One-way ANOVA (α = 0.05) analyzed the results. No significant differences were found in internal fit or marginal adaptation between groups. However, group E exhibited the best fit (axial: 82.9 µm). Trueness differed significantly (p < 0.05) across all groups and areas. Group E had the highest trueness (intaglio: 25.8 µm), while VSCP had the lowest (marginal: 31.9 µm). Precision varied significantly within the occlusal area of printed groups (highest for C: 17.8 µm) and the marginal area between printed/milled (VSCP vs. E) and C vs. E (lowest for E: 20.5 µm, highest for VSCP: 27.9 µm). In conclusion, both milled and 3D-printed crowns achieved comparable internal fit and marginal adaptation. However, group E displayed superior fit and trueness. While C exhibited higher occlusal precision, E had higher marginal precision. These findings suggest the potential for 3D-printed hybrid polymer crowns, warranting further investigation. Full article

Printing orientation is one of the printing parameters that affect the properties of three-dimensional (3D)-printed resins. Different printing orientations and directions have been suggested; however, no clear and specific orientations are recommended in the literature in terms of the printing orientation effect on the accuracy and fit of 3D-printed removable dental prostheses. This review aimed to evaluate the effect of printing orientation on the fit and accuracy of 3D-printed removable dental prostheses. The PubMed, Scopus, and Web of Science databases were searched for published articles that investigated the effect of printing orientations on the accuracy and fit of the 3D-printed denture base. Full-length English published articles were searched between January 2010 and December 2023, which examined topics related to printing orientations, building angles, 3D printing, printing technology, accuracy, dimensional changes, internal fit, marginal integrity, marginal discrepancies, trueness, precision, and adaptation. Of the ten included studies, one investigated maxillary and mandibular denture bases, seven assessed maxillary denture bases, and two evaluated mandibular bases. Different printing orientations, ranging from 0° to 315°, were explored, with a higher prevalence of 0°, 45°, and 90°. The included studies utilized stereolithography and digital light processing printing technologies. High accuracy was observed at 45°, followed by 90. Additional struts and bars on the cameo surface increased the accuracy of the 3D-printed denture base. These results shows that printing orientation has a significant effect on the accuracy of 3D-printed resin, with 45° exhibiting the highest accuracy. In addition to the support structure, the density and position can impact the accuracy. Full article

The present in vitro study focuses on the filling ability of three different bioceramic cements with or without the addition of a bioceramic sealer in an open apex model on the marginal apical adaptation, tubule infiltrations, and void distributions as well as the interface between the cement and the sealer materials. To this end, sixty mandibular premolars were used. MTA-Biorep (BR), Biodentine (BD), and Well-Root Putty (WR) were used to obturate the open apex model with or without the addition of a bioceramic sealer, namely TotalFill^® BC sealer™ (TF). A digital optical microscope and scanning electron microscope (SEM) were used to investigate the cement–dentin interface, marginal apical adaptation, and the material infiltration into the dentinal tubules. Micro-computed X-ray tomography and digital optical microscopy were used to investigate the cement–sealer interface. The results were analyzed by using the Kruskal–Wallis test. No significant difference was found between the groups for the marginal apical adaptation quality (p > 0.05). Good adaptation of the dentin–cement interface was found for all tested groups and the sealer was placed between the cement material and dentinal walls. All the groups demonstrated some infiltrations into the dentinal tubules at the coronal part except for the BR group. A good internal interface was found between the cement and the sealer with the presence of voids at the external interface. A larger number of voids were found in the case of the BD-TF group compared to each of the other two groups (p < 0.05). Within the limitations of the present in vitro study, all the groups demonstrated good marginal apical adaptation. The use of a sealer in an open apex does not guarantee good filling and, in addition, creates voids at the external interfaces with the dental walls when the premixed sealer is used with powder–liquid cement systems. The use of a premixed bioceramic cement could offer fewer complications than when a powder–liquid cement system is used. Full article

Halitosis is a common condition with a significant impact on individuals’ quality of life. The Halitosis Associated Life-Quality Test (HALT) is a reliable instrument for measuring this impact. This study aimed to introduce and validate the Romanian translation of the HALT questionnaire (R-HALT). We hypothesized that the R-HALT would demonstrate good reliability and validity in measuring the impact of halitosis on quality of life among Romanian teenagers and young adults. Our objectives were to translate and adapt the HALT, validate it among a cross-sectional group, and evaluate the extent of halitosis in this population. A multicentric cross-sectional design followed, which was approved by the Ethics Research Committee in Romania. The translation process involved independent translations, retro-translations, expert review, and pre-testing. The psychometric properties were evaluated among 150 patients (mean age 23.6 ± 1.8; 51% males) at dental clinics, including reliability, convergent, and discriminant validity, using accepted statistical measures such as Cronbach’s alpha and Intraclass Correlation Coefficient (ICC). The R-HALT revealed strong internal consistency with Cronbach’s alpha values ranging from 0.93 to 0.96, and an ICC value of 0.87 (95% CI = 0.70–0.99), demonstrating excellent test–retest reliability. Mean scores of individual items ranged from 0.82 ± 0.94 (Q3) to 3.23 ± 1.15 (Q11). The corrected item–total correlation ranged from 0.30 (Q2) to 0.90 (Q19). Organoleptic test scores diagnosed 41% (62 patients) with a score of 2, with increasing severity in 9% (13 patients) with a score of 5. The R-HALT exhibited robust reliability and validity in assessing the impact of halitosis among Romanian teenagers and young adults. The questionnaire is a strong tool for understanding, diagnosing, and managing halitosis in Romania, ultimately aiming to improve the quality of life of affected individuals. Further studies with diverse populations could enhance the applicability of the R-HALT. Full article

This case study aims to explore how customer journey concepts can apply to a hypothetical scenario, centring on a patient (customer persona) within the dentistry arena, and with a particular focus on special care dentistry. As an educational exercise, this paper may inform dental and allied professionals on how aspects of the customer journey notion may be embedded into their own practices, so that patient-centricity might be better optimised. The hypothetical scenario considers the organisational context, customer persona, contemporary customer purchase decision-making models, and marketing approaches. These components are used to create a customer journey map to help visualise and identify the varying customer–business interactions. The customer journey, focussing on the awareness, initial consideration, active evaluation, pre-purchase, purchase and post-purchase stages, is then conceptually analysed. The analyses reveal that there are areas of friction, attributable to numerous factors. The case study recommends that by introducing digitalisation and omnichannel marketing, alongside existing internally generated and multi-channel marketing approaches, considerable improvements may be achievable. As the patient technology landscape becomes more digital and dental organisations face fiercer competition, dental care providers relying on traditional marketing approaches may well need to adapt and introduce innovative, yet cost-effective digitalisation and omnichannel marketing approaches. Nevertheless, dental care providers, and dental and allied professionals must uphold an underlying duty of care, ensuring that all practises are legal, decent, honest, truthful, and above all ethical. Full article