Search Results (333)

Matrix metalloproteinases (MMPs) are zinc-dependent proteolytic enzymes involved in extracellular matrix remodelling in oral and dental tissues, including the periodontal ligament, alveolar bone, dentin, dental pulp, and periapical tissues. This narrative review summarises selected evidence on the role of MMPs and tissue inhibitors of metalloproteinases (TIMPs) in orthodontic tooth movement, dental trauma and root resorption, restorative adhesive dentistry, and pulp/periapical disease. Particular attention is given to signalling pathways that regulate MMP/TIMP activity, including nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPK), Wnt/β-catenin, and transforming growth factor beta (TGF-β)/Smad-related mechanisms. The review also discusses the biomarker potential and translational status of MMP-targeted strategies. Across clinical contexts, MMP activity contributes to both matrix degradation and tissue repair, and its biological effect depends on local stimuli, TIMP-mediated regulation, pathway crosstalk, and the stage of disease or treatment. Full article

Traumatised immature permanent teeth with pulp necrosis pose a clinical challenge due to incomplete root development and limited treatment options. This retrospective observational study evaluated the clinical and radiographic outcomes of regenerative endodontic treatment (RET) incorporating an additional calcium hydroxide-based step for blood clot stabilisation compared with apexification in traumatised immature teeth. A total of 49 teeth treated between 2015 and 2025 were analysed. Clinical and radiographic parameters were recorded at baseline and reassessed at 6- and 12-month follow-up, including root length, dentinal wall thickness, apical diameter, periapical status, and apical closure. RET was associated with significantly greater increases in dentinal wall thickness (p = 0.002), root length (p = 0.010), and reductions in apical diameter (p < 0.001) over time compared with apexification. Apical closure was observed significantly more frequently in the RET group (p < 0.001). Periapical healing improved in both groups, while overall clinical outcomes appeared broadly similar. Within the limitations of this retrospective observational study, RET incorporating an additional calcium hydroxide-based step for blood clot stabilisation appears to be a clinically applicable approach for promoting root development in traumatised immature teeth. Further prospective and controlled studies are required to confirm these findings and to better define the role of this adjunctive step. Full article

Dental malocclusions are common and often underdiagnosed situations in dogs, which might result in oral trauma, impaired mastication, and periodontal disease. Nevertheless, scientific investigations into breed-specific variations in dentition remain scarce. To evaluate breed-specific dental variations in dogs, a retrospective cross-sectional analysis was conducted on 92 clinical canine head computed tomography (CT) scans obtained in Chengdu, China, representing a range of breeds and skull morphologies. Dental alignment and occlusal relationships were calculated using standardized malocclusion classification criteria. As a result, malocclusions were found and identified in 46.7% of dogs. Among them, brachycephalic breeds indicated a high prevalence of malocclusion, with Shiba Inu dogs demonstrating the highest malocclusion rate (66.7%), whereas Golden Retrievers and Akitas showed the lowest prevalence (16.7%). Class I malocclusions characterized by dental crowding were most common (44.19%), followed by Class II malocclusions (overbite) (30.23%), and Class III malocclusions (underbite) (20.93%). Our findings demonstrated a strong association between skull morphology and dental alignment abnormalities. Full article

Background and Clinical Significance: Dental trauma presents a considerable challenge for clinicians due to the diverse and complex effects on teeth. Effective management often requires the collaboration of multiple specialists, including endodontists and orthodontists. Case Presentation: This case report presents the interdisciplinary management of a complex dental trauma case involving three permanent maxillary anterior teeth. Unlike most reports of dental trauma, this case includes complete pre-trauma diagnostic records, providing valuable baseline information for treatment planning and outcome assessment. A 15-year-old female patient was examined in the orthodontic clinic, with comprehensive diagnostic records being obtained at the initial visit. Before the commencement of active orthodontic therapy, the patient experienced an extraoral traumatic incident. Clinical and radiographic assessment revealed concussion and traumatic mobility of the upper right canine, intrusive luxation of the upper right lateral incisor and extrusive luxation with increased mobility of the upper right central incisor. Taking into consideration treatment alternatives, an orthodontic–endodontic approach was preferred. Conclusions: The successful management of complex dental trauma affecting multiple permanent teeth requires interdisciplinary collaboration. The clinical significance lies in the potential long-term consequences on both tooth function and aesthetics, which can impact patient well-being. Full article

Coaggregation by bridging bacteria such as Fusobacterium nucleatum is considered a key element in dental biofilm development and maturation. Previous studies showed that sublethal exposure to blue light caused damage to cell membrane integrity. The aim of the present study was to test the effect of blue light phototoxicity on this bacterium’s ability to coaggregate with the early colonizer Streptococcus sanguinis. Fusobacterium nucleatum bacterial cells were suspended in coaggregation buffer (CAB) and exposed to blue light (400–500 nm) for 0, 70, 140 and 280 s (i.e., fluences of 0, 96, 192 and 384 J/cm², respectively). Following blue light exposure, samples were mixed with Streptococcus sanguinis suspensions and coaggregation was measured using a visual scale, spectrophotometric analysis and light microscopy. Results showed that blue light exposure significantly reduced the ability of Fusobacterium nucleatum to coaggregate with Streptococcus sanguinis. These results suggest that blue light antibacterial phototoxicity may be considered as a viable option in preventing dental biofilm-related conditions. Full article

Background: Maxillary sinus lift is among the most common preprosthetic procedures in the posterior maxilla due to alveolar ridge resorption and the maxillary sinus pneumatization. It often extends treatment duration, significantly increases costs, and is not without complications. Objective: To explore the prevalence and morphology of the palatal bone reservoir as a viable site for dental implant insertion, offering a conservative alternative to avoid maxillary sinus lift. Methods: DICOM data sets from helical CT of maxillofacial trauma patients aged 50 years and older were used to perform virtual dental implant positioning in the edentulous second premolar, first molar, or second molar areas using ImplaStation software (version 5.3.2; ProDigiDent, Inc., Scottsdale, AZ, USA). A 3D Slicer software (version 5.3.2; ProDigiDent, Inc., Scottsdale, AZ, USA) was used to calculate the volume of the palatal bone reservoir and identify its mean density. The density of the residual alveolar process was also identified and compared with that of the previous one. Results: A total of 1822 maxillofacial trauma cases with helical CT between 2015 and 2025 were retrieved. After exclusion, 305 cases were analyzed. A total of 65 implants were virtually positioned in 50 patients. The mean volume of the palatal bone reservoir was 229 ± 139.2 mm³ with a mean radiodensity of 546.7 ± 159.6 HU. The mean radiodensity of the residual alveolar process was 286.3 ± 118.0 HU. The palatal bone reservoir was significantly denser than the residual alveolar process (95% CI [184.2, 336.6]; p < 0.01). Conclusions: The presence of a palatal bone reservoir is not uncommon and can offer a more conservative alternative for implant placement, potentially increasing primary stability and facilitating immediate loading. Full article

Introduction: In the period from the 1960s to the new millennium, dental care for children in Denmark focused mostly on drilling and filling lesions once they appeared. This often led to repeated operative treatments, not to mention the trauma related to the many anxiety-provoking dental treatments undergone by these children. Aim: It is cost-effective to document, by means of clinical data over a 25-year period, that the paradigm shift from operative management of caries to a more non-operative approach. Method: The name of the program is the Nexø method, which was developed in 1987 in the Municipality of Nexø (one of 275 municipalities) in Denmark. The method was operationalized into a structured approach based on three principles, dosed at individually assessed recalls according to diagnosis and risk assessment. The risk assessment was based on four risk criteria, each divided into a “good” (1 point) or “bad” (2 points) situation, which were eventually used to assess the length of the interval between visits to the clinic. Outcomes: National Danish oral health data (SCOR) and oral health data from the Nexø municipality from 1985 to 2005 were analyzed, descriptively as well as statistically (Welch’s t-test, 95%CI and Cohen’s d), to compare the caries experience on a national level with data from Nexø in terms of mean defs/DMFS and percentage of 5-, 15-, and 18-year-olds with a defs/DMFS = 0. Results: The mean defs/DMFS or percentage of children with a defs = 0/DMFS = 0 in Nexø was, prior to the implementation of the Nexø method (before 1987), at the national level or worse. The mean defs/DMFS dropped significantly (p-values < 0.0001) from 1990 onwards in Nexø in 5-, 15- and 18-year-olds compared to national data. The DMFS = 0 among 15-yr-olds in Nexø reached 80% in 2005 compared with 40% nationally in the same year. For 15-yr-olds in 2005, the effect size expressed by Cohen’s d = −0.43, indicating a moderate effect of the Nexø method. The mean number of sealed surfaces in 2003 was 3.1 (1SD = 1.6) in 39 reporting municipalities, and for Nexø the mean value was 2.8 surfaces. The cost (price/child/year) was under control over the years. Conclusions: The Nexø Method shows the clinical evidence that the paradigm shift to prevention of the disease process, rather than operative intervention, is cost effective, even with a rather limited use of sealants. A reduction in fear and anxiety-provoking dental treatments in Nexø compared to most other municipalities in Denmark is expected. Full article

Background/Objectives: Traumatic dental injuries (TDIs), particularly avulsion, require immediate and appropriate first aid to ensure favorable outcomes. Adolescents are often the first responders during school or sports activities, yet their preparedness remains unclear. This study aimed to assess the knowledge, attitude, and awareness of adolescents regarding the emergency management of TDIs. Methods: A descriptive cross-sectional survey was conducted among 400 adolescents aged 15 to 18 years from four randomly selected colleges in Mangaluru, Karnataka. A structured, validated 16-item questionnaire assessed demographic characteristics and domains of knowledge (6 items), attitude (6 items), and awareness (6 items). Data was analyzed using descriptive statistics, chi-square tests, and one-way ANOVA. Results: The mean knowledge score was 2.50 ± 1.04 (95% CI: 2.40–2.60), indicating limited knowledge of dental trauma management; only 26.3% of participants recognized that avulsed permanent teeth can be replanted and 7% identified an appropriate storage medium. The mean attitude score was comparatively high (4.38 ± 1.12; 95% CI: 4.27–4.49), with 88.8% of students willing to assist an injured peer, reflecting a large attitude–knowledge discrepancy (Cohen’s d = 1.47). The mean awareness score was 2.24 ± 1.24 (95% CI: 2.12–2.36), indicating limited awareness of preventive practices, including low mouthguard use (11.5%). Shapiro–Wilk testing confirmed non-normal distribution of KAA scores (p < 0.05); accordingly, non-parametric analyses showed no significant differences across schools, academic streams, gender, or education level (Kruskal–Wallis and Mann–Whitney U tests; p > 0.05). Conclusions: Despite favorable attitudes toward assisting peers, adolescents demonstrated limited knowledge and awareness regarding the emergency management and prevention of traumatic dental injuries, particularly in tooth replantation, appropriate storage media, and mouthguard use, highlighting the need for targeted, school-based dental first-aid education programs. Full article

Background/Objectives: Subcutaneous emphysema is a rare but potentially life-threatening complication of dental procedures caused by the penetration of pressurized air into submucosal tissues and its spread through cervicofacial and mediastinal spaces. This review aimed to summarize all reported cases of subcutaneous emphysema following periodontal interventions and to identify procedure and device-related etiologic factors associated with its occurrence. Methods: A comprehensive literature search was conducted, and case reports published between 1957 and 2025 were included without language restrictions. Cases related to trauma, maxillofacial surgery, endodontic, restorative, or prosthetic procedures were excluded. Results: A total of 34 publications reporting 36 clinical casesmet the inclusion criteria. The median patient age was 48 years (range: 8–76), and 66.7% of cases occurred in female patients. Air-powder abrasive devices were the most frequently implicated etiologic factor (66.7%), followed by dental lasers (11.1%) and air-water syringes (8.3%). Mediastinal spread was reported in 41.7% of cases. Most patients received prophylactic antibiotic therapy, and the median resolution time was 5 days (range: 3–14). Conclusions: Subcutaneous emphysema following periodontal interventions is most frequently reported in association with the use of pressurized air-driven devices, particularly air-powder abrasive systems. Although the clinical course described in the included cases was generally benign, the observed patterns highlight the relevance of procedural and device-related factors in the development and extent of this complication. Full article

Background/Objectives: Emergency department healthcare professionals are often the first to provide treatment, yet studies indicate limited knowledge in Traumatic Dental Injuries (TDIs) management among these providers. While research on TDI management in emergency departments exists globally, recent data from Saudi Arabia is lacking. This study aims to assess the knowledge, attitude, and practice of emergency department physicians, nurses, and Emergency Medical Services (EMS) regarding TDIs in three major hospitals in Riyadh, Saudi Arabia. Results: Physicians (46.4%) were significantly (p = 0.02) more likely to respond that they have sufficient knowledge about TDIs compared to nurses and EMS personnel. Of the 221 respondents, 136 (62%) were in the age group of 30–40 years, while females (OR 4.23, p = 0.00, CI 2.29–23.13) and nurses (OR 4.88, p = 0.00, CI 2.39–9.96) were more likely to say ‘No’ for any form of training they received in dental trauma during their education. Young (20–30 years old) professionals (OR 3.70, p = 0.04, CI 1.53–8.92) were less likely to feel confident in managing cases of dental trauma compared to their senior colleagues. Conclusions: In this study, nurses’ and EMS personnel’s knowledge of dental trauma management was poorer than that of physicians. Most respondents reported that dental trauma management was not part of their curriculum or training, which, in turn, was reflected in their low confidence in managing such cases. Full article

Background: Pediatric orbital floor fractures differ from adult injuries due to bone elasticity and a higher incidence of trapdoor-type defects with extraocular muscle entrapment, often presenting with limited external signs but carrying a high risk of functional impairment. Early recognition and prompt surgical release are essential to prevent irreversible neuromuscular damage and persistent binocular vision disturbances. Case Presentation: A 13-year-old patient sustained an orbital floor blow-out fracture with inferior rectus muscle incarceration following blunt trauma. The child presented with vertical diplopia, ocular motility restriction, and infraorbital hypoesthesia. Computed tomography demonstrated a posteriorly located linear orbital floor defect with soft-tissue entrapment, supporting the indication for urgent surgical intervention to avoid ischemic injury. Management and Outcome: Through a transconjunctival retroseptal approach, the entrapped muscle was promptly released, and orbital floor continuity was restored using an autologous bone graft harvested from the anterior maxillary wall with piezosurgery. This technique allowed controlled and precise bone harvesting while preserving adjacent anatomical and developing dental structures. Postoperative recovery was uneventful, with complete resolution of diplopia and full restoration of binocular ocular motility during follow-up. Conclusion: Early surgical intervention plays a pivotal role in achieving functional recovery in pediatric orbital floor fractures with muscle entrapment. Autologous reconstruction supported by piezosurgical bone harvesting represents a safe and effective approach in growing patients, providing reliable functional and anatomical outcomes. This case reinforces the clinical relevance of timely intervention and highlights practical considerations in pediatric orbital trauma management. Full article

Background: This study compared the reasons for dental presentations between Indigenous and non-Indigenous Australian adults at the Nepean Centre for Oral Health, NSW, Australia. Methods: A retrospective cohort study was conducted on adult patients presenting between 1 July and 31 December 2019. Clinical notes were audited and categorized as either ‘emergency’ (pain, dental infection, dental trauma, loose teeth or dental implants, bleeding) or ‘conservative’ (dental check-ups, examinations, prosthodontic, restorative, periodontal, or non-emergency endodontic therapy). Results: A total of 4663 patients met the inclusion criteria; 61.6% were female, and 6.4% were identified as Indigenous Australians. Overall, 41.3% of presentations were for emergency dental care. Indigenous Australians were significantly more likely to present for dental emergencies compared with non-Indigenous (58.2% vs. 40.2%; χ²(1, N = 4663) = 53.4, p < 0.00001; OR = 2.07, 95% CI: 1.64–2.63), and were also more likely to undergo emergency tooth extractions (p < 0.05). Conclusions: Indigenous Australians demonstrated a higher proportion of emergency and oral surgery-related presentations and underwent tooth extractions as the primary treatment compared to their non-Indigenous counterparts. These findings suggest a higher burden of oral disease and delayed access to general dental services among Indigenous Australians, highlighting the need for targeted and culturally appropriate public health interventions. Full article

Background/Objectives: Dental trauma is common in childhood and may negatively affect oral health-related quality of life (OHRQoL). Given the growing volume and diversity of publications on this topic, a bibliometric approach is suitable for mapping scientific production, collaboration patterns, thematic evolution, and citation dynamics. This study aimed to perform a bibliometric analysis of the literature addressing the impact of dental trauma on OHRQoL in a paediatric population up to 14 years of age. Methods: A bibliometric study was conducted using Clarivate’s Web of Science Core Collection (WoS-CC), selected for its standardized citation indexing and suitability for bibliometric analyses. Publications retrieved up to August 2025, without restrictions on language or year, were analyzed using VOSviewer (version 1.6.20) and Biblioshiny (Bibliometrix package). Indicators included scientific output, collaboration networks, keyword co-occurrence, thematic evolution, and citation performance. Spearman’s correlation was used to explore relationships between citation counts, journal impact factor, and year of publication. Results: A total of 107 articles published between 2006 and 2025 were included. Scientific output increased steadily, with publications concentrated in specific countries, notably Brazil and India. The predominant research focus concerned the impact of dental trauma on children’s quality of life. Dental Traumatology was the most productive journal and showed high local citation impact. Citation analysis demonstrated a weak positive correlation between citation counts and journal impact factor (rho = 0.37, p < 0.001) and a strong negative correlation with year of publication (rho = −0.84, p < 0.001). Conclusions: This bibliometric analysis identifies research trends, thematic stability, and collaboration patterns in studies on dental trauma and OHRQoL in children, highlighting regional concentration and limited international collaboration. Full article

Background: Regenerative endodontic treatment (RET) has emerged as a biologically based alternative to traditional apexification for managing immature permanent teeth with pulp necrosis. By promoting tissue ingrowth and continued root development, RET aims not only to eliminate infection but also to reinforce structurally compromised roots. Although its clinical use has expanded, evidence regarding the long-term predictability and durability of RET remains limited, as most published studies provide only short- or mid-term follow-up. Case presentation: This report describes two pediatric cases involving regenerative procedures performed on three immature permanent maxillary incisors, each followed for more than six years. The first case involved a 7-year-old girl who developed pulp necrosis in a maxillary lateral incisor after acute dental trauma. Management followed a regenerative protocol using triple antibiotic paste (ciprofloxacin, metronidazole, and minocycline) as intracanal medication and mineral trioxide aggregate as the coronal barrier. The second case concerned an 8-year-old girl presenting with chronic infection and sinus tracts affecting both maxillary central incisors. These teeth were treated using a regenerative approach with calcium hydroxide as the intracanal medicament and Biodentine as the sealing material. Clinical, radiographic, and cone beam computed tomography evaluations demonstrated complete symptom resolution and periapical healing but incomplete progressive apical closure. All treated teeth developed a calcified apical barrier, and outcomes remained stable throughout the extended follow-up period. Conclusions: While inherently limited by the nature of case reports, these findings support RET as a reliable and durable therapeutic option for necrotic immature permanent teeth, including cases in which conventional apexification has not been successful. Full article

The application of advanced imaging techniques, particularly computed tomography (CT), photogrammetric scanning, and three-dimensional reconstructions of body surfaces and skeletal remains, is becoming a crucial component of Forensic Anthropology. These tools enable a non-invasive and highly standardized analysis of both intact cadavers and human remains recovered from terrestrial or aquatic environments, providing reliable support in identification processes, traumatological reconstruction, and the assessment of taphonomic processes. In the context of estimating the Post-Mortem Interval (PMI) and the Post-Mortem Submersion Interval (PMSI), digital imaging allows for the objective and reproducible documentation of morphological changes associated with decomposition, saponification, skeletonization, and taphonomic patterns specific to the recovery environment. Specifically, CT enables the precise assessment of gas accumulation, transformations in residual soft tissues, and structural bone modifications, while photogrammetry and 3D reconstructions facilitate the longitudinal monitoring of transformative processes in both terrestrial and underwater contexts. These observations enhance the reliability of PMI/PMSI estimates through integrated models that combine morphometric, taphonomic, and environmental data. Beyond PMI/PMSI estimation, imaging techniques play a central role in anthropological bioprofiling, facilitating the estimation of age, sex, and stature, the analysis of dental characteristics, and the evaluation of antemortem or perimortem trauma, including damage caused by terrestrial or fauna. Three-dimensional documentation also provides a permanent, shareable archive suitable for comparative analyses, ensuring transparency and reproducibility in investigations. Although not a complete substitute for traditional autopsy or anthropological examination, imaging serves as an essential complement, particularly in cases where the integrity of remains must be preserved or where environmental conditions hinder the direct handling of osteological material. Future directions include the development of AI-based predictive models for PMI/PMSI estimation using automated analysis of post-mortem changes, greater standardization of imaging protocols for aquatic remains, and the use of digital sensors and multimodal techniques to characterize microstructural alterations not detectable by the naked eye. The integration of high-resolution imaging and advanced analytical algorithms promises to further enhance the reconstructive accuracy and interpretative capacity of Forensic Anthropology. Full article