Search Results (1,396)

Background: S3-level clinical practice guidelines represent the highest standard of evidence-based healthcare, integrating systematic reviews, formal evidence grading, and structured expert consensus. In periodontology, current S3-level guidelines provide robust recommendations for the management of stage I–III periodontitis. However, increasing clinical complexity, emerging diagnostic technologies, and the need for patient-centred and implementation-oriented care highlight important gaps that warrant further methodological refinement. Objective: This review aims to critically appraise the conceptual foundations, strengths, and limitations of existing S3-level periodontal guidelines and to propose a structured roadmap for the development of next-generation S3 guidance. Methods: A narrative and methodological review was conducted focusing on key European S3-level guidelines in periodontology and endodontics, with emphasis on guideline methodology, evidence grading, outcome prioritization, and consensus processes. Results: Current S3-level periodontal guidelines demonstrate strong methodological rigor but show limited coverage of stage IV periodontitis, peri-implant diseases, and endo–perio lesions. In addition, emerging domains such as biomarker-based diagnostics, artificial intelligence-assisted decision support, and implementation science are not yet systematically integrated. Conclusions: Future S3-level periodontal guidelines should incorporate clinical complexity, patient-reported outcomes, precision diagnostics, digital technologies, and real-world implementation strategies to enhance personalization, transparency, and clinical impact. Full article

Background: Hyperbaric oxygen therapy (HBOT) is considered a potential adjunctive modality to enhance tissue regeneration in oral and maxillofacial surgery. By increasing tissue oxygen availability, HBOT may support bone and soft-tissue repair under hypoxic and chronically inflamed conditions. Aim: This narrative review evaluates current experimental and clinical evidence regarding HBOT in high-risk dental indications, including osteoradionecrosis (ORN), medication-related osteonecrosis of the jaw (MRONJ), chronic osteomyelitis, poorly healing postoperative wounds, and procedures in patients with systemic comorbidities. Methods: A structured search of PubMed, Web of Science, and the Cochrane Library identified 123 relevant English-language publications (from 1 January 2000–September 2025) addressing HBOT mechanisms and clinical applications in oral and maxillofacial surgery, including clinical trials, observational studies, preclinical models, and systematic reviews. Results: Available evidence suggests that HBOT may improve healing outcomes and reduce complication rates in early-stage ORN and MRONJ when used as an adjunct to surgery and systemic therapy. However, findings in implantology—particularly in irradiated or diabetic patients—and in periodontal therapy remain limited, heterogeneous, and methodologically inconsistent. Conclusions: HBOT may be considered in selected clinical scenarios, particularly where healing is impaired by hypoxia or systemic disease. Nevertheless, current evidence remains insufficient to support routine use. Standardized, high-quality studies with clearly defined endpoints and uniform therapeutic protocols are needed to determine its clinical effectiveness and optimal indications. Full article

Oral squamous cell carcinoma (OSCC) is one of the most prevalent types of cancer in the oral cavity and head and neck region. Due to its location and psychological and social implications, early detection and treatment are very important. A liquid biopsy can be used to diagnose cancer by analyzing samples of bodily fluids, such as saliva, blood, or urine, for specific molecules released by tumor cells. The objective of this study was to evaluate the use of liquid biopsy in the diagnosis of oral squamous cell carcinoma. A systematic review was carried out, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251238037). Articles taken into consideration for the review were published before 30 September 2025. The search for manuscripts for the review was conducted using PubMed, Scopus, Google Scholar, and Cochrane databases. Forty-three articles were deemed eligible for inclusion in the systematic review. Key data extracted from the studies included authorship, publication date, study location, methodology, number of participants, and reported complications. Most of the analyzed biomarkers showed promising potential for future use in liquid biopsy for OSCC diagnosis. Tumor DNA and miRNA demonstrated the highest diagnostic accuracy. The standard approach to diagnosis and planning treatment relies on tumor biopsy and diagnostic imaging. Liquid biopsy may complement this process by enabling early detection in high-risk populations and monitoring response to therapy. As such, it serves as a prognostic factor or therapeutic target, successfully identifying disease recurrence. Full article

Peri-implant infections pose a significant challenge in dental implantology. This study aimed to develop and characterize a chitosan–vancomycin coating for titanium surfaces, focusing on drug loading, release kinetics, antimicrobial performance, and cytocompatibility. Grade 4 titanium discs were coated with a chitosan film using the dip-coating technique and subsequently loaded with vancomycin through immersion in an aqueous solution. Coating morphology was examined by scanning electron microscopy (SEM). Vancomycin loading was quantified by spectrophotometry, and release kinetics were monitored over 144 h (6-day). Antimicrobial activity was assessed through agar diffusion assays against Staphylococcus aureus. Cytocompatibility was evaluated using human mesenchymal stem cells (hMSCs), whose metabolic activity, adhesion, and morphology were assessed over a 19-day culture period by resazurin assay and SEM. SEM analysis revealed a uniformly distributed, smooth, and crack-free chitosan film, which remained stable after drug loading. The coating exhibited a biphasic release profile, characterized by an initial burst followed by sustained release over six days, which maintained antimicrobial activity, as confirmed by inhibition zones. hMSCs adhered and proliferated on the coated surfaces, displaying normal morphology despite a transient reduction in metabolic activity on vancomycin-containing films. These findings support the potential of chitosan–vancomycin coatings as localized antimicrobial strategies for implant applications, warranting further in vivo and mechanical evaluations. Full article

Background/Objectives: Hypothyroidism is highly prevalent among HD patients, due to cumulative disturbances in thyroid hormone synthesis, metabolism, and clearance. Subclinical hypothyroidism—defined by elevated TSH with normal fT₄—is common in HD, along with a distinct entity, the low-T₃ syndrome. This study aims to examine the predictors of hypothyroidism in HD and its impact on cardiovascular morbidity and mortality. Methods: We conducted a retrospective cohort study including 282 hemodialysis (HD) patients, with evaluated thyroid function and monitored from January 2022 to June 2025. A total of 66 (23.4%) patients with hypothyroidism were identified, 15 (5.31%) of whom had autoimmune thyroiditis. Subclinical hypothyroidism was documented in 31.81% of the hypothyroid patients. Results: Hypothyroidism occurred predominantly in females (63.63% vs. 41.2%, p ≤ 0.001) and was associated with higher BMI (27.856 ± 6.216 vs. 25.759 ± 6.080, p = 0.017), hypoalbuminemia (3.534 ± 0.547 vs. 3.725 ± 0.471, p = 0.006), elevated LDL-cholesterol and triglyceride levels, as well as with amiodarone use. Hypothyroidism was further associated with atrial fibrillation (33.33 vs. 19.9%, p = 0.022), coronary artery revascularization procedures (18.18% vs. 9.72%, p = 0.047), neoplastic disease (25.75% vs. 12.03%, p = 0.008), and cancer-related mortality (10.6% vs. 1.85%, p = 0.001). Multivariable regression analysis revealed the following predictors of hypothyroidism: female sex (OR 3.848, 95%CI 1.704–8.693, p = 0.001), BMI (OR 1.072, 95%CI 1.007–1.146, p = 0.031), hypoalbuminemia (OR 0.412, 95%CI 0.177–0.962, p = 0.040), hypertriglyceridemia (OR 1.088, 95% CI 1.001–1.016, p = 0.022) and amiodarone use (OR 6.698, 95%CI 1.744–25.722, p = 0.006). Patients with autoimmune thyroiditis did not exhibit clinical or biochemical differences compared with other hypothyroid patients. Subclinical hypothyroidism was associated with longer HD duration (10.476 ± 7.910 vs. 6.567 ± 5.541, p = 0.003), dyslipidemia, hypertension, atrial fibrillation and amiodarone use. Cardiovascular conditions—particularly atrial fibrillation and ischemic coronary disease requiring revascularization—are more common in HD patients with clinical or subclinical hypothyroidism. However, in our cohort, the Kaplan–Meier survival curves at 12, 24, and 36 months for patients with both subclinical and clinical hypothyroidism do not show significant differences in cardiac or overall mortality. Conclusions: The increased incidence of hypothyroidism in HD patients, together with its impact on cardiovascular pathology, underscores the need for multidisciplinary management and supports annual routine assessment of thyroid hormones—particularly in overweight or dyslipidemic patients and in those receiving amiodarone. Full article

Background/Objectives: Formation of tight contacts between oral soft tissue and dental implants is a significant challenge in contemporary implantology. An essential role in this process is played by oral epithelial cells. In the present study, we investigated how titanium and zirconia surfaces with different roughness influence various parameters of oral epithelial cells in vitro. Methods: We used the human oral squamous carcinoma Ca9-22 cell line and cultured them on the following surfaces: machined smooth titanium (TiM) and zirconia (ZrM) surfaces, as well as sandblasted and acid-etched titanium moderately rough (SLA) and zirconia (ZLA) surfaces. Cell proliferation/viability was measured by CCK-8 assay, and cell morphology was analyzed by fluorescent microscopy. The gene expression of interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, E-cadherin, integrin (ITG)-α6, and ITG-β4 was measured by qPCR, and the content of IL-8 in conditioned media by ELISA. Results: At the initial culture phase, cell proliferation was promoted by rougher surfaces. Differences in cell attachment were observed between machined and moderately rough surfaces. Machined surfaces were associated with slightly higher IL-8 levels (p < 0.05). Furthermore, both ZLA and SLA surfaces promoted the expression of (ITG)-α, ITG-β4, and ICAM-1 in Ca9-22 cells (p < 0.05). Surface material had no impact on the investigated parameters. Conclusions: Under the limitations of this in vitro study, some properties of oral epithelial cells, particularly the immunological and barrier function, are moderately modified by roughness but not by material. Hence, the roughness of the implant surface might play a role in the quality of the peri-implant epithelium. Full article

This narrative review examines contemporary applications of polymeric materials in dentistry from 2020 to 2025, spanning prosthodontics, restorative dentistry, orthodontics, endodontics, implantology, diagnostics, and emerging technologies. We searched PubMed, Scopus, Web of Science, and Embase for peer reviewed English language articles and synthesized evidence on polymer classes, processing routes, mechanical and chemical behavior, and clinical performance. Approximately 116 articles were included. Polymers remain central to clinical practice: poly methyl methacrylate (PMMA) is still widely used for dentures, high performance systems such as polyether ether ketone (PEEK) are expanding framework and implant-related indications, and resin composites and adhesives continue to evolve through nanofillers and bioactive formulations aimed at improved durability and reduced secondary caries. Thermoplastic polyurethane and copolyester systems drive clear aligner therapy, while polymer-based obturation materials and fiber-reinforced posts support endodontic rehabilitation. Additive manufacturing and computer aided design computer aided manufacturing (CAD CAM) enable customized prostheses and surgical guides, and sustainability trends are accelerating interest in biodegradable or recyclable dental polymers. Across domains, evidence remains heterogeneous and clinical translation depends on balancing strength, esthetics, biocompatibility, aging behavior, and workflow constraints. Full article

This study aimed to analyze the biomechanics of three abutment systems with distinct retention mechanisms and their impact on the implant–abutment interface (IAI). The finite element analysis method was used to model maxillary three-unit restorations with conventional cement-retained abutment (CRA), multi-unit abutment (MUA), and innovative cementless link-retained abutment (LRA) systems. Dental implants were positioned at 0°/0°, 15°/15°, and 25°/25° angulation combinations. Analyses were performed under 400 N vertical and 200 N oblique loading applied at a 45° angulation. The LRA system exhibited lower stress on the implants and abutments under both loading conditions, whereas the CRA system demonstrated the highest stress. In contrast, the maximum principal stresses within the peri-implant bone were the highest in the LRA system under both loading conditions. Despite greater IAI displacement in the molar region, no specific abutment system exhibited distinct superiority under different scenarios. Overall, an increase in implant angulation led to higher stress values across all parameters. The MUA and LRA systems demonstrated reduced stress concentration and more uniform load distribution compared with the CRA system under tilted implant configurations. The findings suggest that the innovative cementless LRA system may serve as a feasible alternative to conventional CRA and MUA systems, exhibiting superior biomechanical performance, particularly compared with the CRA system. Full article

Background: Alveolar ridge preservation (ARP) techniques have evolved with implantology development. In clinical practice, biomaterials for ARP are tested in laboratory animals, and rat calvaria is a standard option. The study aimed to evaluate biomaterial osteointegration in defects created in the rat calvaria, comparing an experimental synthetic biomaterial with a bovine xenograft and natural healing. Methods: The study included six groups of animals: two negative control groups with natural healing (2 months (M) and 4 M), two positive control groups with bovine xenograft (2 M and 4 M), and two study groups with nanohydroxyapatite titanium reinforced (2M and 4M). After creating and grafting the defects, healing was expected to take 2 or 4 months, after which bone fragments were harvested, prepared, and then analyzed. OCT, stereomicroscopy, and histology techniques were used for bone fragments analysis, and the obtained images were evaluated using Image J 1.54p software. Results: The results obtained from the three analyses provided information about the healing pattern of bone defects and the degree of new bone formation. Histological analysis of the samples confirmed what the stereomicroscopy and OCT images showed: that the bovine xenograft elicited a better tissue response than the synthetic biomaterial, being incorporated into the bone tissue more than the synthetic biomaterial. Conclusions: Both the bovine xenograft and the synthetic nanocomposite based on hydroxyapatite reinforced with titanium particles favored bone healing, but their integration into the bone was limited for the analyzed period. Full article

Background and Objectives: Corneal opacity is the fifth global cause of blindness and moderate-to-severe visual impairment due to scar tissue formation. The purpose of this study is to provide an integrated overview of the current state of corneal engineering strategies focused on the comparison with healthy corneas. It aims to identify engineering strategies that would result in functional corneas, providing real alternatives to donor corneal transplants. Materials and Methods: systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and according to the protocol with the ID: CRD420250654641 at the PROSPERO database. The focus question, prompted by considering the shortage of human corneal grafts, was: what is the performance of bioengineered corneal grafts in experimental animal models when compared with healthy eyes in the restoration of corneal anatomy and function? Results: Incorporating human corneal epithelial cells w/ or w/o human corneal stromal stem cells into a gelatin methacrylate and polyethylene glycol diacrylate matrix emerges as the leading option for epithelial layer regeneration. Human and bovine decellularized corneas, porcine corneal ECM in Gelatin methacrylate, dual layered collagen vitrigel and tissue-engineered human anterior hemi-corneas have shown promise for simultaneous regeneration of the corneal stromal and epithelial layers. Corneal stromal tissue regeneration could be positively impacted by transplantation with grafts derived from aligned self-lifting analogous tissue equivalents and collagen-based hydrogels. Finally, scaffolds of silk fibroin and human purified type I collagen represent promising approaches for corneal endothelial regeneration, though their effectiveness is contingent upon integration with endothelial cells. Conclusions: Collectively, these findings contribute to the growing body of evidence supporting the potential of tissue-engineered corneal substitutes as viable therapeutic options for corneal blindness and vision impairment. Assessing the optical and functional properties of the regenerated cornea should be a cornerstone in all studies aiming to evaluate their clinical effectiveness. Full article

Background and Objectives: The insertion of endosseous implants requires the alveolar bone to be drilled, which produces alterations of the osseous neoalveolus approximately 1 mm deep, an area that will later be subjected to osseous renewal. The healing of the bone around the inserted implant is complex and depends on numerous factors, amongst which the size of the insertion orifice relative to the diameter of the implant, the design, and the pace and depth of the threads play an essential part. Therefore, the aim of this paper is to investigate from a histologic point of view the osseointegration of the implants inserted in a rabbit cortical bone by creating a 150 µm high healing chamber. Materials and Methods: 5 mm-long and 2 mm-wide titan implants were inserted into the femur of 15 12-month-old rabbits by using a drill with a 1.8 mm diameter, obtaining a spiralled healing chamber 150 µm high. The animals were euthanized after 7, 14, and 28 days according to effective legal and ethical protocols. The bone around the implants was severed 5 µm thick. After coloring with the Tricrom Goldner method, the sections that intercepted most centrally the intervention area were examined and photographed with an Olympus microscope. Results: The histologic result showed osseous healing within the healing chamber in the third to the endosteum of the implant after 7 days from the insertion. After 14 days, the osseous healing spread to 2/3 of the healing chamber. After 28 days, the whole healing chamber was occupied by bone. Conclusions: The healing chamber favored proper conditions for osseous healing, which began at the level of the endosteum. This statement is based on the histologic findings of bone formation after 7 days only in the third of the endosteum of the healing chamber. A 150 µm height of the healing chamber obtained in the rabbit cortical bone does not pose a risk of connective tissue proliferation. Full article

The aim of the study was to evaluate the effect of the oxygen-inhibited layer on the bond strength of dental adhesives. The protocol was registered in PROSPERO. PRISMA 2020 guidelines were followed. The focused structured question using Population (P), Intervention (I), Comparison (C), and Outcome (O) was: “What is the effect of oxygen inhibited layer on bonding strength of dental adhesives?” The literature was screened via PubMed, Google Scholar, Scopus, and Web of Science. The last search was carried out in September 2024 with an English language restriction. Two reviewers independently performed screening and evaluation of articles. A total of 71 articles were retrieved from databases, in which only 35 articles were selected for full-text analyses. After implementing the exclusion criteria, eight studies were evaluated and included in the review. The results showed that the presence of an oxygen-inhibited layer led to an increased bond strength when light-cured composite resin was used, but there was a decrease in bond strength and an increased bond failure rate when chemically cured composite was used upon dental adhesive application. Meta-analysis could not be performed due to heterogeneity in the studies. The presence of an oxygen-inhibited layer is beneficial in improving the interfacial bond strength when used with light-cured composite resin (when light curing was performed in accordance with the manufacturer’s instructions). Full article

Background: The maxillary canine is considered a cornerstone tooth that plays an important role in aesthetics and function. This study compared the morphometric measurements and morphology of maxillary canines between Saudi and Spanish populations using cone-beam computed tomography (CBCT). Methods: A total of 100 CBCT scans (50 patients from King Khalid University, Saudi Arabia, and 50 patients from University of Barcelona Dental Hospital, Spain) were analyzed in this retrospective cross-sectional study conducted between May and September 2025. The study examined root length, mesiodistal and buccopalatal dimensions, root canal curvatures, apical foramen position, and canal morphology. Results: Canines from the Spanish population were significantly longer than those from the Saudi population (16.9 ± 2.2 mm vs. 13.2 ± 2.5 mm, p < 0.0001). No significant differences were observed in mesiodistal and buccopalatal dimensions. Both groups primarily exhibited mild root canal curvatures and buccally placed foramina. However, the prevalence of palatal foramina (20% vs. 8%, p = 0.04) and oval/ribbon morphologies (52%/12% vs. 22%/6%, p = 0.01) was higher in the Spanish population. The Saudi population showed a greater prevalence of round or irregular canals. The Spanish group was identified as an independent predictor of root length (β = +3.7 mm, p < 0.001), oval canal morphology (odds ratio = 3.8, p = 0.005), and palatal foramina (relative risk ratio = 2.5, p = 0.04). Conclusion: The Spanish population exhibited longer canine roots, associated with oval or ribbon-shaped canal morphologies. In contrast, the Saudi canines displayed shorter length, with more rounded or irregular morphologies. Full article

Artificial intelligence (AI) is rapidly transforming the landscape of dental implantology by enhancing every stage of treatment, from diagnostics and digital planning to intraoperative navigation, outcome prediction, and long-term follow-up. This narrative review explores the current and emerging applications of AI technologies in implant dentistry, with a focus on machine learning, neural networks, and computer vision. It examines how AI is utilized in digital implant planning, surgical navigation, peri-implant disease monitoring, risk assessment, and the prediction of treatment outcomes such as peri-implantitis and implant failure. These innovations contribute to more efficient workflows, more personalized treatment strategies, and improved cost-effectiveness of care. Finally, future perspectives and educational implications of AI integration in clinical implantology are discussed. Full article

Purpose: The objective of this study was to evaluate and compare the precision of dental implant placements using augmented reality (AR)-iPhone (Apple, Cupertino, CA, USA) navigation technology versus conventional 3D-printed surgical guides. The accuracy was assessed by comparing the actual implant positions to their predefined three-dimensional (3D) locations in surgical plans using the Exocad software (Exocad, Dormstadt, Germany). Materials and Methods: Fourteen standardized mandibular models were divided into two groups: AR-guided (AR1-AR7) and 3D-printed surgical guide-assisted (Group 1–7). Each model received four implants in positions 35, 32, 42, and 45. Postoperative CBCT scans were aligned with the preoperative plans in the Exocad software to measure three-dimensional deviations, including total entry error, total apex error, and angular error. Statistical analysis was performed using the Statistica 12 software (StatSoft, Tulsa, OK, USA), incorporating Shapiro–Wilk normality tests, ANOVA, and post hoc LSD tests (where applicable). Results: The in vitro comparative experiment demonstrated AR group superior accuracy with mean deviations of 0.42 ± 0.12 mm at the entry point and 0.51 ± 0.18 mm at the apex, compared to 0.48 ± 0.15 mm and 0.58 ± 0.22 mm, respectively, in the 3D-printed guide group (p < 0.05). Angular deviation was significantly lower in the AR group (1.8° ± 0.6°) versus the guide group (2.1° ± 0.7°, p = 0.009). Descriptive statistics revealed the median apex error was 0.49 mm (IQR: 0.38–0.61) for AR versus 0.56 mm (IQR: 0.45–0.72) for guides. Conclusions: AR iPhone navigation technology achieved clinically acceptable accuracy compared to static 3D-printed guides, particularly in controlling angular deviations. While both methods produced clinically acceptable results, AR technology represents a significant advancement for precision-sensitive cases. Full article