Search Results (174)

Background/Objectives: Although many studies have examined the determinants and management of dental anxiety (DA), its broader placement as a potential bottleneck along oral–systemic health pathways, from the determinants of DA to consequences through dental avoidance, oral outcomes, psychosocial impacts, and possible systemic health outcomes, has not been mapped across the review literature. This review aimed to conceptually map how existing DA reviews are distributed across this pathway, whether this broad framing changed across 5-year periods, and how systemic health outcomes were framed. Methods: We conducted a conceptual mapping review of DA-focused review articles published between 2005 and 2025. PubMed and Scopus were searched for English-language narrative, systematic, scoping and umbrella reviews and meta-analyses addressing the determinants or consequences of DA. One reviewer screened records, extracted review characteristics, and classified each review into predefined domains using binary framed/not framed coding rules. A structured AI-assisted prompt was used only to support full-text evaluation across domains; all final coding decisions were made by the reviewer. Results: The search identified 851 records; after removing 426 duplicates, 425 unique records were screened, and 39 reviews met the inclusion criteria. Framing concentrated on environmental and psychological determinants and on the pathway from DA to avoidance and poor oral health, whereas broader consequences, including shame, OHRQoL, and systemic health outcomes, were less consistently framed. Across 5-year periods, the broad pattern of framing remained relatively stable. Systemic health outcomes were framed in only a minority of reviews. Conclusions: Future research should test hypothesized pathways from DA to broader health consequences using clearly specified bridge mechanisms and appropriate temporal designs. Full article

Background/Objectives: Dental Practice-Based Research Networks (DPBRNs) bridge the gap between academic research and private dental practice, addressing questions relevant to everyday medical care. Despite their growing scientific output, little research has explored the experiences of practitioners engaged in these networks. Our study therefore aims to investigate these practitioners’ perspectives in order to identify strategies for improving investigator recruitment, training and data quality in future DPBRN studies. Methods: The qualitative methodology was chosen, and our study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines. Semi-structured interviews were conducted with dentists who had participated in a DPBRNs study and transcribed before being thematically analysed using Braun and Clarke’s framework. MaxQDA 2022 software was used to facilitate coding of the verbatim quotes. Results: Three major themes emerged: (1) obstacles to participation, including time constraints, difficulties in patient recruitment, and a perceived disconnect between academia and private practice; (2) facilitators of engagement, such as strong leadership, logistical support, and a collaborative research environment; and (3) personal benefits, such as skill development, breaking professional routines, and counteracting stereotypes about private practitioners’ involvement in research. Conclusions: The findings align with existing literature on medical Practice-Based Research Networks (PBRNs), highlighting logistical and motivational barriers while also emphasizing the importance of social and professional benefits. Notably, although financial compensation or credits for continuing professional development are frequently cited as motivators for research participation, these were not significant concerns for our participants. This study sheds light on the experiences of health practitioners in PBRNs, offering recommendations to overcome challenges through strategies such as accessible training, practical incentives and collaboration opportunities. Full article

Early childhood caries (SECC) in children aged 3–4 years is a high-burden condition with consequences that extend beyond the dentition, including pain, infection, sleep disturbance, impaired nutrition, disrupted family functioning, and diminished quality of life. In contemporary pediatric practice, 38% silver diamine fluoride (SDF) and other minimally invasive approaches are widely used to stabilize disease while behavior matures, preventive strategies are intensified, or access to definitive care is secured. This perspective argues that SDF should be conceptualized not as a standalone solution, but as an evidence-supported interim stabilization strategy embedded within a defined, goal-directed care pathway. Its use is most appropriate when framed as a means of buying time under clear clinical intent, particularly in cases where teeth are expected to remain functional for years, symptoms are present, structural integrity is compromised, or follow up is uncertain. Although clinical guidelines and systematic reviews support SDF for arresting cavitated lesions in primary teeth, current evidence does not support its use as a universal long-term treatment for severe disease. Real-world data suggest that many SDF-treated teeth require additional intervention within approximately 2 years, and that delays to definitive care—including treatment under sedation or general anesthesia when indicated—are often relatively short. In response, this paper proposes a practical bridge-to-destination framework grounded in three principles: explicit treatment intent, child-centered outcomes, and predefined exit criteria to ensure a timely transition to definitive dental care. Rather than discouraging SDF use, this approach seeks to optimize its role within a continuum of dental care, emphasizing proportionality, transparency, and durable outcomes for children. Full article

Dental tissue regeneration, particularly alveolar bone and gingival repair, remains a major challenge in regenerative medicine. 3D bioprinting offers patient-specific and anatomically precise constructs, representing an advanced alternative to conventional grafting. In this study, nanohydroxyapatite (nHA), chitosan (CS), and collagen (CoL) were combined to fabricate and characterize 3D bioprinted dental grafts. SEM revealed a highly porous, interconnected architecture favorable for cell infiltration and nutrient exchange. EDS confirmed Ca/P ratios of 2.06 for nHA/CoL and 1.83 for nHA/CS/CoL, both of which are above the stoichiometric 1.67, indicating the presence of additional mineral phases and ion substitutions. FTIR and XRD verified characteristic functional groups and crystalline phases, including B-type HA with carbonate substitution. Mechanical testing showed that pure nHA exhibited the lowest compressive strength, whereas CoL incorporation improved stiffness. The nHA/CS/CoL composite achieved the highest compressive strength, elastic modulus, and toughness, demonstrating superior mechanical resilience. DSC analysis indicated endothermic peaks at 106.49 °C and 351.91 °C, with enthalpy values (264.91 J/g and 15.09 J/g) surpassing those of nHA alone. TGA revealed ~28.8% weight loss across three degradation stages, confirming enhanced thermal stability. In vitro cytocompatibility testing using L929 fibroblasts validated the biocompatibility of the composites. Collectively, the synergy between bioceramics and biopolymers markedly improved both mechanical and thermal performance. These findings position the nHA/CS/CoL scaffold as a promising candidate for clinical applications in dental tissue regeneration. Unlike conventional grafting materials, this study introduces a synergistically optimized nHA/CS/CoL bio-ink formulation specifically designed for extrusion-based 3D bioprinting of patient-specific dental constructs. The core innovation lies in the precise integration of nHA within a dual-polymer matrix (CS/CoL), which bridges the gap between mechanical resilience and biological signaling, achieving a compressive strength that mimics native alveolar bone while maintaining high cytocompatibility. Full article

Three-dimensional (3D) printing, also known as additive manufacturing (AM), has become increasingly integrated into dentistry because of its high precision, efficiency, and ability to fabricate patient-specific devices. This review comprehensively discusses the historical development of 3D printing and outlines the fundamental principles of the most widely used technologies in dentistry, including stereolithography (SLA), digital light processing (DLP), and liquid crystal display (LCD). These technologies enable the accurate and efficient fabrication of dental models, crowns, bridges, dentures, surgical guides, orthodontic appliances, and tissue engineering scaffolds. Current clinical applications are systematically summarized across major dental disciplines, including prosthodontics, orthodontics, oral and maxillofacial surgery, endodontics, periodontics, and pediatric dentistry. Despite existing challenges, such as limited long-term clinical data for certain materials, high initial equipment costs, and post-processing requirements, 3D printing offers substantial advantages in terms of customization, workflow efficiency, and clinical predictability of the final product. Future developments in advanced biomaterials, artificial intelligence-assisted workflows, bioprinting, and four-dimensional (4D) printing are expected to further expand the role of additive manufacturing in personalized and regenerative dentistry. Full article

By using virtual surgical planning (VSP) and 3D printed guides, complex maxillofacial defects can be reconstructed with high accuracy and predictability. A fully digital workflow resulting in a modular all-in-one 3D printed guide system for fibula osteotomies, bone segment positioning, fully guided dental implant placement and dental prosthesis fixation for mandibular reconstruction was developed at Ghent University Hospital. A follicular ameloblastoma of the left mandible was resected in a 28-year-old male. The defect was reconstructed with a two-segment fibular free flap with immediate placement of three dental implants and immediate implant loading with a screw-retained bridge. A split thickness skin graft and Elemental PerioPlast were used as wound dressing. Comparison of the preoperative planning with the postoperative CT-scan showed a deviation immediately after surgery, which was no longer present at the 6-month follow-up. The patient achieved a stable occlusion and 44 mm mouth opening and reported high satisfaction. This case illustrates that fully digital, immediate mandibular reconstruction with simultaneous implant placement and prosthetic rehabilitation is feasible and accurate and enhances early functional recovery. Future improvements in intraoperative validation may further refine accuracy and reproducibility in complex oncologic reconstructions. Full article

Background: England is a high-income country with a predominantly publicly funded health system organised around the National Health Service (NHS). Yet children’s oral health outcomes continue to reflect a persistent access and prevention gap, with late presentation and hospital-based extractions remaining common. Objective: To present a policy-facing, evidence-informed critique of how structural constraints in NHS dentistry shape paediatric clinical pathways—often converting “advances” (biological caries management, silver diamine fluoride, and planned extraction pathways for compromised permanent molars) into compensations for service failure rather than patient-centred progress. Methods: Narrative commentary drawing on UK official statistics and major policy reports, alongside key clinical trials and evidence syntheses relevant to contemporary paediatric dentistry. Results: The dominant failure mode is not a lack of clinical tools but impaired delivery: restricted access to routine NHS dentistry, contract and workforce pressures, and unequal prevention coverage. These pressures correlate with crisis-led care (including extractions under general anaesthesia) and can distort how minimally invasive/biological interventions are used—functioning as endpoints rather than bridges to definitive care. In parallel, guidance for compromised first permanent molars (including those affected by MIH) risks being operationalised as an “efficiency pathway” when restorative capacity is constrained. Conclusions: In NHS England, paediatric dental “advances” cannot be judged solely by trial efficacy; they must be evaluated within a delivery system that currently selects for late-stage, irreversible outcomes. A credible “advances” agenda requires contract reform, workforce retention, prevention at scale, and explicit safeguards against the normalisation of extraction-only trajectories. Full article

This entry paper explores the multifaceted oral health crisis in the Pacific island nation of Tuvalu, a remote archipelago of nine coral atolls. It delves into the severe burden of oral diseases, such as early childhood caries (ECC) and periodontitis, which are rampant within its population of just over 11,000. The analysis investigates the primary drivers of this crisis, including a significant dietary transition towards imported, ultra-processed foods, compounded by profound socioeconomic challenges and a lack of public health literacy. The paper critically examines the systemic failures of the national healthcare system, characterized by the absence of a formal oral health policy and a critically inadequate dental workforce, which forces residents to seek complex care abroad. Furthermore, it highlights how extreme geographic isolation and severely limited air connectivity function as direct barriers to accessing essential services, rendering specialized treatments like orthodontics and effective management of dental emergencies virtually impossible. In response to these challenges, the paper discusses innovative, forward-looking solutions, including the potential of teledentistry to bridge service gaps, the strategic development of regional medical or dental hubs in proximity to the biggest airports to centralize care, and the necessity of integrating oral health into broader strategies for economic development and climate resilience. Full article

Zirconia is widely used in full-arch restorations due to its strength and aesthetics, but failures can still affect its performance in clinical practice. In this report, a full-arch tooth-supported zirconia bridge fractured prematurely (eleven months), encouraging an investigation into its design and failure mechanisms. STL files obtained from the dental laboratory revealed regions of reduced framework thickness, falling below the manufacturer’s recommendations. Fractographic analysis of the fractured pieces indicated a multifactorial failure pattern. Notable features included a thick cement layer, surface damage likely caused by the CAM bur during milling, and occlusal wear affecting the glazed surface. Crack propagation was observed in an occlusal-to-cervical direction. While no single factor could be definitively identified as the primary cause, the failure is attributed to the combined effect of insufficient design, surface damage, and biomechanical overload. Importantly, most such factors are not visible before failure, raising questions about the proper evaluation of zirconia-based restorations prior to their cementation. Full article

This study examined the association between biofilm growth and surface properties of 3D printed, milled, and conventional materials used for manufacturing fixed dental prostheses. Disc-shaped specimens were produced and finished from five 3D-printing resins (VarseoSmile Crown plus [VSC], NextDent C&B MFH [ND], VarseoSmile Temp [VST], Temp PRINT [TP], P Pro Crown & Bridge [P]), two polymer milling blocks (composite: TetricCAD [TC], PMMA: TelioCAD [TEL]), two conventional polymer materials (Tetric EvoCeram [TEC], Protemp 4 [PT]), and zirconia (ZR). Surface roughness (R_a), wettability, interfacial tension (IFT) and surface topography were examined. Three-day biofilms were grown on the specimens using A. naeslundii, S. gordonii, S. mutans, S. oralis, and S. sanguinis in a multi-species suspension. Biofilms were quantified by crystal violet staining and with a plating and culture method (CFU/mL). Linear regression analysis was computed to demonstrate associations between the surface properties and biofilm growth. The strength of this relationship was quantified by calculating Spearman’s ρ. TC exhibited the highest, and TP the lowest IFT. TEC showed the highest R_a, while TEL had the lowest, with significant differences detected particularly between milled and 3D-printed specimens. TP specimens exhibited the highest biofilm mass, while ZR surfaces retained the least. Bacterial viability within the biofilms remained similar across all tested materials. There was a strong negative correlation between total IFT and biofilm mass, and a moderate positive correlation between R_a and CFU/mL. Surface properties are shaped by material composition, microstructure, and manufacturing methods and play a crucial role in biofilm formation on dental restorations. Full article

Periodontal disease represents a major global concern characterized by chronic biofilm-driven inflammation, excessive oxidative stress, progressive tissue destruction, and impaired regenerative capacity. Beyond conventional antimicrobial approaches, recent progress has shifted toward host-directed and regenerative therapeutic strategies aimed at restoring both oral function and tissue homeostasis. This review consolidates current developments in nanobiotechnology-based materials that modulate immune responses, scavenge reactive oxygen species, and promote angiogenesis and osteogenesis, thereby facilitating the effective regeneration of dental and periodontal tissues. Emphasis is placed on bioresponsive hydrogels, bioactive scaffolds, and gas-releasing platforms that integrate therapeutic regulation with tissue repair. The discussion further highlights key advances in polymeric and inorganic biomaterials designed to balance antibacterial action with cellular compatibility and regenerative potential. By linking pathophysiological mechanisms with material-guided healing processes, this review provides a comprehensive perspective on emerging nanobiotechnological solutions that bridge patho-therapeutics with regenerative and clinical dentistry. Full article

Background/Objectives: Mathematical modelling provides a quantitative way to describe the fate and action of drugs in the oral cavity, where transport processes are shaped by salivary flow, pellicle formation, biofilm structure and the wash-out effect of gingival crevicular fluid (GCF). Local pharmacokinetics in the mouth differ substantially from systemic models, and therefore a dedicated framework is required. The aim of this work was to present a structured, physiologically based concept that links in vitro release testing with local pharmacokinetics and pharmacodynamics. Methods: A narrative review with elements of systematic search was conducted in PubMed, Scopus and Web of Science (1980–2025) for publications describing drug release, local PBPK, and PK/PD modelling in the oral cavity. Mathematical formulations were grouped into release kinetics, mini-PBPK transport and local PK/PD relations. Classical models (Higuchi, Korsmeyer–Peppas, Peppas–Sahlin) were integrated with a mini-PBPK structure describing saliva–mucosa–biofilm–pocket interactions. Results: The combined model captures adsorption to pellicle, diffusion within biofilm and wash-out by GCF. It allows simulation of variable clinical conditions, such as inflammation-related changes in Q_GCF, and links local exposure to pharmacodynamic outcomes. Case studies with PerioChip^®, Arestin^®, and Atridox^® demonstrate how mechanistic models explain observed therapeutic duration and low-systemic exposure. Conclusions: The proposed mini-PBPK framework bridges empirical release data and physiological transport in the oral cavity. It supports rational formulation design, optimisation of local dosage, and personalised prediction of drug retention in gingival pockets. This modelling approach can become a practical tool for the development of dental biomaterials and subgingival therapies. Full article

This study evaluated the efficiency and potential risks associated with three clinical tools for removing cement-retained implant-supported prostheses: Magnetic Mallet, sliding hammer, and Coronaflex. The tests consisted of: cementation of three-unit bridge models onto titanium abutments with different geometries using Zinc Oxide non-eugenol or Zinc Phosphate cement. Seven different geometries of three-unit bridges were tested; therefore, a total of 7 bridges × 2 luting agents × 3 tools were combined in a full factorial analysis. Five test replicates were performed for each combination, resulting in a total of 5 × 7 × 2 × 3 = 210 retrieval tests. The 70 tests regarding the Coronaflex were taken from a previously conducted experiment on the topic, using the same dental bridge models and the same experimental conditions. Efficiency was assessed by the percentage of successful removals and the maximum force recorded with a piezoelectric load cell. For temporary cementations, the sliding hammer achieved the highest retrieval rate, while the Magnetic Mallet demonstrated comparable efficiency with lower forces. Coronaflex showed lower success rates and higher forces than Magnetic Mallet. For permanent cementations, most bridges were not removable, and attempts with the sliding hammer occasionally resulted in abutment screw damage. Within the limitations of this study, the Magnetic Mallet appears to be an effective option for removing bridges cemented with temporary cement, potentially in combination with a sliding hammer for highly retentive geometries. Zinc phosphate cement should be avoided when retrievability is desired, except for abutments with very low retention capability. Full article

Dental composites are commonly used for the restoration of hard tooth tissues, but their low fracture toughness may limit their lifespan. In this study, the effect of liquid rubber modification on the mechanical properties and fracture mechanisms of two types of dental composites, flow and classic, was evaluated. The study used experimental composites containing a mixture of dimethacrylate resins: BisGMA (20% by weight), BisEMA (30% by weight), UDMA (30% by weight), and TEGDMA (20% by weight). Composites were reinforced with Al-Ba-B-Si glass, Ba-Al-B-F-Si glass with particle sizes of 0.7 and 2 μm respectively, as well as pyrogenic silica (20 nm). The inorganic phase was introduced in an amount of 50% vol. for flow material and 80% vol. for classic composite. As a modifier, Hypro 2000X168LC VTB liquid rubber (Huntsman International LLC, USA) was used in an amount of 5% by weight relative to the matrix. The flexural strength, Young’s modulus, and fracture toughness were evaluated. Numerical FEM analysis allowed for the evaluation of stress distribution in the filling area. The results confirmed that the modification of composites with liquid rubber contributes to an increase in fracture toughness. For the flow-type material, the fracture toughness increased from 1.04 to 1.13 MPa·m^1/2. At the same time, a decrease in flexural strength from 71.90 MPa to 61.48 MPa and in Young’s modulus from 2.98 GPa to 2.53 GPa. In the case of the classical composite, the modification with liquid rubber also improved the resistance to fracture, increasing it from 1.97 to 2.18 MPa·m^1/2 while the flexural strength decreased from 102.30 MPa to 90.96 MPa, and the modulus dropped from 7.33 GPa to 6.16 GPa. FEA analysis confirmed that modified composites exhibit a more favorable stress distribution with lower tensile stress levels (approximately 20 MPa in contrast to 25 MPa for the classic composite). Mechanisms of fracture and strengthening were also identified. The main fracture mechanism was intermolecular cracking with crack deflections. Modification with liquid rubber resulted in the formation of elastic bridges and plastic shear zones at the front of the crack. Full article

Background/Objectives: Root canal treatment (RCT) is a common dental procedure performed to preserve teeth by removing infected or at-risk pulp tissue caused by caries, trauma, or other pulpal conditions. A successful outcome, among others, depends on accurate identification of the root canal anatomy, planning a suitable therapeutic strategy, and ensuring a bacteria-tight root canal filling. Despite advances in dental techniques, there remains limited integration of computational methods to support key stages of treatment. This review aims to provide a comprehensive overview of computational methods applied throughout the full workflow of RCT, examining their potential to support clinical decision-making, improve treatment planning and outcome assessment, and help bridge the interdisciplinary gap between dentistry and computational research. Methods: A comprehensive literature review was conducted to identify and analyze computational methods applied to different stages of RCT, including root canal segmentation, morphological analysis, treatment planning, quality evaluation, follow-up, and prognosis prediction. In addition, a taxonomy based on application was developed to categorize these methods based on their function within the treatment process. Insights from the authors’ own research experience were also incorporated to highlight implementation challenges and practical considerations. Results: The review identified a wide range of computational methods aimed at enhancing the consistency and efficiency of RCT. Key findings include the use of advanced image processing for segmentation, image analysis for diagnosis and treatment planning, machine learning for morphological classification, and predictive modeling for outcome estimation. While some methods demonstrate high sensitivity and specificity in diagnostic and planning tasks, many remain in experimental stages and lack clinical integration. There is also a noticeable absence of advanced computational techniques for micro-computed tomography and morphological analysis. Conclusions: Computational methods offer significant potential to improve decision-making and outcomes in RCT. However, greater focus on clinical translation and development of cross-modality methodology is needed. The proposed taxonomy provides a structured framework for organizing existing methods and identifying future research directions tailored to specific phases of treatment. This review serves as a resource for both dental professionals, computer scientists and researchers seeking to bridge the gap between clinical practice and computational innovation. Full article