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Dentistry Journal
Volume 14
Issue 2
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Dent. J., Volume 14, Issue 2 (February 2026) – 59 articles

Cover Story (view full-size image): The management of curved root canals remains a challenge in the success of endodontic treatment. In this study, human teeth extracted for reasons unrelated to this study were divided according to the degree of canal curvature (severe, moderate or straight) and distributed into experimental groups based on the rotary system used: ProTaper Next, TruNatomy, ProTaper Ultimate and Race Evo. Cone-beam computed tomography images were obtained before and after instrumentation, and the measured values enabled comparison of the performance of the four rotary file systems in terms of wear, canal transportation, and centering ability in straight, moderately or severely curved root canals. This study provides additional information to support more informed decision-making, allowing us to select an appropriate system for different challenging anatomies. View this paper
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14 pages, 4950 KB  
Case Report
Extranodal NK/T-Cell Lymphoma, Nasal Type, Presenting as an Isolated Oral Manifestation
by Andrea Kanizsai, Ágnes Bán, László Kereskai and Árpád Szomor
Dent. J. 2026, 14(2), 129; https://doi.org/10.3390/dj14020129 - 23 Feb 2026
Viewed by 526
Abstract
Background/Objectives: Extranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT), is a rare and extremely aggressive subtype of non-Hodgkin lymphoma that most frequently involves the nasal cavity and upper aerodigestive tract. Primary isolated oral manifestation is exceptionally uncommon and may mimic odontogenic or infectious diseases, [...] Read more.
Background/Objectives: Extranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT), is a rare and extremely aggressive subtype of non-Hodgkin lymphoma that most frequently involves the nasal cavity and upper aerodigestive tract. Primary isolated oral manifestation is exceptionally uncommon and may mimic odontogenic or infectious diseases, delaying diagnosis. We report a case of ENKTCL-NT presenting initially as a destructive oral lesion without sinonasal involvement at diagnosis. Methods: A 32-year-old man with progressive palatal ulceration underwent clinical and imaging assessment (panoramic radiography and staging ^18F-FDG PET–CT) and repeated biopsies. Diagnosis was established using histopathology (H&E), immunohistochemistry (T-cell markers and cytotoxic profile), EBV detection by EBER in situ hybridization, and T-cell receptor gamma (TCRG) gene rearrangement analysis. Results: The lesion presented as a hemorrhagic, ulcerative palatal destruction covered by pseudomembranous exudate and was complicated by fungal infection, periostitis, and severe dental inflammatory foci, contributing to diagnostic delay. Histopathological examination revealed extensive necrosis with a dense atypical lymphoid infiltrate; angiocentric and angiodestructive growth was identified in one biopsy specimen. Tumor cells expressed T-cell markers (CD2, CD3, CD5, CD7; heterogeneous) and cytotoxic markers (TIA-1) and showed CD30 and CD56 positivity, with EBV positivity confirmed by EBER in situ hybridization. Molecular analysis demonstrated monoclonal TCRG rearrangement, and Ki-67 indicated high proliferative activity. Initial PET–CT demonstrated an intensely FDG-avid, locally invasive lesion without distant organ involvement. The patient was treated with L-asparaginase-based SMILE chemotherapy followed by radiotherapy (50 Gy), achieving marked initial clinical improvement and partial metabolic response; however, systemic relapse subsequently occurred with refractory disease despite salvage therapy and immunotherapy. Conclusions: This case highlights the substantial diagnostic challenge posed by isolated oral extranodal NK/T-cell lymphoma, nasal type, which may closely mimic benign inflammatory or infectious conditions and lead to significant diagnostic delay. Persistent, progressive, or therapy-resistant oral ulcerations should prompt early consideration of hematologic malignancy. Timely biopsy with comprehensive immunophenotyping, EBV testing, and close multidisciplinary collaboration are essential for accurate diagnosis and may contribute to earlier diagnosis and improved patient outcomes in these rare and atypical presentations. Full article
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13 pages, 1092 KB  
Article
International Perspectives on Digital and Generative AI Adoption and Governance in Undergraduate Dental Education: A Cross-Sectional Survey
by Isabel C. Olegário, Niamh Coffey, Akhilanand Chaurasia and Albert Leung
Dent. J. 2026, 14(2), 128; https://doi.org/10.3390/dj14020128 - 23 Feb 2026
Viewed by 429
Abstract
Background/Objectives: Digital technologies and generative artificial intelligence (AI) are increasingly used in undergraduate dental education, yet international variations in adoption and governance remain insufficiently described. This study aimed to characterise cross-national patterns of educational software use, perceived importance for curriculum delivery, and institutional [...] Read more.
Background/Objectives: Digital technologies and generative artificial intelligence (AI) are increasingly used in undergraduate dental education, yet international variations in adoption and governance remain insufficiently described. This study aimed to characterise cross-national patterns of educational software use, perceived importance for curriculum delivery, and institutional readiness for AI governance. Methods: A cross-sectional online survey of educators and academic administrators involved in undergraduate dental education captured institutional software use across teaching delivery, learning management, assessment, clinical record systems, imaging, simulation, digital workflows, and generative AI. Results: A total of 97 respondents from 38 countries completed the survey, with most institutions delivering both undergraduate and postgraduate dental education (66.0%). Videoconferencing platforms were widely adopted. LMS provision varied, with Google Classroom, Moodle, and Blackboard most frequently reported. Paper-based clinical records remained in use in 32% of institutions. Among digital PMS/EDR platforms, axiUm, Salud/Titanium, and Carestream Dental were the most prevalent. Adoption of simulation software, CAD/CAM systems, and 3D printing was inconsistent. LMS and videoconferencing were most often rated as essential, whereas simulation, scanners, CAD/CAM, and 3D printing were generally considered useful but not essential. Generative AI use was commonly reported, while formal institutional guidance and policies were frequently absent. Conclusions: Although digital integration in undergraduate dental education is widespread, its distribution is uneven across different regions and technology domains. The combination of rapid generative AI uptake and limited governance highlights an urgent need for institution-level guidance, staff development, and strategic investment to support responsible and equitable integration. Full article
(This article belongs to the Special Issue Dental Education: Innovation and Challenge)
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14 pages, 6635 KB  
Article
Human and Artificial Intelligence (AI) Analysis of Patient Experiences of Periodontal Graft Surgery
by William W. N. Mak, Timothy Budden, Sushil Kaur and Maurice J. Meade
Dent. J. 2026, 14(2), 127; https://doi.org/10.3390/dj14020127 - 23 Feb 2026
Viewed by 312
Abstract
Background/Objectives: The prominent role the internet plays in being a source of dental information prompts qualitative evaluation of relevant online content. This study aimed to explore patients’ experience regarding periodontal graft surgery communicated through the social media platform YouTube. Methods: An [...] Read more.
Background/Objectives: The prominent role the internet plays in being a source of dental information prompts qualitative evaluation of relevant online content. This study aimed to explore patients’ experience regarding periodontal graft surgery communicated through the social media platform YouTube. Methods: An initial YouTube search using the term “gum surgery experience” retrieved 40 videos. Graft surgery was the most frequently discussed procedure, and 19 relevant videos were included in the qualitative analysis. Video content was analysed using a combined human-centered and artificial intelligence (AI)–assisted approach. AI-supported analysis of viewer comments was conducted using ChatGPT-4 and Gemini-1.5 Pro. Themes generated by human and AI analyses were compared. Results: Nine key themes were identified from the 19 videos that satisfied selection criteria. Most themes were similar between human and AI analyses, with six overlapping and three unique. The most frequently coded theme was post-operative recovery (n = 177), with pain, work absence, eating difficulties, and disrupted oral hygiene commonly reported. Patient-clinician relationships were frequently highlighted, with mixed experiences regarding communication and trust. Positive experiences were reported more frequently than negative. Comment analysis revealed varied audience engagement and sentiments, emphasizing concerns about pain, recovery, and procedural anxiety. Conclusions: Key themes related to patient experiences were identified, notably concerns regarding post-operative recovery and patient-clinician relationships. Challenges in finding information prior to having surgeries motivated patients to provide support and advice on YouTube, emphasizing the need for patient-centered resources and effective patient-clinician communication. Integrating human and AI methods in qualitative analysis was efficient and insightful, with AI supplementing but not substituting human research. Full article
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16 pages, 1778 KB  
Article
Caries Risk Assessment and Management in Europe: The Multi-Country Observational CARMEN Study
by José Frias-Bulhosa, Agnieszka Mielczarek, Nikolai Sharkov, Maria Gaveli, Ana Luísa Costa, Alberto Ogalla, Pierre-Marie Voisin, Sylvain Levet and Jean-Noel Vergnes
Dent. J. 2026, 14(2), 126; https://doi.org/10.3390/dj14020126 - 23 Feb 2026
Viewed by 661
Abstract
Background: This observational ambispective longitudinal international study explored dentists’ practices and patient records concerning dental caries risk management across four European countries (Bulgaria, Greece, Poland and Portugal). Methods: Dentist volunteers recruited patients needing caries risk management, either through preventive or curative measures, from [...] Read more.
Background: This observational ambispective longitudinal international study explored dentists’ practices and patient records concerning dental caries risk management across four European countries (Bulgaria, Greece, Poland and Portugal). Methods: Dentist volunteers recruited patients needing caries risk management, either through preventive or curative measures, from their regular practice. Analyses focused on assessing dentists’ practices in caries risk assessment and management, along with gathering information on patient and dentist characteristics, oral health assessments, and caries risk evaluation. Results: A total of 51 dentists recruited 1008 patients. Across the countries studied, caries risk assessment and management methods varied, with fewer than 15% of dentists using standardized tools. Primary assessment methods included oral examinations and medical interviews, while nutritional and fluoride intake assessments were less common, and salivary or microbiological tests were rare. There was an inverse association between the risk of dental caries and patients’ socioeconomic status. Specific university training on caries risk showed a positive correlation with adherence to recommendations. Conclusions: Our findings emphasize the importance of clinicians adapting their approaches to individual patient needs in caries risk assessment and management. However, the wide array of available risk assessment tools presents a challenge, underscoring the necessity of integrating biopsychosocial models into dental practice to effectively deliver personalized care. Full article
(This article belongs to the Special Issue Updates and Highlights in Cariology)
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14 pages, 2574 KB  
Article
Anti-Inflammatory Effects on Periodontal Tissue and Antibacterial Effects on Oral Bacteria of Chlorogenic Acid
by Yuya Suzuki, Kosuke Maruyama, Masato Mikami and Soh Sato
Dent. J. 2026, 14(2), 125; https://doi.org/10.3390/dj14020125 - 22 Feb 2026
Viewed by 926
Abstract
Objectives: Combining mechanical plaque control, the physical removal of oral biofilm, with chemical plaque control, the use of agents to inhibit biofilm formation, is effective in preventing periodontal disease. Chlorogenic acid (CGA) found in coffee beans has medicinal effects, such as anti-inflammatory [...] Read more.
Objectives: Combining mechanical plaque control, the physical removal of oral biofilm, with chemical plaque control, the use of agents to inhibit biofilm formation, is effective in preventing periodontal disease. Chlorogenic acid (CGA) found in coffee beans has medicinal effects, such as anti-inflammatory and antibacterial properties. Periodontal pathogens are difficult to reach in certain areas with traditional self-care tools, such as toothbrushes. Additionally, the viscous biofilm is difficult to remove using mechanical plaque control alone. Therefore, this study aimed to evaluate the efficacy of CGA in chemical plaque control. Methods: The mRNA and protein expression of inflammatory cytokines in lipopolysaccharide (LPS)-stimulated human gingival fibroblasts (HGFs) and human periodontal ligament fibroblasts (HPDLs) in the presence of CGA were analyzed using reverse transcription-qPCR and enzyme-linked immunosorbent assay. Additionally, the proliferation levels of oral bacteria in the presence of CGA were evaluated. Results: CGA suppressed mRNA and protein expression levels of the inflammatory cytokines, interleukin (IL)-1β and IL-8, in HGFs and HPDLs stimulated with Porphyromonas gingivalis LPS. Furthermore, CGA inhibited bacterial proliferation of Streptococcus mutans, Aggregatibacter actinomycetemcomitans, P. gingivalis, and Fusobacterium nucleatum. Conclusions: This study demonstrated that CGA exhibits anti-inflammatory effects on gingiva and periodontal ligaments, and antibacterial effects against oral bacteria. These results indicate the potential application of CGA in chemical plaque control and suggest its use in preventing periodontal disease progression. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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13 pages, 890 KB  
Article
Effects of At-Home Bleaching on Color Stability and Surface Roughness of Single-Shade, ORMOCER-Based, and Conventional Resin Composites
by Colwin Yee, Hassan Ziada and Neamat Hassan Abubakr
Dent. J. 2026, 14(2), 124; https://doi.org/10.3390/dj14020124 - 22 Feb 2026
Viewed by 332
Abstract
Background/Objectives: This study evaluated the effects of at-home bleaching on color stability (ΔE) and surface roughness (Ra) of a single-shade nanohybrid composite, an ORMOCER-based composite, and a conventional nanohybrid resin composite, acknowledging that bleaching represents only one of several clinical ageing challenges. [...] Read more.
Background/Objectives: This study evaluated the effects of at-home bleaching on color stability (ΔE) and surface roughness (Ra) of a single-shade nanohybrid composite, an ORMOCER-based composite, and a conventional nanohybrid resin composite, acknowledging that bleaching represents only one of several clinical ageing challenges. Methods: One hundred and five extracted, non-carious human molars received standardized Class I restorations and were randomly allocated to five groups (n = 21): an ORMOCER-based composite (Admira Fusion), a single-shade composite (Omnichroma), Omnichroma bonded with an alternative universal adhesive, and two conventional nanohybrid composites (Filtek Supreme Ultra and Harmonize). Baseline and experimental color (CIELAB, ΔE) were measured with a spectrophotometer, and surface roughness (Ra) was measured using a 3D optical profilometer. Specimens underwent five bleaching cycles using 22% carbamide peroxide, with each cycle consisting of 8 h of bleaching followed by 16 h of storage in artificial saliva at 37 °C. Measurements were taken at baseline and after each cycle. The data were analyzed using a repeated-measures ANOVA, with bleaching cycle as the within-subject factor, the effect sizes reported as partial eta-squared (ηp2), and the statistical significance set at α = 0.05. Results: All restorative materials exhibited progressive color change with repeated bleaching, and ΔE values exceeded established clinical acceptability thresholds across materials. The extent of color change varied among materials. None of the evaluated materials maintained clinically acceptable color stability following repeated bleaching cycles. The single-shade composite (Omnichroma) demonstrated the greatest magnitude of color change, particularly when bonded with Scotchbond Universal Bond. Admira Fusion and Filtek Supreme Ultra had lower ΔE values but still exceeded acceptability thresholds. Surface roughness generally decreased following bleaching, with statistically significant reductions in Ra observed for multiple materials. Admira Fusion and Omnichroma bonded with Tokuyama Universal Bond showed minimal surface alteration. Conclusions: All restorative materials demonstrated clinically unacceptable color changes following bleaching, indicating limited esthetic stability under bleaching conditions. ORMOCER-based composites showed comparatively greater resistance to surface roughness alterations. Full article
(This article belongs to the Special Issue Dental Materials Design and Application)
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11 pages, 1179 KB  
Article
Clinical Outcomes of Bovine Bone Xenografts Following Sequestrectomy in Advanced Medication-Related Osteonecrosis of the Jaw
by Raluca Maracineanu, Ciprian Roi, Marilena Dinuti, Alexandra Roi, Florin Urtila, Anca Tudor, Ivona Mihaela Hum and Serban Talpos-Niculescu
Dent. J. 2026, 14(2), 123; https://doi.org/10.3390/dj14020123 - 21 Feb 2026
Viewed by 374
Abstract
Background/Objectives: Bisphosphonates, a class of drugs that are widely used in the treatment of neoplastic diseases, can lead to the development of medication-related osteonecrosis of the jaw (MRONJ). This condition is challenging to manage due to the high incidence of postoperative complications: [...] Read more.
Background/Objectives: Bisphosphonates, a class of drugs that are widely used in the treatment of neoplastic diseases, can lead to the development of medication-related osteonecrosis of the jaw (MRONJ). This condition is challenging to manage due to the high incidence of postoperative complications: superinfections, local wound dehiscence, or fractures in pathological bone. The aim of this study is to evaluate the therapeutic role of bovine-derived xenografts in the management of MRONJ. Methods: This retrospective observational study evaluates the clinical outcomes of patients with confirmed stage II or III MRONJ, after surgical treatment with Bio-Oss application. All patients had received zoledronic acid therapy, which was discontinued for a minimum of four months prior to surgical intervention. The surgical protocol included local debridement, sequestrectomy, and grafting of the residual defect with a bone substitute, followed by periodic clinical evaluations and monitoring of local healing with a follow-up period of up to one year. Results: Of the total number of patients treated according to this surgical protocol, 85.71% achieved favorable healing without complications at 8 weeks. Cases with poor local healing results were more likely to have prolonged zoledronic acid administration. Conclusions: Within the limits of this retrospective observational study, the use of bovine-derived xenografts following sequestrectomy in stage II–III MRONJ was associated with satisfactory local healing in several cases. However, considering the limited sample size and lack of a comparator group, these findings should be interpreted cautiously. To better understand the connection between the length of antiresorptive therapy, surgical management techniques, and postoperative outcomes, more prospective, multicenter trials with bigger patient cohorts are needed. Full article
(This article belongs to the Section Oral and Maxillofacial Surgery)
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21 pages, 5262 KB  
Case Report
Root Resective Procedures: A Case Series of Tooth Hemisection and Bicuspidization with Prosthetic Rehabilitation in Contemporary Dental Practice
by Sofia Sokratous, Andreas Krokidis and Nikolaos P. Kerezoudis
Dent. J. 2026, 14(2), 122; https://doi.org/10.3390/dj14020122 - 20 Feb 2026
Viewed by 434
Abstract
Background/Objective: Root resective procedures are well established tooth-preserving techniques used when pathology is confined to one root of a multirooted tooth or in the furcation area. Although in recent years implant therapy has become a standard approach in many cases, the rising [...] Read more.
Background/Objective: Root resective procedures are well established tooth-preserving techniques used when pathology is confined to one root of a multirooted tooth or in the furcation area. Although in recent years implant therapy has become a standard approach in many cases, the rising incidence of peri-implantitis has renewed interest in classical conservative treatment alternatives, such as hemisection, root resection and bicuspidization. The aim of this study is to present clinical cases in which hemisection and bicuspidization were performed to maintain compromised molars in function and achieve long-term outcomes. Methods: This retrospective case series study was conducted in a private dental practice and included three patients treated between 2009 and 2017. The presented cases involved molar teeth exhibiting a vertical fracture or extensive subgingival carries in one root while the remaining root(s) demonstrated favourable periodontal, endodontic and restorative prognosis. An interdisciplinary approach was followed in each case, involving comprehensive clinical and radiographic evaluation including cone beam computed tomography when indicated. The clinical treatment included an endodontic approach (primary treatment or retreatment if required) followed by hemisection or bicuspidization and placement of a permanent prosthetic rehabilitation with full-coverage restoration designed to optimize proper load distribution. Clinical and radiographic follow-up examination was done up to six years in case one, after six months in case two and up to six years in case three. Results: The teeth remained in function through their respective follow-up periods. Clinical and radiographic assessments, according to predefined success criteria, demonstrated periodontal stability (probing depth ≤ 4 mm), no evidence of secondary caries or root fracture, absence of clinical symptoms, normal tooth mobility and masticatory function, absence or reduction in periradicular radiolucency, and stable bone levels. Conclusions: Resective techniques require an interdisciplinary approach, namely, careful case selection, lege artis endodontic treatment, precise surgical technique, and appropriate prosthetic rehabilitation, in order to provide predictable and long-term outcomes. Within the limitations of this case series, resective techniques appeared to be a reliable and predictable alternative to extraction and implant placement in carefully selected clinical cases. Full article
(This article belongs to the Special Issue Present Status and Future Directions in Endodontics)
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14 pages, 666 KB  
Article
Early Clinical Outcomes of Full-Arch Rehabilitations with Immediately Loaded Implants with Buccal Dehiscence Treated with Horizontal Augmentation: A 1-Year Retrospective Case Series
by Alfonso Acerra, Mario Caggiano, Angelo Aliberti, Michele Langone and Francesco Giordano
Dent. J. 2026, 14(2), 121; https://doi.org/10.3390/dj14020121 - 19 Feb 2026
Viewed by 311
Abstract
Background: Buccal bone dehiscence is a frequent finding during implant placement and often requires horizontal bone augmentation. When combined with immediate loading protocols, concerns remain regarding early implant stability and failure risk. This retrospective case series aimed to describe the early clinical [...] Read more.
Background: Buccal bone dehiscence is a frequent finding during implant placement and often requires horizontal bone augmentation. When combined with immediate loading protocols, concerns remain regarding early implant stability and failure risk. This retrospective case series aimed to describe the early clinical outcomes of immediately loaded implants placed in sites with buccal dehiscence treated by horizontal bone augmentation and restored with full-arch screw-retained prostheses. Methods: Fifty-nine consecutive edentulous patients were rehabilitated with immediately loaded cross-arch implant-supported prostheses. A total of 253 implants were placed, including 148 implants presenting buccal dehiscence and treated with horizontal bone augmentation using particulate grafting materials with or without autogenous bone and a resorbable collagen membrane. Clinical outcomes were assessed over a 1-year follow-up period. Implant survival and biological complications were recorded. Descriptive statistics were applied. An exploratory event-based comparison between augmented and non-augmented implants was performed using Fisher’s exact test, and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. Results: At 1 year, no patients were lost to follow-up. Two implant failures occurred, both in augmented sites (2/148; 1.35%), while no failures were observed among non-augmented implants (0/105). The exploratory comparison did not show a statistically significant difference in failure rates between groups (p = 0.51). The estimated RR for implant failure associated with horizontal augmentation was 3.56 (95% CI: 0.17–73.34). Two biological complications (one peri-implantitis and one peri-implant mucositis) were recorded, both involving augmented implants. Conclusions: Within the limitations of this retrospective case series, immediately loaded implants placed in sites with buccal dehiscence and treated with horizontal bone augmentation demonstrated high early survival rates and a low incidence of biological complications. These findings are descriptive and exploratory and should be interpreted as hypothesis-generating. Further prospective controlled studies with longer follow-up are needed to confirm these observations. Full article
(This article belongs to the Special Issue Contemporary Dentistry: Classical and Modern Approaches)
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20 pages, 18996 KB  
Article
Comparative Evaluation of Conventional and Digital Workflow Impressions for Implant-Supported Restorations
by Cristian Abad-Coronel, David Ruiz, Miguel Ángel Quelal, Diana Estrada, Nancy Mena Córdova and Paulina Aliaga
Dent. J. 2026, 14(2), 120; https://doi.org/10.3390/dj14020120 - 18 Feb 2026
Viewed by 474
Abstract
Background: Digital technologies, particularly CAD/CAM workflows, have transformed implant prosthodontics by improving the accuracy and efficiency of impression procedures, facilitating clinician–laboratory communication, and supporting the preservation of peri-implant tissues. Objective: To compare the three-dimensional accuracy (trueness) and passive fit of five conventional and [...] Read more.
Background: Digital technologies, particularly CAD/CAM workflows, have transformed implant prosthodontics by improving the accuracy and efficiency of impression procedures, facilitating clinician–laboratory communication, and supporting the preservation of peri-implant tissues. Objective: To compare the three-dimensional accuracy (trueness) and passive fit of five conventional and digital impression techniques for fixed prostheses supported by two implants. Methods: An in vitro experimental study was conducted using a partially edentulous maxillary model with two implants supporting a three-unit zirconia bridge. Five impression workflows were evaluated: conventional techniques (open-tray and closed-tray, splinted and non-splinted) and digital impressions using plastic and titanium scan bodies. Three-dimensional accuracy was assessed by digital superimposition analysis, and passive fit was evaluated by marginal gap measurements using digital microscopy and ImageJ (version 1.54r) software. Statistical analyses were performed using exploratory ANOVA with Welch’s correction and Games–Howell post hoc tests (p < 0.05), complemented by effect size analysis. Results: Three-dimensional superimposition analysis revealed that digital impression workflows and the splinted conventional open-tray technique exhibited the highest trueness, with minimal spatial deviations relative to the reference model, together with the lowest marginal gap values (<1 µm). The non-splinted open-tray technique presented higher discrepancies (7.37 ± 0.94 µm), although all techniques remained within clinically acceptable tolerance ranges (60–150 µm). Conclusions: Under controlled in vitro conditions, both digital impression techniques and conventional splinted protocols achieve high three-dimensional accuracy and clinically acceptable passive fit for multi-implant-supported fixed prostheses. Digital workflows represent a predictable and efficient alternative, while conventional splinted impressions remain a reliable option depending on clinical and technological considerations. Full article
(This article belongs to the Section Dental Implantology)
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20 pages, 2262 KB  
Review
Toward a Functional and Conceptual Framework for Adhesive Materials: The Role of Etching Technique
by Miguel Angel Muñoz and Issis Luque-Martinez
Dent. J. 2026, 14(2), 119; https://doi.org/10.3390/dj14020119 - 18 Feb 2026
Viewed by 427
Abstract
Background/Objectives: The classification of adhesive systems has historically relied on the type of etching agent and the sequence of application steps, distinguishing etch-and-rinse and self-etch categories. However, these models do not encompass the versatility introduced by universal adhesives or other emerging polymeric [...] Read more.
Background/Objectives: The classification of adhesive systems has historically relied on the type of etching agent and the sequence of application steps, distinguishing etch-and-rinse and self-etch categories. However, these models do not encompass the versatility introduced by universal adhesives or other emerging polymeric materials. This review aimed to integrate etching technique as a defining parameter within adhesive classification, linking material composition, bonding strategy, and clinical execution into a coherent functional framework. Methods: A structured narrative review of experimental, translational, and clinical studies published between 2010 and 2025 was conducted using PubMed and Scopus. Literature addressing adhesive categories, etching strategies, etching techniques, and smear layer characteristics was critically synthesized to identify functional relationships relevant to bonding performance and clinical decision-making. Results: The proposed taxonomy classifies materials as conventional, universal, touch-cure primers, self-adhesive/universal, and glass ionomer cements. Bonding strategies are organized as etch-and-rinse, self-etch, pre-etched, and unassisted, while etching techniques are defined as selective or nonselective families encompassing five clinically defined techniques. Incorporating etching technique clarifies the role of smear layer density, the acidity of adhesive materials, and functional monomer reactivity in demineralization and bonding. This structure enhances the understanding and teaching of adhesive concepts and supports evidence-based clinical selection of materials and techniques. Conclusions: Integrating etching technique into adhesive classification provides a functional and dynamic framework that unifies material, strategy, and technique. This taxonomy facilitates clinical decision-making and can evolve with future adhesive formulations. Further independent, long-term studies are warranted to validate the proposed combinations of materials and etching procedures. Full article
(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)
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13 pages, 2522 KB  
Article
Prevalence of Pre-Eruptive Intracoronal Resorption (PEIR) and Proposal of a Novel Classification: Retrospective Study with the Aid of Cone Beam Computed Tomography (CBCT)
by Emmanuel Mazinis, Konstantinos Ioannidis, Shanon Patel, Vassilis Karagiannis and Christos Gogos
Dent. J. 2026, 14(2), 118; https://doi.org/10.3390/dj14020118 - 17 Feb 2026
Viewed by 397
Abstract
Background/Objectives: Pre-eruptive intracoronal resorption (PEIR) in impacted or unerupted teeth often remains undiagnosed. The aim of this study was to investigate the prevalence of PEIR with the aid of cone beam computed tomography (CBCT) and propose a new three-dimensional (3D) classification for [...] Read more.
Background/Objectives: Pre-eruptive intracoronal resorption (PEIR) in impacted or unerupted teeth often remains undiagnosed. The aim of this study was to investigate the prevalence of PEIR with the aid of cone beam computed tomography (CBCT) and propose a new three-dimensional (3D) classification for the analysis of the lesions. Methods: A total of 164 unerupted teeth diagnosed in CBCT scans, derived from an equivalent number of patients, were examined for the presence of PEIR, tooth type, angulation and position. A novel 3D classification system was proposed and all PEIR lesions were further classified. The classification system was used to stage PEIR lesions according to their extend from the enamel level apically, the circumferential spread and their proximity to the pulp chamber. Descriptive statistics were used to assess the prevalence and type of resorption. The association between PEIR, demographics, tooth type, position and angulation were studied. The estimation of the multivariate relationship between PEIR, patient’s demographics and tooth characteristics was conducted with the multiple binary logistic regression model. Results: The prevalence of PEIR was 33.5%, affecting mostly maxillary canines, and maxillary and mandibular molars. The prevalence of PEIR in ages over 45 years was significantly higher (p < 0.001). The presence of PEIR was significantly associated with buccal position (p = 0.002) and buccal angulation (p = 0.016) of the tooth. Conclusions: Due to the high prevalence of PEIR, CBCT may improve detection and 3D characterization when imaging is already clinically indicated, and influence treatment planning in selected cases. Full article
(This article belongs to the Special Issue Present Status and Future Directions in Endodontics)
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14 pages, 1814 KB  
Article
Gap Formation at Luting Interfaces of CAD/CAM Ceramic and Composite Partial Crowns Assessed by OCT
by Nadia Oberück, Dennis Palsa, Tobias Meißner, Marco Pellino, Rainer Haak, Ellen Schulz-Kornas and Dirk Ziebolz
Dent. J. 2026, 14(2), 116; https://doi.org/10.3390/dj14020116 - 17 Feb 2026
Viewed by 353
Abstract
(1) Background/Objectives: Gap formation contributes to the clinical failure of partial crowns. Therefore, it was analyzed at the interfaces between restoration, luting material, and tooth in partial crowns made of lithium disilicate ceramic (LS2) and nanohybrid composite (RBC) after thermomechanical loading (TCML) [...] Read more.
(1) Background/Objectives: Gap formation contributes to the clinical failure of partial crowns. Therefore, it was analyzed at the interfaces between restoration, luting material, and tooth in partial crowns made of lithium disilicate ceramic (LS2) and nanohybrid composite (RBC) after thermomechanical loading (TCML) using optical coherence tomography (OCT). (2) Materials and Methods: Sixteen human mandibular molars were restored with CAD/CAM partial crowns made of LS2 (IPS e.max® CAD) or RBC (Tetric® CAD) using adhesive cementation (Variolink® Esthetic DC). The restorations were imaged by OCT (1550 nm, 28 kHz) at t0 = 24 h, t1 = 90 days of water, t2 = after TCML with 480,000 loading cycles, and t3 = TCML with 1,200,000 loading cycles. Gap lengths (%) at interface 1 (partial crown-luting material) and interface 2 (luting material–enamel/dentin) were quantified. Groupwise and pairwise comparison of OCT parameters was conducted using the Mann–Whitney U, Friedman, and Conover–Iman tests with Bonferroni correction (α = 0.05). (3) Results: At interface 1, LS2 showed a larger median gap length than RBC (ceramic = 48.4%; composite = 5.2%, p < 0.01). At interface 2, the largest median gap length for LS2 was measured at the dentin (ceramic = 59.7%; composite = 52.5%), while for RBC, the enamel was more affected (ceramic = 26.2%; composite = 36.9%). (4) Conclusions: OCT enables reliable gap detection in partial crowns under functional loading and is therefore suitable for monitoring adhesive interface integrity. Under in vitro conditions, both materials demonstrated stable adhesive performance without debonding, while material-dependent differences in gap formation and distribution were observed. Full article
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17 pages, 2170 KB  
Article
Comparative Evaluation of Commercial Bulk-Fill Resin-Based Composites: Flexural Properties, Roughness, Water Sorption and Solubility, and Color Stability
by Khalid S. Almulhim, Sarah M. Alghamdi, Raghad S. Alqahtani, Jood K. Alsahiem, Afnan O. Al-Zain, Mohammed M. Gad and Abdulrahman A. Balhaddad
Dent. J. 2026, 14(2), 117; https://doi.org/10.3390/dj14020117 - 14 Feb 2026
Viewed by 406
Abstract
Background/Objectives: Bulk-fill (BF) resin-based composites (RBCs) have become increasingly popular due to their efficient placement. However, there is a lack of comprehensive performance comparisons among commercially available BF RBCs. In standardized curing conditions, this study aimed to compare the mechanical performance, water [...] Read more.
Background/Objectives: Bulk-fill (BF) resin-based composites (RBCs) have become increasingly popular due to their efficient placement. However, there is a lack of comprehensive performance comparisons among commercially available BF RBCs. In standardized curing conditions, this study aimed to compare the mechanical performance, water sorption and solubility, surface roughness, and color stability of commercially available BF RBCs with different consistencies (flowable and packable). Methods: Ten BF RBCs, along with a conventional RBC (control), were evaluated. Flexural strength and elastic modulus were measured using a three-point bending test. Water sorption and solubility were assessed after 28-day water storage. Color (ΔE00) and surface roughness (ΔRa) changes were measured after 28-day immersion in water, Pepsi, or coffee. One-way ANOVA and Tukey’s tests analyzed the data. Results: 3M Flow, Shofu Bulk, and Ivoclar Flow revealed lower strength (p < 0.001) compared to 3M Bulk (132.17 ± 12.54 MPa) and the control (124.56 ± 15.60 MPa). Shofu Bulk (24.68 ± 12.55 µg/mm3) and Ivoclar Flow (27.11 ± 6.27 µg/mm3) were the least affected by water sorption. While Shofu Bulk (13.98 ± 11.39 µg/mm3), Ivoclar Flow (20.28 ± 6.64 µg/mm3), and SDR (20.84 ± 9.74 µg/mm3) exhibited the lowest solubility (p < 0.01). After water and Pepsi immersion, FGM Bulk showed a significant color change compared to 3M Bulk and Ivoclar Bulk (p < 0.05). Following coffee immersion, Shofu Bulk (17.38 ± 1.82) revealed significant color changes (p < 0.001). Increased surface roughness was observed in 3M Bulk and Ivoclar Bulk after water immersion, Shofu Bulk after Pepsi immersion, and FGM Bulk after coffee immersion. Conclusions: BF RBCs exhibit notable variability in their intrinsic properties. 3M Bulk and Control showed the highest strength, while Shofu Bulk had significant color changes. Full article
(This article belongs to the Section Dental Materials)
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19 pages, 509 KB  
Article
Assessment of Language Barriers Between Dental Students and Patients in Riyadh, Saudi Arabia—A Mixed Methods Study
by Sanjeev B. Khanagar, Samar Alanazi, Razan Alotaibi, Hebah Alenazi and Lujain Altalhi
Dent. J. 2026, 14(2), 115; https://doi.org/10.3390/dj14020115 - 14 Feb 2026
Viewed by 346
Abstract
Background: Language serves as a significant barrier to accessing dental services. Dental treatment options are often complex and involve terminology that is unfamiliar to most patients. In some cases, dental students may use technical terms that patients do not understand, leading to [...] Read more.
Background: Language serves as a significant barrier to accessing dental services. Dental treatment options are often complex and involve terminology that is unfamiliar to most patients. In some cases, dental students may use technical terms that patients do not understand, leading to confusion and misunderstandings. Therefore, this study aimed to assess the language barriers faced by dental students and patients in Riyadh, Saudi Arabia. Methods: A mixed-methods research design was employed to evaluate language barriers between dental students and patients, as it provides an in-depth understanding and generates information beyond mere numerical data. The study was conducted from 1 September 2024, to 30 August 2025, in Riyadh, Saudi Arabia. Data collection primarily involved conducting interviews with focus group members using a comprehensive topic guide consisting of predetermined questions. Results: Forty dental students and forty patients agreed to participate in this study. The students encountered significant difficulty explaining terms such as crown lengthening (72.5%) and periodontitis (67.5%), while patients reported limited understanding of interim removable dental prosthesis (65%) and fixed dental prosthesis (60%). Comparative analysis indicated that sixth-year students reported significantly more difficulty explaining “crown lengthening” and “prefabricated post and core” compared to fifth-year students. It was also observed that patients’ educational level had a significant impact on their understanding of terms such as “interim dental prosthesis” and “removable dental prosthesis.” Qualitative analysis revealed patients’ partial understanding or misinterpretation of dental terminologies. Conclusions: Our findings indicate that language discordance, even among speakers of the same native language, can hinder effective communication, particularly when technical vocabulary is involved. Students may struggle to explain procedures in a manner that patients can easily understand. This can lead to incomplete patient comprehension and potential non-compliance with treatment recommendations. Hence, we recommend incorporating Arabic dental terminologies alongside English into the curriculum, developing bilingual glossaries, and using visual aids when communicating with patients. Full article
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18 pages, 792 KB  
Review
CBCT in Evaluation of Root Canal Preparation—A Scoping Review
by Andreia Vidal, Ana Moura Teles, Miguel Cardoso, Maria Bartolomeu and Rita Noites
Dent. J. 2026, 14(2), 114; https://doi.org/10.3390/dj14020114 - 14 Feb 2026
Viewed by 327
Abstract
Cone-beam computed tomography (CBCT) is widely utilized in endodontics for evaluating root canal shaping outcomes, offering critical three-dimensional imaging capabilities. This study aims to assess the differences in apical and root canal preparation across various instrumentation techniques using CBCT. A systematic search of [...] Read more.
Cone-beam computed tomography (CBCT) is widely utilized in endodontics for evaluating root canal shaping outcomes, offering critical three-dimensional imaging capabilities. This study aims to assess the differences in apical and root canal preparation across various instrumentation techniques using CBCT. A systematic search of the Medline database (via PubMed) and Web of Science was performed up to 12 April 2025, yielding a total of 70 studies, with 45 full-text articles assessed for eligibility; 28 were included in the review. Studies showed great heterogeneity in experimental design, anatomical variables, and outcome measurements. The results indicate that rotary instruments, such as ProTaper Next® and XP-Endo Shaper®, were reported more frequently or showed favorable shaping trends in individual studies. Although rotary systems often appeared advantageous, conclusions were limited by study design variability and a lack of correlation with clinical outcomes. The evidence highlights the need for standardized methodologies and further research, especially on manual techniques. CBCT remains a valuable research tool despite inherent spatial resolution limitations. Full article
(This article belongs to the Special Issue Present Status and Future Directions in Endodontics)
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16 pages, 1745 KB  
Article
Evaluation of Four 3D Facial Scanning Technologies: From Photogrammetry to Structured-Light Systems in Clinical Dentistry
by Oana Elena Burlacu Vatamanu, Corina Marilena Cristache, Sergiu Drafta and Vanda Roxana Nimigean
Dent. J. 2026, 14(2), 113; https://doi.org/10.3390/dj14020113 - 14 Feb 2026
Viewed by 407
Abstract
Background/Objectives: Accurate three-dimensional (3D) facial scanning is increasingly important in digital dentistry for diagnosis, treatment planning, and virtual patient creation. Multiple facial scanning technologies are available; however, their metric reliability varies depending on acquisition principles and anatomical orientation. This study aimed to evaluate [...] Read more.
Background/Objectives: Accurate three-dimensional (3D) facial scanning is increasingly important in digital dentistry for diagnosis, treatment planning, and virtual patient creation. Multiple facial scanning technologies are available; however, their metric reliability varies depending on acquisition principles and anatomical orientation. This study aimed to evaluate the trueness, orientation-dependent performance (vertical midline versus horizontal facial measurements), and scanning time of four facial scanning technologies using calibrated manual anthropometry as the reference standard. Methods: Thirty dentate adult participants received adhesive fiducial markers on five predefined facial landmarks. Four linear facial distances were measured clinically using a digital caliper and compared with corresponding measurements obtained from standardized 3D facial scans. Digital measurements were extracted following uniform metric normalization. Inter-examiner reliability, measurement trueness, orientation-related differences, and scanning time were analyzed. Results: Inter-examiner reliability was excellent for both clinical and digital measurements (ICC > 0.93). All facial scanning technologies significantly overestimated manual distances (p < 0.001). The structured-light scanning system showed the smallest deviations (typically <1 mm) and the highest overall accuracy, followed by the depth-fusion system, while photogrammetry-based and NeRF-based approaches demonstrated larger errors, frequently exceeding 2–3 mm. Horizontal facial distances consistently showed greater deviations than vertical midline measurements across all systems. Scanning time differed significantly between technologies, with passive image-based approaches being the fastest and NeRF-based acquisition requiring the longest capture time. Conclusions: Active structured-light facial scanning demonstrated the highest trueness for linear facial anthropometry, whereas passive photogrammetry and NeRF-based approaches showed lower metric trueness and are currently more suitable for educational applications. Full article
(This article belongs to the Special Issue New Trends in Digital Dentistry)
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18 pages, 5209 KB  
Review
Peri-Implantitis—An Overview of Treatment Options and a New Approach to the Treatment of Peri-Implantitis Using a Magnesium Membrane in Three Case Reports
by Domagoj Vražić, Katarina Komar Milas, Marko Blašković, Ivana Butorac Prpić, Marija Čandrlić and Željka Perić Kačarević
Dent. J. 2026, 14(2), 112; https://doi.org/10.3390/dj14020112 - 13 Feb 2026
Viewed by 843
Abstract
Background/Objectives: Dental implants are a preferred solution for missing teeth, but peri-implantitis remains a major challenge in implant dentistry. This narrative review provides an overview of the therapeutic interventions for peri-implantitis based on the current literature and illustrates a new clinical approach using [...] Read more.
Background/Objectives: Dental implants are a preferred solution for missing teeth, but peri-implantitis remains a major challenge in implant dentistry. This narrative review provides an overview of the therapeutic interventions for peri-implantitis based on the current literature and illustrates a new clinical approach using novel magnesium membrane through three case presentations. Methods: A comprehensive literature search on peri-implantitis management was conducted, with emphasis on current clinical practice guidelines. In addition, three clinical cases were presented to demonstrate the use of a fully resorbable magnesium membrane in combination with a bovine xenograft with hyaluronate. Results: The narrative review identified and summarized a wide range of non-surgical and surgical therapeutic strategies for treatment of peri-implantitis. Additionally, three case reports with novel magnesium membrane highlighted distinct clinical scenarios: (1) bone defect reconstruction without implant removal, (2) reconstruction following implant removal, and (3) a minimally invasive shield technique performed without removal of the implant or crown. All cases demonstrated favorable clinical outcomes following the novel biomaterial approach. Conclusions: The combination of a resorbable magnesium membrane with bovine xenograft with hyaluronate represents a promising therapeutic strategy for treatment of peri-implantitis. This approach may improve clinical outcomes and potentially set new standards in implant dentistry. Further studies with larger cohorts and control groups are required to confirm these preliminary findings. Full article
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15 pages, 1172 KB  
Review
Transforming Dental Care Through Empathetic and Clear Communication: A Comprehensive Review and Implementation Framework
by Jasmine Cheuk Ying Ho, Joanna Cheuk Yan Hui, Hollis Haotian Chai, Michelle Zeping Huang, Edward Chin Man Lo and Chun Hung Chu
Dent. J. 2026, 14(2), 111; https://doi.org/10.3390/dj14020111 - 13 Feb 2026
Viewed by 670
Abstract
Effective dentist-patient communication underpins care, empowering informed decisions, reducing anxiety, improving efficiency, and fostering trust through clear, accurate, cohesive exchanges. This narrative review used a structured Medline search of literature, employing key terms to select and synthesize relevant English-language publications on dentist-patient communication [...] Read more.
Effective dentist-patient communication underpins care, empowering informed decisions, reducing anxiety, improving efficiency, and fostering trust through clear, accurate, cohesive exchanges. This narrative review used a structured Medline search of literature, employing key terms to select and synthesize relevant English-language publications on dentist-patient communication without strict inclusion criteria. Key strategies include active listening, empathetic dialogue, patient-centred approaches, and the use of plain language and visual aids to demystify complex information. Additionally, integrating technology for appointment reminders, virtual consultations, and feedback mechanisms can streamline interactions. Crucially, cultural competency and sensitivity to individual needs ensure inclusivity and personalized care. Building on these findings, the study outlines ten actionable pillars for effective communication: (1) Initial Consultation: Establish rapport and gather comprehensive medical/dental histories. (2) Treatment Explanation: Simplify diagnoses and options using layman’s terms. (3) Informed Consent: Transparently discuss risks/benefits and invite questions. (4) Patient Education: Clarify oral hygiene practices and post-treatment expectations. (5) Anxiety Management: Address fears through reassurance and tailored coping strategies. (6) Follow-Up Care: Maintain post-treatment engagement to resolve concerns. (7) Feedback Systems: Leverage patient insights for service improvement. (8) Cultural Sensitivity: Adapt communication to diverse backgrounds. (9) Non-Verbal Cues: Employ positive body language and active listening. (10) Technology Integration: Utilize digital tools for efficiency and accessibility. By prioritizing empathy, clarity, and adaptability, clinicians can transform dental visits from anxiety-inducing encounters into collaborative partnerships. This approach not only elevates patient satisfaction and adherence but also redefines the standard of care, aligning clinical practice with the evolving needs of modern dentistry. Full article
(This article belongs to the Section Dental Education)
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21 pages, 1317 KB  
Systematic Review
Comparison Between Natural Products and Chlorhexidine in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials
by Andrea Scribante, Matteo Pellegrini, Maurizio Pascadopoli, Valentino Natoli, Valentina Poma and Andrea Butera
Dent. J. 2026, 14(2), 110; https://doi.org/10.3390/dj14020110 - 13 Feb 2026
Viewed by 617
Abstract
Objectives: To evaluate the clinical effectiveness and safety of natural products compared with chlorhexidine (CHX) as adjuncts to non-surgical periodontal therapy (NSPT) in patients with periodontitis. Materials and Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines [...] Read more.
Objectives: To evaluate the clinical effectiveness and safety of natural products compared with chlorhexidine (CHX) as adjuncts to non-surgical periodontal therapy (NSPT) in patients with periodontitis. Materials and Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines and registered in PROSPERO (CRD420251133219). Electronic searches of PubMed, Scopus, and Web of Science were performed to identify randomized controlled trials (RCTs) published between 2020 and 2025. Eligible studies included adult patients with periodontitis treated with NSPT, comparing CHX-based products with natural formulations (mouthwashes, gels, irrigants, or dentifrices). Data extraction included product type, concentration, mode of application, follow-up duration, and primary periodontal outcomes. Study quality was assessed using the NIH Quality Assessment Tool. Results: Thirteen randomized controlled clinical trials met the inclusion criteria. Natural products such as Curcuma longa, Morus alba, Spirulina platensis, Propolis, Triphala, and Lycium barbarum demonstrated improvements in clinical attachment level (CAL) and probing pocket depth (PPD) comparable to those obtained with CHX, along with significant reductions in bleeding on probing (BoP) and plaque index (PI). Probiotic- and ozone-based treatments also showed favorable clinical outcomes, with faster healing and fewer adverse effects, such as tooth staining and taste alteration. Follow-up periods ranged from 14 days to 3 months. Conclusions: Natural products appear to be safe and effective alternatives to CHX when used as adjuncts to non-surgical periodontal therapy, providing comparable clinical benefits with a lower incidence of side effects. Nevertheless, further large-scale, long-term randomized trials are needed to standardize formulations and concentrations and to confirm the durability of these clinical effects. Full article
(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management: 2nd Edition)
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13 pages, 1124 KB  
Article
Comparative Performance of Haptic Virtual Simulation vs. Conventional Training in Class V Cavity Preparation: A Paired In Vitro Study
by Aitor Basterra López, Sebastiana Arroyo Bote, Ángel Arturo López-González, Raúl Cuesta Román, Joan Obrador de Hevia and Pere Riutord-Sbert
Dent. J. 2026, 14(2), 109; https://doi.org/10.3390/dj14020109 - 13 Feb 2026
Viewed by 277
Abstract
Background: Haptic virtual simulation (HVS) has emerged as a promising tool in dental education, yet evidence comparing its performance to conventional preclinical training remains limited. Establishing its effectiveness is essential to support its integration into competency-based curricula. Objective: The aim of this study [...] Read more.
Background: Haptic virtual simulation (HVS) has emerged as a promising tool in dental education, yet evidence comparing its performance to conventional preclinical training remains limited. Establishing its effectiveness is essential to support its integration into competency-based curricula. Objective: The aim of this study was to compare Class V cavity preparations performed using conventional training on extracted teeth with those performed using a haptic virtual simulator, evaluating preparation time and cavity volume. Methods: Sixty-one extracted human molars were digitized using cone-beam computed tomography (CBCT) to generate corresponding virtual replicas. A calibrated operator prepared 122 standardized Class V cavities (61 real and 61 virtual). The simulator automatically recorded preparation time and cavity volume. For natural teeth, cavity volume was calculated by digital superimposition of pre- and post-operative STL models using Blender. Paired means were compared using Student’s t-test (α = 0.05). Results: Preparation time was significantly shorter when using HVS compared with the conventional method (p < 0.001). Virtual preparations resulted in slightly larger cavity volumes than real preparations, with a statistically significant yet clinically small difference (p = 0.047). Conclusions: Haptic virtual simulation enables more time-efficient Class V cavity preparation while producing cavity volumes comparable to those obtained through conventional training. These findings support the implementation of haptic simulators as a valid and effective complement for preclinical skill acquisition in operative dentistry. Full article
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19 pages, 6042 KB  
Article
Impact of Taper Design on Cleaning Efficacy, Stress Generation, and Irrigant Performance: A Combined Experimental, Finite Element Analysis, and Computational Fluid Dynamics Assessment
by Celia Vinuesa Maqueda, Natalia Navarrete, Ana Ramírez-Muñoz, Ana Martín-Díaz, César de Gregorio, José Aranguren, Giulia Malvicini, Simone Grandini, Gaya C. S. Vieira and Alejandro R. Pérez
Dent. J. 2026, 14(2), 108; https://doi.org/10.3390/dj14020108 - 13 Feb 2026
Viewed by 349
Abstract
Background/Objectives: This study aimed to compare the cleaning efficacy, biomechanical stress distribution under simulated occlusal loading after instrumentation, and irrigant dynamics of three NiTi rotary systems, namely ProTaper Gold, TruNatomy, and SlimShaper, using a combined experimental, finite element analysis (FEA), and computational fluid [...] Read more.
Background/Objectives: This study aimed to compare the cleaning efficacy, biomechanical stress distribution under simulated occlusal loading after instrumentation, and irrigant dynamics of three NiTi rotary systems, namely ProTaper Gold, TruNatomy, and SlimShaper, using a combined experimental, finite element analysis (FEA), and computational fluid dynamics (CFD) approach. Methods: Transparent 3D replicas of mandibular mesial roots filled with a gel-like pulp tissue were instrumented with the three systems (n = 13 per group). Standardized irrigation was performed with 4% NaOCl delivered through IrriFlex® needles positioned 2 mm from the working length. Cleaning effectiveness was assessed through digital image analysis, FEA simulation of occlusal loading, and CFD evaluation of irrigation flow, wall shear stress, and dynamic pressure. Results: All systems left residual tissue, with no statistically significant differences in cleaning efficacy among them (p > 0.05). Descriptively, ProTaper Gold showed the lowest mean residual tissue (0.15 ± 0.25%), followed by SlimShaper (2.50 ± 3.81%) and TruNatomy (4.20 ± 5.12%). CFD revealed that ProTaper Gold generated the highest irrigant velocities and wall shear stresses, while SlimShaper showed the highest dynamic pressure. FEA indicated that ProTaper Gold produced the highest stress concentrations, especially in the pericervical dentin, whereas TruNatomy and SlimShaper preserved more dentin. Conclusions: Cleaning efficacy was comparable across systems. CFD/FEA from representative models illustrated patterns of irrigant dynamics and dentin preservation without supporting system superiority. Full article
(This article belongs to the Special Issue Endodontics and Restorative Sciences: 2nd Edition)
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16 pages, 1789 KB  
Article
Essential Attributes of a Successful Dentist: A Quantitative Study of Dental Students at a University in Mainland China
by Jasmine Cheuk Ying Ho, Hollis Haotian Chai, Michelle Zeping Huang, Edward Chin Man Lo, Hao Yu and Chun Hung Chu
Dent. J. 2026, 14(2), 107; https://doi.org/10.3390/dj14020107 - 12 Feb 2026
Viewed by 364
Abstract
Background: The pursuit of a successful dental career extends beyond clinical skills to encompass various personal and professional attributes. Understanding the qualities that define a successful dentist from the perspective of dental students is essential. Objective: This study aims to explore [...] Read more.
Background: The pursuit of a successful dental career extends beyond clinical skills to encompass various personal and professional attributes. Understanding the qualities that define a successful dentist from the perspective of dental students is essential. Objective: This study aims to explore the perspectives of dental students at a university in mainland China regarding the attributes that define a good or successful dentist. Methods: A cross-sectional survey was administered to dental students at Fujian Medical University (FJMU) from March to August 2025 using an anonymous questionnaire. The questionnaire included four self-administered questions: (1) qualities associated with “a successful dentist”, (2) qualities of “a good dentist”, (3) qualities students expect from their own dentists, and (4) qualities dental education should emphasize. For each question, participants selected the three most important attributes from a list of 23 predefined options or provided their own responses. Results: All 651 dental students at FJMU were invited to participate, with 645 (99%) completing the survey. Their ages ranged from 18 to 24 years, and 281 (44%) were male. Clinical competence, experience, knowledge, good communication skills, and a sense of responsibility or accountability were consistently ranked as the top five attributes by dental students across all four survey questions. Attributes such as punctuality and altruism received the lowest ratings. Bivariate analysis revealed that senior students (Years 4–5) considered good communication skills a more important quality than junior students (Years 1–3) across all four questions. Conclusions: Dental students in mainland China perceive clinical competence, experience, and knowledge as essential attributes for dental practice, alongside communication skills and responsibility. Full article
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11 pages, 873 KB  
Article
Marginal Fit Evaluation of Zirconia Copings Based on Conventional and Digital Impressions Using a Tooth Section Microscopic Examination Technique
by Marc Schulze, Peter Ottl and Mareike Warkentin
Dent. J. 2026, 14(2), 106; https://doi.org/10.3390/dj14020106 - 12 Feb 2026
Viewed by 335
Abstract
Background/Objectives: This study compared the marginal fit of CAD/CAM zirconia copings based on digital and conventional impression techniques by using a new method of tooth section examination. Methods: Twenty premolars were prepared for an all-ceramic full crown. Ten conventional impressions using the polyether [...] Read more.
Background/Objectives: This study compared the marginal fit of CAD/CAM zirconia copings based on digital and conventional impression techniques by using a new method of tooth section examination. Methods: Twenty premolars were prepared for an all-ceramic full crown. Ten conventional impressions using the polyether Impregum and ten digital impressions using the cara TRIOS intraoral scanner were used to fabricate zirconia copings. Slices were prepared by cutting each tooth five times. The marginal fit was microscopically analyzed using seven defined distances at 20 measuring points per tooth. The statistical analyses were carried out by using the Mann–Whitney test and the Kruskal–Wallis test (α = 0.05). Results: The median values for the copings based on the conventional (c) and digital (d) impressions showed significant differences for the internal gap (c: 56 μm (IQR = 22); d: 30 μm (IQR = 13); p < 0.001), horizontal marginal discrepancy (c: 64 μm (IQR = 59); d: 84 μm (IQR = 41); p < 0.001), absolute marginal discrepancy (c: 81 μm (IQR = 40); d: 98 μm (IQR = 50); p < 0.001) and the overextension (c: 63 μm (IQR = 48); d: 89 μm (IQR = 50); p < 0.001). All copings based on digital impressions were overextended. Underextensions only occurred with the conventional impression method with a median value of 40 μm (IQR = 64). For the marginal gap (c: 29 μm (IQR = 27); d: 31 μm (IQR = 22); p = 0.477) and the vertical marginal discrepancy (c: 34 μm (IQR = 32); d: 35 μm (IQR = 40); p = 0.944) no significant differences could be found. Conclusions: Both impression methods are suitable for the fabrication of ceramic copings. The microscopic examination of tooth sections seems to be a suitable in vitro method for the evaluation of the marginal fit of ceramic copings. Full article
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27 pages, 5270 KB  
Article
Exploring Thymol’s Cytocompatibility and Potential Selective Cytotoxicity in Human Primary Gingival Fibroblasts and Pharyngeal Carcinoma Cells: An In Vitro and In Ovo Investigation
by Diana Florina Nica, Raluca Mioara Cosoroabă, Ștefania Dinu, Ștefania-Irina Dumitrel, Doina Chioran, Alina Tănase and Mălina Popa
Dent. J. 2026, 14(2), 105; https://doi.org/10.3390/dj14020105 - 12 Feb 2026
Viewed by 395
Abstract
Background/Objectives: Thymol (THY) is widely used in oral care products for its antimicrobial and anti-inflammatory activity, but data on its cytocompatibility, potential differential effects on oropharyngeal-derived cells, and mucosal irritation under prolonged exposure remain limited. This study evaluated THY’s effects on healthy [...] Read more.
Background/Objectives: Thymol (THY) is widely used in oral care products for its antimicrobial and anti-inflammatory activity, but data on its cytocompatibility, potential differential effects on oropharyngeal-derived cells, and mucosal irritation under prolonged exposure remain limited. This study evaluated THY’s effects on healthy human gingival fibroblasts (HGF-1) and pharyngeal carcinoma (Detroit-562) cells after 24 h exposure, together with its irritation potential in ovo. Methods: Cells were treated with THY (100–300 µM) for 24 h. Cellular viability (MTT), morphology, mitochondrial alterations (MitoTracker™/Hoechst 33342), mitochondrial membrane potential (JC-1), and apoptosis/necrosis (AO/PI) were assessed. Clonogenic assays evaluated long-term proliferative capacity. Lastly, irritation score was examined using the HET-CAM assay at 300 µM. Results: THY produced a dose-dependent viability decrease in both lines, with HGF-1 viability remaining ≥75% and Detroit-562 reduced to ~68% at 300 µM. Morphology, mitochondrial staining, JC-1 ratios, and AO/PI imaging showed progressive apoptotic features, more evident in Detroit-562 cells. Clonogenic capacity increased slightly in HGF-1 at 100 µM and declined to ~75% at 300 µM, whereas Detroit-562 colonies decreased from ~68% to ~40% across the dose range. Additionally, THY (300 µM) showed no irritation in the HET-CAM assay. Conclusions: THY demonstrated acceptable cytocompatibility in gingival fibroblasts, stronger inhibitory effects on carcinoma cells at higher concentrations, and no acute irritation in ovo. These findings support THY’s safe use within defined concentration limits and justify further evaluation in advanced oral tissue models. Full article
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8 pages, 1928 KB  
Case Report
Impacted Mandibular Third Molar Migration in the Presence of Idiopathic Osteosclerosis: A Rare Case Report
by Jure Martinić, Petra Stazić Kunčić, Tanja Gović, Ante Pojatina, Ante Mihovilović and Daniel Jerković
Dent. J. 2026, 14(2), 104; https://doi.org/10.3390/dj14020104 - 12 Feb 2026
Viewed by 417
Abstract
Background: Idiopathic osteosclerosis is a non-expansile bone lesion of unknown etiology, mostly detected incidentally on dental radiographs. It is typically asymptomatic and does not require intervention. Methods: This case report presents a rare clinical presentation in a 30-year-old female patient in whom enlargement [...] Read more.
Background: Idiopathic osteosclerosis is a non-expansile bone lesion of unknown etiology, mostly detected incidentally on dental radiographs. It is typically asymptomatic and does not require intervention. Methods: This case report presents a rare clinical presentation in a 30-year-old female patient in whom enlargement of idiopathic osteosclerosis was associated with the progressive migration of an impacted mandibular third molar into close proximity with the inferior alveolar canal. Consequently, this caused paresthesia of the lower lip and chin and required surgical intervention. Results: The diagnosis was confirmed through histopathological examination following surgical removal of the tooth and bone biopsy, which verified the presence of idiopathic osteosclerosis and excluded other possible differential diagnoses. Conclusions: The postsurgical period was uneventful, and the patient reported no neurosensory disturbances after surgical treatment. Full article
(This article belongs to the Section Oral and Maxillofacial Surgery)
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15 pages, 634 KB  
Article
Combining Hyaluronic Acid and Amino Acids for Improved Healing of Post-Extraction Tooth Socket in Type 2 Diabetes Mellitus Subjects: A Randomized Clinical Trial
by Tiziana Ruggiero, Davide Camisassa, Marta Bezzi, Ettore Cogno, Benedetta Brugiafreddo, Vincenzo Nobile, Renato Pol, Ilaria Roato, Federico Mussano and Paolo Giacomo Arduino
Dent. J. 2026, 14(2), 103; https://doi.org/10.3390/dj14020103 - 11 Feb 2026
Viewed by 442
Abstract
Background/Objectives: Conventional wound care often fails to address the complex pathology of diabetic wounds adequately. Research shows that hyaluronic acid and its derivatives promote tissue regeneration in the later stages of wound healing. We evaluated the efficacy of a novel topical formulation [...] Read more.
Background/Objectives: Conventional wound care often fails to address the complex pathology of diabetic wounds adequately. Research shows that hyaluronic acid and its derivatives promote tissue regeneration in the later stages of wound healing. We evaluated the efficacy of a novel topical formulation in promoting socket healing following post-extraction in patients with type-2 diabetes mellitus, by combining sodium hyaluronate and six amino acids involved in collagen synthesis. Methods: A single-center, two-arm randomized controlled trial was conducted in adults aged 18 and over with type 2 diabetes requiring extraction of at least one non-impacted tooth. Forty-four participants were randomized to receive either the intervention or no treatment. Primary outcomes included a modified Landry’s healing index and rate of socket closure. Results: Comparative analysis showed significantly improved healing index scores in the intervention group by day 7 and day 14 compared to control, with no improvements in the rate of socket closure. Conclusions: This research provides evidence on the therapeutic efficacy of the gel formulation under study in promoting wound healing of post-extraction sites in diabetic patients undergoing tooth extraction. Further research is needed to compare its efficacy with standard treatments and adjunct therapies. Full article
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12 pages, 997 KB  
Article
Evolving Trends in Dental Services in Aging Japan: An Age–Period–Cohort Analysis Using Nationwide Data from Fiscal Years 2016 to 2023
by Asuka Takeda, Katsuo Oshima and Hideki Fukuda
Dent. J. 2026, 14(2), 102; https://doi.org/10.3390/dj14020102 - 11 Feb 2026
Viewed by 414
Abstract
Background/Objectives: Understanding changes in dental service utilization is vital for planning effective oral health strategies in aging societies. In this study, we aimed to elucidate nationwide trends in major dental procedures in Japan from fiscal year (FY) 2016 to FY2023, and to [...] Read more.
Background/Objectives: Understanding changes in dental service utilization is vital for planning effective oral health strategies in aging societies. In this study, we aimed to elucidate nationwide trends in major dental procedures in Japan from fiscal year (FY) 2016 to FY2023, and to assess the age, period, and cohort effects underlying these trends. Methods: Using open data from Japan’s National Database of Health Insurance Claims, five procedure types were analyzed: cavity filling, dental calculus removal, tooth extraction, dental crown procedures, and denture procedures. Descriptive analyses were performed to examine the annual and age-specific changes in the number of procedures per 1000 population. Age–period–cohort (APC) analyses were conducted using Poisson regression with spline functions, applying 10-year age groups. Results: From FY2016 to FY2023, restorative and prosthetic procedures, including cavity fillings, crowns, and dentures, demonstrated a steady decline, whereas preventive procedures, such as dental calculus removal increased, particularly among younger age groups. The APC analysis revealed distinct age-, period-, and cohort-related patterns in dental service utilization. Age effects indicated relatively higher rates of prosthetic procedures among older adults, whereas cohort effects suggested generational improvements in oral health. Period effects showed a downward shift beginning in FY2020, temporally aligned with the coronavirus disease pandemic. Conclusions: The combined descriptive and APC analyses indicate evolving patterns in dental service utilization in Japan, characterized by increased preventive care among younger generations and persistent age-related differences in prosthetic service use. These findings provide population-based evidence relevant for planning sustainable oral healthcare systems in aging societies. Full article
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17 pages, 1383 KB  
Article
Feeding Practices, Prenatal Oral Health Information, and Early Childhood Caries in Toddlers Born Before and During the COVID-19 Pandemic: A Cross-Sectional Study from Hungary
by Andrea Radacsi, Krisztian Katona, Timea Dergez, Alexandra Jurasek, Marcell Herlicska, Istvan Somoskovi, Ildiko Szanto and Balazs Sandor
Dent. J. 2026, 14(2), 101; https://doi.org/10.3390/dj14020101 - 11 Feb 2026
Viewed by 361
Abstract
Objectives: Early childhood caries (ECC) remains a significant global health issue. COVID-19 disrupted protective factors such as in-office parental support and routine dental screenings. This study investigates caries prevalence and severity in Hungarian toddlers (<3 years) born during the lockdown, compared with pre-pandemic [...] Read more.
Objectives: Early childhood caries (ECC) remains a significant global health issue. COVID-19 disrupted protective factors such as in-office parental support and routine dental screenings. This study investigates caries prevalence and severity in Hungarian toddlers (<3 years) born during the lockdown, compared with pre-pandemic data from 2019. Methods: A serial cross-sectional study was conducted through nursery-based dental screenings and a parental questionnaire. Key indices (caries prevalence; average number of decayed, missing, and filled tooth—dmf-t index; Significant Caries Index—SiC-index; and Restorative Index—RI) were calculated and analyzed in relation to parental education and knowledge of caries etiology. The results were compared to 2019 data. Results: A total of 636 children were examined; 274 (mean age: 29.37 ± 4.56 months) were part of the 2024 cohort. Caries prevalence decreased from 15.46% in 2019 to 13.87%. The mean dmf-t index also declined significantly (0.685 ± 2.20 vs. 0.383 ± 1.29; p = 0.025). Initial feeding practices, such as exclusive breastfeeding, were positively linked to later liquid intake habits (p < 0.01). Prenatal information did not affect caries rates or cariogenic liquid consumption. While parental education level was significantly related to caries prevalence and feeding practices in 2019, its influence was less marked in the 2024 cohort. Conclusions: ECC prevalence declined slightly among children born during the pandemic but remains high. Prenatal education did not promote healthier feeding-related oral health behaviors or outcomes. The reduced impact of parental education post-lockdown may suggest that heightened general health awareness during the pandemic lessened education-based disparities. Full article
(This article belongs to the Section Preventive Dentistry)
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18 pages, 1334 KB  
Article
Effect of Training Sequence on Learning Outcomes Using a Haptic Virtual Simulator for Endodontic Access Cavities: A Controlled Experimental Study
by Andreina Fernandes da Silva, Thais Pereira, Ángel Arturo López-González, Raúl Cuesta Román, Joan Obrador de Hevia and Pere Riutord-Sbert
Dent. J. 2026, 14(2), 99; https://doi.org/10.3390/dj14020099 - 10 Feb 2026
Viewed by 318
Abstract
Background: Haptic virtual simulators are increasingly incorporated into dental education, yet it remains unclear whether the sequence of simulation-based and natural-tooth training influences early endodontic skill acquisition. Objective: The objective of this study was to compare the effect of two training sequences—haptic simulation [...] Read more.
Background: Haptic virtual simulators are increasingly incorporated into dental education, yet it remains unclear whether the sequence of simulation-based and natural-tooth training influences early endodontic skill acquisition. Objective: The objective of this study was to compare the effect of two training sequences—haptic simulation followed by natural-teeth practice, versus natural-teeth practice followed by haptic simulation—on performance in endodontic access cavity preparation among undergraduate dental students. Methods: Thirty-eight third-year dental students were randomly assigned to two groups. All participants completed three consecutive attempts on a haptic simulator (Simodont®) and one access cavity preparation on extracted mandibular incisors. Simulator metrics included progress, precision, target volume removed, and excess volume removed. Natural-tooth preparations were scored by two blinded endodontists (ICC range = 0.75–0.88). Data were analyzed using Mann–Whitney U tests with Holm correction, Wilcoxon signed-rank tests, and a linear mixed-effects model to characterize learning trajectories. Results: No significant between-group differences were found in any simulator metric (Holm-adjusted p = 0.47–0.62; effect sizes r = 0.12–0.20, 95% CI −0.14 to 0.43) or in natural-tooth performance (all Bonferroni-adjusted p = 1.00). Students demonstrated significant improvement between the first and second simulator attempts (p < 0.05), with a clear learning plateau thereafter. Mixed-effects modelling confirmed significant overall improvement across attempts (p < 0.001), with no effect of training sequence or attempt × group interaction. Conclusions: Training sequence did not influence learning outcomes or final clinical-quality access preparations. Early performance gains suggest a rapid familiarization effect, and both modalities provide complementary—but non-hierarchical—learning affordances. Haptic simulation can therefore be integrated flexibly within preclinical endodontic curricula without compromising educational effectiveness. Full article
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