Journal Of Dentistry[JOURNAL]
Sun
200 papers
In vitro evaluation of antibacterial activity and biocompatibility of silver-doped fluorapatite glass-ceramic/zirconia gradient composites.
Zhang Y, Kong T, Kang J … +5 more , Yang Y, Li Q, Ma T, Wang G, Wu J
J Dent · 2026 Jun · PMID 42309378 · Publisher ↗
OBJECTIVE: This study aims to fabricate graded silver-doped fluorapatite (Ag-FAp) glass-ceramics/zirconia composites with interfacial fracture resistance and bonding stability, whose biological activity and antibacterial...
OBJECTIVE: This study aims to fabricate graded silver-doped fluorapatite (Ag-FAp) glass-ceramics/zirconia composites with interfacial fracture resistance and bonding stability, whose biological activity and antibacterial performance can be improved by varying Ag⁺ dopant concentrations. METHODS: Ag-FAp glass-ceramics (0, 0.25%, 0.5%, 0.75% and 1% Ag⁺ mass fractions) were prepared via melt quenching. Co-sintering of the Ag-FAp glass-ceramics with porous zirconia green bodies, afforded a gradient composite structure. The microstructure, thermal stability, interfacial fracture resistance, bonding stability, ion release, biocompatibility and antibacterial activity were comprehensively characterised. RESULTS: X-ray diffraction results confirmed that Ag⁺ formed a solid-solution in the FAp lattice, preserving its hexagonal structure. The finest grain morphology was obtained with 0.75% Ag⁺. Particle agglomeration was apparent with 1% Ag⁺. The Ag-FAp glass-ceramics exhibited excellent thermal stability, confirming their suitability for zirconia sintering. The porous structure of the zirconia green body facilitated infiltration of the Ag-FAp glass-ceramics, forming stable, high-strength interfaces. Ag⁺ release increased with increasing Ag⁺ doping, whereas F⁺ release maintained a steady state. Importantly, the 0.5 mol% Ag⁺-doped sample achieved a favourable trade-off between biocompatibility and in vitro antibacterial activity. CONCLUSIONS: The as-prepared Ag-FAp/zirconia composites possessed a stable interfacial structure with desirable ion release behaviour. The composites exhibited favourable in vitro biocompatibility and potent antibacterial activity against typical oral pathogens, providing an experimental basis for their clinical application in preventing secondary caries. CLINICAL RELEVANCE: The Ag-FAp/zirconia composites enable the transition of dental restorations from passive repair to active caries prevention, with potential clinical application.
Arresting root caries with nonrestorative strategies: A systematic review with network meta-analysis.
Zhang RR, Zhang JS, Li SK … +3 more , Lam WY, Chu CH, Yu OY
J Dent · 2026 Jun · PMID 42309377 · Publisher ↗
OBJECTIVE: To assess the effectiveness of professionally-applied and self-applied nonrestorative strategies for arresting root caries. DATA AND SOURCES: A systematic search was conducted to include randomized controlled...
OBJECTIVE: To assess the effectiveness of professionally-applied and self-applied nonrestorative strategies for arresting root caries. DATA AND SOURCES: A systematic search was conducted to include randomized controlled trials evaluating the clinical effectiveness between nonrestorative strategies (professional or self-applied strategies) and controls in arresting root caries. The search was conducted on PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and Scopus. Gray literature was searched in ClinicalTrials.gov and Google Scholar. Risk of bias (RoB) was assessed via RoB 2.0. Network Meta-analyses (NMAs) for effectiveness assessment, Surface Under the Cumulative Ranking (SUCRA) for treatment effectiveness ranking, and Confidence in Network Meta-Analysis (CINeMA) for the evidence certainty were conducted. STUDY SELECTION/RESULTS: Seventeen studies reporting root caries arrest rates of nonrestorative strategies were included. Fifteen of them were eligible for NMA, with two at low risk of bias and thirteen raised some concerns. The total number of participants and active root caries lesions at baseline that were used for quantitative analysis were 2869 and 5233, respectively. Professionally-applied strategies that were superior to positive control included quarterly 5% sodium fluoride (NaF) varnish, 5% NaF varnish with casein phosphopeptide-amorphous calcium phosphate (CPP‑ACP), 40% chlorhexidine (CHX) varnish, and annual applications of 38% silver diamine fluoride (SDF) with or without potassium iodide (KI). Among self‑applied strategies, daily use of 5000 ppm fluoride dentifrice, 1450 ppm fluoride dentifrice containing 1.5% arginine, and 1400 ppm fluoride dentifrice combined with a 250 ppm amine fluoride and potassium fluoride (AmF/KF) mouthrinse were more effective than negative control. By SUCRA rankings, the annual 38% SDF plus KI was the most effective professionally applied strategy, while the daily 1400 ppm dentifrice plus a 250 ppm fluoride (AmF/KF) mouthrinse ranked highest among self‑applied strategies. The certainty of evidence ranged from low to moderate. CONCLUSION: Annual professional application of 38% SDF with or without KI, quarterly applications 5% NaF with or without CPP-ACP, or 40% CHX can arrest root caries with statistically better outcomes compared with positive controls. Daily self-application of 5000 ppm fluoride dentifrice, 1450 ppm fluoride dentifrice containing 1.5% arginine, or 1400 ppm fluoride dentifrice with 250 ppm fluoride mouthrinse can arrest root caries, with statistically better outcomes compared with negative controls. However, given the low to very low certainty of the evidence, these findings should be interpreted with caution. CLINICAL SIGNIFICANCE: This review provides evidence to inform the selection of optimal treatments and oral hygiene measures for patients with root caries.
Effectiveness of selective, non-selective, and stepwise caries removal techniques in permanent teeth: An umbrella review of systematic reviews and meta-analyses.
Aldakhil S, Mubarak M, BaHammam F … +1 more , Vasconcellos A
J Dent · 2026 Jun · PMID 42309376 · Publisher ↗
OBJECTIVES: To synthesize evidence from systematic reviews/meta-analyses of clinical trials comparing selective removal (SR), non-selective removal (NSR), and stepwise removal (SW) for caries management in permanent teet...
OBJECTIVES: To synthesize evidence from systematic reviews/meta-analyses of clinical trials comparing selective removal (SR), non-selective removal (NSR), and stepwise removal (SW) for caries management in permanent teeth, reporting outcomes of pulp health preservation, pulp exposure risk, post-operative pain, restorative success, dentin deposition/remineralization, and microbial load. METHODS: This umbrella review was conducted in accordance with PRIOR guidelines and registered in PROSPERO. Five electronic databases were searched for eligible systematic reviews/meta-analyses. Methodological quality was assessed using AMSTAR-2, and certainty of evidence was evaluated using GRADE. Overlap of primary studies across reviews was also assessed. RESULTS: Seven systematic reviews and/or meta-analyses were included. No single caries removal technique was superior across all outcomes. SR was generally favored when pulp exposure risk was high; however, avoiding exposure did not fully ensure pulp health or eliminate pulpal complications. Post-operative pain was slightly lower with NSR compared to SW. NSR and SW may be associated with higher restorative success compared with SR. No significant differences were observed among techniques in dentin deposition/remineralization and microbial load reduction. Overall certainty of evidence ranged from low to very low, and methodological quality was moderate in only two systematic reviews and critically low in the remaining. Therefore, the findings should be interpreted with caution. CONCLUSION: Current evidence remains insufficient to recommend a gold-standard caries removal technique. Technique selection should be guided by an accurate pulpal diagnosis, the radiographic depth of the lesion, an understanding of patient-related factors, and the limitations of adhesive bonding to carious and caries-affected dentin. Further high-quality primary studies with longer follow-up are required to clarify clinical indications and the impact of removal techniques on the restorative cycle. CLINICAL SIGNIFICANCE: This umbrella review highlights that preserving pulp vitality in deep carious lesions requires more than simply avoiding pulp exposure. While selective caries removal may offer a safer biological approach by reducing exposure risk, the available evidence does not demonstrate consistent superiority relative to pulp health, restorative success, microbial reduction, or dentin remineralization outcomes. Clinicians should therefore adopt a patient-centered and diagnosis-driven approach, balancing the benefits of minimally invasive excavation with the restorative challenges of bonding to caries-affected dentin.
Applications of graphene-based quantum dots in oral healthcare: A scoping review of current evidence and future perspectives.
Huang M, Dissanayaka WL, Yiu C
J Dent · 2026 Jun · PMID 42309375 · Publisher ↗
OBJECTIVES: This review aims to provide a comprehensive overview of graphene-based quantum dots (GBQDs) in oral healthcare, focusing on their physicochemical properties tailored to the oral microenvironment, their applic...
OBJECTIVES: This review aims to provide a comprehensive overview of graphene-based quantum dots (GBQDs) in oral healthcare, focusing on their physicochemical properties tailored to the oral microenvironment, their applications in dental disease management, current research limitations, and future perspectives for clinical translation. DATA SOURCES: systematic literature search was conducted in PubMed, Web of Science, and Scopus for publications from the last 15 years up to February 2026. Keywords included "graphene quantum dots", "graphene oxide quantum dots", "dentistry", "oral", "antibacterial", "tissue regeneration", "oral cancer", and "dental materials". Manual searching of reference lists was also performed. STUDY SELECTION: From 401 initially identified records, 49 studies underwent full-text review, and 20 representative studies were included based on their relevance to the oral microenvironment and scientific contribution to the field. Studies were categorized into four key areas: antibacterial applications, tissue regeneration, oral cancer therapy, and dental material modification. CONCLUSIONS: GBQDs exhibit unique properties such as nanoscale dimensions, tunable fluorescence, high surface area for drug loading, and multimodal antibacterial mechanisms, which make them particularly suitable for the complex oral environment. Current applications span infectious disease management, tissue regeneration, oral cancer theranostics, and dental material enhancement. However, challenges remain in expanding applications beyond current focus, understanding microbial interactions, and achieving vascular and neural regeneration. Future efforts should prioritize disease-specific design, multi-species inhibition strategies, and clinical translation. CLINICAL SIGNIFICANCE: This scoping review provides clinicians and researchers with a comprehensive understanding of GBQDs' potential in dentistry, highlighting the role in targeted drug delivery, antimicrobial therapy, tissue engineering, and diagnostic imaging, thereby informing future clinical applications and research directions in nanodentistry.
Managing dentine erosion with silver diamine fluoride: An in situ study.
Chawhuaveang D, Lam WYH, Chan AKY … +2 more , Chu CH, Yu OY
J Dent · 2026 Jun · PMID 42309374 · Publisher ↗
OBJECTIVES: To evaluate anti-erosive effect and associated color change (ΔE) of 38% silver diamine fluoride (SDF) on human dentine. METHODS: A crossover in situ study involving 15 volunteers was conducted. Participants w...
OBJECTIVES: To evaluate anti-erosive effect and associated color change (ΔE) of 38% silver diamine fluoride (SDF) on human dentine. METHODS: A crossover in situ study involving 15 volunteers was conducted. Participants wore an intra-oral appliance carrying four dentine blocks for three 14-day treatment phases, separated by a 7-day washout period. Three treatments included weekly application of 38% SDF (255,000 ppmAg and 44,800 ppmF, Group SDF), daily application of stannous chloride/amine fluoride/sodium fluoride (800 ppmSn and 500 ppmF, Group SNF), and daily application of deionized water (Group DW). Appliances with dentine blocks were exposed to citric acid (pH 3.2), five daily extraoral erosive challenges. Dentine blocks were assessed for percentage surface microhardness loss (%SMHL), dentine loss, salivary pellicle morphology, crystal characteristics, dentine surface morphology, elemental composition, and ΔE by a microhardness tester, optical profilometry, atomic force microscopy (AFM), X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and spectrophotometry, respectively. RESULTS: %SMHL of the experimental groups were SDF:23.3 ± 2.4, SNF:30.2 ± 2.0 and DW:42.4 ± 2.2 (SDF<SNF<DW; p < 0.001). Dentine loss (μm) were SDF:4.2 ± 1.1, SNF: 6.1 ± 1.4, and DW:10.5 ± 1.4 (SDF<SNF<DW; p < 0.001). AFM revealed a globular appearance of the pellicle on the surfaces of Groups SDF and SNF. XRD showed the formation of silver-containing compounds in Group SDF. SEM images showed dentinal tubular occlusion in Group SDF. EDS confirmed silver deposition in Group SDF. ΔE: SDF 14.8 ± 2.4, SNF 8.1 ± 2.2, DW 4.8 ± 2.3 (SDF>SNF>DW; p < 0.001). CONCLUSION: Weekly application of 38% SDF demonstrated significantly better anti-erosive protection but caused black staining on dentine surfaces. CLINICAL SIGNIFICANCE: SDF with weekly application has been demonstrated to be effective in preventing dentine erosion, although dentine staining remains a clinical consideration.
Comparing the Effect of Scaling and Polishing on Nine Oral Health and Dental Aesthetic Measures between Current and Never Smokers from the SMILE Study Cohort.
La Rosa GRM, Kowalski J, Isola G … +5 more , Cibella F, Urso S, Tomaino E, Polosa R, SMILE Study Working Group
J Dent · 2026 Jun · PMID 42309373 · Publisher ↗
OBJECTIVES: To evaluate the short-term effects of professional scaling and polishing on nine oral health and dental aesthetic outcomes in current smokers and never smokers. METHODS: A total of 371 participants from the S...
OBJECTIVES: To evaluate the short-term effects of professional scaling and polishing on nine oral health and dental aesthetic outcomes in current smokers and never smokers. METHODS: A total of 371 participants from the SMILE Study Cohort (305 smokers and 66 never smokers) were assessed at baseline (V0) and 14 days after scaling and polishing (V1). Outcomes included Modified Gingival Index (MGI), quantitative light-induced fluorescence parameters (ΔR30, reflecting the percentage of tooth surface covered by mature plaque, and ΔR120, reflecting the percentage covered by thicker deposits including calculus), MacPherson-modified Lobene Stain Index (MLSI) for buccal and lingual surfaces, Whitening Index for Dentistry (WID), Simple Oral Hygiene score (SOH), oral health-related quality of life (OHRQoL), and general health perception (EQ-VAS). Linear mixed model analysis was used for between-group comparisons of V0-V1 changes. RESULTS: At baseline, smokers exhibited significantly worse values across all objective indices. Following intervention, significant improvements were observed in MGI, MLSI, ΔR30, ΔR120, and SOH in both groups (p<0.0001). MGI improved by a median of -0.5 units in smokers (IQR: -0.8/-0.2) and -0.08 units in never smokers (IQR: -0.3/-0.02); the magnitude of improvement was significantly greater in smokers (p<0.0001). Similarly, greater reductions in buccal MLSI (p<0.0001), lingual MLSI (p<0.0001), and ΔR120 (p=0.010) were observed in smokers compared to never smokers. WID showed no significant changes in either group. OHRQoL improved slightly without between-group differences; EQ-VAS did not change significantly. CONCLUSIONS: Professional scaling and polishing produced consistent short-term improvements in objective oral health indicators in both smokers and never smokers, with greater gains among smokers reflecting their higher baseline burden. CLINICAL SIGNIFICANCE: Regular professional mechanical plaque removal is clinically beneficial for smokers, producing measurable short-term improvements in gingival and aesthetic parameters even in the presence of ongoing tobacco exposure, although smoking cessation remains essential for long-term oral health.
Comparative evaluation of proximal caries detection methods using human, artificial intelligence, and micro-CT assessments.
Heiden G, Pereira P, Yoshida ML … +3 more , Oliveira D, Rocha M, Ribeiro APD
J Dent · 2026 Jun · PMID 42303112 · Publisher ↗
OBJECTIVE: To validate the diagnostic accuracy of ICDAS visual examination, conventional bitewing radiography, and artificial intelligence (AI)-assisted bitewing analysis (Overjet Caries Assist) for classifying proximal...
OBJECTIVE: To validate the diagnostic accuracy of ICDAS visual examination, conventional bitewing radiography, and artificial intelligence (AI)-assisted bitewing analysis (Overjet Caries Assist) for classifying proximal caries lesion depth using micro-computed tomography (micro-CT) as the reference standard. Specifically, this study evaluated: (1) reliability and inter-method agreement with micro-CT; (2) agreement between AI-assisted and human bitewing interpretation; and (3) diagnostic performance at enamel and dentin thresholds relevant to preventive and restorative decision-making. METHODS: Twenty-seven extracted human teeth representing ICDAS scores 0-6 were imaged using bitewing radiography and micro-CT. Two calibrated raters independently scored bitewing and micro-CT images using an ICDAS-analogous scale (E0-D3). AI-assisted scores were generated from the same bitewing images. Scores were categorized into four groups: sound, enamel, outer dentin, and inner dentin. Micro-CT consensus served as the reference standard. Intra-rater reliability was assessed using weighted Cohen's kappa. Inter-method agreement was evaluated using weighted kappa and Spearman's rho. Diagnostic accuracy (sensitivity and specificity) was calculated at enamel and dentin thresholds with 95% confidence intervals. Bitewing and AI performance were compared using a one-sided Wilcoxon signed-rank test (α = 0.05). RESULTS: Intra-rater agreement was high across modalities (κ = 0.93-0.94). Agreement with micro-CT was substantial for ICDAS (κ = 0.67) and bitewing (κ = 0.70), and moderate for AI (κ = 0.53). Bitewing classified lesion depth significantly more accurately than AI (p = 0.042). At the enamel threshold, bitewing and AI demonstrated 100% sensitivity, whereas ICDAS achieved 81%. At the dentin threshold, ICDAS showed 100% sensitivity and specificity, while bitewing and AI achieved sensitivities of 75% and 56%, respectively. AI and bitewing errors were exclusively under-classifications. CONCLUSIONS: No single method was superior across all diagnostic thresholds. AI-assisted and conventional bitewing imaging supported enamel-level detection, whereas ICDAS provided superior identification of dentin involvement. AI should be considered a screening adjunct rather than a standalone diagnostic method, supporting a multimodal diagnostic approach integrating visual and radiographic assessment. CLINICAL SIGNIFICANCE: AI-assisted caries detection reliably identifies proximal enamel lesions, supporting its use as a screening adjunct in preventive care workflows. However, AI demonstrated reduced sensitivity for dentin involvement and systematically underestimated lesion depth. Clinical visual examination remains essential for accurate diagnosis and treatment planning, reinforcing the value of a multimodal diagnostic approach integrating visual and radiographic assessment.
Social inequalities in the use of implant-supported prostheses among older adults: A cross-sectional study.
Drumond VZ, de Arruda JAA, Kimura ACRS … +4 more , de Andrade BAB, AlDosari M, Mesquita RA, Abreu LG
J Dent · 2026 Jun · PMID 42303111 · Publisher ↗
OBJECTIVES: To estimate the prevalence of implant-supported prostheses and examine socioeconomic and service-related inequalities among Brazilian adults, aged 65-74 years, using nationally representative data. METHODS: A...
OBJECTIVES: To estimate the prevalence of implant-supported prostheses and examine socioeconomic and service-related inequalities among Brazilian adults, aged 65-74 years, using nationally representative data. METHODS: A cross-sectional analysis was conducted using secondary data from the 2023 Brazilian Oral Health Survey (SB Brasil). Survey-weighted descriptive analyses, Rao-Scott tests, and multivariable logistic regression were applied. Inequalities were assessed using slope and relative indices of inequality for income and education. RESULTS: Among 9745 individuals, the weighted prevalence of having at least one dental implant was 21.1%, representing approximately 2.49 million individuals nationwide. Implant prevalence was highest among individuals earning ≥5 minimum wages (54.0%), recent dental service users (29.4%), those using private care (26.7%), White individuals (25.7%), and women (23.2%). Conversely, fully adjusted models revealed that the absence of implants was independently associated with the lowest household income category (≤1 minimum wage; OR=4.06, 95% CI: 2.36-6.99), infrequent dental visits (>3 years, OR=2.56; 95% CI: 1.78-3.70), reliance on public healthcare (OR=1.98, 95% CI: 1.47-2.66), Black/Brown race (OR=1.47, 95% CI: 1.10-1.97), and male sex (OR=1.40; 95% CI:1.02-1.91). Income showed the strongest and most persistent inequality gradient, whereas educational inequalities were attenuated after adjustment. Model discrimination was moderate. CONCLUSION: Access to implant-supported oral rehabilitation among older Brazilians is strongly patterned by socioeconomic position, with income appearing as the dominant determinant. CLINICAL SIGNIFICANCE: Socioeconomic disparities, particularly income, substantially influence access to implant-supported rehabilitation among older Brazilian adults. These findings highlight the need for policies that expand equitable access to advanced oral rehabilitation within public health systems.
Accuracy of impressions and framework marginal fit of implant-supported complete-arch fixed dental prostheses fabricated by using direct and indirect workflows.
Karasan D, Yilmaz B, Gouveia D … +3 more , Fehmer V, Sailer I, Çakmak G
J Dent · 2026 Jun · PMID 42289199 · Publisher ↗
OBJECTIVE: To compare the scan trueness and marginal gaps of monolithic zirconia implant-supported fixed complete prostheses (iFCPs) fabricated using direct and indirect digital workflows. In addition, to compare average...
OBJECTIVE: To compare the scan trueness and marginal gaps of monolithic zirconia implant-supported fixed complete prostheses (iFCPs) fabricated using direct and indirect digital workflows. In addition, to compare average marginal gap values of digital analysis and stereomicroscopic image analysis, performing 1-screw test, evaluating potential correlations between them. METHODS: A master model of an edentulous maxilla with four implants following the all-on-4 concept was fabricated and digitized to design a 12-unit zirconia iFCP for evaluating scan accuracy and marginal fit. Two digital workflows-direct (multi-unit abutment level intraoral scanning) and indirect (digitized stone casts from conventional impressions)-were used to design iFCPs (n=8). iFCPs were milled out of zirconia discs in a centralized milling center. Scan trueness and marginal fit were assessed using 3D analysis software through trueness evaluation and vertical gap measurements, including 1-screw test. Vertical gaps were measured also using stereomicroscope images. The scan trueness and vertical gap were analyzed with two-way ANOVA with Bonferroni post hoc, Mann-Whitney U and Dunn's tests, and Spearman's Rho was used for correlation. RESULTS: The IOS scans showed significantly higher scan body distance deviations than LBS scans overall (P ≤ 0.001) and at abutments 13 and 16, with significant effect of scanner-scan body location interactions at y- and z-axes (P ≤ 0.018). Marginal gap values at abutments 13, 16, and 23 were higher for IOS scans in both stereomicroscope and TSP analyses (P =0.038, P =0.001, and P =0.015, respectively), except at abutment 23, where similar marginal gap values were found with TSP. Positive correlations were found between scan body deviations and average gap values using both measurement methods, and between the two methods themselves. CONCLUSIONS: Indirect digital workflows resulted in superior trueness and marginal fit compared to direct digital workflows using IOS. TSP enabled marginal gap values mostly comparable and correlated to those from stereomicroscope, which revealed promising findings for the validity of the technique. CLINICAL SIGNIFICANCE: Investigated indirect digital workflow may provide superior impression trueness and marginal fit for monolithic zirconia implant-supported complete-arch fixed dental prostheses, compared with tested digital workflow, potentially reducing the risk of mechanical and biological complications related to misfit.
Digital and artificial intelligence-based screening for erosive tooth wear.
O'Toole S, Gerhardt M, Kuralt M … +4 more , Hallberg N, Kang J, Austin R, Bartlett D
J Dent · 2026 Jun · PMID 42288173 · Publisher ↗
BACKGROUND: Accurate detection of Erosive Tooth Wear (ETW) is essential for early intervention and monitoring. The Basic Erosive Wear Examination (BEWE) is frequently used clinically, yet reproducibility is limited. Digi...
BACKGROUND: Accurate detection of Erosive Tooth Wear (ETW) is essential for early intervention and monitoring. The Basic Erosive Wear Examination (BEWE) is frequently used clinically, yet reproducibility is limited. Digital intraoral scans and Artificial Intelligence (AI) may offer increased sensitivity, reduced bias, and improved diagnostic reliability. METHODS: This cross-sectional clinical study (ISRCTN16797270) recruited 61 dentate adults with mild, moderate and severe ETW, with analysis of 1600 teeth (4797 surfaces). Participants received a clinical BEWE and dentine-exposure examination by Examiner 1, followed by an intraoral scan (TRIOS 5, 3Shape A/S, Denmark). After a 2-week washout, Examiner 1, Examiner 2 and an AI assessment tool independently assessed BEWE and dentine on each scan. Twelve patients (n = 24 scans) reflecting mild, moderate and severe wear were reassessed by Examiners and the AI to determine intra-examiner repeatability. Sensitivity, specificity, and Intraclass Correlation Coefficients (ICC) were calculated at surface, tooth and patient-level. RESULTS: On-scan assessments recorded increased BEWE scores >2 (37%) than clinical examination (22.3%). On-scan assessment-clinical agreement was good (ICC 0.73-0.78). AI-clinical agreement was moderate at surface level with the AI scoring more wear than clinical examination (ICC=0.65). Tooth-level sensitivity/specificity of on-scan versus clinical scoring was 0.98/0.56 respectively. AI-clinical sensitivity/specificity was 0.85/0.68. For dentine-exposure detection, sensitivity/specificity exceeded 0.80; AI achieved 0.82/0.90. Intra-examiner and inter-examiner ICC's were 0.73-0.78 and 0.49 respectively while AI demonstrated perfect repeatability (ICC=1.00). CONCLUSION: AI-derived assessments demonstrated perfect repeatability alongside comparable sensitivity/specificity with clinical assessment and improved dentine exposure assessment. Digital and AI-derived wear assessments represent promising adjuncts for earlier diagnosis and improved monitoring of ETW. CLINICAL SIGNIFICANCE: Digital intraoral scanning combined with artificial intelligence improves the sensitivity and diagnostic consistency of identifying tooth wear. This has the potential to position them as the gold standard for wear assessment and, at the minimum, to be promising adjuncts to traditional BEWE scoring in clinical and research settings.
Adherence to core outcome set for endodontic treatments (COSET) international consensus: Two-year before/after bibliometric systematic review.
Hoppe CB, Lang PM, Dotto L … +2 more , Hartmann MSM, Grecca FS
J Dent · 2026 Jun · PMID 42285212 · Publisher ↗
OBJECTIVES: The Core Outcome Set for Endodontic Treatments (COSET) was introduced to standardize reporting and reduce outcome heterogeneity in clinical endodontic research. Despite its publication to guide both clinician...
OBJECTIVES: The Core Outcome Set for Endodontic Treatments (COSET) was introduced to standardize reporting and reduce outcome heterogeneity in clinical endodontic research. Despite its publication to guide both clinician- and patient-centred metrics, the extent of its adherence remains unexplored. This study aimed to compare the adherence of the endodontic literature to the COSET in the two-year periods preceding and following its publication, and to assess compliance among studies citing the guidelines. DATA AND STUDY SELECTION: A bibliometric systematic review was conducted comparing clinical studies published before (2022-2023) and after (2024-2025) the COSET publication. Adherence to the eight core domains (pain, signs of infection, further intervention, tenderness to percussion/palpation, radiographic healing, function, tooth survival, and patient satisfaction) was quantitatively scored. A secondary analysis evaluated documents citing COSET. Methodological quality used standard risk of bias tools. REGISTRATION: PROSPERO CRD420251122526. RESULTS: Overall adherence to the core domains did not improve post-publication, exhibiting a slight decrease from 52.4% (n = 26 studies) to 50.7% (n = 37 studies). While radiographic healing was universally reported (100%), fundamental clinical parameters such as pain declined to 73.0% and signs of infection declined to 70.3% of reporting. Crucial patient-centred metrics, including strict tooth survival (10.8%) and patient satisfaction (2.7%), remained neglected. Furthermore, citing studies revealed selective reporting rather than full eight-domain integration. The risk of bias shifted from "Serious Risk" to "Moderate Risk" after COSET. CONCLUSION: COSET publication has not yet standardized endodontic outcome reporting. However, due to the brief two-year post-publication window (2024-2025) this bibliometric analysis may serve as a foundational baseline for future evaluations of adoption rates. CLINICAL RELEVANCE: Critical aspects remain neglected, and selective compliance persists highlighting the need for COSET broader adherence.
Accuracy of conventional impression versus direct digital scanning strategies for CAD-CAM post-and-core restorations in dual-post molars: A combined clinical and in vitro study.
Luo Y, Wei X, Yang S … +3 more , Liang Q, Wu Z, Miao X
J Dent · 2026 Jun · PMID 42285211 · Publisher ↗
OBJECTIVES: To compare the accuracy of different acquisition strategies for CAD-CAM post-and-core restorations in molars with dual post spaces and to explore the underlying technique-specific error mechanisms. METHODS: T...
OBJECTIVES: To compare the accuracy of different acquisition strategies for CAD-CAM post-and-core restorations in molars with dual post spaces and to explore the underlying technique-specific error mechanisms. METHODS: Three representative molar cases were selected in which CAD-CAM glass fiber post-and-core restorations fabricated from conventional quadrant impressions showed poor seating, marginal discrepancy, or optimal adaptation. Three-dimensional printed models derived from these cases were used for controlled in vitro evaluation. Four polyvinyl siloxane (PVS) impression techniques were tested using quadrant or single-tooth trays, with or without impression posts, and two direct digital scanning approaches were evaluated using Primescan and Trios 3 scanners. Accuracy was assessed qualitatively and quantitatively using depth difference (Δdepth), apical deviation, and root mean square (RMS) values. RESULTS: PVS impressions without impression posts and direct Primescan scanning demonstrated the highest trueness and repeatability. In pooled analysis, these methods showed median Δdepth values of 0.02-0.04 mm and median RMS values of 59-65 μm, with apical deviation values remaining low at 0.00-0.06 mm. In contrast, PVS impressions incorporating impression posts were associated with greater distortion, with median Δdepth values of 0.25-0.37 mm, median apical deviation values of 0.20-0.32 mm, and median RMS values of 113-137 μm. Direct Trios 3 scanning showed a different error pattern, characterized by incomplete apical capture and increased overall deviation, with median Δdepth value of 0.31 mm and median RMS value of 83 μm despite relatively small median apical deviation value. CONCLUSIONS: In dual-post molars, PVS impressions without impression posts and direct Primescan scanning provide the most reliable acquisition accuracy. Routine use of impression posts may introduce removal-induced distortion and should be applied selectively. Conventional impressions and direct digital workflows are affected by distinct mechanical and optical limitations, respectively. CLINICAL SIGNIFICANCE: For CAD-CAM post-and-core restorations in dual-post molars, PVS impressions without impression posts and direct Primescan scanning may represent suitable strategies for improving acquisition accuracy and restoration adaptation, which may support long-term tooth preservation.
Digitally Guided Transcrestal Sinus Floor Elevation Using Collagenated Synthetic Hydroxyapatite or Collagenated Xenograft: Histologic and Volumetric Comparison.
Canullo L, Savadori P, Mura R … +5 more , Triestino A, Bixio F, Sora VM, Consolo U, Stacchi C
J Dent · 2026 Jun · PMID 42285210 · Publisher ↗
OBJECTIVES: This study evaluated clinical, radiographic, and histological outcomes after digitally guided transcrestal maxillary sinus floor elevation using two bone substitutes: a composite of cross-linked collagen with...
OBJECTIVES: This study evaluated clinical, radiographic, and histological outcomes after digitally guided transcrestal maxillary sinus floor elevation using two bone substitutes: a composite of cross-linked collagen with synthetic hydroxyapatite (test) and a collagen-enriched bovine-derived bone substitute (control). METHODS: In a prospective controlled trial, 26 patients with <5 mm residual bone height underwent digitally guided transcrestal sinus augmentation using test or control biomaterial, followed by staged implant placement after six months (T1). Bone cores were harvested during implant site preparation for histological analysis using a dedicated surgical guide. Radiographic volumetric and linear changes were evaluated on pre- and post-operative CBCT scans. Data were analyzed using Mann-Whitney U-test, Kruskal-Wallis, and Fisher's exact tests. RESULTS: At T1 both groups achieved significant graft volume gain with no intergroup difference. The test group showed a higher percentage of newly-formed bone (31.6 ± 21.6% vs. 18.2 ± 16.0%; p = 0.004) and lower residual graft (2.2 ± 6.3% vs. 6.2 ± 6.8%; p = 0.003). Inflammatory infiltration was lower in the test group (p < 0.001). Significant differences in residual graft distribution among biopsy regions were found only in the test group (p = 0.03). CONCLUSIONS: The cross-linked collagen/synthetic hydroxyapatite scaffold promoted greater bone regeneration with lower graft remnants than the collagen-enriched xenograft. The digital workflow was used to standardize surgical planning, guided crestal access, biopsy harvesting, and implant placement, supporting procedural consistency in the histological assessment. CLINICAL SIGNIFICANCE: Both biomaterials supported bone regeneration after staged transcrestal sinus floor elevation. The synthetic hydroxyapatite scaffold showed more newly-formed bone and a lower percentage of area occupied by residual graft material at 6 months, but the clinical significance of these preliminary findings requires confirmation in larger randomized studies with long-term follow-up.
Accuracy of full-arch digital implant impression and bite registration: effect of different reference object strategies and intraoral scanners.
Rutkūnas V, Kubilius A, Akulauskas M … +4 more , Borbély J, Kispélyi B, Vitai V, Stasiūnas D
J Dent · 2026 Jun · PMID 42285209 · Publisher ↗
OBJECTIVES: This in vitro study evaluated the accuracy of digital impressions for full-arch implantsupported restorations by assessing scan body (SB) positional accuracy and inter-arch registration under different intrao...
OBJECTIVES: This in vitro study evaluated the accuracy of digital impressions for full-arch implantsupported restorations by assessing scan body (SB) positional accuracy and inter-arch registration under different intraoral scanners (IOS) and scan protocol conditions. MATERIALS AND METHODS: Two IOSs (Medit i700 and Trios 5) were evaluated across multiple protocols. In Part A, SB trueness and precision were investigated using three inter-implant distances (1-2, 1-3, 1-4) and angulations across five groups (n=10 each), with and without reference objects (ROs) on an edentulous maxillary model. In Part B, inter-arch distance accuracy was evaluated with the help of four sphere pairs used in the same upper edentulous arch with implants and a dentated mandibular model in an articulator using six scanning protocols, including one- and two-step bite registration. Trueness and precision were analyzed using linear mixed-effects models for each data type. RESULTS: In Part A, Medit i700 with ROs (A-M700-RO) showed the highest trueness and precision in both linear and angular SB measurements. RO use significantly improved performance, particularly for Trios 5. Angular deviation was lowest in A-M700-RO, especially in distal segments (mean difference -0.24°, p < 0.05). In Part B, Trios 5 with a two-step RO bite registration (B-T5-RO-1) had the highest inter-arch accuracy, especially in molar regions. Accuracy in this group was significantly higher than all other groups (p < 0.01). CONCLUSION: Digital impression accuracy is influenced by both the scanner type and scanning protocol. Additional reference objects improved the accuracy of distance measurements but did not significantly affect measurements of angulation. Medit i700 outperforms in SB accuracy, while Trios 5 excels in inter-arch registration when combined with ROs and a two-step protocol. CLINICAL SIGNIFICANCE: Additional reference objects may improve the digital implant impressions' distance accuracy, although they do not significantly affect angulation outcomes.
Color change over time in one-shade composite restorations of non-carious cervical lesions after in-office dental bleaching: A controlled clinical trial.
Favoreto MW, Barbosa LMM, Matos TP … +5 more , Mayer-Santos E, Medeiros JR, Trevelin LT, Reis A, Loguercio AD
J Dent · 2026 Jun · PMID 42285208 · Publisher ↗
OBJECTIVES: This double-blind and split-mouth randomized controlled trial evaluated color change progression in non-carious cervical lesions (NCCLs) restored with one-shade or multi-shade resin composites following in-of...
OBJECTIVES: This double-blind and split-mouth randomized controlled trial evaluated color change progression in non-carious cervical lesions (NCCLs) restored with one-shade or multi-shade resin composites following in-office dental bleaching. METHODS AND MATERIALS: Eighty-four NCCLs were restored using one-shade (Vittra Unique, FGM) or multi-shade (Vittra APS, FGM) resin composites (n = 42). Each participant received two restorations (one per hemiarch). Afterward, two sessions of in-office bleaching with 35% hydrogen peroxide were performed. Color progression was assessed using WI, ΔE, and ΔE at baseline, after each bleaching session, and one-month post-bleaching. Color matching between the cervical (restoration) and middle (adjacent tooth structure) thirds was also evaluated. Secondary outcomes included tooth sensitivity and clinical performance according to FDI criteria. Data were analyzed using paired t-tests, linear mixed models, and the McNemar test (α = 0.05). RESULTS: In the middle third, no differences between materials were observed for any color parameter (p > 0.05). In the cervical third, the one-shade composite showed higher WI values over time than the multi-shade composite (p < 0.05), whereas no differences were observed for ΔE or ΔE progression (p > 0.05). After one month, the multi-shade composite showed greater color mismatch than the one-shade composite (p < 0.05). Tooth sensitivity did not differ between groups (p = 1.00). All restorations were classified as clinically very good according to FDI criteria. CONCLUSION: The one-shade composite showed greater whitening progression in the restored cervical area and lower color mismatch after bleaching, while both materials presented similar short-term clinical performance and participant-related outcomes. CLINICAL SIGNIFICANCE: The single-shade composite may promote greater short-term whitening progression in the restored cervical area and improved color matching performance after in-office bleaching compared with multi-shade composites in NCCLs. Clinically, this may support minimally invasive approaches by reducing the need for restoration replacement and preserving tooth structure.
Comparative Analysis of Monomer Elution, Polymerization Efficiency, Mechanical Properties and Biocompatibility of 3D-Printed Provisional and Permanent Dental Resins.
Intarak N, Prommanee S, Somkana S … +5 more , Srijunbarl A, Kamnoedboon P, Khan AS, Porntaveetus T, Srinivasan M
J Dent · 2026 Jun · PMID 42285207 · Publisher ↗
OBJECTIVE: This study compared monomer elution, degree of conversion, mechanical performance, and cytocompatibility of 3D-printed dental resins used for crown and denture-base applications. METHODS: Four 3D-printed resin...
OBJECTIVE: This study compared monomer elution, degree of conversion, mechanical performance, and cytocompatibility of 3D-printed dental resins used for crown and denture-base applications. METHODS: Four 3D-printed resins: provisional-crown (DTO), permanent-crown (CT), denture-base (DB), and permanent denture-base (DTT) (n=7 per group). Elution of Tri-ethylene glycol methacrylate (TEGDMA), Urethane dimethacrylate (UDMA), Hydroxyethyl methacrylate (HEMA), and Ethoxylated bisphenol-A dimethacrylate (Bis-EMA) into artificial saliva was quantified using Liquid chromatography-mass spectrometry (LC-MS). Fourier-transform infrared spectroscopy (FT-IR) spectroscopy evaluated the polymerization efficiency. Mechanical properties were evaluated using nanoindentation and three-point bending tests. Cytocompatibility was determined by exposing primary human gingival fibroblasts (HGFs) to resin extracts using an MTT assay. Statistical significance was set at α=0.05. RESULTS: All materials achieved a high degree of conversion (>90%). DTO released significantly higher amounts of UDMA, TEGDMA, and HEMA than CT (p<0.0001, p=0.0011, and p=0.0001, respectively). CT and DTT showed higher nano-hardness and elastic modulus than DB and DTO. DB exhibited higher flexural strength and modulus than DTT (p=0.0423 and p=0.0147, respectively). DTO showed the lowest HGF viability (20.98±5.73%), which was significantly lower than CT (43.55±8.18%; p<0.0001), DB (38.80±9.52%; p=0.0007), and DTT (41.53±3.71%; p<0.0001), consistent with its higher monomer elution. CONCLUSIONS: Within the limitations of the study, it can be concluded that the performance of 3D-printed denture resins varies according to the resin material used. DTO demonstrated the highest monomer elution and the lowest HGF viability, while permanent materials generally had superior nano-hardness and elastic modulus. DB also outperformed DTT in flexural properties. CLINICAL SIGNIFICANCE: Material selection for 3D-printed denture crowns and bases should be considered by combined chemical, mechanical, and biological performance. Careful post-processing and indication-specific material selection are essential to reduce residual monomer-related biological risks and optimize clinical durability.
Fracture force and marginal adaptation of additively fabricated resin composite crowns.
Edelmann N, Hahnel S, Rauch A … +2 more , Fleiner FJ, Rosentritt M
J Dent · 2026 Jun · PMID 42276514 · Publisher ↗
OBJECTIVES: The aim of this study was to compare the in vitro performance and marginal adaptation of additively fabricated resin-based composite molar crowns. MATERIALS AND METHODS: Molar crowns (n = 8 per group, 9 group...
OBJECTIVES: The aim of this study was to compare the in vitro performance and marginal adaptation of additively fabricated resin-based composite molar crowns. MATERIALS AND METHODS: Molar crowns (n = 8 per group, 9 groups) were 3D-printed from materials for temporary or permanent application. Milled resin based composite crowns were used as a reference. All crowns were adhesively bonded on prepared extracted human molars. Thermal cycling and mechanical loading (TCML) were performed and fracture force was determined. Marginal adaptation was evaluated before and after TCML based on images of the cement gap. STATISTICS: one-way ANOVA, Bonferroni post-hoc-test (α = 0.05). RESULTS: All crowns survived TCML without failures. Fracture forces of the additively manufactured crowns varied between 1707.9 ± 470.2 N and 2839.6 ± 682.1 N (Reference: 3121.8 ± 557.1 N). Statistical analyses revealed significant (p ≤ 0.004) individual differences. Fracture pattern was characterized as a fracture of the crown, partially combined with a fracture of the tooth. No visible differences were found in the assessment of margin quality before and after chewing simulation. Signs of wear and scratches were visible at the contact points, but the transitions between the contact points and the crown surface showed no cracks or defects. The perfect margin of the additively manufactured crowns varied between 97.8 % and 100.0 %, before TCML, and between 92.3 % and 99.0 % after TCML. CONCLUSION: 3D-printed molar crowns provided sufficient to good in vitro performance and fracture force. Good marginal adaptation was not negatively influenced by in vitro aging. CLINICAL RELEVANCE: Additively manufactured resin molar crowns on human teeth show adequate fracture resistance, moderate wear, and acceptable marginal adaptation, indicating potential suitability for posterior restorations.
Large Language Models and Retrieval-Augmented Platforms for Dental Implant Complications: A Blinded, Expert-Rated Benchmarking Study.
Mayer Y, Canullo L, Kivovics M … +3 more , Giladi HZ, Gabay E, Ginesin O
J Dent · 2026 Jun · PMID 42269758 · Publisher ↗
OBJECTIVES: To compare expert-rated diagnostic accuracy, patient safety, completeness of management, and freedom from detectable hallucinations across eleven conversational artificial-intelligence (AI) platforms (general...
OBJECTIVES: To compare expert-rated diagnostic accuracy, patient safety, completeness of management, and freedom from detectable hallucinations across eleven conversational artificial-intelligence (AI) platforms (general-purpose large language models [LLMs], a general-purpose retrieval-augmented [RAG] platform, and a medical-domain RAG platform) using synthetic vignettes of dental implant complications. METHODS: Thirty vignettes (10 surgical, 10 biological, 10 mechanical/prosthetic) were submitted as independent prompts to each platform. Four blinded specialists (periodontists or oral and maxillofacial surgeons, >10 years' implant experience) scored each response on a 5-point Likert scale across four parameters. Friedman tests (Kendall's W effect size) assessed ordinal scores, and Cochran's Q tested two binary outcomes: safe (Safety ≥ 4) and hallucination-free (Hallucinations ≥ 4). RESULTS: Across 330 responses (1,320 ratings), OpenEvidence achieved 100% safe and 100% hallucination-free responses. Among general-purpose platforms, safe rates ranged from 56.7% (Claude 4.5 Haiku) to 86.7% (Perplexity) and hallucination-free rates from 36.7% (Claude 4.5 Haiku) to 93.3% (GPT-5.4 Thinking; Qwen 3.5-Plus), both significant (Cochran's Q, p < 0.01). Friedman tests were significant for every parameter (lowest p = 1.7 × 10⁻¹⁵; Kendall's W 0.126-0.293). OpenEvidence had the highest composite score (4.90 ± 0.18), with the largest effects in the mechanical/prosthetic subcategory (W = 0.548, large). CONCLUSIONS: Within a vignette-based design, the medical-domain RAG platform (OpenEvidence) achieved the highest ratings across all domains, with Perplexity second; among general-purpose LLMs, GPT-5.4 Thinking, Claude Opus, and Mistral led. These findings reflect performance under tested conditions, not real-world efficacy. All platforms should serve as adjuncts to specialist judgement, and prospective validation is required before clinical deployment. CLINICAL SIGNIFICANCE: Retrieval-augmented platforms grounded in peer-reviewed literature earned higher expert ratings than general-purpose LLMs, with the medical-domain platform OpenEvidence rated 100% safe and hallucination-free. Inter-model gaps were largest for mechanical/prosthetic cases; specialist verification remains essential before clinical use.
Colour change, stability, sensitivity and patient satisfaction after combined in-office and at-home bleaching with 6% hydrogen peroxide: A longitudinal study.
Portillo Muñoz M, Lobato M, MartínCasado AM … +2 more , Loguercio A, Gómez-Polo C
J Dent · 2026 Jun · PMID 42264291 · Publisher ↗
INTRODUCTION: Combined in-office and at-home tooth bleaching protocols using hydrogen peroxide (HP) have been proposed to enhance colour stability while maintaining tolerability. However, evidence on the short-term colou...
INTRODUCTION: Combined in-office and at-home tooth bleaching protocols using hydrogen peroxide (HP) have been proposed to enhance colour stability while maintaining tolerability. However, evidence on the short-term colour stability of at-home bleaching with 6% HP remains limited. OBJECTIVES: To evaluate: (1) the whitening effect of a 6% HP gel applied for 30 minutes per day over 30 days; (2) colour stability at 30 days after treatment completion; (3) dental sensitivity at the 30-day follow-up according to gender and prior in-office bleaching time (20 vs 40 min); and (4) patient satisfaction. METHODS: This study included 69 participants previously treated with two in-office sessions using 35% HP (20 or 40 min). All participants subsequently used a 6% HP gel with custom trays for 30 days. Tooth colour was measured instrumentally (CIELAB; ΔE and ΔE₀₀) at baseline after in-office bleaching (T0), immediately after at-home treatment (T1), and 30 days later (T2). Dental sensitivity and patient satisfaction (VAS 0-10) were recorded at T2. Paired t-tests and Mann-Whitney U tests were applied (α = 0.05). RESULTS: During the active bleaching phase (T0-T1), colour changes were pronounced: b* decreased significantly, especially in the incisal third, and both ΔEab and ΔE₀₀ exceeded perceptibility thresholds in most participants. In contrast, during the post-treatment period (T1-T2), changes were markedly smaller: colour coordinates showed only minor variations, indicating short-term stability, although perceptible differences still occurred in a subset of cases. Median dental sensitivity at 30 days was low (3/10), with no significant differences according to gender or prior in-office bleaching time (P > 0.05). Patient satisfaction was high (median=9/10), with no differences between groups. CONCLUSIONS: Across the 30-day at-home bleaching protocol with 6% hydrogen peroxide, colour coordinates showed measurable changes compared with the end of the in-office phase. At 30 days, many participants presented perceptible colour differences relative to T0-T1. During the subsequent month without treatment, variations were smaller and generally limited in magnitude. Dental sensitivity remained low and patient satisfaction high. No significant differences were found between the two in-office exposure times (20 vs 40 minutes) in terms of sensitivity, or satisfaction. CLINICAL SIGNIFICANCE: At-home bleaching with 6% HP applied for 30 min did not stabilise the whitening achieved with prior in-office treatment and was frequently associated with perceptible colour relapse. The greatest reduction in whitening effect appeared to occur within the first month after in-office bleaching, even when complemented with low-concentration at-home treatment, after which colour tended to remain relatively stable.
Clinical and patient-related factors influencing postoperative pain and oral health-related quality of life after emergency endodontic treatment: a prospective observational study.
Thep-Akrapong P, Jearanaiphaisarn T, Chivatxaranukul P … +2 more , Lertchirakarn V, Sinsareekul C
J Dent · 2026 Jun · PMID 42263928 · Publisher ↗
OBJECTIVES: This prospective study aimed (i) to evaluate postoperative pain intensity and Oral Health-Related Quality of Life (OHRQoL) following emergency endodontic treatment, and (ii) to identify clinical- and patient-...
OBJECTIVES: This prospective study aimed (i) to evaluate postoperative pain intensity and Oral Health-Related Quality of Life (OHRQoL) following emergency endodontic treatment, and (ii) to identify clinical- and patient-related factors associated with pain and changes in OHRQoL. METHODS: Patients presenting with moderate to severe endodontic pain (Numerical Rating Scale, NRS ≥ 4) were enrolled. After recording baseline NRS and Oral Health Impact Profile-14 (OHIP-14) scores, participants underwent access opening followed by no, partial, or complete root canal debridement. Pain intensity and OHRQoL were reassessed at 1, 2, and 7 days postoperatively. These outcomes across time intervals were analyzed using Friedman test. Linear regression analysis was performed to identify factors associated with pain and changes in OHRQoL. (p < 0.05). RESULTS: A total of 110 patients were enrolled, of whom 96 completed the study. Postoperative pain and OHRQoL improved significantly over time (p < 0.001), with the greatest pain reduction occurring within 24 h. Pain reduction and OHRQoL improvement were positively correlated (r = 0.645, p < 0.001). Preoperative pain severity significantly predicted higher postoperative pain levels (p < 0.05). Greater OHRQoL improvement was significantly associated with severe preoperative pain and complete root canal debridement (p < 0.05). CONCLUSIONS: Emergency endodontic treatment significantly reduced postoperative pain and improved OHRQoL within one week. Pain reduction was strongly associated with OHRQoL improvement. Preoperative pain severity was a significant determinant of postoperative pain intensity and was also associated with changes in OHRQoL. Complete root canal debridement contributed to better quality of life. CLINICAL SIGNIFICANCE: Emergency endodontic treatment rapidly reduces postoperative pain and improves oral health-related quality of life within one week. Greater pain reduction is closely linked to better OHRQoL outcomes. Preoperative pain severity predicts postoperative recovery, while thorough root canal debridement contributes to more favorable patient-reported quality-of-life improvements.
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