Search Results (279)

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

Background: Prosthetic cementation using the biologically oriented preparation technique (BOPT) presents challenges in removing excess cement from the gingival sulcus, due to the absence of a finishing line and the impossibility of using absolute isolation with a rubber dam. This study aimed to evaluate the effectiveness of relative isolation using polytetrafluoroethylene (PTFE) tape in reducing cement retention during BOPT cementation. Methods: Fifteen 3D-printed resin models were created from an intraoral scan of a patient restored with BOPT in both upper central incisors. Each model included removable gingiva. Splinted polymethylmethacrylate (PMMA) provisional crowns were fabricated and cemented with temporary cement. One central incisor was isolated with PTFE (0.1 mm or 0.2 mm), while the contralateral tooth was left unisolated as a control. After debonding, digital scanning and volumetric analysis using root mean square (RMS) deviation were performed to quantify retained cement. Paired t-tests were applied to compare groups. Results: The mean RMS for the PTFE group was 0.1248 ± 0.0519 mm, compared to 0.1973 ± 0.0361 mm in the non-isolated group (p < 0.001). No significant difference was found between PTFE thicknesses of 0.1 mm and 0.2 mm (p = 0.388). Conclusions: PTFE tape is effective for relative isolation when rubber dam placement is not feasible in BOPT restorations. Further clinical studies are recommended to confirm these findings in vivo. Full article

Deep margin elevation (DME) is a widely adopted technique for managing subgingival cervical proximal margins by repositioning them to a supragingival location. This approach enhances access, visibility, and control in these anatomically challenging areas. This narrative review aimed to evaluate current evidence on the indications, materials, clinical protocols, and outcomes of DME. A structured search was conducted in PubMed, the Cochrane Library and Scopus up to February 2025, using keywords such as “deep margin elevation”, “proximal box elevation” and “subgingival margin.” Clinical studies, in vitro investigations, relevant reviews and reports in English were included. A total of 59 articles were selected based on eligibility criteria. The hypothesis was that DME can serve as a reliable alternative to surgical crown lengthening in appropriate cases. A variety of materials have been investigated for use as the intermediate layer, with composite resins of varying viscosities and filler compositions being preferred due to their favorable long-term mechanical properties. DME may reduce the need for surgical intervention while maintaining periodontal health; however further randomized clinical trials are needed to clarify the material selection, establish long-term outcomes, and standardize clinical protocols. Understanding the indications, limitations, and protocol of DME is critical for achieving biologically sound and predictably functional restorations. Full article

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case Presentation: This case report illustrates a fully digital, prosthetically driven workflow for the rehabilitation of a posterior mandibular site following implant failure. A 44-year-old female patient underwent removal of a failing implant and adjacent tooth due to advanced peri-implantitis and periodontitis. After healing, a digital workflow—including intraoral scanning, cone-beam computed tomography (CBCT), and virtual planning—was employed to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. The grafting procedure utilized a composite mixture of autogenous bone and anorganic bovine bone (A-Oss). After nine months of healing, two implants with a hydrophilic surface (SOI) were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and final prosthetic rehabilitation with monolithic zirconia restorations resulted in stable functional and aesthetic outcomes. Conclusions: This case highlights how the integration of modern digital technologies with advanced regenerative procedures and innovative implant surfaces can enhance the predictability and long-term success of implant retreatment in compromised posterior sites. Full article

Background/Objectives: Schoolteachers play a central role in shaping their students’ beliefs and attitudes towards oral health. Our aim was to investigate the oral and periodontal health knowledge of schoolteachers in Riyadh and factors affecting this knowledge. Methods: Government schoolteachers from representative areas of Riyadh (n = 895) responded to a structured questionnaire. Descriptive statistics, t-tests, one-way analysis of variance, and multiple linear regression (p ≤ 0.05). Results: Teachers demonstrated good basic oral/periodontal health knowledge (mean score = 60.21 ± 10.68). Most knew that toothbrushing is necessary to preserve dental (78.66%) and periodontal (57.88%) health; that gingival bleeding (74.41%), swelling (64.25%), and abscess formation (52.96%) are signs of periodontal disease; about 63% identified dental biofilm as an etiologic factor, and 58% knew that periodontitis may cause gingival recession and influence systemic health (74.07%). However, only 38% knew that dental flossing is necessary to preserve periodontal health, and 66.03% believed that gingival health can be restored with a special toothpaste. Teachers who were female, older in age, worked in north Riyadh, and taught the intermediate stage demonstrated statistically significantly better knowledge than the other categories. Conclusions: The studied sample of schoolteachers possesses acceptable basic oral health knowledge but has inadequate knowledge of periodontal health. Factors influencing teachers’ knowledge were age, gender, region of work, and teaching stage. Full article

Diabetes is a risk factor for periodontitis. Increasing evidence suggests that a central player in this link is the vacuolar H+-ATPase (V-ATPase), which provides a physical and functional core for regulation by the catabolic lysosomal AMP-activated protein kinase complex (L-AMPK) and the anabolic mammalian target of rapamycin complex 1 (mTORC1). These complexes detect levels of various cellular nutrients, including glucose at the lysosome, and promote cellular responses to restore homeostasis. The high-glucose conditions of diabetes foster anabolic mTORC1 signaling that increases inflammation and inflammatory bone resorption in response to periodontal infections. Here, we review the structure and composition of V-ATPase, L-AMPK, mTORC1, and other elements of the energy-sensing platform. Mechanisms by which V-ATPase passes signals to the complexes are examined and recent data are reviewed. Current anti-bone resorptive therapeutics, bisphosphonates and denosumab, enhance the risk of medicine-related osteonecrosis of the jaw (MRONJ) and are not used to treat periodontal bone loss. Accumulating data suggest that it may be possible to target inflammatory bone resorption through agents that stimulate L-AMPK, including metformin and glucagon-like peptide-1 agonists. This approach may reduce inflammatory bone resorption without major effects on overall bone remodeling or increased risk of MRONJ. Full article

Glehnia littoralis Fr. Schmidt ex Miq. has been cultivated in China for a long time and used as a medicinal plant called “Beishashen” in traditional Chinese medicine and has been traditionally known to have antibacterial and anti-inflammatory effects, but its direct role in periodontitis has not been known. Currently used periodontal treatments require long-term administration, which causes many side effects. Therefore, in this study, we evaluated the effects of G. littoralis extract (GLE) on periodontitis in an experimental periodontitis-induced in vitro and vivo model and understood its potential molecular mechanism. The effect of GLE on periodontitis in vitro was investigated using human periodontal ligament (HPDL) cells mediated by PG-LPS. Additionally, a ligature-induced periodontitis model and a PG-LPS-induced periodontal inflammation model were used to investigate the effect of GLE in vivo. In vitro study results showed that GLE down-regulated the increased inflammatory cytokines and mediators in HPDL cells stimulated with PG-LPS, and simultaneously down-regulated the levels of 11β-HSD1 and glucocorticoid receptor (GR), thereby alleviating periodontal inflammation. At the same time, it restored the lost osteoblast differentiation potential of HPDL cells. In addition, in an in vivo model representatively used for periodontitis research, the periodontal inflammation-alleviating effect and the effect of restoring or protecting damaged periodontal tissue were confirmed. GLE can be considered as a new periodontitis treatment agent through regulating 11β-HSD1. Full article

Objectives: This study aimed to evaluate the success rates of NSRCT performed by AEGD residents and to identify predictive factors associated with clinical outcomes and patient satisfaction. Methods: A retrospective chart review was conducted on cases treated between 2012 and 2021. Eligible cases included fully developed permanent teeth that underwent NSRCT and received a final restoration by general dentistry residents, with a minimum of 12 months of follow-up. Data collected included demographic information, medical history, clinical symptoms, radiographic findings, instrumentation, type and timing of final restorations, and patient satisfaction scores. Treatment success was defined as the absence of symptoms and either the resolution or stability of periapical radiolucency. Patient satisfaction and pain levels were also analyzed. Results: AEGD residents achieved radiographic and clinical RCT success rates of 93.3% and 91.5%, respectively. Multivariate logistic regression showed that the presence of an intact restoration was significantly associated with increased odds of tooth retention (odds ratio [OR] = 3.4, p < 0.001), while post placement in a straight root was also a significant predictor of survival (OR = 4.2, p = 0.02). Conversely, pre-existing radiolucency (OR = 0.37, p = 0.018) and the use of a metal post (OR = 0.23, p = 0.012) were significantly associated with lower odds of tooth retention. Worse periodontal health was significantly associated with increased odds of pain on percussion, with a 74.19% increase in odds per worsening category (OR = 1.74, p = 0.002). Patient satisfaction was significantly higher when restorations remained intact, with esthetic satisfaction increasing by a factor of 3.08 (OR = 3.08, p < 0.001) and functional satisfaction increasing by a factor of 3.9 (OR = 3.9, p < 0.001). Conclusions: Endodontic treatments performed by AEGD residents demonstrated high success rates and favorable patient-reported outcomes. Restoration integrity, periodontal health, and post and final restoration selection play critical roles in treatment success and patient satisfaction. Full article

Background and Clinical Significance: Prosthetic rehabilitation in the aesthetic zone of periodontally compromised patients presents a complex clinical challenge, requiring a careful coordination of aesthetic, functional, and biological demands. This case highlights the benefits of digital dentistry, interdisciplinary collaboration, and regular maintenance in achieving long-term success in complex rehabilitations of periodontally compromised patients. Case Presentation: This case report describes the digital minimally invasive rehabilitation of a 39-year-old male patient with Stage III periodontitis, occlusal discrepancies, tooth mobility, and an interincisal diastema. A fully digital workflow—including intraoral scanning, aesthetic previewing, and mandibular motion analysis—was employed to guide diagnosis, treatment planning, and prosthetic execution. Conservative tooth preparations using a biologically oriented approach (BOPT) were combined with customised provisional restorations to support soft tissue conditioning and functional control throughout the provisional phases. Mandibular motion tracking facilitated the design of a personalised anterior guidance to improve occlusion and correct the deep bite. The interincisal diastema was initially maintained then closed during the advanced phase of treatment based on aesthetic simulations and patient preference. One unplanned endodontic treatment was required during the provisional phase, but no other complications occurred. Conclusions: At the four-year follow-up, the patient demonstrated stable periodontal and occlusal conditions, improved clinical indices, and high satisfaction with the aesthetic outcome. Full article

The oral cavity harbors a highly intricate and dynamic microbial ecosystem of multiple microhabitats supporting diverse microbial populations. As the second most complex microbiome in the human body, surpassed only by the gut, the oral microbiome comprises over 1000 species. Disruptions in the microbial balance have been associated with an increased risk of both oral diseases (dental caries and periodontitis) and systemic conditions, including inflammatory diseases and certain types of cancers. In our pilot study, we purified bacterial DNA from pre-treated, saponin-based, host-depleted saliva samples and performed 16S amplicon sequencing, using Oxford Nanopore Technologies, to identify bacterial composition and investigate changes in the oral microbiota of patients with solid tumors in response to chemotherapy, either alone or in combination with immunotherapy. We found significant reductions in microbial diversity of the oral microbiota following cancer treatment, which may contribute to post-therapeutic complications such as oral mucositis. Moreover, our findings indicate that on the one hand, following chemotherapy treatment the microbial profile is characterized by an increased abundance of Streptococcus, Gemella, and Granulicatella and a decrease in the abundance of Neisseria and Veillonella. On the other hand, post combined treatment, only Streptococcus relative abundance increased, Veillonella exhibited a slight decline, and Haemophilus and Neisseria displayed a marked decrease, whilst Granulicatella and Gemella remained relatively stable. Our findings underline the impact of cancer therapy on the oral microbiome, highlighting the potential for precision-based strategies to restore microbial balance and minimize treatment-related complications. Full article

Background: The behavior of soft tissues following recession type 1 (RT1) and/or non-carious cervical lesions (NCCLs) treated with class V restorations is not well understood. These conditions cause both functional and esthetic issues. Recent studies show that increased cervical thickness can influence gingival tissue response. This suggests that restoration design has a key impact. This study aims to evaluate the effect of tooth shape modification on gingival tissue response and periodontal health with 3D analysis. Methods: Seven patients with buccal gingival recession and NCCL were selected, resulting in 50 treated teeth. Patients underwent class V buccal restorations using the BOVR technique. Three-dimensional evaluation through scanned dental impressions was performed at baseline and at T1 to monitor tissue profile changes in the buccal zenith sagittal plane. The average observation period was 4 months. Following the assessment, linear measurements were calculated according to standard planes. These measurements aimed to monitor transverse and axial tissue modifications. Probing depth, plaque index, and bleeding index were also recorded. Results: Increased tooth thickness led to tissue alteration. Greater composite thickness was significantly associated with an increase in tissue thickness (p ≤ 0.001) and gingival creeping (p ≤ 0.001) at the free gingival margin. Periodontal health remained unaffected, and 50% of the teeth required no additional surgical treatment due to satisfactory outcomes. Conclusions: Class V restorations that increase cervical thickness may promote soft tissue volume gain over a 4-month period without compromising periodontal health. A 4-month observation period is recommended before considering the surgical correction. Full article

Background and Objectives: This in vitro trial aimed to investigate if there is a correlation between the homogeneities of different composite materials and their adhesion to glass fiber posts (GFPs). Materials and Methods: Twenty intact human upper jaw central incisors extracted due to periodontal diseases were selected for this trial. Endodontic treatment was performed according to ISO recommendations. A total of 4 mm of guttapercha was left in the apical region. Canals were prepared for post insertion. Teeth were randomly allocated into the two following groups depending on the core restorative material (n = 10): I—cores build up with light cured composite; II—cores build up with dual cured composite resin. GFPs were inserted and cores were rebuilt with different composite resins. Longitudinal cuts were made across the axis of the teeth and examined under a scanning electron microscope (SEM). Statistical analysis was accomplished using Mann–Whitney U and Spearman tests (p < 0.05). Results: In the group where the number and size of pores at the interface of GFPs were analyzed, pores were found only in the specimens restored with the light-cured “bulk-filled” composite. In the group where the number and size of pores in the core material were analyzed, pores were found in specimens restored with both the light-cured “bulk-filled” composite and dual-cured resin composite. However, the dual-cured resin composite yielded better results in terms of core integration. Conclusions: There is no statistically significant correlation between the homogeneities of different composite materials and their adhesion to GFP. Full article

Background/Objectives: Patients with head and neck cancer frequently develop oral complications such as oral mucositis, infections, necrosis, and periodontal disease among others as a consequence of antineoplastic therapy. It is mainly radiotherapy that promotes oral dysbiosis, favouring the overgrowth of opportunistic microorganisms. Identifying effective adjunctive strategies to prevent or mitigate these adverse effects is crucial. Recent studies have suggested that probiotics could be used to restore microbial homeostasis and modulate inflammatory responses in the oral cavity. This systematic review and meta-analysis assessed the efficacy of probiotics in alleviating oral complications associated with antineoplastic treatments in this patient population. Methods: A comprehensive search was conducted in PubMed, LILACS, Scopus and the Cochrane Central Register of Controlled Trials, following the PRISMA 2020 guidelines. Only randomised controlled trials (RCTs) were included. Results: Nine eligible RCTs were analysed using a random-effects meta-analysis. Probiotic use was significantly associated with a reduced incidence of severe (grade 3–4) oral mucositis (RR = 0.58; 95% CI: 0.41–0.81). Moderate benefits were also observed in modulating the oral microbiota and reducing levels of pathogenic bacteria and Candida spp. However, no significant improvements were noted in periodontal parameters or plaque indices. Conclusions: Probiotics show promise in the management of oral mucositis, but further well-designed trials are needed to evaluate their broader impact on oral health during cancer therapy. This review is not registered on PROSPERO. Full article

Objectives: This study aims to investigate the underlying causes of dental implant failure, focusing on implant-related complications and associated risk factors. Understanding these factors will help improve treatment planning and enhance implant success rates. Methods: A retrospective case-control study was conducted using clinical, medical, surgical, and radiographic records of patients who underwent dental implant removal due to complications. Key factors analyzed included patient-related variables (age, gender, medical conditions, periodontal disease), implant-related factors (implant site, implant system, restoration status), and procedural aspects (previous surgical interventions and reasons for implant removal). Results: The findings revealed that implant type (p = 0.004) and type of restoration (p = 0.001) significantly influenced implant survival. Gender (p = 0.001), medical conditions, smoking status (p = 0.004), and restoration status (p = 0.005) were significantly associated with specific failure mechanisms. Lack of osseointegration (36.4%) and absence of primary stability (22.4%) were the predominant causes of implant failure. Prior surgical interventions (p = 0.001) and decisions for re-implantation (p = 0.005) significantly affected implant removal frequency. Conclusions: Implant survival is influenced by multiple factors, with implant type, restoration type, and gender playing key roles in failure outcomes. Patient-specific risk assessment, particularly regarding medical conditions and smoking, meticulous surgical technique, and appropriate prosthetic planning, is vital for improving implant longevity and minimizing failure rates. Full article