Search Results (674)

Background and Objectives: This study is aimed at evaluating periodontal health in patients with psoriasis and investigating its impact on dermatology-specific and oral health-related quality of life. Materials and Methods: A total of 226 individuals were enrolled, including 113 patients with clinically diagnosed psoriasis and 113 age- and gender-matched healthy controls. The periodontal parameters recorded included plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (CAL). Oral health-related quality of life was assessed using the Oral Health Impact Profile-14 (OHIP-14), while dermatology-specific quality of life was evaluated with the Psoriasis Quality of Life Questionnaire (PQLQ). Psoriasis severity was measured by the Psoriasis Area and Severity Index (PASI). Results: Patients with psoriasis demonstrated significantly poorer periodontal parameters compared to controls, with higher PI (p = 0.006), PD (p = 0.001), and CAL (p = 0.041), as well as a lower number of teeth (p = 0.027). No significant differences in GI were observed (p = 0.331). Subdomain analysis of OHIP-14 indicated significantly greater functional limitation in the psoriasis group (p = 0.001), although no differences were detected in other domains. Positive and significant correlations were found among all the OHIP-14 subscales in both groups, and PQLQ scores were strongly correlated with OHIP-14 outcomes in the psoriasis group (p < 0.05). PASI scores tended to be higher among patients with periodontitis than those with gingivitis or periodontal health, but this difference did not reach statistical significance (p = 0.257). Conclusions: Psoriasis patients exhibited poorer periodontal status and reduced oral health-related quality of life compared to healthy individuals. However, differences in oral hygiene habits may also have contributed to these findings. Our findings suggest an association between psoriasis and impaired periodontal health, but due to the cross-sectional design, a causal relationship cannot be established. Full article

Background/Objectives: Integrating 3D visualization technologies, including virtual reality (VR), augmented reality (AR), and mixed reality (MR), into dental education may enhance students’ understanding of facial anatomy and clinical procedures. This study aimed to assess dental students’ perceptions of using MR for three-dimensional visualizations of impacted teeth. Methods: Cone-beam computed tomography (CBCT) scans of patients with impacted teeth were retrospectively selected from a university clinic database. The CBCT images were processed to adjust contrast for optimal visualization before being uploaded to MR goggles (HoloLens 2). A total of 114 final-year dental students participated, each manipulating the 3D images in space using the goggles. Following this, they completed a seven-question survey on a five-point Likert scale (1 = strongly agree, 5 = strongly disagree), evaluating image quality and the usefulness of 3D visualization. Results: The study group consisted of 29 males and 85 females (mean age = 24.11 years, SD = 1.48). The most favorable responses were for enhanced visualization of the impacted tooth’s position relative to adjacent structures and the inclusion of 3D image visualization as a teaching aid, which benefited students while learning and allowed them to better understand the course of the procedure for exposure/extraction of the impacted tooth, with median scores of 1, indicating a highly favorable opinion. A statistically significant relationship was found between the responses of females and males regarding the quality of the presented image using HoloLens 2 goggles. No significant correlation was found between participants with and without prior experience using VR/MR/AR. No significant correlation was found between age and responses. Conclusions: Students reported an improved understanding of the relationships between impacted teeth and adjacent structures, as well as potential benefits for clinical training. These findings demonstrate a high level of acceptance of MR technology among students; however, further research is required to objectively assess its effectiveness in enhancing learning outcomes. Full article

Background: Enamel surface roughness after bracket debonding is an important issue due to its impact on plaque accumulation and the potential development of carious lesions. This in vitro study aimed to assess enamel roughness after the removal of metallic and sapphire brackets and the effect of a remineralization treatment. Methods: Two hundred extracted human permanent teeth with healthy enamel were randomly distributed into two groups (n = 100) and bonded with either metallic or sapphire brackets using the same adhesive (3M™ Transbond™ XT (St. Paul, MN, USA), Minnesota Mining and Manufacturing Company, MN, USA). The enamel surface roughness was measured before bonding, after debonding, and after remineralization using SEM and a TR200 roughness (SaluTron GmbH, Frechen, Germany) tester. The parameter Ra was used to quantify the surface roughness. One-way ANOVA, the normality test, variance homogeneity, and the Bonferroni post hoc test were used to analyze the data. Results: Debonding significantly increased the enamel surface roughness in both groups. The sapphire bracket group presented significantly higher mean Ra values post debonding (4.14 ± 0.36 µm) compared to the metallic group (2.56 ± 0.52 µm). Remineralization led to a decrease in surface roughness in both groups, though not to baseline levels. The changes were statistically significant (p < 0.01), with a power of the test of 1.0. Conclusions: The bracket material significantly affects enamel surface roughness after orthodontic debonding. Sapphire brackets produced greater surface irregularities than metallic ones. Remineralization partially reduced roughness in both groups, with the final values in the metallic group being closer to baseline levels. Crucially, these values remained far above the clinical threshold for plaque retention, highlighting the need for improved debonding techniques. Full article

Early-life exposure to organic chemicals (OCs) may influence childhood obesity and associated cardiometabolic risk. These conditions have been shown to disproportionately affect minority populations such as Mexican Americans (MAs). However, information on the impact of organic chemicals on cardiometabolic risk in MA children is limited. Therefore, we conducted a pilot study to assess the extent to which exposure to organic chemicals influences cardiometabolic traits (CMTs) in MA children. We recalled 25 children from a previous study and collected 25 primary teeth from them. Chemical analyses of the teeth were performed using established protocols. Target analytes included acetaminophen (APAP); 3,5,6-trichloro-2-pyridinol (TCPy), 2-isopropyl-6-methyl-4-pyrimidinol (IMPy), diethyl phosphate (DEP), N,N-diethyl-m-toluamide (DEET), tris(2-butoxyethyl) phosphate (TBOEP), monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), monoisobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-2-ethylhexyl phthalate (MEHP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP). The organic chemicals most frequently detected in the teeth were APAP; the insect repellent DEET; plasticizers MnBP and MiBP; and the plasticizer-derived metabolite MEHP. These five analytes were included in association analyses with selected CMTs. After adjusting for covariate (age, sex, tooth-type) effects, we found significant (p < 0.05) positive correlations between MiBP and the following CMTs: fat mass, fasting insulin, and the homeostasis model of assessment-insulin resistance (HOMA-IR). Both MnBP and MEHP exhibited negative correlation with blood pressure measures and triglycerides, respectively. In addition, APAP showed a strong negative correlation with HDL-C (p = 0.009) and positive association with triglycerides (p < 0.10). These findings suggest a potential role for early-life exposures to organic chemicals in influencing cardiometabolic risk in MA children. Full article

Background: To overcome the esthetic limitations of dental monolithic zirconia restorations, multichromatic systems were developed to combine improved structural integrity with a natural shade gradient that mimics the optical properties of natural teeth. In response to the clinical demand for time-efficient, i.e., chairside fabrication of zirconia restorations, rapid sintering protocols have become necessary to adjust clinical efficiency along with material performance. This study addresses the challenges of a rapid sintering protocol related to optical performance and phase transformation of the final restoration and the zirconia–cell interaction. Methods: The influence of a rapid sintering protocol on the color stability of the final dental restoration was evaluated by the CIE L*a*b* color space. Phase transformation was assessed through X-ray diffraction analysis. Cellular behavior was evaluated by measuring wettability, the material’s surface energy, and a cell mitochondrial activity assay on human gingival fibroblasts. Results: Optical measurements demonstrated that the total color change in all layers after rapid sintering was above the perceptibility threshold (ΔE* > 1.2), while only the polished enamel layer (ΔE* = 3.01) exceeded the acceptability threshold (ΔE* > 2.7), resulting in a clinically perceptible mismatch. Results of X-ray diffraction analysis, performed for fixed occupancy at Z_0.935Y_0.065O_0.984, revealed that rapid sintering caused a decrease in the cubic (C-) phase and an increase in the total amount of tetragonal (T-) phases. Conventionally sintered zirconia consists of 54% tetragonal (T-) and 46% cubic (C-) phase, whereas in the speed-sintered specimens, an additional T1 phase was detected (T = 49%; T1 = 27%), along with a reduced cubic fraction (C = 24%). Additionally, a small amount of the monoclinic (M) phase is noticed. Although glazing as a surface finishing procedure resulted in increased hydrophilicity, both polished and glazed surface-treated specimens showed statistically comparable cell adhesion and proliferation (p > 0.05). Conclusions: Rapid sintering induced perceptible color changes only in the enamel layer of multichromatic zirconia, suggesting that even layer-specific alterations may have an impact on the overall esthetic outcome of the final prosthetic restoration. Five times higher heating and cooling rates caused difficulty in reaching equilibrium, leading to changes in lattice parameters and the formation of the metastable T1 phase. Full article

Background/Objectives: Periodontal disease, the most widespread chronic inflammatory non-communicable disease, is caused by the host-mediated inflammatory and immune responses to the bacterial biofilm. Fusobacterium nucleatum contributes to its progression and is associated with gastrointestinal cancers, including gastric cancer (GC), by promoting inflammation and immune evasion. Additionally, cathepsin K (CTSK) enhances tumor invasiveness and metastasis, playing a crucial role in GC progression. Aim: The present study was carried out to evaluate the possible association between the amount of F. nucleatum from gingival crevicular fluid and the periodontal status with the characteristics of GC. Methods: This cross-sectional study included 48 GC patients with periodontal changes, presenting to the Surgery Department in Craiova, Romania, from March 2023 to February 2024. Clinical assessments, where the number of teeth present, probing depth (PD), and bleeding on probing (BOP) were recorded, gingival crevicular fluid sampling, qPCR for Fusobacterium nucleatum, and ELISA for cathepsin K were performed. Histological analysis evaluated tumor characteristics, where tumor dimension (TD) and differentiation grade (DG) were recorded, and statistical analysis was conducted using R software. Results: Smokers presented higher PD and F. nucleatum levels than non-smokers. Gender had no impact on PD, BOP, CTSK, F. nucleatum, or TD. PD correlated with F. nucleatum, TD, and CTSK. F. nucleatum strongly correlated with CTSK and TD, and CTSK was strongly correlated with TD. Conclusions: These results suggest an association between F. nucleatum, periodontal parameters, and characteristics of GC but future studies are needed. Full article

Background: Supplemental teeth are a rare subtype of supernumerary elements that closely resemble the morphology of normal dentition. Their occurrence in the mandibular anterior region is extremely uncommon. Aim: To describe the clinical features, diagnosis, and phased orthodontic management of a rare case involving bilateral supplemental mandibular incisors in a pediatric patient. Case report: A 7-year-old female patient presented with early mixed dentition and significant lower anterior crowding due to the presence of two fully erupted supplemental mandibular incisors. Treatment phase I included extraction of the malpositioned supplemental teeth and rapid maxillary expansion to transversally coordinate the arches. By the end of phase I, spontaneous alignment of the remaining lower incisors was observed. Discussion: The presence of two supplemental mandibular incisors is extremely rare in Caucasian populations. Supernumerary teeth can cause crowding, impaction, or delayed eruption of adjacent permanent teeth. Timely extraction can prevent such complications and often allows spontaneous alignment. Conclusions: The prompt removal of supplemental mandibular incisors, when they have just erupted, might lead to the alignment of the other incisors, considering that they spontaneously occupy the extractive spaces often without the aid of fixed appliances first line. Full article

Background/Objectives: This study aimed to investigate the association between the position of impacted mandibular third molars and the morphology of the lingual cortical bone using cone beam computed tomography (CBCT), and to determine how impaction depth and angulation influence the risk of lingual cortical perforation. Methods: CBCT scans of 120 impacted mandibular third molars from 71 adult patients were retrospectively evaluated. Teeth were classified based on Pell & Gregory’s and Winter’s classifications. Lingual cortical morphology was categorized as undercut, parallel, slanted, or round. The relationship between the root apex and the lingual plate was classified as non-contact, contact, or perforating. Linear measurements included cortical lingual bone thickness and the distance from the apex to the outer surface of the lingual cortex. Results: Lingual bone morphology showed significant associations with both impaction depth and angulation, with parallel morphology more common in deeper and more angulated impactions. Lingual cortical perforation was observed in approximately 30% of the teeth, predominantly at the apex, with horizontal and deeply impacted molars (Class II, Level C) representing the highest-risk configurations. Although cortical thickness and apex-to-cortex distance were significantly smaller in apically perforated cases, no definitive threshold could be established, and these parameters were insufficient as standalone predictors at the cementoenamel junction or mid-root levels. Conclusions: Tooth angulation and impaction depth are significant predictors of lingual bone morphology and perforation risk. CBCT imaging is therefore recommended beyond low-risk cases (Level A, Class I, vertical) to improve preoperative planning, strengthen informed consent, and guide surgical strategies aimed at minimizing complications and enhancing patient safety. Full article

The traditional vertical-shaft-impact sand-making machine has the problems of uneven discharge particles and discharge port wear. To solve these problems, the influence of the main structural parameters (number of impact rotors, angle of impact plates, angle of anvil, and number of teeth on the anvil) on sand production is researched through orthogonal testing and polar analysis. The results show that the parameters’ degrees of influence on the sand production rate are as follows: the angle of impact plates, the number of impact plates, the angle of the anvil, and the number of teeth on the anvil. The double rotor exhibits the best crushing effect when the number of impact rotors is six, the angle of the impact plate is 0°, the angle of the anvil plate is 0°, and the number of teeth on the anvil plate is 89. By taking the working speed of the double rotors as a factor, an equal-level uniform design table is constructed for the double-rotor crushing system. Polynomial regression analysis shows that the best crushing effect occurs when the accelerating rotor speed is 1200 r/min and the impact rotor speed is 585 r/min. Finally, the crushing characteristics of the double-rotor vertical-shaft-impact sand-making machine are simulated and analyzed to obtain the kinetic energy distribution of particles in the crushing chamber. The kinetic energy of particles in the main crushing area is determined, and the wear pattern of the discharge port and parts is identified. Full article

Background/Objectives: The individual and combined effects of diverse dental problems on site-specific respiratory tract cancer remain insufficiently addressed. This study investigated the associations between six oral conditions—dentures, loose teeth, painful gums, bleeding gums, toothache, and mouth ulcers—and the risk of developing cancers of the lung, bronchus, larynx, and trachea, both individually and collectively. Methods: This prospective cohort study, utilizing baseline data from the UK Biobank, analyzed 438,762 participants aged 40–69 years. Multivariable Cox proportional hazards models were employed to estimate hazard ratios (HRs) and 95% CIs for incident respiratory tract cancer associated with individual oral conditions and their cumulative impact. Effect modification by sociodemographics, lifestyle, and underlying medical conditions was further assessed. Results: During the follow-up (median = 11.0 years), 3568 participants developed respiratory tract cancer. After adjusting for confounders, including smoking history, individuals with any oral issues exhibited a 35–76% higher risk of respiratory tract cancer (HR [95% CI]: 1.35 [1.25–1.46] for the total risk, 1.34 [1.24–1.45] for bronchus/lung cancer, and 1.76 [1.23–2.52] for laryngeal cancer). Dentures (1.48 [1.36–1.60]), loose teeth (1.36 [1.20–1.54]), and painful gums (1.25 [1.04–1.50]) had a strong association with respiratory tract cancer. The overall risk escalated progressively with the number of concurrent problems (HR [95% CI] of 1.32 [1.22–1.43] for one, 1.42 [1.25–1.62] for two, 1.57 [1.23–1.98] for three, and 1.71 [1.16–2.50] for ≥four). Associations were pronounced among smokers (p-interaction = 0.002). Conclusions: Poor oral health is linked to a heightened risk of respiratory tract cancer, especially when coupled with smoking, underscoring the importance of oral health promotion in cancer prevention strategies. Full article

Background/Objectives: Clear aligners are increasingly prescribed for orthodontic treatment, primarily in adult patients; however, concerns have been raised that this treatment approach may negatively impact root length, especially in endodontically treated teeth. The present investigation aims to systematically synthesize available research addressing the potential effects of clear aligner orthodontic treatment on root length changes in endodontically treated teeth. Methods: Four electronic databases were searched until May 2025, and lists of references from relevant publications were screened to identify studies (randomized clinical trials, controlled clinical trials, and observational studies) written in the English language with no date restriction. Clinical studies comparing clear aligner orthodontic treatment in endodontically treated teeth versus vital pulp teeth in humans, using cone beam computed tomography or panoramic radiographs to evaluate root resorption, were assessed. Following study selection and data extraction, the risk-of-bias assessment was evaluated with the Newcastle–Ottawa tool for the observational studies. Results: A total of 173 studies were retrieved, and ultimately 2 observational cohort studies were included in the systematic review, encompassing 135 patients (69.6% female; with an average age of 22.5 years). The present review found an association between endodontic status and root resorption, with vital pulp teeth (VPT) exhibiting a greater degree of resorption compared to root canal treated teeth (RCT). Clear aligner (CA) orthodontic treatment resulted in less root resorption than fixed orthodontic appliances (FAs). Conclusions: Limited evidence indicates that clear aligner orthodontic treatment leads to a lower occurrence of root resorption and fewer cases of severe root resorption in endodontically treated teeth. Based on findings from studies comparing CAs to FAs, there is overall significantly greater resistance to root resorption in RCT than VPT, irrespective of the orthodontic treatment modality (CAs or FAs). Full article

Mandibular second molar (MM2) impaction presents a relatively rare but complex orthodontic challenge, with potential consequences for occlusal function, periodontal health, and adjacent teeth. The aim of the article is to share data on the design and protocols of working with digitally designed systems for Printed Dento-alveolar Anchorage (PDaA) used in orthodontic traction of MM2. Accuracy in design comes from incorporating intraoral scans with CBCT files when planning the support system. The customized PDaA has an extension in the retention area of MM2 and allows multiple points of force application and vector control for precise tooth movement. The clinical flow includes surgical exposure and button placement on MM2, orthodontic traction using elastic elements attached to the PDaA, periodic activation every 3–4 weeks until the introduction of MM2 into the dental arch, and continuing with complete treatment of the entire orthodontic malocclusion. The clinical results demonstrated successful eruption and vertical leveling of MM2, stable anchorage, and absence of adverse effects on supporting teeth. Therapy with PDaA was well tolerated by patients, and did not disrupt aesthetics. This study highlights the potential of digital orthodontics to deliver personalized, biomechanically efficient solutions for molar impaction cases. Full article

Objectives: To assess the impact of PVS impression material viscosity and implant angulation on the three-dimensional accuracy of implant casts in a partially edentulous situation using the closed-tray technique. Materials and Methods: Three epoxy resin mandibular partially edentulous models (Kennedy Class I) were fabricated, each with four implant analogues placed at teeth positions 35, 37, 45, and 47. The anterior analogues were positioned parallel (0), while the posterior analogues were placed at different angulations: Group 1, 30° mesiodistal; Group 2, 20° mesiodistal; Group 3, 20° buccolingual. All analogues were placed 2 mm subgingivally. Closed-tray impressions (n = 8 per subgroup) were made using either heavy + light body PVS or monophase PVS. Resulting stone casts were scanned, and STL files were processed and analyzed using reverse engineering software (Geomagic Control X). Three-dimensional deviations (root mean square, RMS) between reference and test models were calculated by superimposition and best-fit algorithm. Results: With monophase PVS, implant angulation significantly influenced cast accuracy (p < 0.001). The 30° MD group exhibited the highest deviation (96 ± 7 µm), followed by the 20° BL group (81 ± 6 µm), then the 20° MD group (75 ± 6 µm). In contrast, no statistically significant difference in accuracy was observed among angulation groups when using heavy + light body PVS (77 ± 3 µm, 82 ± 13 µm, and 79 ± 8 µm for 30° MD, 20° BL, and 20° MD, respectively; p = 0.550). Conclusions: Both monophase and heavy + light body PVS impression materials produced clinically acceptable accuracy for closed-tray implant impressions. However, the heavy + light body PVS demonstrated greater consistency across various implant angulations and is recommended for multiple angulated subgingival posterior implants when using the closed-tray technique. Full article

Background/Objectives: Trauma from occlusion (TFO) is a modifying factor in periodontal disease progression, yet its morphometric impact on mandibular molars remains underexplored. The crown–root ratio (CRR), traditionally used in prosthodontic prognosis, may also serve as a diagnostic marker for structural changes in periodontally compromised teeth. This study evaluated the relationship between crown and root dimensions and clinical/radiographic parameters in mandibular first molars with TFO and developed predictive models emphasizing the role of CRR. Methods: This retrospective cross-sectional study included 99 periodontitis patients clinically and radiographically diagnosed with TFO. Digitized periapical radiographs of mandibular first molars (tooth 36 or 46) were analyzed to measure clinical and radiographic CRR, crown and root length, tooth inclination, alveolar bone loss, and root morphology. Correlation and stepwise multiple regression analyses identified predictors of crown and root length. Results: Males had significantly greater crown length (7.6 vs. 7.2 mm), root length (13.3 vs. 12.3 mm), and radiographic CRR (1.2 vs. 1.0) (p = 0.008). Clinical CRR showed a moderate positive correlation with crown length (r = 0.526) and a strong inverse correlation with root length (r = −0.735) (p < 0.001). Regression models revealed that clinical CRR, root length, and sex significantly predicted crown length (R² = 0.955), while CRR and crown length predicted root length (R² = 0.958). Conclusions: This study demonstrated that the clinical crown–root ratio (CRR) is a strong predictor of both crown and root lengths in mandibular first molars affected by trauma from occlusion (TFO) in periodontitis patients. Full article

Objectives: The aim of this study was to evaluate the performance of GPT-4o in identifying nine common dental conditions on panoramic radiographs, both overall and at specific tooth sites, and to assess whether the use of different tooth numbering systems (FDI and Universal) in prompts would affect its diagnostic accuracy. Methods: Fifty panoramic radiographs exhibiting various common dental conditions including missing teeth, impacted teeth, caries, endodontically treated teeth, teeth with restorations, periapical lesions, periodontal bone loss, tooth fractures, cracks, retained roots, dental implants, osteolytic lesions, and osteosclerosis were included. Each image was evaluated twice by GPT-4o in May 2025, using structured prompts based on either the FDI or Universal tooth numbering system, to identify the presence of these conditions at specific tooth sites or regions. GPT-4o responses were compared to a consensus reference standard established by an oral-maxillofacial radiology team. GPT-4o’s performance was evaluated using balanced accuracy, sensitivity, specificity, and F1 score both at the patient and tooth levels. Results: A total of 100 GPT-4o responses were generated. At the patient level, balanced accuracy ranged from 46.25% to 98.83% (FDI) and 49.75% to 92.86% (Universal), with the highest accuracies for dental implants (92.86–98.83%). F1-scores and sensitivities were highest for implants, missing, and impacted teeth, but zero for caries, periapical lesions, and fractures. Specificity was generally high across conditions. Notable discrepancies were observed between patient- and tooth-level performance, especially for implants and restorations. GPT-4o’s performance was similar between using the two numbering systems. Conclusions: GPT-4o demonstrated superior performance in detecting dental implants and treated or restored teeth but inferior performance for caries, periapical lesions, and fractures. Diagnostic accuracy was higher at the patient level than at the tooth level, with similar performances for both numbering systems. Future studies with larger, more diverse datasets and multiple models are needed. Full article