Dentistry Journal

16 pages, 9741 KiB

Open AccessArticle

Evaluation of the Disinfection Efficacy of Er: YAG Laser Light on Single-Species Candida Biofilms—An In Vitro Study

by Diana Dembicka-Mączka, Małgorzata Kępa, Jakub Fiegler-Rudol, Zuzanna Grzech-Leśniak, Jacek Matys, Kinga Grzech-Leśniak and Rafał Wiench

Dent. J. 2025, 13(2), 88; https://doi.org/10.3390/dj13020088 - 19 Feb 2025

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Abstract

Background/Objectives: Oral candidiasis is an opportunistic infection caused by Candida species. Recently, antifungal drugs have become less effective due to yeast resistance, emphasizing the need for new treatment strategies. This study aimed to assess the effect of the Er:YAG laser on the inhibition [...] Read more.

Background/Objectives: Oral candidiasis is an opportunistic infection caused by Candida species. Recently, antifungal drugs have become less effective due to yeast resistance, emphasizing the need for new treatment strategies. This study aimed to assess the effect of the Er:YAG laser on the inhibition of growth and elimination of mature single-species Candida biofilms. Methods: The study utilized reference strains of C. albicans, C. glabrata, C. parapsilosis, and C. krusei organized in single-species biofilms on Sabouraud dextrose agar (SDA). First part: Candida suspensions (0.5 McFarland standard) were spread on SDA plates—two for each strain. Er:YAG laser irradiation was applied in a single pulse mode, 30 to 400 mJ, to 32 predetermined points. The growth inhibition zones (GIZs) were measured at 24–96 h of incubation. Second part: biofilms were prepared similarly and, after 96 h of incubation, exposed to Er:YAG laser irradiation at different energies (50, 100, 150, 200 mJ) for 180 s, per 1.44 cm area. Post-irradiation, impressions were taken using Rodac Agar to determine yeast counts. The count of colony-forming units (CFU) after irradiation was measured and results were analysed statistically. Results: First part: GIZ was found in all irradiated sites, with various Candida strains. The results showed a significant increase in the width of GIZ in the energy range of 30–280 mJ and a non-significant increase in the energy range of 300–400 mJ. Second part: the number of CFU remaining after the irradiation of biofilms with 150 mJ energy differed statistically significantly from other results obtained after using 50, 100, or 200 mJ energy, regardless of the Candida strain tested. Conclusions: The Er:YAG is shown to have good disinfecting properties (inhibiting biofilm growth, even at low-energy doses (50 mJ), and eliminating maturity, Candida spp. biofilms most effective on the 150 mJ energy dose). Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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9 pages, 1680 KiB

Open AccessArticle

Antibacterial Efficacy of Benefect™ Botanical Disinfectant in Comparison with Sodium Hypochlorite and Chlorohexidine Against Multiple Endodontic Pathogens: An Ex Vivo Study

by Sarmed Toma, Joseph Ferracciolo, Mazin Askar, Eric Krukonis and Susan Paurazas

Dent. J. 2025, 13(2), 87; https://doi.org/10.3390/dj13020087 - 18 Feb 2025

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Abstract

Background/Objectives: Natural antibacterial agents, such as essential oils, can potentially be used for endodontic disinfection with less toxicity than other available irrigants such as sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Benefect^TM is a formulation of essential oils with broad antibacterial spectrum [...] Read more.

Background/Objectives: Natural antibacterial agents, such as essential oils, can potentially be used for endodontic disinfection with less toxicity than other available irrigants such as sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Benefect^TM is a formulation of essential oils with broad antibacterial spectrum efficacy. This study aims to compare the antibacterial efficacy of Benefect^TM to 6% NaOCl and 2% CHX irrigant solutions against multiple endodontic pathogens. Methods: The study utilized 100 extracted human single-canal permanent teeth. Samples were decoronated, instrumented, and autoclaved. The teeth were infected with Streptococcus mutans, Enterococcus faecalis, Actinomyces naeslundii, or Porphyromonas gingivalis for 6–24 h. The teeth were divided into four groups according to the irrigant solution used. Contact with each irrigant was maintained for 12 min. The antibacterial efficacy of each treatment was calculated relative to viable bacteria recovered after saline treatment. Statistical analysis was performed using Student’s t-test. Results: All S. mutans samples treated with NaOCl, CHX, and Benefect^TM showed a complete absence of bacterial colonies when compared to saline (>99.9% killing). The E. faecalis, A. naeslundii, and P. gingivalis samples treated with all tested irrigants showed at least 99% antibacterial killing activity. There was no statistical difference in killing between these three antimicrobial treatments. Conclusions: Benefect^TM botanical disinfectant has comparable antibacterial efficacy to NaOCl and CHX against S. mutans, E. faecalis, A. naeslundii, and P. gingivalis. Full article

(This article belongs to the Special Issue Oral Microbiology and Immunology: Present Research, Challenges and Development)

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18 pages, 600 KiB

Open AccessReview

Evaluating the Impact of Kefir Consumption on Dental Caries and Periodontal Disease: A Narrative Review

by Anna González-Rascón, Elda Georgina Chávez-Cortéz, Angélica Hurtado-Camarena, Nicolás Serafín-Higuera, Sandra Castillo-Uribe, Víctor Manuel Martínez-Aguilar, Bertha Arelly Carrillo-Ávila and Viviana Pitones-Rubio

Dent. J. 2025, 13(2), 86; https://doi.org/10.3390/dj13020086 - 18 Feb 2025

Viewed by 348

Abstract

Background/Objectives: Dental caries and periodontal diseases are the most common illnesses in the oral cavity and represent a public health concern globally. In recent decades, diverse studies showed that Kefir, a traditional beverage that can be milk- or water-based, contains a complex [...] Read more.

Background/Objectives: Dental caries and periodontal diseases are the most common illnesses in the oral cavity and represent a public health concern globally. In recent decades, diverse studies showed that Kefir, a traditional beverage that can be milk- or water-based, contains a complex microbial community and has health benefits. The goal of this review was to update the current knowledge of kefir consumption and its impact on oral health. Methods: The search of a combination of keywords—kefir; dental caries; probiotics; microbiota; periodontal diseases; biofilm; and oral health—was conducted using PubMed, Google Scholar, and Web of Science databases for studies in human subjects. Discussion: The research suggests that kefir consumption may aid in decreasing counts of microorganisms typically associated with oral illness. Conclusions: Kefir has the potential to inhibit certain oral pathogens and reduce biofilm formation by promoting diversity within the oral microbiota, suggesting that kefir could be a promising adjuvant treatment for dental caries and periodontal diseases by improving oral health. Full article

(This article belongs to the Section Preventive Dentistry)

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16 pages, 6538 KiB

Open AccessArticle

Guided Bone Regeneration Using Carbonated Apatite Granules and L-Lactic Acid/ε-Caprolactone Membranes: A Case Series and Histological Evaluation

by Yoichi Taniguchi, Tatsuro Koyanagi, Yutaro Kitanaka, Azusa Yamada, Akira Aoki and Takanori Iwata

Dent. J. 2025, 13(2), 85; https://doi.org/10.3390/dj13020085 - 17 Feb 2025

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Abstract

Background/Objectives: The newly developed poly L-lactic acid/ε-caprolactone (P(LA/LC)) membrane has recently been proposed as a guided bone regeneration (GBR) procedure in implant treatment. This case series details the clinical, radiographic, and histological results of ridge augmentation using bone graft comprising a P(LA/LC) [...] Read more.

Background/Objectives: The newly developed poly L-lactic acid/ε-caprolactone (P(LA/LC)) membrane has recently been proposed as a guided bone regeneration (GBR) procedure in implant treatment. This case series details the clinical, radiographic, and histological results of ridge augmentation using bone graft comprising a P(LA/LC) membrane and carbonated apatite for implant treatment. Methods: Ten patients (15 sites) requiring bone augmentation and implant placement were retrospectively assessed. Simultaneous implant placement (Si) was performed at five sites in three patients. Si immediately following tooth extraction (SiIP) was performed at four sites in four patients. The staged approach (St) was performed at six sites in three patients. In the St-treated cases, hard tissue samples were taken from the implant placement site under patient consent. Results: The mean regenerated bone width for each treatment method was Si, 6.34 ± 2.64 mm (excluding implant diameter, 2.60 ± 2.42); SiIP, 7.55 ± 1.17 mm (excluding implant diameter, 3.90 ± 0.78) and St, 5.57 ± 1.08 mm. The mean regenerated bone width for all the cases was 6.36 ± 1.83 mm (excluding implant diameter, 4.14 ± 1.99). Significant differences were observed between the pre- and post-operative bone width in all the cases and the SiIP group (p < 0.001). All cases were followed up for more than 2 years after attaching the superstructure. No inflammation, shrinkage, or other problems were observed in the hard and soft tissues surrounding the implant. In the histological evaluation, there was no soft tissue ingrowth into the augmented bone, and new bone formation was observed. Conclusions: The use of P(LA/LC) membranes and carbonated apatite as GBR materials in implant treatment resulted in stable and favorable bone augmentation. Full article

(This article belongs to the Special Issue Oral Implantology and Bone Regeneration)

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12 pages, 958 KiB

Open AccessArticle

Ultrasound Screening of Temporomandibular Joint Pathology in Children with Chronic Kidney Disease

by Natalia Sergeevna Morozova, Alina Alekseevna Elovskaya, Ekaterina Andreevna Maslikova, Oleg Ivanovich Admakin, Arif Fuad Allahverdiyev, Ellina Valerievna Velichko, Larisa Dmitrievna Maltseva, Pavel Pavlovich Tregub and Olga Leonidovna Morozova

Dent. J. 2025, 13(2), 84; https://doi.org/10.3390/dj13020084 - 15 Feb 2025

Viewed by 202

Abstract

Background/Objectives: Chronic kidney disease (CKD) influences different organs including the temporomandibular joint (TMJ). This study aims to identify structural and functional TMJ changes in children with CKD using ultrasound as the least invasive and most accessible method. Methods: TMJ changes were [...] Read more.

Background/Objectives: Chronic kidney disease (CKD) influences different organs including the temporomandibular joint (TMJ). This study aims to identify structural and functional TMJ changes in children with CKD using ultrasound as the least invasive and most accessible method. Methods: TMJ changes were examined using ultrasound screening in 40 children. The first group (control, n = 10) included children with normal occlusion without TMJ complaints. The second group (n = 10) included children with CKD stage 1 and 2. The third group (n = 10) included patients on hemodialysis after renal transplantation. The forth group (n = 10) included patients at least 6 months after renal transplantation. Results: The size of the anterior section of the right TMJ gap in the third group was the largest among all the groups studied (1.085 mm) and statistically significantly different from the first group (0.570 mm; p = 0.001) and the second one (0.665 mm, p = 0.001). The width of the middle section was also greatest in the third group and statistically significantly different when compared to the first and second groups (0.390 mm; p = 0.023 and 0.340 mm; p < 0.001, respectively). A posterior articular gap width differences between the individual patient groups under study were not statistically significant in a posteriori comparison with Bonferroni correction. Statistical significance of differences between all groups when comparing the gap width was found in all sections of the left TMJ. The frequency of anterior disc displacement between groups ranged from 50 to 100% in all groups studied and was not statistically different when comparing right and left TMJs between groups (p = 0.084 and p = 0.662, respectively). Conclusions: CKD children have different TMJ changes, so TMJ ultrasound could screen joint pathology at early stages, and dental specialists can start timely rehabilitation. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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12 pages, 1534 KiB

Open AccessArticle

Prognosis of Vital Teeth Involved in Large Cystic Lesions After a Surgical Intervention: A Longitudinal Ambidirectional Cohort Study

by Khalid A. Merdad, Maha Shawky, Khalid A. Aljohani, Rawia Alghamdi, Saja Alzahrani, Omar R. Alkhattab and Abdulaziz Bakhsh

Dent. J. 2025, 13(2), 83; https://doi.org/10.3390/dj13020083 - 15 Feb 2025

Viewed by 191

Abstract

Background/Objectives: Large cystic lesions in the maxillofacial region present a challenge for clinicians due to their impact on the health and functionality of the involved teeth. This longitudinal, ambidirectional cohort study aimed to evaluate the prognosis of vital teeth affected by large cystic [...] Read more.

Background/Objectives: Large cystic lesions in the maxillofacial region present a challenge for clinicians due to their impact on the health and functionality of the involved teeth. This longitudinal, ambidirectional cohort study aimed to evaluate the prognosis of vital teeth affected by large cystic lesions following surgical intervention. Methods: Data were gathered from patients at King Abdulaziz University Dental Hospital and King Fahad General Hospital in Jeddah, Saudi Arabia, between July 2021 and August 2022. Seventeen individuals with large jawbone cysts were included in the study. Clinical and radiographic assessments were performed including sensibility testing and the function of teeth. The results indicated a linear relationship between the size of postoperative bony defects and the sensibility testing of teeth. Results: Of the 63 examined teeth, 54% did not receive endodontic treatment, 33% had pre-surgical treatment, and 12.7% had post-surgical treatment. The study revealed a high prevalence of inflammatory cysts, particularly in the maxilla. Surgical enucleation was the primary treatment modality, with few postoperative complications. Conclusions: This study highlights the necessity for standardized follow-up protocols and more extensive research to develop universal guidelines for managing large cystic lesions affecting vital teeth. Understanding the prognosis of cystic lesions is crucial for effective treatment planning and ensuring optimal patient outcomes. Full article

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15 pages, 3756 KiB

Open AccessCase Report

Combined Surgical and Orthodontic Treatment of Complex Odontoma in Growing Patients: Presentation of Two Cases

by Natalia Muczkowska, Ewa Czochrowska, Klaudia Masłowska, Andrzej Wojtowicz and Wojciech Popowski

Dent. J. 2025, 13(2), 82; https://doi.org/10.3390/dj13020082 - 14 Feb 2025

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Abstract

Background/Objectives: Odontomas are the most common mixed odontogenic tumors and may cause impaction of adjacent teeth and masticatory disorders. Treatment of tooth impaction caused by the presence of odontomas is related to their stages of root development and their positions in the alveolar [...] Read more.

Background/Objectives: Odontomas are the most common mixed odontogenic tumors and may cause impaction of adjacent teeth and masticatory disorders. Treatment of tooth impaction caused by the presence of odontomas is related to their stages of root development and their positions in the alveolar bone. The aim of this case report is to present the combined surgical and orthodontic treatment in growing patients with odontomas and to discuss the treatment outcomes. Methods: Two growing patients, an 8-year-old boy and a 17-year-old girl, with large odontomas in the posterior maxillary region of the maxilla were presented. The tumors were found during a radiological examination, and the first molars on the affected sides were impacted due to the presence of odontomas. Results: The treatment plans included the surgical removal of the tumors. In the case of the younger patient, the impacted developing molar erupted spontaneously in the oral cavity one year and two months after surgery. An orthodontic traction of the impacted molar was successfully applied in the older patient. Conclusions: The presence of a large odontoma in the posterior segments may lead to a displacement and impaction of neighboring molars and malformation of their roots. Spontaneous eruption of the affected molar can be expected if the tumor is diagnosed and removed early before its root formation is completed; otherwise, an orthodontic extrusion is needed. Interdisciplinary cooperation is important to diagnose and plan the dental treatment in young patients with odontomas. Full article

(This article belongs to the Special Issue Dentistry in the 21st Century: Challenges and Opportunities)

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15 pages, 231 KiB

Open AccessArticle

Developing and Evaluating a New Preclinical Curriculum with Focus on Prevention in Dentistry

by Ina M. Schüler, Katharina Bach, Pauline Schädlich and Ute Rabe

Dent. J. 2025, 13(2), 81; https://doi.org/10.3390/dj13020081 - 14 Feb 2025

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Abstract

Background/Objectives: New licensing regulations for dentists in Germany offered the opportunity to modernize the dental curriculum regarding content, methodology and structure. This paper aims to evaluate the newly requested preclinical curriculum “Dental Propaedeutic—Focus on Prevention” by dental students and dental educators and to [...] Read more.

Background/Objectives: New licensing regulations for dentists in Germany offered the opportunity to modernize the dental curriculum regarding content, methodology and structure. This paper aims to evaluate the newly requested preclinical curriculum “Dental Propaedeutic—Focus on Prevention” by dental students and dental educators and to describe the process of development. Methods: The curriculum was developed according to the Kern cycle and the National Competence-Based Learning Objectives Catalog for Dentistry. Lesson planning was based on Bloom’s taxonomy and the taxonomy of significant learning, according to the principle of constructive alignment. A variety of evidence-based teaching methods were implemented. For evaluation, dental students answered a written questionnaire, graded eight topics and added free text. Dental educators were interviewed. Results: Thirty out of fifty-four dental students’ enrolled in the third semester participated in the survey, giving the highest grades to the learning atmosphere. All dental educators involved in the delivery of the curriculum participated in the interview. Dental students and educators expressed satisfaction with this comprehensive teaching approach of prevention in an early stage of the dental curriculum. Dental educators reflected on the high workload for development but valued the opportunity to participate in an evidence-based development process and to introduce various modern teaching and examination methods. Conclusions: The expenditure of time for the development, performance and examination was high. In order to perform 240 teaching units for eight ECTS credits, 419 h of conceptualization/preparation and 344 h for examination had to be invested. This paper might help to facilitate better understanding of the chances and efforts accompanied by curricular changes. Full article

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

10 pages, 745 KiB

Open AccessArticle

A Communication Toolkit to Assist Families Access Dental Care Services in Scotland: A Qualitative Evaluation

by Sucharita Nanjappa, Thushani I. D. Wijesiri, Susan J. Carson and Ruth Freeman

Dent. J. 2025, 13(2), 80; https://doi.org/10.3390/dj13020080 - 14 Feb 2025

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Abstract

Background: Childsmile is Scotland’s national child oral health improvement programme designed to reduce inequalities in oral health and ensure universal access to NHS dental services by working closely with children and their families. Research has shown that parents with more dental concerns are [...] Read more.

Background: Childsmile is Scotland’s national child oral health improvement programme designed to reduce inequalities in oral health and ensure universal access to NHS dental services by working closely with children and their families. Research has shown that parents with more dental concerns are less likely to bring their children for regular preventive dental check-ups.Therefore, a communication toolkit named ‘Chatterbox’ was created to help families access dental care services. Methods: This study aimed to evaluate the acceptability of Chatterbox from the perspective of parents with young children and from staff who work with them. Thirty parents of young children, volunteers, and staff affiliated with three third-sector family support organisations in Dundee participated in in-depth interviews, focus groups, and observations to assess the objectives of Chatterbox. A framework analysis was conducted to capture the themes, patterns, and findings triangulated using observations and field notes. Results: Chatterbox was found to promote effective communication, identify barriers to dental attendance, provide a platform for reflection, convey the complexities of daily life, and boost parents’ confidence to seek assistance. Conclusions: Chatterbox has the potential to help parents in accessing preventive dental care for their young children when used with trained support workers. Full article

(This article belongs to the Special Issue A Commemorative Issue of the Work of Prof. Dr. Ruth Freeman)

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16 pages, 2178 KiB

Open AccessReview

Revolutionizing Dentistry: Preclinical Insights and Future Applications of mRNA Vaccines in Dentistry—A Narrative Review

by Luciana Koren, Andro Koren, Robert Likić and Tomislav Katanec

Dent. J. 2025, 13(2), 79; https://doi.org/10.3390/dj13020079 - 13 Feb 2025

Viewed by 408

Abstract

Background: Recent advances in mRNA vaccine technology, accelerated by the global COVID-19 pandemic, have generated significant interest in their applications beyond infectious diseases. Dentistry has emerged as a promising field for exploring the potential of mRNA-based therapies in preventing and treating oral diseases. [...] Read more.

Background: Recent advances in mRNA vaccine technology, accelerated by the global COVID-19 pandemic, have generated significant interest in their applications beyond infectious diseases. Dentistry has emerged as a promising field for exploring the potential of mRNA-based therapies in preventing and treating oral diseases. Objectives: This narrative review aims to evaluate the current status of mRNA vaccine development and its preclinical applications in oral health, focusing on periodontal disease, dental caries, regenerative medicine, implantology, and oral cancer. Methods: The review synthesizes findings from preclinical studies, including research conducted in animal models and in vitro, to assess the potential of mRNA-based therapies to modulate immune responses and promote tissue regeneration in the oral cavity. Clinical trials were only mentioned in the context of broader areas of mRNA vaccine implementation such as oncology and immunotherapy. Results: The preclinical studies highlight the capacity of mRNA vaccines to enhance the body’s immune response and facilitate tissue repair processes. Despite these promising results, challenges persist in delivering mRNA vaccines effectively within the complex oral environment. These challenges include vaccine stability, delivery mechanisms, and the modulation of immune responses. Conclusions: While mRNA vaccines offer significant promise for revolutionizing oral health care, they face notable limitations concerning safety, efficacy, and clinical feasibility. Overcoming these obstacles through further research is essential to unlock their full translational potential and ensure their safe and effective integration into dental practice. Full article

(This article belongs to the Special Issue Dentistry in the 21st Century: Challenges and Opportunities)

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17 pages, 2231 KiB

Open AccessArticle

Bone Remodeling Around Implants with Different Macro-Design Placed in Post-Extraction Sockets: A Cone-Beam Computed Tomography (CBCT) Randomized Controlled Clinical Trial (RCT)

by Roberta Grassi, Fábio França Vieira e Silva, Gennaro Musella, Francesco Pettini, Gisela Cristina Vianna Camolesi, Martina Coppini and Stefania Cantore

Dent. J. 2025, 13(2), 78; https://doi.org/10.3390/dj13020078 - 11 Feb 2025

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Abstract

Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two [...] Read more.

Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two implant designs, System 2P and Dura-Vit 3P, which feature semi-conical microgeometry and apical self-tapping portions for improved stability and bone regeneration. Methods: With a 1:1 allocation ratio, the current investigation was a two-arm parallel group randomized clinical trial. Patients qualified if they required immediate dental replacements with adequate buccal bone support. Two types of implants were placed: System 2P (cylindrical shape) and Dura-Vit 3P (more conical shape, with a particular architecture of threads). Following the intervention, CBCT was performed both immediately (T1) and six months later (T2). Measurements of CBCT horizontal bone level at apical, medial, and bevel height on the palatal/lingual and vestibular sides as well as the buccal vertical gap were the primary results. Complications, implant stability quotient (ISQ), and torque insertion were evaluated. The Mann–Whitney test was used to determine time-based differences within each group, while the Wilcoxon test was used to estimate differences between groups. The impact of baseline marginal gap dimension and gingival biotype was estimated using multiple regressions. Results: Thirty patients were recruited and randomized to treatments, with two lost to follow-up. One System 2P implant failed and two patients of the Dura-Vit 3P group dropped out. At T1, the Dura-Vit 3P group exhibited a lower mean insertion torque and a higher ISQ than the System 2P group. Furthermore, the Dura-Vit 3P group showed lower bone reduction compared to System 2P at horizontal and vertical measurements with significant differences for the vestibular and palatal base and medial level (p-values < 0.05). Regression models indicated a positive effect of thick biotypes on gap filling and dimensional bone reduction. No complications were observed in both groups. Conclusions: The Dura-Vit 3P implant exhibits high primary stability when inserted in post-extraction sites. Furthermore, this kind of implant stimulates higher bone stability on both the palatal and buccal side when compared to the System 2P implant. The present findings support the evidence that the macro-design of the Dura-Vit 3P implant promotes increased primary stability and reduces bone loss. Full article

(This article belongs to the Special Issue Dentistry in the 21st Century: Challenges and Opportunities)

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13 pages, 6436 KiB

Open AccessArticle

Topical Oxygenation Improves Microvascularity in a Human Ex Vivo Palatal Tissue Model: A Histological Analysis

by Andrea Pilloni, Cira Rosaria Tiziana Di Gioia, Raffaella Carletti, Gerarda D’Elia, Michaela Di Mario, Angela Molendini, Umberto Romeo and Lorenzo Marini

Dent. J. 2025, 13(2), 77; https://doi.org/10.3390/dj13020077 - 10 Feb 2025

Viewed by 283

Abstract

Background: Several therapies involving the use of oxygen have been developed; however, the literature to date has poorly addressed the effects of Topical Oxygen Therapy (TOT) on oral tissues. The aim of the present pilot study was to histologically evaluate the response to [...] Read more.

Background: Several therapies involving the use of oxygen have been developed; however, the literature to date has poorly addressed the effects of Topical Oxygen Therapy (TOT) on oral tissues. The aim of the present pilot study was to histologically evaluate the response to TOT in epithelial–connective samples harvested from the palate. Methods: In eight patients selected for a free gingival graft (FGG) procedure, the lateral portions of the graft were randomly assigned to receive TOT (test) or no treatment (control). Both the portions were stained with hematoxylin–eosin for the evaluation of histomorphological changes and with Picrosirius for the study of collagen. Immunohistochemical staining was performed with antibodies for the characterization of the inflammatory infiltrate and neoangiogenesis. Results: The analysis failed to show morphological variations in both groups, demonstrating that there was no tissue damage due to TOT. The prevalence of type I collagen in both samples supported this finding. Immune cells were present in low levels and mainly consisted of CD3+ T lymphocytes. The histomorphometric analysis showed an increased average vessel area (7607.95 μm² ± 3983.24 vs. 4038.42 μm² ± 1823.52), an increased number and caliber of vessels (49.82 ± 20.55 vs. 32.35 ± 16.64), and a higher microvessel density (7.89 ± 3.25 vessels/0.26 mm² vs. 5.13 ± 2.63 vessels/0.26 mm²) in the test group. Conclusions: Although further investigations are needed, TOT could improve and speed up oral wound healing through the local condition of hyperoxia. Full article

(This article belongs to the Special Issue Dentistry in the 21st Century: Challenges and Opportunities)

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22 pages, 6709 KiB

Open AccessArticle

Photobiomodulation LED Devices for Home Use: Design, Function and Potential: A Pilot Study

by Mark Cronshaw, Steven Parker, Omar Hamadah, Josep Arnabat-Dominguez and Martin Grootveld

Dent. J. 2025, 13(2), 76; https://doi.org/10.3390/dj13020076 - 10 Feb 2025

Viewed by 583

Abstract

Background/Objectives: Many commercial light-emitting diode (LED) devices are available for consumer home usage. The performance characteristics in respect to the dosimetry of many of the devices, currently on direct sale to the public, have not been subject to formal appraisal. In order [...] Read more.

Background/Objectives: Many commercial light-emitting diode (LED) devices are available for consumer home usage. The performance characteristics in respect to the dosimetry of many of the devices, currently on direct sale to the public, have not been subject to formal appraisal. In order to ‘bridge the gap’ between the evidence-based photobiomodulation therapy (PBMT) community and other interested parties, an evaluation is made of a selection of torch type hand-held LED PBMT products currently available for home use. Methods: Five randomly chosen intra-oral and hand-held LED PBMT devices were selected. The optical delivery parameters of the devices were measured, including the beam divergence angle, surface area exposure as well as the output power at the level of the LEDs. The surface and sub-surface temperature changes in porcine tissue samples were assessed under standardised conditions. The manufacturer’s patient instructions were correlated to the measured optical parameters. Calculations were made of irradiance and surface radiant exposure. Consumer satisfaction ratings and feedback data were collated, and a relevant statistical analysis conducted. Results: The results were heterogeneous with a wide range of applied wavelengths, output power and irradiance. Power output stability was variable, and, together with a wide beam divergence angle of 74°, the manufacturer’s directions for dosimetry were found to be inconsistent with an accurate dose delivery. Conclusions: The manufacturer’s proposed dosimetry fails to consider the relevance of the beam divergence angle and optical attenuation in view of the scatter and absorption. Appropriate instructions on how best to gain and optimise an acceptable clinical outcome were inconsistent with an evidence-based approach. Subject to validation by well-planned clinical trials, the concept of home PBMT may open interesting new therapeutic approaches. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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12 pages, 476 KiB

Open AccessArticle

Exploring Factors Contributing to Effective Teaching in Dental Clinical Settings: Perceptions of Dental Students

by Rayan Sharka, Mansour Alghamdi, Ammar Almarghlani, Hassan Abed, Shahad Alluqmani, Ruza Alhazmi and Jameel Abuljadayel

Dent. J. 2025, 13(2), 75; https://doi.org/10.3390/dj13020075 - 8 Feb 2025

Viewed by 525

Abstract

Background: Clinical teaching is crucial to dental education as it shapes the identity and professional development of students. However, there is a lack of research regarding the responsibilities of clinical teachers, their professional behavior, pedagogical approaches, and their influence on students’ clinical learning [...] Read more.

Background: Clinical teaching is crucial to dental education as it shapes the identity and professional development of students. However, there is a lack of research regarding the responsibilities of clinical teachers, their professional behavior, pedagogical approaches, and their influence on students’ clinical learning outcomes. This study aims to identify factors that students perceive in clinical teachers and how these factors influence the effectiveness of their clinical education. Methods: This cross-sectional study involved predoctoral and graduate dental students (N = 354). Data were collected using a questionnaire adapted from the Stanford Faculty Development Program (SFDP) scale and open-ended questions. Simple and multiple linear regression analyses were conducted to examine associations and predictive capabilities of the SFDP constructs for clinical teaching effectiveness. Data were analyzed using SPSS version 29. Results: A total of 332 responses were received, with a 94% response rate. Significant positive correlations were found between SFDP constructs and clinical teaching effectiveness. The evaluation construct had the strongest correlation (r = 0.480, p < 0.001), explaining 23.1% of the variance. The communication of clinical goals had the second strongest correlation (r = 0.415, p < 0.001), explaining 17.3%. The lowest correlation was for promotion of understanding and retention (r = 0.332, p < 0.001), explaining 11%. Cronbach’s alpha ranged from 0.607 to 0.783. Conclusions: This study highlighted key factors influencing the effectiveness of clinical teaching, including evaluation quality, clear communication of clinical goals, supportive learning environments, and effective feedback. Clinical teachers’ respect for students also facilitates successful education. More studies are required to explore additional factors across different contexts. Full article

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

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13 pages, 2904 KiB

Open AccessReview

Three-Dimensional Surgical Guides in Orthodontics: The Present and the Future

by Silvia Izabella Pop, Eugen Bud, Kinga Mária Jánosi, Anamaria Bud and Bernadette Kerekes-Máthé

Dent. J. 2025, 13(2), 74; https://doi.org/10.3390/dj13020074 - 8 Feb 2025

Viewed by 490

Abstract

Surgical guides are integral tools in orthodontics, enhancing the precision and predictability of mini-implant placement. These guides facilitate accurate positioning, reduce risks to surrounding anatomical structures, and ensure proper angulation and depth during procedures. The aim of the present paper is to present [...] Read more.

Surgical guides are integral tools in orthodontics, enhancing the precision and predictability of mini-implant placement. These guides facilitate accurate positioning, reduce risks to surrounding anatomical structures, and ensure proper angulation and depth during procedures. The aim of the present paper is to present a detailed review of the surgical guides used in orthodontics, focusing on their classification, mechanical properties, biocompatibility, and future developments. The advantages, disadvantages, clinical steps, and implications are also described based on the data in recent scientific literature. Future developments may incorporate artificial intelligence and augmented reality, further optimizing treatment planning and patient outcomes, thus solidifying the role of surgical guides in efficient orthodontic care. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)

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13 pages, 10433 KiB

Open AccessCase Report

Immediate Implant Therapy with Full-Digital Workflow to Replace a Central Incisor

by Francisco Garcia-Torres, Carlos A. Jurado, Silvia Rojas-Rueda, Clint Conner, Ali Abulkasim Mohamed and Francisco X. Azpiazu-Flores

Dent. J. 2025, 13(2), 73; https://doi.org/10.3390/dj13020073 - 8 Feb 2025

Viewed by 595

Abstract

Background: Replacing a maxillary central incisor and immediately placing an implant represents a clinical challenge. Methods: This case report demonstrates a full digital workflow to achieve a predictable implant placement and esthetically pleasing restoration for a 35-year-old male patient who suffered a horizontal [...] Read more.

Background: Replacing a maxillary central incisor and immediately placing an implant represents a clinical challenge. Methods: This case report demonstrates a full digital workflow to achieve a predictable implant placement and esthetically pleasing restoration for a 35-year-old male patient who suffered a horizontal root fracture after a sports accident. The patient’s treatment included digital implant planning, minimally traumatic tooth extraction, computer-guided implant placement, soft tissue augmentation, and a provisional restoration to contour the augmented gingival tissues. The process began with cone beam computed tomography (CBCT) evaluation and patient consultation on treatment options, with the patient opting for implant therapy. Using a 3D-printed surgical guide, the implant was placed precisely, and a soft tissue graft was used to enhance the gingival architecture and volume. A provisional restoration was designed to support the emergence profile and condition the peri implant soft tissues. A final digital impression was made, and a screw-retained all-ceramic crown was fabricated uneventfully after healing. Results: This digital approach allowed accurate planning and allowed the efficient execution of a technique-sensitive procedure such as immediate implant placement, thus providing an esthetic and functional solution while minimizing treatment time. Conclusions: The case highlights that immediate implant therapy in the esthetic zone requires meticulous planning and execution, and that incorporating advanced digital tools and techniques is required to achieve favorable clinical outcomes. Full article

(This article belongs to the Special Issue Advancements and Implications of Digital Workflow Integration in Implant Dentistry)

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9 pages, 951 KiB

Open AccessArticle

Morphology of Maxillary Central Incisors in a Mixed Swiss–German Population by Means of Micro-CT

by Thomas Gerhard Wolf, Kevin Simon Florian Ottiger, David Donnermeyer, Sven Schumann and Andrea Lisa Waber

Dent. J. 2025, 13(2), 72; https://doi.org/10.3390/dj13020072 - 5 Feb 2025

Viewed by 607

Abstract

Background/Objectives: The objective of this study was to investigate the internal morphology and root canal configurations (RCCs) of maxillary central incisors (MxCIs) in a Swiss–German population by means of micro-computed tomography (µCT). Methods: RCCs, main foramina, and accessory canals of MxCIs [...] Read more.

Background/Objectives: The objective of this study was to investigate the internal morphology and root canal configurations (RCCs) of maxillary central incisors (MxCIs) in a Swiss–German population by means of micro-computed tomography (µCT). Methods: RCCs, main foramina, and accessory canals of MxCIs were examined using µCT and 3D imaging software. The root canal anatomy was classified according to three classification systems by Vertucci (Ve, 1984), Weine et al. (We, 1969), and Briseño-Marroquín et al. (Br, 2015). Results: The most common RCC observed among a total of 112 investigated single-rooted maxillary central incisors was Br 1-1-1/1 (97.3%, Ve I, We I), with a small percentage showing Br 1-1-1/2 (2.7%). One main foramen existed in 87.5% of the specimens, 8% had one accessory foramen, 3.5% had two, and a rare case had four accessory foramina (0.9%). Accessory root canals were mainly located in the middle and apical regions of the roots. Conclusions: Detailed insights into the root canal morphology of MxCIs in a Swiss–German population are provided. The predominant RCC was a simple root canal (Ve I, Br 1-1-1/1). However, accessory canals were detected in the middle and apical third in over 40% of the teeth examined. These anatomical features should be considered during endodontic treatment planning and execution. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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13 pages, 2643 KiB

Open AccessArticle

Balancing the Load: How Optimal Forces Shape the Longevity and Stability of Orthodontic Mini-Implants

by Tinela Panaite, Carmen Savin, Nicolae Daniel Olteanu, Cristian Liviu Romanec, Raluca-Maria Vieriu, Carina Balcos, Alice Chehab and Irina Nicoleta Zetu

Dent. J. 2025, 13(2), 71; https://doi.org/10.3390/dj13020071 - 5 Feb 2025

Viewed by 685

Abstract

Objective: This study aims to investigate the mechanical behavior of titanium (Ti6Al4V) mini-implants (MIs) under varying orthodontic forces using finite element analysis (FEA) and to evaluate their performance and durability under realistic clinical conditions. Optimal orthodontic forces significantly influence the structural integrity [...] Read more.

Objective: This study aims to investigate the mechanical behavior of titanium (Ti6Al4V) mini-implants (MIs) under varying orthodontic forces using finite element analysis (FEA) and to evaluate their performance and durability under realistic clinical conditions. Optimal orthodontic forces significantly influence the structural integrity and functional longevity of MIs while minimizing adverse effects on surrounding bone tissues. Materials and Methods: A commercially available MI (diameter: 2.0 mm, length: 12 mm) was modeled using FEA. The mandible geometry was obtained using computed tomography (CT) scanning, reconstructed in 3D using SpaceClaim software 2023.1, and discretized into 10-node tetrahedral elements in ANSYS Workbench. Material properties were assigned based on the existing literature, and the implant–bone interaction was simulated using a nonlinear frictional contact model. Orthodontic forces of 2 N and 10 N, inclined at 30°, were applied to simulate clinical loading conditions. Total displacement, von Mises stresses, equivalent strains, fatigue life, and safety factors were analyzed to assess the implant’s mechanical performance. Results: At 2 N, the MI demonstrated minimal displacement (0.0328 mm) and sustained approximately 445,000 cycles under safe fatigue loading conditions, with a safety factor of 4.8369. At 10 N, the implant’s lifespan was drastically reduced to 1546 cycles, with significantly elevated stress (6.468 × 10⁵ MPa) and strain concentrations, indicating heightened risks of mechanical failure and bone damage. The findings revealed the critical threshold beyond which orthodontic forces compromise implant stability and peri-implant bone health. Conclusions: This study confirms that maintaining orthodontic forces within an optimal range, approximately 2 N, is essential to prolong MI lifespan and preserve bone integrity. Excessive forces, such as 10 N, lead to a rapid decline in durability and increased risks of failure, emphasizing the need for calibrated force application in clinical practice. These insights provide valuable guidance for enhancing MI performance and optimizing orthodontic treatment outcomes. Full article

(This article belongs to the Special Issue Risk Factors in Implantology)

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12 pages, 1030 KiB

Open AccessArticle

Orthodontic Treatment with Fixed Appliances Versus Aligners: An Experimental Study of Periodontal Aspects

by Lucia Giannini, Guido Galbiati, Francesco Carlo Tartaglia, Maria Elena Grecolini, Cinzia Maspero and Roberto Biagi

Dent. J. 2025, 13(2), 70; https://doi.org/10.3390/dj13020070 - 4 Feb 2025

Viewed by 530

Abstract

Objective: This study aimed to compare the effects of orthodontic treatment on the same patients using aligners (upper arch) versus traditional fixed appliances (lower arch) on oral hygiene and periodontal health. Materials and Methods: A total of 90 patients, all treated by the [...] Read more.

Objective: This study aimed to compare the effects of orthodontic treatment on the same patients using aligners (upper arch) versus traditional fixed appliances (lower arch) on oral hygiene and periodontal health. Materials and Methods: A total of 90 patients, all treated by the same orthodontist and with an average age of 26 years, were included in the study. The research focused on factors predisposing patients to periodontitis, as well as plaque and tartar accumulation. Statistical analysis was performed using the paired-samples Student’s t-test, with values of p < 0.05 deemed statistically significant. Results: Patients treated with fixed orthodontic appliances generally showed increased plaque accumulation (+10% PI) and a decline in periodontal health compared to those treated with aligners (40% presented a high level of S.Mutans and Lactobacilli). In patients who did not maintain proper oral hygiene, the initial conditions of the upper arch remained stable, while the lower arch exhibited significant deterioration, with increased plaque buildup and greater tissue inflammation. Conclusions: The findings emphasize the critical role of individual oral hygiene practices during orthodontic treatment in preserving periodontal health. Aligners appear to be more favorable in protecting periodontal tissues, improving plaque control, and reducing gingival inflammation. Various supplementary approaches for plaque management and microbial colonization in saliva should be implemented based on the type of orthodontic appliance used. Full article

(This article belongs to the Special Issue Feature Papers to Celebrate the First Impact Factor of Dentistry Journal)

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11 pages, 214 KiB

Open AccessArticle

Assessing the Management and Evaluation of Impacted Wisdom Teeth in a Dental Teaching Hospital

by Ahmed Al Subaie, Raghad Alruwili, Bayan Alkhuadher, Sarah Alzawwad, Wareef Alzamil and Khalifa S. Al-Khalifa

Dent. J. 2025, 13(2), 69; https://doi.org/10.3390/dj13020069 - 3 Feb 2025

Viewed by 737

Abstract

Background: Untreated impacted wisdom teeth can lead to complications, including delayed healing and inferior alveolar nerve damage. Delayed management is further complicated by age-related comorbidities. Aim: This study aimed to evaluate the management of impacted wisdom teeth in a teaching dental [...] Read more.

Background: Untreated impacted wisdom teeth can lead to complications, including delayed healing and inferior alveolar nerve damage. Delayed management is further complicated by age-related comorbidities. Aim: This study aimed to evaluate the management of impacted wisdom teeth in a teaching dental hospital and identify challenges faced by dental care providers. Materials and Methods: A retrospective radiographic study was conducted using data from electronic medical records and panoramic radiographs of patients. Independent variables included demographics and clinical details of wisdom teeth, such as type and presence of impaction, associated pathology, nerve proximity, second molar resorption, and extraction difficulty. The study assessed the evaluation of dental care provider practices in managing impacted wisdom teeth. Chi-square tests analyzed relationships between management type, provider level, and extraction difficulty. Results: Data from 270 panoramic radiographs and dental records were analyzed. Most cases were not managed (n = 216, 80%), irrespective of extraction difficulty or care provider level (undergraduate vs. graduate). There was no significant association between care provider levels and the type of management or between impaction difficulty and management type (p > 0.05). Conclusions: The findings highlight a lack of proper evaluation and management of impacted wisdom teeth, regardless of the provider’s experience. In hospital settings, all care providers should ensure the timely evaluation and management of impacted wisdom teeth to prevent complications. Full article

(This article belongs to the Special Issue Impacted Teeth: Biological Heritage or Clinical Limit?)

16 pages, 947 KiB

Open AccessArticle

Is the Modified Dental Anxiety Scale (MDAS) a Single or Two Construct Measure? A Theoretical and Pragmatic Perspective

by Gerald Michael Humphris and Jonathan Timothy Newton

Dent. J. 2025, 13(2), 68; https://doi.org/10.3390/dj13020068 - 31 Jan 2025

Viewed by 547

Abstract

Background: The MDAS questionnaire is one of a number of scales available to assess dental anxiety. It is widely used and translated into many world languages; however, it lacks an explicit theoretical backdrop to the content and structure of the measure. This paper [...] Read more.

Background: The MDAS questionnaire is one of a number of scales available to assess dental anxiety. It is widely used and translated into many world languages; however, it lacks an explicit theoretical backdrop to the content and structure of the measure. This paper draws upon original expositions of dental anxiety: how it develops, is maintained, and how this draws attention to a re-evaluation of the measure. To assist this inspection it was proposed to investigate a two latent construct formulation through a stepwise analysis using data from a representative survey of English respondents on their oral health (the Adult Dental Health Survey). Aim: To present a brief theoretical framework to underpin the measure and, as part of this study’s objectives, to provide some evidence to support the measure’s potential two-construct structure. Method: Narrative review, structural equation modelling, and testing of specific associations to indicate a two latent construct formulation. Data included the MDAS items (where items 1 and 2 comprise the anticipatory subscale, and items 3 to 5 describe the treatment-related subscale). These items were completed by the representative sample of respondents from the most recent Adult Dental Health Survey conducted in 2009. Results: The two latent construct solution for describing dental anxiety was supported. The anticipated and treatment-related subscales could be discriminated, although they were strongly correlated, demonstrating overlap. Comparison of how each construct varied across the three age groups suggests an interesting heterogeneity. In addition, the two constructs behaved differently when acknowledging previous experience of respondents’ last dental visit. Anticipatory dental anxiety was more strongly related to oral health-related quality of life (OHRQoL) than treatment-related dental anxiety as predicted. This partial evidence from empirical data and previous reports in other studies suggests that the separation of the MDAS measure into the two subscales may be warranted. Discussion: Researchers are recommended to report not only the total score of the MDAS in their studies but also consider presenting the two subscale scores, namely, anticipatory and treatment-related dental anxiety. Further work is indicated to determine if clinicians may find the subscales of use when assessing their patients. Full article

(This article belongs to the Special Issue A Commemorative Issue of the Work of Prof. Dr. Ruth Freeman)

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12 pages, 3450 KiB

Open AccessArticle

Mechanical Behaviour of Orthodontic Auxiliary Photopolymerisable Resins in Simulated Oral Conditions: An In Vitro Study

by Riccardo Favero, Tommaso Zanetti, Vincenzo Tosco, Riccardo Monterubbianesi and Andrea Volpato

Dent. J. 2025, 13(2), 67; https://doi.org/10.3390/dj13020067 - 31 Jan 2025

Viewed by 515

Abstract

Background: The widespread adoption of clear aligners in orthodontic practice has driven the development of biomechanical devices to improve treatment efficiency. The mechanical properties of these materials play a critical role in determining their clinical performance and efficacy. This study investigates the Young’s [...] Read more.

Background: The widespread adoption of clear aligners in orthodontic practice has driven the development of biomechanical devices to improve treatment efficiency. The mechanical properties of these materials play a critical role in determining their clinical performance and efficacy. This study investigates the Young’s modulus of Clear-Blokker^® (Scheu Dental), a photopolymerisable resin used for the attachment of clear aligner, and evaluates its mechanical behaviour under different curing times (5 s and 10 s) and environmental conditions (dry storage and immersion in artificial saliva at 37 °C). Methods: Forty-eight cylindrical specimens were prepared and subjected to quasistatic compression tests after 14 days. A multi-factorial analysis of variance (ANOVA) at a significance level of 5% was performed to compare the variances. Results: The results showed that samples immersed in artificial saliva had significantly reduced Young’s moduli compared to samples stored in dry conditions (p = 0.0213), while no significant difference was observed between curing times. Conclusions: The results suggest that Clear-Blokker^® has mechanical properties comparable to those of clear aligner materials, making it suitable as a biomechanical aid for orthodontic treatment. However, further clinical studies are required to confirm its long-term efficacy in the oral environment. Full article

(This article belongs to the Special Issue Restorative Dentistry: Emerging Trends and Personalized Treatment Strategies for Optimal Patient Care)

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16 pages, 2668 KiB

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

Viewed by 669

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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23 pages, 378 KiB

Open AccessSystematic Review

Impact of Molar Distalization with Clear Aligners on Periodontal Ligament Stress and Root Resorption Risk: A Systematic Review of 3D Finite Element Analysis Studies

by Ava Nazeri, Jose A. Castillo, Jr. and Arash Ghaffari-Rafi

Dent. J. 2025, 13(2), 65; https://doi.org/10.3390/dj13020065 - 31 Jan 2025

Viewed by 456

Abstract

Background/Objectives: Molar distalization with clear aligners is increasingly used for Class II malocclusions, yet the associated periodontal ligament (PDL) stress and potential root resorption risk remain unclear. Three-dimensional finite element analysis (3D FEA) provides insight into these factors, but variations in attachments and [...] Read more.

Background/Objectives: Molar distalization with clear aligners is increasingly used for Class II malocclusions, yet the associated periodontal ligament (PDL) stress and potential root resorption risk remain unclear. Three-dimensional finite element analysis (3D FEA) provides insight into these factors, but variations in attachments and anchorage strategies merit systematic evaluation. To determine whether molar distalization with clear aligners exceeds the PDL stress thresholds for root resorption and to assess how different attachments and anchorage methods influence stress distribution. Methods: In accordance with the PRISMA 2020 guidelines, four electronic databases were searched without language or date restrictions. Studies were included if they (1) employed 3D FEA, (2) analyzed PDL stress during aligner-based molar distalization, and (3) assessed root resorption risk or stress thresholds. Two reviewers independently screened and extracted data, yielding eight studies. Results: Attachments lowered PDL stress and distributed forces more evenly, reducing root resorption risk compared with no attachment cases. Micro-implants shifted stress to molars and protected anterior teeth; palatal mini-screws achieved greater distalization but higher stress, requiring caution, while buccal mini-screws showed lower stress in first premolar roots. Placing a mini-screw between first and second molars yielded the lowest, most uniform stress. Class II elastics—with precision cuts—demonstrated low compressive stress and improved anchorage, although some resorption risk persisted in maxillary anteriors. Conclusions: Clear aligner–based molar distalization can elevate PDL stress to potentially resorptive levels. Although attachments, micro-implants, and Class II elastics improve stress distribution and lessen root resorption risk, it is not fully eliminated. Careful, individualized treatment planning remains essential, and further clinical validation is needed to establish definitive guidelines. Full article

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11 pages, 1235 KiB

Open AccessArticle

An In-Vitro Investigation into the Fracture Resistance of Prefabricated and Custom-Made Zirconia Crowns for Permanent Molars in Children

by Thikrayat Bani-Hani, Rami S. Al-Fodeh, Ahed M. Al-Wahadni, Elham S. Abu-Alhaija and Mahmoud Al-Hakam

Dent. J. 2025, 13(2), 64; https://doi.org/10.3390/dj13020064 - 30 Jan 2025

Viewed by 409

Abstract

Background: Recently, the demand for esthetic restorations has grown dramatically and extended into the pediatric population. The prefabricated zirconia crowns (PZCs) and custom-made zirconia crowns (CZCs) are new esthetic options in pediatric dentistry. However, they are still inadequately tested for use in children. [...] Read more.

Background: Recently, the demand for esthetic restorations has grown dramatically and extended into the pediatric population. The prefabricated zirconia crowns (PZCs) and custom-made zirconia crowns (CZCs) are new esthetic options in pediatric dentistry. However, they are still inadequately tested for use in children. Aim: To determine the fracture resistance and failure mode of the PZC in comparison to the CZC. Materials and Methods: In this in-vitro study, thirty cobalt-chromium dies were fabricated by scanning the negative replica of a prefabricated lower first permanent molar zirconia crown. CZCs were designed and milled using two different zirconia brands: Ceramill Zolid-FX (FX) and the Highly-Translucent (HT) zirconia. Dies were randomly assigned to receive either a PZC or a CZC (n = 10 in each group). All crowns were cemented on their respective dies using glass ionomer cement. Following artificial aging, all specimens were loaded to failure. Fracture mode analysis was performed. One-way ANOVA and Bonferroni post-hoc test were used for multiple comparisons across the groups. The significant level was set at p ≤ 0.05. Results: HT zirconia had a significantly higher fracture load compared to other groups (p < 0.05). The mean fracture resistance values were: (3087 ± 385) N for HT zirconia, (2633 ± 300) N for PZCs, and (2483 ± 381) N for FX, with no statistically significant difference in fracture strengths between PZCs and FX. Conclusions: HT zirconia crowns showed the highest fracture resistance amongst all groups. The fracture loads of tested crowns exceeded the maximum posterior biteforce. When placed in permanent molars, PZC are expected to perform well under masticatory forces in children. Full article

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14 pages, 793 KiB

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

Viewed by 503

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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13 pages, 686 KiB

Open AccessArticle

Home Efficacy of a Postbiotic-Based Gel Compared with a Gel Without Active Ingredients for the Treatment of Gingival Inflammation in Patients with Down Syndrome: A Randomized Controlled Study

by Andrea Scribante, Paolo Appendino, Carolina Maiorani, Paolo Fontanarosa, Maurizio Pascadopoli, Sara Cammisuli, Basmala Azouz, Simone Buttiglieri and Andrea Butera

Dent. J. 2025, 13(2), 62; https://doi.org/10.3390/dj13020062 - 30 Jan 2025

Viewed by 650

Abstract

Objectives: The aim of this six-month randomized controlled study was to evaluate the efficacy of a non-surgical periodontal treatment combined with the use of an active gel compared to a non-surgical treatment alone in reducing inflammatory indices in periodontal patients with Down syndrome. [...] Read more.

Objectives: The aim of this six-month randomized controlled study was to evaluate the efficacy of a non-surgical periodontal treatment combined with the use of an active gel compared to a non-surgical treatment alone in reducing inflammatory indices in periodontal patients with Down syndrome. Methods: A total of 40 patients were included in the study, 20 of which were assigned to the active group and 20 to the control group. The active group underwent non-surgical periodontal treatment supplemented by daily home application of an intensive soothing gel containing probiotics. The control group received non-surgical periodontal treatment combined with the application of a gel without active ingredients. The following clinical indices were assessed: Bleeding on Probing (BOP %), Plaque Control Record (PCR %), Mobility (Miller Index), and Modified Marginal Gingival Index (MGI). Measurements were taken at baseline (T0), one month after treatment initiation (T1), after three months (T2), and after six months (T3). The patient compliance was evaluated at each visit, and product satisfaction was assessed through a questionnaire using a Visual Analogue Scale (VAS). Results: By the end of the study, statistically significant improvements were observed in both the groups from T0 to T3 evaluation (p < 0.05). The BOP score was significantly lower in the Trial group at the T3 intergroup evaluation (p < 0.05). Conclusions: A soothing gel with postbiotic and natural compounds was a valuable adjunct to non-surgical periodontal treatment to improve periodontal health in patients with Down syndrome, reducing BOP after 6 months of treatment. Full article

(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)

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13 pages, 4632 KiB

Open AccessArticle

Study of Podoplanin-Deficient Mouse Bone with Mechanical Stress

by Takenori Kanai, Kyoko Osawa, Koichiro Kajiwara, Yoshiaki Sato and Yoshihiko Sawa

Dent. J. 2025, 13(2), 61; https://doi.org/10.3390/dj13020061 - 29 Jan 2025

Viewed by 510

Abstract

Objective: We investigated morphological differences in osteocyte processes between aged mice and our original podoplanin-conditional knockout (cKO) mice in which the floxed exon 3 of podoplanin was deleted by Dmp-1-driven Cre (Dmp1-Cre;PdpnΔ/Δ). Methods: SEM observation on osteocyte cell process, histochemistry for bone remodeling [...] Read more.

Objective: We investigated morphological differences in osteocyte processes between aged mice and our original podoplanin-conditional knockout (cKO) mice in which the floxed exon 3 of podoplanin was deleted by Dmp-1-driven Cre (Dmp1-Cre;PdpnΔ/Δ). Methods: SEM observation on osteocyte cell process, histochemistry for bone remodeling with mechanostress, and RT-PCR for RANKL and M-CSF in podoplanin cKO mouse bone with mechanostress was investigated. Results: SEM observations showed fewer and thinner osteocyte processes in femurs from 23-week-old Dmp1-Cre;PdpnΔ/Δ mice than from 23-week-old wild-type mice, while the numbers of osteocyte processes in femurs and calvarias were similar in 23-week-old Dmp1-Cre;PdpnΔ/Δ mice and 48-week-old wild-type mice. Furthermore, cell process numbers in femurs and calvarias were significantly smaller in 23-week-old Dmp1-Cre;PdpnΔ/Δ mice than in 48-week-old wild-type mice. In the test for differences in alveolar bone resorption under mechanical stress between Dmp1-Cre;PdpnΔ/Δ and wild-type mice, the area of TRAP-positive resorption pits was larger in wild-type mice than in Dmp1-Cre;PdpnΔ/Δ mice. In a quantitative tissue PCR analysis, the mRNA expression levels of RANKL and M-CSF in alveolar bone under mechanical stress were significantly lower in Dmp1-Cre;PdpnΔ/Δ mice than in wild-type mice. These results suggest that a reduction in cell process formation in osteocytes with podoplanin cKO affected the absorption of alveolar bone under mechanical stress in Dmp1-Cre;PdpnΔ/Δ mice. Conclusions: In podoplanin-deficient bone, the deformation of osteocyte processes by mechanical stimuli is not recognized as a stress due to the lower number of cell processes with podoplanin deficiency; therefore, the production of osteoclast migration/differentiation factors by activated osteocytes is not fully induced and macrophage migration to alveolar bone with mechanical stress appeared to be suppressed. These results indicate that podoplanin-dependent osteocyte process formation indirectly plays a key role in sensing mechanical stress in bone. Full article

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25 pages, 5099 KiB

Open AccessArticle

Pathophysiological Responses of Oral Keratinocytes After Exposure to Flavored E-Cigarette Liquids

by Abrar Shamim, Hannah Herzog, Raivat Shah, Sara Pecorelli, Virginia Nisbet, Ann George, Giancarlo A. Cuadra and Dominic L. Palazzolo

Dent. J. 2025, 13(2), 60; https://doi.org/10.3390/dj13020060 - 29 Jan 2025

Viewed by 870

Abstract

Background: Electronic cigarettes (ECIGs) have grown in popularity, particularly among adolescents and young adults. Flavored ECIG-liquids (E-liquids) are aerosolized by these ECIGs and inhaled into the respiratory system. Several studies have shown detrimental effects of E-liquids in airway tissues, revealing that flavoring agents [...] Read more.

Background: Electronic cigarettes (ECIGs) have grown in popularity, particularly among adolescents and young adults. Flavored ECIG-liquids (E-liquids) are aerosolized by these ECIGs and inhaled into the respiratory system. Several studies have shown detrimental effects of E-liquids in airway tissues, revealing that flavoring agents may be the most irritating component. However, research on the effects of E-liquids on biological processes of the oral cavity, which is the first site of aerosol contact, is limited. Hence, this study focuses on the effects of E-liquid flavors on oral epithelial cells using the OKF6/TERT-2 cell line model. Methodology: E-liquid was prepared with and without flavors (tobacco, menthol, cinnamon, and strawberry). OKF6/TERT-2 oral epithelial cells, cultured at 37 °C and 5% CO₂, were exposed to 1% E-liquid ± flavors for 24 h. Outcomes determined include cell morphology, media pH, wound healing capability, oxidative stress, expression of mucin and tight junction genes, glycoprotein release, and levels of inflammatory cytokines (TNFα, IL-6, and IL-8). Results: Exposure to 1% flavored E-liquids negatively affect cellular confluency, adherence, and morphology. E-liquids ± flavors, particularly cinnamon, increase oxidative stress and production of IL-8, curtail wound healing recovery, and decrease glycoprotein release. Gene expression of muc5b is downregulated after exposure to E-liquids. In contrast, E-liquids upregulate occludin and claudin-1. Conclusions: This study suggests that ECIG use is not without risk. Flavored E-liquids, particularly cinnamon, result in pathophysiological responses of OKF6/TERT-2 cells. The dysregulation of inflammatory responses and cellular biology induced by E-liquids may contribute to various oral pathologies. Full article

(This article belongs to the Special Issue Dentistry in the 21st Century: Challenges and Opportunities)

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19 pages, 940 KiB

Open AccessSystematic Review

Orthodontic Management of Different Stages and Grades of Periodontitis According to the 2017 Classification of Periodontal Diseases

by Nada Tawfig Hashim, Shahistha Parveen Dasnadi, Hassan Ziada, Muhammed Mustahsen Rahman, Ayman Ahmed, Riham Mohammed, Md Sofiqul Islam, Rohan Mascarenhas, Bakri Gobara Gismalla and Neamat Hassan Abubakr

Dent. J. 2025, 13(2), 59; https://doi.org/10.3390/dj13020059 - 29 Jan 2025

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Abstract

Background/Objectives: The 2017 Periodontal Classification offers a comprehensive framework for the diagnosis and management of periodontitis based on staging and grading criteria. Orthodontic therapy is increasingly incorporated into the management of periodontitis to rectify malocclusion, pathological tooth migration, and occlusal stability. Nonetheless, few [...] Read more.

Background/Objectives: The 2017 Periodontal Classification offers a comprehensive framework for the diagnosis and management of periodontitis based on staging and grading criteria. Orthodontic therapy is increasingly incorporated into the management of periodontitis to rectify malocclusion, pathological tooth migration, and occlusal stability. Nonetheless, few data directly correspond with this revised classification scheme. The objective of this systematic review is to figure out the influence of orthodontic therapy on periodontal outcomes in patients with Stage III and IV periodontitis, as categorized by the 2017 framework. Methods: A systematic review was performed in accordance with the PRISMA 2020 principles. The databases examined were PubMed, Web of Science, Scopus, and Google Scholar. The evaluation focuses on research published from 2012 to 2024. Seventeen studies were assessed after the application of the inclusion criteria. Key outcomes included clinical attachment level (CAL) improvement, probing depth (PD) decrease, and radiographic bone fill. Results: The integration of orthodontic treatment with periodontal therapy markedly enhanced CAL (mean gain: 4.35–5.96 mm), decreased PD (mean reduction: 3.1–6.3 mm), and facilitated radiographic bone regeneration (mean vertical fill: 4.89 mm). Patients with Stage IV Grade C periodontitis had the most significant improvement, especially with early orthodontic intervention subsequent to regenerative treatment. Prolonged follow-ups (up to 10 years) validated consistent results. Conclusions: Orthodontic intervention, as a supplementary measure to periodontal therapy, improves results in severe periodontitis, especially in Stage III and IV patients. These results underscore the need for multidisciplinary teamwork and defined protocols for including orthodontics in periodontitis therapy. Full article

(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)

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Dent. J., Volume 13, Issue 2 (February 2025) – 44 articles

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