Journal Of Dentistry[JOURNAL]
Sun
200 papers
Material fracture/retention rates of occluso-proximal composite resin restorations with polyethylene fibers in primary molars: an interim randomized controlled trial.
Rocha AO, Dos Anjos LM, Pinho NS … +8 more , Ramos I, Rosa BM, Santos PS, Favoreto MW, Reis A, Loguercio AD, Santana CM, Cardoso M
J Dent · 2026 Jun · PMID 42361885 · Publisher ↗
OBJECTIVES: This 12-month, double-blind, parallel, randomized controlled trial compared the material fracture/retention rates of occluso-proximal direct composite resin restorations associated with polyethylene fiber (CR...
OBJECTIVES: This 12-month, double-blind, parallel, randomized controlled trial compared the material fracture/retention rates of occluso-proximal direct composite resin restorations associated with polyethylene fiber (CR+PF; Ribbond®) with conventional CR restorations in primary molars. METHODS: A total of 60 children received occluso-proximal restorations using either CR+PF or CR. Children should be 5 to 10 years were selected for the study. The restorations were evaluated at baseline and after 3, 6, and 12 months of clinical service according to the FDI World Dental Federation criteria. Additional data were collected regarding participant characteristics, restored teeth, and clinical working time. Statistical analyses included Kaplan-Meier survival and the Chi-square test. Cox regression analysis was used and independent t-test (α=0.05). RESULTS: After 12 months, 53 restorations were evaluated. Seven restorations failed (four for CR+PF group). The retention rates (95% confidence interval [CI]) were 85.7% (81.5%-99.9%) for CR+PF group and 88.0% (81.1%-96.0%) for the CR group (p > 0.05). The hazard ratio (95% CI) was 0.52 (0.27 to 1.01), also showing no significant difference between groups. All other FDI parameters indicated that the restorations were clinically acceptable. Cox regression analysis showed that age had a significant effect on clinical success (p < 0.05). The mean clinical working time was 30.7 (28.0%-33.3%) min in the CR group and 25.2 (21.4%-29.0%) min in the CR+PF group (p < 0.05). CONCLUSIONS: The survival rate of the occluso-proximal restorations with or without PF was not statistically different, although the use of PF was associated with a significantly longer clinical working time. CLINICAL SIGNIFICANCE: This study, the first clinical trial to investigate this topic, demonstrates that the incorporation of polyethylene fibers does not improve the clinical performance of composite resin restorations. Therefore, their use is not justified in clinical practice, allowing simplification of the restorative protocol without compromising outcomes.
AI-assisted Software Development in Digital Dentistry: A Technical Innovation Report with Three Open-Source Applications.
Reymus M, Tichy A, Diegritz C … +3 more , Weisbrod B, Schwendicke F, Werner N
J Dent · 2026 Jun · PMID 42361884 · Publisher ↗
OBJECTIVES: To present a feasible workflow for artificial intelligence (AI)-assisted software engineering in dentistry as a technical innovation report. The use of this workflow is illustrated through three self-develope...
OBJECTIVES: To present a feasible workflow for artificial intelligence (AI)-assisted software engineering in dentistry as a technical innovation report. The use of this workflow is illustrated through three self-developed open-source dental applications. METHODS: Four AI-assisted development approaches were employed: chat-based interfaces of large language models, command-line interface tools, integrated development environments with AI assistance, and agent-based architectures. The dental software applications were created by a single clinician without formal programming training. RESULTS: Three applications were created: (1) VirtualEndo Converter, a Blender add-on for automated CBCT derived STL conversion for augmented/virtual reality (AR/VR), (2) MeshComparisonTool, a 3D Slicer extension for quantitative 3D morphology comparisons, and (3) DentalEmergencyTrainer, an application for simulating dental trauma emergency calls. All the applications are publicly available under the MIT license on GitHub. CONCLUSIONS: This report demonstrates that AI-assisted software development can enable dental practitioners without formal programming training to create functional prototypes of applications for research, education, and potentially clinical support. However, the reproducibility of this approach remains to be established, as the three tools were developed by a single clinician, and their clinical deployment would require thorough validation, security auditing, and regulatory assessment. CLINICAL SIGNIFICANCE: AI-assisted development can help dental practitioners prototype tools that address unmet needs in clinical workflows, research, and education, but clinical use requires cautious separation from validated medical software. Before deployment, such tools require defined intended use, safety evaluation, data-protection safeguards, maintenance plans, and regulatory assessment.
Effect of a Stackable Scanning Guide, Intraoral Scanner Type, and Operator on the Accuracy of Maxillary Full-Arch Implant Scans: An In Vitro Study.
Cakmak G, Bazelli N, Schenk V … +3 more , Güven E, Molinero-Mourelle P, Abou-Ayash S
J Dent · 2026 Jun · PMID 42349629 · Publisher ↗
PURPOSE: To evaluate how a stackable scanning guide, scanner type, and operator influence the accuracy of maxillary full-arch implant scans. MATERIALS AND METHODS: A maxillary edentulous model with four implants was digi...
PURPOSE: To evaluate how a stackable scanning guide, scanner type, and operator influence the accuracy of maxillary full-arch implant scans. MATERIALS AND METHODS: A maxillary edentulous model with four implants was digitized with an industrial scanner (reference model) and scanned using 2 intraoral scanners (Primescan (PS) and Trios 4 (T4)), without (NG) and with a stackable scanning guide (SG), by two independent operators (n=7). In addition, a conventional open-tray impressions (CNV) were made. Accuracy was assessed superimposing and assessing the 3D, angular, and interimplant distance deviations. RESULTS: Impression type affected all 3D, angular, and 2D distance deviation outcomes, while operator influence was minimal (ICC 0-4%). CNV showed the greatest deviations. The scanning guide improved 3D accuracy in a position-dependent manner, with the greatest benefits observed at specific implant sites, particularly at distal positions, with deviations ranked CNV > T4 > PS. PS and T4 performed similarly without the guide, and having the guide a limited influence on angular and interimplant distance outcomes. CONCLUSION: Digital implant scans were more accurate than conventional open-tray impressions for maxillary full-arch implant scans. The use of a stackable scanning guide improved scan trueness in a position-dependent manner, with scanner type influencing deviation patterns; Trios 4 demonstrated more consistent accuracy across implant positions, operator influence was minimal. CLINICAL SIGNIFICANCE: A stackable scanning guide can improve full-arch digital implant scan accuracy by providing stable reference landmarks and potentially reducing stitching errors, particularly at distal implant sites.
Preoperative photobiomodulation reduces pain in molar surgery: A, double-blind clinical trial.
Mello EDS, Horliana ACRT, Bezerra CDDS … +7 more , Fernandes KPS, Salviatto LTC, Bussadori SK, Dos Santos Pereira SR, Dalapria V, de Sales RS, Deana AM
J Dent · 2026 Jun · PMID 42349628 · Publisher ↗
BACKGROUND: Postoperative pain, swelling, and functional limitations are common after mandibular third molar surgery, affecting recovery and quality of life. This randomized, double-blind clinical trial evaluated the eff...
BACKGROUND: Postoperative pain, swelling, and functional limitations are common after mandibular third molar surgery, affecting recovery and quality of life. This randomized, double-blind clinical trial evaluated the effects of preemptive photobiomodulation therapy with infrared LED on postoperative pain, as well as edema and trismus. METHODS: Eighty healthy participants requiring lower third molar extraction were randomly assigned to a photobiomodulation group or a sham group. Nine patients from each group were excluded from the sample because they did not comply with the postoperative instructions. The treated group received photobiomodulation (850 nm, 100 mW, 24 J) 1 hour before surgery and additional applications at 48 h and 7 days postoperatively. Pain intensity, swelling, trismus, and quality of life were assessed at baseline, 48 h, and 7 days after surgery. RESULTS: The photobiomodulation significantly reduced pain at 48 h (p < 0.001) compared to sham, although no difference was observed on day 7. Swelling resolution was superior in the photobiomodulation group, with facial measurements returning to baseline by day 7, unlike in the sham group. No significant difference was found for trismus. Quality-of-life scores favored photobiomodulation, particularly regarding social activities, swallowing, and sleep quality. CONCLUSIONS: Preemptive photobiomodulation with infrared LED effectively reduces early postoperative pain and accelerates edema resolution in lower third molar surgery. This simple, non-invasive, and low-cost intervention improves recovery and enhances patient comfort. Further studies are warranted to confirm these findings and optimize treatment protocols. CLINICAL SIGNIFICANCE: Preemptive photobiomodulation using infrared LED may serve as an effective adjunctive therapy to improve early postoperative recovery after mandibular third molar surgery. Its ability to reduce pain and accelerate edema resolution can enhance patient comfort and quality of life while offering a non-invasive and cost-effective approach easily integrated into routine clinical practice.
Comparison of Accuracy in Full-Arch Implant Impressions Using Conventional, Intraoral, and Photogrammetric Techniques: An In Vitro Study.
Ye Y, Lin M, Qu Y … +4 more , Gong J, Wang C, Wang Y, He F
J Dent · 2026 Jun · PMID 42349627 · Publisher ↗
OBJECTIVES: To compare the accuracy of conventional impression (CNV), extraoral photogrammetry (EPG), intraoral photogrammetry (IPG), two intraoral scanners (IOSs), and three implant Scan bodies (ISBs) for capturing an e...
OBJECTIVES: To compare the accuracy of conventional impression (CNV), extraoral photogrammetry (EPG), intraoral photogrammetry (IPG), two intraoral scanners (IOSs), and three implant Scan bodies (ISBs) for capturing an edentulous model with six implant analogs. MATERIAL AND METHODS: An edentulous mandibular master stone cast with six implant analogs was digitized using a desktop scanner. Stone casts obtained from CNV were scanned using the same laboratory scanner. Digital scans of the master cast were obtained using an EPG system (ICam4D, ICam), an IPG system (Aoralscan Elite, Elite), and two IOSs (TRIOS 5 and AS 200E) combined with three ISBs (Truefit Pro5, Trufit; Digital Wings, DW, and DirectIP, DIP) (n = 20). Scan trueness was evaluated using root-mean-square (RMS) and interimplant linear, distance, and angular deviations, with master model scans as the reference. Precision was defined as the variance of deviations within each group. RESULTS: The DIP group showed comparable RMS and interimplant linear trueness deviations to the ICam group (p < .05). The Elite group exhibited the best angular trueness (p < .001). No significant differences in precision deviations were found among the ICam, Elite, and DIP groups. Among the three groups, only ICam demonstrated significantly higher precision than CNV, Truefit, and DW. CONCLUSIONS: The accuracy of full-arch implant impressions was influenced by the scanning technology used. EPG demonstrated the highest overall accuracy, whereas Elite and DIP also showed favorable performance. CLINICAL SIGNIFICANCE: The accuracy of full-arch implant impressions is significantly influenced by the selection of ISBs and IOS systems. EPG remains a highly accurate method for recording full-arch digital implant positions, while IPG and DIP may also be promising alternatives.
Time to color stabilization during in-office bleaching with 35% hydrogen peroxide: A prospective clinical study.
Dias RM, Cordeiro DCF, Rodrigues MA … +5 more , Condolo L, Lenhani MM, Favoreto MW, Loguercio AD, Reis A
J Dent · 2026 Jun · PMID 42349626 · Publisher ↗
OBJECTIVES: To characterize color change progression during in-office bleaching (IOB) and to estimate the median number of bleaching sessions to reach color stabilization across consecutive sessions. Tooth sensitivity (T...
OBJECTIVES: To characterize color change progression during in-office bleaching (IOB) and to estimate the median number of bleaching sessions to reach color stabilization across consecutive sessions. Tooth sensitivity (TS), gingival irritation (GI), pulp sensibility at 10 months and patient-reported esthetic outcomes were also evaluated. METHODS AND MATERIALS: This prospective, single-arm controlled trial enrolled 40 adults with canine shade A2 or darker. Participants underwent six IOB sessions with 35% hydrogen peroxide. Color change was assessed after each session using instrumental and visual metrics. Time to stabilization was analyzed using Kaplan-Meier methods; stabilization being the first session after which all subsequent inter-session changes remained below perceptibility thresholds (PT). TS and GI were recorded using visual analog scales. Orofacial Esthetic Scale (OES) was applied at baseline and after treatment. Pulp sensibility was checked after 10 months. RESULTS: Using PT, only 18-25% of the participants stabilized color by third session. Shade-guide-based outcomes reached median stabilization at the second-third session. Under acceptability thresholds (AT), median stabilization occurred at the third session. TS and GI were transient, mild, with no evidence of cumulative worsening (p < 0.05). All recalled patients (28/40) showed positive normal pulpal response. All OES items improved significantly from baseline to post-treatment (p < 0.05). CONCLUSION: Color stabilization is dependent on thresholds used. Half of participants stabilized by third week using AT and shade guide units as reference. TS and GI were mild, with positive pulp sensibility. High patient satisfaction was observed. CLINICAL SIGNIFICANCE: Decisions on IOB duration should be guided by patient's bleaching response, expectations, and adverse effects.
Clinical Performance of 3D Printed Porous Titanium Dental Implants Supporting Single Crowns: A 2-Year Retrospective Study.
Mangano C, Lerner H, Mangano FG
J Dent · 2026 Jun · PMID 42349625 · Publisher ↗
OBJECTIVES: To evaluate the 2-year clinical, radiographic, and prosthetic outcomes of 3D printed porous titanium implants supporting single crowns. METHODS: This retrospective study included 70 patients (31 males, 39 fem...
OBJECTIVES: To evaluate the 2-year clinical, radiographic, and prosthetic outcomes of 3D printed porous titanium implants supporting single crowns. METHODS: This retrospective study included 70 patients (31 males, 39 females; mean age 58.4 ± 12.1 years) rehabilitated with 85 3D printed porous titanium implants supporting single crowns. Forty-six implants (54.1%) were placed in the maxilla and 39 (45.9%) in the mandible; 77 implants (90.6%) were inserted in healed ridges and 8 (9.4%) in post-extraction sockets. Clinical, prosthetic, and radiographic outcomes were assessed after 2 years of functional loading. Outcome measures included implant survival, biologic and prosthetic complications, and marginal bone loss (MBL). Descriptive and inferential statistical analyses were performed with a significance level of p < 0.05. RESULTS: At the 2-year follow-up, 84 of 85 implants remained functional, resulting in a cumulative survival rate of 98.8%. One implant failed because of peri-implantitis, while no additional biologic complications were observed. Two prosthetic complications (2.4%) occurred, consisting of implant-abutment connection loss in bruxist patients. Mean MBL increased from 0.65 ± 0.43 mm (95% CI: 0.56-0.74 mm) at 1 year to 0.78 ± 0.50 mm (95% CI: 0.67-0.89 mm) at 2 years, representing a statistically significant change (mean difference: 0.13 mm; 95% CI: 0.07-0.19 mm; p < 0.001). Healed sites exhibited lower MBL than post-extraction sockets, and mandibular implants showed lower MBL than maxillary implants; however, these differences did not reach statistical significance (p > 0.05). CONCLUSIONS: 3D printed porous titanium implants demonstrated excellent short-term clinical performance, high survival, minimal complication rates, and stable peri-implant bone levels after 2 years of functional loading, supporting their use for single-tooth implant rehabilitation. CLINICAL RELEVANCE: 3D printed porous titanium implants may represent a biologically advanced approach to implant design, potentially improving osseointegration through controlled open-cell architecture.
Evaluation of Six Cutting-edge Large Language Models in Answering a Set of Open-ended Questions in Dental Case Reports.
Zhang H, Yan X, Yang Y … +3 more , Jin L, Yang P, Wang J
J Dent · 2026 Jun · PMID 42342199 · Publisher ↗
OBJECTIVES: This study implemented a structured evaluation pipeline integrating automated metrics with expert scoring to assess six widely used large language models (LLMs) on their abilities to interpret longitudinal de...
OBJECTIVES: This study implemented a structured evaluation pipeline integrating automated metrics with expert scoring to assess six widely used large language models (LLMs) on their abilities to interpret longitudinal dental case vignettes through open-ended questions, aiming for providing practical guidance for dental practitioners. MATERIALS AND METHODS: Thirty-four standardized longitudinal periodontal case vignettes were sourced from a published textbook, generating 258 open-ended question-answer pairs. A controlled three-step prompting protocol was used to generate responses respectively from six LLMs, including GPT, Gemini, Copilot, DeepSeek, Llama and MedGemma. Performances were assessed using automated metrics (faithfulness, answer relevancy and readability) and blinded expert evaluation based on a 5-point Likert scale. RESULTS: There were significant differences across all evaluation metrics among the six models. DeepSeek achieved the highest expert ratings, with a median score of 4.5/5, outperforming other models such as GPT (4.0/5), Gemini (4.0/5), Copilot (4.0/5), MedGemma (3.75/5), and Llama (3.5/5). DeepSeek also demonstrated comparable or superior performance in faithfulness, answer relevancy, and readability. Distinct performance trade-offs were observed, where Copilot offered high readability at the cost of accuracy, Gemini tended to produce less relevant responses, and Llama generated less readable text. CONCLUSIONS: The evaluation pipeline enabled reproducible and transparent comparison of LLMs in dental case reasoning, and identified DeepSeek as a robust choice for answering open-ended dental questions. Dental practitioners should be aware of limitations of each current model, when selecting an AI tool for clinical or educational tasks. CLINICAL SIGNIFICANCE: This study provides a multi-dimensional evaluation framework that characterizes how current LLMs perform on open-ended dental questions. The results highlight meaningful differences across models and emphasize the need for practitioners to consider each model's strengths and limitations when selecting them for educational or decision-support tasks.
Is erosive tooth wear a truly non-bacterial condition? A scoping review.
González JAC, Brant CF, Pigossi SC … +4 more , Wiegand A, Sabino-Silva R, Massignan C, Zanatta RF
J Dent · 2026 Jun · PMID 42342198 · Publisher ↗
OBJECTIVE: This scoping review examined the current knowledge on oral biofilm ecology and erosion-associated dysbiosis, proposing pathways by which the oral microbiome may contribute to erosive tooth wear (ETW). DATA: Th...
OBJECTIVE: This scoping review examined the current knowledge on oral biofilm ecology and erosion-associated dysbiosis, proposing pathways by which the oral microbiome may contribute to erosive tooth wear (ETW). DATA: The PRISMA-ScR guidelines were followed (OSF platform, doi: 10.17605/OSF.IO/KM4JQ). Primary research articles (in vitro, in situ, or clinical trials) that investigated ETW associated with oral biofilm ecology, erosion-associated dysbiosis, or microbiome pathways were included. SOURCES: A systematic search of PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library was conducted up to April 2026 using predefined terms. STUDY SELECTION: A total of 2355 records were identified. After screening, 16 full texts were eligible, and 7 studies were included for data extraction. The included studies were highly heterogeneous in design [including observational (3), randomized (1), and in situ/ex vivo (3) models], outcomes, and biological targets. Two studies evaluated the biofilm´s protective effect against erosive challenge, showing reduced enamel erosion but limited protection of dentin. Two studies assessed bioactive compounds' influence on microbiome, demonstrating reduced bacterial adhesion, altered pellicle structure, and improved erosion protection. Three studies investigated microbial ecology directly with inconsistent findings: one found no significant differences in microbial counts, another reported similar alpha- and beta-diversity but taxon-level differences, and a third showed lower microbial diversity, proteolytic protein degradation, altered gene expression, and metabolic profiles compatible with acid-adapted and proteolytic communities. CONCLUSIONS: The findings suggest that the oral microbiome may act as an ecological modifier of ETW by influencing biofilm organization, and local metabolic behavior, but current evidence is insufficient to determine whether ETW is truly a non-bacterial condition. CLINICAL SIGNIFICANCE: The oral microbiome can influence erosive tooth wear, which impacts risk assessment and prevention strategies.
Conceptual development of a restorative dental prognosis index: A proof-of-concept framework integrating survival evidence and restorability assessment".
Howe MS, Richards D
J Dent · 2026 Jun · PMID 42336077 · Publisher ↗
OBJECTIVE: Restorative dentistry lacks an integrated prognostic framework linking restorability assessment to long-term survival evidence. This study evaluates whether published 10-year survival data can be systematicall...
OBJECTIVE: Restorative dentistry lacks an integrated prognostic framework linking restorability assessment to long-term survival evidence. This study evaluates whether published 10-year survival data can be systematically anchored to an existing multi-domain restorability index to develop a structured Restorative Dental Prognosis Index (RDPI). METHODS: A theory-driven, five-stage conceptual methodology was applied. A structured literature search identified validated restorability or risk indices as a conceptual anchor. Prognostic features were classified by relevance to restorative outcomes. Published 10-year survival estimates and uncertainty intervals were extracted from systematic reviews and re-analysed to characterise dispersion. Estimates were mapped onto an ordinal prognostic structure to minimise overfitting in heterogeneous evidence. Scenario modelling explored internal coherence, recognising differences between whole-mouth and tooth-level risk. No empirical validation was undertaken. RESULTS: A single multidomain index met eligibility criteria. Across 13 domains, 10-year survival estimates showed wide variation (74-93%), very broad prediction intervals, and high heterogeneity (I²=74.8-99.8%). Despite this, survival data aligned with a three-category ordinal structure, generating a coherent prognostic scaffold. Scenario modelling demonstrated non-linear increases in whole-mouth risk and integration of biological risk with financial exposure. CONCLUSIONS: By mapping long-term survival evidence onto a validated multidomain restorability framework, this proof-of-concept framework provides a structurally consistent prognostic scaffold. While not a predictive model, it offers a foundation for future empirical parameterisation, validation, and integration into restorative treatment planning, teaching, and practice. CLINICAL SIGNIFICANCE: This framework integrates multi-domain restorability assessment with long-term survival evidence to support whole-mouth prognostic reasoning. By simplifying heterogeneous data into ordinal risk states and enabling aggregation, it may help clinicians compare strategies, anticipate failure risk, and align decisions with proportionality, cost exposure, and patient-centred outcomes.
Accuracy of intraoral scanners when digitizing post preparations: A µ-CT based feasibility study.
Wildhagen S, Rechlin J, Kocaöz G … +5 more , Bruhnke M, Cakmak G, Blunck U, Beuer F, Pieralli S
J Dent · 2026 Jun · PMID 42336076 · Publisher ↗
OBJECTIVES: The aim of this in vitro study was to evaluate the scanning accuracy of two intraoral scanners at different post-preparation depths and diameters, using micro-computed tomography (µ-CT) data as the reference...
OBJECTIVES: The aim of this in vitro study was to evaluate the scanning accuracy of two intraoral scanners at different post-preparation depths and diameters, using micro-computed tomography (µ-CT) data as the reference standard. METHODS: Twenty extracted human mandibular premolars were prepared to simulate advanced coronal substance loss. After endodontic treatment, post space preparations with varying depths (10 mm, 12 mm) and diameters (ISO 090, ISO 110) were created (n=5). Two intraoral scanners, Primescan (PR) and TRIOS 4 (TR), were used for digital post-space acquisition. Reference datasets were generated using µCT. Trueness and precision were assessed by aligning intraoral scan data to µCT reference models using best-fit alignment and evaluating deviations at three predefined cross-sectional levels. Statistical analysis included three-way ANOVA, post-hoc testing, independent t-tests, and correlation analysis (α=0.05) RESULTS: Regarding trueness, the three-way ANOVA revealed a significant effect of the scanner system and depth (p<0.001), with PR demonstrating higher trueness than TR. A significant scanner-depth interaction was observed (p<0.001). Preparation diameter showed no significant effect. For precision, significant main effects were found for scanner system and depth (p<0.001). PR exhibited significantly higher precision than TR, particularly at increased depths. Preparation diameter had a minor but significant effect on precision (p= 0.041). A positive correlation was identified between trueness and precision (r = 0.838). CONCLUSIONS: The performance of intraoral scanners in post-space digitization was strongly scanner- and depth-dependent. PR demonstrated superior and more consistent trueness and precision across increasing preparation depths compared with TR. CLINICAL RELEVANCE: In clinical practice, the type of intraoral scanner and the preparation geometry should be considered when selecting a digital workflow, as these factors can influence the fit of the resulting restorations.
Robot-assisted haptic guidance in endodontics: A pilot study evaluating efficiency and tooth structure preservation.
Momen R, Dale J, Suresh M … +3 more , Ravenel TD, Marshall J, Hahn CL
J Dent · 2026 Jun · PMID 42336075 · Publisher ↗
OBJECTIVES: A robot-assisted haptic guidance system (RA) has recently been introduced to facilitate implant placement. Unlike dynamic navigation systems, this platform uses haptic guidance to constrain operator movement...
OBJECTIVES: A robot-assisted haptic guidance system (RA) has recently been introduced to facilitate implant placement. Unlike dynamic navigation systems, this platform uses haptic guidance to constrain operator movement along a predefined path. We hypothesized that RA-guided access preparation would reduce operative time while minimizing the volume of tooth structure removed. Therefore, the aim of this study was to evaluate the effectiveness and precision of the RA approach compared with the freehand (FH) approach across three in vitro endodontic treatment modalities: (A) access to calcified canals, (B) fiber post removal, and (C) endodontic microsurgery. METHODS: Extracted teeth for each treatment modality were divided into three groups: an RA group treated by a resident, an FH group treated by the same resident, and a separate FH group treated by an experienced endodontist. Effectiveness was assessed based on the time required to reach the predefined endpoint for each procedure. Precision was evaluated by measuring the volume of tooth structure removed using cone-beam computed tomography images obtained after treatment. One-way analysis of variance and Kruskal-Wallis tests were used to analyze differences between the RA and FH approaches with respect to operative time, volume of tooth structure removed, and bevel angle. RESULTS: Compared with the FH approach, the RA approach significantly reduced operative time and the volume of tooth structure removed across all three treatment modalities. Additionally, the RA approach resulted in a significantly smaller bevel angle following root-end resection. CONCLUSION: The robot-assisted haptic guidance approach demonstrated improved efficiency and precision in challenging endodontic procedures. CLINICAL SIGNIFICANCE: Robot-assisted haptic guidance may enhance the efficiency and precision of complex endodontic procedures while preserving tooth structure. This technology has potential clinical value in managing challenging conditions requiring procedures such as access to calcified canals, fiber post removal, and endodontic microsurgery.
CINEMATIC RENDERING IN CONE-BEAM COMPUTED TOMOGRAPHY: A CLINICAL AND OBSERVER-BASED EVALUATION.
Doğan B, Köse TE, Çene E … +1 more , Karabaş HÇ
J Dent · 2026 Jun · PMID 42336074 · Publisher ↗
OBJECTIVES: To compare volume rendering (VR) and cinematic rendering (CR) in cone-beam computed tomography (CBCT)-based three-dimensional (3D) visualisation, focusing on perceived image quality, distance/length estimatio...
OBJECTIVES: To compare volume rendering (VR) and cinematic rendering (CR) in cone-beam computed tomography (CBCT)-based three-dimensional (3D) visualisation, focusing on perceived image quality, distance/length estimation accuracy, perceived treatment-planning impact, and practical applicability within clinical workflow. MATERIALS AND METHODS: Fourteen CBCT cases in five categories (implant planning, periodontal, soft-tissue calcifications, endodontic, surgical/maxillofacial) were reconstructed using VR and CR in OsiriX MD. In two sessions (VR first; CR after a 3-week washout), 110 observers (students, general dental practitioners, specialists) rated visual realism, 3D perception, detail sharpness, and perceived impact on anticipated treatment planning on a visual analogue scale and estimated a reference distance in millimetres via open-ended responses. Reconstruction and video export times were recorded. RESULTS: CR outperformed VR for visual realism, 3D perception, and detail sharpness (+14-19%; all p≤0.007). Distance-estimation error was 2.7% lower with CR, but not statistically significant. Although the perceived impact on anticipated treatment planning favoured CR overall (+14.0%; p>0.05), gains were statistically significant in surgical/maxillofacial cases (+32%; p<0.01). Reconstruction was <1 min for both; video export was longer for CR (12-89 min/case) than VR (2-9 min/case). CONCLUSIONS: CR markedly improved perceived image quality over VR. However, its contribution to observer-based measurement accuracy was limited and its perceived impact on anticipated treatment planning was evident, mainly in surgical/maxillofacial cases. Longer export times support selective use alongside VR rather than replacement. CLINICAL SIGNIFICANCE: CR may serve as an adjunctive visualisation tool in selected CBCT applications, particularly in surgical/maxillofacial cases, whereas VR remains more practical for routine use.
Clinical outcome of fiber post and fiber-reinforced resin composite for the full crowns of anterior endodontically treated teeth: a 5-year randomized clinical trial.
Ferrari M, Saracutu OI, Pontoriero DIK … +4 more , Gastaldi G, Verniani G, Manfredini D, Ferrari Cagidiaco E
J Dent · 2026 Jun · PMID 42336073 · Publisher ↗
AIM: To compare the outcome of short fiber reinforced composites, as a core material, with respect to conventional fiber post, for the reconstruction of anterior endodontically treated teeth (ETT), covered by a lithium d...
AIM: To compare the outcome of short fiber reinforced composites, as a core material, with respect to conventional fiber post, for the reconstruction of anterior endodontically treated teeth (ETT), covered by a lithium disilicate crown. MATERIALS AND METHODS: Patients in need of endodontic treatment and a single-unit full crown restoration for anterior teeth (incisors or canines) were recruited. Only teeth with >50% of residual tooth structure were included. The teeth were required to be in occlusal function with a natural antagonist tooth and in interproximal contact with two adjacent natural teeth. A simple randomized design with 2 arms was adopted to evenly allocate patients to the two experimental groups. The fluctuation of oral behaviors was assessed via the Oral Behavior Checklist. For the assessment of the prosthodontic outcome, the modified US Public Health Service criteria were used. Statistical analysis was set at p<0.05. RESULTS: The statistical analysis showed no significant association between the type of build-up material, the high risk for oral behaviors (p = 0.197), and the prosthodontic failures (p = 0.471). CONCLUSION: This randomized clinical trial shows no significant difference in the outcome of anterior ETT with >50% of residual tooth structure restored with fiber post or fiber-reinforced composite, covered by a lithium disilicate crown, at 5 years of follow-up. CLINICAL SIGNIFICANCE: Short fiber-reinforced composites represent a valid alternative material to fiber post, for the build-up of anterior endodontically treated teeth, with at least 50% of residual tooth structure, covered by a lithium disilicate crown.
Correlation between periodontal parameters at teeth and implants: An up to 20-year long-term observational cohort study in periodontitis patients.
Walther KA, Akdeniz MA, Wöstmann B … +1 more , Vogler JAH
J Dent · 2026 Jun · PMID 42320591 · Publisher ↗
OBJECTIVES: The study aimed to evaluate the long-term correlation between periodontal parameters at implants and contra-lateral natural teeth over a follow-up period of up to 20 years in periodontitis patients undergoing...
OBJECTIVES: The study aimed to evaluate the long-term correlation between periodontal parameters at implants and contra-lateral natural teeth over a follow-up period of up to 20 years in periodontitis patients undergoing supportive periodontal care (SPC). MATERIALS AND METHODS: This observational cohort study involved systemically healthy, non-smoking patients who received periodontal and implant therapy, followed by regular SPC. The following parameters were assessed at baseline (i.e. implant loading) and at 5, 10, 15 and 20 years: clinical attachment level (CAL), pocket probing depth (PPD), gingival margin (GM) and bleeding on probing (BOP). Intra- and inter-group differences over time between implants and teeth were analysed. Survival rates were calculated. RESULTS: 167 patients with 419 implants were included. Mean CAL increased significantly over time at implants and teeth (p ≤ 0.015), approximately doubling every five years. After 20 years, CAL loss amounted to 4.47±2.45 mm at implants and 4.38±2.64 mm at teeth. Implants demonstrated significantly greater PPD increases after 10 and 15 years compared with teeth (p ≤ 0.027), whereas differences in CAL between implants and teeth were largely non-significant beyond 5 years. Differences in GM and BOP were small and inconsistent. No association was observed between SPC frequency and changes in CAL or PPD. Implant survival was 100% and three contra-lateral teeth were lost over 20 years. CONCLUSIONS: In patients with treated periodontitis under regular SPC, implants and natural teeth exhibited comparable long-term clinical stability and survival. However, a non-linear progression of CAL loss occurs at teeth and implants, which SPC effectively limits but does not completely prevent. CLINICAL SIGNIFICANCE: For systemically healthy, non-smoking patients with treated periodontitis who attend SPC programme twice per year, implants can provide durable tooth replacement. Survival is comparable to that of contra-lateral teeth over 20 years. Clinicians should prioritise maintenance and monitoring, as CAL and PPD may progress despite overall excellent long-term survival.
Staging-dependent dysbiosis of plaque microbiota in early childhood caries.
Zhang JS, Lu W, Zhu H … +5 more , Liang Z, Chu CH, Jakubovics NS, Chen Z, Yu OY
J Dent · 2026 Jun · PMID 42320590 · Publisher ↗
OBJECTIVES: The stage-specific ecological and functional microbial features of ECC remains poorly defined. This study aimed to characterize the lesion-associated microbiome and evaluate stage-specific microbial signature...
OBJECTIVES: The stage-specific ecological and functional microbial features of ECC remains poorly defined. This study aimed to characterize the lesion-associated microbiome and evaluate stage-specific microbial signatures of ECC. METHODS: Paired supragingival plaque samples were collected from an active cavitated lesion (caries) and a spatially-matched intact surface (control) of 84 ECC-affected children aged 3 - 4 years. Lesions were classified by depth as enamel caries and dentine caries. Microbial profiles were generated by 16S rRNA sequencing and analysed for community diversity, structure, and differentially abundant taxa. PICRUSt2 was used for functional prediction. RESULTS: Alpha diversity did not differ between caries and controls, but beta diversity revealed significant compositional separation. PERMANOVA identified disease status as the main driver of community variation, with disease staging as an additional significant factor. Caries lesions were enriched with classical and emerging cariogenic taxa, including Streptococcus mutans, Prevotella histicola, Prevotella salivae, Selenomonas sputigena, Scardovia wiggsiae, and Veillonella dispar. A 13-species panel distinguished caries from controls with an AUC of 0.85. Stratification by caries staging revealed pronounced dysbiosis confined to the dentine caries subgroup. Functional prediction suggested that dentine caries had a distinct inferred profile, with predicted enrichment of carbohydrate metabolism pathways, the phosphotransferase system, and the pentose phosphate pathway. CONCLUSIONS: In ECC-affected children, plaque microbiome in carious lesions showed distinct compositional, ecological and functional alterations versus unaffected surfaces, with further dysbiosis driven by caries progression. Dentine caries featured a stage-specific consortium of cariogenic taxa and a predicted functional shift toward intensified carbohydrate uptake and fermentation, informing potential microbiome-targeted strategies for ECC management. CLINICAL SIGNIFICANCE: The identified ecological progression of ECC offers key microbial biomarkers to inform microbiome-targeted preventive and therapeutic strategies, ultimately improving clinical outcomes in pediatric dentistry.
Dental pain inequalities in two cross-sectional national oral health surveys.
Chisini LA, Salvi LC, Cenci MS … +4 more , Pereira-Cenci T, Conde MCM, Costa FDS, Demarco FF
J Dent · 2026 Jun · PMID 42320589 · Publisher ↗
OBJECTIVE: To evaluate the socioeconomic position (SEP) inequalities in dental pain prevalence in Brazil between 2010 and 2023. METHODS: Data from two Brazilian National Oral Health Surveys (2010, n = 37,519; 2023, n = 4...
OBJECTIVE: To evaluate the socioeconomic position (SEP) inequalities in dental pain prevalence in Brazil between 2010 and 2023. METHODS: Data from two Brazilian National Oral Health Surveys (2010, n = 37,519; 2023, n = 40,720) were analyzed. The outcome was self-reported dental pain in the last six months. SEP was modeled as a latent variable using household income, household goods, educational attainment, and housing density. Inequalities were measured using the Slope Index of Inequality (SII) and the Concentration Index of Inequality (CIX) across age groups (5y, 12y, 15-19y, 35-44y, 65-74y). Sensitivity analyses excluded edentulous individuals. RESULTS: The prevalence of dental pain was 23.3% (95%CI:21.3-25.4) in 2010 and 20.4% (95%CI:18.6-22.3) in 2023. Negative SII and CIX values confirmed persistent SEP inequalities concentrated among disadvantaged groups across most age groups in both surveys. A significant inequality reduction was observed among 5-year-olds, where absolute inequality decreased from -23.5 to -5.0 percentage points, becoming non-significant in 2023. This reduction was driven by a convergence across socioeconomic groups, with decreased pain among the poorest and increased pain among the wealthiest. Among older adults (65-74 years), no significant inequalities were detected in the main analysis, but sensitivity analysis excluding edentulous individuals revealed significant inequalities in 2023 (SII=-12.4; CIX=-11.4%). CONCLUSION: The prevalence of dental pain did not significantly change during the study period. SEP inequalities in dental pain remained largely stable and significant in Brazil from 2010 to 2023, except for a reduction among young children (5 years). CLINICAL SIGNIFICANCE: The consistent socioeconomic gap indicates that patients from lower socioeconomic backgrounds continue to bear a higher pain burden. Clinically, this implies that screening for pain should be prioritized in vulnerable populations, and policies aimed at reducing social disparities remain a needed path toward equitable oral health.
Dietary acid exposure and intake phenotypes in young adults: a 4-year longitudinal study with implications for erosive tooth wear.
Ganss C, Jung K, Schlenz MA
J Dent · 2026 Jun · PMID 42309381 · Publisher ↗
OBJECTIVES: To characterise the longitudinal behaviour in diet-related attitudes and frequency-based dietary acid exposure over four-year period, and to evaluate the concordance between attitudes and self-reported intake...
OBJECTIVES: To characterise the longitudinal behaviour in diet-related attitudes and frequency-based dietary acid exposure over four-year period, and to evaluate the concordance between attitudes and self-reported intake within the context of erosive tooth wear research. METHODS: Ninety-one dental students (mean age 20.9±2.2 years) were followed annually from baseline to year 4, with four follow-up assessments. A self-administered questionnaire captured frequencies of acidic food and beverage consumption as well as seven diet-related attitude items. Consumption frequencies were converted into estimated daily dietary acid exposure events. Statistical analyses included participant-clustered linear models, Friedman sensitivity tests, Cronbach's alpha, exploratory k-means clustering, Kruskal-Wallis tests, and Spearman correlations. RESULTS: Group-level dietary acid exposure and diet-related attitudes remained broadly stable over time, with no robust longitudinal effects observed. However, substantial within-person variability in acid exposure was evident. Attitude items showed predominantly stable responses or minor adjacent-wave shifts, alongside low internal consistency. Total dietary acid exposure was driven primarily by fruit- and juice-related sources rather than by soft drink. Four baseline intake phenotypes were identified: lower-intake/low-acid, fruit-juice, wine-vinegar, and soft-drink. Persistence of phenotypes over time was moderate. Person-level profiling revealed fluctuating total acid exposure in 45.1% of participants and consistently high exposure in 8.8%. Associations between attitudes and behaviour were modest. CONCLUSIONS: The longitudinal questionnaire data did not support a one-dimensional interpretation of dietary acid exposure. Instead, acid-exposure magnitude, temporal variability, source-specific intake patterns, and diet-related attitudes emerged as partly distinct layers of dietary behaviour. CLINICAL RELEVANCE: In the context of erosive tooth wear, dietary history-taking may be more informative when it considers not only the frequency of dietary acid exposure, but also its temporal variability and broader source-specific intake patterns, rather than relying solely on global questions about acidic intake.
Dentine hypersensitivity in the Australian adult population: prevalence, determinants, impacts, and management.
Schuch HS, Ha DH, Le T … +2 more , Torwane N, Do LG
J Dent · 2026 Jun · PMID 42309380 · Publisher ↗
OBJECTIVE: To describe the burden of dentine hypersensitivity (DH) among Australian adults, including its prevalence, distribution, impacts on quality of life, and management patterns. METHODS: A cross-sectional online s...
OBJECTIVE: To describe the burden of dentine hypersensitivity (DH) among Australian adults, including its prevalence, distribution, impacts on quality of life, and management patterns. METHODS: A cross-sectional online survey was conducted among Australian adults recruited from two established population-based cohorts: the Tooth for Health (TfH) Study and the Study of Mothers' and Infants' Life Events Affecting Oral Health (SMILE). Participants completed a structured questionnaire assessing sociodemographic characteristics, oral health behaviours and indicators, DH symptoms and management, and general and oral health-related quality of life. Quality of life was assessed using the Oral Health Impact Profile (OHIP-14), the Dentine Hypersensitivity Experience Questionnaire (DHEQ), and the EQ-5D-5 L and EQ visual analogue scale. Associations were examined using descriptive analyses and regression models. RESULTS: Among 815 participants, 67.2% reported symptoms consistent with DH. DH prevalence was higher among women than men (71.6% vs 51.1%, p < 0.001) and among participants reporting fair/poor oral health compared with excellent/very good oral health (81.0% vs 54.2%, p < 0.001). DH was associated with indicators of periodontal disease and problem-driven dental attendance. Participants with DH reported worse oral and general health-related quality of life across measures. Coping scores on the DHEQ were worse among those with DH (mean difference -11.93; 95% CI -14.13 to -9.73), representing almost 17% of the scale range. Despite this burden, 74.3% had not sought professional care, and 26.3% reported never having used any treatment; many relied on self-directed strategies, including analgesics and dietary modifications. CONCLUSIONS: In this population-based sample of Australian adults, DH was highly prevalent and was associated with poorer oral and general health-related quality of life. Most participants reporting DH had not sought professional care, and many had never used treatment, indicating a gap between symptom experience and management. CLINICAL SIGNIFICANCE: DH is common yet frequently unmanaged, highlighting the need for greater recognition, education, and evidence-based management in clinical practice.
Three-year clinical outcomes of additively manufactured hybrid composite implant-supported restorations fabricated through tilting stereolithography: a retrospective clinical study.
Mangano FG, Mangano C, Lerner H … +6 more , Loktionova M, Dudnik O, Malanova O, Elovskaya A, Maltseva A, Dybov A
J Dent · 2026 Jun · PMID 42309379 · Publisher ↗
OBJECTIVES: To evaluate the 3-year clinical performance of additively manufactured (AM) hybrid composite short-span implant-supported restorations fabricated through tilting stereolithography (TSLA) within a fully digita...
OBJECTIVES: To evaluate the 3-year clinical performance of additively manufactured (AM) hybrid composite short-span implant-supported restorations fabricated through tilting stereolithography (TSLA) within a fully digital workflow. METHODS: This retrospective clinical study included 218 patients rehabilitated with 278 implant-supported restorations fabricated from a ceramic-filled hybrid composite material using TSLA technology. The restorations comprised 207 single crowns (SCs) and 71 fixed partial dentures (FPDs), supported by 360 implants. All rehabilitations were produced through a complete digital workflow. Primary outcomes included marginal adaptation, occlusal and interproximal contact quality, and chromatic integration, assessed at delivery by two independent evaluators using a 5-point scoring system. Secondary outcomes included restoration survival and restoration success during follow-up. Kaplan-Meier survival analysis was performed. RESULTS: At delivery, both evaluators assigned predominantly excellent or satisfactory scores for marginal adaptation, occlusal contacts, interproximal contacts and chromatic integration, with no significant differences between restoration types (p > 0.05). During follow-up, 3 biological complications (1.1%) and 19 prosthetic complications (6.8%) were recorded, including 7 cases of abutment screw loosening, 6 decementations and 6 restoration fractures. Two implants failed during early healing, while three patients were lost to follow-up during the third year. Kaplan-Meier analysis revealed a cumulative restoration survival rate of 97.8% and an overall restoration success rate of 92.0% after 3 years. CONCLUSIONS: Within the limitations of this short-term study, TSLA-manufactured hybrid composite restorations demonstrated favourable clinical accuracy, high survival rates and acceptable short-term clinical performance. CLINICAL RELEVANCE: Hybrid composite restorations fabricated through TSLA may represent a promising option for definitive short-span implant-supported rehabilitations within contemporary digital prosthodontic workflows.
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