Search Results (1,504)

Obstructive sleep apnea syndrome (OSAS) is a prevalent disorder with significant systemic and oral health consequences. This narrative review synthesizes the current knowledge on the interplay between dental health and sleep apnea, highlighting the expanding role of dentists in the screening, early detection, and management of OSAS. Validated questionnaires, anatomical assessments, and anthropometric measurements have enhanced dentists’ capacity for early screening. However, knowledge and training gaps remain, particularly in low- and middle-income countries. Dentists are uniquely positioned to identify anatomical and oral risk factors, facilitate referrals for diagnosis, and provide therapeutic interventions such as oral appliance therapy. Interdisciplinary collaboration between dental and medical professionals is essential to improve early detection, treatment outcomes, and patient quality of life. Enhancing education, standardizing protocols, and integrating dentists into multidisciplinary care pathways are critical steps for advancing the management of sleep apnea. Full article

Objective: With a global prevalence ranging from 50% to 100%, gingivitis is considered the most common oral disease in adults worldwide. It is characterized by clinical signs of inflammation, such as redness, swelling and bleeding, on gentle probing. Although it is considered a milder form of periodontal disease, gingivitis plays an important role in overall oral health. Early detection and treatment are essential to prevent progression to more severe conditions. Typically, diagnosis is performed by dental professionals, as individuals are often unable to accurately assess whether they are affected. Therefore, the aim of the present study was to determine to what degree gingivitis is visually detectable by an easy-to-use camera-based application. Materials and methods: Standardized intraoral photographs were taken using a specialized intraoral camera and processed using a custom-developed filter based on a machine-learning algorithm. The latter was trained to highlight areas suggestive of gingivitis. A total of 110 participants were enrolled through ad hoc sampling, resulting in 320 assessable test sites. A dentist provided two reference standards: the clinical diagnosis based on bleeding on probing of the periodontal sulcus (BOP) and an independent visual assessment of the same images. Agreement between diagnostic methods was measured using Cohen’s kappa statistic. Results: The agreement between the application’s output and the BOP-based clinical diagnosis was low, with a kappa value of 0.055 [p = 0.010]. Similarly, the dentist’s visual assessment of clinical photos showed low agreement with BOP, with a kappa value of 0.087 [p < 0.001]. In contrast, the agreement between the application and the dentist’s photo-based evaluations was higher, with a kappa value of 0.280 [p < 0.001]. Conclusions: In its current form, the camera-based application is not able to reliably detect gingivitis. The low level of agreement between dentists’ visual assessments and the clinical gold standard highlights that gingivitis is difficult to identify merely visually. These results underscore the need to refine visual diagnostic approaches further, which could support future self-assessment or remote screening applications. Full article

Objectives: The aim of the study was to investigate caries experience in correlation with self-reported oral health-related habits in a sample of blind and low-vision individuals in Croatia. Methods: The study is a part of the research in the “Project for Oral Health Promotion in Blind and Visually Impaired Persons” conducted at the Zagreb University School of Dental Medicine from 2014 to 2018. The final sample consisted of 85 adults: 42 females and 43 males; 50 blind and 35 low-vision individuals, age range 18–98. The assessment included dental examination and a questionnaire. Results: The median DMFT (Decayed, Missing, and Filled Teeth) index score was 17.0 (IQR = 12.5–22.0), with no significant difference between sexes or between blind and low-vision individuals. The occurrence of untreated caries was low (median D-component = 1.0), while the median F-component was 6.0. There was a significant increase in M-component and DMFT in older age groups. The number of untreated caries (D-component) was significantly correlated with consummation of soft drinks and smoking. Total DMFT did not correlate with frequency of tooth brushing, time since last dental visit, smoking, or level of education. Conclusions: This study revealed high caries experience among blind and visually impaired individuals that did not correlate with factors that normally influence oral health. Similar results were found in the control group, reflecting a 30-year post-war period without organized preventive care. The low number of decayed teeth reflects the availability of public dental care in Croatia; however, preventive care should be provided for both this vulnerable group and the general population. Full article

Background/Objectives: Dental caries is the most prevalent oral condition worldwide. Consequences of untreated dental caries (CUDC) can range from pulp damage and soft tissue ulceration due to root debris to more severe issues, such as fistulas and abscesses. Rural communities might be more vulnerable to CUDC because of lower socioeconomic status, poorer access to healthcare, and lower education levels. The objective of this study was to evaluate and compare the prevalence of CUDC in rural and urban areas in schoolchildren aged 8 to 12 years in the State of Mexico. Methods: A cross-sectional study was conducted using the PUFA index, considering the presence of pulp involvement (P), soft tissue ulcerations due to root remnants (U), fistulas (F), and abscesses (A). The independent variable was the geographic area (rural or urban), and the covariates were nutritional status, hyposalivation, having one’s own toothbrush, and having received topical fluoride in the last year. Logistic regression models were fitted, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results: The prevalence of CUDC (PUFA > 0) was 42.9% in rural areas and 25.9% in urban areas. Residing in a rural area (OR: 2.15, 95% CI 1.38–3.34, p = 0.001), hyposalivation (OR: 1.93, 95% CI 1.11–3.37, p = 0.020), and professional fluoride application (OR: 0.15, 95% CI 0.07–0.32, p < 0.001) were associated with the prevalence of CUDC. Conclusions: To prevent caries and its clinical consequences due to the lack of treatment, it is important to promote timely care seeking and access to dental care services, considering the conditions of each geographic area. Full article

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

Background/Objectives: The expansion of National Health Insurance (NHI) coverage for dental implants in South Korea has substantially increased implant placements among older adults. While implants offer functional and esthetic benefits, their lack of periodontal ligaments alters occlusal force distribution, potentially increasing biomechanical stress on adjacent or opposing teeth. This study aimed to investigate the association between the increased number of dental implants and the incidence of cracked teeth following the introduction of implant insurance. Methods: A retrospective analysis was conducted using the Clinical Data Warehouse of Seoul St. Mary’s Dental Hospital. Patients who underwent molar crown restorations between 2014 and 2022 were included. The incidence and clinical features of cracked teeth were compared before (2014–2015) and after (2016–2022) the introduction of implant insurance. Statistical analyses assessed differences in symptom presentation, pulp status, and treatment outcomes. Results: Among 5044 molars restored with crowns, 1692 were diagnosed with cracks. The incidence of cracked teeth significantly increased after NHI coverage for implants (25.5% vs. 32.6%, p < 0.001). Cases after insurance implementation showed fewer signs and symptoms at initial presentation (67.4% vs. 50.0%, p < 0.001), reduced irreversible pulpitis (37.2% vs. 25.8%, p < 0.001), and increased preservation of pulp vitality (46.9% vs. 57.8%, p < 0.001). These shifts may reflect changes in occlusal adjustment practices and earlier clinical intervention. Conclusions: The findings suggest a temporal link between increased implant placement and the rising incidence of cracked teeth. Implant-induced occlusal changes may contribute to this trend. Careful occlusal evaluation and follow-up are essential after implant placement, and further prospective studies are warranted to confirm causality and refine prevention strategies. Full article

Background: The aim of this review is to summarize and evaluate the properties of antibacterial polysaccharides for application in dental implantology to identify knowledge gaps and provide new research ideas. Methods: The electronic databases PubMed, Medline, ProQuest, and Google Scholar were used to search for peer-reviewed scientific publications published between 2018 and 2025 that provide insights to answer research questions on the role of antibacterial polysaccharides in combating pathogens in dental implantology without triggering immune reactions and inflammation. Further research questions relate to the efficacy against various dental pathogens and the understanding of the antibacterial mechanism, which may enable the development of functionalized polysaccharides with long-term antibacterial activity. Results: Biomedical implants have revolutionized medicine but also increased the risk of infections. Implant infections are a major problem in implantology and lead to implant failure and replacement. An antibacterial coating could be an excellent strategy to extend the lifespan of implants and improve the quality of the patient’s life. Bacterial resistance to antibiotics poses significant challenges for researchers, forcing them to search for new ways to prevent bacterial infections in implantology. Antibacterial natural polymers have recently received considerable research attention due to their long-term antibacterial activity. Polysaccharides from marine sources, such as chitosan and alginate, or pectin, xanthan, etc., from various plants, appear to be promising biopolymers for such applications in implantology due to their antibacterial activity, biocompatibility, and osteogenic properties. The antibacterial activity of these natural biopolymers depends on their chemical and physical properties. Nanopolysaccharides exhibit higher antibacterial activity than conventional polysaccharides, but their toxicity to human cells must be considered. Their antibacterial activity is based on the disruption of bacterial DNA or RNA synthesis, increased cell wall permeability, membrane disruption, and cytoplasmic leakage. Conclusions: Polysaccharides are a class of natural polymers with a broad spectrum of biological activities. They exhibit antioxidant, immunomodulatory, anticoagulant, anticancer, anti-inflammatory, antibacterial, and antiviral activity. Furthermore, polysaccharides are non-cytotoxic and exhibit good biocompatibility with osteogenic cells. Bactericidal polysaccharides are attractive new antibacterial materials against implant infections and open up new perspectives in implantology. Full article

Background: Burnout syndrome (BS) is an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed. Although there are underlying causes associated with personal attributes, it is generally linked to external factors within the work environment. The aim of the present study was to investigate the impact of lifestyle factors on BS and its dimensions, as well as on suicidal ideation among Spanish professionals dedicated to implant dentistry. Methods: A cross-sectional observational study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was distributed to members of the Spanish Society of Implants. The data were analysed using descriptive statistical methods. Results: A total of 305 participants (20.9%) responded to the questionnaire. Notably, 10.8% of the professionals reported experiencing suicidal thoughts, a factor significantly associated with the presence of BS. The lifestyle factors associated with BS included the following: not engaging in aerobic exercise for at least 30 min per day (p < 0.05), not having hobbies that facilitate mental disconnection from work (p < 0.001), not following a balanced diet (p < 0.0001), having an insufficient social life (p < 0.0001), and experiencing suicidal ideation (p < 0.01). Conclusions: The surveyed dentists generally reported having healthy lifestyle habits. Nevertheless, one in ten professionals acknowledged having experienced suicidal ideation at some point, highlighting a concerning association with BS. Full article

Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article

Introduction: Ocular complications associated with dental procedures are diverse but have been primarily reported through case reports and series, with no comprehensive reviews to date. The underlying mechanisms of these complications are often poorly understood by medical professionals, partly due to limited interdisciplinary education. This review aims to bridge this gap by summarizing the relevant anatomical connections between the oral and ocular regions, exploring the mechanisms through which dental procedures may lead to ophthalmic complications, and detailing their clinical presentations, progression, and potential management and preventive strategies. Methods: Published case reports and case series from 1950 to October 2024 that described ophthalmic complications in human patients following dental procedures were included in this scoping review. Results: Dental procedures can give rise to a variety of ophthalmological complications, whether neuro–ophthalmic (e.g., diplopia, ptosis, or vision loss), vascular (e.g., retrobulbar hemorrhage or cervical artery dissection), infectious (e.g., orbital cellulitis or abscess), mechanical (e.g., orbital trauma or fractures), or air-related (e.g., orbital and subcutaneous emphysema). Conclusions: Most of the ophthalmological complications following dental procedures are often reversible, but some can be vision-threatening or lead to permanent sequelae if not promptly recognized and managed. Prevention through precise technique and anatomical awareness, early identification of symptoms, and timely multidisciplinary collaboration are crucial to minimizing risks and ensuring better patient outcomes. Full article

Background and Clinical Significance: Traumatic dental injuries, particularly complicated crown fractures of permanent incisors, are common in adolescents, with maxillary central incisors most frequently affected due to their prominent position. These injuries, often resulting from sports or accidents, require prompt management to prevent complications such as pulp necrosis or infection, which can compromise long-term prognosis. Fragment reattachment offers a conservative, esthetically favorable approach when the fractured segment is intact, with outcomes comparable to composite restorations. This case report underscores the importance of timely intervention and advanced restorative techniques in pediatric dentistry. Case Presentation: A 16-year-old male presented with a complicated crown fracture of the upper left central incisor sustained during a soccer game. The fracture extended subgingivally with pulp exposure. The patient preserved the fragment in saline. Treatment involved fragment reattachment using a dentin bonding agent and flowable composite resin, followed by single-visit root canal therapy due to delayed presentation (48 h). A glass fiber post was placed to reinforce the restoration due to significant coronal loss. Three years of follow-up visits (1, 3, 6, 12, 24, and 36 months) revealed no clinical or radiographic complications, with the tooth remaining asymptomatic and functional. Conclusions: This case underscores the effectiveness of fragment reattachment when combined with meticulous technique and long-term monitoring. Full article

Background/Objectives: Educational background is an aspect of socio-economic status, that may be associated with higher caries risk. This study aimed to investigate differences in caries prevalence between different school types for older adolescents in Greifswald, Germany. Methods: Cross-sectional data were collected as part of compulsory dental school examinations between 2020 and 2023. Oral health status was assessed according to WHO criteria by six calibrated examiners and reported as mean D₃MFT (D₃: dentin caries, M: missing, F: filled, SD/±: standard deviation). To compare educational backgrounds, the adolescents were divided into two groups according to their age and type of school (11–15 and 16–18 years old). Results: The study included 5816 adolescents (48.7% females) with a mean D₃MFT of 0.65 (Q1–Q3: 0–1); 73.8% were clinically caries-free, having D₃MFT = 0, confirming the polarization in caries experience with 2.5 ± 2.13 SaC index. The logistic regression model showed a significantly increased Odds Ratio for having caries in relation to age, being male, having plaque or gingivitis (p < 0.005). There were significant differences in caries experience and prevalence between school types, where high schools had the lowest D₃MFT values in both age groups (0.39 ± 1.17 and 0.64 ± 1.49, respectively). The highest D₃MFT values were in schools for special educational needs in younger adolescents (1.12 ± 1.9) and in vocational schools in older adolescents (1.63 ± 2.55). Conclusions: In a low-caries-risk population, there were significant differences in caries experience and prevalence among adolescents in different school types. Prevention strategies should aim to reduce the polarization in caries across different educational backgrounds in late adolescence. Full article

Background: Midfacial fractures are common outcomes of facial trauma. While younger individuals typically sustain these injuries through high-energy events like assaults and traffic or sports accidents, elderly patients increasingly present with fractures from low-energy mechanisms, primarily falls. Purpose: The aim of this study was to analyze age- and gender-specific patterns in midfacial fractures over a 10-year period, with emphasis on elderly individuals and low-energy trauma. Methods: A retrospective review was performed of proven midfacial fractures between 2013 and 2022 at the Department of Oral and Maxillofacial Surgery (University of Pécs, Hungary). The patients were stratified by age (<65 vs. ≥65 years) and gender. The variables included the injury mechanism, fracture localization, the dental status, hospitalization, and the presence of associated injuries. Bivariate analyses were performed, and the significance level was set to p < 0.05. Results: A total of 957 radiologically confirmed midfacial fracture cases were evaluated, of whom 344 (35.9%) were ≥65 years old. In the elderly group, females had a 19-fold higher risk for midfacial trauma than younger females (OR: 19.1, 95%CI: 9.30–39.21). In the older group, a fall was significantly the most frequent injury mechanism (OR: 14.5; 95%CI: 9.9–21.3), responsible for 89.5% of the cases, while hospitalization (OR: 0.36; 95%CI: 0.23–0.56) was less characteristic. Most of the fractures occurred in the zygomatic bone, in the zygomaticomaxillary complex, or in the anterior wall of the maxilla. Associated injuries in the elderly group included mostly lower limb injuries—particularly pertrochanteric femoral fractures in females—and upper limb injuries, with a slight male dominance. Conclusions: Low-energy falls are the primary cause of midfacial fractures in elderly patients, particularly in women. Tailored prevention and management strategies are essential for improving the outcomes in this growing demographic group. Full article

Glass ionomer cements (GICs) are bioactive restorative materials valued for their sustained ion release and remineralisation capacity. However, their long-term interactions with sound enamel and dentine remain underexplored. This 12-month in vitro study aimed to evaluate microstructural and compositional changes in sound dental tissues adjacent to four GICs—Ketac Universal, Fuji IX and Equia Forte Fil (conventional GICs) and the advanced Glass Carbomer (incorporating hydroxyapatite nanoparticles)—using field-emission scanning electron microscopy (FE-SEM) and energy-dispersive X-ray spectroscopy (EDS). Glass Carbomer uniquely formed hydroxyapatite nanoparticles and mineralised regions indicative of active biomineralisation—features not observed with conventional GICs. It also demonstrated greater fluoride uptake into dentine and higher silicon incorporation in both enamel and dentine. Conventional GICs exhibited filler particle dissolution and mineral deposition within the matrix over time; among them, Equia Forte released the most fluoride while Fuji IX released the most strontium. Notably, ion uptake was consistently higher in dentine than in enamel for all materials. These findings indicate that Glass Carbomer possesses superior bioactivity and mineralising potential which may contribute to the reinforcement of sound dental tissues and the prevention of demineralisation. However, further in vivo studies are required to confirm these effects under physiological conditions. Full article

Background/Objectives: Caries risk assessment is essential for the management of dental caries. There are different assessment methods with the most commonly used being CAMBRA, the Cariogram, and Caries Risk Semaphore (CRS). The aim of this study was to determine the diagnostic agreement between the three different caries risk assessment methods mentioned above. Methods: This study was conducted in the Dental Clinic of the University of Valencia by Preventive and Community Dentistry II students on patients examined during clinical practices (n = 672). Patients were evaluated to determine their caries risk using the three methods named above. A descriptive analysis of the sample was performed, and diagnostic agreement was assessed using the Kappa coefficient. Results: According to CRS, 321 patients (48%) showed high risk, 96 patients (14%) moderate risk, and 255 (38%) low risk. The highest diagnostic agreement was found between CRS and CAMBRA, with an unweighted Kappa of 0.36. Regarding risk severity assessments, the highest Kappa was also observed between CRS and CAMBRA, with a Kappa of 0.46 for low risk, 0.14 for moderate risk, and 0.40 for high risk. Conclusions: There is an important heterogeneity in the obtained results. This highlights the need to further study different caries risk assessment methods and determine their predictive capacity to choose the one that yields the best outcome. Full article