Search Results (2,004)

Background: The contribution of oral inflammatory conditions to systemic disease burden remains underexplored within multimorbidity frameworks. Emerging evidence suggests that periodontal inflammation may play a role in the clustering of chronic diseases, yet few studies have evaluated this at a population level using robust datasets. The aims of this study were to investigate whether periodontal diseases are associated with Multiple long-term conditions (MLTCs) burden and severity in two population-based cohorts and to examine whether systemic inflammatory biomarkers mediate these associations. Materials and Methods: We analyzed two population-based cohorts: the UK Biobank (UKB; n = 500,612) and the US National Health and Nutrition Examination Survey (NHANES; n = 10,714). MLTCs were defined as the coexistence of ≥2 chronic diseases. Associations between periodontal diseases and MLTCs were assessed using multivariable logistic and multinomial logistic regression. Causal mediation analyses examined the contribution of systemic inflammatory markers. Results: Approximately half of all participants had MLTCs. The prevalence of periodontal diseases was 17.8% in UKB (self-reported symptoms), and 42.3% in NHANES (clinically assessed). Periodontal diseases were independently associated with greater odds of MLTCs in both UKB (OR 1.12; 95% CI 1.10–1.14) and NHANES (OR 1.22; 95% CI 1.09–1.37). Associations were stronger among adults aged ≤ 60 years. A consistent dose-response relationship was observed between periodontal status and the number and severity of chronic conditions, as well as inflammatory-related MLTCs. Mediation analyses suggested partial effects through white blood cell count, neutrophils, and C-reactive protein. Conclusions: Periodontal inflammation is independently associated with greater multimorbidity burden, particularly in younger adults. Systemic inflammation may offer a plausible biological link, and these findings position oral health as an underrecognized and modifiable target in multimorbidity prevention and management frameworks, warranting prospective investigation. Full article

Background: Digital fabrication techniques such as CAD/CAM milling and 3D printing are widely used for provisional dental restorations. However, differences in mechanical performance remain controversial. Objective: To compare the hardness and flexural strength of CAD/CAM-milled resins versus 3D-printed resins used in restorative dentistry. Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines and registered in PROSPERO (CRD420251045547). Electronic searches were performed in PubMed, Scopus, Web of Science, Embase, and LILACS. In vitro studies comparing CAD/CAM-milled and 3D-printed resins in terms of hardness and/or flexural strength were included. A random-effects inverse-variance model was applied using standardized mean difference (SMD) with 95% confidence intervals (CI). Risk of bias was assessed using the RoB-Iv tool. Results: Four studies (n = 124 specimens) were included in the hardness meta-analysis. CAD/CAM-milled resins showed significantly higher hardness (SMD = 2.92; 95% CI: 0.34–5.49; p = 0.026), although heterogeneity was high (I² = 94.9%). Funnel plot asymmetry suggested possible small-study effects. For flexural strength, three studies (n = 40 specimens) were analyzed, demonstrating a significant effect favoring milled resins (SMD = 1.28; 95% CI: 0.42–2.14; p = 0.0036) with low-to-moderate heterogeneity (I² = 27.8%). Sensitivity analyses confirmed robustness for both outcomes. Overall methodological quality was acceptable, with no high risk of bias identified in strength studies. Conclusions: CAD/CAM-milled resins tend to demonstrate higher hardness and flexural strength compared with 3D-printed resins. However, the substantial heterogeneity observed, particularly for hardness, and the potential influence of methodological variability, warrant cautious interpretation of these findings. Full article

White spot lesions (WSLs) are a common aesthetic concern and can be managed in a minimally invasive manner via resin infiltration to enhance their appearance. However, resin-infiltrated teeth may discolour over time due to dietary stains, posing a potential long-term aesthetic challenge. This in vitro study aims to evaluate the effectiveness of 10% carbamide peroxide on resin infiltrated WSLs following staining by common dietary sources. Forty-four extracted premolars with artificially created WSLs were infiltrated with resin and randomly distributed into four groups, including a control group. The specimens underwent staining with coffee, tea, and turmeric before bleaching with 10% carbamide peroxide for 14 days. Colour parameters were measured via spectrophotometer using the CIE L*a*b* system, and the colour changes (ΔE) across timelines were calculated. All of the specimens were susceptible to staining, with evidently high ΔE values. Following the bleaching protocol, all specimens showed statistically significant increases in L* (lightness) compared to the baseline. The post-bleaching colour change (ΔE) was compared to the baseline ΔE = 0, and the results indicated that full reversion was not achieved. Turmeric exhibited the highest stainability and the greatest resistance to bleaching. Within the limitations of this study, resin-infiltrated enamel was shown to be susceptible to dietary staining. Although full reversion to the baseline colour remains challenging, the marked aesthetic improvements indicate that resin-infiltrated enamel remains highly responsive to low-concentration bleaching agents. Full article

Background: Natural compounds such as propolis and chitosan have been investigated for their potential use in dental formulations. Aim: To evaluate the effect of an experimental propolis/chitosan varnish on previously demineralized primary tooth enamel using surface roughness, wear profile, microhardness, and morphological analysis. Design: Primary enamel specimens were allocated to three groups (n = 13): no treatment control (C), Duraphat varnish (DV), and experimental propolis/chitosan varnish (EV). Specimens were first subjected to a demineralizing challenge to produce artificial caries-like lesions. After treatment application, samples underwent seven days of pH cycling. Surface roughness, wear profile, and longitudinal Knoop microhardness were evaluated. Data were analyzed using ANOVA and Tukey’s post hoc test (α = 5%). Results: For wear profile, no significant differences among groups were observed after initial demineralization or after treatment/pH cycling. Post-treatment roughness differed among groups, with DV showing the highest Sa values, whereas C and EV were statistically similar. For microhardness, DV showed the highest EA/DA and EA/CA percentage values and differed significantly from C and EV. The EV group did not differ significantly from the untreated control for wear profile or microhardness. Morphological analysis showed surface irregularities after demineralization and different surface patterns after treatment. Conclusions: Under the conditions of this in vitro study, the experimental propolis/chitosan varnish did not promote remineralization of previously demineralized primary enamel and did not demonstrate superiority over the untreated control. Duraphat varnish showed microhardness values suggestive of partial mineral recovery. Full article

Background/Objectives: Food and nutritional insecurity (FNI) is a major social determinant of health that disproportionately affects older adults, with significant implications for their health, nutrition, and well-being. In this context, this scoping review aims to map and synthesize the available scientific evidence on the main determinants of FNI among older adults, considering socioeconomic, health-related, functional, psychosocial, and structural factors. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA-ScR guidelines. A comprehensive search was performed across eight databases (PubMed/MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, LILACS, ProQuest, and Google Scholar), up to November 2024. Original studies addressing FNI in individuals aged ≥60 years were included. Study selection and data extraction were conducted independently by two reviewers, with disagreements resolved by consensus. Results: Of 5897 records identified, 15 studies met the inclusion criteria. FNI in older adults was described as a multifactorial phenomenon associated with low income, limited education, social isolation, widowhood, chronic diseases, functional limitations, depressive symptoms, and poor housing conditions. Structural determinants, including institutional racism, gaps in social protection systems, and barriers to accessing food assistance programs, were also reported. Considerable heterogeneity in measurement instruments highlights the complexity of assessing FNI in this population. Conclusions: Addressing FNI in older adults requires moving beyond isolated interventions toward integrated, intersectoral strategies that tackle its underlying social and structural drivers. Strengthening social protection systems, reducing access barriers, and promoting equity-oriented policies are essential to ensure adequate nutrition and support healthy and dignified aging. Full article

Oral and Maxillofacial Surgery (OMFS) is a surgical specialty with a distinctive position at the intersection of medicine and dentistry. This unique expertise enables reliable reconstructions of complex head and neck defects, with a focus on function, esthetics, and quality of life. This review examines the historical progression, current practices, and prospective directions of head and neck reconstruction, with particular emphasis on the essential contributions of Oral and Maxillofacial Surgeons (OMSs). Beginning with early reconstructive efforts in ancient civilizations and progressing through the transformative advancements of the Renaissance, the introduction of anesthesia and antiseptics, and innovations during periods of war, the specialty has evolved in response to increasing clinical complexity. The contemporary era is characterized by the integration of microvascular reconstruction, dental rehabilitation, and advanced imaging modalities, enhancing the restoration of occlusal function, facial aesthetics, and overall quality of life. Emerging innovations such as patient-specific three-dimensional printed hardware, tissue engineering, regenerative medicine, artificial intelligence, and supermicrosurgical techniques are expected to further reshape reconstructive approaches. These technological advances aim to reduce the number of surgical steps, improve biological reconstruction, and enhance diagnostic and planning capabilities. However, they also raise ethical considerations and validation challenges that warrant careful assessment. In conclusion, Oral and Maxillofacial Surgeons continue to play a central and expanding role in head and neck reconstruction and rehabilitation. Owing to comprehensive training and technological expertise, the specialty is uniquely positioned to advance value-based, multidisciplinary care while persistently striving to improve functional, aesthetic, and quality-of-life outcomes for patients with complex craniofacial defects. Full article

Background/Objectives: Provisional restorations are essential in prosthodontic treatment, and reliable intraoral repair is clinically important during extended interim use. This in vitro study evaluated the effects of organic solvent pretreatment on surface characteristics and shear bond strength (SBS) of CAD/CAM provisional restorative materials fabricated by milling, stereolithography (SLA), and digital light processing (DLP). Methods: Three materials were assigned to five surface treatment conditions: no solvent (control), isopropyl alcohol (IPA), tetrahydrofuran (THF), acetonitrile (ACN), and pyridine (PYR). After pretreatment, separate specimens were used for surface analysis and SBS testing. Surface roughness was measured by atomic force microscopy using arithmetic mean height (S_a) and root mean square height (S_q), and surface morphology was examined by scanning electron microscopy (SEM). For SBS testing, specimens were repaired using a universal adhesive and a flowable resin composite, followed by failure mode analysis. Data were analyzed using two-way ANOVA and Tukey’s post hoc test (α = 0.05). Results: Material type, solvent treatment, and their interaction significantly affected SBS, S_a, and S_q. The DLP material showed the highest SBS overall, with no significant differences among treatments. In the SLA material, ACN resulted in the lowest SBS, whereas PYR showed the highest mean value. In the milled material, THF, ACN, and PYR produced significantly higher SBS than the control and IPA groups. Conclusions: Within the limitations of this study, the effect of organic solvent pretreatment on repair performance was substrate-dependent. Full article

Backround: The aim of this study was to evaluate the effects of probiotic yogurt containing Lactobacillus rhamnosus (LGG) on the microhardness and surface roughness of restorative dental materials commonly used in pediatric dentistry. Methods: Three materials were tested: conventional glass ionomer cement Fuji II, high-viscosity glass ionomer cement Fuji IX, and microhybrid composite resin Te Econom. The samples were prepared according to the manufacturers’ instructions, initially stored in distilled water, and subsequently immersed in probiotic yogurt. Microhardness was measured by the Vickers hardness test, and surface roughness was assessed by 3D profilometers. Results: Statistical analysis was performed using the Wilcoxon signed-rank test and the Kruskal–Wallis test. Exposure to probiotic yogurt resulted in increased microhardness for the resin-modified and high-viscosity glass ionomer cements, whereas the microhardness of the microhybrid composite resin decreased. The surface roughness increased for all the tested materials, with statistically significant differences observed in most groups (p < 0.05). Conclusions: These findings indicate that probiotic yogurt can alter the physical properties of restorative dental materials and highlight the importance of careful selection of preventive agents in pediatric dental practice. Further research is needed to clarify the long-term effects of probiotic preparations on dental restorations. Full article

Background: Social media platforms, particularly Instagram, have become significant sources of health information, yet the quality of dental content remains underexplored. This study compared the scope and reliability of information in popular Turkish-language Instagram posts on tooth whitening by poster source and examined associations with post format, purpose, and whitening approach. As a secondary aim, the association between information quality and normalized audience engagement was investigated within this algorithmically curated sample. Methods: This cross-sectional content analysis included 500 publicly accessible Turkish Instagram posts retrieved under the hashtag #dişbeyazlatma. The posts were classified by source, purpose, format, and whitening approach. Content scope and information reliability were assessed using the Descriptive Coverage Index (DCI) and Modified Treatment-Information Reliability (MTIR) scores by two calibrated evaluators. Engagement Rate was calculated as (likes + comments)/follower count × 100. Results: Most posts originated from dentist/clinic accounts (75.8%) and were marketing-oriented (72.0%). Dentist/clinic accounts demonstrated significantly higher MTIR scores than independent users and brand accounts (p < 0.001), whereas DCI did not differ significantly across sources. Raw engagement differences disappeared after normalization (p = 0.408). Reel posts scored higher than photo posts on both measures; carousel posts scored higher than photos on MTIR but not DCI. In-office whitening content scored significantly higher than DIY- or OTC-focused posts on both measures (p < 0.001). A weak positive association was observed between MTIR and Engagement Rate (r = 0.141). Conclusions: Popular Turkish Instagram posts on tooth whitening exhibited substantial variability in content scope and reliability. Independent users commanded greater raw audience reach yet predominantly produced DIY-focused content with substantially lower content scope scores than in-office and multi-method posts, and among the lowest reliability scores, raising a public health concern within this high-visibility content stratum. These findings may inform content development strategies for dental professionals and public health communicators targeting Turkish-speaking audiences. Full article

Background: The application of veneer restorations over previously composite-restored anterior teeth presents significant clinical challenges, particularly in achieving optimal marginal sealing. Aim: This in vitro study aimed to evaluate the marginal integrity and sealing ability of different 3D-printed resin veneer restorations on sound versus composite-restored anterior teeth. Materials and Methods: Eighty freshly extracted human anterior teeth (40 central incisors and 40 canines) were randomly assigned into two main groups: sound teeth and composite-restored teeth. All the teeth received 3D-printed resin veneer restoration utilizing two different types of 3D-printed resin (GC Temp Print, GC, Tokyo, Japan; and Varseosmile Triniq, BEGO GmbH & Co., Bremen, Germany). The specimens were then subjected to microleakage, marginal fitness, cement void, and cement loss testing. Results: There were no statistically significant differences among all examined groups. Microleakage scores were predominantly 0 across all groups, with median values of 0 at both cervical and proximal surfaces. Marginal fitness showed fit percentages ranging from 20% to 100%, while cement voids and cement loss were rare events (<10%). Statistical analysis confirmed no significant differences between groups (p > 0.05), with p-values ranging from 0.151 to 1.000. Conclusions: No, the presence of pre-existing composite restorations did not adversely affect 3D-printed veneer performance. The marginal integrity and sealing ability of two different 3D-printed resin veneers are not affected by the presence of previous composite restoration on cervical and proximal surfaces for both incisor and canine teeth. 3D-printed veneers applied to sound and restored teeth showed good marginal integrity and proper sealing ability. Full article

Heat generated during photopolymerization of resin-based composites from both the exothermic reaction of the material and the irradiance of light-curing units poses a risk to pulp vitality, especially in deep restorations. This study aimed to evaluate temperature variation (ΔT) during the photopolymerization of different resin composites, considering material type, shade, increment thickness, and light-curing unit output. An in vitro experimental study with a factorial design was conducted. Specimens were prepared using 2.0 mm and 4.0 mm increments from conventional (nanohybrid), bulk-fill, and flowable resin composites in different shades (BW, A1, A3, A4, and XB) and different light-curing unit output (100% and 50% battery charge). ΔT was measured using a type K thermocouple (Omega Engineering, Norwalk, CT, USA) positioned at the center of each increment. Data were analyzed using four-way analysis of variance (ANOVA) (α = 0.05). All groups demonstrated a statistically significant temperature increase (p < 0.05), with ΔT values ranging from 3.24 °C to 18.18 °C. Composite type significantly influenced ΔT (p < 0.001), with flowable composites showing the highest temperature rise, followed by bulk-fill and conventional composites. Increment thickness also had a significant effect (p = 0.008), with 4.0 mm increments producing greater temperature increases. Shade significantly affected ΔT (p < 0.001), with the XB shade exhibiting the highest values. Additionally, higher light-curing output (100%) resulted in significantly greater temperature increases compared to 50% output (p < 0.001). Photopolymerization temperature rise is influenced by multiple interacting factors. The combination of flowable composites, darker shades, thicker increments, and higher curing output may increase thermal risk. These findings should be considered when optimizing clinical protocols to minimize potential pulpal damage. Full article

Purpose: This study provides a comparative evaluation of surface changes in BioHPP materials under routine professional hygiene procedures, which is recommended by dentists, twice a year. BioHPP is a polyetheretherketone polymer used in prosthetic dentistry as a frame material. The aim was to investigate whether routine dental cleaning procedures such as ultrasonic scaling and brushing affect the surface proprieties of prosthetic BioHPP restorations. This study was conducted to evaluate the surface properties of different restorations based on BioHPP (veneered with composite resin and polished) after brushing and ultrasonic scaling exposure. Materials and Methods: The BioHPP specimens were divided into three groups. The first group (marked BioHPP) served as a baseline reference for assessing the effect of different surface processing approaches, and no further treatment was applied. The specimens in the second group (BioHPP-P) were polished, while the specimens in the third group (BioHPP-C) were veneered with composite resin. Group BioHPP-P and BioHPP-C of samples was divided into three subgroups: 0—no treatment, 1—exposed to tooth brushing, 2—exposed to ultrasonic scaling. Untreated samples (subgroup 0) served as controls for evaluating treatment-related changes within groups 2 and 3. The surface morphology was investigated by atomic force microscopy (AFM). The structure of samples was analyzed using the XRD technique, and the surface wettability was evaluated. Results: The surface roughness of the samples was evaluated via root mean square (RMS) parameter. Baseline BioHPP specimens exhibited higher roughness values compared to the other analyzed groups. The roughness of the non-treated specimens (0) decreased in the line 59.18→28.84→14.51 nm. Treatment of the samples by brushing and ultrasonic scaling was associated with an increase in surface roughness. Variations in water contact angle values were observed. However, no consistent treatment-related trend could be established. Conclusions: Composite veneered BioHPP showed a tendency toward higher surface resistance to brushing and ultrasonic scaling. These findings should be interpreted within the limitations of an in vitro descriptive study. Full article

Severe early childhood caries (SECC) in preschool children is a progressive, multifactorial disease with far-reaching consequences for child health, family functioning, and health systems. Minimally invasive dentistry (MID), particularly 38% silver diamine fluoride (SDF), is increasingly used to arrest lesions and “buy time” when definitive restorative care is delayed. This narrative review synthesizes current evidence-based guidelines and real-world utilization data to clarify the appropriate role and limits of SDF in SECC management. Professional guidance supports SDF for lesion arrest within an ongoing caries management plan, but does not endorse it as a universal long-term substitute for durable restorative care. Observational studies show that many SDF-treated primary teeth receive additional intervention within approximately 2 years, and any delay in sedation/general anesthesia is typically measured in weeks to months. A large recent private practice study found that 35% of children with caries progressed to higher-intensity treatment (restoration or extraction) over a median of 547 days, reinforcing the time-limited nature of interim stabilization. We propose a “preservation-to-precision” framework that prioritizes child-centered outcomes—freedom from pain and infection, durable function, and acceptable psychosocial impact—through risk-based, tooth- and child-specific planning, realistic follow-up assessment, and clear exit criteria for transition to definitive care. In high-income settings, the ethical value of “buying time” depends on whether systems use that time to advance children toward timely, definitive care rather than normalizing prolonged temporization as routine practice. Full article

Background: Full pulpotomy has gained increasing attention as a conservative treatment option for managing complicated crown fractures and pulp exposures in mature permanent teeth. However, little is known about how undergraduate dental students perceive this treatment approach and which factors influence their willingness to adopt it in clinical practice. Objective: This study aimed to evaluate undergraduate dental students’ knowledge, attitudes, and preferences regarding full pulpotomy and to identify factors associated with willingness to use full pulpotomy as a definitive treatment option. Materials and Methods: A cross-sectional questionnaire-based study was conducted among fourth- and fifth-year dental students. The questionnaire evaluated participants’ treatment preferences, perceived procedural difficulties, preferred pulp capping materials, attitudes toward rubber dam use, perceived barriers to full pulpotomy adoption, and willingness to use full pulpotomy as a definitive treatment. Associations between variables were assessed using chi-square tests and multivariable binary logistic regression analysis. Results: In total, 255 undergraduate dental students participated in the study. Spontaneous pain (69.4%), prolonged pain to heat (50.6%), percussion sensitivity (46.7%), and radiographic findings (43.9%) were the most frequently reported diagnostic criteria for symptomatic irreversible pulpitis. In the standardized clinical scenario, a pulpotomy-based approach was the most preferred treatment strategy (45.1%), followed by single-visit pulpectomy with obturation (28.6%) and pulpectomy with calcium hydroxide dressing (24.7%). MTA was the most preferred pulp capping material (57.3%), followed by Biodentin (12.9%) and calcium hydroxide (8.2%). Overall, 55.7% of participants reported willingness to use full pulpotomy as a definitive treatment option. Clinical year, previous exposure to pulpotomy cases, and confidence in bleeding control were independently associated with willingness to use full pulpotomy. Previous performance of pulpotomy procedures and attitude toward mandatory rubber dam use were independently associated with greater willingness to use full pulpotomy, whereas perceived barriers and uncertainty regarding implementation were negatively associated. Conclusions: In this single-center, questionnaire-based study, undergraduate dental students generally showed a positive attitude toward full pulpotomy; however, acceptance was strongly influenced by practical experience, confidence in procedural protocols, and perceived implementation barriers. These findings may help inform future educational strategies aimed at improving confidence and supporting evidence-based adoption of conservative pulp-preserving approaches. Full article

The use of zirconia as a material in the base of modern restorative dentistry is due to its high strength, biocompatibility, and improved aesthetic performance. The aim of this review is to provide an integrated and coherent overview of the recent developments in zirconia crowns by focusing on the development of materials, microstructure, digital fabrication processes, optical capabilities, and clinical performance. A survey of literature in the form of a narrative literature review was conducted in the most significant databases, such as PubMed, Scopus, Web of Science, and Google Scholar, including publications published since 2000, with a focus on systematic reviews, meta-analyses, clinical studies, and materials science studies. The results show that zirconia materials have developed beyond traditional 3Y-TZP systems, characterized by high strength and fracture toughness to high-translucency and multilayer zirconia (4Y 6Y-PSZ) systems, which provide better aesthetics at the cost of lower mechanical reliability. The implementation of CAD/CAM technologies has enhanced the accuracy of fabrication, marginal fit and reproducibility and the development of sintering, surface modification and bonding protocols has enhanced clinical performance. Recent clinical results have shown high survival rates (around 85–95 percent over 5–10 years), and the results depend on the design of the restoration, the zirconia generation, and the functional loading circumstances. Despite these developments, there are still concerns about the durability of bonding, trade-offs between translucency and strength, and long-term performance of high-translucency zirconia. The development of new technologies, such as additive manufacturing, design-aided artificial intelligence, and bioactive surface modification, is a promising avenue toward improving clinical reliability and performance. Full article