Dentistry Journal

22 pages, 3399 KB

Open AccessArticle

Challenges of Future Patient Recruitment: A Cross-Sectional Study in Conservative Dentistry Teaching

by Marco M. Herz, Michael Scharl, Diana Wolff and Valentin Bartha

Dent. J. 2025, 13(11), 495; https://doi.org/10.3390/dj13110495 (registering DOI) - 25 Oct 2025

Background: Direct clinical training on real patients is essential in dental education. However, the declining patient inflow increasingly challenges this objective. This cross-sectional study aimed to assess patients’ experiences and preferences to derive recommendations for improving patient recruitment. Material and Methods: Over a [...] Read more.

Background: Direct clinical training on real patients is essential in dental education. However, the declining patient inflow increasingly challenges this objective. This cross-sectional study aimed to assess patients’ experiences and preferences to derive recommendations for improving patient recruitment. Material and Methods: Over a period of one year, patients treated by students in the courses and final examinations at the dental school of conservative dentistry were questioned using a specially designed questionnaire and reviewed using their medical records. They were asked about their complete treatment process, and patient files were used to record socio-demographic as well as economic and appointment-specific data. Results: We analysed 297 patients (142 women, 47.8%; 155 men, 52.2%) treated by undergraduates across two semesters (four courses) and two final examinations. Median age was 57.0 years (IQR 46–67; mean 55.2, SD 15.2; range 14–85) with no sex-based difference (p > 0.05). Arrival was predominantly by car (72.7%, n = 216); median one-way distance was 20.5 km (IQR 11.2–32.1); and 58.4% were employed, while 41.6% were not employed (33.7% retired, 7.9% unemployed). The leading reason for course attendance was “satisfaction with previous treatments” (65.32%). Information sources were reported by 290/297 (98%); the most common was already being a course patient (143, 48.1%). Most patients attended one appointment (109, 36.7%). Median travel cost per appointment (including parking) was €17.0 (typically €10.0–€23.5). Of 285 respondents, 93.68% answered “Yes” to satisfaction with student treatment. Conclusions: Important steps include enhancing parking facilities, optimizing recall systems and appointment accessibility, and strengthening relationships with regular patients to encourage word-of-mouth referrals. The main focus is to maintain high clinical quality, ensure affordability, and further reduce patient copayments where possible. Full article

(This article belongs to the Special Issue Dental Education: Innovation and Challenge)

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19 pages, 6997 KB

Open AccessArticle

Bone Morphogenetic Protein 7 Promotes the Differentiation of Periodontal Ligament Fibroblasts into F-Spondin-Expressing Cementoblast-like Cells During Root Canal Treatment—An In Vivo Rat Pulpectomy Model and In Vitro Human Fibroblast Study

by Hiroki Iwasawa, Yoshihiko Akashi, Kei Nakajima, Katsutoshi Kokubun, Masahiro Furusawa and Kenichi Matsuzaka

Dent. J. 2025, 13(11), 494; https://doi.org/10.3390/dj13110494 (registering DOI) - 25 Oct 2025

Abstract

Background/Objectives: The optimal healing process following root canal treatment involves biological apical sealing through new cementum formation. Bone morphogenetic protein 7 (BMP-7) has recently gained attention as a potential regulator of cementoblast differentiation and periodontal regeneration. However, its effects on periodontal ligament fibroblasts [...] Read more.

Background/Objectives: The optimal healing process following root canal treatment involves biological apical sealing through new cementum formation. Bone morphogenetic protein 7 (BMP-7) has recently gained attention as a potential regulator of cementoblast differentiation and periodontal regeneration. However, its effects on periodontal ligament fibroblasts (PDLFs) and the underlying mechanisms remain incompletely understood. This study aimed to investigate whether BMP-7 induces cementoblast-like differentiation of PDLFs both in vivo and in vitro via the BMP-SMAD signaling pathway. Methods: In a rat pulpectomy model, root canals were treated with or without BMP-7 and examined histologically and immunohistochemically for F-spondin (Spon1) expression. In vitro, human PDLFs were stimulated with BMP-7, and analyses of mineralization, cementoblast marker expression, alkaline phosphatase activity, and SMAD-1/5/9 phosphorylation were conducted. Results: Immunohistochemical analysis revealed that Spon1-positive regions increased around the apical area following BMP-7 treatment, suggesting the induction of cementoblast-like differentiation. In vitro, BMP-7 enhanced the expression of cementoblast-associated genes and mineral deposition while activating SMAD-1/5/9 signaling. Phosphorylation was suppressed by the BMP receptor inhibitor LDN-193189, indicating canonical BMP-SMAD pathway involvement. Conclusions: Although the specific concentration range of maximal activity remains to be determined, the findings collectively suggest that BMP-7 can promote cementoblast-like differentiation of PDLFs and may contribute to apical healing through cementum-related mechanisms. These results provide mechanistic and biological insights that support the potential of BMP-7 as a modulator for biologically favorable periapical tissue regeneration following root canal therapy. Full article

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16 pages, 1118 KB

Open AccessArticle

Association of Herpes Virus Type 1, Cytomegalo Virus and Epstein–Barr Virus to the Pathogenesis of Peri-Implantitis: A Cross-Sectional Study

by Ioana Suciu, Simona Ruta and George Suciu

Dent. J. 2025, 13(11), 492; https://doi.org/10.3390/dj13110492 (registering DOI) - 25 Oct 2025

Abstract

Background/Objectives: This study explores the potential relationship between herpesvirus infections and the severity and progression of peri-implantitis. A secondary goal is to investigate whether a virus–bacteria interaction may contribute to differences in bone loss patterns between periodontitis and peri-implantitis. Methods: Biological [...] Read more.

Background/Objectives: This study explores the potential relationship between herpesvirus infections and the severity and progression of peri-implantitis. A secondary goal is to investigate whether a virus–bacteria interaction may contribute to differences in bone loss patterns between periodontitis and peri-implantitis. Methods: Biological samples, including blood, saliva, and peri-implant crevicular fluid, were collected for viral detection. Blood samples were processed at Queen Mary Laboratory in Bucharest, Romania, while saliva and peri-implant crevicular fluid samples were analyzed at the laboratory of ADD Laboral in Malden, the Netherlands. Sterile paper points were used to collect peri-implant crevicular fluid from the deepest peri-implant sites in 43 patients. A nearby tooth was sampled when present, with edentulous patients being the exception. Several clinical parameters were also considered, including implant and dentition status, smoking, gender, implant location, duration of functional loading, periodontal pocket depth (PPD), bleeding on probing (BoP), suppuration (SUP), and periodontal history. Results: Epstein–Barr virus (EBV) was detected in 30.2% of cases, Herpes virus (HSV) in 7.0%, and Cytomegalo virus (CMV) in 0%. EBV showed a moderate inverse correlation with probing depth (r = −0.48) in non-smokers with periodontal disease. Viral detection was highest on lingual and mesial surfaces. Peri-implantitis cases exhibited significantly deeper PPD, higher BoP (96.15%), and suppuration (96.15%) compared to healthy implants or teeth. Conclusions: An association was observed between the presence of Herpes viruses and increased peri-implantitis severity, suggesting a potential contributory role of viral pathogens in disease progression. Full article

(This article belongs to the Section Dental Implantology)

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15 pages, 770 KB

Open AccessArticle

Effect of Remineralization Products on the Microtensile Strength of Universal Dentin Bonding Systems

by Andra Claudia Tărăboanță-Gamen, Cristian Marius Toma, Vasilica Toma, Ionuț Tărăboanță, Simona Stoleriu, Veronica Serban Pintiliciuc and Sorin Andrian

Dent. J. 2025, 13(11), 493; https://doi.org/10.3390/dj13110493 (registering DOI) - 24 Oct 2025

Abstract

Background/Objectives: Adhesion to caries-affected dentin remains challenging due to its altered structure and composition. Remineralizing agents have been proposed to strengthen this substrate and improve bonding. This study evaluated the effect of three remineralization treatments, CPP-ACP, self-assembling peptide P11-4, and silver diamine [...] Read more.

Background/Objectives: Adhesion to caries-affected dentin remains challenging due to its altered structure and composition. Remineralizing agents have been proposed to strengthen this substrate and improve bonding. This study evaluated the effect of three remineralization treatments, CPP-ACP, self-assembling peptide P11-4, and silver diamine fluoride (SDF), on the microtensile bond strength (μTBS) of universal adhesive systems applied to caries-affected dentin, using both etch-and-rinse and self-etch strategies. Methods: Seventy human molars were sectioned and artificially demineralized to simulate caries-affected dentin. Samples were divided into ten groups: four untreated and six treated with CPP-ACP (MI Paste™), P11-4 (Curodont™ Protect), or SDF (Riva Star™). Universal adhesives were applied via etch-and-rinse or self-etch mode, followed by composite restoration. Microtensile bond strength was measured using a universal testing machine, and results were statistically analyzed with ANOVA and t-tests (p < 0.05). Results: Untreated caries-affected dentin showed significantly lower μTBS than sound dentin (C3: 18.3 ± 5.4 MPa vs. C1: 41.3 ± 2.7 MPa). Remineralization agents improved μTBS considerably. CPP-ACP achieved the highest recovery (S1: 31.8 ± 2.6 MPa; S2: 29.2 ± 4.6 MPa), nearing sound dentin levels. P11-4 yielded moderate gains (S3: 24.4 ± 6.5 MPa; S4: 24.1 ± 4.7 MPa), while SDF provided the lowest, yet significant, improvements (S5: 23.7 ± 7.5 MPa; S6: 21.3 ± 5.3 MPa). Etch-and-rinse generally produced higher μTBS than self-etch, but differences were not statistically significant (p > 0.05). Conclusions: Pre-treatment of caries-affected dentin with CPP-ACP, P11-4, or SDF enhances universal adhesive bond strength, with CPP-ACP showing the most pronounced effect. Remineralization protocols represent a valuable adjunct in restorative procedures involving compromised dentin. Full article

(This article belongs to the Section Dental Materials)

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13 pages, 2709 KB

Open AccessSystematic Review

Hemophilic Pseudotumor of the Maxilla Secondary to Endodontic Treatment: Case Report and Systematic Review

by Jose Rodolfo Quiroz-Gomez, Carlos Manuel Roa-Encarnación, Ana Graciela Puebla-Mora, Antonio Hernández-Morales, Miguel Padilla-Rosas and Mario Nava-Villalba

Dent. J. 2025, 13(11), 491; https://doi.org/10.3390/dj13110491 - 23 Oct 2025

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Abstract

Hemophilic pseudotumor (HP) is a rare but severe complication of hemophilia, characterized by progressive bleeding in the muscles, joints, and bone tissue, which can lead to lytic lesions. Its prevalence is approximately 1–2% among patients with hemophilia. This report presents a male patient [...] Read more.

Hemophilic pseudotumor (HP) is a rare but severe complication of hemophilia, characterized by progressive bleeding in the muscles, joints, and bone tissue, which can lead to lytic lesions. Its prevalence is approximately 1–2% among patients with hemophilia. This report presents a male patient with mild hemophilia A who developed an intraosseous lesion in the posterior region of the right maxilla, with a prior history of endodontic treatment in the area. Surgical excision was performed and, following clinicopathological correlation, the lesion was diagnosed as HP. Background/Objectives: This review aims to identify previously reported cases of HP located in the maxilla. Methods: The study protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The databases PubMed, Scopus, and ScienceDirect were searched, and Google Scholar was used to identify gray literature. The Joanna Briggs Institute (JBI) tool was employed to assess the risk of bias and the quality of the included reports and case series. Results: A total of 1487 publications were identified using specific keywords. After removing duplicates and non-relevant titles/abstracts, 42 full-text articles were reviewed. Of these, 10 met the inclusion criteria: 7 case reports and 3 case series, comprising 13 cases of HP in the maxilla, including the case presented here. Although rare in the maxillofacial region, when it does occur, it is more commonly seen in the mandible and is often linked to prior trauma. In this case, endodontic treatment may have triggered lesion development. Conclusions: This report highlights that, although uncommon, HP can manifest with involvement of the maxilla, and that specific dental interventions may represent potential triggering events. Full article

(This article belongs to the Section Oral and Maxillofacial Surgery)

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22 pages, 698 KB

Open AccessReview

Oral Health Impact Profile (OHIP) as a Tool for the Assessment of the Oral Health-Related Quality of Life—A Scoping Review

by Łukasz Wojszko, Karolina Banaszek, Oliwia Gagacka and Joanna Bagińska

Dent. J. 2025, 13(11), 490; https://doi.org/10.3390/dj13110490 - 23 Oct 2025

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Abstract

Background/Objectives: The Oral Health Impact Profile (OHIP) is the most widely used tool for OHRQoL assessment. The measure has several versions, but there is no comprehensive summary of available Oral Health Impact Profile variants. The purpose of this scoping review is to [...] Read more.

Background/Objectives: The Oral Health Impact Profile (OHIP) is the most widely used tool for OHRQoL assessment. The measure has several versions, but there is no comprehensive summary of available Oral Health Impact Profile variants. The purpose of this scoping review is to identify and summarize Oral Health Impact Profile versions for the adult population available in the literature. Methods: PubMed, Scopus, and Web of Science databases were searched on 25–28 May 2025 to find papers presenting the Oral Health Impact Profile versions’ development process. Records written in English without any time restrictions were included. The Joanna Briggs Institute framework for scoping reviews was applied. The PRISMA-ScR approach was followed. Results: In total, 11 generic OHIP scales (the OHIP version that was not targeted at any specific condition) and 16 condition-specified OHIP scales were found. The analysis revealed a wide variety of number of items (from 49 to 5), recall period (from one year to one week), rating scale (4-0; 5-0; 5-1; 6-1; 1, 0, and −1), dimensionality of scale (7, 4, or 3 dimensions, 2–6 factors, or unidimensional), and validation process. Conclusions: Differences in OHIP features have to be taken into account during a comparison of results from different studies. Due to the availability of various tools, the idea of creating new versions of the OHIP should be considered with caution. Researchers should carefully select the appropriate OHIP version for their purposes, as the process of adapting the tool to a new language and culture is time-consuming and expensive. Full article

(This article belongs to the Special Issue Oral Health-Related Quality of Life and Its Determinants)

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21 pages, 2365 KB

Open AccessSystematic Review

Artificial Intelligence in Endodontic Education: A Systematic Review with Frequentist and Bayesian Meta-Analysis of Student-Based Evidence

by Carlos M. Ardila, Eliana Pineda-Vélez and Anny M. Vivares-Builes

Dent. J. 2025, 13(11), 489; https://doi.org/10.3390/dj13110489 - 23 Oct 2025

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Abstract

Background/Objectives: Artificial intelligence (AI) is entering dental curricula, yet its educational value in endodontics remains unclear. This review synthesized student-based evidence on AI in endodontics, primarily comparing AI vs. students on diagnostic tasks as an educational endpoint and secondarily considering assessment tasks relevant [...] Read more.

Background/Objectives: Artificial intelligence (AI) is entering dental curricula, yet its educational value in endodontics remains unclear. This review synthesized student-based evidence on AI in endodontics, primarily comparing AI vs. students on diagnostic tasks as an educational endpoint and secondarily considering assessment tasks relevant to training. Methods: PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched in July 2025. Eligible studies involved dental students using AI in endodontic tasks or applied AI to student-generated outputs. For diagnostic comparisons we performed random-effects meta-analysis and a complementary Bayesian random-effects model with weakly informative priors. Risk of bias used QUADAS-2; certainty used GRADE. Results: Five studies met inclusion. Two provided complete mean–SD data for the primary meta-analysis and one contributed to a sensitivity model after SD imputation; two were summarized narratively (AUC/F1 only). Pooled effects favored AI: Hedges g = 1.48 (95% CI 0.60–2.36; I² ≈ 84%); sensitivity (k = 3) g = 1.45 (95% CI 0.77–2.14; I² ≈ 77%). Across the two LLM studies with analyzable means/SDs, the pooled mean difference in accuracy was approximately +20 percentage points (AI − students). Bayesian analyses yielded posterior means near 1.5 with 95% credible intervals excluding 0 and P (μ > 0) ≈ 1.00. Educational outcomes were sparsely and non-standardly reported. Conclusions: Student-based evidence indicates that AI likely outperforms dental students on endodontic diagnostic tasks, supporting its use as an adjunct for formative tutoring, objective feedback, and more consistent assessment. Full article

(This article belongs to the Special Issue Dental Education: Innovation and Challenge)

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14 pages, 850 KB

Open AccessArticle

Retrospective Assessment of Palatal Biofilm and Mucosal Inflammation Under Orthodontic Appliances in Young Adults (2022–2025): A Single-Center Cohort with Microbiologic Sub-Sampling

by Bianca Dragos, Dana-Cristina Bratu, George Popa, Magda-Mihaela Luca, Remus-Christian Bratu, Carina Neagu and Cosmin Sinescu

Dent. J. 2025, 13(11), 488; https://doi.org/10.3390/dj13110488 - 23 Oct 2025

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Abstract

Background and Objectives: Orthodontic auxiliaries create plaque-retentive niches that may amplify biofilm accumulation and inflame adjacent soft tissues. While cross-sectional comparisons suggest higher palatal burden beneath acrylic elements, less is known about real-world patterns accumulated across years of routine care. We retrospectively evaluated [...] Read more.

Background and Objectives: Orthodontic auxiliaries create plaque-retentive niches that may amplify biofilm accumulation and inflame adjacent soft tissues. While cross-sectional comparisons suggest higher palatal burden beneath acrylic elements, less is known about real-world patterns accumulated across years of routine care. We retrospectively evaluated periodontal and palatal outcomes, and, in a microbiology sub-sample, site-specific colonization, across three device types: molar bands, Nance buttons, and removable acrylic plates. Methods: We reviewed 2022–2025 records from a university orthodontic service, including consecutive patients aged 18–30 years with documented pre-placement and 6-month follow-up indices. Groups were bands (n = 92), Nance (n = 78), acrylic (n = 76). Standardized charted measures were abstracted: Plaque Index (PI), Gingival Index (GI), bleeding on probing (BOP%), probing depth (PD), and palatal erythema grade (0–3). A laboratory sub-sample (n = 174 visits) had archived swabs cultured for total aerobic counts (log₁₀ CFU/cm²) at the device, adjacent enamel, and palatal mucosa; Streptococcus mutans burden was available from qPCR (log₁₀ copies/mL). Results: Baseline characteristics were similar, except for longer wear at follow-up in Nance (10.1 ± 4.0 months) vs. bands (8.7 ± 3.2) and acrylic (6.9 ± 3.0; p < 0.001). At 6 months, device type was associated with greater worsening of PI and GI (both p < 0.001) and with higher palatal erythema (bands 0.7 ± 0.5; Nance 1.6 ± 0.8; acrylic 1.9 ± 0.7; p < 0.001). Microbiologically, palatal mucosal colonization was lowest with bands (3.3 ± 0.5), higher with Nance (4.9 ± 0.6), and highest with acrylic (5.0 ± 0.7; p < 0.001); S. mutans mirrored this gradient (p < 0.001). Palatal CFU correlated with erythema (ρ = 0.6, p < 0.001) and ΔGI (ρ = 0.5, p < 0.001). In adjusted models, acrylic (OR 6.7, 95% CI 3.5–12.8) and Nance (OR 4.9, 2.5–9.3) independently predicted erythema ≥2; recent prophylaxis reduced odds (OR 0.6, 0.3–0.9). Conclusions: In this single-center cohort, palate-contacting designs were associated with higher palatal biomass and erythema than bands. These associations support device-tailored hygiene considerations and proactive palatal surveillance, particularly for acrylic components. Full article

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17 pages, 3124 KB

Open AccessArticle

Fit Accuracy of Plate-Type Retainers Fabricated Using Dental CAD/CAM Systems: A Controlled In Vitro Comparison Using Typodont-Derived Models

by Kosuke Nomi, So Koizumi, Masatoshi Shimura, Kazuhide Seimiya, Osamu Nikaido, Heetae Park, Reina Hatanaka, Masahiro Takahashi, Shinya Fuchida and Tetsutaro Yamaguchi

Dent. J. 2025, 13(11), 487; https://doi.org/10.3390/dj13110487 - 23 Oct 2025

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Abstract

Objectives: This study aimed to compare the fit accuracy between retainers fabricated using conventional cold-curing resin (hereinafter referred to as “conventional retainers”) and those fabricated using three-dimensional (3D) printing based on computer-aided design/computer-aided manufacturing (CAD/CAM) technology (hereinafter referred to as “CAD/CAM retainers”). Furthermore, [...] Read more.

Objectives: This study aimed to compare the fit accuracy between retainers fabricated using conventional cold-curing resin (hereinafter referred to as “conventional retainers”) and those fabricated using three-dimensional (3D) printing based on computer-aided design/computer-aided manufacturing (CAD/CAM) technology (hereinafter referred to as “CAD/CAM retainers”). Furthermore, the study aimed to compare two different methods to evaluate the fit accuracy: the impression replica technique and the 3D triple-scan protocol. Methods: For each of the 20 working models derived from a maxillary typodont, one conventional retainer and one CAD/CAM retainer were fabricated. The fit accuracy was evaluated using the impression replica technique and the 3D triple-scan protocol. Measurements were taken at 12 points on each model, and the differences in thickness (gap) were analyzed using Wilcoxon’s signed-rank test. Moreover, the correlation between thickness and measurement site was evaluated using Spearman’s rank correlation coefficient. Results: In both evaluation methods, the CAD/CAM retainers exhibited superior fit accuracy compared to the conventional retainers. Notably, the 3D triple-scan protocol clearly demonstrated that the fit accuracy differed depending on the measurement site. Conclusions: CAD/CAM retainers demonstrated superior fit accuracy compared to conventional retainers, possibly because digital design can account for polymerization shrinkage. In the impression replica technique, the median (interquartile range) thickness for the conventional retainers was 0.169 (0.120–0.260) mm, whereas that for the CAD/CAM retainers was 0.136 (0.096–0.198) mm. The CAD/CAM retainers showed significantly smaller gap values (p < 0.001). Within the limitations of this in vitro study, CAD/CAM retainers showed significantly smaller gap values than conventional retainers, indicating improved fit accuracy. In particular, the 3D triple-scan protocol accurately captured site-specific variations in fit accuracy among the anterior, canine, and molar regions. Full article

(This article belongs to the Section Digital Technologies)

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14 pages, 565 KB

Open AccessArticle

In Vitro Comparison of Three Chairside Bleaching Protocols: Effects on Enamel Microhardness, Colour, and Qualitative Cytotoxicity Risk

by Berivan Laura Rebeca Buzatu, Octavia Balean, Magda Mihaela Luca, Roxana Buzatu, Atena Galuscan, Ramona Dumitrescu, Vlad Alexa, Vanessa Bolchis and Daniela Elisabeta Jumanca

Dent. J. 2025, 13(11), 486; https://doi.org/10.3390/dj13110486 - 22 Oct 2025

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Abstract

Background and Objectives: The rapid increase of whitening products use raises questions about enamel safety. We compared three high-concentration protocols—Opalescence Quick (45% carbamide peroxide ≈ 15% H₂O₂), Opalescence Boost (40% H₂O₂), and BlancOne Ultra (35% [...] Read more.

Background and Objectives: The rapid increase of whitening products use raises questions about enamel safety. We compared three high-concentration protocols—Opalescence Quick (45% carbamide peroxide ≈ 15% H₂O₂), Opalescence Boost (40% H₂O₂), and BlancOne Ultra (35% H₂O₂ + LED)—under controlled conditions to balance color change (ΔE) with enamel integrity (microhardness, FTIR). We also constructed a qualitative cytotoxicity risk profile from published data; no biological assays were performed in this study. Methods: Seventy-two matched half-crowns were randomized to Control or one of the three protocols. Outcomes were a change in Vickers microhardness, spectrophotometric color difference, and FTIR carbonate-to-phosphate ratio after 24 h in artificial saliva. We also compiled a qualitative cytotoxicity risk profile from published evidence; no biological assays were performed. One-way ANOVA with Tukey HSD on Δ-scores, Shapiro–Wilk and Levene’s tests for assumptions, Welch’s t-tests for tooth-class comparisons, and Pearson correlation between ΔE and ΔMH. Results: All active protocols produced clearly visible whitening (mean ΔE 5.7–6.3). Hydrogen-peroxide gels showed greater hardness loss and carbonate depletion than the carbamide-peroxide gel under similar contact time. The association between greater shade change and hardness loss was moderate and not predictive for individuals. Conclusions: Under harmonized conditions, all systems whitened effectively. Pursuing changes beyond ~6 units offered little extra benefit while increasing enamel impact. Carbamide-based Opalescence Quick achieved comparable aesthetics with lower acute enamel effects. Clinicians should individualize exposure time and pair in-office whitening with short-term remineralising care. Cytotoxicity comments are qualitative and literature-based only. Full article

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14 pages, 1090 KB

Open AccessArticle

Efficacy and Feasibility of OptraDam^® Plus Versus Conventional Rubber Dams in Preclinical Simulation Training: A Randomized Crossover Trial

by Fahad BaHammam, Mohammed Alsuhaibani, Faisal Almutairi, Sultan Aldakhil, Shug Albarrak, Lulwah Alreshaid and Fathima Farook

Dent. J. 2025, 13(11), 485; https://doi.org/10.3390/dj13110485 - 22 Oct 2025

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Abstract

Background/Objectives: Despite clear benefits, conventional rubber dam use remains low due to barriers that often originate during undergraduate training. To examine a potential approach to mitigating these barriers, this study evaluated the efficacy and feasibility of OptraDam^® Plus, a user-friendly alternative to [...] Read more.

Background/Objectives: Despite clear benefits, conventional rubber dam use remains low due to barriers that often originate during undergraduate training. To examine a potential approach to mitigating these barriers, this study evaluated the efficacy and feasibility of OptraDam^® Plus, a user-friendly alternative to the conventional rubber dam, in preclinical simulation training. Methods: In this 2 × 2 crossover trial, preclinical undergraduate students were randomly assigned to two groups to perform two types of dental isolation, conventional rubber dam and OptraDam^® Plus, in alternating sequences on a dental simulator. The efficacy and feasibility of both systems were evaluated based on application time, isolation quality, and students’ perceptions. Results: Data from 94 randomized students were collected and analyzed. Although students’ performance was suboptimal with both systems, there were significant differences in efficacy and feasibility between them. Application time was shorter with the conventional rubber dam (mean reduction 77 s; 95% CI 4–151; p = 0.039), whereas using OptraDam^® Plus was associated with 51% lower odds of achieving a higher isolation quality category (OR 0.49; p = 0.011). In addition, students perceived the conventional rubber dam to be superior to the OptraDam^® Plus in achieving higher-quality dental isolation and in their confidence in using it. Conclusions: OptraDam^® Plus cannot be considered a suitable alternative to the conventional rubber dam in preclinical simulation training due to its inferior efficacy and feasibility. The findings of this study challenge the assumption that utilization of newer marketed “user-friendly” rubber dam systems necessarily overcome the core technical barriers faced by undergraduate students. Full article

(This article belongs to the Special Issue Dental Education: Innovation and Challenge)

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18 pages, 451 KB

Open AccessPerspective

Environmental Determinants of Early Childhood Caries: A Narrative Synthesis of Observational Evidence and Implications for Global Policy

by Moréniké Oluwátóyìn Foláyan, Robert J. Schroth, Olubukola Olatosi and Maha El Tantawi

Dent. J. 2025, 13(11), 484; https://doi.org/10.3390/dj13110484 - 22 Oct 2025

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Abstract

Early childhood caries (ECC) remains a significant global health challenge, disproportionately affecting marginalized populations. While traditional research emphasizes behavioral and biological risk factors, emerging evidence highlights the critical role of environmental determinants. This narrative synthesis aims to highlight the role of environmental determinants [...] Read more.

Early childhood caries (ECC) remains a significant global health challenge, disproportionately affecting marginalized populations. While traditional research emphasizes behavioral and biological risk factors, emerging evidence highlights the critical role of environmental determinants. This narrative synthesis aims to highlight the role of environmental determinants as a risk factor for ECC pathogenesis. Environmental toxins (e.g., lead, perfluoroalkyl acids, tobacco smoke, air pollution) disrupt enamel development, impair salivary function, and compromise immune responses, directly increasing caries susceptibility. Environmental degradation, including air pollution, reduces ultraviolet B radiation exposure, limiting endogenous vitamin D synthesis that is vital for enamel mineralization and immune regulation. These risks are compounded in low- and middle-income countries, where structural inequities, inadequate sanitation, and climate disruptions exacerbate ECC burdens. We introduce ecovitality—the resilience of ecosystems supporting human health—as a novel framework linking ecological vitality to oral health. Degraded environments limit access to fluoridated water and nutrient-dense foods while promoting sugary diets and endocrine disruptors. A One Health approach is advocated to address interconnected environmental, social, and biological determinants of the risk for ECC. Despite global reductions in tobacco use and lead exposure, the Global Burden of Disease 2021 analysis reports stagnation in ECC prevalence. This underscores the critical need for longitudinal and mechanistic studies to establish causality, quantify the contributions of environmental controls, and explore how mitigating these risks can reduce the global ECC burden. Such evidence may promote interdisciplinary action to align oral health promotion for children with the Sustainable Development Goals. Full article

(This article belongs to the Topic Preventive Dentistry and Public Health)

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Dent. J., Volume 13, Issue 11 (November 2025) – 12 articles

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