Search Results (1,924)

Background/Objectives: Soft tissues are essential for maintaining the function and long-term success of dental implants. In many cases, implant placement necessitates soft tissue augmentation procedures such as free gingival grafts (FGGs) or connective tissue grafts (CTGs) to restore lost gingival architecture. Nevertheless, a significant challenge associated with FGG and CTG is postoperative pain, largely due to morbidity at the palatal donor site. To address this issue, various approaches have been proposed to reduce patient discomfort and promote improved wound healing at the donor site. This study aimed to compare the effectiveness of four different methods for protecting the palatal donor site following free gingival graft harvesting. Methods: A total of 76 patients undergoing implant therapy with an indication for free gingival grafting were selected and divided into four groups based on the method used to protect the palatal donor site: an absorbable gelatin sponge secured with sutures (GS); an absorbable gelatin sponge with sutures and cyanoacrylate tissue adhesive (GS+CTA); oxidized regenerated cellulose combined with cyanoacrylate tissue adhesive (ORC+CTA); and an absorbable gelatin sponge covered with a flowable resin composite and stabilized with sutures (GS+FRC). The effectiveness of each method was evaluated in terms of postoperative pain, bleeding, and wound healing. Results: Although the differences in pain intensity among the groups were not statistically significant throughout the observation period (p > 0.05), the GS+FRC group consistently exhibited the lowest mean pain scores. No statistically significant differences were observed between the groups regarding the incidence of secondary bleeding. The highest mean wound healing rate was recorded in the GS+FRC group (75.95 ± 18.75%), whereas the ORC+CTA group demonstrated the lowest rate (43.66 ± 25.74%). Conclusions: The use of an absorbable gelatin sponge covered with a flowable resin composite and secured with sutures, despite the presented limitations, appears to be a promising approach for palatal wound protection. While this group consistently demonstrated the lowest mean pain scores, differences in pain intensity among the groups were not statistically significant. Nonetheless, it achieved the most favorable outcomes in terms of wound epithelialization. Full article

Background/Objectives: Oral health plays a crucial role in the physical, emotional, and social well-being of children. Data from 2019 indicate that oral diseases remain a major concern in the Italian paediatric population, affecting not only children’s health but also caregivers’ well-being. This study aimed to assess the importance attributed by Italian families to their children’s oral health and correlate parents’ perceptions with children’s actual oral health status. Methods: A total of 131 children aged 0–12 years, admitted to the IRCCS Giannina Gaslini Children’s Hospital (Genoa, Italy) for reasons other than dental problems, were enroled between January 1 and December 31, 2024. Parents completed validated questionnaires (ECOHIS or PCPQ + FIS) based on their child’s age, along with supplementary questions on socio-demographic background and dental history. Oral examination was performed to assess dmft/DMFT scores, the Index of Orthodontic Treatment Need (IOTN), and the Modified Gingival Index (MGI). Results: In younger children (0–5 years), oral health was generally good, but the presence of caries negatively impacted the family’s quality of life. Older children (6–12 years) showed higher rates of caries and gingival inflammation, affecting their daily functioning and emotional well-being. Poor oral health was more common among children of non-European backgrounds and those with lower parental education. Early dental visits, within the recommended 24 months of age, were rare. Conclusions: Despite clear international recommendations, early dental visits remain uncommon, and many children experience preventable oral health issues. These findings highlight the urgent need to improve caregiver education and public health strategies to promote early preventive dental care. Full article

Aim: Peroxisome Proliferator-Activated Receptor Gamma (PPAR-γ) plays important anti-inflammatory roles, including in periodontitis. This systematic review with a meta-analysis compiles evidence on the transcriptional and translational levels of PPAR-γ in clinical and experimental periodontitis studies, alongside functional enrichment and PPAR-γ interaction network analyses. Method: Electronic searches were conducted in six databases for publications up to February 2024. For the meta-analysis of experimental studies of periodontitis, PPAR-γ levels in the periodontal tissues were assessed through gene expression (RT-qPCR) or protein expression (Western blotting). In the clinical periodontitis studies, PPAR-γ levels in the gingival tissues were evaluated through protein expression (immunohistochemistry). A risk of bias (RoB) assessment was performed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) and Newcastle Ottawa Scale (NOS) tools for experimental and clinical studies, respectively. The enrichment analysis was performed using the g:Profiler tool, and gene interaction networks were analyzed using GeneMANIA. Results: The meta-analysis demonstrated significantly lower PPAR-γ protein levels in the periodontal tissues from animals with periodontitis. PPARG mRNA and PPAR-γ quantification through immunohistochemistry remained inconclusive. The bioinformatics analyses indicated direct or indirect PPAR-γ-associated molecules involved in the immune response to periodontitis. The PPAR-γ protein expression was higher in periodontal tissues from healthy animals compared to that from those with periodontitis. Conclusions: Given the inconclusive findings of RT-qPCR and immunohistochemistry, further PPARG mRNA and PPAR-γ protein evaluations are needed to clarify their levels in the periodontal tissues. Full article

Background: The present study investigated the relation between dental inclination, colorimetric variation, and aesthetic perception according to the modification of incisor inclination. Smile aesthetics, shaped by morphological factors and patient perception, are vital for social attractiveness and treatment success. This study aimed to assess the effect of varying head tilt on the perceived colour of upper central incisors by simulating changes in torque of the tooth, as well as evaluate factors influencing the perception of an aesthetic smile, including morphological characteristics and gingival aesthetic parameters. Methods: The study was comprised of three stages: colour analysis, evaluation of micro- and mini-aesthetic smile features, and an image-based assessment to determine evaluator perceptions and overall smile attractiveness. A sample of 50 students with complete, lesion-free anterior dentition was analysed. To simulate the effect of orthodontic torque changes during colour analysis, subjects tilted their heads downward and upward, representing palatal and buccal crown torque, respectively. Standardized macro-intraoral photographs were captured under controlled lighting conditions using a DSLR camera stabilized on a tripod in the different positions: the neutral head position (p0), 15° upward (p + 15), and 15° downward (p − 15). Digital colour analysis was conducted in the CIELAB colour space (L*, a*, b*). In the next stage, focusing on micro- and mini-aesthetic evaluation, an additional 50 smiles were generated using artificial intelligence via the SmileCloud program—one digitally enhanced smile per subject—complementing the initial set of 50 spontaneous smiles. These 100 smile images were evaluated by 50 laypersons and 50 dentists using a visual analogue scale via an online questionnaire, in order to assess perceptions, determine smile attractiveness, and quantify gingival aesthetic parameters. Results: The statistically significant regression results are as follows: those for the L* values in all three head inclinations: downward (−15 degrees), upward (+15 degrees), and total tilting (−15 to +15 degrees), as well as for the a* values for downward tilting and the b* values for total tilting. When the head is tilted downwards, the central incisors are positioned retrusively, and the L* b* values reveal a darker and more yellowish appearance, whereas, with the head tilted upwards, the central incisors protrude, and L* a* values indicate a brighter and more greenish appear. In the evaluation stage of the smile aesthetics study, no significant differences were observed in the judgments between laypersons and dentists or between males and females. Smiles with a high or average anterior line, parallel arc, upward lip curvature, visible first/second premolars, a smile index of 5.08–5.87, and symmetry score of 1.04 were rated as more attractive. Significant asymmetries were observed between upper dental hemi-quadrants in gingival contour and interdental papilla height, highlighting subtle morphological variations relevant to smile aesthetics. Conclusions: Aesthetic assessment revealed that the findings suggest a measurable impact of head position on dental colour perception and aesthetic evaluation. Evaluator variables including profession and gender exerted negligible effects on aesthetic perception, whereas smile attractiveness features and gingival aesthetic parameters demonstrate significant clinical applicability in patient management. Full article

Background/Objectives: The effectiveness of clear aligner therapy depends significantly on the precision of force delivery through the aligner–attachment interface. This study aimed to evaluate the microscopic compatibility between different orthodontic clear aligner materials (Duran+ and Zendura FLX) and attachment designs (rectangular and optimized) using scanning electron microscopy (SEM). Methods: Fifty-six samples were divided into four groups: rectangular attachments with Duran+ aligners (n = 14), rectangular attachments with Zendura FLX aligners (n = 14), optimized attachments with Duran+ aligners (n = 14), and optimized attachments with Zendura FLX aligners (n = 14). Attachments were bonded to bovine incisors using standardized protocols. Clear aligners were thermoformed at 220 °C for 40 s. Cross-sectional samples were analyzed using SEM at 250× magnification. Gap measurements were taken at seven points for rectangular attachments and five points for optimized attachments. Results: Gap measurements ranged from 14.75 ± 1.41 µm to 91.07 ± 3.11 µm. Zendura FLX demonstrated significantly better adaptation than Duran+ with rectangular attachments (42.10 ± 1.07 µm vs. 44.52 ± 1.51 µm, p < 0.001). Optimized attachments showed better overall adaptation than rectangular attachments. All combinations showed regional variation with the largest gaps at gingival borders (67.18–91.07 µm) and the smallest at flat buccal surfaces (14.75–20.98 µm). Conclusions: Perfect adaptation was not achieved with any material–attachment combination tested. Material selection and attachment design significantly influence microscopic adaptation, with multi-layer materials and optimized geometries showing superior performance. These findings provide mechanical explanations for clinical limitations in clear aligner therapy. Full article

Background and objectives: Desquamative gingivitis (DG) is a clinical term used to describe gingival conditions marked by erythema (unrelated to dental plaque), epithelial desquamation, and various intraoral lesions, with occasional extraoral involvement. It is typically linked to a range of underlying diseases. Materials and methods: A narrative literature review was conducted using PubMed, Scopus, Google Scholar, and the Cochrane Library, searching with keywords like “oral dysplasia”, “oral mucosa lesions”, or “desquamative gingivitis”. In addition to the literature review, a case report of a patient with DG is included to illustrate the diagnostic challenges and treatment considerations in a clinical setting, and to design and test simplified diagnosis and treatment-planning algorithms. Results: Diagnosis can be supported by a standard punch biopsy to obtain tissue samples for histopathological evaluation. The complex clinical case presented illustrates the clinical features of DG and highlights the challenges associated with its diagnosis and management. The mainstay of treatment, as resulted from 96 studies included in our review, involves topical and systemic corticosteroids, with topical calcineurin inhibitors serving as adjunctive therapy. Conclusions: A universally accepted treatment protocol is still lacking for DG, so this report outlines an effective, experience-based therapeutic approach. Additionally, it offers a simplified framework for diagnosis, treatment planning, and therapeutic management, contributing to the growing knowledge base needed for a decision-support algorithm development. Full article

Periodontal disease is a prevalent condition in companion animals. It is crucial to prevent the plaque and bacteria on tooth surfaces to avoid gingivitis and the more harmful periodontitis. The aim of the present study was to assess the impact of MLS laser treatment on the bacterial load by analyzing the gingival swabs of a total of 16 owned dogs with no history of dental disease that were selected from a cohort of patients admitted for plaque removal and dental hygiene procedures. Following each dental hygiene session, each dog received a single MLS laser therapy treatment (808–905 nm diode laser, frequency 36 Hz, and fluence 0.16 J/cm²). Swabs were collected from the two upper premolars before and after the laser treatment. These were submitted for mesophilic bacteria counts, and microbiological analysis was conducted on 10 positive cultures to evaluate the changes in the oral bacterial microbiota. MLS laser therapy statistically significantly reduced the mesophilic bacteria count by 1 log, with higher pre-laser treatment counts (n = 0.44; 5.77 ± 0.21 95%CI) in comparison to post-laser treatment counts (n = 0.73; 4.80 ± 0.346 95%CI). The MLS laser therapy was found to reduce the bacterial load in 80% of the subjects (p < 0.05). No significant differences pre- and post-laser treatment were observed in the bacteria species isolated from the microbiological cultures. MLS laser therapy appears to be a useful, non-invasive method for reducing the bacterial load in the treatment and prophylaxis of periodontal disease in dogs. Full article

Adenosine signaling plays protective roles in gingival mitochondrial health and inflammation control, with the ectoenzyme CD73 implicated in periodontitis. Here, we investigated the effects of selective adenosine A2a receptor (A2aR) stimulation using the agonist CGS21680 in a mouse model of ligature-induced periodontitis (LIP) and in gingival fibroblast mitochondrial function. Mature C57Bl/6 mice underwent LIP and received daily intraperitoneal injections of CGS21680 (0.1 mg/Kg) or saline. After 8 days, gingival tissues and maxillae were analyzed for alveolar bone loss and Il-1β levels. In parallel, murine gingival fibroblasts (mGFs) were treated with Tnf-α (5 ng/mL) ± CGS21680 (10 µM) to assess mitochondrial function, morphology, and quality control. A2aR activation significantly reduced alveolar bone loss and Il-1β expression in vivo. In vitro, CGS21680 suppressed Tnf-α-induced Cxcl10 and Cxcl12 expressions and enhanced Vegf production. Mitochondrial analysis revealed increased mitochondrial complex levels, membrane potential, and mass, alongside reduced reactive oxygen species (ROS), proton leak, and mitochondrial stress. Ultrastructural studies showed elongated, healthier mitochondria and increased pro-fusion markers, indicating enhanced mitochondrial quality control. Overall, A2aR stimulation attenuates periodontal inflammation and confers mitoprotective effects on gingival fibroblasts, supporting its potential as a therapeutic strategy to both mitigate periodontitis progression and preserve tissue bioenergetics supporting cellular resilience. Full article

Background/Objectives: This study evaluates the effectiveness of a toothpaste containing Java Tea and Little Ironweed in alleviating tooth sensitivity compared to a conventional potassium nitrate toothpaste. Methods: A total of 90 healthy patients aged 18–70 with up to two teeth exhibiting gingival recession were recruited into this study. All selected teeth had a visual analog scale (VAS) score ≥ 4 in response to tactile or air blast stimuli. Excluded teeth included those requiring restoration or participants undergoing treatments affecting sensitivity or taking pain medication/anti-sensitivity agents. Participants were randomly divided into three groups and instructed to brush twice daily with different toothpastes. The S1 group was prescribed toothpaste containing Java Tea and Little Ironweed extract, the S2 group was prescribed toothpaste containing Java Tea and Little Ironweed extract with 0.7% potassium nitrate, and the S3 group was prescribed toothpaste containing potassium nitrate. VAS scores were recorded at baseline, 2 weeks, and 4 weeks. Data were then compared and statistically analyzed between the groups. Results: For the tactile test, the final number of included teeth was 47 in the S1 group, 46 in the S2 group, and 22 in the S3 group. For the air blast test, the number of teeth included was 38 in the S1 group, 30 in the S2 group, and 27 in the S3 group. At baseline, mean VAS scores were comparable across groups for both tactile (S1: 6.89 ± 0.98; S2: 6.65 ± 1.52; S3: 6.82 ± 1.99) and air blast tests (S1: 7.39 ± 1.15; S2: 7.53 ± 1.31; S3: 6.89 ± 2.12). All groups showed significant reductions in VAS scores from baseline at both 2 and 4 weeks. A Kruskal–Wallis test indicated significant between-group differences in VAS scores at 2 and 4 weeks (p = 0.001). Post hoc analysis (Dunn’s test with Bonferroni correction) at 2 weeks revealed that the S1 group had significantly higher VAS scores than those of S2 (tactile p = 0.001, air blast p = 0.001) and S3 (tactile p = 0.002, air blast p = 0.018). By 4 weeks, the S2 group demonstrated superior efficacy, with significantly lower VAS scores compared to those of S1 (tactile p < 0.001, air blast p = 0.030) and S3 (tactile p = 0.035, air blast p = 0.001). Conclusions: All tested toothpastes effectively reduced dentin hypersensitivity over the study period. Potassium nitrate toothpaste provided more rapid initial relief, when compared to the herbal formulation alone; however, both achieved similar outcomes by 4 weeks. The herbal toothpaste supplemented with potassium nitrate demonstrated superior efficacy and may offer a promising natural alternative for managing dentin hypersensitivity. Full article

Peri-implant disease and gingival recession may be partially attributed to inadequate keratinized tissue. Soft tissue augmentation procedures utilizing non-autologous biomaterials, such as porcine-derived collagen membranes, have been gaining prominence and exogenous crosslinking is being actively investigated to improve the collagen membrane’s stability and potential for keratinized tissue gain. The aim of this preclinical study was to evaluate the performance of a novel, crosslinked porcine collagen membrane (Zderm^TM, Osteogenics Biomedical, Lubbock, TX, USA) relative to an established, commercially available, non-crosslinked counterpart (Mucograft^®, Geistlich Pharma North America Inc., Princeton, NJ, USA) in a canine mandibular model. Bilateral split-thickness mucosal defects were created in adult beagles (n = 17), with each site receiving one membrane. Qualitative and quantitative histomorphometric analyses of groups were performed after 4, 8, and 12 weeks of healing and compared to unoperated, positive controls from the same subject. No significant differences in membrane presence were observed between Zderm^TM and Mucograft^® at 4, 8, and 12 weeks of permitted healing (p > 0.05). Similarly, the average keratinized tissue (KT) length between Zderm^TM and Mucograft^® groups was statistically equivalent across all healing times (p > 0.05). However, qualitative histological evaluation revealed greater rete ridge morphology amongst defects treated with Zderm^TM in comparison to Mucograft^®. Nevertheless, both membranes exhibited excellent biocompatibility and are well-suited for soft tissue augmentation procedures in the oral cavity. Full article

Objective: To evaluate the short-term clinical impact of daily use of calibrated interdental brushes (IDBs) on gingival bleeding among dental and dental hygiene students within academic curricula. Methods: A prospective cohort of 117 students from three Italian universities was followed over three months. All participants received personalized training and calibrated interdental brushes matched to their interdental spaces. The primary outcome was the percentage of interdental sites exhibiting bleeding on interdental brushing (BOIB), assessed at baseline (T0), one month (T1), and three months (T2). Adherence was self-reported. Statistical analyses included Wilcoxon tests, multivariate regression, and adjusted ANCOVA models. Results: Median bleeding scores decreased from 50.0% [IQR: 26.9–69.2] at baseline to 15.4% [IQR: 3.8–30.8] at one month and further to 11.5% [IQR: 0.0–26.9] at three months (p < 0.001). Regular interdental brush users showed a 15 to 16 percentage point greater reduction in bleeding compared to occasional users (p < 0.001). Dental hygiene students had significantly lower baseline bleeding scores than dental students, but both groups experienced comparable benefits from the intervention. Adjusted analyses confirmed a sustained beneficial effect of regular interdental brushing. Initial weak and transient correlations between behavioral factors and bleeding likely reflect multifactorial influences and variable adherence. Conclusions: Daily use of calibrated interdental brushes produces a rapid, significant, and sustained reduction in gingival bleeding among dental students. Systematic integration of this protocol within dental education programs is feasible and effective, promoting early adoption and maintenance of essential preventive oral health behaviors. Full article

This study aimed to develop and evaluate a bakuchiol-loaded thermosensitive hydrogel (BTH) as a novel local drug delivery system for the management of periodontitis. Bakuchiol, a natural phenolic compound extracted from Psoralea corylifolia, was incorporated into a hydrogel composed of poloxamers and carboxymethylcellulose. The gelation behavior, physicochemical properties, and drug release profile were analyzed. Additionally, antibacterial activity against Porphyromonas gingivalis was assessed. Cytotoxicity was evaluated in human gingival fibroblasts and RAW 264.7 cells. Anti-inflammatory effects were determined by measuring proinflammatory cytokine expression in lipopolysaccharide-stimulated RAW 264.7 macrophages. Furthermore, alveolar bone loss, cytokine expression, and histological findings were assessed in a rat model of ligature-induced periodontitis. BTH demonstrated sol–gel transition at body temperature, with sustained drug release over 15 days. Moreover, it exhibited significant antibacterial activity against P. gingivalis and was non-cytotoxic at an extract concentration of 6.25%. In vitro, it significantly downregulated inflammatory cytokines in activated macrophages. In vivo, BTH application reduced alveolar bone loss and interleukin-1β expression in gingival tissues. Histological analysis confirmed decreased inflammatory cell infiltration and alveolar bone destruction. Thus, BTH demonstrated both antibacterial and anti-inflammatory activities, exhibiting potential as a promising therapeutic strategy for localized periodontal treatment. Full article

Background: Oral antiseptic formulations are widely used as adjuncts in oral hygiene to reduce pathogenic microorganisms and prevent oral diseases. While these agents are effective in controlling biofilm, their broader effects may disrupt the oral microbiota’s balance, potentially contributing to systemic health implications. The complex relationship between antiseptic use, microbial composition, and systemic outcomes remains insufficiently mapped. Objective: This scoping review aimed to explore and map the current evidence regarding the impact of antiseptic formulations on oral microbiota composition and to examine their potential associations with systemic diseases. Methods: A comprehensive literature search was performed using PubMed, Scopus, and Web of Science up to June 2025. Studies were included if they investigated antiseptic formulations commonly used in oral healthcare—such as chlorhexidine, essential oils, and cetylpyridinium chloride—and reported effects on oral microbiota and/or systemic health. Eligible study types included human clinical trials, observational studies, in vitro, and animal studies. Two reviewers independently screened and selected studies, with disagreements resolved by consensus. Data extraction focused on study design, antiseptic agents, microbial outcomes, and systemic implications. A total of 12 studies were included and charted. Results: The included studies demonstrated that oral antiseptics effectively reduce pathogenic microorganisms and improve clinical outcomes in oral diseases such as gingivitis and periodontitis. However, several studies also reported alterations in commensal microbial communities, suggesting a potential for dysbiosis. Some studies indicated possible links between antiseptic-induced microbial changes and systemic conditions, including cardiovascular and respiratory diseases. Conclusions: The evidence highlights a dual effect of antiseptic formulations: while beneficial in controlling oral pathogens, they may disrupt microbial homeostasis with possible systemic consequences. Further research is needed to evaluate long-term effects and develop targeted, microbiota-preserving oral hygiene strategies. Full article

Objectives: The objective of this narrative review was to evaluate the clinical challenges encountered in the application of the 2018 AAP/EFP Classification of Periodontitis. Methods: Electronic and manual searches were conducted to identify studies reporting diagnostic accuracy and inter- and intra-examiner agreement when using the 2018 Classification, both with and without the aid of implementation tools. Results: Eleven studies were included, encompassing a total of 459 clinical cases. Overall, 852 examiners participated, with 31 gold-standard examiners providing the reference diagnoses. General dentists often exhibited lower diagnostic accuracy and consistency compared to students and periodontal experts. Diagnostic challenges were observed in staging, particularly distinguishing between Stage III/IV and gingivitis/Stage I. Grading reliability was reduced in the absence of longitudinal data and high-level modifying factors. This review also explored difficulties in reporting ‘hopeless teeth’ and assigning the extent of periodontitis. Education, training, and implementation tools substantially improved diagnostic accuracy and consistency, increasing the agreement with reference diagnosis and strengthening inter- and intra-examiner agreement. Conclusions: The application of the 2018 Classification showed notable variability in diagnostic accuracy and inter- and intra-examiner agreement. Improving clinician experience and training and incorporating diagnostic aids and emerging AI technologies has the potential to enhance diagnostic accuracy and consistency, which are essential for precisely estimating periodontitis prevalence, interpreting research findings, and determining prognosis and treatment needs. Full article

Background/Objectives: Periodontitis is a chronic infectious inflammatory disorder that affects the supporting structures of the teeth. The gingival epithelium plays a crucial role as a physical and immunological barrier, producing pro-inflammatory cytokines in response to microbial pathogens. Modulation of gingival epithelial function has been proposed as a therapeutic strategy to prevent the progression of periodontal disease. Houttuynia cordata, a perennial herb traditionally used in Asian medicine, is recognized for its anti-inflammatory properties, with documented benefits in the cardiovascular, respiratory, and gastrointestinal systems. However, its potential therapeutic role in oral pathologies, such as periodontitis, remains underexplored. This study aimed to investigate the anti-inflammatory effects of H. cordata extract on interleukin (IL)-1β-stimulated primary gingival keratinocytes (PGKs) subjected to IL-1β-induced inflammatory stress, simulating the conditions encountered during orthodontic treatment. Methods: Inflammation was induced in PGKs using IL-1β, and the impact of H. cordata extract pretreatment was assessed using quantitative real-time reverse transcription polymerase chain reaction, enzyme-linked immunosorbent assay, and immunoblotting. Results: H. cordata extract significantly downregulated the mRNA and protein expression levels of tumor necrosis factor-alpha, IL-8, and intercellular adhesion molecule-1 in IL-1β-stimulated PGKs without inducing cytotoxicity. Conclusions: These findings suggest that H. cordata holds promise as a preventive agent against periodontitis by attenuating inflammatory responses in gingival epithelial tissues. We believe that our findings will inform the development of prophylactic interventions to reduce periodontitis risk in patients undergoing orthodontic therapy. Full article