Journal Description
Dentistry Journal
Dentistry Journal
is an international, peer-reviewed, open access journal on dentistry published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: JCR - Q1 (Dentistry, Oral Surgery and Medicine) / CiteScore - Q2 (General Dentistry)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 21.5 days after submission; acceptance to publication is undertaken in 3.5 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
3.1 (2024);
5-Year Impact Factor:
3.3 (2024)
Latest Articles
Challenges of Future Patient Recruitment: A Cross-Sectional Study in Conservative Dentistry Teaching
Dent. J. 2025, 13(11), 495; https://doi.org/10.3390/dj13110495 (registering DOI) - 25 Oct 2025
Abstract
Background: Direct clinical training on real patients is essential in dental education. However, the declining patient inflow increasingly challenges this objective. This cross-sectional study aimed to assess patients’ experiences and preferences to derive recommendations for improving patient recruitment. Material and Methods: Over a
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Background: Direct clinical training on real patients is essential in dental education. However, the declining patient inflow increasingly challenges this objective. This cross-sectional study aimed to assess patients’ experiences and preferences to derive recommendations for improving patient recruitment. Material and Methods: Over a period of one year, patients treated by students in the courses and final examinations at the dental school of conservative dentistry were questioned using a specially designed questionnaire and reviewed using their medical records. They were asked about their complete treatment process, and patient files were used to record socio-demographic as well as economic and appointment-specific data. Results: We analysed 297 patients (142 women, 47.8%; 155 men, 52.2%) treated by undergraduates across two semesters (four courses) and two final examinations. Median age was 57.0 years (IQR 46–67; mean 55.2, SD 15.2; range 14–85) with no sex-based difference (p > 0.05). Arrival was predominantly by car (72.7%, n = 216); median one-way distance was 20.5 km (IQR 11.2–32.1); and 58.4% were employed, while 41.6% were not employed (33.7% retired, 7.9% unemployed). The leading reason for course attendance was “satisfaction with previous treatments” (65.32%). Information sources were reported by 290/297 (98%); the most common was already being a course patient (143, 48.1%). Most patients attended one appointment (109, 36.7%). Median travel cost per appointment (including parking) was €17.0 (typically €10.0–€23.5). Of 285 respondents, 93.68% answered “Yes” to satisfaction with student treatment. Conclusions: Important steps include enhancing parking facilities, optimizing recall systems and appointment accessibility, and strengthening relationships with regular patients to encourage word-of-mouth referrals. The main focus is to maintain high clinical quality, ensure affordability, and further reduce patient copayments where possible.
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(This article belongs to the Special Issue Dental Education: Innovation and Challenge)
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Open AccessArticle
Bone Morphogenetic Protein 7 Promotes the Differentiation of Periodontal Ligament Fibroblasts into F-Spondin-Expressing Cementoblast-like Cells During Root Canal Treatment—An In Vivo Rat Pulpectomy Model and In Vitro Human Fibroblast Study
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Hiroki Iwasawa, Yoshihiko Akashi, Kei Nakajima, Katsutoshi Kokubun, Masahiro Furusawa and Kenichi Matsuzaka
Dent. J. 2025, 13(11), 494; https://doi.org/10.3390/dj13110494 (registering DOI) - 25 Oct 2025
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Background/Objectives: The optimal healing process following root canal treatment involves biological apical sealing through new cementum formation. Bone morphogenetic protein 7 (BMP-7) has recently gained attention as a potential regulator of cementoblast differentiation and periodontal regeneration. However, its effects on periodontal ligament fibroblasts
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Background/Objectives: The optimal healing process following root canal treatment involves biological apical sealing through new cementum formation. Bone morphogenetic protein 7 (BMP-7) has recently gained attention as a potential regulator of cementoblast differentiation and periodontal regeneration. However, its effects on periodontal ligament fibroblasts (PDLFs) and the underlying mechanisms remain incompletely understood. This study aimed to investigate whether BMP-7 induces cementoblast-like differentiation of PDLFs both in vivo and in vitro via the BMP-SMAD signaling pathway. Methods: In a rat pulpectomy model, root canals were treated with or without BMP-7 and examined histologically and immunohistochemically for F-spondin (Spon1) expression. In vitro, human PDLFs were stimulated with BMP-7, and analyses of mineralization, cementoblast marker expression, alkaline phosphatase activity, and SMAD-1/5/9 phosphorylation were conducted. Results: Immunohistochemical analysis revealed that Spon1-positive regions increased around the apical area following BMP-7 treatment, suggesting the induction of cementoblast-like differentiation. In vitro, BMP-7 enhanced the expression of cementoblast-associated genes and mineral deposition while activating SMAD-1/5/9 signaling. Phosphorylation was suppressed by the BMP receptor inhibitor LDN-193189, indicating canonical BMP-SMAD pathway involvement. Conclusions: Although the specific concentration range of maximal activity remains to be determined, the findings collectively suggest that BMP-7 can promote cementoblast-like differentiation of PDLFs and may contribute to apical healing through cementum-related mechanisms. These results provide mechanistic and biological insights that support the potential of BMP-7 as a modulator for biologically favorable periapical tissue regeneration following root canal therapy.
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Open AccessArticle
Association of Herpes Virus Type 1, Cytomegalo Virus and Epstein–Barr Virus to the Pathogenesis of Peri-Implantitis: A Cross-Sectional Study
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Ioana Suciu, Simona Ruta and George Suciu
Dent. J. 2025, 13(11), 492; https://doi.org/10.3390/dj13110492 (registering DOI) - 25 Oct 2025
Abstract
Background/Objectives: This study explores the potential relationship between herpesvirus infections and the severity and progression of peri-implantitis. A secondary goal is to investigate whether a virus–bacteria interaction may contribute to differences in bone loss patterns between periodontitis and peri-implantitis. Methods: Biological
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Background/Objectives: This study explores the potential relationship between herpesvirus infections and the severity and progression of peri-implantitis. A secondary goal is to investigate whether a virus–bacteria interaction may contribute to differences in bone loss patterns between periodontitis and peri-implantitis. Methods: Biological samples, including blood, saliva, and peri-implant crevicular fluid, were collected for viral detection. Blood samples were processed at Queen Mary Laboratory in Bucharest, Romania, while saliva and peri-implant crevicular fluid samples were analyzed at the laboratory of ADD Laboral in Malden, the Netherlands. Sterile paper points were used to collect peri-implant crevicular fluid from the deepest peri-implant sites in 43 patients. A nearby tooth was sampled when present, with edentulous patients being the exception. Several clinical parameters were also considered, including implant and dentition status, smoking, gender, implant location, duration of functional loading, periodontal pocket depth (PPD), bleeding on probing (BoP), suppuration (SUP), and periodontal history. Results: Epstein–Barr virus (EBV) was detected in 30.2% of cases, Herpes virus (HSV) in 7.0%, and Cytomegalo virus (CMV) in 0%. EBV showed a moderate inverse correlation with probing depth (r = −0.48) in non-smokers with periodontal disease. Viral detection was highest on lingual and mesial surfaces. Peri-implantitis cases exhibited significantly deeper PPD, higher BoP (96.15%), and suppuration (96.15%) compared to healthy implants or teeth. Conclusions: An association was observed between the presence of Herpes viruses and increased peri-implantitis severity, suggesting a potential contributory role of viral pathogens in disease progression.
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(This article belongs to the Section Dental Implantology)
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Open AccessArticle
Effect of Remineralization Products on the Microtensile Strength of Universal Dentin Bonding Systems
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Andra Claudia Tărăboanță-Gamen, Cristian Marius Toma, Vasilica Toma, Ionuț Tărăboanță, Simona Stoleriu, Veronica Serban Pintiliciuc and Sorin Andrian
Dent. J. 2025, 13(11), 493; https://doi.org/10.3390/dj13110493 (registering DOI) - 24 Oct 2025
Abstract
Background/Objectives: Adhesion to caries-affected dentin remains challenging due to its altered structure and composition. Remineralizing agents have been proposed to strengthen this substrate and improve bonding. This study evaluated the effect of three remineralization treatments, CPP-ACP, self-assembling peptide P11-4, and silver diamine
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Background/Objectives: Adhesion to caries-affected dentin remains challenging due to its altered structure and composition. Remineralizing agents have been proposed to strengthen this substrate and improve bonding. This study evaluated the effect of three remineralization treatments, CPP-ACP, self-assembling peptide P11-4, and silver diamine fluoride (SDF), on the microtensile bond strength (μTBS) of universal adhesive systems applied to caries-affected dentin, using both etch-and-rinse and self-etch strategies. Methods: Seventy human molars were sectioned and artificially demineralized to simulate caries-affected dentin. Samples were divided into ten groups: four untreated and six treated with CPP-ACP (MI Paste™), P11-4 (Curodont™ Protect), or SDF (Riva Star™). Universal adhesives were applied via etch-and-rinse or self-etch mode, followed by composite restoration. Microtensile bond strength was measured using a universal testing machine, and results were statistically analyzed with ANOVA and t-tests (p < 0.05). Results: Untreated caries-affected dentin showed significantly lower μTBS than sound dentin (C3: 18.3 ± 5.4 MPa vs. C1: 41.3 ± 2.7 MPa). Remineralization agents improved μTBS considerably. CPP-ACP achieved the highest recovery (S1: 31.8 ± 2.6 MPa; S2: 29.2 ± 4.6 MPa), nearing sound dentin levels. P11-4 yielded moderate gains (S3: 24.4 ± 6.5 MPa; S4: 24.1 ± 4.7 MPa), while SDF provided the lowest, yet significant, improvements (S5: 23.7 ± 7.5 MPa; S6: 21.3 ± 5.3 MPa). Etch-and-rinse generally produced higher μTBS than self-etch, but differences were not statistically significant (p > 0.05). Conclusions: Pre-treatment of caries-affected dentin with CPP-ACP, P11-4, or SDF enhances universal adhesive bond strength, with CPP-ACP showing the most pronounced effect. Remineralization protocols represent a valuable adjunct in restorative procedures involving compromised dentin.
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(This article belongs to the Section Dental Materials)
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Open AccessSystematic Review
Hemophilic Pseudotumor of the Maxilla Secondary to Endodontic Treatment: Case Report and Systematic Review
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Jose Rodolfo Quiroz-Gomez, Carlos Manuel Roa-Encarnación, Ana Graciela Puebla-Mora, Antonio Hernández-Morales, Miguel Padilla-Rosas and Mario Nava-Villalba
Dent. J. 2025, 13(11), 491; https://doi.org/10.3390/dj13110491 - 23 Oct 2025
Abstract
Hemophilic pseudotumor (HP) is a rare but severe complication of hemophilia, characterized by progressive bleeding in the muscles, joints, and bone tissue, which can lead to lytic lesions. Its prevalence is approximately 1–2% among patients with hemophilia. This report presents a male patient
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Hemophilic pseudotumor (HP) is a rare but severe complication of hemophilia, characterized by progressive bleeding in the muscles, joints, and bone tissue, which can lead to lytic lesions. Its prevalence is approximately 1–2% among patients with hemophilia. This report presents a male patient with mild hemophilia A who developed an intraosseous lesion in the posterior region of the right maxilla, with a prior history of endodontic treatment in the area. Surgical excision was performed and, following clinicopathological correlation, the lesion was diagnosed as HP. Background/Objectives: This review aims to identify previously reported cases of HP located in the maxilla. Methods: The study protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The databases PubMed, Scopus, and ScienceDirect were searched, and Google Scholar was used to identify gray literature. The Joanna Briggs Institute (JBI) tool was employed to assess the risk of bias and the quality of the included reports and case series. Results: A total of 1487 publications were identified using specific keywords. After removing duplicates and non-relevant titles/abstracts, 42 full-text articles were reviewed. Of these, 10 met the inclusion criteria: 7 case reports and 3 case series, comprising 13 cases of HP in the maxilla, including the case presented here. Although rare in the maxillofacial region, when it does occur, it is more commonly seen in the mandible and is often linked to prior trauma. In this case, endodontic treatment may have triggered lesion development. Conclusions: This report highlights that, although uncommon, HP can manifest with involvement of the maxilla, and that specific dental interventions may represent potential triggering events.
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(This article belongs to the Section Oral and Maxillofacial Surgery)
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Open AccessReview
Oral Health Impact Profile (OHIP) as a Tool for the Assessment of the Oral Health-Related Quality of Life—A Scoping Review
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Łukasz Wojszko, Karolina Banaszek, Oliwia Gagacka and Joanna Bagińska
Dent. J. 2025, 13(11), 490; https://doi.org/10.3390/dj13110490 - 23 Oct 2025
Abstract
Background/Objectives: The Oral Health Impact Profile (OHIP) is the most widely used tool for OHRQoL assessment. The measure has several versions, but there is no comprehensive summary of available Oral Health Impact Profile variants. The purpose of this scoping review is to
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Background/Objectives: The Oral Health Impact Profile (OHIP) is the most widely used tool for OHRQoL assessment. The measure has several versions, but there is no comprehensive summary of available Oral Health Impact Profile variants. The purpose of this scoping review is to identify and summarize Oral Health Impact Profile versions for the adult population available in the literature. Methods: PubMed, Scopus, and Web of Science databases were searched on 25–28 May 2025 to find papers presenting the Oral Health Impact Profile versions’ development process. Records written in English without any time restrictions were included. The Joanna Briggs Institute framework for scoping reviews was applied. The PRISMA-ScR approach was followed. Results: In total, 11 generic OHIP scales (the OHIP version that was not targeted at any specific condition) and 16 condition-specified OHIP scales were found. The analysis revealed a wide variety of number of items (from 49 to 5), recall period (from one year to one week), rating scale (4-0; 5-0; 5-1; 6-1; 1, 0, and −1), dimensionality of scale (7, 4, or 3 dimensions, 2–6 factors, or unidimensional), and validation process. Conclusions: Differences in OHIP features have to be taken into account during a comparison of results from different studies. Due to the availability of various tools, the idea of creating new versions of the OHIP should be considered with caution. Researchers should carefully select the appropriate OHIP version for their purposes, as the process of adapting the tool to a new language and culture is time-consuming and expensive.
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(This article belongs to the Special Issue Oral Health-Related Quality of Life and Its Determinants)
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Open AccessSystematic Review
Artificial Intelligence in Endodontic Education: A Systematic Review with Frequentist and Bayesian Meta-Analysis of Student-Based Evidence
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Carlos M. Ardila, Eliana Pineda-Vélez and Anny M. Vivares-Builes
Dent. J. 2025, 13(11), 489; https://doi.org/10.3390/dj13110489 - 23 Oct 2025
Abstract
Background/Objectives: Artificial intelligence (AI) is entering dental curricula, yet its educational value in endodontics remains unclear. This review synthesized student-based evidence on AI in endodontics, primarily comparing AI vs. students on diagnostic tasks as an educational endpoint and secondarily considering assessment tasks relevant
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Background/Objectives: Artificial intelligence (AI) is entering dental curricula, yet its educational value in endodontics remains unclear. This review synthesized student-based evidence on AI in endodontics, primarily comparing AI vs. students on diagnostic tasks as an educational endpoint and secondarily considering assessment tasks relevant to training. Methods: PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched in July 2025. Eligible studies involved dental students using AI in endodontic tasks or applied AI to student-generated outputs. For diagnostic comparisons we performed random-effects meta-analysis and a complementary Bayesian random-effects model with weakly informative priors. Risk of bias used QUADAS-2; certainty used GRADE. Results: Five studies met inclusion. Two provided complete mean–SD data for the primary meta-analysis and one contributed to a sensitivity model after SD imputation; two were summarized narratively (AUC/F1 only). Pooled effects favored AI: Hedges g = 1.48 (95% CI 0.60–2.36; I2 ≈ 84%); sensitivity (k = 3) g = 1.45 (95% CI 0.77–2.14; I2 ≈ 77%). Across the two LLM studies with analyzable means/SDs, the pooled mean difference in accuracy was approximately +20 percentage points (AI − students). Bayesian analyses yielded posterior means near 1.5 with 95% credible intervals excluding 0 and P (μ > 0) ≈ 1.00. Educational outcomes were sparsely and non-standardly reported. Conclusions: Student-based evidence indicates that AI likely outperforms dental students on endodontic diagnostic tasks, supporting its use as an adjunct for formative tutoring, objective feedback, and more consistent assessment.
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(This article belongs to the Special Issue Dental Education: Innovation and Challenge)
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Open AccessArticle
Retrospective Assessment of Palatal Biofilm and Mucosal Inflammation Under Orthodontic Appliances in Young Adults (2022–2025): A Single-Center Cohort with Microbiologic Sub-Sampling
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Bianca Dragos, Dana-Cristina Bratu, George Popa, Magda-Mihaela Luca, Remus-Christian Bratu, Carina Neagu and Cosmin Sinescu
Dent. J. 2025, 13(11), 488; https://doi.org/10.3390/dj13110488 - 23 Oct 2025
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Background and Objectives: Orthodontic auxiliaries create plaque-retentive niches that may amplify biofilm accumulation and inflame adjacent soft tissues. While cross-sectional comparisons suggest higher palatal burden beneath acrylic elements, less is known about real-world patterns accumulated across years of routine care. We retrospectively evaluated
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Background and Objectives: Orthodontic auxiliaries create plaque-retentive niches that may amplify biofilm accumulation and inflame adjacent soft tissues. While cross-sectional comparisons suggest higher palatal burden beneath acrylic elements, less is known about real-world patterns accumulated across years of routine care. We retrospectively evaluated periodontal and palatal outcomes, and, in a microbiology sub-sample, site-specific colonization, across three device types: molar bands, Nance buttons, and removable acrylic plates. Methods: We reviewed 2022–2025 records from a university orthodontic service, including consecutive patients aged 18–30 years with documented pre-placement and 6-month follow-up indices. Groups were bands (n = 92), Nance (n = 78), acrylic (n = 76). Standardized charted measures were abstracted: Plaque Index (PI), Gingival Index (GI), bleeding on probing (BOP%), probing depth (PD), and palatal erythema grade (0–3). A laboratory sub-sample (n = 174 visits) had archived swabs cultured for total aerobic counts (log10 CFU/cm2) at the device, adjacent enamel, and palatal mucosa; Streptococcus mutans burden was available from qPCR (log10 copies/mL). Results: Baseline characteristics were similar, except for longer wear at follow-up in Nance (10.1 ± 4.0 months) vs. bands (8.7 ± 3.2) and acrylic (6.9 ± 3.0; p < 0.001). At 6 months, device type was associated with greater worsening of PI and GI (both p < 0.001) and with higher palatal erythema (bands 0.7 ± 0.5; Nance 1.6 ± 0.8; acrylic 1.9 ± 0.7; p < 0.001). Microbiologically, palatal mucosal colonization was lowest with bands (3.3 ± 0.5), higher with Nance (4.9 ± 0.6), and highest with acrylic (5.0 ± 0.7; p < 0.001); S. mutans mirrored this gradient (p < 0.001). Palatal CFU correlated with erythema (ρ = 0.6, p < 0.001) and ΔGI (ρ = 0.5, p < 0.001). In adjusted models, acrylic (OR 6.7, 95% CI 3.5–12.8) and Nance (OR 4.9, 2.5–9.3) independently predicted erythema ≥2; recent prophylaxis reduced odds (OR 0.6, 0.3–0.9). Conclusions: In this single-center cohort, palate-contacting designs were associated with higher palatal biomass and erythema than bands. These associations support device-tailored hygiene considerations and proactive palatal surveillance, particularly for acrylic components.
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Open AccessArticle
Fit Accuracy of Plate-Type Retainers Fabricated Using Dental CAD/CAM Systems: A Controlled In Vitro Comparison Using Typodont-Derived Models
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Kosuke Nomi, So Koizumi, Masatoshi Shimura, Kazuhide Seimiya, Osamu Nikaido, Heetae Park, Reina Hatanaka, Masahiro Takahashi, Shinya Fuchida and Tetsutaro Yamaguchi
Dent. J. 2025, 13(11), 487; https://doi.org/10.3390/dj13110487 - 23 Oct 2025
Abstract
Objectives: This study aimed to compare the fit accuracy between retainers fabricated using conventional cold-curing resin (hereinafter referred to as “conventional retainers”) and those fabricated using three-dimensional (3D) printing based on computer-aided design/computer-aided manufacturing (CAD/CAM) technology (hereinafter referred to as “CAD/CAM retainers”). Furthermore,
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Objectives: This study aimed to compare the fit accuracy between retainers fabricated using conventional cold-curing resin (hereinafter referred to as “conventional retainers”) and those fabricated using three-dimensional (3D) printing based on computer-aided design/computer-aided manufacturing (CAD/CAM) technology (hereinafter referred to as “CAD/CAM retainers”). Furthermore, the study aimed to compare two different methods to evaluate the fit accuracy: the impression replica technique and the 3D triple-scan protocol. Methods: For each of the 20 working models derived from a maxillary typodont, one conventional retainer and one CAD/CAM retainer were fabricated. The fit accuracy was evaluated using the impression replica technique and the 3D triple-scan protocol. Measurements were taken at 12 points on each model, and the differences in thickness (gap) were analyzed using Wilcoxon’s signed-rank test. Moreover, the correlation between thickness and measurement site was evaluated using Spearman’s rank correlation coefficient. Results: In both evaluation methods, the CAD/CAM retainers exhibited superior fit accuracy compared to the conventional retainers. Notably, the 3D triple-scan protocol clearly demonstrated that the fit accuracy differed depending on the measurement site. Conclusions: CAD/CAM retainers demonstrated superior fit accuracy compared to conventional retainers, possibly because digital design can account for polymerization shrinkage. In the impression replica technique, the median (interquartile range) thickness for the conventional retainers was 0.169 (0.120–0.260) mm, whereas that for the CAD/CAM retainers was 0.136 (0.096–0.198) mm. The CAD/CAM retainers showed significantly smaller gap values (p < 0.001). Within the limitations of this in vitro study, CAD/CAM retainers showed significantly smaller gap values than conventional retainers, indicating improved fit accuracy. In particular, the 3D triple-scan protocol accurately captured site-specific variations in fit accuracy among the anterior, canine, and molar regions.
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(This article belongs to the Section Digital Technologies)
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Open AccessArticle
In Vitro Comparison of Three Chairside Bleaching Protocols: Effects on Enamel Microhardness, Colour, and Qualitative Cytotoxicity Risk
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Berivan Laura Rebeca Buzatu, Octavia Balean, Magda Mihaela Luca, Roxana Buzatu, Atena Galuscan, Ramona Dumitrescu, Vlad Alexa, Vanessa Bolchis and Daniela Elisabeta Jumanca
Dent. J. 2025, 13(11), 486; https://doi.org/10.3390/dj13110486 - 22 Oct 2025
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Background and Objectives: The rapid increase of whitening products use raises questions about enamel safety. We compared three high-concentration protocols—Opalescence Quick (45% carbamide peroxide ≈ 15% H2O2), Opalescence Boost (40% H2O2), and BlancOne Ultra (35%
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Background and Objectives: The rapid increase of whitening products use raises questions about enamel safety. We compared three high-concentration protocols—Opalescence Quick (45% carbamide peroxide ≈ 15% H2O2), Opalescence Boost (40% H2O2), and BlancOne Ultra (35% H2O2 + LED)—under controlled conditions to balance color change (ΔE) with enamel integrity (microhardness, FTIR). We also constructed a qualitative cytotoxicity risk profile from published data; no biological assays were performed in this study. Methods: Seventy-two matched half-crowns were randomized to Control or one of the three protocols. Outcomes were a change in Vickers microhardness, spectrophotometric color difference, and FTIR carbonate-to-phosphate ratio after 24 h in artificial saliva. We also compiled a qualitative cytotoxicity risk profile from published evidence; no biological assays were performed. One-way ANOVA with Tukey HSD on Δ-scores, Shapiro–Wilk and Levene’s tests for assumptions, Welch’s t-tests for tooth-class comparisons, and Pearson correlation between ΔE and ΔMH. Results: All active protocols produced clearly visible whitening (mean ΔE 5.7–6.3). Hydrogen-peroxide gels showed greater hardness loss and carbonate depletion than the carbamide-peroxide gel under similar contact time. The association between greater shade change and hardness loss was moderate and not predictive for individuals. Conclusions: Under harmonized conditions, all systems whitened effectively. Pursuing changes beyond ~6 units offered little extra benefit while increasing enamel impact. Carbamide-based Opalescence Quick achieved comparable aesthetics with lower acute enamel effects. Clinicians should individualize exposure time and pair in-office whitening with short-term remineralising care. Cytotoxicity comments are qualitative and literature-based only.
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Open AccessArticle
Efficacy and Feasibility of OptraDam® Plus Versus Conventional Rubber Dams in Preclinical Simulation Training: A Randomized Crossover Trial
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Fahad BaHammam, Mohammed Alsuhaibani, Faisal Almutairi, Sultan Aldakhil, Shug Albarrak, Lulwah Alreshaid and Fathima Farook
Dent. J. 2025, 13(11), 485; https://doi.org/10.3390/dj13110485 - 22 Oct 2025
Abstract
Background/Objectives: Despite clear benefits, conventional rubber dam use remains low due to barriers that often originate during undergraduate training. To examine a potential approach to mitigating these barriers, this study evaluated the efficacy and feasibility of OptraDam® Plus, a user-friendly alternative to
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Background/Objectives: Despite clear benefits, conventional rubber dam use remains low due to barriers that often originate during undergraduate training. To examine a potential approach to mitigating these barriers, this study evaluated the efficacy and feasibility of OptraDam® Plus, a user-friendly alternative to the conventional rubber dam, in preclinical simulation training. Methods: In this 2 × 2 crossover trial, preclinical undergraduate students were randomly assigned to two groups to perform two types of dental isolation, conventional rubber dam and OptraDam® Plus, in alternating sequences on a dental simulator. The efficacy and feasibility of both systems were evaluated based on application time, isolation quality, and students’ perceptions. Results: Data from 94 randomized students were collected and analyzed. Although students’ performance was suboptimal with both systems, there were significant differences in efficacy and feasibility between them. Application time was shorter with the conventional rubber dam (mean reduction 77 s; 95% CI 4–151; p = 0.039), whereas using OptraDam® Plus was associated with 51% lower odds of achieving a higher isolation quality category (OR 0.49; p = 0.011). In addition, students perceived the conventional rubber dam to be superior to the OptraDam® Plus in achieving higher-quality dental isolation and in their confidence in using it. Conclusions: OptraDam® Plus cannot be considered a suitable alternative to the conventional rubber dam in preclinical simulation training due to its inferior efficacy and feasibility. The findings of this study challenge the assumption that utilization of newer marketed “user-friendly” rubber dam systems necessarily overcome the core technical barriers faced by undergraduate students.
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(This article belongs to the Special Issue Dental Education: Innovation and Challenge)
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Open AccessPerspective
Environmental Determinants of Early Childhood Caries: A Narrative Synthesis of Observational Evidence and Implications for Global Policy
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Moréniké Oluwátóyìn Foláyan, Robert J. Schroth, Olubukola Olatosi and Maha El Tantawi
Dent. J. 2025, 13(11), 484; https://doi.org/10.3390/dj13110484 - 22 Oct 2025
Abstract
Early childhood caries (ECC) remains a significant global health challenge, disproportionately affecting marginalized populations. While traditional research emphasizes behavioral and biological risk factors, emerging evidence highlights the critical role of environmental determinants. This narrative synthesis aims to highlight the role of environmental determinants
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Early childhood caries (ECC) remains a significant global health challenge, disproportionately affecting marginalized populations. While traditional research emphasizes behavioral and biological risk factors, emerging evidence highlights the critical role of environmental determinants. This narrative synthesis aims to highlight the role of environmental determinants as a risk factor for ECC pathogenesis. Environmental toxins (e.g., lead, perfluoroalkyl acids, tobacco smoke, air pollution) disrupt enamel development, impair salivary function, and compromise immune responses, directly increasing caries susceptibility. Environmental degradation, including air pollution, reduces ultraviolet B radiation exposure, limiting endogenous vitamin D synthesis that is vital for enamel mineralization and immune regulation. These risks are compounded in low- and middle-income countries, where structural inequities, inadequate sanitation, and climate disruptions exacerbate ECC burdens. We introduce ecovitality—the resilience of ecosystems supporting human health—as a novel framework linking ecological vitality to oral health. Degraded environments limit access to fluoridated water and nutrient-dense foods while promoting sugary diets and endocrine disruptors. A One Health approach is advocated to address interconnected environmental, social, and biological determinants of the risk for ECC. Despite global reductions in tobacco use and lead exposure, the Global Burden of Disease 2021 analysis reports stagnation in ECC prevalence. This underscores the critical need for longitudinal and mechanistic studies to establish causality, quantify the contributions of environmental controls, and explore how mitigating these risks can reduce the global ECC burden. Such evidence may promote interdisciplinary action to align oral health promotion for children with the Sustainable Development Goals.
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(This article belongs to the Topic Preventive Dentistry and Public Health)
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Open AccessCase Report
Modified Roll Flap Soft-Tissue Augmentation at Single-Stage Implant Placement: A Digital-Scan–Verified Case Report
by
Kamen Kotsilkov, Hristina Maynalovska and Zdravka Pashova-Tasseva
Dent. J. 2025, 13(10), 483; https://doi.org/10.3390/dj13100483 - 21 Oct 2025
Abstract
Background and Objectives: Adequate peri-implant soft tissue dimensions are essential for health, hygiene, and esthetics. When ridge volume is sufficient, phenotype modification may avoid bone grafting. This case report describes a pedicled roll flap performed concurrently with single-stage implant placement after spontaneous socket
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Background and Objectives: Adequate peri-implant soft tissue dimensions are essential for health, hygiene, and esthetics. When ridge volume is sufficient, phenotype modification may avoid bone grafting. This case report describes a pedicled roll flap performed concurrently with single-stage implant placement after spontaneous socket healing, without bone substitute, and assesses soft-tissue stability with serial intraoral scans. Clinical case: A single-tooth edentulous site underwent prosthetically driven, fully guided implant placement. A modified roll flap with vertical and palatal incisions was prepared; the de-epithelialized crestal connective tissue was elevated and rolled into a buccal envelope to augment thickness. No graft material was used. A provisional crown conditioned the emergence profile. Follow-up included photographs, radiographs, and intraoral scan superimpositions at 2 weeks, 3–4 months, 8 months, and 14 months after implant treatment. Healing was uneventful. Buccal soft-tissue thickness increased, keratinized mucosa was preserved, and midfacial levels remained stable. Emergence profile and papillae integrated harmoniously. Crestal bone levels were stable radiographically. Digital scans corroborated soft-tissue thickness maintenance. No donor-site morbidity occurred. Conclusions: In healed sockets with adequate bone, a modified pedicled roll flap at implant placement can thicken the peri-implant phenotype and achieve stable esthetic integration without bone substitutes.
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(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management: 2nd Edition)
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Open AccessArticle
In Vitro Evaluation of Tooth Enamel Abrasion and Roughness Using Toothpaste with and Without Activated Charcoal: An SEM Analysis
by
Fiorella Thais Aquino Carmen, Renzo Jesús Pro Romero, Alexander Roger Espinoza Salcedo and Paul Martín Herrera-Plasencia
Dent. J. 2025, 13(10), 482; https://doi.org/10.3390/dj13100482 - 21 Oct 2025
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Background/Objectives: Dental enamel constitutes the first barrier of defense against external factors that constantly generate wear and damage. This study aimed to evaluate in vitro the abrasion and roughness of dental enamel using toothpaste with and without activated charcoal and to analyze this
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Background/Objectives: Dental enamel constitutes the first barrier of defense against external factors that constantly generate wear and damage. This study aimed to evaluate in vitro the abrasion and roughness of dental enamel using toothpaste with and without activated charcoal and to analyze this under scanning electron microscopy (SEM). Materials and methods: The research design was experimental; 10 enamel blocks were randomly assigned to each group to perform brushing cycles with soft- and medium-filament brushes with two types of toothpaste, one with activated charcoal and one without activated charcoal. A pumice stone with etching acid was used as the positive control and artificial saliva served as the negative control; both were analyzed separately. Roughness was evaluated using a roughness meter and abrasion with an analytical balance. The surface of the enamel blocks of each group was randomly analyzed under an SEM. Statistical analysis was performed using the Shapiro–Wilk test and the homogeneity of variances with Bartlett’s test. Student’s t-test (two-tailed) was applied to compare tooth enamel roughness and abrasion. Results: Both enamel roughness (p = 0.0016) and abrasion (p = 0.0001) were significantly higher in the groups using activated charcoal paste and medium-filament brushes. SEM observation revealed greater alteration on the surface of the enamel subjected to brushing cycles with activated charcoal paste and a medium-filament brush. Conclusions: The in vitro study showed that the use of toothpaste with activated charcoal increases the roughness and abrasion of tooth enamel, especially when the medium-filament brush is used.
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Open AccessArticle
Psychological Experiences of Ocular Trauma and Traumatic Dental Injury Victims of Police Violence
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Gonzalo Rojas-Alcayaga, Andrea Herrera, Camila Corral Nuñez, Joaquín Varas, Sebastián Córdova, Carolina Lineros and Matías Ríos-Erazo
Dent. J. 2025, 13(10), 481; https://doi.org/10.3390/dj13100481 - 20 Oct 2025
Abstract
Background/Objectives: Ocular trauma (OT) and traumatic dental injuries (TDI) inflicted by police officers not only cause significant physical harm, but also psychological trauma. The clinical attention given by health care teams may induce revictimization or retraumatization phenomena, which affect the psychological status
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Background/Objectives: Ocular trauma (OT) and traumatic dental injuries (TDI) inflicted by police officers not only cause significant physical harm, but also psychological trauma. The clinical attention given by health care teams may induce revictimization or retraumatization phenomena, which affect the psychological status of the victim. The objective of this research is to bring to light the psychological experiences related to emergency care processes and rehabilitation of people affected by OT and TDI caused by police violence. Methods: Qualitative research was conducted based on in-depth interviews with eighteen people affected by OT or TDI during the social outbreak in Chile in 2019–2020. Data analysis was based on the principles of grounded theory. Results: Three main categories emerged: quality of interpersonal relationships with health care providers, expectations of care and treatment and psychological consequences. The findings show that retraumatization and revictimization arise from clinical care in the context of state violence. Conclusions: Revictimization and retraumatization are the most characteristic phenomena occurring in the health care of people affected by OT and TDI caused by police violence. The probability of their occurrence depends mainly on the interpersonal relationships established with the health care team and the management of patient expectations regarding health care.
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(This article belongs to the Section Restorative Dentistry and Traumatology)
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Open AccessArticle
Assessment of Common Oral Behaviors in Patients with Temporomandibular Joint Disorders and Their Relationship to Psychosocial Factors
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Nguyen Ngoc Hoa, Hoang Viet Hai, Tran Thai Binh, To Thanh Dong, Tran Thi Minh Quyen and Toan Do
Dent. J. 2025, 13(10), 480; https://doi.org/10.3390/dj13100480 - 20 Oct 2025
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Background: Temporomandibular disorders (TMDs) exhibit a complex relationship with depression, anxiety disorders, and oral behaviors. This cross-sectional study aimed to assess the differences in oral behaviors among subgroups of TMD-related pain and patients with varying levels of anxiety and depression. Methods: A total
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Background: Temporomandibular disorders (TMDs) exhibit a complex relationship with depression, anxiety disorders, and oral behaviors. This cross-sectional study aimed to assess the differences in oral behaviors among subgroups of TMD-related pain and patients with varying levels of anxiety and depression. Methods: A total of 120 patients diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), completed the Oral Behavior Checklist (OBC), Visual Analog Scale (VAS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder (GAD-7), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaire-15 (PHQ-15), and Jaw Functional Limitation Scale-8 (JFLS-8). Associations were examined using Chi-square, Fisher’s exact, and Spearman’s correlation; logistic regression and multivariable linear regression were performed (p < 0.05). Results: In univariate analyses, several item-level OBs were more prevalent with higher anxiety, including nocturnal bruxism, sleep positions exerting jaw pressure, daytime grinding, and gum chewing (p = 0.007, 0.041, 0.011, and 0.014, respectively). A modest difference among pain subgroups was observed for sleep position (p = 0.044). In multivariable models, anxiety was independently associated only with nocturnal bruxism (OR = 2.95; 95% CI: 1.30–6.67; p = 0.010), whereas depression showed no independent associations. Pain intensity remained the sole predictor of total OBC scores (Coef = 1.829; 95% CI: 0.51–3.15; p = 0.007). No independent effects were detected for TMD subgroups. Conclusions: Psychosocial factors appeared related to OBs in univariate analyses, but these associations were explained by confounding influences. After adjustment, pain intensity and anxiety emerged as key determinants. These findings highlight the need for comprehensive TMD management integrating pain control with behavioral strategies.
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Open AccessSystematic Review
Salivary Biomarkers as Prognostic Tools in Oral Squamous Cell Carcinoma: A Systematic Review of Survival and Progression Outcomes
by
Matteo Pellegrini, Maurizio Pascadopoli, Mario Romolo Faretta, Alessandro Nobili, Carlos Pérez-Albacete Martínez, Francesco Spadari and Andrea Scribante
Dent. J. 2025, 13(10), 479; https://doi.org/10.3390/dj13100479 - 17 Oct 2025
Abstract
Background/Objectives: Oral squamous cell carcinoma (OSCC) remains associated with poor survival, and conventional prognostic indicators such as TNM staging provide limited accuracy. Saliva has emerged as a promising liquid biopsy, but evidence regarding its prognostic role is limited. This review systematically assessed
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Background/Objectives: Oral squamous cell carcinoma (OSCC) remains associated with poor survival, and conventional prognostic indicators such as TNM staging provide limited accuracy. Saliva has emerged as a promising liquid biopsy, but evidence regarding its prognostic role is limited. This review systematically assessed salivary proteomic, transcriptomic, and metabolomic biomarkers with prognostic value for survival and disease progression in OSCC patients. Methods: A systematic literature search was performed across PubMed, Scopus, Web of Science, Embase, and Cochrane Library up to 7 June 2025, following PRISMA 2020 and JBI guidelines. Human studies evaluating associations between salivary biomarkers and prognosis in OSCC were included. Risk of bias was assessed with the QUIPS tool. The review protocol was registered on PROSPERO (CRD42024535737). Results: Fifteen studies were included, involving 872 OSCC patients and 548 healthy controls. Biomarkers were identified using proteomic (n = 9), transcriptomic (n = 4), and metabolomic (n = 2) approaches. Among the most promising, miR-423-5p was independently associated with shorter disease-free survival (DFS), AKR1B10 levels above 646 pg/mL predicted worse overall survival (OS), and 3-methylhistidine was validated as a metabolomic marker of reduced OS. Additionally, miR-1307-5p correlated with nodal metastasis and chemoresistance, Cyfra 21-1 with recurrence and grade, and a low apoptotic/non-apoptotic salivary microvesicle ratio with poorer outcomes. However, heterogeneity in methods, small sample sizes, and lack of external validation limit clinical applicability. Conclusions: Salivary biomarkers show potential as non-invasive tools for prognostic stratification in OSCC. Among the identified candidates, miR-423-5p, AKR1B10, and 3-methylhistidine provide the most robust evidence. Future multicenter, longitudinal studies with standardized protocols and validation are essential.
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(This article belongs to the Special Issue Dental Oncology)
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Open AccessArticle
Flapless Immediate Implants: Soft Tissue Alterations Following a Trimodal Approach with or Without Modifying Osseous and Mucosal Compartments in the Esthetic Zone: A Non-Randomized Clinical Trial with Historical Control Group
by
Gustavo Cabello, María Rioboo, Daniel Torres-Lagares and Javier Fábrega
Dent. J. 2025, 13(10), 478; https://doi.org/10.3390/dj13100478 - 17 Oct 2025
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Objective: This study aimed to compare two protocols for immediate implants with fixed provisional restoration, no grafting (trimodal approach = TA) versus grafting in both the osseous gap and peri-implant mucosa (a trimodal approach with modification of the bony and mucosal compartments
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Objective: This study aimed to compare two protocols for immediate implants with fixed provisional restoration, no grafting (trimodal approach = TA) versus grafting in both the osseous gap and peri-implant mucosa (a trimodal approach with modification of the bony and mucosal compartments = TAOM), by measuring soft tissue changes over time. The periodontal phenotype was noted to investigate the relationship between its thickness and the clinical outcomes. Methods: Thirty-one patients met the inclusion criteria (15 in the TA group and 16 in the TAOM group). The TA group was a historical control group. Measurements were taken using a digital caliper at T0 and 3, 6, and 12 months following the procedure (T3), (T6), and (T12), respectively, from reference points marked in a dental-supported stent. The periodontal phenotype was determined using an analogical caliper. Results: T12: Vertical midfacial change was −0.17 ± 0.37 in the TAOM group and 0.54 ± 0.33 in the TA group, respectively. Statistical significance (p = 0.0001) was found. Papilla vertical change in the TAOM group was −0.16 ± 0.45 mesially and 0.00 ± 0.44 distally. In the TA group, it was 0.55 ± 0.82 mesially and 0.86 ± 0.95 distally. Statistical significance (p = 0.0001) was also found. Conclusions: There were differences in soft tissue change between the two groups, and changes were related to the periodontal phenotype. Studies with more extended follow-up periods are needed to assess the long-term evolution of both protocols.
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Open AccessSystematic Review
Modified Coronally Advanced Flaps: A Systematic Review and Meta-Analysis
by
Miriana Gualtieri, Annarita Signoriello, Alessia Pardo, Diana Andreea Muresan, Alessandro Zangani, Paolo Faccioni, Giovanni Corrocher and Giorgio Lombardo
Dent. J. 2025, 13(10), 477; https://doi.org/10.3390/dj13100477 - 17 Oct 2025
Abstract
Background: Gingival recession (GR) is defined as the exposure of the root surface due to the gingival margin shifting apically from the cemento-enamel junction. Current effective management of defects related to GR relies on root coverage periodontal plastic surgery (RCPPS), using the
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Background: Gingival recession (GR) is defined as the exposure of the root surface due to the gingival margin shifting apically from the cemento-enamel junction. Current effective management of defects related to GR relies on root coverage periodontal plastic surgery (RCPPS), using the Modified Coronally Advanced Flap (mCAF) with an envelope design. Recent literature also reported the association of different biomaterials to the mCAF procedure. In light of these considerations, a systematic review (SR) was conducted to determine and compare the efficacy of all mCAF adjunctive techniques for the treatment of multiple adjacent GR-type (MAGR) defects. Methods: An electronic search was conducted in 2025 on studies published between 2013 and 2025, using PubMed, Scopus, Web of Science, and Cinahl Complete, to address the focused question: “which is the efficacy of different mCAF adjunctive techniques for the treatment of multiple adjacent GR-type defects, in terms of root coverage (RC), esthetic outcomes, and keratinized tissue (KT) augmentation?”. Randomized controlled trials with a minimum follow-up of 6 months with ≥ 5 patients treated for coverage of MAGR were included. Risk of bias was assessed with RoB 2 Tool. A meta-analysis was performed using RevMan5.4 software and the level of evidence of included studies was analyzed with GRADEPro GDT. Results: A total of 17 studies were included in the SR, 9 of which evaluating mCAF + sCTG (subepithelial connective tissue graft) vs. mCAF adjunctive techniques [Collagen Matrix (CM), xenogeneic acellular dermal matrix (XADM), Platelet-Rich Fibrin (PRF), Enamel Matrix Derivatives (EMD), sCTG harvested double blade scalpel] were then included in the meta-analysis. The primary outcomes of complete root coverage (CRC) and keratinized tissue width variation (ΔKTW) were statistically significant ([CRC: Odds Ratio (OR) 1.70; 95% CI (confidence interval) 1.18, 2.44; p = 0.004]; [ΔKTW: SMD (standardized mean difference) 0.37; 95% CI 0.11, 0.63; p = 0.005]) in favor of mCAF + CTG. Meanwhile, no statistically significant difference was observed in terms of RES. The certainty assessment highlighted relevant results: despite the lack of evidence in the long-term, a high level of evidence showed that sCTG was more effective than XADM in terms of CRC (p = 0.002) and ΔKTW (p = 0.0001). A low level of evidence revealed that sCTG achieved a greater ΔKTW compared to CM (p = 0.0006). Although no significant differences were observed, a low level of evidence suggested that mCAF + EMD and mCAF + sCTG (DBS) may provide good results. To date, only one RCT showed long-term stable results of CTG in terms of RC. Conclusions: The association of sCTG to mCAF demonstrated better results in terms of RC and KTW augmentation in short- and medium-term follow-ups. Long-term studies are needed to confirm the efficacy of the other mCAF adjunctive techniques, considering limitations due to heterogeneity in follow-ups, distribution of techniques analyzed, and different study designs. Registration in PROSPERO (International prospective register of systematic reviews) was performed with ID CRD420251085823.
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(This article belongs to the Topic Oral Health Management and Disease Treatment)
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Open AccessArticle
The Impact of Centrifugation Devices and Collection Tubes on Fibrin Characteristics and Growth Factor Release Under High- and Low-Speed Protocols
by
Oranit Bunyatratchata, Wutigri Nimlamool and Supatra Sangin
Dent. J. 2025, 13(10), 476; https://doi.org/10.3390/dj13100476 - 17 Oct 2025
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Background: Platelet-rich fibrin (PRF) is an autologous platelet concentrate (APC) produced through blood centrifugation. Despite the development of various centrifugation systems, protocol variability continues to pose challenges in selecting the optimal method. This study investigated the effects of three different centrifuges and collection
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Background: Platelet-rich fibrin (PRF) is an autologous platelet concentrate (APC) produced through blood centrifugation. Despite the development of various centrifugation systems, protocol variability continues to pose challenges in selecting the optimal method. This study investigated the effects of three different centrifuges and collection tubes on the fibrin characteristics and growth factor release in leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin plus (A-PRF+). Methods: Blood samples from six healthy female volunteers were processed using three centrifuges (Duo, IntraSpin, and LMC-3000) and three collection tubes (Pyrex, A-P, and silica-coated plastic) under high- (~700× g for 12 min) and low-speed (~200× g for 8 min) protocols. Fibrin clot weight and length were assessed. Growth factor release of platelet-derived growth factor-BB (PDGF-BB) and vascular endothelial growth factor (VEGF) was quantified using ELISA. Fibrin architecture was examined via scanning electron microscopy (SEM). Results: High-speed protocols tended to produce larger clots, whereas low-speed protocols generated smaller but more biologically active matrices. The IntraSpin and Duo centrifuges yielded greater clot dimensions and higher growth factor release than the LMC-3000. While tube type had no significant effect on growth factor levels, silica-coated tubes tended to produce the largest clots. The Pyrex tubes demonstrated comparable or superior growth factor release. Conclusions: PRF quality is influenced by centrifuge design, g-force, and tube material. Low-speed protocols with certified centrifuges are recommended, and FDA-approved glass tubes may provide a reliable alternative to reduce silica-related risks. Standardization and appropriate material selection are essential for consistent, safe, and effective regenerative outcomes.
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