Dentistry Journal

13 pages, 612 KiB

Open AccessArticle

Efficacy of N-Acetyl Cysteine in the Treatment of Burning Mouth Syndrome—A Randomized Controlled Trial

by Lorena Horvat Aleksijević, Božana Lončar Brzak, Miroslav Sikora, Ivana Škrinjar, Vlaho Brailo, Ana Andabak Rogulj, Marko Aleksijević and Danica Vidović Juras

Dent. J. 2025, 13(8), 336; https://doi.org/10.3390/dj13080336 (registering DOI) - 23 Jul 2025

Abstract

Objectives: Burning mouth syndrome (BMS) is a chronic, painful, idiopathic condition of the oral cavity, characterized by the absence of visible pathological changes on the oral mucosa and normal laboratory findings. Recent evidence from the literature supports the classification of BMS as a [...] Read more.

Objectives: Burning mouth syndrome (BMS) is a chronic, painful, idiopathic condition of the oral cavity, characterized by the absence of visible pathological changes on the oral mucosa and normal laboratory findings. Recent evidence from the literature supports the classification of BMS as a neuropathic condition. It has been proposed that oxidative stress may contribute to neuropathic pain. N-acetylcysteine (NAC) is an antioxidant that exhibits neuroprotective properties. The aim of the study was to evaluate the efficacy of N-acetyl cysteine in the treatment of burning mouth syndrome (BMS). Methods: Eighty female patients with previously diagnosed BMS were randomly assigned to one out of two groups. One group received N-acetyl cysteine (600 mg/twice a day) and the other received placebo, for an eight-week period. The outcome was measured by the Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire and Numeric Pain Rating Scale, for burning and discomfort, both before and after completing the therapy. Results: Both groups experienced a significant reduction in burning and discomfort sensations, along with a significant improvement in oral health-related quality of life. However, the difference between the treatment and control group was not statistically significant. Conclusions: NAC does not significantly improve the oral health-related quality of life, burning sensations, and discomfort in BMS subjects compared to placebo. Full article

(This article belongs to the Special Issue Oral Pathology: Current Perspectives and Future Prospects)

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12 pages, 961 KiB

Open AccessArticle

Changes in the Position of Anatomical Points, Cranio-Cervical Posture, and Nasopharyngeal Airspace Dimensions in Complete Denture Wearers—A Cephalometric Pilot Study

by Andrea Maria Chisnoiu, Mihaela Hedeșiu, Oana Chira, Iris Bara, Simona Iacob, Andreea Kui, Smaranda Buduru, Mihaela Păstrav, Mirela Fluerașu and Radu Chisnoiu

Dent. J. 2025, 13(8), 335; https://doi.org/10.3390/dj13080335 (registering DOI) - 22 Jul 2025

Abstract

Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, [...] Read more.

Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, at the Department of Dental Prosthetics at the University of Medicine and Pharmacy in Cluj-Napoca. All patients had complete bimaxillary edentulism and received removable dentures as treatment. Clinical and cephalometric analyses were performed before and after prosthetic treatment to compare changes. The cephalometric analysis was based on the guidelines of Tweed and Rocabado for evaluation. Quantitative data were described using the mean and standard deviation for normal distribution and represented by bar graphs with error bars. A paired samples t-test was used to determine differences between groups, with a significance threshold of 0.05 for the bilateral p-value. Results: When analyzing changes in cranial base inclination, the corresponding angles exhibited an increase, indicating cephalic extension. A statistically significant difference in the anteroposterior diameter of the oropharyngeal lumen with and without bimaxillary complete dentures was identified (p < 0.05). For hyperdivergent patients, modifications in the position of anatomical features on cephalometry slightly reduced the VDO and had a slight compensatory effect on skeletal typology. In contrast, for hypodivergent patients, modifications to the position of anatomical landmarks also had a compensatory effect on skeletal typology, increasing the VDO. Conclusion: Changes in the position of anatomical features on cephalometry generally have a compensatory effect on skeletal typology after complete denture placement. Complete prosthetic treatment with removable dentures can significantly influence respiratory function by reducing the oropharyngeal lumen and body posture by cephalic extension and attenuation of the lordotic curvature of the cervical spine. Full article

(This article belongs to the Special Issue Women's Research in Dentistry)

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11 pages, 231 KiB

Open AccessArticle

Dental, Oral and General Health of Geriatric In-Hospital Patients Before Immediate Prosthetic Treatment: A Retrospective Cohort Study

by Michael Pampel, Jana Kraft, Thomas Tümena and Johannes W. Kraft

Dent. J. 2025, 13(8), 334; https://doi.org/10.3390/dj13080334 (registering DOI) - 22 Jul 2025

Abstract

Objectives: The relationship between oral health and general health of geriatric in-hospital patients (GIH) who are poly-morbid and edentulous is currently unclear. This study determined the relationship between oral health and general health, and further implications and recommendations were derived. Methods: [...] Read more.

Objectives: The relationship between oral health and general health of geriatric in-hospital patients (GIH) who are poly-morbid and edentulous is currently unclear. This study determined the relationship between oral health and general health, and further implications and recommendations were derived. Methods: This retrospective cohort study included 81 GIH patients with impairment of oral state and masticatory function and need for immediate prosthetic treatment. The number of medical diagnoses, particularly main diagnoses of being hospitalized, comorbid diagnoses and the dental/oral state, were evaluated. Laboratory data of vitamin D3 and albumin concentrations were measured. Intraoral risk factors (IRF) affecting the masticatory function were intraoral inflammation, mucogingival impairment (MGI) and severe bone crest atrophy (SBCA). Masticatory function was evaluated by DMF*-T Index (number of destroyed/diseased, missing teeth and artificial fabrication), Eichner Index and Scores. The clinical relevance was surveyed by significance and effect size calculations. Results: In GIH, the number of medical diagnoses correlated significantly with the occurrence of IRFs. SBCA was the most affecting IRF, as measured by Eichner Index at baseline (p = 0.001). Single main diagnoses CNS and gastro-intestinal disease (GID) correlated with both deficiency of vitamin D3 levels (p = 0.011; p = 0.028) and hypoalbuminemia (p = 0.013; p = 0.023). Single comorbid diagnoses significantly correlated with both vitamin D3 deficiency and hypoalbuminemia (CVD (p = 0.031); DM (p = 0.042). Hypoalbuminemia was further found to be correlated with the sum of comorbid diagnoses (p = 0.033). Conclusions: GIH patients suffered from general and dental poly-morbidity. The prevalence of diseases was higher due to SBCA and impaired masticatory function. Deficiency of vitamin D3 and hypoalbuminemia were possible malnutrition markers. Full article

12 pages, 5900 KiB

Open AccessTechnical Note

Digitally-Driven Surgical Guide for Alveoloplasty Prior to Immediate Denture Placement

by Zaid Badr, Jonah Jaworski, Sofia D’Acquisto and Manal Hamdan

Dent. J. 2025, 13(8), 333; https://doi.org/10.3390/dj13080333 - 22 Jul 2025

Abstract

Objective: This article presents a step-by-step digital technique for fabricating a 3D-printed surgical guide to assist in alveoloplasty for immediate denture placement. Methods: The workflow integrates intraoral scanning, virtual tooth extraction, digital soft tissue modeling, and additive manufacturing to produce a customized guide [...] Read more.

Objective: This article presents a step-by-step digital technique for fabricating a 3D-printed surgical guide to assist in alveoloplasty for immediate denture placement. Methods: The workflow integrates intraoral scanning, virtual tooth extraction, digital soft tissue modeling, and additive manufacturing to produce a customized guide with an occlusal window and buccal slot, along with a verification stent. Results: This method ensures precise ridge recontouring and verification, enhancing surgical predictability and prosthetic fit. Conclusions: Unlike traditional surgical guides based on conventional casts or manual fabrication, this fully digital approach offers a practical and replicable protocol that bridges digital planning and clinical execution. By improving surgical precision, reducing operative time, and ensuring optimal denture fit, this technique represents a significant advancement in guided pre-prosthetic surgery. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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19 pages, 773 KiB

Open AccessSystematic Review

The Physiopathological Link Between Bisphenol A Exposure and Molar Incisor Hypomineralization Occurrence: A Systematic Review

by Estelle Mathonat, Thibault Canceill, Mathieu Marty, Alison Prosper, Alexia Vinel and Emmanuelle Noirrit-Esclassan

Dent. J. 2025, 13(8), 332; https://doi.org/10.3390/dj13080332 - 22 Jul 2025

Abstract

Objective: This study aimed to assess, through a systematic review, the potential link between bisphenol A (BPA) exposure and molar incisor hypomineralization (MIH). Methods: A systematic review was performed according to the PRISMA grid. All international studies—in vitro, in vivo, or [...] Read more.

Objective: This study aimed to assess, through a systematic review, the potential link between bisphenol A (BPA) exposure and molar incisor hypomineralization (MIH). Methods: A systematic review was performed according to the PRISMA grid. All international studies—in vitro, in vivo, or clinical—evaluating the relationships between bisphenol A and MIH were included. An iterative search of eligible publications was conducted on May 26, 2025, using three different databases: PubMed, Science Direct, and Google Scholar. Results: Eleven studies were included in the review, ten of which were experimental studies. They were published between 2013 and 2024. Among the selected articles, a rat model was used in eight studies and seven established a link between MIH and BPA (63.64% of the articles). In the included studies, the incisors of rats treated with BPA presented asymmetrical white spots at the enamel level, with a phenotype similar to human MIH. The authors highlight the hypothesis of the implication of steroid receptors expressed by ameloblasts, in particular at the stage of maturation, thus impacting enamel quality. Conclusions: The results presented in this review highlight a trend in the interaction of bisphenol A with steroid receptors, thus affecting enamel quality. However, these associations are weak, and future studies should investigate cofactors modulating BPA’s role in the development of MIH. Full article

(This article belongs to the Special Issue Current Advances in Pediatric Odontology)

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14 pages, 2892 KiB

Open AccessArticle

Green-Synthesized Nano-Silver Fluoride for Remineralization of Enamel Lesions in Primary Teeth: A Comparative In Vitro Study with SDF and SDF/KI

by Antonia Palankalieva, Plamen Katsarov and Ani Belcheva

Dent. J. 2025, 13(7), 331; https://doi.org/10.3390/dj13070331 - 21 Jul 2025

Abstract

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This [...] Read more.

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This study aimed to evaluate the remineralization potential and aesthetic effects of novel, green-synthesized nano-silver fluoride (NSF) on artificial white spot lesions in primary teeth in comparison to 38% silver diamine fluoride (SDF) and silver diamine fluoride/potassium iodide (SDF/KI). Materials and Methods: NSF was synthesized using green tea extract. Sixty primary teeth specimens with artificial enamel lesions were randomly divided into five groups depending on the applied material: 38% SDF, 38% SDF/KI, single and double application of NSF, and control group. Treatments were followed by pH cycling. Surface microhardness and photographic analysis were conducted to assess remineralization and staining. Statistical analysis was conducted using non-parametric tests including Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Results: The greatest increase in microhardness was observed in the group receiving double NSF application. Its remineralizing potential was comparable to that of 38% SDF/KI, with no statistically significant difference (p = 1.000). Importantly, NSF-treated samples exhibited no teeth discoloration, unlike the black staining observed in SDF and SDF/KI groups. Conclusions: Green-synthesized NSF is a promising alternative to conventional SDF and SDF/KI, offering remineralization benefits without compromising aesthetics. The eco-friendly formulation and non-staining properties support its potential for clinical use in pediatric dentistry. Full article

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14 pages, 381 KiB

Open AccessArticle

A Cross-Sectional Analysis of Oil Pulling on YouTube Shorts

by Jun Yaung, Sun Ha Park and Shahed Al Khalifah

Dent. J. 2025, 13(7), 330; https://doi.org/10.3390/dj13070330 - 21 Jul 2025

Abstract

Objective: This cross-sectional content analysis aimed to investigate how oil pulling is portrayed on YouTube Shorts, focusing on the types of speakers, claims made, and alignment with scientific evidence. The study further explored how the content may influence viewer perception, health behaviors, [...] Read more.

Objective: This cross-sectional content analysis aimed to investigate how oil pulling is portrayed on YouTube Shorts, focusing on the types of speakers, claims made, and alignment with scientific evidence. The study further explored how the content may influence viewer perception, health behaviors, and the potential spread of misinformation. Methods: On 28 January 2025, a systematic search of YouTube Shorts was performed using the term “oil pulling” in incognito mode to reduce algorithmic bias. English language videos with at least 1000 views were included through purposive sampling. A total of 47 Shorts met the inclusion criteria. Data were extracted using a structured coding framework that recorded speaker type (e.g., dentist, hygienist, influencer), engagement metrics, stated benefits, oil type and regimen, the use of disclaimers or citations, and stance toward oil pulling rated on a 5-point Likert scale. Speaker background and nationality were determined through publicly available channel descriptions or linked websites, with user identities anonymized and ethical approval deemed unnecessary due to the use of publicly available content. In total, 47 videos met the inclusion criteria. Results: Of the 47 YouTube Shorts that met the inclusion criteria, most were posted by influencers rather than dental professionals. These videos predominantly encouraged oil pulling, often recommending coconut oil for 10–15 min daily and citing benefits such as reduced halitosis and improved gum health. However, a smaller subset advanced more extreme claims, including reversing cavities and remineralizing enamel. Notably, US-licensed dentists and dental hygienists tended to discourage or express skepticism toward oil pulling, assigning lower Likert scores (1 or 2) to influencers and alternative health practitioners (often 4 or 5). Conclusions: YouTube Shorts largely promote oil pulling through anecdotal and testimonial-driven content, often diverging from evidence-based dental recommendations. The findings reveal a disconnect between professional dental guidance and popular social media narratives. While some benefits like halitosis reduction may have limited support, exaggerated or misleading claims may result in improper oral hygiene practices. Greater engagement from dental professionals and improved health communication strategies are needed to counteract misinformation and reinforce oil pulling’s role, if any, as an adjunct—not a replacement—for standard oral care. Future studies should explore viewer interpretation, behavioral influence, and cross-platform content patterns to better understand the impact of short-form health videos. Full article

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

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13 pages, 299 KiB

Open AccessArticle

Psychometric Validation of the Spanish OSAKA Questionnaire: A Cross-Sectional Study Among Colombian Dental Professionals

by Olga Patricia López-Soto, Juan Alberto Aristizabal-Hoyos, Jackeline Mulett-Vásquez, Héctor Fuentes-Barría, Raúl Aguilera-Eguía, Lissé Angarita-Davila, Diana Rojas-Gómez and Ángel Roco-Videla

Dent. J. 2025, 13(7), 329; https://doi.org/10.3390/dj13070329 - 20 Jul 2025

Abstract

Objectives: To evaluate the psychometric properties of the Spanish version of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire among dental professionals in Colombia. Methods: A cross-sectional study was conducted in Manizales, Colombia, between January and June 2024. A total of [...] Read more.

Objectives: To evaluate the psychometric properties of the Spanish version of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire among dental professionals in Colombia. Methods: A cross-sectional study was conducted in Manizales, Colombia, between January and June 2024. A total of 120 dental professionals, including general dentists, specialists, residents, and academic clinicians, were selected through stratified random sampling. Participants completed the Spanish-adapted OSAKA questionnaire and a structured sociodemographic survey. Internal consistency was assessed using Cronbach’s alpha (α) and McDonald’s Omega (Ω). Construct validity was examined through exploratory factor analysis (EFA), with Kaiser Meyer Olkin (KMO) values and Bartlett’s test. Results: The knowledge subscale (18 items) showed good reliability (α = 0.83; Ω = 0.83), while the attitude subscale (5 items) showed near-acceptable reliability (α = 0.68; Ω = 0.59). KMO values were 0.79 for knowledge and 0.57 for attitudes; Bartlett’s test was significant in both cases (p ≤ 0.001). EFA supported structural validity: six components with eigenvalues >1 explained 61.66% of the variance for knowledge, and two components explained 79.49% for attitudes. Significant differences in attitude scores were found among professional groups (p ≤ 0.001, η² = 0.13), with specialists scoring highest (

\bar{X}

= 17.66) and general dentists lowest (

\bar{X}

= 14.62). Knowledge scores did not significantly differ between groups (p = 0.47). Conclusions: The Spanish OSAKA questionnaire is a valid and reliable tool to assess knowledge and attitudes toward obstructive sleep apnea in Colombian dental professionals. Its use may support improved education, screening, and interdisciplinary collaboration in dental settings. Full article

17 pages, 1937 KiB

Open AccessArticle

Detection of Protein Carbonylation in Gingival Biopsies from Periodontitis Patients with or Without Diabetes Mellitus—A Pilot Study

by Alexandra Efthymiou, Pinelopi Anastasiadou, Eleftherios Anagnostou, George Koliakos, Sotirios Kalfas and Ioannis Vouros

Dent. J. 2025, 13(7), 328; https://doi.org/10.3390/dj13070328 - 18 Jul 2025

Abstract

Background: Protein carbonylation is an irreversible post-translational modification that is considered indicative of oxidative damage. Objective: The purpose of the study was to examine by an immunohistochemical method for the first time the extent and localization of protein carbonylation in biopsies of gingiva [...] Read more.

Background: Protein carbonylation is an irreversible post-translational modification that is considered indicative of oxidative damage. Objective: The purpose of the study was to examine by an immunohistochemical method for the first time the extent and localization of protein carbonylation in biopsies of gingiva from periodontitis patients with or without diabetes mellitus (DM). Methods: These were processed for immunohistochemical staining of the carbonylated proteins, using the ENVISIOM FLEX Mini Kit, high pH, and anti-dinitrophenyl (DNP) antibody, a marker of oxidative damage to a given protein. The extent of protein carbonylation was semi-quantitatively estimated and evaluated by calculation of the Allred score (percentage of stained cells × intensity of staining). Results: The biopsies from periodontitis patients with diabetes mellitus (DM) exhibited higher staining scores as per the percentage of positively stained cells than the biopsies from patients with only periodontitis (means of 49.2 and 16.7, respectively), the difference being statistically significant (p = 0.036). The same trend was observed in the case of the combination of the above with the intensity of staining (score parameter) as well (means of 59.6 and 20.8, p = 0.036, respectively). Conclusions: An immunohistochemical method with the novelty of utilization for the first time of the anti-dinitrophenyl (DNP) antibody in gingival tissues was introduced and showed efficacy in detecting protein carbonylation indicative of oxidative stress and its impact in the pathogenesis of these two prevalent diseases of periodontitis and diabetes mellitus. Full article

(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)

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17 pages, 283 KiB

Open AccessArticle

Critical–Reflective Self-Assessment in Clinical Activities in a Dentistry Program at a Brazilian Public University

by Luís Eduardo Genaro, Aylton Valsecki Júnior, Silvio Rocha Corrêa da Silva, Elaine Pereira da Silva Tagliaferro and Fernanda Lopez Rosell

Dent. J. 2025, 13(7), 327; https://doi.org/10.3390/dj13070327 - 18 Jul 2025

Abstract

Objectives: This study aimed to analyze the critical and reflective self-assessment capacity of dentistry students based on two clinical courses that employ self-assessment processes as a strategy to foster autonomy in health care. Materials and Methods: Reflections from third- and fifth-year students were [...] Read more.

Objectives: This study aimed to analyze the critical and reflective self-assessment capacity of dentistry students based on two clinical courses that employ self-assessment processes as a strategy to foster autonomy in health care. Materials and Methods: Reflections from third- and fifth-year students were evaluated over a three-year period. The methodology sought to identify the presence of critical reflections, perceptions of strengths and weaknesses, and the formulation of improvement plans. Results: The results revealed low levels of continuous reflection, with only 20.0% of third-year students and 24.1% of fifth-year students engaging in reflection in at least half of their clinical activities. However, 78.7% of third-year students and 90.8% of fifth-year students completed at least one reflection during the academic year. The ability to sustain continuous critical reflection was observed in only 22.1% of the 453 students evaluated. These findings present a concerning scenario, as critical reflection is directly linked to competence in health care and informed decision-making. Conclusions: The study concludes that formative assessment processes requiring critical and reflective self-assessment must be broadly integrated into the curriculum to foster significant gains in the development of professional competencies. Full article

10 pages, 842 KiB

Open AccessReview

Comparison of Intraosseous and Conventional Dental Anesthesia in Children—A Scoping Review

by Anastasia Dermata, Sotiria Davidopoulou, Aristidis Arhakis, Nikolaos Dabarakis, Konstantinos N. Arapostathis and Sotirios Kalfas

Dent. J. 2025, 13(7), 326; https://doi.org/10.3390/dj13070326 - 18 Jul 2025

Abstract

Background/Objectives: The main purpose of the present scoping review was to map and explore the efficacy of computer-controlled intraosseous anesthesia (CCIA) in comparison with conventional dental anesthesia in pediatric dental patients. Secondarily, this study aimed to compare the acceptance and preference factors [...] Read more.

Background/Objectives: The main purpose of the present scoping review was to map and explore the efficacy of computer-controlled intraosseous anesthesia (CCIA) in comparison with conventional dental anesthesia in pediatric dental patients. Secondarily, this study aimed to compare the acceptance and preference factors between CCIA and conventional dental anesthesia in children. Given the limited and heterogeneous nature of the available literature, this review aimed to identify gaps and scope the extent of research conducted in this area, providing a foundation for future, more targeted studies. Methods: The search was conducted in 19 electronic databases, and the appropriate studies were identified according to PRISMA-ScR guidelines. Only split-mouth randomized controlled clinical trials that reported on the clinical outcomes of CCIA in children were included. Two reviewers worked independently on the screening and selection of the studies. The same two reviewers carried out the data extraction and the risk of bias assessment, using the Cochrane risk of bias tool. Due to the exploratory nature, this review focused on mapping the characteristics, outcomes, and research trends rather than synthesizing effect sizes. Results: Out of 841 papers, 2 randomized clinical trials were ultimately included in the scoping review. The outcomes were categorized as primary (including results that answered the focus question) and secondary (relating to additional quality characteristics). Regarding the primary outcomes, in both studies, intraosseous anesthesia was efficacious in achieving the adequate level of anesthesia. One of the secondary outcomes was the acceptance and preference of CCIA in comparison with conventional dental anesthesia in children. The limited number and the high risk of bias in existing studies highlight the necessity for more comprehensive and high-quality research. Conclusions: The selected studies support the assertion that CCIA is a promising technique since it results in less pain perception and is preferred by patients compared to conventional local anesthesia. However, the existing literature is limited and at high risk of bias. Thus, further targeted investigations are needed to evaluate and yield more definitive results regarding the superiority of CCIA. Full article

(This article belongs to the Special Issue Current Advances in Pediatric Odontology)

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14 pages, 15062 KiB

Open AccessArticle

Short-Term Effects of Visceral Manual Therapy on Autonomic Nervous System Modulation in Individuals with Clinically Based Bruxism: A Randomized Controlled Trial

by Cayetano Navarro-Rico, Hermann Fricke-Comellas, Alberto M. Heredia-Rizo, Juan Antonio Díaz-Mancha, Adolfo Rosado-Portillo and Lourdes M. Fernández-Seguín

Dent. J. 2025, 13(7), 325; https://doi.org/10.3390/dj13070325 - 16 Jul 2025

Abstract

Background/Objectives: Bruxism has been associated with dysregulation of the autonomic nervous system (ANS). Visceral manual therapy (VMT) has shown beneficial effects on the vagal tone and modulation of ANS activity. This study aimed to evaluate the immediate and short-term effects of VMT [...] Read more.

Background/Objectives: Bruxism has been associated with dysregulation of the autonomic nervous system (ANS). Visceral manual therapy (VMT) has shown beneficial effects on the vagal tone and modulation of ANS activity. This study aimed to evaluate the immediate and short-term effects of VMT in individuals with clinically based bruxism. Methods: A single-blind randomized controlled trial was conducted including 24 individuals with clinically based bruxism. Participants received two sessions of either VMT or a sham placebo technique. Outcome measures included heart rate variability (HRV), both normal-to-normal intervals (HRV-SDNN), and the root mean square of successive normal-to-normal intervals (HRV-RMSSD), as well as muscle tone and stiffness and pressure pain thresholds (PPTs). Measurements were made at T1 (baseline), T2 (post-first intervention), T3 (pre-second intervention), T4 (post-second intervention), and T5 (4-week follow-up). Results: A significant time*group interaction was observed for HRV-SDNN (p = 0.04, η² = 0.12). No significant changes were found for muscle tone or stiffness. PPTs significantly increased at C4 after the second session (p = 0.049, η² = 0.16) and at the left temporalis muscle after the first session (p = 0.01, η² = 0.07). Conclusions: The findings suggest that two sessions of VMT may lead to significant improvements in HRV-SDNN compared to the placebo, suggesting a modulatory effect on autonomic function. No consistent changes were observed for the viscoelastic properties of the masticatory muscles. Isolated improvements in pressure pain sensitivity were found at C4 and the left temporalis muscle. Further research with larger sample sizes and long-term follow-up is needed to determine the clinical relevance of VMT in the management of signs and symptoms in individuals with bruxism. Full article

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

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24 pages, 9660 KiB

Open AccessArticle

Effect of Mouth Rinsing and Antiseptic Solutions on Periodontitis Bacteria in an In Vitro Oral Human Biofilm Model

by Jan Tinson Strenge, Ralf Smeets, Maria Geffken, Thomas Beikler and Ewa Klara Stuermer

Dent. J. 2025, 13(7), 324; https://doi.org/10.3390/dj13070324 - 16 Jul 2025

Abstract

Background/Objectives: The formation of oral biofilms in periodontal pockets and around dental implants with induction of periodontitis or peri-implantitis is an increasing problem in dental health. The intelligent design of a biofilm makes the bacteria embedded in the biofilm matrix highly tolerant [...] Read more.

Background/Objectives: The formation of oral biofilms in periodontal pockets and around dental implants with induction of periodontitis or peri-implantitis is an increasing problem in dental health. The intelligent design of a biofilm makes the bacteria embedded in the biofilm matrix highly tolerant to antiseptic therapy, often resulting in tooth or implant loss. The question therefore arises as to which mouthwashes have eradication potential against oral biofilm. Methods: A human oral biofilm model was developed based on donated blood plasma combined with buffy coats, inoculated with oral pathogenic bacterial species found in periodontal disease (Actinomyces naeslundii, Fusobacterium nucleatum, Streptococcus mitis, and Porphyromonas gingivalis). Over a span of 7 days, we tested different mouth rinsing and antiseptic solutions (Chlorhexidine, Listerine^®, NaOCl, Octenisept^®, and Octenident^®) covering the matured biofilm with 24 h renewal. Phosphate-buffered saline (PBS) was used as a control. Bacterial growth patterns were detected via quantitative polymerase chain reaction (qPCR) after 2, 4, and 7 days of treatment. Results: While all groups showed initial bacterial reduction, the control group demonstrated strong regrowth from day 2 to 4. Listerine showed a near-significant trend toward bacterial suppression. Additionally, strain-specific efficacy was observed, with Octenisept^® being most effective against Streptococcus mitis, Octenident^® and NaOCl showing superior suppression of Actinomyces naeslundii, and Listerine^® outperforming other solutions in reducing Fusobacterium nucleatum. Donor-specific, individual variability further influenced treatment outcomes, with distinct trends in bacterial suppression and regrowth observed across donors. Conclusions: These findings underscore the complexity of biofilm-associated infections and highlight the importance of targeted therapeutic approaches for managing bacterial biofilms. In this experiment, the donor-specific outcomes of the antimicrobial effects of the solutions may indicate that genetic predisposition/tolerance to oral infections appears to play a critical role in the control of oral biofilms. Full article

(This article belongs to the Special Issue Oral Microbiology and Related Research)

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17 pages, 2879 KiB

Open AccessArticle

The Impact of Integrating 3D-Printed Phantom Heads of Newborns with Cleft Lip and Palate into an Undergraduate Orthodontic Curriculum: A Comparison of Learning Outcomes and Student Perception

by Sarah Bühling, Jakob Stuhlfelder, Hedi Xandt, Sara Eslami, Lukas Benedikt Seifert, Robert Sader, Stefan Kopp, Nicolas Plein and Babak Sayahpour

Dent. J. 2025, 13(7), 323; https://doi.org/10.3390/dj13070323 - 16 Jul 2025

Abstract

Background/Objectives: This prospective intervention study examined the learning effect of using 3D-printed phantom heads with cleft lip and palate (CLP) and upper jaw models with CLP and maxillary plates during a lecture for dental students in their fourth year at J. W. [...] Read more.

Background/Objectives: This prospective intervention study examined the learning effect of using 3D-printed phantom heads with cleft lip and palate (CLP) and upper jaw models with CLP and maxillary plates during a lecture for dental students in their fourth year at J. W. Goethe Frankfurt University. The primary aim was to evaluate the impact of 3D-printed models on students’ satisfaction levels along with their understanding and knowledge in dental education. Methods: Six life-sized phantom heads with removable mandibles (three with unilateral and three with bilateral CLP) were designed using ZBrush software (Pixologic Inc., Los Angeles, CA, USA) based on MRI images and printed with an Asiga Pro 4K 3D printer (Asiga, Sydney, Australia). Two groups of students (n = 81) participated in this study: the control (CTR) group (n = 39) attended a standard lecture on cleft lip and palate, while the intervention (INT) group (n = 42) participated in a hands-on seminar with the same theoretical content, supplemented by 3D-printed models. Before and after the session, students completed self-assessment questionnaires and a multiple-choice test to evaluate knowledge improvement. Data analysis was conducted using the chi-square test for individual questions and the Wilcoxon rank test for knowledge gain, with the significance level set at 0.05. Results: The study demonstrated a significant knowledge increase in both groups following the lecture (p < 0.001). Similarly, there were significant differences in students’ self-assessments before and after the session (p < 0.001). The knowledge gain in the INT group regarding the anatomical features of unilateral cleft lip and palate was significantly higher compared to that in the CTR group (p < 0.05). Conclusions: The results of this study demonstrate the measurable added value of using 3D-printed models in dental education, particularly in enhancing students’ understanding of the anatomy of cleft lip and palate. Full article

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

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15 pages, 1266 KiB

Open AccessReview

Comparison of Oral Microbial Profile Among Patients Undergoing Clear Aligner and Fixed Orthodontic Therapies for the Treatment of Malocclusions: An Updated Review

by Emilie Ponton, Paul Emile Rossouw and Fawad Javed

Dent. J. 2025, 13(7), 322; https://doi.org/10.3390/dj13070322 - 16 Jul 2025

Abstract

Objective: The present review aims to compare the oral microbial profile (OMP) of patients undergoing fixed orthodontic therapy (OT) versus clear aligner therapy (CAT) for the treatment of malocclusions. Methods: Clinical studies were included. Case-reports/-series, letters to the editor, reviews, perspectives, [...] Read more.

Objective: The present review aims to compare the oral microbial profile (OMP) of patients undergoing fixed orthodontic therapy (OT) versus clear aligner therapy (CAT) for the treatment of malocclusions. Methods: Clinical studies were included. Case-reports/-series, letters to the editor, reviews, perspectives, and expert opinions were excluded. Indexed databases (MEDLINE/PubMed, Embase, Scopus, and Web of Science) were searched up to the end point of May 2025, without time and language barriers. The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias (RoB) and quality of evidence were assessed. Results: Three randomized clinical trials (RCTs) and seven non-RCTs were included. In all RCTs and five non-RCTs, OMP was assessed using subgingival plaque samples. Periodontopathogenic bacteria and Gram-negative anaerobic microbes were more often identified in patients undergoing fixed OT than CAT. The biofilm mass was higher in patients undergoing fixed OT than CAT. In two RCTs, periodontopathogenic bacteria were dominant among patients undergoing fixed OT than CAT. All RCTs and two non-RCTs had a high RoB. The certainty of evidence was “moderate” in 70% of the studies. Conclusions: Due to a high RoB, variability in study designs, and lack of power analysis, direct comparisons remain limited. Full article

(This article belongs to the Special Issue Current Research Topics in Orthodontics)

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14 pages, 1213 KiB

Open AccessArticle

Development of a Microfluidic Paper-Based Analytical Device for Myeloperoxidase Detection in Periodontitis

by Juliane Caroline Leão, Thiago Mazzu, Vitor Leão, Paola Gomes Souza, Nathalya Maria Vilela Moura, Emanuel Carrilho and Mario Taba, Jr.

Dent. J. 2025, 13(7), 321; https://doi.org/10.3390/dj13070321 - 15 Jul 2025

Abstract

Objectives: To develop a microfluidic paper-based analytical device (μPAD) that identifies myeloperoxidase (MPO) levels in the saliva of healthy patients and those with periodontal disease. Materials and Methods: A platform similar to a 96-well plate was printed on Watman^® chromatography paper to [...] Read more.

Objectives: To develop a microfluidic paper-based analytical device (μPAD) that identifies myeloperoxidase (MPO) levels in the saliva of healthy patients and those with periodontal disease. Materials and Methods: A platform similar to a 96-well plate was printed on Watman^® chromatography paper to run the experimental analysis with unstimulated saliva samples were collected from two groups of patients: those with periodontal health (H, n = 15) and established periodontitis (PD, n = 15). Then, three types of chromophore substrates were pipetted into the wells of the prototype: (1) Guaiacol; (2) Guaiacol, 4,4 ′-diaminodifenilsulfon (DAB) and hydrogen peroxide in Tris-HCl buffer; and (3) 3,3′,5,5′-Tetramethylbenzidine (TMB), followed by saliva samples. The reaction images were analyzed by numbering according to the intensity scale. Results: The comparative results of the reactions using μPAD demonstrated that both the H and PD groups were compatible with each other without differences among the chromophore substrates (p > 0.05). However, the protocol with TMB showed a faster reaction and better color difference when comparing 15.62 ng/mL and 7.81 ng/mL of MPO in the plate embedded with Guaiacol; 1000 ng/mL and 62.5 ng/mL on the Guaiacol and DAB plate; and 62.5 ng/mL of TMB. The average detectable concentrations of MPO in saliva using TMB were H = 21.2 ± 10.4 ng/mL and PD = 28.9 ± 12.8 ng/mL (p = 0.08). Conclusions: The developed microfluidic paper-based analytical device has been tested for identifying the myeloperoxidase saliva levels of healthy patients and those with periodontal disease. This rapid test demonstrated its possible applicability mainly when associated with the TMB chromophore, but further studies are required with different biomarkers to explore this promising diagnostic platform. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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17 pages, 618 KiB

Open AccessSystematic Review

Clinical Performance of Bulk-Fill Versus Incremental Composite Restorations in Primary Teeth: A Systematic Review of In Vivo Evidence

by Maria Sarapultseva, Desheng Hu and Alexey Sarapultsev

Dent. J. 2025, 13(7), 320; https://doi.org/10.3390/dj13070320 - 15 Jul 2025

Abstract

Background and Objectives: This is the first systematic review to focus exclusively on in vivo randomized controlled trials that compare bulk-fill and conventional incremental composite restorations in primary teeth. Our aim was to synthesize current evidence on their clinical performance, including retention, [...] Read more.

Background and Objectives: This is the first systematic review to focus exclusively on in vivo randomized controlled trials that compare bulk-fill and conventional incremental composite restorations in primary teeth. Our aim was to synthesize current evidence on their clinical performance, including retention, two-year survival rates, marginal integrity, and procedural efficiency. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and the Elicit AI platform up to March 2025. Eligible studies were in vivo randomized controlled trials involving children aged 3–12 years with carious primary teeth, directly comparing bulk-fill and incremental composite restorations. Primary outcomes included retention rates, two-year survival, and marginal integrity, while secondary outcomes were postoperative sensitivity, secondary caries, and aesthetic outcomes. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessments using the Cochrane RoB 2.0 tool. A narrative synthesis was undertaken due to substantial heterogeneity in study design and outcome reporting. The review protocol was registered in PROSPERO (CRD420251021433). Results: Thirteen randomized controlled trials met the inclusion criteria. Both restoration techniques demonstrated high short-term retention rates (>90%) and comparable two-year survival (85–90%). Marginal integrity was generally equivalent, though incremental techniques showed modest advantages in complex cavities. Secondary outcomes were inconsistently reported, with no significant group differences. Bulk-fill restorations consistently reduced the procedural time by 2–4 min per restoration, representing a meaningful advantage in pediatric clinical settings. Conclusions: Bulk-fill composites offer a clinically effective and time-efficient alternative to incremental layering in the restoration of primary teeth. This focused synthesis addresses a gap in existing reviews by concentrating solely on primary dentition and in vivo evidence. Despite similar clinical outcomes, the time savings associated with bulk-fill techniques may enhance their utility in pediatric dentistry. Further standardized and long-term trials are warranted to confirm these findings and inform clinical guidelines. Full article

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

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19 pages, 406 KiB

Open AccessReview

Pacifier Use and Its Influence on Pediatric Malocclusion: A Scoping Review of Emerging Evidence and Developmental Impacts

by Man Hung, Jacob Marx, Corban Ward and Connor Schwartz

Dent. J. 2025, 13(7), 319; https://doi.org/10.3390/dj13070319 - 14 Jul 2025

Abstract

Background/Objectives: Pacifier use is a widespread soothing practice during infancy, but extended use has been linked to adverse dental outcomes, particularly malocclusion. This review aimed to evaluate the association between pacifier use and dental developmental issues in infants and toddlers and to [...] Read more.

Background/Objectives: Pacifier use is a widespread soothing practice during infancy, but extended use has been linked to adverse dental outcomes, particularly malocclusion. This review aimed to evaluate the association between pacifier use and dental developmental issues in infants and toddlers and to identify key influencing factors. Methods: A scoping review using PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source was performed. Peer-reviewed, full-text articles published in English between 2014 and 2024 were screened by two independent reviewers using predefined criteria. Eligible studies were thematically analyzed. Results: From 262 records, 35 studies met the inclusion criteria. Pacifier use was consistently associated with an increased prevalence of malocclusions, including anterior open bite, posterior crossbite, and overjet. The risk and severity of dental issues were strongly influenced by the duration, frequency, and intensity of pacifier use. Prolonged use beyond three years significantly increased the likelihood of structural changes requiring intervention. Conclusion: There is strong evidence linking pacifier use to negative dental developmental outcomes, particularly when use is prolonged or frequent. Early intervention, caregiver education, and timely weaning are critical to minimizing long-term oral health risks. Future research should explore pacifier design, objective measures of use, and how socioeconomic factors may influence pacifier use patterns and oral health outcomes. Understanding these relationships can support the development of more targeted and equitable prevention strategies. Full article

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20 pages, 6738 KiB

Open AccessFeature PaperArticle

Biocompatible Inorganic PVD MeSiON Thin Films (Me = Cr or Zr) Used to Enhance the Bond Strength Between NiCr-Based Metallic Frameworks and Ceramic in Dental Restorations

by Mihaela Dinu, Cosmin Mihai Cotrut, Alina Vladescu (Dragomir), Florin Baciu, Anca Constantina Parau, Iulian Pana, Lidia Ruxandra Constantin and Catalin Vitelaru

Dent. J. 2025, 13(7), 318; https://doi.org/10.3390/dj13070318 - 14 Jul 2025

Abstract

Background/Objectives: The increasing demand for aesthetics in dentistry has driven significant advancements in both materials and techniques. The primary cause of ceramic detachment in dental restorations is extensive mechanical stress, which often results in detachment and clinical complications. This study aims to improve [...] Read more.

Background/Objectives: The increasing demand for aesthetics in dentistry has driven significant advancements in both materials and techniques. The primary cause of ceramic detachment in dental restorations is extensive mechanical stress, which often results in detachment and clinical complications. This study aims to improve the bond strength between NiCr-based metal frameworks and ceramic coatings by introducing biocompatible inorganic MeSiON thin films (Me = Cr or Zr) as interlayers. Methods: MeSiON coatings with a thickness of ~2 μm were deposited on NiCr alloy using cathodic arc evaporation. To tailor the stoichiometry, morphology, and mechanical properties of the coatings, the substrate bias voltage was varied: −50 V, −100 V, −150 V, −200 V. Structural and surface characterization was performed using SEM/EDS, XRD, profilometry, and contact angle analysis. The coating adhesion was evaluated by using standardized scratch testing, while the bond strength was evaluated using a three-point bending test. Results: The NiCr alloy exhibited a dendritic microstructure, and the ceramic layer consisted mainly of quartz, feldspar, kaolin, and ZrO₂. ZrSiON coatings showed superior roughness, elemental incorporation, and adhesion compared to Cr-based coatings, these properties being further improved by increasing the substrate bias. The highest bond strength was achieved with a ZrSiON coating deposited at −200 V, a result we attributed to increased surface roughness and mechanical interlocking at the ceramic-metal interface. Conclusions: CrSiON and ZrSiON interlayers enhanced ceramic-to-metal adhesion in NiCr-based dental restorations. The enhancement in bond strength is primarily ascribed to substrate bias-induced modifications in the coating’s stoichiometry, roughness, and adhesion. Full article

(This article belongs to the Special Issue Dental Materials Design and Innovative Treatment Approach)

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