Search Results (566)

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

Objectives: To evaluate the efficacy of resin infiltrants (RIs) in controlling non-cavitated occlusal carious lesions (NCOCLs) in primary and permanent teeth. Methods: This systematic review followed PRISMA guidelines. Randomized clinical trials (RCTs) and in vitro/ex vivo studies comparing RI with placebo or other materials were included. Searches were conducted in five databases and gray literature up to December 2025. Risk of bias was assessed using the RoB 2.0 tool for RCT and an adapted instrument for in vitro/ex vivo studies. Certainty of evidence was evaluated using the GRADE tool, and data were synthesized qualitatively. Results: Eight studies were included, of which only two were RCTs, and six were in vitro and ex vivo studies. RCTs showed reduced caries progression in infiltrant-treated groups compared with controls, with efficacy comparable to conventional sealants. In vitro studies demonstrated improved resin penetration and sealing ability with optimized protocols. Risk of bias ranged from low to moderate. Certainty of clinical evidence was low, primarily due to the limited number of RCTs and methodological limitations. Conclusions: RIs may be effective in managing NCOCLs, with performance comparable to conventional preventive approaches. However, the limited number of clinical trials and short follow-up periods reduce the strength of the evidence. Long-term clinical studies are needed to confirm the sustained effectiveness and durability of RIs. Full article

Background: This study aimed to determine the prevalence of infraocclusion in primary molars, its distribution according to age, gender, and location, dental anomalies associated with infraocclusion, radiographic findings related to infraocclusion, and treatments applied to affected teeth. Methods: A total of 8452 digital panoramic radiographs of children aged 7–11 years (2019–2022) were retrospectively evaluated for infraocclusion of primary molars. Radiographs were assessed by calibrated examiners, and infraocclusion severity was classified according to the Brearley and McKibben system. The presence of permanent successors, applied treatments, and associated dental and radiographic findings were recorded. Data were analyzed using descriptive statistics and chi-square tests (SPSS 28.0). Results: Infraocclusion was most frequently observed in mandibular second primary molars and was most prevalent at the age of 9. The majority of cases were mild (49.5%), followed by moderate (29.8%) and severe (20.7%). A significant correlation was found between infraocclusion severity and radiographic findings such as adjacent tooth tipping, supraeruption of opposing teeth, and eruption disturbances of permanent successors (p < 0.05). A statistically significant relationship was also observed between infraocclusion severity and treatment modality (p < 0.05). As infraocclusion severity increased, restorative treatment decreased and extraction rates increased. In 10.3% of cases, no permanent successor was present beneath the affected tooth. Dens invaginatus and hypodontia were the most commonly associated dental anomalies. The overall prevalence of infraocclusion was 3.6%, with no significant gender difference (p > 0.05). Conclusions: Although infraocclusion is relatively uncommon in primary molars, the present findings highlight its frequent associations with dental anomalies and variations in permanent successor presence. These results emphasise the importance of careful radiographic evaluation and follow-up in children with infraoccluded primary molars. Future longitudinal studies are needed to better understand the aetiology and progression of infraocclusion. Full article

Glass ionomer-based restorative materials are widely used in pediatric dentistry because of their chemical adhesion to tooth structure, ion-releasing capacity, and clinical handling advantages; however, their mechanical durability under simulated oral aging conditions remains a critical factor influencing long-term clinical performance. This in vitro study aimed to evaluate and compare the surface microhardness of three contemporary glass ionomer-based restorative materials—Beautifil Bulk Restorative, EQUIA Forte HT, and Fuji II LC—before and after thermocycling. A total of 90 disc-shaped specimens (10 mm in diameter and 2 mm in thickness) were prepared, with 30 samples allocated to each material group. Microhardness measurements were performed using the Vickers hardness test at baseline and after 10,000 thermocycling cycles between 5 °C and 55 °C to simulate intraoral aging. Results were expressed as the mean ± standard deviation, and statistical analyses were conducted using non-parametric tests. Thermocycling resulted in a statistically significant reduction in microhardness values for all tested materials (p < 0.05). Beautifil Bulk Restorative exhibited the highest microhardness values both before and after thermocycling, followed by Fuji II LC and EQUIA Forte HT, with significant differences observed among all groups (p < 0.001). Within the limitations of this study, Beautifil Bulk Restorative may be considered a favorable option for restorations in young permanent teeth, whereas EQUIA Forte HT, exhibiting lower microhardness values, may be more suitable for primary teeth, where physiological wear is expected. Full article

This article studies different stator structures and modeling methods for using grain-oriented electrical steels (GOES) to improve the performance of high-power-density permanent magnet synchronous motors (PMSMs). The magnetic characteristics of GOES samples are measured under magnetizations at different angles and frequencies. Models of various GOES stator teeth and yokes are established. The effects of different GOES stators on PMSM performance are studied, and their advantages and disadvantages are compared. Three typical GOES PMSM prototypes are fabricated and tested to demonstrate the superiority of GOES stators and validate the effectiveness of the established models. Full article

Reconstructing original cusp dimensions in worn molars represents a fundamental challenge across dentistry, anthropology, and paleontology, as dental wear obscures critical morphological information. In this proof-of-concept study, we present a standardized machine learning pipeline for predicting original cusp height, specifically the horn tips of the enamel–dentine junction (EDJ), in worn lower molars using three-dimensional morphometric data from micro-computed tomography (micro-CT). We analyzed 40 permanent lower first (M1) and second (M2) molars from four hominin groups, systematically evaluated across three wear stages: original, moderately worn (worn1), and severely worn (worn2). Morphometric variables including height, area, and volume were quantified for each cusp, with Random Forest and multiple linear regression models developed individually and combined through ensemble methods. To mimic realistic reconstruction scenarios while preserving a known ground truth, models were trained on unworn specimens (original EDJ morphology) and tested on other teeth after digitally simulated wear (worn1 and worn2). Predictive performance was evaluated using root mean square error (RMSE) and coefficient of determination (R²). Our results demonstrate that under moderate wear (worn1), the ensemble models achieved normalized RMSE values between 11% and 17%. Absolute errors typically below 0.25 mm for most cusps, with R² values up to ~0.69. Performance deteriorated under severe wear (worn2), particularly for morphologically variable cusps such as the hypoconid and entoconid, but generally remained within sub-millimetric error ranges for several structures. Random Forests and linear models showed complementary strengths, and the ensemble generally offered the most stable performance across cusps and wear states. To enhance transparency and accessibility, we provide a comprehensive, user-friendly software pipeline including pre-trained models, automated prediction scripts, standardized data templates, and detailed documentation. This implementation allows researchers without advanced machine learning expertise to explore EDJ-based reconstruction from standard morphometric measurements in new datasets, while explicitly acknowledging the limitations imposed by our modest and taxonomically unbalanced sample. More broadly, the framework represents an initial step toward predicting complete crown morphology, including enamel thickness, in worn or damaged teeth. As such, it offers a validated methodological foundation for future developments in cusp and crown reconstruction in both clinical and evolutionary dental research. Full article

Horses’ hypsodont (high-crowned) teeth face permanent dental wear. This is compensated for by a continuous eruption, which requires a high adaptability of odontoblasts; otherwise, the dental pulp would be exposed. Here, we report on how equine odontoblasts respond to the challenge of maintaining a high production rate of dentin. We analyzed CD90, a marker of odontoblastic differentiation, and nestin, a marker of mature odontoblasts, in equine pulpal tissue via immunofluorescence. For comparison, we examined the hypselodont (ever-growing) incisors and brachydont (short-crowned) molars of rats. Immunofluorescence and Western blot analysis of pulpal tissue revealed a higher content of CD90-positive cells in hypsodont equine teeth than in brachydont and hypselodont rat teeth. The odontoblastic layer of hypsodont teeth was positive for CD90 (marker for differentiating odontoblasts), which was not the case for brachydont and hypselodont rat teeth. Most samples of hypsodont teeth were negative for nestin, whereas in hypselodont and brachydont teeth, odontoblasts were positive for nestin (marker for mature odontoblasts). Our findings suggest that there is a constant replacement of odontoblasts in the equine dentition, enabling a continuous high production rate of dentin. These results contradict the idea of lifelong vital, postmitotic and productive odontoblasts. Full article

This work presents the design, fabrication, and characterization of a three-dimensional FeCo-based flux-modulator microwinding intended for integration into high-torque axial-flux Vernier micromotors. The proposed micromotor architecture modulates the stator magnetic flux using 12 magnetically isolated FeCo teeth interacting with an 11-pole permanent-magnet rotor. The design requires the manufacturing of complex three-dimensional micrometric parts, including three teeth and a cylindrical core. Such a complex design cannot be manufactured using conventional micromanufacturing lithography or 2D planar methods. The flux-modulator envelope dimensions are 250 μm outer diameter and 355 μm height. It is manufactured using a femtosecond laser-machining process that preserves factory-finished surfaces and minimizes heat-affected zones. In addition, this micrometric part has been wound using 20 μm diameter enamelled copper wire. A dedicated magnetic clamping fixture is developed to enable multilayer microwinding of the integrated core, producing a 17-turn inductor with a 60.6% fill factor—the highest reported for a manually wound ferromagnetic-core microcoil of this scale. Geometric and magnetic characterization validates the simulation model and demonstrates the field distribution inside the isolated core. The results establish a viable micromanufacturing workflow for complex 3D FeCo microwindings, supporting the development of next-generation high-performance MEMS micromotors. Full article

Aim: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of protective mouthguards. Methods: A cross-sectional study was conducted using a self-administered questionnaire among 333 parents in dental clinics in Split and Zagreb, Croatia. The questionnaire assessed sociodemographic data, parental knowledge of TDIs, and prior experience with dental trauma. Statistical analysis included chi-square test (p < 0.05). Results: The overall level of parental knowledge regarding traumatic dental injuries was generally low (7.6 out of 15 points). Almost all parents correctly identified the age when children have primary or permanent teeth. However, less than half knew that an avulsed primary tooth should not be replanted, while about three-quarters recognized that professional help should be sought within 30 min after trauma. Overall, 43.5% of parents reported that their child had experienced dental trauma, most often affecting primary teeth (60.7%), particularly the maxillary central incisor (76.6%). Mothers demonstrated significantly higher knowledge than fathers (p = 0.025), and prior experience or information about dental trauma significantly improved awareness (p < 0.001). Although 54.3% of respondents were unaware of the purpose of dental shields, 82.3% considered them necessary during contact sports, yet only 12.9% reported that their child actually uses them. Conclusions: Within the limitations of this clinic-based study, the findings indicate gaps in parental knowledge regarding the appropriate management of dental trauma. Strengthening parents’ understanding of emergency response and preventive measures may support timelier and appropriate care and contribute to improved outcomes for children experiencing traumatic dental injuries. Full article

Background: Tooth loss reflects cumulative oral inflammation and has been associated with adverse cardiovascular outcomes. This study evaluated the relationship between the number of missing permanent teeth and the angiographic severity of coronary artery disease (CAD) in patients with acute myocardial infarction (AMI). Methods: In this prospective cross-sectional study, 200 consecutive AMI patients underwent coronary angiography and standardized dental assessment during hospitalization. Tooth loss was categorized as 1–10, 11–20, or 21–32 missing teeth. CAD severity was defined by the number of major epicardial arteries with significant stenosis. Multivariate logistic regression adjusted for age, sex, smoking status, diabetes, obesity, dyslipidemia, and hypertension. Results: Increasing tooth loss was associated with more extensive CAD. The mean number of affected vessels rose from 1.58 ± 0.79 in the 1–10 tooth-loss group to 2.06 ± 0.99 in the 21–32 group (p = 0.014). Tooth loss correlated with CAD severity (r = 0.19, p = 0.007). After adjustment, >20 missing teeth remained an independent predictor of multivessel disease (OR = 1.84; 95% CI: 1.01–3.34; p = 0.047). ROC analysis showed modest discrimination (AUC = 0.61). Conclusions: Extensive tooth loss independently correlates with greater angiographic CAD severity in AMI patients. Dental status may serve as a simple, non-invasive clinical marker of cardiovascular disease burden. Full article

Background: The bond strength of orthodontic tubes to the enamel surface is essential for maintaining appliance stability, especially due to high masticatory forces on molars. Strong adhesion reduces the need for rebonding, shortening treatment time. This study aimed to evaluate the impact of tube base size and enamel sandblasting on bond strength in vitro. Methods: Eighty extracted permanent molar teeth were used for this study, divided into four groups of 20 samples each: M—small base tubes (non-sandblasted enamel), SM—small base tubes (sandblasted enamel), T—large base tubes (non-sandblasted enamel), and ST—large base tubes (sandblasted enamel). Shear bond strength was measured using the Mecmesim Multitesters 2.5-I device. Statistical analysis was conducted using IBM SPSS 27.0 software, applying ANOVA and Tukey’s post hoc test. Results: The highest bond strength (N) was recorded in the ST group, 85.51 ± 25.04 N, and the lowest in the M group, 50.23 ± 19.76 N. In terms of MPa, the SM group had the highest average value, 11.31 ± 3.57 MPa, while the T group had the lowest, 4.89 ± 1.33 MPa. ANOVA showed a statistically significant effect of tube base size on bond strength (p < 0.001), while sandblasting had no significant effect (p > 0.05). Conclusions: Larger base orthodontic tubes demonstrate stronger adhesion to enamel and are recommended for molars. Sandblasting the enamel does not significantly impact bond strength. Full article

Background: Bioactive composite resins combine the esthetic and mechanical properties of resin composites with therapeutic functions such as ion release, remineralization, and caries inhibition. While in vitro studies suggest promising bioactivity, their clinical performance in permanent teeth remains uncertain. Objective: This systematic review and meta-analysis critically appraised randomized controlled trials and prospective clinical studies to determine whether bioactive composites offer superior clinical performance compared to conventional resin composites and glass ionomer-based materials. Methods: Electronic databases (PubMed/MEDLINE, Scopus, Web of Science, Google Scholar) were searched for eligible studies (2018–2025). Clinical outcomes assessed restoration survival, marginal integrity, secondary caries, postoperative sensitivity, and esthetic outcomes (color match). Data were pooled using a random-effects model, and risk of bias was assessed with Cochrane criteria. Results: Twenty-two trials met the inclusion criteria. No significant differences were found between bioactive and control restorations for survival/retention (RD = 0.01; 95% CI, –0.01 to 0.03), marginal adaptation (RD = 0.02; 95% CI, –0.02 to 0.06), secondary caries (RD = 0.01; 95% CI, –0.01 to 0.03), or postoperative sensitivity (RD = 0.01; 95% CI, –0.02 to 0.04), with negligible heterogeneity (I² = 0–4%). For color match, glass ionomer restorations showed significantly poorer outcomes (RD = –0.23; 95% CI, –0.31 to –0.14; p < 0.00001; I² = 98%), while conventional resin composites had a slight but significant advantage over bioactive composites (RD = 0.07; 95% CI, 0.02 to 0.12; p = 0.003; I² = 76%). Most studies presented moderate risk of bias and short-term follow-up (<36 months). Conclusions: Current evidence indicates that bioactive composites perform comparably, but not superior, to conventional restoratives in permanent teeth. The discrepancy between laboratory bioactivity and clinical effectiveness highlights the need for long-term, well-designed clinical trials with standardized outcome reporting. Full article

Background: Dens invaginatus is a rare developmental tooth anomaly that can occur in permanent, primary, and supernumerary teeth, with a tendency to affect the maxillary second incisors. It develops during odontogenesis due to the invagination of the enamel organ into the dental papilla. Methods: This study describes the endodontic management of a 24-year-old patient with a type IIIb invaginated tooth in the mandibular second molar. Clinical examination revealed no response to thermal and electrical stimuli, no response to vertical and horizontal percussion, and no pathological mobility. The depth of the gingival pocket was 8 mm. Root canal therapy was performed over three sessions. The patient remained asymptomatic during the treatment and follow-up visits. Results: Radiographs at 4-, 6-, and 9-month post-treatment showed healing of the periapical lesion. Conclusions: Due to the complex canal anatomy of invaginated teeth, confirming the diagnosis with cone-beam computed tomography (CBCT) is essential. Treating invaginated teeth presents significant challenges for clinicians, requiring a thorough understanding of the dental anatomical variability, advanced manual skills, and the use of specialized equipment. Full article

Background: Molar–Incisor Hypomineralization (MIH) represents a developmental enamel defect of systemic origin, typically affecting the first permanent molars and often the incisors. Within the limitations of this study, several associations were observed between perinatal factors and MIH-related outcomes. However, most of these connections were not retained in adjusted analyses. Febrile illness during the first year of life showed a significant association with hypersensitivity. Methods: A structured 30-item questionnaire was distributed to mothers of 50 children diagnosed with MIH between February and March 2024. Data was analyzed using chi-square tests, with p < 0.05 considered significant, and univariate and multivariate logistic regressions at 95% confidence interval. Clinical diagnosis followed the Weerheijm (EAPD) criteria. Results: Maternal medication during pregnancy (antibiotics, antiepileptics, asthma drugs) was significantly associated with preterm birth (p = 0.01). Low birth weight correlated with tooth eruption disorders (p = 0.009) and perinatal complications such as hypoxia and respiratory distress (p = 0.0001). Fluoride application demonstrated a protective effect against discolorations (p = 0.005), caries (p = 0.002), and hypersensitivity (p = 0.01). In the multivariate model, febrile illness during the first year of life may be associated with hypersensitivity in MIH-affected teeth (aOR = 5.71, 95% CI: 1.01–32.27, p = 0.049). Conclusions: Maternal medication and perinatal complications, particularly low birth weight, were associated with MIH occurrence. Preventive strategies emphasizing maternal health, early screening, and remineralization-based therapies can mitigate long-term oral health impacts. Full article

Introduction: Infantile Refsum disease (IRD) is considered one of the milder phenotypes within the Zellweger Spectrum Disorders (ZSDs), a group of peroxisomal biogenesis disorders characterized by a generalized impairment of peroxisomal function. Pathognomonic features of IRD are growth retardation, hearing and cognitive impairment, neuromuscular problems, and craniofacial anomalies. Due to the relatively short lifespan, severe dental anomalies have not been previously reported in association with this disorder. This case report describes a rare manifestation of multiple impacted teeth and near complete edentulism in an adult patient diagnosed with Infantile Refsum disease (IRD). Material and Methods: The patient, a 24-year-old female, presented with a skeletal Class III malocclusion, severe maxillary hypoplasia, and complete impaction of the permanent dentition. The diagnosis of Infantile Refsum disease (IRD) was genetically confirmed and was associated with both neurological and dermatological manifestations. Conclusions: This case underscores that severe disturbances in tooth eruption and impaction may represent underrecognized manifestations of metabolic and genetic disorders such as Infantile Refsum disease (IRD). Dental professionals should remain vigilant to the potential association between systemic conditions and delayed or failed tooth eruption, emphasizing the need for interdisciplinary management and further investigation. Full article