Oral, Volume 5, Issue 4 (December 2025) – 12 articles

The rapid digitization of dentistry is significantly transforming fixed prosthodontics, a discipline highly dependent on technical precision. This narrative review, incorporating a structured literature search, provides a critical overview of how digital tools—including computer-aided design and manufacturing (CAD/CAM), intraoral scanners (IOS), and additive manufacturing—are influencing clinical protocols and production methods. A database-guided selection process was employed to identify relevant studies published between 2000 and 2024, spanning in vitro research, observational studies, and clinical trials. While digital workflows offer promising benefits, such as increased accuracy, efficiency, and patient comfort, supporting evidence remains preclinical or short-term in nature. The review highlights areas of innovation as well as ongoing limitations in clinical validation, standardization, and adoption. A more cautious interpretation of the current evidence is warranted, especially regarding long-term clinical outcomes and cost-effectiveness. This review aims to inform clinicians, researchers, and educators about both the potential and the present limitations of digital fixed prosthodontics. Full article

This study aimed to explore the added value and usage of laser Doppler flowmetry (LDF) in conjunction with continuous tissue (arterial) oxygen saturation (SO₂) monitoring, electrical pulp testing (EPT), cold stimulation (CS) testing, and apical X-rays (RX). LDF data were evaluated in relation to three different scenarios. LDF records of all four upper incisors from 30 randomly selected patients aged 21–40 were analysed in relation to the following scenarios: (a) simultaneous SO₂ measurements using a pre-manufactured splint handled by an experienced LDF dentist, (b) EPT, and (c) CS. A total of 120 teeth were analysed, of which 11 were non-vital (7 denervated and 4 traumatised). Data assessment showed the following mean LDF values: vital teeth: 23.6 Perfusion Units (PU), SD 6.3 and SaO₂ of 88.7%, SD 17.1. For non-vital teeth, the mean LDF value was 16.1 PU (SD 11.8) and the mean SO₂ value was 70.8% (SD 31.9). The standard deviation was found to be twice as high for non-vital teeth as for vital teeth. No direct relationship was found between LDF and SO₂ values at low SO₂. For vitality discrimination, the ROC curves showed an area under the curve of 0.799 for LDF and 0.643 for SO₂. EPT data assessment showed a mean value of 18.1 (SD 19.7) out of a possible score of 0–80. This was distributed as follows: seven non-vital teeth (80/80); 109 vital teeth; and four undecided teeth. This was compared to the LDF and SO₂ results. The data assessment showed nine non-vital teeth, 108 vital teeth, and three undecided teeth in comparison to LDF and SO₂ results. Conclusion: LDF and SO₂ do not complement each other sufficiently in detecting non-vital teeth when the selection criteria are applied. While LDF clearly contributes, the vital or non-vital classification still depends on a combination of X-ray, sensitivity, and vitality tests. Full article

Background: Early childhood caries (ECC) is a common chronic disease in young children, influenced by multiple factors, including the activity of bacteria and other microorganisms, diet, and immune response. Pro-inflammatory cytokines like interleukin-8 (IL-8) and anti-inflammatory cytokines like interleukin-10 (IL-10) play crucial roles in the inflammatory process of caries. However, their relationship with ECC severity remains unclear. This study aimed to compare salivary IL-8 and IL-10 levels in children with and without ECC and analyze their association with caries severity using the International Caries Detection and Assessment System (ICDAS). Children with and without central obesity were included to evaluate the potential influence of nutritional status on cytokine expression. Methods: A cross-sectional study was conducted from March 2022 to December 2023 in San Luis Potosí, México, including 76 children aged 3 to 5 years (40 with ECC and 36 caries-free). Anthropometric measurements were taken to classify children as centrally obese or non-centrally obese. Unstimulated saliva samples were collected, and IL-8 and IL-10 levels were measured using ELISA. Statistical analysis included the Mann–Whitney U test, Spearman’s rank correlation coefficient, and binary logistic regression analysis, considering p < 0.05 as statistically significant. Results: IL-8 levels were higher in the ECC group (85 ± 119 pg/mL) than in the control group (45 ± 74 pg/mL), but this difference was not significant (p = 0.3613). IL-10 levels were lower in the ECC group (3 ± 2 pg/mL) than in the control group (11 ± 44 pg/mL; p = 0.6481). The difference between IL-8 and IL-10 levels was greater in the ECC group (27 ± 41 pg/mL) than in the control group (17 ± 33 pg/mL; p = 0.1709). No significant correlation was found between cytokine levels and ICDAS scores (p > 0.05), and binary logistic regression did not show an association between IL-8, IL-10, WHtR, and cavitated caries lesions. Conclusions: Although IL-8 tended to be elevated and IL-10 reduced in children with ECC, the differences were not statistically significant. The observed trend suggests a possible local immunological imbalance in children with caries, which may contribute to disease progression independently of bacterial activity or behavioral influences. Full article

Objective: The purpose of this study was to compare the flexural strength, flexural modulus, hardness, and surface roughness of one brand each of 3D-printed and heat-cured acrylic resin materials after they were immersed in various disinfection solutions. Methods: The study included 160 specimens, consisting of 80 heat-cured and 80 3D-printed specimens. Forty specimens of each resin material type were prepared for flexural testing, while an additional forty specimens were designated for hardness and surface roughness assessments. Each collection of 40 specimens was subsequently randomized into four subgroups (n = 10) for immersion in either distilled water (control), 1% sodium hypochlorite, Superdent, or Kin Oro denture cleansers. Flexural test, hardness, and surface roughness assessments were performed. Data analysis was conducted using SPSS, with a level of significance set at p < 0.05. Results: Flexural strength and surface roughness did not differ significantly between the two resin types. Flexural modulus was significantly higher in the heat-cured resin among all the disinfectants (p = 0.000). The heat-cured resin had significantly higher microhardness than the 3D-printed resin among the disinfectants except for the Kin Oro group, and both resins showed a significant reduction in hardness after immersion in disinfectants compared to distilled water (p < 0.05). Conclusions: The heat-cured resin demonstrated higher flexural modulus and surface hardness compared to the 3D-printed resin. Flexural strength and surface roughness were comparable between the two materials. Both resins had their highest mechanical properties in distilled water. Full article

Background: Peri-implantitis is an inflammatory condition caused by bacterial plaque and several factors like diabetes, smoking, titanium bio-tribocorrosion, implant–abutment micromovements, occlusal overload, cement remnants, and poor oral hygiene, resulting in bone resorption. The aim of this review was to evaluate the relationship between titanium metal particles and the development of peri-implantitis, specifically the characterisation of the inflammatory response regarding cytokine profile, immune cell infiltration, and transcription factors up-regulated in the peri-implant sites. Methods: A systematic review was conducted following the PRISMA guidelines, from January 2004 to January 2025, in three databases: PubMed, Web of Science, and Wiley Library. The inclusion criteria included in vivo human studies and in vitro studies with a focus on bio-tribocorrosion of titanium particles in peri-implant tissues, and their immunological and cellular implications. Quality assessment of in vivo transversal and case–control studies used Joanna Briggs Institute Critical Appraisal Tools, and, for in vitro studies, the modified CONSORT checklist. Results: A total of 27 studies were included, 20 in vitro and 7 in vivo. Titanium particles induced the secretion of IL-1β, IL-6, and TNF-α by peri-implant cells, activation of the NLRP3 inflammasome, and RANKL/OPG bone resorption, further stimulating an exacerbated inflammatory response, LPS independent. There was a significant increase in IL-33, an alarmin, possibly associated with implant–pillar micromovements. IL-8 production by gingival stromal cells and fibroblasts, and downregulation of CCR7 can explain an altered leukocyte migration and the mixture of M1/M2 macrophage populations in peri-implantitis. Conclusions: Titanium particle bio-tribocorrosion stimulates a chronic inflammatory response impacting immune cell composition and cytokine secretion in peri-implant tissue, leading, ultimately, to osteolysis. Modulation of the immune response may contribute to the development of therapeutic strategies and the prevention of implant failure. Full article

Background/Objectives: This study evaluates students’ awareness and perceptions of interdisciplinary education. It focuses specifically on digital dentistry among students in the Department of Dental Technology. The findings aim to support the development of interdisciplinary courses and programs to enhance students’ skills in response to the growing digitalization of dental healthcare. Methods: A cross-sectional survey was conducted using a 23-item online questionnaire administered to a total of 203 students to collect data on general characteristics, perceptions of interdisciplinary education, the perceived necessity of such education, and the demand for interdisciplinary training, including topics related to CAD/CAM and 3D printing technologies. A t-test was performed to analyze grade-level differences in perceptions. Correlation analysis was conducted between perceptions and digital dental laboratory technology skills. Results: Despite the relatively low level of awareness regarding interdisciplinary education, students expressed a strong perceived need for it. A total of 76.6% of respondents preferred to collaborate with the Department of Dental Hygiene. No clear link exists between students’ perceptions of interdisciplinary education and their digital dental competencies. Practical training is more important than awareness. A significant difference in competencies was seen between lower- and higher-year students, indicating that advanced programs for higher-year students may be effective. Conclusions: Clear guidance on interdisciplinary education can enhance student understanding and acceptance. Interdisciplinary education with the dental hygiene department may increase engagement. Full article

Background/Objectives: Disinfection of removable prostheses is essential for controlling oral infections, yet the methods employed may compromise the mechanical reliability of denture base materials. This study evaluated the effect of microwave irradiation and immersion in 0.2% chlorhexidine solution on the fracture strength of three commonly used acrylic denture bases. Methods: Forty-five standardised maxillary palatal denture bases were fabricated from cross-linked conventional, high-impact, and light-cured acrylic resins. The specimens were divided equally into three treatment groups: water storage (control), immersion in 0.2% chlorhexidine solution for 30 min twice weekly, and microwave disinfection at 650 W for three minutes, each continued for four weeks. Fracture strength was determined by using the Universal testing machine. The data were analysed with one-way ANOVA followed by Bonferroni post hoc testing. Results: Cross-linked and high-impact acrylic resins exhibited significantly greater fracture strength than light-cured acrylics (p < 0.001). The overall ANOVA showed no statistically significant differences among disinfection methods (p = 0.069); however, post hoc comparisons revealed significant reductions in fracture strength within specific material groups following microwave disinfection. This effect was most pronounced in the light-cured group, whereas immersion in chlorhexidine produced no significant changes. Notably, the fracture strength of all groups remained above clinically acceptable thresholds. Conclusions: Microwave disinfection negatively influences the mechanical integrity of acrylic denture bases, particularly those fabricated from light-cured resins. In contrast, immersion in 0.2% chlorhexidine preserves fracture strength, supporting its use as a safe and effective protocol for routine disinfection in dental practice. Full article

This narrative review addresses the complexities of managing the vertical dimension of occlusion (VDO) in restorative dentistry, focusing on predictability in prosthetic reconstructions. Altering VDO impacts biological, biomechanical, esthetic, and functional aspects, making it a controversial topic. While VDO naturally evolves throughout life, interventions require careful consideration due to potential complications. Various techniques guide VDO determination, including facial proportions, physiological methods, phonetics, and cephalometric analysis. Clinicians must understand these principles and adapt them to individual patient needs. Materials and Methods: A narrative literature review was conducted using PubMed, Scopus, Google Scholar, and the Cochrane Library, searching keywords like “vertical dimension of occlusion”, “dental”, “diagnosis”, “management” and “complications”. In addition to the literature review, two case reports with extensive prosthodontic restorations were included to illustrate the diagnostic challenges and treatment considerations in a clinical setting. Results: Increasing VDO aids restorative treatments, re-establishing morphology, and facilitating additive procedures. Minimally invasive approaches, provisional restorations, and fixed restorations with functional contours are favored. Individualized, patient-centered care is critical, recognizing unique anatomical and functional needs. This approach optimizes stomatognathic system rehabilitation while preventing adverse effects on body posture and airway dimensions. Conclusions: To ensure predictable results and minimize risks, changes in VDO should be kept to a minimum to achieve dentofacial aesthetic harmony and secure adequate space for the planned restorations The two case reports presented, with different clinical approaches, underline the importance of understanding the potential risks and benefits of VDO alteration which is crucial for achieving predictable and successful outcomes in complex restorative cases. Full article

Obstructive sleep apnea (OSA) is a chronic disorder associated with serious health consequences, yet many cases remain undiagnosed due to limited access to standard diagnostic tools such as polysomnography. Recent advances in artificial intelligence (AI) have enabled the development of deep convolutional neural networks that analyze craniofacial radiographs, particularly lateral cephalograms, to detect anatomical risk factors for OSA. The goal of this approach is not to replace polysomnography but to identify individuals with a high suspicion of OSA at the primary care or dental level and to guide them toward timely and appropriate diagnostic evaluation. Current studies have demonstrated that AI can recognize patterns of oropharyngeal crowding and anatomical imbalance of the upper airway with high accuracy, often exceeding manual assessment. Furthermore, interpretability analyses suggest that AI focuses on clinically meaningful regions, including the tongue, mandible, and upper airway. Unexpected findings such as predictive signals from outside the airway also suggest AI may detect subtle features associated with age or obesity. Ultimately, integrating AI with cephalometric imaging may support early screening and referral for polysomnography, improving care pathways and reducing delays in OSA treatment. Full article

Mucins are a family of heavily glycosylated proteins that form the main organic component of the oral mucosal barrier complex. Transmembrane mucin 1 (tMUC1) is anchored at the superficial epithelial surface to provide a protective function. The interaction of tMUC1 with oral microbes provides nutrients and physicochemical protection, promotes adhesion, and increases the microbe residence time in the oral cavity. Mucin-degrading microorganisms in the consortia also offer some advantages to oral microbes. The high molecular weight of mucin glycoproteins is hard to study because of their size, complexity, and heterogeneity. This review discusses how mucin facilitates oral microbiome colonization and how mucin–microbial interactions influence the development of oral cancer, mainly oral squamous cell carcinoma. Full article

Objective: The material properties of craniofacial sutures significantly influence the outcomes of orthodontic treatment, particularly with newer appliances. This study specifically investigates how the Young’s modulus of craniofacial sutures impacts the anterosuperior protraction achieved using a recently developed extraoral appliance. Our goal is to identify the patterns by which suture properties affect skull deformation induced by this device. Materials and Methods: We conducted four finite element (FE) simulations to evaluate the Right Angle Maxillary Protraction Appliance (RAMPA) when integrated with an intraoral device (gHu-1). We tested Young’s moduli of 30 MPa, 50 MPa, and 80 MPa for the sutures, drawing on values reported in previous research. To isolate RAMPA’s effects on craniofacial deformation, we also performed an additional simulation with rigid sutures and a separate model that included only the intraoral device. Results: Simulations with flexible sutures showed consistent displacement and stress patterns. In contrast, the rigid suture model exhibited substantial deviations, ranging from 32% to 76%, especially in the maxillary palatine suture and orbital cavity. Both displacements and von Mises stresses were proportional to the Young’s modulus, with linear variations of approximately 15%. Conclusions: Our findings demonstrate that RAMPA effectively achieves anterosuperior protraction across a broad spectrum of suture material properties. This positions RAMPA as a promising treatment option for patients with long-face syndrome. Furthermore, the observed linear relationship (with a fixed slope) between craniofacial deformation and the Young’s modulus of sutures provides a crucial foundation for predicting treatment outcomes in various patients. Full article

The global demographic transition toward an ageing population has necessitated substantive reforms in dental education, particularly within the field of geriatric prosthodontics. Conventional curricula have frequently prioritized technical competencies while insufficiently addressing the integration of biological, psychosocial, and ethical complexities inherent in the care of older adults. This scoping review critically examined these curricular deficiencies by synthesizing evidence from 34 peer-reviewed studies, employing Bloom’s Taxonomy as a conceptual framework to inform a systematic and pedagogically grounded curriculum redesign. The primary aim was to identify existing gaps in undergraduate and postgraduate education, evaluate the efficacy of active and simulation-based learning modalities, assess the utility of reflective practices and standardised assessment tools, and formulate strategic, taxonomy-aligned pedagogical guidelines. Following the PRISMA-ScR methodology, the included studies were thematically analysed and categorized across the six cognitive levels of Bloom’s Taxonomy. Findings highlighted the effectiveness of integrated educational strategies, including Case-Based Learning, interprofessional education, virtual simulations, and structured assessments such as Objective Structured Clinical Examinations (OSCE). Furthermore, reflective models such as “What? So What? Now What?” fostered higher-order cognitive processes, ethical reasoning, and self-directed learning. By aligning cognitive levels—from foundational knowledge recall to innovative creation—ten evidence-based educational guidelines were developed. These guidelines are pedagogically sound, empirically supported, and adaptable to diverse curricular contexts. The proposed framework ensures a deliberate, progressive trajectory from theoretical comprehension to clinical expertise and ethical leadership. Future research should explore longitudinal outcomes and develop scalable, culturally responsive models to support the broader implementation of curricular reform in geriatric dental education. Full article