Search Results (3,926)

Recent breakthroughs in materials science have driven transformative advancements in restorative dentistry. Advanced dental materials, such as bioactive materials, nanocomposites, and fibre-reinforced composites, are attracting attention. Bioactive materials, such as calcium silicate-based cements and bioactive glass, represent a paradigm shift by interacting with biological tissues to stimulate regeneration. They promote hydroxyapatite formation, accelerating mineralisation in hard and soft tissues, and are pivotal tools in minimally invasive procedures due to their functions of structural support and biological interaction. Nanomaterials, especially nanocomposites with embedded nanoparticles, effectively address polymerisation shrinkage and wear in traditional composites. With just 1.5% shrinkage, a flexural strength over 150 MPa, and 44–60% higher wear resistance than conventional composites, they offer significant improvements. Nanocomposites also provide enamel-like translucency and a bond strength of 27–38 MPa to dentin, ensuring excellent aesthetics and durability—making them ideal for direct restorations. Fibre-reinforced composites with glass or polymer fibres balance aesthetics with strength and are increasingly used in restorations. Their high fracture resistance, which closely approaches that of a natural tooth, enables clinicians to preserve more healthy teeth during restoration, in line with the principles of modern conservative dentistry. Overall, bioactive materials enhance tissue repair, nanocomposites optimise form and function, and fibre-reinforced composites deliver strength without compromising aesthetics. As these materials transition from research to clinical practice, they promise longer-lasting treatments, fewer complications, and higher patient satisfaction. This narrative review aims to explore three types of advanced dental materials and their role in improving clinical outcomes. Full article

Introduction: Antibiotics are routinely prescribed for odontogenic abscesses in emergency departments and dental offices. Augmentin is recommended for moderate to severe dentofacial infections. It is usually prescribed in two popular regimens, namely twice (bid) or three times (tid) per day. The aim of this study was to compare the efficacy of two different formulations of amoxicillin–clavulanate, 875/125 mg bid versus 500/125 mg tid, for the treatment of acute dental apical abscesses with orofacial involvement. Methods: Sixty-one patients with acute apical abscesses were prescribed Augmentin in either an 875/125 mg bid or 500/125 mg tid formulation. The patients were tested for inflammatory markers upon admission and again after 72 h. Results: Although all patients experienced a decrease in inflammatory markers over 72 h of antibiotic therapy, there was a statistically significant greater decrease in white blood cells and neutrophils in the patients receiving the 500/125 mg tid regimen. Conclusions: A 500/125 mg tid Augmentin regimen results in a greater decline in inflammatory markers than 875/125 mg bid over 72 h in the setting of dentofacial infection. Full article

Background and Clinical Significance: Oral ulcers are a common disease for dental practitioners. The policy of treating oral ulcers includes removing etiology and medication. Standard management of oral ulcers includes elimination of etiologic factors and pharmacologic therapy. Topical corticosteroids are the most commonly used medicine for oral ulcers. Exclude possible etiologies related to ulcers; refractory ulcers need systemic evaluation and precise medication use to improve patients’ quality and satisfaction. Case Presentation: We present a case of refractory oral ulcers resistant to multiple conventional treatments, which were found to be ineffective. These ulcers significantly impact patient quality of life. We prescribed a series of oral ulcer treatments following the removal of cause factors, such as rounding the teeth and making a soft occlusal bite plate to reduce traumatic sources from the patient’s Parkinson’s disease. A biopsy of the ulcer lesions was also done. All the treatments involving corticosteroids and removing the ulcer-associated etiology were ineffective. Conclusions: Finally, combined therapy using low-dose thalidomide (50 mg/day) and colchicine (1.5 mg/day) resulted in substantial clinical improvement, and complete remission was sustained for over six months without recurrence. A narrative discussion of relevant literature is provided to contextualize therapeutic considerations in refractory oral ulceration. Conclusion: This case suggests that low-dose thalidomide and colchicine combination therapy may be a therapeutic consideration for refractory oral ulcers when conventional management fails; however, the observation is hypothesis-generating and further studies are required to evaluate efficacy and safety. Full article

In addition to standardized lateral cephalometric radiographs, comprehensive assessment using dental cone-beam computed tomography (CBCT) and CT has become commonplace in the diagnosis and treatment of jaw deformities. Simulation based on cephalometric and CT data is particularly useful in the management of jaw deformities, both for evaluation and prognostic prediction. As such imaging examinations cover a wide anatomical region, it is not uncommon for various incidental pathologies to be discovered. This review emphasizes the necessity of evaluating the entire imaged area in addition to the chief complaint. Furthermore, it outlines the essential anatomical structures that should be assessed during diagnostic imaging performed prior to representative surgical procedures for jaw deformities (e.g., sagittal split ramus osteotomy and Le Fort I osteotomy). This review paper is descriptive in nature, incorporating our facility’s empirical aspects, and presents representative cases in a narrative format; it is not a systematic review. In other word, as the evidence-based literature does not cover all aspects of pretreatment evaluation, these criteria are based on the past experience of the authors. Full article

Background: Diffuse large B cell lymphoma is an aggressive, heterogeneous yet treatable disease. Primary bone lymphoma is a lymphoma involving a single or multiple osseous sites with or without regional nodal involvement. It is exceedingly rare, representing <1% of new non-Hodgkin lymphoma cases per year. Most cases of primary bone lymphoma are diffuse large B cell lymphoma. They infrequently involve the craniofacial bones and mandible; its rarity can lead to delays in diagnosis. Case Series Presentation: Two 64-year-old male patients initially presented to local dentists with concerns of tooth pain and numbness. Both underwent extensive dental procedures including extraction and debridement, with an initial diagnosis of osteomyelitis. They were placed on long-term antibiotics. After months without improvement, further testing was pursued, including imaging and repeat biopsies. The patients were finally diagnosed with primary bone diffuse large B cell lymphoma. From the initial treatment of osteomyelitis, a median time of 8.5 months passed before diagnosis of lymphoma. Treatment with cytotoxic chemotherapy was initiated and both patients achieved remission. Conclusions: As in the two cases presented here, the initial point of entry into the medical system may be a visit to the local dentist. When patients present with periodontal complaints, it is imperative to maintain a broad differential, including lymphoma. This is especially crucial when the patient’s clinical course does not respond to initial treatment. This results in delays of diagnosis and initiation of therapy for a treatable cancer. Full article

Growing evidence suggests that persistent oral infectious diseases (OIDs) contribute to systemic disease, highlighting the importance of understanding their pathogenic mechanisms. Conventional dental treatments, primarily mechanical debridement, surgical intervention, or antimicrobial therapy, often struggle to fully control inflammation or prevent progressive tissue destruction. The nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain-containing 3 (NLRP3) inflammasome is a key regulator of innate immunity, mediating the maturation of proinflammatory cytokines (IL-1β and IL-18) and the pyroptosis-inducing protein gasdermin D. Dysregulated or excessive activation of NLRP3 contributes to the initiation and progression of major oral diseases, including periodontitis, peri-implantitis, pulpitis, and oral mucosal inflammation. Despite growing interest in NLRP3, comprehensive and up-to-date reviews integrating its pathogenic mechanisms and therapeutic potential remain limited. This review summarizes current and past evidence on the role of the NLRP3 inflammasome in oral disease development, highlights emerging pharmacological strategies, and outlines future research directions. Existing studies demonstrate that microbial components and danger signals from injured tissues activate NLRP3, thereby amplifying inflammation, tissue degradation, and bone resorption. Preclinical studies indicate that inflammasome inhibitors and several natural compounds reduce tissue damage; however, their clinical translation remains limited. These findings emphasize the need for deeper understanding of NLRP3-mediated pathways, with translational and clinical research offering promising therapeutic opportunities for oral diseases. Full article

Due to the limitations of conventional antibiotics, antimicrobial peptides (AMPs) have emerged as promising therapeutic alternatives for the prevention and treatment of oral infections. This study systematically evaluated in vitro evidence regarding the antimicrobial and anti-biofilm activity of natural AMPs against oral pathogens. A systematic search using the PICOT strategy was conducted in PubMed, EMBASE, and Scopus, retrieving 7711 articles. After title and abstract screening, 109 studies were selected for full-text analysis, resulting in 26 articles that met the eligibility criteria. Among the AMPs evaluated, nisin (n = 15) and LL-37 (n = 5) were the most frequently investigated, while other peptides included lactoferrin, lactoferricin, melittin, lysozyme, histatin-5, cystatin C, chromogranin A, parasin-1, protamine, AmyI-1-18, and DCD-1L. Natural AMPs of human and animal origin demonstrated antimicrobial activity against bacteria associated with oral infections, particularly Streptococcus mutans and Enterococcus faecalis. These peptides were tested in different formulations, including solutions, incorporation into dental materials and polymers, and application in sonodynamic antimicrobial therapy. Overall, the findings indicate that natural AMPs represent a promising class of biomolecules for controlling oral biofilms; however, further clinical studies are required to validate their long-term efficacy and safety. Full article

Background: Diagnosis is the fundamental basis for understanding biomechanics in orthodontic treatment and for accurately designing the treatment plan. Traditionally, the sagittal plane has been the primary focus of assessment; however, it is essential to consider the patient in all three spatial planes. Therefore, it is necessary to explore the transverse plane, which is equally as crucial as the sagittal and vertical planes. With current technological advances, it is now possible to obtain three-dimensional images of the patient using cone-beam computed tomography (CBCT), allowing evaluation of all planes in a single diagnostic test. This study aimed to assess the diagnostic methods used for transverse analysis and the usefulness of CBCT for this purpose. Material and Methods: To select the studies for this review, we searched the PubMed, Scopus, and Cochrane databases for publications between 1965 and 2021. Our inclusion criteria targeted studies that evaluated the transverse plane using CBCT or CT. We assessed the level of evidence according to the OCEBM classification and evaluated the risk of bias using the QUADAS-2 scale. Results: After reviewing 535 articles, we selected 16 that met the established criteria. These studies compared various diagnostic methods for transverse analysis and their reproducibility indices. We identified the absence of a gold standard for measuring transverse discrepancies and high variability among diagnostic methods as the main limitations. Conclusions: Based on the available evidence, it can be concluded that dental and skeletal transverse discrepancies can be reliably differentiated using the diagnostic techniques evaluated in this study, particularly through CBCT-based assessment. Therefore, the diagnosis of transverse discrepancies should not be considered unclear, as it can be established using objective and measurable criteria. These findings reinforce the clinical value of current diagnostic tools and highlight the importance of accurate three-dimensional interpretation for informed and effective treatment decision-making. Full article

Background and Objectives: Recent advances in dentistry include microbiological and metabolomic analyses, which have the potential to improve the understanding of oral microbiome–host imbalances during orthodontic treatment. Fixed appliances, functional devices and, more recently, clear aligners have been associated with several oral health conditions, including enamel demineralization, dental caries, gingivitis, periodontitis and root and bone resorption. In this context, metabolomic approaches may enable the identification of metabolites in biological samples that could potentially serve as biomarkers and reflect functional biological changes within the oral ecosystem. Investigating orthodontic appliances and associated metabolomic alterations may therefore contribute to advancing current knowledge in orthodontics. This systematic review aimed to describe the available evidence on oral metabolomic changes during orthodontic treatment. Materials and Methods: A systematic literature search was conducted in PubMed, Web of Science, Scopus and the Cochrane Library. A total of 1632 records were identified. After duplicate removal and screening, 18 full-text articles were assessed for eligibility. Of these, 15 studies were excluded, and three studies met the inclusion criteria. Risk of bias was assessed using the ROBINS-I and RoB 2 tools, and the GRADE approach was applied to evaluate the certainty of evidence. The review protocol was registered in PROSPERO (CRD420251141544). Results: Three studies met the inclusion criteria. Overall, the available evidence was limited and heterogeneous. The included studies suggested potential differences in oral microbiome composition and metabolomic profiles between patients treated with fixed appliances and those treated with clear aligners. Reported metabolomic findings were exploratory and involved amino acid-related, immune-associated, and acidic metabolic pathways. Limitations: Only three studies were included, all conducted in a single country. The small sample size and methodological heterogeneity limit the generalizability of the findings. In addition, potential confounding variables highlight the need for further standardized longitudinal studies. Full article

Background: Congenital Insensitivity to Pain and Anhidrosis (CIPA) is a rare autosomal recessive disorder characterized by congenital analgesia, anhidrosis, and multisystem involvement affecting the musculoskeletal, cutaneous, oral, and para-oral structures. This case report describes the oral phenotype and multidisciplinary clinical management of a child with CIPA. Case Description: A 9-year-old boy presented with poor oral hygiene, multiple severely damaged teeth, masticatory difficulty, limited mouth opening, impaired bolus control, and para-oral traumatic injuries. Medical and orthopedic history indicated recurrent painless fractures, self-inflicted injuries, cutaneous scarring, and recurrent hyperpyrexia. Oral self-injury associated with CIPA was suspected and supported by the Nociception Assessment Test and Minor’s Iodine–Starch Test. Although the clinical findings were suggestive of CIPA, the diagnosis remained presumptive due to the absence of confirmatory molecular or histopathological testing. Management: A wearable wireless continuous temperature-monitoring device was prescribed to assist in tracking hyperpyrexia associated with CIPA (RHA-CIPA). A conservative, staged, multidisciplinary treatment was planned rather than full-mouth extraction, emphasizing prevention of dental sepsis and mitigation of future self-injury. Dental procedures were performed under local anesthesia to manage discomfort related to tactile hyperesthesia. To reduce nocturnal biting and oral trauma, a hard acrylic occlusal protector was fabricated using an intraoral scanner and a 3D-printed cast. The patient was followed for 12 months. Outcomes: At the 12-month follow-up, clinical improvement was observed, with particularly notable gains in cheek elasticity and soft tissue resilience. Conclusions: This case highlights the considerable challenges involved in the interdisciplinary management of children with CIPA, including oral self-injury prevention, limited mouth opening, and the necessity of close coordination with medical specialties. These findings are descriptive observations of a single case and do not establish efficacy or generalizability of any intervention. Full article

Mesenchymal stem cells (MSCs) are multipotent adult cells that are highly valued for their immunomodulatory potential and intrinsic ability to home to inflamed sites. This study specifically utilized human dental pulp stem cells (hDPSCs), a unique MSC subtype derived from the neural crest, due to their reported superior anti-inflammatory capacity. To rigorously test their efficacy, we employed the AIRmax murine model, which exhibits a genetically determined high-inflammatory phenotype. Acute inflammation was induced by subcutaneous injection of the polyacrylamide suspension Biogel P-100. Two hours post-induction, AIRmax mice were treated intravenously with hDPSCs. Our results demonstrate that hDPSC treatment produced significant anti-inflammatory effects evident at 24 h. The treated group showed a pronounced reduction in leukocyte migration and decreased protein extravasation in the inflammatory exudate. Crucially, hDPSCs also modulated molecular mediators, significantly decreasing the pro-inflammatory cytokine TNF-alpha and reactive oxygen species (ROS) production. Furthermore, while hDPSCs efficiently and rapidly homed to the inflammation site within 2 h, their maximal therapeutic benefits only manifested after 24 h. This suggests that their robust capacity to modulate acute inflammatory responses relies not only on rapid migration but also on a paracrine “hit-and-run” mechanism that suppresses cellular infiltration and oxidative stress over time. This study reinforces the potential of hDPSCs as a powerful, multi-target therapeutic agent for inflammatory conditions, supporting further investigation into their precise mechanisms and clinical application. Full article

Design: Retrospective observational cohort study conducted at university and private practice setting. Objective: To evaluate whether operator experience affects the predictability of orthodontic tooth movements and the overall treatment duration in clear aligner therapy. Materials and Methods: This retrospective observational study was conducted at the Dental School of the University of Turin and in private orthodontic settings. Seventy-two patients (50 females, 22 males; median age: 24.6 years; IQR = 5.9) with mild to moderate malocclusions were included and equally distributed between two groups: 36 patients treated by postgraduate orthodontic students (Group B) and 36 patients treated by experienced orthodontists (Group E). Post-treatment digital models were analyzed to assess discrepancies between the predicted and achieved tooth positions. The accuracy of specific movements—rotation, vertical displacement, and treatment duration—was statistically evaluated using the Mann–Whitney U test. Most of these differences, although statistically significant, remained below established thresholds for clinical relevance (0.5 mm/2°). Results: Expert operators achieved significantly greater accuracy in controlling the vertical movements of the upper central incisors (p = 0.01) and the rotational movements of the upper first molars (p = 0.03), upper lateral incisors (p = 0.03), lower incisors (p = 0.001), and lower premolars (p = 0.001). In contrast, non-expert operators demonstrated superior outcomes in the control of vertical movements of the upper premolars (p = 0.01) and in the rotational movement of the lower canines (p = 0.03). Treatment duration was significantly shorter in the expert group, with a median difference of 4.1 months (p = 0.0037). Conclusions: These findings confirm the importance of clinical experience in enhancing the predictability and efficiency of clear aligner therapy, particularly in complex movements. However, the improved performance of non-expert operators in selected areas—such as vertical control of upper premolars and rotation of lower canines—suggests that conservative movement planning may also play a role in improving clinical outcomes. Overall, expert clinicians achieved more predictable tooth movements and shorter treatment durations, underscoring the value of structured training and accumulated clinical expertise in optimizing clear aligner therapy. Full article

Background: Obstructive sleep apnea is characterized by recurrent upper airway obstruction during sleep, leading to intermittent hypoxemia, sleep fragmentation, and excessive daytime sleepiness. Affecting up to 11% of the adult Polish population and more commonly diagnosed in men, OSA poses a major public health concern due to its association with cardiovascular, metabolic, and neurocognitive complications. This review summarizes the current evidence on diagnostic methods, risk factors, and therapeutic approaches, with particular emphasis on oral appliance therapy using mandibular advancement devices (MADs). Methods: A systematic literature review was conducted using the PubMed and Scopus databases, covering publications from 2020 to 2025, including clinical trials, meta-analyses, and systematic reviews evaluating the efficacy and safety of MAD therapy. Results: Findings demonstrate that MAD effectively reduces apnea–hypopnea index (AHI) values, improves oxygen saturation, and alleviates snoring and daytime fatigue, offering a patient-tolerable alternative for those intolerant to continuous positive airway pressure (CPAP). However, long-term use may cause occlusal or dental changes. Novel techniques, such as Er:YAG laser therapy, show potential in treating mild OSA. Moreover, epidemiological data suggest a correlation between tooth loss and an increased risk of OSA, particularly among men over 65. Conclusions: Dentists play a pivotal role in early detection, screening, and interdisciplinary management of OSA, underscoring the importance of collaboration between dental professionals and sleep medicine specialists for comprehensive care. Full article

Oral infections in neutropenic patients are an underestimated but likely fatal cause of infectious complications, with clinical manifestations often diminished or absent due to immune deficiency. The evaluation and management of these infections requires a personalized multidisciplinary strategy, including prevention through pre-therapy dental assessment, individualized oral hygiene protocols, and rapid treatment of dental lesions. Antimicrobial strategies should be adapted not only to the local resistance profile and individual risk, with a priority on antibiotic stewardship and rapid de-escalation when possible, but also to individual patterns of colonization and comorbidities. Dental procedures can be performed without risk in neutropenic patients with a low complication rate, but further studies are key to stratifying risk. Future research directions include the application of artificial intelligence for infectious risk stratification, the use of salivary or microbiome biomarkers for early detection, and the development of innovative technologies for targeted antimicrobial delivery. This narrative review aims to provide an overview of the common clinical manifestations in neutropenic patients and also the potential progression of dental infections into sepsis in this category of patients. Full article

Background: Temporomandibular disorders (TMD) and bruxism are prevalent conditions managed by dentists. However, treatment choices—especially concerning botulinum toxin (BTX)—often lack consistency. This study aimed to develop and assess a structured clinical decision-making algorithm for BTX use in patients with TMD and bruxism. Methods: A treatment algorithm was designed through a qualitative analysis of the literature and aligned with German S3 guidelines. A total of 227 dentists assessed three clinical case vignettes reflecting routine clinical practice. Each vignette was evaluated first without and subsequently with the algorithm, focusing on typical indications for botulinum toxin treatment. Data were collected via online survey (SurveyMonkey) and analyzed using Microsoft Excel. Participants were stratified by gender and clinical experience (≤5 years vs. >5 years). Results: Of the 227 dentists contacted, 103 responded, and 56 completed the survey (57.1% male; mean age: 34.5 ± 10.6 years). BTX decision accuracy significantly improved for Case 1 (62.5% → 87.5%, p = 0.0013) and Case 2 (14.3% → 87.5%, p < 0.0001), but not for Case 3 (44.6% → 46.4%, p = 1.000). Confidence increased, and uncertainty decreased, particularly among less experienced dentists. The algorithm also significantly influenced both first- and second-line treatment choices, aligning them more closely with guideline-based therapy. Usefulness was confirmed by 78.6% of respondents, with no significant differences based on gender or experience. Conclusions: The proposed algorithm significantly improved diagnostic accuracy, treatment consistency, and confidence in the use of BTX for TMD and bruxism. It facilitates evidence-based, experience-independent decision-making and potentially represents a useful clinical tool in dental practice. Full article