Oral Health Management and Disease Treatment

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Applied Sciences applsci	2.5	5.5	2011	16 Days	CHF 2400	Submit
Dentistry Journal dentistry	3.1	4.1	2013	25.4 Days	CHF 2000	Submit
International Journal of Molecular Sciences ijms	4.9	9.0	2000	17.8 Days	CHF 2900	Submit
Journal of Clinical Medicine jcm	2.9	5.2	2012	18.5 Days	CHF 2600	Submit
Medicina medicina	2.4	4.1	1920	17.5 Days	CHF 2200	Submit

16 pages, 594 KB

Open AccessReview

Clinical Outcomes, Success/Failure Patterns, and Complications of Microscrew-Assisted Rapid Palatal Expansion in Post-Pubertal Transverse Maxillary Deficiency: A Scoping Review

by Claudia Butrón-Téllez Girón, Juan Carlos Flores-Arriaga, Daniel Oliva-Buhaya, Alan Martínez-Zumarán, Amaury Pozos-Guillén and Arturo Garrocho-Rangel

Dent. J. 2026, 14(5), 261; https://doi.org/10.3390/dj14050261 - 1 May 2026

Viewed by 351

Abstract

Background/Objectives: A non-surgical orthodontic treatment strategy for transverse maxillary deficiencies, especially in late adolescents and young adults, is microscrew-assisted rapid palatal expansion (MARPE). The literature indicates several concerns regarding its long-term efficacy and potential complications. Recent studies have provided valuable insights into [...] Read more.

Background/Objectives: A non-surgical orthodontic treatment strategy for transverse maxillary deficiencies, especially in late adolescents and young adults, is microscrew-assisted rapid palatal expansion (MARPE). The literature indicates several concerns regarding its long-term efficacy and potential complications. Recent studies have provided valuable insights into the MARPE technique, particularly focusing on its efficacy, potential complications, and treatment failures. The present scoping review aims to synthesize and critically appraise clinical evidence on MARPE in post-pubertal patients, with a specific focus on treatment outcomes, mechanisms of failure, and local and systemic adverse effects to inform risk–benefit assessment and clinical decision-making. Methods: A systematic search was conducted across four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) to identify English-language clinical trials, observational studies, and systematic reviews published between January 2015 and December 2025. The search strategy employed controlled vocabulary (MeSH terms) and Boolean operators targeting MARPE, treatment failure, and adverse effects in patients aged ≥ 16 years. After title/abstract screening and full-text assessment using predetermined inclusion criteria, 15 studies (3 systematic reviews with meta-analysis, 2 umbrella reviews, 4 systematic/scoping reviews, 2 randomized controlled trials, and 4 observational studies) were selected for qualitative synthesis. Results: Fifteen studies were finally included, which demonstrated significant heterogeneity in methodological design, sample characteristics, outcome measurement protocols, and MARPE device specifications. Mean success rates of 92.5% for maxillary transverse expansion were reported, with mean expansion duration ranging between 20 and 126 days. Key adverse effects comprised dentoalveolar tipping (buccal inclination of maxillary molars and premolars), periodontal complications (buccal bone resorption of 0.6–0.9 mm, gingival recession, papilla recession in 18% of cases), root resorption, miniscrew loosening, midpalatine/circummaxillary sutures, and potential but minimally documented intracranial effects. Conclusions: MARPE appears to be a valid non-surgical option for selected post-pubertal patients, but its success depends on careful case selection and monitoring for dentoalveolar, periodontal, sutural, and rare intracranial adverse effects. Full article

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14 pages, 246 KB

Open AccessReview

The Impact of Periodontal Instrumentation on Enamel and Cementum: A Narrative Review

by Maike Lodigkeit, Mariusz Lipski, Laurentia Schuster, Till Dammaschke, Włodzimierz Dura, Martyna Mochol and Małgorzata Mazurek-Mochol

Dent. J. 2026, 14(5), 259; https://doi.org/10.3390/dj14050259 - 30 Apr 2026

Viewed by 262

Abstract

Objectives: Achieving a smooth tooth surface following periodontal instrumentation is critical for maintaining periodontal health and minimizing plaque and calculus reaccumulation. This narrative review aimed to synthesize preclinical laboratory-based evidence regarding the effects of periodontal instrumentation techniques on enamel and cementum surface roughness [...] Read more.

Objectives: Achieving a smooth tooth surface following periodontal instrumentation is critical for maintaining periodontal health and minimizing plaque and calculus reaccumulation. This narrative review aimed to synthesize preclinical laboratory-based evidence regarding the effects of periodontal instrumentation techniques on enamel and cementum surface roughness and hard-tissue loss. Methods: A focused literature search was conducted using the PubMed database to identify relevant in vitro and in vitro/in vivo hybrid studies published within the last 15 years. This review focused on ultrasonic scaling, hand instrumentation, and air polishing of human teeth during periodontal treatment. Results: Periodontal instrumentation was associated with surface alterations of enamel and cementum, with the extent of these changes depending on instrumentation parameters. Manual instrumentation was generally associated with greater surface irregularities and increased cementum removal, whereas ultrasonic scaling tended to produce more uniform surface characteristics. However, outcomes varied depending on instrumentation parameters. Air-polishing systems were described as less abrasive, particularly in biofilm management. Conclusions: Within the limitations of predominantly in vitro evidence, periodontal instrumentation appears to alter dental hard tissues to varying degrees depending on the technique and application. The clinical relevance of these findings remains uncertain, as the evidence was primarily laboratory-based and may not fully reflect clinical conditions or predict long-term outcomes. Full article

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11 pages, 1169 KB

Open AccessStudy Protocol

Feasibility and Safety of High-Flow Nasal Cannula Use During Dental Treatment: A Pilot Study

by Terumi Ayuse, Kaori Yamaguchi, Takao Ayuse and Stanislav Tatkov

Dent. J. 2026, 14(4), 208; https://doi.org/10.3390/dj14040208 - 2 Apr 2026

Viewed by 349

Abstract

Background: Dental treatment often requires prolonged mouth opening. This may compromise comfort during spontaneous nasal breathing and saliva swallowing, leading to stress or anxiety. A high-flow nasal cannula (HFNC) delivers warmed and humidified air at high flow rates and may improve breathing comfort; [...] Read more.

Background: Dental treatment often requires prolonged mouth opening. This may compromise comfort during spontaneous nasal breathing and saliva swallowing, leading to stress or anxiety. A high-flow nasal cannula (HFNC) delivers warmed and humidified air at high flow rates and may improve breathing comfort; however, the feasibility of its routine use during dental treatment has not been established. Objectives: The primary objective of this pilot study is to evaluate the feasibility of conducting a definitive clinical trial to investigate the use of a HFNC during dental treatment. The secondary objective is to explore preliminary patient-centered outcomes related to stress and comfort to inform the design of future clinical trials. Methods: This single-center, open-label pilot feasibility study will be conducted at Nagasaki University Hospital, with adult patients undergoing routine full-mouth periodontal treatment participating in two treatment sessions, one without a HFNC and one with a HFNC, separated by at least four weeks. The primary feasibility outcomes include recruitment and retention rates, patient tolerance and acceptability of the HFNC, completeness of data collection, and device-related adverse events. The secondary outcomes are exploratory and include physiological stress-related parameters (pulse rate, respiratory rate, autonomic nervous system indices, and electroencephalographic alpha wave activity) and patient-reported comfort assessed using a questionnaire. Conclusions: This pilot study was designed to assess the feasibility and safety of HFNC use during full-mouth periodontal treatment and to inform the design of future definitive clinical trials. In particular, the resultant exploratory patient-centered outcomes and preliminary data may be used to guide outcome selection and sample size estimation. Full article

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22 pages, 413 KB

Open AccessReview

Sex-Specific Oral Health: A Narrative Review of Hormonal Influences and Disease Patterns

by Agnes Holtkamp, Florian Beuer, Thomas Gerhard Wolf and Michael Naumann

Dent. J. 2026, 14(3), 147; https://doi.org/10.3390/dj14030147 - 6 Mar 2026

Viewed by 702

Abstract

This narrative review aims to analyze sex-specific differences in oral health, examine hormonal influences in women during puberty, pregnancy, and menopause, and compare oral health behaviors between men and women. Articles were selected based on: (1) sex-specific aspects of oral diseases, (2) hormonal [...] Read more.

This narrative review aims to analyze sex-specific differences in oral health, examine hormonal influences in women during puberty, pregnancy, and menopause, and compare oral health behaviors between men and women. Articles were selected based on: (1) sex-specific aspects of oral diseases, (2) hormonal influences on oral health, (3) comparative analyses between sexes, and (4) sex-disaggregated data on oral disease prevalence. Women experience hormonal vulnerabilities with estrogen deficiency causing xerostomia, mucosal atrophy, and increased caries susceptibility, showing parallels between oral and vaginal mucosa. Men demonstrate higher periodontitis prevalence (57% vs. 38%), utilize preventive services one-third less frequently, and show higher smoking rates (67% vs. 42%) and traumatic dental injuries (2:1 ratio). Women maintain better oral hygiene and treatment adherence. Sex-specific factors affecting both sexes remain unconsidered in dental practice. Women need targeted interventions during hormonal transitions, while men require improved preventive care engagement. Future research integrating sex-specific considerations is required to enable personalized oral health approaches for both sexes. Full article

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12 pages, 487 KB

Open AccessArticle

Oral Health Status and Dental Care Needs Among Long-Term Care Facility Residents in Warsaw: A Cross-Sectional Study

by Julia Maria Brulińska, Aleksandra Sokołowska, Joanna Peradzyńska and Dominika Gawlak

Dent. J. 2026, 14(2), 90; https://doi.org/10.3390/dj14020090 - 4 Feb 2026

Viewed by 592

Abstract

Background: Oral health is a key component of general health and quality of life in the elderly. Residents of long-term care facilities (LTCFs) are particularly vulnerable to poor oral health due to multimorbidity, polypharmacy, and dependence on caregivers. Despite increasing awareness of this [...] Read more.

Background: Oral health is a key component of general health and quality of life in the elderly. Residents of long-term care facilities (LTCFs) are particularly vulnerable to poor oral health due to multimorbidity, polypharmacy, and dependence on caregivers. Despite increasing awareness of this issue, dental needs in institutionalized populations remain largely unmet. Objectives: The objective of this study was to evaluate the dental treatment needs of LTCF residents in Warsaw. The analysis focused on oral health status, oral hygiene practices, difficulties with food intake, and the need for assistance in daily oral and nutritional care. Material and methods: A cross-sectional study was conducted among 29 LTCF residents. Data collection included interviews on hygiene habits and dietary difficulties, followed by clinical examination assessing oral mucosa, dentition, prosthetic status, and plaque coverage (Plaque Index). Statistical analyses were performed using GraphPad Prism with Mann–Whitney U, Fisher’s exact, and Spearman’s rank correlation tests. Results: The median number of missing teeth ranged from 22 to 24. Active caries were found in 17 residents and periodontitis in 19. Oral hygiene was poor, with plaque covering up to 100.0% of tooth surfaces. Women had significantly more missing teeth than men (p = 0.0128). Difficulties with food intake were reported by 69.0% of residents. No significant associations were found between oral hygiene products use and dental or prosthetic status. Conclusions: This study revealed severely compromised oral health among LTCF residents. Extensive tooth loss, poor hygiene, and limited access to preventive dental care indicate the need for systematic, on-site oral health programs, caregiver training, and integration of dental services into standard geriatric care. Full article

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16 pages, 1100 KB

Open AccessSystematic Review

Effects of Oral Probiotics on Streptococcus mutans in Children: A Systematic Review and Meta-Analysis

by Andrea Caiza-Rennella, Andrea Ordoñez-Balladares, Rosangela Caicedo-Quiroz, Indira Gómez-Capote and Zuilen Jiménez-Quintana

Dent. J. 2026, 14(2), 87; https://doi.org/10.3390/dj14020087 - 3 Feb 2026

Viewed by 961

Abstract

Background: Early childhood caries is closely associated with oral dysbiosis and the proliferation of Streptococcus mutans. Oral probiotics, particularly Lactobacillus reuteri and Lactobacillus rhamnosus, have been proposed as ecological modulators capable of reducing cariogenic microorganisms. Objective: To evaluate the [...] Read more.

Background: Early childhood caries is closely associated with oral dysbiosis and the proliferation of Streptococcus mutans. Oral probiotics, particularly Lactobacillus reuteri and Lactobacillus rhamnosus, have been proposed as ecological modulators capable of reducing cariogenic microorganisms. Objective: To evaluate the efficacy of orally administered L. reuteri and L. rhamnosus in reducing salivary S. mutans levels in children aged 6 months to 12 years through a systematic review and meta-analysis. Methods: This review followed the PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420251086304). Searches were conducted in MEDLINE/PubMed, CENTRAL, Embase, Scopus and LILACS without language or date restrictions. Randomized controlled trials administering the target probiotic strains for ≥30 days were included. Risk of bias was assessed using RoB 2, and certainty of evidence using GRADE. Random-effects meta-analyses were performed for continuous and dichotomous outcomes. Results: Six randomized controlled trials were included (N = 1362). Only two trials reported continuous outcomes in comparable log₁₀ CFU/mL format and could therefore be pooled for the continuous meta-analysis. This analysis showed a significant reduction in salivary S. mutans levels (MD = −0.65 log₁₀ CFU/mL; 95% CI: −0.97 to −0.34; p < 0.0001; I² = 19%), although the pooled estimate was largely driven by one study and should be interpreted cautiously. Four trials contributed to the dichotomous meta-analysis, which showed a non-significant trend toward risk reduction (OR = 0.73; 95% CI: 0.51–1.06; p = 0.10; I² = 35%). Short-term interventions using high oral-retention formulations demonstrated the most consistent microbiological effects. Conclusions: Oral probiotics may significantly reduce salivary S. mutans in the short-term, especially when delivered through slow-dissolving formulations. However, their effects vary according to strain, vehicle, and intervention duration. Larger, standardized, and longer-term clinical trials are needed to determine the sustainability and clinical relevance of these effects. Full article

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13 pages, 1333 KB

Open AccessArticle

Oral Side Effects of the Most Commonly Prescribed Drugs in Germany

by Frank Halling, Rainer Lutz and Axel Meisgeier

Dent. J. 2026, 14(2), 83; https://doi.org/10.3390/dj14020083 - 2 Feb 2026

Viewed by 807

Abstract

Background: The aim of this study is to investigate the potential link between the use of specific medications and oral adverse drug reactions. Methods: The 100 most frequently prescribed drugs in Germany in 2023 were compiled using the “PharMaAnalyst” database. According to the [...] Read more.

Background: The aim of this study is to investigate the potential link between the use of specific medications and oral adverse drug reactions. Methods: The 100 most frequently prescribed drugs in Germany in 2023 were compiled using the “PharMaAnalyst” database. According to the descriptions of adverse drug reactions (ADRs) in the patient information leaflets the ADRs were selected, analyzed and weighted with scores according to a classification system that distinguishes four groups of ADRs by frequency: ‘very common’ (4), ‘common’ (3), ‘uncommon’ (2) and ‘rare’ (1). The objective was to summarize the scores of the oral ADRs and define the ‘oral side effect score’ (OSES). Results: After accounting for duplication due to various brand names, 49 medications were reviewed. A total of 65% of the medications exhibited oral ADRs. The number of oral ADRs per medication ranged from one to seven. Xerostomia and dysgeusia were the most prevalent oral side effects, accounting for 37% of cases. Overall, 34% of side effects were classified as either ‘very common’ or ‘common’. The medication groups with the highest OSES were antidepressants, antibiotics and analgesics. Of the individual medications, azithromycin, gabapentin and pregabalin exhibited the highest OSES. Conclusions: This study provides a comprehensive overview of oral side effects associated with the 100 most frequently prescribed drugs. Patients with polypharmacy are particularly likely to experience oral side effects such as xerostomia and dysgeusia. Due to their high OSES combinations, antibiotics, analgesics or antidepressants may trigger multiple oral ADRs. It is essential that the medical community is continuously updated on pharmacological knowledge to raise awareness of oral ADRs. Full article

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15 pages, 245 KB

Open AccessArticle

The Effect of Age and Use of Enamel Matrix Derivative on Implant Loss

by Stephen K. Harrel, Thomas G. Wilson, Jr., Martha E. Nunn and Charles M. Cobb

Dent. J. 2026, 14(1), 63; https://doi.org/10.3390/dj14010063 - 19 Jan 2026

Viewed by 386

Abstract

Background: Previous reports suggest that patient age at the time of implant placement is not a factor in implant survival. However, analysis of data compiled for a previously published study on the effect of enamel matrix derivative (EMD), a frequently used biomaterial to [...] Read more.

Background: Previous reports suggest that patient age at the time of implant placement is not a factor in implant survival. However, analysis of data compiled for a previously published study on the effect of enamel matrix derivative (EMD), a frequently used biomaterial to aid bone regeneration, on peri-implantitis indicated that age and use of EMD may be a factor in implant survival. The current study further evaluated the existing database to determine the effect of age and EMD use on long term survival of implants. Methods: An existing database from a private periodontal specialty practice was evaluated for the effect of age at the time of implant placement on implant survival. In addition, all available clinical factors were evaluated, including the use of EMD at any point during site preparation or implant placement to determine any effect on implant survival. Results: Patient age at the time of implant placement had a negligible effect on implant survival for younger individuals. However, starting at 58 years of age, an increase in relative risk for implant loss was noted. When the patient age was divided into groups, it was determined that patients ≥ 58 and ≤68 years had a statistically significantly increased relative risk of implant loss (2.75), which was sharply reduced if EMD had been used (1.24). This trend was also noted to a lesser extent in patients older than 68 years. Conclusions: The risk of implant loss was elevated when implants were placed in older patients. This risk was reduced if EMD had been used at any point during implant site preparation or placement. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

11 pages, 919 KB

Open AccessSystematic Review

Obstructive Sleep Apnea: The Expanding Role of Dental Sleep Medicine—A Systematic Review of Mandibular Advancement Devices, Treatment Efficacy, and Occlusal Complications

by Jędrzej Szmyt, Tymoteusz Szczapa, Maksymilian Chyła, Adam Bęben and Izabela Maciejewska

Dent. J. 2026, 14(1), 62; https://doi.org/10.3390/dj14010062 - 17 Jan 2026

Viewed by 977

Abstract

Background: Obstructive sleep apnea is characterized by recurrent upper airway obstruction during sleep, leading to intermittent hypoxemia, sleep fragmentation, and excessive daytime sleepiness. Affecting up to 11% of the adult Polish population and more commonly diagnosed in men, OSA poses a major public [...] Read more.

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

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11 pages, 797 KB

Open AccessCase Report

Kinematic Analysis-Guided Individualized Exercise for Temporomandibular Disorders: A Case Series

by Jonggeun Woo, Jeongwoo Jeon and Jiheon Hong

J. Clin. Med. 2026, 15(2), 655; https://doi.org/10.3390/jcm15020655 - 14 Jan 2026

Viewed by 464

Abstract

Background/Objectives: Exercise-based interventions are strongly recommended for managing temporomandibular disorders (TMDs). However, conventional approaches have limited capacity to address symptoms associated with mandibular kinematic abnormalities and often lack sufficient logical clarity for reproducible clinical applications. Furthermore, although current diagnostic criteria and imaging [...] Read more.

Background/Objectives: Exercise-based interventions are strongly recommended for managing temporomandibular disorders (TMDs). However, conventional approaches have limited capacity to address symptoms associated with mandibular kinematic abnormalities and often lack sufficient logical clarity for reproducible clinical applications. Furthermore, although current diagnostic criteria and imaging modalities primarily assess static anatomical conditions, traditional three-dimensional motion analysis is difficult to implement in routine practice. This study aimed to evaluate the effectiveness of a personalized, exercise-based intervention optimized to patients’ lateral excursion (LE) characteristics using an artificial intelligence (AI)-assisted motion analysis system. Methods: An AI-based two-dimensional motion analysis platform was used to quantify maximum mouth opening (MMO) and LE in three patients with TMD. Individualized interventions—including massage, stretching, resistance exercises, coordination training, and breathing exercises—were provided over 3 weeks based on each patient’s clinical presentation and movement patterns identified through the kinematic analysis. Results: All three patients successfully completed the intervention. Average pain intensity declined across all cases. Mandibular function improved: the mean MMO increased by 38.92% on average, and LE decreased by −1.55 mm on average. Conclusions: This study demonstrates that a personalized, exercise-based intervention guided by AI-assisted mandibular kinematic analysis was associated with reductions in pain and improvements in dynamic mandibular function. This approach provides a logically clear and objective framework that may support physical therapy in TMD management, advancing beyond conventional static assessment methods. Full article

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15 pages, 1076 KB

Open AccessFeature PaperReview

From Thermal Springs to Saline Solutions: A Scoping Review of Salt-Based Oral Healthcare Interventions

by Elisabetta Ferrara, Manela Scaramuzzino, Biagio Rapone, Giovanna Murmura and Bruna Sinjari

Dent. J. 2026, 14(1), 32; https://doi.org/10.3390/dj14010032 - 5 Jan 2026

Viewed by 936

Abstract

Background: Therapeutic applications of saline solutions in oral healthcare range from mineral waters to standardized sodium chloride preparations. Despite widespread traditional use, their scientific foundation remains inadequately characterized. This scoping review aimed to systematically map the available evidence for salt-based oral health [...] Read more.

Background: Therapeutic applications of saline solutions in oral healthcare range from mineral waters to standardized sodium chloride preparations. Despite widespread traditional use, their scientific foundation remains inadequately characterized. This scoping review aimed to systematically map the available evidence for salt-based oral health interventions, characterize study populations and outcomes, and identify research gaps to guide future investigations. Methods: Following JBI methodology and PRISMA-ScR guidelines, four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) were systematically searched for publications from 2000 to 2025. Studies were classified along a spectrum from geological mineral waters to artificial preparations. Narrative synthesis was employed with systematic gap identification. Results: Seventeen studies met inclusion criteria, with a median sample size of 41 participants and a median follow-up of 4 weeks. Evidence distribution revealed concentration on hypersaline Dead Sea derivatives (n = 7, 41%) and European thermal waters (n = 5, 29%), with limited representation of marine-derived (n = 1, 6%) and simple saline solutions (n = 3, 18%). Reported outcomes included periodontal parameters, xerostomia symptoms, viral load, mucositis severity, and dentin hypersensitivity, with variable methodological quality across studies. Heterogeneity in interventions, comparators, and outcome measures precluded direct comparisons. Conclusions: The current evidence base for salt-based oral interventions remains limited and methodologically heterogeneous. While preliminary findings suggest potential applications across multiple clinical domains, small sample sizes, short follow-up periods, and inconsistent outcome measures preclude definitive recommendations. Standardized protocols and adequately powered trials are needed before evidence-based clinical integration. Full article

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19 pages, 2003 KB

Open AccessSystematic Review

Prevalence and Severity of Oral Conditions in Elite Athletes: A Systematic Review and Meta-Analysis

by Fátima Campana Zamudio, Victor Sebastián Aleman Soto, Diego Azañedo and Akram Hernández-Vásquez

Dent. J. 2025, 13(12), 589; https://doi.org/10.3390/dj13120589 - 8 Dec 2025

Cited by 1 | Viewed by 1038

Abstract

Background: Oral health problems are common among elite athletes, yet the evidence remains fragmented and inconsistent. Objectives: To estimate the prevalence and severity of oral conditions in elite athletes through a systematic review and meta-analysis. Methods: Studies published in English, Spanish, or Portuguese, [...] Read more.

Background: Oral health problems are common among elite athletes, yet the evidence remains fragmented and inconsistent. Objectives: To estimate the prevalence and severity of oral conditions in elite athletes through a systematic review and meta-analysis. Methods: Studies published in English, Spanish, or Portuguese, with observational design, available in PubMed, Embase, CINAHL, Web of Science, Scopus, Dentistry & Oral Science Source, and LILACS databases until 5 January 2025, were included. A narrative synthesis was used to describe the studies, and a meta-analysis of prevalences was performed using a random-effects model. Study quality assessment was performed using the Joanna Briggs Institute Critical Appraisal tools. Results: A total of 10 articles were included in the systematic review and meta-analysis. The overall combined prevalence of caries was found to be 44.4% (95%CI: 33.9–55.1%), the prevalence of dental erosion was 36.5% (95%CI: 22.6–51.7%), the prevalence of gingivitis was 41.4% (95%CI: 14.7–71%), the prevalence of pericoronitis was 18.7% (95%CI: 2.3–45.4%), the prevalence of periodontitis was 10.8% (95%CI: 2.7–23.3%) and the prevalence of orofacial trauma was 15.6% (95%CI: 5.3–29.7%). High heterogeneity was observed across studies. Most studies presented limitations related to participant recruitment and sample size adequacy. Conclusions: Dental caries, gingivitis, and dental erosion are highly prevalent among elite athletes, underscoring the importance of integrating oral health assessments into sports medicine care. High heterogeneity across studies limits the precision of prevalence estimates, emphasizing the need for standardized methodologies in future research. Full article

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10 pages, 741 KB

Open AccessArticle

Computer-Guided Intraosseous Anesthesia as a Primary Anesthetic Technique in Oral Surgery and Dental Implantology—A Pilot Study

by Minou Hélène Nilius and Manfred Nilius

Dent. J. 2025, 13(12), 572; https://doi.org/10.3390/dj13120572 - 3 Dec 2025

Viewed by 765

Abstract

This pilot study evaluated the feasibility and preliminary outcomes of computer-guided intraosseous anesthesia for oral surgery and dental implantology. Background/Objectives: The inferior alveolar nerve block (IANB) is widely used for dental anesthesia; however, issues such as anatomical variation and inflammation can hinder [...] Read more.

This pilot study evaluated the feasibility and preliminary outcomes of computer-guided intraosseous anesthesia for oral surgery and dental implantology. Background/Objectives: The inferior alveolar nerve block (IANB) is widely used for dental anesthesia; however, issues such as anatomical variation and inflammation can hinder effective pain control. Alternatives have been studied primarily in irreversible pulpitis, with limited data available for other procedures. Methods: In a retrospective analysis, data from 85 patients who underwent implantation, root resection, or osteotomy using QuickSleeper^® intraosseous anesthesia (IO), infiltration (INF), or IANB were assessed. Results: IO, IANB, and INF produced similar pain levels during administration, procedure, and recovery; blood pressure and heart rate were comparable. IO and INF led to less lip numbness after 15 min and required less anesthetic. IO had a significantly shorter latency than IANB, allowing earlier surgery. Conclusions: Computer-guided IO is a viable alternative to IANB for implantation, root resection, and osteotomy, offering equal pain control, shorter latency, earlier surgery, and reduced injection volume. Within the limitations of this pilot study, the findings should be considered preliminary and require confirmation in larger prospective studies. Given the exploratory pilot design, no formal sample size calculation was performed; the sample size was defined by feasibility considerations. Full article

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24 pages, 339 KB

Open AccessReview

Effect of Nutritional Antioxidants on Periodontal Disease and Periodontal Therapy

by Konstantina Vavetsi, Tzortzis Nomikos, Spyridon Vassilopoulos and Yiorgos A. Bobetsis

Dent. J. 2025, 13(12), 570; https://doi.org/10.3390/dj13120570 - 2 Dec 2025

Cited by 2 | Viewed by 1639

Abstract

Oxidative stress plays a significant role in the pathophysiology of periodontal disease (PD). Therefore, it is reasonable to suggest that a diet rich in antioxidants, such as several vitamins and essential minerals, may positively affect periodontal health. However, the evidence from the relevant [...] Read more.

Oxidative stress plays a significant role in the pathophysiology of periodontal disease (PD). Therefore, it is reasonable to suggest that a diet rich in antioxidants, such as several vitamins and essential minerals, may positively affect periodontal health. However, the evidence from the relevant literature is yet inconclusive. Studies evaluating the levels of intake of nutritional antioxidants in relation to periodontal status demonstrate contradictory results. This inconsistency could be attributed to heterogeneity in study design and methodological limitations, such as the small sample size, the assessment of periodontal status based on partial mouth measurements that usually underestimate the actual severity of PD, the lack of adjustment for confounders, which may obscure any potential but weak effect of nutrition, and the use of a 24 h recall to assess nutrient intake. Regarding the intervention studies that evaluated the effect of nutritional antioxidant supplementation as an adjunct to periodontal therapy, again, the results are not consistent. Few studies are randomized, and often different nutritional supplements are combined, making it difficult to distinguish the actual effect of each nutrient. Moreover, the dosage and duration of use of these supplements vary, rendering comparisons impossible. Therefore, better designed studies are necessary for the future. The assessment methods used for both PD and vitamin/mineral intake need to be more accurate and standardized to improve comparability. Also, prospective longitudinal and randomized controlled studies are important to establish the optimal dosing and the long-term effects of vitamin/mineral supplementation on periodontal health in different patient populations. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

9 pages, 1219 KB

Open AccessArticle

The Effect of Fermented Lingonberry Spray on Oral Health—A Pilot Study

by Hanna Lähteenmäki, Leo Pärnänen, Ismo T. Räisänen, Marjut Sakko, Pirjo Pärnänen and Timo Sorsa

Dent. J. 2025, 13(12), 568; https://doi.org/10.3390/dj13120568 - 2 Dec 2025

Viewed by 1046

Abstract

Background/Objectives: A fermented lingonberry juice spray (FLJ spray) was developed from lingonberry (Vaccinium vitis idaea L.) juice as a natural adjunct for oral health. It has a low sugar content and contains naturally occurring phenolic compounds to decrease oral microbial burden, inflammation, [...] Read more.

Background/Objectives: A fermented lingonberry juice spray (FLJ spray) was developed from lingonberry (Vaccinium vitis idaea L.) juice as a natural adjunct for oral health. It has a low sugar content and contains naturally occurring phenolic compounds to decrease oral microbial burden, inflammation, and dry mouth symptoms. This human intervention single-arm pilot study examined the oral effects of fermented lingonberry spray (FLJ spray) treatment, used for a period of 30 days. Methods: Eleven adult patients were recruited from a private dental clinic in Tampere, Finland. Traditional clinical oral examinations, periodontal status, and samples were collected at baseline, two weeks, and four weeks. Bleeding on probing (BOP), visible plaque index (VPI), and probing pocket depths (PPD) were examined, and active-matrix metalloproteinase-8 (aMMP-8) mouthrinse assays (cut off 20 ng/mL) were conducted. Additionally, stimulated and resting saliva, pH, and buffering capacity were assessed. A questionnaire assessing dry mouth symptoms was also recorded. Results: The effect of FLJ spray on clinical variables during the study period was analyzed by repeated measures ANOVA. Use of the Lingora^® spray reduced the assessed periodontal indices BOP (p < 0.05), VPI (p < 0.001), PPD ≥ 6 mm (p = 0.136), and aMMP-8 (p = 0.084). No adverse or contrary effects on the parameters were observed during the study. Conclusions: The use of FLJ spray improved periodontal status and reduced plaque burden and signs of inflammation, such as BOP and collagenolytic aMMP-8 levels. This pilot study suggests that FLJ spray is safe and appeared to be beneficial for use in addition to oral home care. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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9 pages, 9052 KB

Open AccessCase Report

Surgical Management of a Maxillary Odontogenic Keratocyst: A Clinical Case Report

by Ioan Sîrbu, Ionut Cosmin Nisipasu, Pasquale Savino, Andreea Mihaela Custura, Elisei Adelin Radu, Vladimir Nastasie and Valentin Daniel Sîrbu

Dent. J. 2025, 13(11), 514; https://doi.org/10.3390/dj13110514 - 5 Nov 2025

Cited by 1 | Viewed by 1658

Abstract

Introduction: Odontogenic keratocyst (OKC) is a locally aggressive cystic lesion derived from remnants of the dental lamina. It is most commonly located in the posterior mandible, while maxillary involvement is rare and poses diagnostic and surgical challenges due to its proximity to [...] Read more.

Introduction: Odontogenic keratocyst (OKC) is a locally aggressive cystic lesion derived from remnants of the dental lamina. It is most commonly located in the posterior mandible, while maxillary involvement is rare and poses diagnostic and surgical challenges due to its proximity to critical anatomical structures. This case report describes the surgical management of a maxillary OKC with an uncommon localisation. Methods: A 50-year-old male presented with an asymptomatic swelling in the posterior maxilla. Cone beam computed tomography (CBCT) revealed a well-defined unilocular radiolucency extending toward the maxillary sinus floor. Surgical management included complete enucleation and peripheral curettage, followed by histopathological confirmation. The defect was left to heal naturally through bone regeneration without the need for grafting. Results: Intraoperatively, a thin pearly white cystic capsule and buccal cortical thinning were observed, consistent with OKC. The lesion was enucleated intact, without rupture or sinus perforation. Histology confirmed the diagnosis. Postoperative healing was uneventful, with radiographic follow-up at one month showing favourable healing changes. Conclusions: Careful surgical planning combined with advanced imaging facilitates safe and effective management of OKCs in uncommon maxillary sites. Enucleation with peripheral curettage provided satisfactory short-term outcomes. Long-term follow-up remains essential due to the risk of recurrence. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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26 pages, 4031 KB

Open AccessSystematic Review

Modified Coronally Advanced Flaps: A Systematic Review and Meta-Analysis

by Miriana Gualtieri, Annarita Signoriello, Alessia Pardo, Diana Andreea Muresan, Alessandro Zangani, Paolo Faccioni, Giovanni Corrocher and Giorgio Lombardo

Dent. J. 2025, 13(10), 477; https://doi.org/10.3390/dj13100477 - 17 Oct 2025

Viewed by 2457

Abstract

Background: Gingival recession (GR) is defined as the exposure of the root surface due to the gingival margin shifting apically from the cemento-enamel junction. Current effective management of defects related to GR relies on root coverage periodontal plastic surgery (RCPPS), using the [...] Read more.

Background: Gingival recession (GR) is defined as the exposure of the root surface due to the gingival margin shifting apically from the cemento-enamel junction. Current effective management of defects related to GR relies on root coverage periodontal plastic surgery (RCPPS), using the Modified Coronally Advanced Flap (mCAF) with an envelope design. Recent literature also reported the association of different biomaterials to the mCAF procedure. In light of these considerations, a systematic review (SR) was conducted to determine and compare the efficacy of all mCAF adjunctive techniques for the treatment of multiple adjacent GR-type (MAGR) defects. Methods: An electronic search was conducted in 2025 on studies published between 2013 and 2025, using PubMed, Scopus, Web of Science, and Cinahl Complete, to address the focused question: “which is the efficacy of different mCAF adjunctive techniques for the treatment of multiple adjacent GR-type defects, in terms of root coverage (RC), esthetic outcomes, and keratinized tissue (KT) augmentation?”. Randomized controlled trials with a minimum follow-up of 6 months with ≥ 5 patients treated for coverage of MAGR were included. Risk of bias was assessed with RoB 2 Tool. A meta-analysis was performed using RevMan5.4 software and the level of evidence of included studies was analyzed with GRADEPro GDT. Results: A total of 17 studies were included in the SR, 9 of which evaluating mCAF + sCTG (subepithelial connective tissue graft) vs. mCAF adjunctive techniques [Collagen Matrix (CM), xenogeneic acellular dermal matrix (XADM), Platelet-Rich Fibrin (PRF), Enamel Matrix Derivatives (EMD), sCTG harvested double blade scalpel] were then included in the meta-analysis. The primary outcomes of complete root coverage (CRC) and keratinized tissue width variation (ΔKTW) were statistically significant ([CRC: Odds Ratio (OR) 1.70; 95% CI (confidence interval) 1.18, 2.44; p = 0.004]; [ΔKTW: SMD (standardized mean difference) 0.37; 95% CI 0.11, 0.63; p = 0.005]) in favor of mCAF + CTG. Meanwhile, no statistically significant difference was observed in terms of RES. The certainty assessment highlighted relevant results: despite the lack of evidence in the long-term, a high level of evidence showed that sCTG was more effective than XADM in terms of CRC (p = 0.002) and ΔKTW (p = 0.0001). A low level of evidence revealed that sCTG achieved a greater ΔKTW compared to CM (p = 0.0006). Although no significant differences were observed, a low level of evidence suggested that mCAF + EMD and mCAF + sCTG (DBS) may provide good results. To date, only one RCT showed long-term stable results of CTG in terms of RC. Conclusions: The association of sCTG to mCAF demonstrated better results in terms of RC and KTW augmentation in short- and medium-term follow-ups. Long-term studies are needed to confirm the efficacy of the other mCAF adjunctive techniques, considering limitations due to heterogeneity in follow-ups, distribution of techniques analyzed, and different study designs. Registration in PROSPERO (International prospective register of systematic reviews) was performed with ID CRD420251085823. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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26 pages, 2360 KB

Open AccessSystematic Review

Evaluating the Clinical Success of Clear Aligners for Rotational Tooth Movements in Adult Patients: A Systematic Review

by Giulia Benedetti, Nicolò Sicca, Gaia Lopponi, Claudia Dettori, Alessio Verdecchia and Enrico Spinas

Dent. J. 2025, 13(10), 440; https://doi.org/10.3390/dj13100440 - 24 Sep 2025

Cited by 5 | Viewed by 10910

Abstract

Objectives: Despite the widespread adoption of clear aligner therapy (CAT), its effectiveness in managing rotations remains debated. This systematic review aims to evaluate rotational accuracy in adults and the influence of treatment variables—such as attachments, interproximal reduction (IPR), and staging. Methods: Following [...] Read more.

Objectives: Despite the widespread adoption of clear aligner therapy (CAT), its effectiveness in managing rotations remains debated. This systematic review aims to evaluate rotational accuracy in adults and the influence of treatment variables—such as attachments, interproximal reduction (IPR), and staging. Methods: Following PRISMA guidelines, seven databases and two grey literature sources were searched up to July 2025. Eligible studies assessed rotational accuracy in patients treated exclusively with clear aligners, using 3D digital model superimposition. Primary outcomes included percent accuracy, lack of correction (LC), or mean absolute error (MAE). Risk of bias (RoB 2, ROBINS-I) and certainty of evidence (GRADE) were assessed. Results: Twelve studies (one RCT, eleven non-randomized) were included, showing wide heterogeneity in aligner systems, tooth types, outcome measures, and adjunctive strategies. Reported accuracy ranged from 36% to 85%, averaging around 65%. LC values varied from 0.7° to 4.5°, and mean MAE was about 2.3°. Incisors and molars showed higher predictability, whereas maxillary canines and premolars remained the least reliable. Attachments and IPR were widely used, but their effectiveness was inconsistent. Staging protocols were generally set at 2°/aligner and most studies adopted 7–14-day wear schedules. Nearly all investigations showed moderate-to-serious risk of bias, and certainty of evidence was rated low to moderate. Conclusions: CAT shows limited yet improving predictability in rotational movements, with performance strongly influenced by tooth morphology and staging. Attachments, IPR, and overcorrections may contribute but lack consistent validation. Given the low certainty and high risk of bias of current evidence, these findings should be interpreted cautiously. Well-designed RCTs with standardized protocols are required to develop reliable clinical guidelines. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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18 pages, 1593 KB

Open AccessArticle

Determinants of Severe Oral Mucositis Development Despite Photobiomodulation Therapy in Stem Cell Transplant Patients

by Sandra Bastos Rezende, Luana Campos, Maria Clara de Souza, Marcos Schoenmann, Maria Cristina Martins de Almeida Macedo, Roberto Luiz da Silva and Alyne Simões

Dent. J. 2025, 13(9), 411; https://doi.org/10.3390/dj13090411 - 8 Sep 2025

Cited by 1 | Viewed by 1542

Abstract

Background/Objectives: Oral mucositis (OM) is an extremely common and debilitating side effect in patients undergoing Hematopoietic Stem Cell Transplantation (HSCT). As such, managing this condition is an obligatory component for their supportive care. Among the available treatment options, photobiomodulation therapy has long [...] Read more.

Background/Objectives: Oral mucositis (OM) is an extremely common and debilitating side effect in patients undergoing Hematopoietic Stem Cell Transplantation (HSCT). As such, managing this condition is an obligatory component for their supportive care. Among the available treatment options, photobiomodulation therapy has long since established itself as the most promising approach, with consistent evidence supporting its efficacy. Despite this, the clinical results of this therapy are still influenced by the chosen dosimetry parameters, as well as patient-specific factors. Therefore, this study aimed to assess which factors can continue to influence the severity and onset of OM despite the protective effect provided by the ongoing photobiomodulation therapy. Methods: To achieve this, a retrospective analysis was conducted on the medical records of 171 patients who underwent PBMT during HSCT over a two-year period at the Brazilian Institute of Cancer Control. These files were used to review clinical and laboratorial parameters, such as OM grade, serum CRP, creatinine, urea, OGT, PGT, pain levels, presence of microorganisms in cultures, type of transplant, and conditioning regimens. All of these were evaluated at two different time points: the first day of conditioning and the day of highest OM degree. The statistical analysis was then conducted to evaluate the correlation between the variables and OM grade. Results: Results showed that type of conditioning regimens, use of MTX during conditioning, presence of microorganisms in cultures, and increased serum CRP, PGT, and initial urea levels were associated with severe OM. Conclusions: Among these, the type of conditioning regimens, MTX usage, positive results in cultures, and increased PGT levels on the first day of conditioning could be considered predictive for severe OM and the worst PBMT results. Consequently, in patients exposed to additional risk factors, adjustments in dosimetry paraments of PBMT or employment of adjuvant therapies should be considered to achieve better results. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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27 pages, 2300 KB

Open AccessReview

Collagen-Composite Scaffolds for Alveolar Bone and Dental Tissue Regeneration: Advances in Material Development and Clinical Applications—A Narrative Review

by Natesan Thirumalaivasan

Dent. J. 2025, 13(9), 396; https://doi.org/10.3390/dj13090396 - 29 Aug 2025

Cited by 18 | Viewed by 3975

Abstract

Background/Objectives: The use of collagen-based scaffolds in dentition tissue engineering has gained significance and importance in the field as they are structurally equivalent and biologically compatible with the native extracellular matrix (ECM). In this review, collagen-composite scaffolds for pulp, alveolar bone, and periodontal [...] Read more.

Background/Objectives: The use of collagen-based scaffolds in dentition tissue engineering has gained significance and importance in the field as they are structurally equivalent and biologically compatible with the native extracellular matrix (ECM). In this review, collagen-composite scaffolds for pulp, alveolar bone, and periodontal regeneration are analyzed in terms of materials, fabrication techniques, and clinical outcomes. Methods: Recent developments in collagen scaffolds are highlighted in this review, with a focus on type I collagen due to its structural strength and arginine–glycine–aspartic acid (RGD) motifs, which promote cell adhesion and differentiation. Composite materials, freeze-drying, electrospinning, and 3D bioprinting, which are used to improve the functionality of the scaffold, are key developments. Results: This review shows progress in collagen-based scaffolds for restoring dental tissues, such as dentin, gingival tissue, or bone, in humans. Electrospinning and 3D bioprinting are new manufacturing techniques that enhance the functionality of scaffold devices, and incorporating bioactive molecules increases the regenerative capacity; however, stability and long-term efficacy are still problems. Conclusions: Although they have a lot of potential, collagen-composite scaffolds face challenges like rapid degradation and limited mechanical strength. To make long-lasting, tailored dental regeneration therapies feasible, future research needs to improve smart biomaterials, gene delivery, and personalized designs for dental regenerative therapy. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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14 pages, 1901 KB

Open AccessArticle

Antibacterial and Antibiofilm Activity of TheraBreath™ Oral Rinses: An In Vitro Study

by Zaid A. Aboona, Laura A. Young and Joshua J. Thomson

Dent. J. 2025, 13(9), 383; https://doi.org/10.3390/dj13090383 - 24 Aug 2025

Viewed by 6083

Abstract

Background/Objectives: There are many commercial mouthrinses, used for a variety of purposes, including antiseptic activity. The objective of this study was to determine the antibacterial activity of various TheraBreath™ oral rinses against the cariogenic bacterium, Streptococcus mutans, and saliva-derived microbial communities, and [...] Read more.

Background/Objectives: There are many commercial mouthrinses, used for a variety of purposes, including antiseptic activity. The objective of this study was to determine the antibacterial activity of various TheraBreath™ oral rinses against the cariogenic bacterium, Streptococcus mutans, and saliva-derived microbial communities, and their antibiofilm activity against S. mutans in vitro biofilms. Methods: Bactericidal activity against planktonic S. mutans was assessed by colony counting after 30 and 2 min exposures to mouthrinses. Ten saliva samples were exposed to mouthrinses for 30 s and plated aerobically on blood agar and Mitis Salivarius agar. Mature biofilms of S. mutans were treated with mouthrinses for 15 min followed by fluorescent vitality staining and polysaccharide measurement, followed by crystal violet staining for measurement of total biofilm remaining. Statistical analysis was performed using Kruskal–Wallis with Dunn’s multiple comparisons test comparing all mean ranks (α = 0.05). Results: TheraBreath™ Fresh Breath, Healthy Smile, and Dry Mouth exhibited no significant antibacterial activity. TheraBreath™ Healthy Gums showed antibacterial activity against S. mutans and microbes from saliva samples similar to Listerine^® Naturals at all exposure times. Whitening Fresh Breath showed intermediate killing of S. mutans after 30 min in liquid but not after 2 min or against salivary microbes. Live/Dead fluorescence vitality staining showed that Healthy Gums and Whitening Fresh Breath had antibacterial activity against mature biofilms of S. mutans statistically similar to Listerine^® Naturals and Colgate^® Total; however, Whitening Fresh Breath did not have significant killing compared to PBS. Conclusions: TheraBreath™ Healthy Gums demonstrated similar antiseptic activity levels to other antiseptic-claiming commercial rinses. Whitening Fresh Breath was comparable but unable to kill in short exposure times. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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16 pages, 818 KB

Open AccessReview

Psychoneurobiological Aspects of Burning Mouth Syndrome and Oral Lichen Planus: A Narrative Review

by Dora Martić, Ana Glavina, Liborija Lugović-Mihić and Maja Vilibić

Medicina 2025, 61(8), 1489; https://doi.org/10.3390/medicina61081489 - 20 Aug 2025

Cited by 2 | Viewed by 2193

Abstract

Burning mouth syndrome (BMS) and oral lichen planus (OLP) are two chronic oral diseases/disorders that continue to pose a challenge for conventional diagnosis and treatment. Both diseases do not occur in isolation but rather appear to reflect a broader interplay of psychological, neurological, [...] Read more.

Burning mouth syndrome (BMS) and oral lichen planus (OLP) are two chronic oral diseases/disorders that continue to pose a challenge for conventional diagnosis and treatment. Both diseases do not occur in isolation but rather appear to reflect a broader interplay of psychological, neurological, endocrine, and immunological factors, i.e., complex disorders in interconnected biological and psychological systems. In BMS, patients often suffer from persistent burning sensations without visible lesions, which may be related to altered pain processing, emotional stress, and dysregulation in the brain regions responsible for interoception and perception. Although OLP is primarily characterised by immune-mediated mucosal damage, it often has significant psychological comorbidity, particularly in the erosive form. Common features such as cortisol imbalance, disturbed cytokine patterns, and high levels of anxiety and depression suggest that these conditions may be due to overlapping systemic disorders. It is no longer sufficient to focus only on the visible lesions or symptom relief. Understanding these diseases/disorders through a more comprehensive psychoneuroendocrine immune system (PNEI) opens up new opportunities for early intervention, improved diagnostics, and more personalised therapeutic strategies that go beyond treating symptoms. Ultimately, these diseases/disorders require a more integrated and patient-centred approach, where understanding the whole system is as important as treating its individual parts. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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26 pages, 857 KB

Open AccessReview

The Infant Oral Microbiome: Developmental Dynamics, Modulating Factors, and Implications for Oral and Systemic Health

by Paula Olate, Ailín Martínez, Eulàlia Sans-Serramitjana, Matías Cortés, Rommy Díaz, Genisley Hernández, Erwin A. Paz, Néstor Sepúlveda and John Quiñones

Int. J. Mol. Sci. 2025, 26(16), 7983; https://doi.org/10.3390/ijms26167983 - 19 Aug 2025

Cited by 4 | Viewed by 3962

Abstract

The infant oral microbiome is a complex and dynamic microbial community that undergoes various transformations during human development. From birth, these microorganisms are modulated by factors such as birth type, nutrition, oral hygiene, hormonal changes, and environmental and socioeconomic conditions. These elements interact [...] Read more.

The infant oral microbiome is a complex and dynamic microbial community that undergoes various transformations during human development. From birth, these microorganisms are modulated by factors such as birth type, nutrition, oral hygiene, hormonal changes, and environmental and socioeconomic conditions. These elements interact continuously, shaping the diversity and stability of the oral microbiome and consequently influencing the oral and general health of individuals. The main objective of this study was to review the literature on the evolution of the oral microbiome at different stages of growth, with special emphasis on the maintenance of dental homeostasis and prevention of pathologies such as caries and periodontitis. A bibliographic review of scientific databases was conducted, focusing on the last decade. In general, oral microbiome dysbiosis increases the risk of oral diseases and systemic conditions. Diet, parental practices, and horizontal transmission of bacteria from caregivers have been shown to modulate and influence the composition and functioning of the infant oral microbiome. Despite these advances, gaps remain in our understanding of the impact of the pediatric oral microbiome on long-term comprehensive health. Therefore, longitudinal research is needed to understand the development of the oral microbiome and its potential role in early prediction, prevention, and treatment of oral and systemic diseases. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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12 pages, 282 KB

Open AccessArticle

Comparison of Herbal and Potassium Nitrate Toothpastes in Managing Dentin Hypersensitivity: A Randomized Controlled Trial

by La-ongthong Vajrabhaya, Supranee Benjasupattananan, Kraisorn Sappayatosok, Papatpong Sirikururat, Suwanna Korsuwannawong and Vittawin Dechosilpa

Dent. J. 2025, 13(8), 369; https://doi.org/10.3390/dj13080369 - 15 Aug 2025

Viewed by 5838

Abstract

Background/Objectives: This study evaluates the effectiveness of a toothpaste containing Java Tea and Little Ironweed in alleviating tooth sensitivity compared to a conventional potassium nitrate toothpaste. Methods: A total of 90 healthy patients aged 18–70 with up to two teeth exhibiting [...] Read more.

Background/Objectives: This study evaluates the effectiveness of a toothpaste containing Java Tea and Little Ironweed in alleviating tooth sensitivity compared to a conventional potassium nitrate toothpaste. Methods: A total of 90 healthy patients aged 18–70 with up to two teeth exhibiting gingival recession were recruited into this study. All selected teeth had a visual analog scale (VAS) score ≥ 4 in response to tactile or air blast stimuli. Excluded teeth included those requiring restoration or participants undergoing treatments affecting sensitivity or taking pain medication/anti-sensitivity agents. Participants were randomly divided into three groups and instructed to brush twice daily with different toothpastes. The S1 group was prescribed toothpaste containing Java Tea and Little Ironweed extract, the S2 group was prescribed toothpaste containing Java Tea and Little Ironweed extract with 0.7% potassium nitrate, and the S3 group was prescribed toothpaste containing potassium nitrate. VAS scores were recorded at baseline, 2 weeks, and 4 weeks. Data were then compared and statistically analyzed between the groups. Results: For the tactile test, the final number of included teeth was 47 in the S1 group, 46 in the S2 group, and 22 in the S3 group. For the air blast test, the number of teeth included was 38 in the S1 group, 30 in the S2 group, and 27 in the S3 group. At baseline, mean VAS scores were comparable across groups for both tactile (S1: 6.89 ± 0.98; S2: 6.65 ± 1.52; S3: 6.82 ± 1.99) and air blast tests (S1: 7.39 ± 1.15; S2: 7.53 ± 1.31; S3: 6.89 ± 2.12). All groups showed significant reductions in VAS scores from baseline at both 2 and 4 weeks. A Kruskal–Wallis test indicated significant between-group differences in VAS scores at 2 and 4 weeks (p = 0.001). Post hoc analysis (Dunn’s test with Bonferroni correction) at 2 weeks revealed that the S1 group had significantly higher VAS scores than those of S2 (tactile p = 0.001, air blast p = 0.001) and S3 (tactile p = 0.002, air blast p = 0.018). By 4 weeks, the S2 group demonstrated superior efficacy, with significantly lower VAS scores compared to those of S1 (tactile p < 0.001, air blast p = 0.030) and S3 (tactile p = 0.035, air blast p = 0.001). Conclusions: All tested toothpastes effectively reduced dentin hypersensitivity over the study period. Potassium nitrate toothpaste provided more rapid initial relief, when compared to the herbal formulation alone; however, both achieved similar outcomes by 4 weeks. The herbal toothpaste supplemented with potassium nitrate demonstrated superior efficacy and may offer a promising natural alternative for managing dentin hypersensitivity. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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14 pages, 1322 KB

Open AccessSystematic Review

Neuroimaging Signatures of Temporomandibular Disorder and Burning Mouth Syndrome: A Systematic Review

by Sarah Fischer, Charalampos Tsoumpas, Pavneet Chana, Richard G. Feltbower and Vishal R. Aggarwal

Dent. J. 2025, 13(8), 340; https://doi.org/10.3390/dj13080340 - 24 Jul 2025

Viewed by 1728

Abstract

Background: Chronic primary orofacial pain (COFP) affects approximately 7% of the population and often leads to reduced quality of life. Patients frequently undergo multiple assessments and treatments across healthcare disciplines, often without a definitive diagnosis. The 2019 ICD-11 classification of chronic primary pain [...] Read more.

Background: Chronic primary orofacial pain (COFP) affects approximately 7% of the population and often leads to reduced quality of life. Patients frequently undergo multiple assessments and treatments across healthcare disciplines, often without a definitive diagnosis. The 2019 ICD-11 classification of chronic primary pain clusters together COFP subtypes based on chronicity and associated functional and emotional impairment. Objective: This study aimed to evaluate whether these subtypes of COFP share common underlying mechanisms by comparing neuroimaging findings. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Searches were performed using Medline (OVID) and Scopus up to April 2025. Inclusion criteria focused on MRI-based neuroimaging studies of participants diagnosed with COFP subtypes. Data extraction included participant demographics, imaging modality, brain regions affected, and pain assessment tools. Quality assessment used a modified Coleman methodological score. Results: Fourteen studies met the inclusion criteria, all utilising MRI and including two COFP subtypes (temporomandibular disorder and burning mouth syndrome). Resting- and task-state imaging revealed overlapping alterations in several brain regions, including the thalamus, somatosensory cortices (S1, S2), cingulate cortex, insula, prefrontal cortex, basal ganglia, medial temporal lobe, and primary motor area. These changes were consistent across both TMD and BMS populations. Conclusions: The findings suggest that chronic primary orofacial pain conditions (TMD and BMS) may share common central neuroplastic changes, supporting the hypothesis of a unified pathophysiological mechanism. This has implications for improving diagnosis and treatment strategies, potentially leading to more targeted and effective care for these patients. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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11 pages, 696 KB

Open AccessReview

Role of Brain Networks in Burning Mouth Syndrome: A Narrative Review

by Takahiko Nagamine

Dent. J. 2025, 13(7), 304; https://doi.org/10.3390/dj13070304 - 4 Jul 2025

Cited by 4 | Viewed by 2251

Abstract

Objective: Burning mouth syndrome (BMS) is a chronic and often debilitating orofacial pain condition characterized by a burning sensation in the oral mucosa without clear abnormal lesions. While its etiology is considered multifactorial, the underlying pathophysiology remains unclear. This narrative review aims [...] Read more.

Objective: Burning mouth syndrome (BMS) is a chronic and often debilitating orofacial pain condition characterized by a burning sensation in the oral mucosa without clear abnormal lesions. While its etiology is considered multifactorial, the underlying pathophysiology remains unclear. This narrative review aims to synthesize existing functional magnetic resonance imaging (fMRI) studies to shed light on the central neural mechanisms contributing to BMS. Methods: A focused electronic search was conducted across the PubMed and J-STAGE databases for relevant articles published in English from January 2000 to May 2025. The review prioritized studies investigating brain structure and function using fMRI in individuals with BMS. Results: Our synthesis of the literature consistently demonstrated that the brains of individuals with BMS exhibit augmented connectivity within the medial pain system and a diminished gray matter volume in the medial prefrontal cortex (mPFC). These findings suggest a crucial role for altered brain circuitry, particularly a reduction in the output of the basal ganglia dopamine system, in the experience of BMS pain. Conclusions: The consistent fMRI findings strongly indicate that BMS involves significant functional and structural brain alterations. The observed changes in the mPFC and its connections to the basal ganglia dopamine system highlight this pathway as a potential target for both pharmacological and non-pharmacological neurological interventions for individuals with BMS. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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11 pages, 720 KB

Open AccessArticle

Bone Stability After Immediate Implants and Alveolar Ridge Preservation: A 15-Year Retrospective Clinical Study

by Nicola De Angelis, Paolo Pesce, Catherine Yumang, Domenico Baldi and Maria Menini

Dent. J. 2025, 13(7), 299; https://doi.org/10.3390/dj13070299 - 2 Jul 2025

Cited by 1 | Viewed by 5373

Abstract

Background: In modern dentistry, alveolar socket preservation after tooth extraction plays a critical role in maintaining the alveolar ridge for future dental implants. This retrospective clinical study evaluated bone-level changes 15 years after immediate implant placement, coupled with alveolar ridge preservation. Methods: Fifty [...] Read more.

Background: In modern dentistry, alveolar socket preservation after tooth extraction plays a critical role in maintaining the alveolar ridge for future dental implants. This retrospective clinical study evaluated bone-level changes 15 years after immediate implant placement, coupled with alveolar ridge preservation. Methods: Fifty non-smoking patients aged 25 to 75 (30 males and 20 females) who underwent single-implant rehabilitation in both anterior and posterior regions of the upper and lower jaws were included. The study examined bone levels and implant survival over time, using standardized intraoral radiographs at 1, 5, and 15 years post-loading. Implants were placed immediately after atraumatic extraction, and the residual gap was grafted with bovine hydroxyapatite and covered with a collagen membrane. The primary outcome was bone-level stability, while secondary outcomes included implant failure. No temporary crowns or removable dentures were provided during healing. Radiographs were digitized for detailed analysis. Results: The results for 50 patients with immediate implant placement showed that bone-resorption levels were significantly higher in the upper jaw than in the lower jaw. Conclusions: Posterior implants exhibited greater bone loss than anterior implants, particularly at 1 year and 15 years, while no implant failures occurred. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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14 pages, 513 KB

Open AccessSystematic Review

Probiotics and Oral Complications of Antineoplastic Therapy in Head and Neck Cancer: A Systematic Review and Meta-Analysis

by Tanya Pereira-Riveros, Enric Jané-Salas, José López-López, Constanza Saka-Herran, Isabel Linares-Galiana and Teresa Vinuesa-Aumedes

Dent. J. 2025, 13(6), 254; https://doi.org/10.3390/dj13060254 - 6 Jun 2025

Cited by 4 | Viewed by 3404

Abstract

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 [...] Read more.

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

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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19 pages, 1614 KB

Open AccessArticle

The Occlusal Contact Area Is Associated with the Magnitude but Not Peak Timing of Changes in Chewing-Induced Brain Blood Flow in Mandibular Prognathism

by Hiroyuki Kanzaki, Chihiro Kariya, Kana Yoshida, Yuri Inagawa, Masao Kumazawa and Hiroshi Tomonari

Dent. J. 2025, 13(6), 250; https://doi.org/10.3390/dj13060250 - 3 Jun 2025

Viewed by 2206

Abstract

Background/Objectives: Jaw deformities affect not only facial aesthetics but also various oral functions. While previous studies have demonstrated that mandibular prognathism (MP) alters masticatory-induced brain blood flow (BBF), the temporal characteristics of these hemodynamic changes have remained unclear. In this cross-sectional observational [...] Read more.

Background/Objectives: Jaw deformities affect not only facial aesthetics but also various oral functions. While previous studies have demonstrated that mandibular prognathism (MP) alters masticatory-induced brain blood flow (BBF), the temporal characteristics of these hemodynamic changes have remained unclear. In this cross-sectional observational study, we investigated the following two specific objectives: (1) whether food hardness affects not only the magnitude but also the temporal patterns of BBF changes during mastication and (2) how malocclusion is associated with these temporal hemodynamic responses. Methods: Twenty-six participants with normal occlusion (NORM) and twenty patients with MP participated in this study. BBF was measured using functional near-infrared spectroscopy, while participants chewed soft paraffin or hard gummy candy. Maximum oxygenated hemoglobin (oxy-Hb) values and time-to-peak BBF were analyzed. Results: While food hardness did not significantly affect maximum oxy-Hb within groups, the MP group showed significantly lower responses during hard gummy candy mastication compared to the NORM group. The occlusal contact area exhibited significant positive correlation with maximum oxy-Hb values, while the ANB angle, an indicator of intermaxillary skeletal relationship, showed no significant correlation with BBF parameters. The hard gummy candy/paraffin ratio of maximum oxy-Hb was significantly higher in the NORM group compared to the MP group. Time-to-peak BBF was approximately twice as long for hard gummy candy compared to paraffin in both groups, with no significant differences between groups. Conclusions: These findings reveal that while MP attenuates the magnitude of masticatory-induced BBF, particularly during hard food mastication, the temporal adaptation to increased food hardness is preserved. This dissociation between magnitude and timing effects suggests that intact basic neurovascular coupling mechanisms would be maintained even in the condition of altered masticatory function in a MP subject, which is providing new insights for rehabilitation strategies in orthognathic surgery cases. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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10 pages, 2142 KB

Open AccessCase Report

The Benefits of a Dental Operating Microscope for Tooth Extractions: A Case Report

by Bruno Calkovsky, Ladislava Slobodnikova, Sarah Kalmanova and Maria Janickova

Dent. J. 2025, 13(6), 243; https://doi.org/10.3390/dj13060243 - 29 May 2025

Cited by 2 | Viewed by 3317

Abstract

Background/Objectives: Operating microscopes are becoming increasingly common tools in dentistry and dentoalveolar surgery due to their ability to enhance procedural precision and control. This case report aims to highlight the benefits of the operating microscope in minimizing surgical trauma and improving clinical outcomes [...] Read more.

Background/Objectives: Operating microscopes are becoming increasingly common tools in dentistry and dentoalveolar surgery due to their ability to enhance procedural precision and control. This case report aims to highlight the benefits of the operating microscope in minimizing surgical trauma and improving clinical outcomes during tooth extractions. Methods: Three clinical cases involving potentially complicated tooth extractions were treated using a dental operating microscope. The procedures were performed without flap elevation, extensive bone removal, or suturing, with the goal of reducing trauma to adjacent structures. Results: In all three cases, the use of the microscope facilitated minimally invasive extractions. The surrounding tissues were preserved, and the patients experienced uneventful healing. Clinical re-evaluation was performed several weeks postoperatively to confirm mucosal healing and absence of complications. Conclusions: The dental operating microscope allowed for precise, minimally traumatic extractions, resulting in favorable healing outcomes. Although limited, current literature and the presented cases suggest promising results and superior outcomes when incorporating a microscope into dentoalveolar surgical practice. This case report further supports the role of magnification in improving surgical precision and patient care. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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19 pages, 2166 KB

Open AccessArticle

Effectiveness of Erythritol-Based Air Polishing and Ultrasonic Instrumentation with PEEK Inserts in Peri-Implant Maintenance: A Randomized Clinical Trial Including Different Prosthetic Materials

by Carolina Maiorani, Andrea Butera, Carlos Pérez-Albacete Martínez, Maurizio Pascadopoli, Silvia Sabatini, Gianna Maria Nardi and Andrea Scribante

Dent. J. 2025, 13(6), 235; https://doi.org/10.3390/dj13060235 - 26 May 2025

Cited by 2 | Viewed by 4367

Abstract

Background: Peri-implant diseases, including mucositis and peri-implantitis, pose a challenge to implant dentistry and require effective maintenance protocols. Professional biofilm removal is essential for peri-implant health, but the optimal decontamination method remains controversial. Methods: This randomized clinical trial compared erythritol-based air polishing and [...] Read more.

Background: Peri-implant diseases, including mucositis and peri-implantitis, pose a challenge to implant dentistry and require effective maintenance protocols. Professional biofilm removal is essential for peri-implant health, but the optimal decontamination method remains controversial. Methods: This randomized clinical trial compared erythritol-based air polishing and ultrasonic instruments with PEEK (polyetheretherketone) inserts in peri-implant maintenance, also regarding the different prosthetic materials. A total of 120 patients with implant-supported feldspar ceramic, zirconia, or lithium disilicate prosthetic crowns were randomly assigned to one of the two decontamination methods. Clinical parameters, including probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI), were evaluated at baseline (T0), six months (T1), and twelve months (T2). Statistical analysis was performed using Friedman’s test for repeated measures, followed by Dunn’s post hoc test. Subgroup analysis was conducted based on the prosthetic material. Results: Both treatment modalities led to statistically significant reductions in clinical parameters over 12 months. In the erythritol group, PPD decreased by 21.62%, BOP by 86.62%, and PI by 90.74%. In the ultrasonic group, PPD decreased by 14.86%, BOP by 78.69%, and PI by 64.86% (p < 0.05 for all). No statistically significant differences were observed between groups (p > 0.05). Subgroup analysis revealed similar clinical improvements across all crown materials, suggesting that treatment efficacy was not influenced by the type of prosthetic material. Conclusions: Both erythritol-based air polishing and ultrasonic instrumentation with PEEK inserts are effective and comparable in the maintenance of peri-implant health. As treatment outcomes were independent of crown composition, the choice between modalities should be tailored to patient-specific needs and clinical conditions. Future studies with a longer follow-up are recommended to evaluate the long-term impact on peri-implant tissue stability and to explore the role of prosthetic materials more comprehensively. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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11 pages, 3234 KB

Open AccessArticle

In Situ Eradication of Mature Oral Biofilm on Titanium Implant Surfaces Using Cold Atmospheric Plasma

by Markus Jörg Altenburger, Michael Eckhard Bergmann, Loic Alain Ledernez and Georgios Romanos

Dent. J. 2025, 13(5), 210; https://doi.org/10.3390/dj13050210 - 14 May 2025

Cited by 1 | Viewed by 1506

Abstract

Objective: This study evaluated the effectiveness of a new cold atmospheric plasma device (AmbiJet) for eradicating mature oral biofilm on titanium implant surfaces, aiming to improve decontamination methods for the treatment of peri-implant infections. Material and methods: Mature oral biofilms were grown on [...] Read more.

Objective: This study evaluated the effectiveness of a new cold atmospheric plasma device (AmbiJet) for eradicating mature oral biofilm on titanium implant surfaces, aiming to improve decontamination methods for the treatment of peri-implant infections. Material and methods: Mature oral biofilms were grown on titanium disks placed in participants’ mouths. These disks were divided into control and plasma treatment groups. The AmbiJet device delivered plasma directly to the implant surface for 3 min per 20 mm², utilizing the applicator nozzle and implant as electrodes. Biofilm reduction was quantified by counting colony-forming units (CFUs). Results: Cold plasma treatment rendered approximately 90% of samples bacteria-free. A > 6-log₁₀ reduction (≈99.9999%) in bacterial load was achieved in 30% of samples, with an overall average reduction of 4.9-log₁₀ across all treated samples. The temperature during treatment remained below 40 °C. Conclusions: Within the study’s limitations, cold atmospheric plasma effectively eradicates mature oral biofilm on titanium surfaces. This high disinfection efficacy is likely due to the combined action of reactive species and electrical phenomena, which does not cause significant temperature increases. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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14 pages, 1091 KB

Open AccessArticle

Perioperative/Periprocedural Antithrombotic Management in Oral Health Procedures. A Prospective Observational Study

by María González-Zamora, Nagore Ambrosio, Raquel González, Paula Anguita, Ana Molina, David Herrera, Mariano Sanz, Francisco Marín, María Anguita-Gámez, Raquel Ferrandis, David Vivas, Manuel Anguita and Elena Figuero

Dent. J. 2025, 13(5), 196; https://doi.org/10.3390/dj13050196 - 29 Apr 2025

Cited by 2 | Viewed by 1510

Abstract

Background/Objectives: This paper evaluates the incidence of thrombotic and/or hemorrhagic adverse events within 30 days after oral health procedures (OHPs) in patients taking antithrombotic agents. Secondary objectives were to determine proper antithrombotic management and its association with adverse events. Methods: As part of [...] Read more.

Background/Objectives: This paper evaluates the incidence of thrombotic and/or hemorrhagic adverse events within 30 days after oral health procedures (OHPs) in patients taking antithrombotic agents. Secondary objectives were to determine proper antithrombotic management and its association with adverse events. Methods: As part of a multicenter multispecialty prospective observational study (ReQXAA), individuals with antithrombotic therapy and receiving at least one OHP were selected. Before OHP, participants were referred to their medical doctors to indicate the antithrombotic therapy management. Adverse events were evaluated thirty days after OHP by phone call. Proportions and odds ratios (ORs) were generated applying Fisher’s exact test, chi-square tests and multiple regression models. Results: A total of 138 patients underwent 144 OHPs. Fifteen adverse events (10.5%) were registered, among which the most frequent was slight bleeding (n = 13), which was followed by bleeding that required suspension of the antithrombotic agent (n = 1) and a myocardial infarction (n = 1). Antithrombotic management was appropriate in 122 (84.7%) cases. In 15.3% of the cases it was inappropriate, the main reason being the unnecessary interruption of the antithrombotic medication (n = 11; 50%). Inadequate management was associated with a higher incidence of adverse events (OR = 4.7; 95% confidence interval [1.3, 16.3]; p = 0.016) after adjusting for confounding factors. Conclusions: The incidence of adverse events 30 days after OHPs was low (10.5%). An inappropriate perioperative/periprocedural antithrombotic management occurred in 15.3% of the cases and was associated with a higher incidence of adverse events (OR = 4.7). Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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18 pages, 5349 KB

Open AccessTechnical Note

Innovative Approach to Computer-Aided Measurement of Unilateral Cleft Lip and Palate Models Using OnyxCeph³™

by Sarah Bühling, Cedric Thedens, Katrin Eßing, Sara Eslami, Babak Sayahpour, Nicolas Plein, Robert Sader and Stefan Kopp

Appl. Sci. 2025, 15(6), 3278; https://doi.org/10.3390/app15063278 - 17 Mar 2025

Cited by 2 | Viewed by 2017

Abstract

As advancements in digital technologies reshape the modern healthcare, integrating digital impression techniques, such as intraoral 3D scanning and 3D analysis and treatment planning, is becoming increasingly essential in the standard care of infants with cleft lip and palate. This study introduces a [...] Read more.

As advancements in digital technologies reshape the modern healthcare, integrating digital impression techniques, such as intraoral 3D scanning and 3D analysis and treatment planning, is becoming increasingly essential in the standard care of infants with cleft lip and palate. This study introduces a novel digital measurement method designed specifically for analyzing digital models of infants with unilateral cleft lip and palate, utilizing OnyxCeph³™ software within the interdisciplinary framework of the Frankfurt approach. To support its integration into routine clinical practice, we outlined the complete digital workflow—from data acquisition through intraoral 3D scanning to model preparation and processing. Our method involves precise anatomical and constructed measurement points and diverse distances and angles to evaluate sagittal, transverse, and vertical parameters comprehensively. By leveraging OnyxCeph³™ software for computer-aided measurements of digital 3D models, this approach aims to enhance the accuracy and efficiency of cleft treatment planning, facilitating more informed, personalized care decisions and ultimately improving patient outcomes. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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18 pages, 2990 KB

Open AccessSystematic Review

Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention

by Mohammad Sabeti, Natalie Black, Mohsen Ramazani, Nafiseh Zarenejaddivkolahei and Mahmood Moosazadeh

Dent. J. 2025, 13(3), 91; https://doi.org/10.3390/dj13030091 - 20 Feb 2025

Cited by 5 | Viewed by 5367

Abstract

Background/Objectives: Guided tissue regeneration (GTR) and the use of various grafting materials and platelet concentrates have emerged as promising adjunctive techniques in endodontic surgery to enhance bone regeneration and improve healing outcomes, although evidence regarding their consistent effectiveness remains inconclusive. The aim of [...] Read more.

Background/Objectives: Guided tissue regeneration (GTR) and the use of various grafting materials and platelet concentrates have emerged as promising adjunctive techniques in endodontic surgery to enhance bone regeneration and improve healing outcomes, although evidence regarding their consistent effectiveness remains inconclusive. The aim of this systematic review is to evaluate existing randomized controlled trials (RCTs) and prospective clinical trials to determine the efficacy of bone grafts, membranes, or platelet concentrates on outcomes in endodontic periapical surgery, employing a robust evidence-based approach. Methods: Searches were conducted in MEDLINE (PubMed), Embase, Cochrane Library, and gray literature databases from their inception until March 2024. Study selection and data extraction were conducted independently by two reviewers. Eligible randomized controlled trials (RCTs) and prospective clinical trials underwent critical appraisal for risk of bias and quality of evidence and were subjected to meta-analysis to determine treatment effects. Results: Twelve studies were included. The pool success rate for periapical surgery using any regenerative material (bone graft, membrane, or platelet concentrate) was 2.48 (OR: 2.48, 95% CI: 1.42–4.34). Multiple subgroup analyses based on the type of regenerative material used during treatment were performed, presenting high certainty of evidence. The subgroup analysis, which examined bone graft only, bone graft with membrane, membrane only, concentrated growth factor only, and concentrated growth factor with bone graft, yielded significant results only for concentrated growth factor with bone graft (OR: 15.01, 95% CI: 1.12–271.70). While the success rate of periapical surgery with other regenerative materials did not reach statistical significance, the effect size was substantial. Conclusions: Overall, the findings indicate that utilizing a concentrated growth factor with a bone graft significantly improves the success of bone regeneration procedures over a 12-month follow-up period compared to interventions without these components. However, more research will be needed with larger sample sizes and longer follow-up times. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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16 pages, 2668 KB

Open AccessReview

Treatments for Recurrent Aphthous Stomatitis: A Literature Review

by Maurizio D’Amario, Giordano Foffo, Filippo Grilli, Mario Capogreco, Tommaso Pizzolante and Sofia Rastelli

Dent. J. 2025, 13(2), 66; https://doi.org/10.3390/dj13020066 - 31 Jan 2025

Cited by 6 | Viewed by 20910

Abstract

Background/Objectives: This literature review aims to provide guidance on the treatment of recurrent aphthous stomatitis (RAS) based on studies published over the past 10 years. Methods: This study included randomized clinical trials involving human patients from 2013 and 2023, published in any language. [...] Read more.

Background/Objectives: This literature review aims to provide guidance on the treatment of recurrent aphthous stomatitis (RAS) based on studies published over the past 10 years. Methods: This study included randomized clinical trials involving human patients from 2013 and 2023, published in any language. The trials examined both pharmacological and non-pharmacological treatments for aphthous lesions, mainly focusing on the adult population, with pain management as the primary outcome. The research was conducted using PubMed, EMBASE, and CINHAL databases. Results: Most of the 45 analyzed studies focused on non-pharmacological therapies, which led to positive results with minimal adverse effects or contraindications, even when compared to cortisone-based treatments. Laser therapy also showed excellent results, particularly in the immediate post-treatment period. Non-pharmacological therapies appeared to offer the best risk–benefit ratio for patients suffering from RAS. Conclusions: Treatment should be individualized based on the patient’s specific form of RAS, and laser therapy can be used either as a standalone treatment or as an adjunct to other treatments considered in the review. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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14 pages, 793 KB

Open AccessArticle

A Survey of Physicians’ Knowledge and Practices Towards Oral Appliance Therapy for Obstructive Sleep Apnea Treatment

by Chaniporn Ananwattananon, Supatchai Boonpratham, Yodhathai Satravaha, Chaiyapol Chaweewannakorn and Supakit Peanchitlertkajorn

Dent. J. 2025, 13(2), 63; https://doi.org/10.3390/dj13020063 - 30 Jan 2025

Cited by 1 | Viewed by 2170

Abstract

Background: Oral appliance therapy (OAT) is an effective treatment alternative for obstructive sleep apnea (OSA). Understanding physicians’ knowledge and practices regarding OAT is crucial for improving OSA treatment, particularly in Southeast Asia, where there is limited research on this topic. Objectives: This study [...] Read more.

Background: Oral appliance therapy (OAT) is an effective treatment alternative for obstructive sleep apnea (OSA). Understanding physicians’ knowledge and practices regarding OAT is crucial for improving OSA treatment, particularly in Southeast Asia, where there is limited research on this topic. Objectives: This study sought to survey physicians’ knowledge and practices regarding OAT for OSA treatment. Methods: A descriptive cross-sectional survey was conducted among Thai physicians attending the annual Sleep Society of Thailand meeting. The questionnaire included questions on demographics (six items), educational background (four items), OAT knowledge (two items), indications (three items), effectiveness (seven items), referral practices (five items), treatment planning (eight items), and the importance of OAT education (one item). Descriptive and comparative analyses were performed using SPSS to assess differences in knowledge and referral practices across various demographics. Results: This study achieved a response rate of 51.7% (30/58), with the respondents averaging 37.8 ± 6.0 years in age and 13.7 ± 6.7 years in practice. Although over 66.7% of the respondents recognized OAT’s effectiveness and understood its indications, only 36.7% regularly prescribed OAT, and 57.7% referred patients to specific dentists. Knowledge and referral practices differed significantly based on years of practice and postgraduate training in sleep medicine. Physicians with 11–20 years of practice demonstrated higher pediatric OAT knowledge scores compared to those with less experience. Those with postgraduate training achieved higher adult OAT knowledge scores and had greater referral experience. Conclusions: Despite the general awareness and good knowledge of OAT among physicians, clinical use and referral rates remain low. To bridge the gap between knowledge and practice, it is recommended that postgraduate training in dental sleep medicine is promoted and further research is conducted to identify barriers to the adoption of OAT. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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36 pages, 3188 KB

Open AccessSystematic Review

The Early Exposure Rate and Vertical Bone Gain of Titanium Mesh for Maxillary Bone Regeneration: A Systematic Review and Meta-Analysis

by Felice Lorusso, Sergio Alexandre Gehrke, Iris Alla, Sergio Rexhep Tari and Antonio Scarano

Dent. J. 2025, 13(2), 52; https://doi.org/10.3390/dj13020052 - 23 Jan 2025

Cited by 5 | Viewed by 6170

Abstract

Background/Objectives: The use of titanium meshes in bone regeneration is a clinical procedure that regenerates bone defects by ensuring graft stability and biocompatibility. The aim of the present investigation was to evaluate the clinical effectiveness of titanium mesh procedures in terms of vertical [...] Read more.

Background/Objectives: The use of titanium meshes in bone regeneration is a clinical procedure that regenerates bone defects by ensuring graft stability and biocompatibility. The aim of the present investigation was to evaluate the clinical effectiveness of titanium mesh procedures in terms of vertical bone gain and the exposure rate. Methods: The product screening and eligibility analysis were performed using the Pubmed/MEDLINE, EMBASE, and Google Scholar electronic databases by two authors. The selected articles were classified based on the study design, regenerative technique, tested groups and materials, sample size, clinical findings, and follow-up. A risk of bias calculation was conducted on the selected randomized controlled trials (RCTs) and non-randomized trials and a series of pairwise meta-analysis calculations were performed for the vertical bone gain (VBG) and exposure rate. A significantly lower exposure rate was observed using coronally advanced lingual flaps (p < 0.05). No difference was observed between the titanium mesh and GBR techniques in terms of VBG (p > 0.05). Results: The initial search output 288 articles, and 164 papers were excluded after the eligibility analysis. The descriptive synthesis considered a total of 97 papers and 6 articles were considered for the pairwise comparison. Conclusions: Within the limits of the present investigation, the titanium mesh procedure reported high VBG values after the healing period. The mesh exposure rate was drastically lower with passive management of the surgical flap. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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12 pages, 894 KB

Open AccessArticle

Analysis of the Relationship Between Body Mass Index (BMI) and Dento-Skeletal Maturation: A Cross-Sectional Case-Control Study

by Alessio Verdecchia, Inmaculada Coronado de la Torre, Ivan Menéndez Diaz, Veronica García Sanz, Yolanda García Mesa, Teresa Cobo and Vanessa Paredes Gallardo

Dent. J. 2025, 13(1), 8; https://doi.org/10.3390/dj13010008 - 26 Dec 2024

Cited by 3 | Viewed by 8408

Abstract

Background/Objectives: The aim of this cross-sectional study was to establish if there is a relationship between body mass index (BMI) and skeletodental development in young obese patients in comparison with normal-weight patients. Methods: The sample consisted of 178 individuals (115 normal weight, 37 [...] Read more.

Background/Objectives: The aim of this cross-sectional study was to establish if there is a relationship between body mass index (BMI) and skeletodental development in young obese patients in comparison with normal-weight patients. Methods: The sample consisted of 178 individuals (115 normal weight, 37 overweight and 26 obese), aged 6 to 16 years, with a mean biological age of 11.96 ± 2.44 years. Dental maturation (dental age) was determined by using Demerjian’s method; craniofacial growth pattern, skeletal and dental class were determined by using cephalometric measurements; skeletal maturation was determined by using Baccetti’s method. Data were statistically analyzed. Results: According to Demirjian’s method, the mean dental age of the overweight and obese subjects was significantly higher than that of the normal-weight subjects (p = 0.001 and p = 0.02, respectively). A higher rate of dental class III was detected in the overweight group (p = 0.002). Concerning cephalometric records, statistically significant differences (p = 0.018) were observed in the distribution of SNA and SNB values, higher values being found in obese subjects. No difference was detected in the distribution of the ANB angle between the groups. As regards craniofacial growth pattern, no significant differences were found between the groups. Children with obesity presented more advanced skeletal maturation, reaching statistically significant differences (p = 0.02), in comparison with the normal-weight subjects. Conclusions: In conclusion, obese children showed increased tooth and skeletal development in comparison to the normal-weight subjects. These findings may be of interest for orthodontists, who should consider weight status when performing orthodontic treatment in children and adolescents. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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12 pages, 258 KB

Open AccessArticle

Nutritional Status, Frailty, Oral Health, and Oral Motor Functions in Long-Term Care Residents with Swallowing Dysfunction

by Chih-Hung Ko, Chia-Ling Chao, Chih-Hsing Hung, Je-Kang Du and Ming-Chu Feng

J. Clin. Med. 2025, 14(1), 62; https://doi.org/10.3390/jcm14010062 - 26 Dec 2024

Cited by 6 | Viewed by 3298

Abstract

Background: Swallowing dysfunction is a prevalent but often overlooked problem in long-term care facilities. This study investigated the relationships between nutritional deficits, frailty, oral health, and swallowing dysfunction. Additionally, we explored the associations between oral muscle weakness, frailty markers, and swallowing dysfunction. [...] Read more.

Background: Swallowing dysfunction is a prevalent but often overlooked problem in long-term care facilities. This study investigated the relationships between nutritional deficits, frailty, oral health, and swallowing dysfunction. Additionally, we explored the associations between oral muscle weakness, frailty markers, and swallowing dysfunction. Methods: We recruited 373 participants from seven long-term care facilities across Taiwan. Swallowing function, frailty, nutrition status, and oral health were assessed by research staff. Oral muscle function was evaluated through tongue strength measurements, cheek bulging function tests, the Repetitive Saliva Swallowing Test (RSST), and a diadochokinetic task. Frailty was assessed through grip strength as well as mid-upper arm and calf circumference measurements. Results: The Functional Oral Intake Scale revealed that 97 participants (26%) had swallowing dysfunction. Participants with swallowing dysfunction had poorer nutritional status, higher frailty levels, and worsened oral health. Frailty was the factor most strongly associated with swallowing dysfunction. Participants with swallowing dysfunction also exhibited lower tongue pressure, decreased cheek-bulging ability, fewer repetitions in the diadochokinetic task, lower scores on the RSST, lower calf circumferences, and lower grip strength. Logistic regression demonstrated that cheek bulging was most strongly associated with swallowing dysfunction. Furthermore, lower grip strength was significantly associated with swallowing dysfunction. Conclusions: Frailty was most strongly associated with swallowing dysfunction, followed by poorer nutritional status and worsened oral health. These factors should be thoroughly assessed in long-term care residents. Participants with swallowing dysfunction also experienced oral muscle weakness, particularly in cheek bulging. Grip strength, which represents frailty, was directly associated with swallowing dysfunction and could serve as a crucial indicator of swallowing dysfunction. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

20 pages, 5171 KB

Open AccessCase Report

Sporadic Burkitt Lymphoma First Presenting as Painful Gingival Swellings and Tooth Hypermobility: A Life-Saving Referral

by Erofili Papadopoulou, Maria Kouri, Dimitrios Velonis, Anastasia Andreou, Maria Georgaki, Spyridon Damaskos, Evangelia Piperi, Konstantina Delli, Ioannis K. Karoussis, Antonia Vlachou, Georgia Avgerinou, Antonis Kattamis and Nikolaos G. Nikitakis

Dent. J. 2025, 13(1), 6; https://doi.org/10.3390/dj13010006 - 25 Dec 2024

Cited by 2 | Viewed by 3453

Abstract

Background: Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma (NHL), subdivided into endemic, sporadic, and immunodeficiency-associated forms. While jaw lesions are common in endemic BL, they are infrequent in sporadic cases, only rarely constituting the first manifestation of the disease. The aim of [...] Read more.

Background: Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma (NHL), subdivided into endemic, sporadic, and immunodeficiency-associated forms. While jaw lesions are common in endemic BL, they are infrequent in sporadic cases, only rarely constituting the first manifestation of the disease. The aim of this study is to present a rare pediatric case of sporadic BL first manifesting as gingival swellings and tooth hypermobility and provide a review of all the published sporadic BL case reports as the first sign of disease. Case report: An 11-year-old Caucasian female was referred for the evaluation of hypermobility of posterior lower teeth, associated with painful gingival swellings of 20 days duration. Clinical examination revealed right facial asymmetry and bilateral prominent swellings of the posterior lower gingiva. A panoramic radiograph revealed ill-defined radiolucent lesions in the posterior mandible bilaterally. On computed tomography, soft-tissue masses were identified along the mandibular ramus extending into the maxillary sinus bilaterally. The histopathologic and immunohistochemical analyses of the lesions led to a diagnosis of Burkitt lymphoma (BL). The patient underwent a full staging work-up, revealing bone marrow involvement and widespread disease. A multi-chemotherapy regimen was initiated with the regression of oral lesions and symptoms within a few weeks and complete disease remission after nine chemotherapy cycles. The patient remains free of disease 11 years later. Conclusions: This case underscores the critical importance of the timely diagnosis and life-saving referral of rapidly growing jaw lesions, which may represent the first sign of an underlying lymphoreticular malignancy with aggressive course, such as BL. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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17 pages, 6362 KB

Open AccessCase Report

Challenges in Differential Diagnosis of Diffuse Gingival Enlargement: Report of Two Representative Cases and Literature Review

by Erofili Papadopoulou, Maria Kouri, Anastasia Andreou, Smaragda Diamanti, Maria Georgaki, Konstantinos Katoumas, Spyridon Damaskos, Emmanouil Vardas, Evangelia Piperi and Nikolaos G. Nikitakis

Dent. J. 2024, 12(12), 403; https://doi.org/10.3390/dj12120403 - 10 Dec 2024

Cited by 4 | Viewed by 10822

Abstract

Background/Objectives: The etiology of diffuse gingival enlargement is multifactorial, and the definitive diagnosis may be challenging. To highlight the nuances of the differential diagnosis, we present two cases of generalized gingival overgrowth and discuss the diagnostic dilemmas. Case description: In the first case, [...] Read more.

Background/Objectives: The etiology of diffuse gingival enlargement is multifactorial, and the definitive diagnosis may be challenging. To highlight the nuances of the differential diagnosis, we present two cases of generalized gingival overgrowth and discuss the diagnostic dilemmas. Case description: In the first case, an 82-year-old male with a medical history of hypertension and prostatitis had a chief complaint of symptomatic oral lesions of a 20-day duration, accompanied by fever and loss of appetite. The clinical examination revealed diffusely enlarged, hemorrhagic, and focally ulcerative upper and lower gingiva, ecchymoses on the buccal mucosa, as well as bilateral cervical lymphadenitis. The histopathologic and immunohistochemical findings combined with the hematologic examination led to a final diagnosis of acute myeloid leukemia, and the patient was referred to a specialized hematology/oncology unit for further management. The second case was a 74-year-old female with a medical history of breast cancer (successfully managed in the past), type II diabetes mellitus, and cardiovascular disease, taking various medications. An intraoral examination revealed diffusely enlarged, erythematous, and hemorrhagic upper and lower gingiva. An incisional biopsy showed hyperplastic granulation and fibrous connective tissue with a predominantly chronic inflammatory infiltrate. Considering the patient’s medical history and current medications, the clinical and microscopic findings were in support of the diagnosis of drug-induced gingival overgrowth associated with calcium channel blocker (amlodipine), partially controlled diabetes serving as an additional predisposing factor. Gingivectomy and periodontal scaling, along with substitution of the offending medication, were curative, and better diabetic control was recommended. Conclusions: Diffuse gingival overgrowth may be caused by a variety of diverse conditions, ranging from an exuberant response to local factors, potentially exacerbated by hormonal influences (e.g., puberty or pregnancy), to drug side effects to genetic, systemic, or even neoplastic diseases. A careful evaluation of the medical and drug history and clinicopathologic correlation is essential for accurate diagnosis and appropriate management. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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15 pages, 1638 KB

Open AccessSystematic Review

Effectiveness and Personalized Approaches in the Correction of Gummy Smile: A Systematic Review of Orthodontic and Surgical Treatments

by Alessio Danilo Inchingolo, Angelo Michele Inchingolo, Fabio Viapiano, Anna Netti, Anna Maria Ciocia, Irene Ferrara, Antonio Mancini, Andrea Palermo, Francesco Inchingolo and Gianna Dipalma

J. Clin. Med. 2024, 13(22), 6843; https://doi.org/10.3390/jcm13226843 - 14 Nov 2024

Cited by 4 | Viewed by 7409

Abstract

Background/Objectives: This systematic review seeks to assess the effectiveness of different orthodontic and combined orthodontic–surgical approaches for correcting gummy smile, with a focus on treatment efficacy, duration, and the potential for integrating various techniques. The objective is to offer evidence-based recommendations for the [...] Read more.

Background/Objectives: This systematic review seeks to assess the effectiveness of different orthodontic and combined orthodontic–surgical approaches for correcting gummy smile, with a focus on treatment efficacy, duration, and the potential for integrating various techniques. The objective is to offer evidence-based recommendations for the optimal management of gummy smile. Methods: A thorough search of the literature was conducted in the PubMed, Cochrane Library, Scopus, and Web of Science databases, covering publications from 1 January 1982 to 4 November 2024. Only randomized controlled trials involving adult human subjects with available full-text articles were included, while systematic reviews, editorials, case reports, and studies involving animals or in vitro experiments were excluded. Studies were selected based on their relevance to orthodontic or combined orthodontic–surgical treatments for correcting excessive gingival display (gummy smile), particularly in cases where residual growth does not impact treatment outcomes. The primary focus was on evaluating the efficacy of these interventions in improving smile aesthetics. Follow-up data were considered when available, though not required for inclusion. Results: The findings revealed that both orthodontic and surgical methods are effective in reducing gingival display. Orthognathic surgery offers lasting outcomes, particularly for patients with vertical maxillary excess, whereas orthodontic treatments, including the use of skeletal anchorage devices, are particularly effective for less severe cases. Minimally invasive approaches, such as botulinum toxin injections, provided temporary but promising results for patients reluctant to undergo surgery. Conclusions: Orthodontic and surgical techniques are viable options for treating gummy smile, with treatment choices depending on the condition’s severity. Future research, particularly long-term randomized studies, is required to further refine treatment protocols and improve patient outcomes. Full article

(This article belongs to the Topic Oral Health Management and Disease Treatment)

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