Search Results (5,444)

Background: Despite its crucial role in overall health, oral health is frequently overlooked within healthcare systems, partly due to the misconception that oral diseases are neither life-threatening nor directly disabling. This perception has led to an underestimation of the psychological, social, and economic burden associated with oral diseases. Τhe present study aimed to assess oral health status and oral health-related quality of life among dental patients attending a public Special Care Center in Greece. Methods: A cross-sectional study was conducted among 400 dental patients aged 18 years and older who visited a public Special Care Center for a routine check-up or a dental problem between September and October 2024. Data was collected through personal interviews and clinical examinations after informed consent was obtained. Oral health-related quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14) and the Oral Impacts on Daily Performance (OIDP) questionnaires. Categorical variables were presented as absolute and relative frequencies, while quantitative variables were summarized as mean, standard deviation, median, minimum, and maximum. Normality was assessed using the Kolmogorov–Smirnov test. Bivariate analyses and multivariate linear regression models were performed, with statistical significance set at p < 0.05. Statistical analyses were conducted using IBM SPSS 23.0. Results: The majority of participants were female (56.3%) with a mean age of 50.4 years (SD = 14.9). Overall oral health-related quality of life was moderate (OHIP-14: Mean = 21.0, SD = 14.8; OIDP: Mean = 14.0, SD = 12.8). Patients who attended the center due to a dental problem reported significantly poorer oral health outcomes than those attending routine check-ups (p < 0.001). Poorer self-rated oral health, having ≥12 missing teeth, prosthetic restoration, and foreign nationality were significantly associated with worse oral health-related quality of life. Conclusions: Dental patients attending the Special Care Center demonstrated moderate oral health status, which was associated with psychological distress, physical disability, and social limitations. These findings underline the need for targeted public oral health interventions, especially for vulnerable population groups. Full article

Background: Tooth loss reflects cumulative oral inflammation and has been associated with adverse cardiovascular outcomes. This study evaluated the relationship between the number of missing permanent teeth and the angiographic severity of coronary artery disease (CAD) in patients with acute myocardial infarction (AMI). Methods: In this prospective cross-sectional study, 200 consecutive AMI patients underwent coronary angiography and standardized dental assessment during hospitalization. Tooth loss was categorized as 1–10, 11–20, or 21–32 missing teeth. CAD severity was defined by the number of major epicardial arteries with significant stenosis. Multivariate logistic regression adjusted for age, sex, smoking status, diabetes, obesity, dyslipidemia, and hypertension. Results: Increasing tooth loss was associated with more extensive CAD. The mean number of affected vessels rose from 1.58 ± 0.79 in the 1–10 tooth-loss group to 2.06 ± 0.99 in the 21–32 group (p = 0.014). Tooth loss correlated with CAD severity (r = 0.19, p = 0.007). After adjustment, >20 missing teeth remained an independent predictor of multivessel disease (OR = 1.84; 95% CI: 1.01–3.34; p = 0.047). ROC analysis showed modest discrimination (AUC = 0.61). Conclusions: Extensive tooth loss independently correlates with greater angiographic CAD severity in AMI patients. Dental status may serve as a simple, non-invasive clinical marker of cardiovascular disease burden. Full article

Objectives: Post-extraction remodelling of hard and soft tissues results in volume reduction, leading to aesthetic challenges in planning prosthetic restorations, particularly in the anterior maxilla. This study assessed whether atraumatic vertical extraction, versus conventional extraction, could reduce postoperative volume loss and aesthetic compromises at the extraction site and adjacent teeth. Methods: Following randomized tooth extraction with unassisted healing in the test (Benex^® extraction, n = 10) and control group (conventional extraction, n = 10), postoperative scans were conducted at 30 days (t₁), 60 days (t₂), 90 days (t₃) and 12 months (t₄). Each scan was aligned with the baseline scan (t₀), and surface comparison was performed with five regions of interest (ROIs: central, mesial, distal, papilla mesial and papilla distal). Aesthetic parameters, including recession and Pink Esthetic Score (PES) of adjacent teeth, were clinically evaluated at each follow-up appointment. Statistical analysis used a mixed linear model accounting for confounding factors such as smoking, buccal bone integrity, gingival phenotype, and provisional use. Results: Both groups showed significant volume reduction from baseline to t₃ and t₄. The largest volume loss occurred in the central ROI in both test (t₄: −65.34 ± 36.89 mm³) and control group (t₄: −70.85 ± 30.96 mm³), with no significant difference between groups. A decline in PES and recession at the adjacent teeth was noted in both groups at 12 months. Conclusions: Both groups showed significant volume reduction with aesthetic impairment at the adjacent teeth’s soft tissue. Full article

In fixed orthodontic treatment, brackets are orthodontic attachments bonded to the tooth enamel, and their placement and removal may affect the underlying enamel surface. Enamel degradation is a critical factor for oral health, as it reduces the mechanical strength of teeth and increases susceptibility to caries and erosion. Accurate diagnosis of enamel changes is therefore essential for the evaluation of preventive and restorative treatments. In this study, enamel degradation was investigated via two integrated methods: energy-dispersive X-ray spectroscopy (EDS) and surface roughness measurement. The experimental protocol was performed in three stages: before bracket bonding, after bracket removal, and after applying a remineralization treatment. The experimental design included a repeated-measures structure, with stage (baseline, post-debonding, post-remineralization) as the within-tooth factor and bracket type (sapphire vs. metallic) as the between-tooth factor. Given the violation of the variance homogeneity assumption, group comparisons were ultimately performed using Welch ANOVA followed by Games–Howell post hoc tests, with Bonferroni-adjusted values used for pairwise comparisons. The presence of orthodontic brackets can influence enamel mineralization because the bonding and debonding procedures modify the enamel surface microtopography. These procedures can generate microcracks and surface irregularities, which may affect mineral exchange between enamel and the surrounding environment. In our study, bracket removal led to a significant decrease in the mean atomic percentages of Ca (from 32.65% to 16.37% for sapphire) and P (from 16.35% to 8.60% for sapphire), accompanied by a sharp increase in surface roughness. After remineralization, Ca and P levels increased, while roughness decreased. However, neither the mineral content nor the surface topography fully returned to the initial values, indicating that remineralization achieved only a partial recovery of enamel integrity. These findings highlight that the integrated EDS approach and roughness analysis offer a promising descriptive framework for assessing enamel degradation and monitoring the effectiveness of remineralization therapies. The generated mathematical model provides a powerful descriptive framework for the in vitro data obtained, correlating roughness with mineral composition and treatment stage. However, such a high goodness-of-fit (R² > 0.98) should be interpreted cautiously due to the risk of overfitting. Therefore, rigorous external validation is mandatory before this model can be considered a reliable predictive tool. It also highlights the importance of enamel remineralization therapies after orthodontic treatment, but also the importance of choosing personalized treatment strategies adapted to the enamel type. Full article

The occurrence of cysts and tumors in pediatric patients varies across different age groups. Follicular and dentigerous cysts are among the most common lesions. However, typical odontogenic tumors in juvenile patients are not frequently observed. Early stages of cyst and odontogenic tumor development might exhibit some similar characteristics due to the presence of unerupted teeth or their relationship with various stages of tooth formation and eruption. Many small lesions are discovered accidentally on routine orthopantomography (OPG), while the bigger ones manifest themselves as bone swelling, cortical perforation, or displacement and mobility of teeth. Each odontogenic tumor has characteristic clinical and radiological features. Biopsy of larger lesions, or incisional biopsy of smaller lesions, allows detailed histopathological evaluation to determine tumor type and growth behavior and guide appropriate treatment planning. In some cases, atypical signs on OPGs, like asymmetry in dental follicles, occurrence of round or oval bone lesions near impacted or retained teeth, and visibility of irregular radiolucent, radiopaque, or mixed jawbone lesions, might suggest the occurrence of some possible odontogenic tumor in juvenile patients. Each case should be handled individually. In this case, we demonstrate how atypical appearances of dental follicles on panoramic radiographs may not correspond with cone-beam computed tomography findings and may indicate the early stages of odontogenic myxoma in a juvenile patient. Full article

Background: The bond strength of orthodontic tubes to the enamel surface is essential for maintaining appliance stability, especially due to high masticatory forces on molars. Strong adhesion reduces the need for rebonding, shortening treatment time. This study aimed to evaluate the impact of tube base size and enamel sandblasting on bond strength in vitro. Methods: Eighty extracted permanent molar teeth were used for this study, divided into four groups of 20 samples each: M—small base tubes (non-sandblasted enamel), SM—small base tubes (sandblasted enamel), T—large base tubes (non-sandblasted enamel), and ST—large base tubes (sandblasted enamel). Shear bond strength was measured using the Mecmesim Multitesters 2.5-I device. Statistical analysis was conducted using IBM SPSS 27.0 software, applying ANOVA and Tukey’s post hoc test. Results: The highest bond strength (N) was recorded in the ST group, 85.51 ± 25.04 N, and the lowest in the M group, 50.23 ± 19.76 N. In terms of MPa, the SM group had the highest average value, 11.31 ± 3.57 MPa, while the T group had the lowest, 4.89 ± 1.33 MPa. ANOVA showed a statistically significant effect of tube base size on bond strength (p < 0.001), while sandblasting had no significant effect (p > 0.05). Conclusions: Larger base orthodontic tubes demonstrate stronger adhesion to enamel and are recommended for molars. Sandblasting the enamel does not significantly impact bond strength. Full article

Background: Bioactive composite resins combine the esthetic and mechanical properties of resin composites with therapeutic functions such as ion release, remineralization, and caries inhibition. While in vitro studies suggest promising bioactivity, their clinical performance in permanent teeth remains uncertain. Objective: This systematic review and meta-analysis critically appraised randomized controlled trials and prospective clinical studies to determine whether bioactive composites offer superior clinical performance compared to conventional resin composites and glass ionomer-based materials. Methods: Electronic databases (PubMed/MEDLINE, Scopus, Web of Science, Google Scholar) were searched for eligible studies (2018–2025). Clinical outcomes assessed restoration survival, marginal integrity, secondary caries, postoperative sensitivity, and esthetic outcomes (color match). Data were pooled using a random-effects model, and risk of bias was assessed with Cochrane criteria. Results: Twenty-two trials met the inclusion criteria. No significant differences were found between bioactive and control restorations for survival/retention (RD = 0.01; 95% CI, –0.01 to 0.03), marginal adaptation (RD = 0.02; 95% CI, –0.02 to 0.06), secondary caries (RD = 0.01; 95% CI, –0.01 to 0.03), or postoperative sensitivity (RD = 0.01; 95% CI, –0.02 to 0.04), with negligible heterogeneity (I² = 0–4%). For color match, glass ionomer restorations showed significantly poorer outcomes (RD = –0.23; 95% CI, –0.31 to –0.14; p < 0.00001; I² = 98%), while conventional resin composites had a slight but significant advantage over bioactive composites (RD = 0.07; 95% CI, 0.02 to 0.12; p = 0.003; I² = 76%). Most studies presented moderate risk of bias and short-term follow-up (<36 months). Conclusions: Current evidence indicates that bioactive composites perform comparably, but not superior, to conventional restoratives in permanent teeth. The discrepancy between laboratory bioactivity and clinical effectiveness highlights the need for long-term, well-designed clinical trials with standardized outcome reporting. Full article

Background/Objectives: The early and accurate identification of impacted teeth in the maxilla is critical for effective dental treatment planning. Traditional diagnostic methods relying on manual interpretation of radiographic images are often time-consuming and subject to variability. Methods: This study presents a deep learning-based approach for automated classification of impacted maxillary canines using panoramic radiographs. A comparative evaluation of four pre-trained convolutional neural network (CNN) architectures—ResNet50, Xception, InceptionV3, and VGG16—was conducted through transfer learning techniques. In this retrospective single-center study, the dataset comprised 694 annotated panoramic radiographs sourced from the archives of a university dental hospital, with a mildly imbalanced representation of impacted and non-impacted cases. Models were assessed using accuracy, precision, recall, specificity, and F1-score. Results: Among the tested architectures, VGG16 demonstrated superior performance, achieving an accuracy of 99.28% and an F1-score of 99.43%. Additionally, a prototype diagnostic interface was developed to demonstrate the potential for clinical application. Conclusions: The findings underscore the potential of deep learning models, particularly VGG16, in enhancing diagnostic workflows; however, further validation on diverse, multi-center datasets is required to confirm clinical generalizability. Full article

Background: Resin infiltration has emerged as a micro-invasive strategy for managing enamel porosities, offering both therapeutic and aesthetic benefits. ICON^® (DMG, Hamburg, Germany) is the most widely used system; however, evidence on its penetration behavior in sound enamel remains limited. Objectives: This in vitro study aimed to evaluate the penetration depth and morphological pattern of ICON resin infiltration in sound human enamel, using quantitative morphometric analysis and scanning electron microscopy (SEM). Methods: Fourteen freshly extracted, caries-free anterior teeth were sectioned longitudinally. ICON^® resin infiltrate was applied to the buccal enamel surfaces according to the manufacturer’s protocol, while the lingual/palatal surfaces served as internal controls. Penetration depth was measured quantitatively on both mesial (surface A) and distal (surface B) halves, and SEM was used to assess resin–enamel interface morphology. Statistical analysis included the Shapiro–Wilk test, paired t-test, Pearson correlation, and percentage difference calculation. Results: The mean difference in penetration depth between surfaces A and B was −21.29 µm (p = 0.525), indicating no statistically significant variation. A strong positive correlation was observed between surfaces (r = 0.783, p = 0.001). The mean percentage difference was −3.57% (SD = 18.61%), suggesting minimal directional bias. SEM images confirmed continuous and homogeneous resin infiltration within enamel prisms. Post-hoc power analysis indicated 15.2% power, reflecting the impact of the limited sample size typical for SEM-based exploratory studies. Conclusions: Within the limitations of this in vitro investigation, ICON resin infiltration demonstrated uniform and consistent penetration in sound enamel, supported by both quantitative and SEM analyses. These findings validate its potential as a reliable preventive and micro-invasive biomaterial in dental practice, particularly for protecting enamel surfaces prior to orthodontic bracket bonding. Further clinical research with larger cohorts is recommended to confirm its long-term stability and prophylactic performance. Full article

Bone defects in the maxillofacial region severely impair patient function and esthetics. Free autologous bone grafting remains the gold-standard treatment; however, surgical intervention at donor sites limits clinical applicability. Treatment using artificial materials also presents challenges, including insufficient bone regeneration and poor biocompatibility. Bio three-dimensional (3D) printing, which enables the fabrication of scaffold-free 3D constructs from cellular spheroids has emerged as a promising regenerative approach. This study investigated the osteogenic potential of scaffold-free constructs composed of human dental pulp stem cell (DPSC) spheroids in a rat mandibular defect model. DPSCs isolated from extracted human teeth were used to generate spheroids, which were assembled into 3D constructs using a Bio 3D printer. The spheroids exhibited higher mRNA expression of stem cells and early osteogenic markers than monolayer cultures. The constructs were transplanted into mandibular defects of immunodeficient rats, and bone regeneration was assessed eight weeks post-transplantation. Radiographic and micro-Computed Tomography analyses revealed significantly greater bone volume and mineral density in the 3D construct group. Histological and immunohistochemical examinations confirmed newly formed bone containing osteogenic cells derived from the transplanted DPSCs. These findings indicate that Bio 3D-printed, scaffold-free DPSC constructs promote mandibular bone regeneration and may provide a novel strategy for maxillofacial reconstruction. Full article

The use of miniscrews as Temporary Skeletal Anchorage Devices (TSAD) in orthodontics has allowed clinicians to perform challenging tooth movements by dissipating undesired forces into the bone structure; thus, avoiding unwanted movement of the adjacent teeth. It is essential for miniscrews to be highly resistant to fracture during clinical use. While many studies have analysed torsional loads, none have measured the changes in flexural and bending strength of miniscrews before and after an ageing process. This study aims to analyse the resistance to orthogonal forces of miniscrews with different diameters, focusing on both new and aged materials, the latter subjected to thermocycling and autoclaving laboratory processes to simulate a 3- and a 6-month exposure to the oral environment. A total of 105 pristine miniscrews have been tested; specimens were divided into seven groups based on the different endosseous body diameters. Each group was further subdivided into three subgroups, according to the simulated ageing of the miniscrews (intact, 3 months of ageing and 6 months of ageing, respectively). An Instron Universal Testing Machine has been used to measure deflection at 0.1 mm and 0.2 mm, as well as maximum load at fracture. The results evidenced that miniscrews respond differently to cutting forces; in particular, the resistance to orthogonal loads increases as the diameter of the miniscrews increases. Linear regression analysis revealed a significant influence between all the dependent variables—maximum load, 0.1 mm deflection load, and 0.2 mm deflection load—and the independent variables, such as diameter and thermocycling (p < 0.05). Both new and aged miniscrews are suitable for orthodontic and orthopaedic loads; moreover, ageing up to 6 months does not seem to significantly decrease the resistance to shear forces for the same diameter. Linear regression analysis of the miniscrews subjected to experimental ageing showed a slight but significant decrease in resistance to orthogonal loading. Full article

This study aimed to compare the translucency values of anterior crowns fabricated with ultra-high-translucent (UHT) zirconia, low-translucent (LT) lithium disilicate (LDS), and LT zirconia-reinforced lithium silicate (ZLS) glass-ceramics. In total, 48 central incisor crowns (n = 12) were fabricated from IPS e.max CAD LT (IPS), Celtra Duo LT (CD), and GC Initial UHT zirconia (GC, GC1). A standard of 1.5 mm labial thickness of the crowns was determined for three groups (IPS, CD, GC), and 1 mm labial thickness was determined for GC1. The crowns’ translucency values were assessed in terms of the contrast ratio (CR). One-way ANOVA and Tamhane tests were used for analyzing the data. The mean CRs of GC1, GC, IPS, and CD specimens were 0.13 ± 0.01, 0.22 ± 0.01, 0.22 ± 0.04, and 0.29 ± 0.04, respectively. The CD group had significantly higher CR values than the other groups. The difference between the CR values of GC and IPS groups was not statistically significant. The GC1 group’s CR was significantly lower than the GC group. It is critical to select monolithic materials in order to achieve esthetic restorations, particularly for anterior teeth. The translucency of monolithic restorative materials was influenced by the type and the thickness of the material used. Full article

As a commonly used dental restorative material, light-cured composite resin exhibits mechanical properties that closely match those of natural tooth structure. In the process of biting, the filling material falls off severely due to fretting between the filling material and the fixed interface of the teeth, which shortens the life of the filling material. This study aimed to investigate the mechanisms and contributing factors of this phenomenon. In particular, this study investigated the friction and wear mechanisms at the tangential fretting interface between light-cured composite resin and the tooth substrate under varying fretting amplitudes, normal loads, and lubrication conditions. In artificial saliva, the friction coefficient increased with the fretting amplitude and decreased with the increase in the normal load. The result showed that when the fretting amplitude was large or the normal load was small, the fretting was always in the complete slip regime. When the fretting amplitude was small or the normal load was large, the fretting changed from the complete slip zone to the partial slip regime. The minimum friction coefficient in milk was 0.117, and the maximum friction coefficient in artificial saliva was 0.567. Coke and milk have little effect on the fixation of filling materials. Abrasive wear was the predominant mechanism, with small amplitudes or high loads leading to adhesive wear. The composite resin exhibited the least wear in cola and milk, while soda water and artificial saliva caused significantly greater damage. Full article

Background/Objectives: External root resorption is an undesirable complication of orthodontic treatment, characterized by the loss of dental root structure. The aim of this study was to identify the biological and dental risk factors involved in the development of external root resorption at the end of orthodontic treatment. Methods: A retrospective observational study was conducted on a sample of 120 patients who underwent orthodontic treatment. External root resorption was assessed using pre- and post-treatment panoramic radiographs. Correlations were established between the severity of external root resorption and various biological and dental risk factors. Results: Out of a total of 2639 teeth analyzed, 52.14% exhibited external root resorption, with most cases being mild to moderate (<3 mm). The maxillary central incisors were the most affected teeth. Age showed a statistically significant correlation with the severity of external root resorption in the lower anterior region (p < 0.01). No significant differences were observed in relation to gender, facial growth pattern, or type of dento-maxillary anomaly. Conclusions: External root resorption is a common consequence of orthodontic treatment, most often presenting with low severity. The type of tooth and the patient’s age influence the severity of root resorption, while factors such as gender, facial growth pattern, and type of dento-maxillary anomaly did not prove to be significant in this context. Full article

Vital pulp therapy (VPT) is increasingly recognised as a biologically driven alternative to root canal treatment in teeth with deep caries and a vital pulp diagnosis. Resin-modified calcium silicate-based materials (RM-CSMs) were introduced to combine the bioactivity of traditional cements with improved handling and immediate light-curing, but their biological performance remains debated. Objectives: This systematic review and meta-analysis aimed to evaluate the clinical and radiographic outcomes of VPT performed with RM-CSMs compared with conventional non-resin-modified calcium silicate-based materials (NRM-CSMs) Methods: PRISMA Guidelines were followed to carry out this systematic review. Electronic databases (Medline, Embase, Scopus, and Web of Science) were searched up to October 2025 for randomised clinical trials evaluating indirect pulp capping, direct pulp capping, or pulpotomy. Nine trials met the inclusion criteria. Meta-analyses were performed for TheraCal LC, the only RM-CSM with sufficient clinical evidence. The risk of bias was assessed using the RoB 2 Tool. The certainty of evidence was assessed using GRADE. Results: Pooled results showed no significant differences in overall clinical–radiographic success between RM-CSMs and NRM-CSMs at 90 or 180 days. At 360 days, a trend favouring NRM-CSMs emerged, though not statistically significant. Dentine bridge formation at 360 days was significantly lower with TheraCal LC. Conclusions: Current RM-CSMs demonstrate comparable short-term success to conventional materials but still present biological limitations, particularly regarding long-term reparative outcomes. NRM-CSMs remain the preferred option when maximal bioactivity and predictable dentinogenesis are required Full article