Journal Of Dentistry[JOURNAL]
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200 papers
Survey on the acceptability of digital impression procedures in care-dependent older adults in Zurich: an exploratory study.
Baumgartner S, Srinivasan M
J Dent · 2026 Jun · PMID 42242611 · Publisher ↗
OBJECTIVE: This study aimed to evaluate older adults' attitudes toward digital impressions compared with conventional alginate impressions, and to assess time efficiency and cost implications of both techniques. METHODS:...
OBJECTIVE: This study aimed to evaluate older adults' attitudes toward digital impressions compared with conventional alginate impressions, and to assess time efficiency and cost implications of both techniques. METHODS: Older adults receiving domiciliary dental care were requested to participate in this study. Each participant received both a digital intraoral scan (IOS) and a conventional alginate impression. Acceptability and preference were assessed using a 9-item Visual Analog Scale (VAS) questionnaire evaluating comfort, breathing difficulty, gag reflex, sensitivity, time perception, tray/scanner size, taste/smell, overall preference, and recommendation to others. Time required for the procedures along with billed and unbilled costs were recorded. Statistical analyses were performed using t-tests (α = 0.05). RESULTS: Sixteen older adults (mean age 87.6 ± 7.7 years; MMSE 26.8 ± 6.1) participated in this study. Participants demonstrated a clear preference for IOS in most domains. The overall VAS score was significantly higher for IOS (88.5 ± 7.1) compared with conventional impressions (74.7 ± 13.6; p < 0.001). IOS was rated superior regarding comfort (p < 0.001), recommendation to others (p = 0.001), time perception (p = 0.003), breathing (p = 0.004), and gag reflex (p = 0.027). Sensitivity was not significant (p = 0.051). Total procedure time was comparable for the maxilla, but slightly longer for mandibular IOS (p = 0.031). Billed costs were identical however, IOS required four repetitions, resulting in additional unbilled costs (CHF 167.20). CONCLUSION: Care-dependent older adults preferred digital impressions over conventional alginate techniques. Digital impressions may offer patient-centered advantages in selected geriatric contexts and may be considered a favorable approach in geriatric dental care, provided workflow efficiency is optimized. CLINICAL SIGNIFICANCE: Digital impression techniques may enhance patient cooperation and clinical experience in very old adults, particularly by reducing patient discomfort and in increasing patient compliance. However, clinicians should anticipate potential workflow inefficiencies and repetition-related costs, highlighting the need for optimized scanning protocols when integrating digital approaches into geriatric prosthodontic care.
Adapting to life with removable dentures in Japan: A qualitative study of patients' daily experiences.
Kim MJ, Okuhara T
J Dent · 2026 Jun · PMID 42235676 · Publisher ↗
BACKGROUND: Tooth loss affects not only oral function but also sociopsychological well-being. Although quantitative studies have assessed these effects, patients' subjective experiences remain underexplored. This study q...
BACKGROUND: Tooth loss affects not only oral function but also sociopsychological well-being. Although quantitative studies have assessed these effects, patients' subjective experiences remain underexplored. This study qualitatively described the daily denture adaptation process, identifying difficulties, coping strategies, and the dentists' role in providing foundational knowledge for patient support. METHODS: Using reflexive thematic analysis, 11 participants (aged 18+) with current or past denture experience were recruited from a domiciliary dental clinic. Data were collected through semi-structured interviews. RESULTS: Five themes describing the post-delivery adaptation process emerged. The participants initially experienced social difficulties owing to unfamiliar "foreign body" sensations. Through psychological acceptance and physical trial-and-error, they developed a subjective sense of adaptation. The findings revealed that patients do not merely modify food choices, but actively engage in self-training, such as adjusting denture positioning and fine-tuning physical sensations at home. A trusting relationship with dental professionals functioned as a continuous resource supporting this process rather than just a satisfaction factor. Specifically, a secure environment for communicating symptoms is essential for developing a sense of subjective fit that is distinct from objective clinical fit. CONCLUSION: Denture adaptation is a temporal process that transitions from unfamiliarity to a subjective sense of fit. Trusting relationships with clinicians serve as the foundation for both psychological and physical adaptation. CLINICAL SIGNIFICANCE: This paper underscores the necessity of individualized support that addresses the patient's subjective adjustment in removable dentures. Effective patient support requires fostering trust and providing individualized guidance to facilitate subjective comfort.
Comparison of implant stability and peri-implant bone changes following simultaneous lateral sinus floor elevation: A prospective randomized clinical study.
Gai L, Wang X, Yu H … +3 more , Wang S, Chen X, He F
J Dent · 2026 Jun · PMID 42235675 · Publisher ↗
OBJECTIVE: To compare implant stability and peri‑implant bone changes between two bone-level implant systems placed simultaneously with lateral sinus floor elevation (LSFE) in the posterior maxilla. MATERIALS AND METHODS...
OBJECTIVE: To compare implant stability and peri‑implant bone changes between two bone-level implant systems placed simultaneously with lateral sinus floor elevation (LSFE) in the posterior maxilla. MATERIALS AND METHODS: Sixty patients requiring LSFE with simultaneous implant placement were enrolled in this prospective, randomized clinical study. A total of 92 implants were placed: a predominantly cylindrical implant with a mild apical taper (test group, n = 48) and a parallel-walled cylindrical implant (control group, n = 44). Implant stability quotient (ISQ) values were recorded at placement (T1) and after 6 months of healing (T2). Cone-beam computed tomography was used to assess endo-sinus bone gain (ESBG), marginal bone loss (MBL), and three-dimensional bone-volume (BV) changes. Generalized estimating equations were applied to adjust for clustering of multiple implants within individual patients. RESULTS: All implants healed without complications, yielding a 100% survival rate. The test implant showed higher primary stability than the control implant at T1 (70.48 ± 8.02 vs. 55.04 ± 12.47, p < 0.001). Both groups demonstrated increased ISQ values over 6 months, with a modest but statistically significant difference at T2 (80.83 ± 3.43 vs. 78.98 ± 4.18, p = 0.038). No significant differences were observed between groups in ESBG, MBL, BV, or BV resorption rate at any time point. CONCLUSIONS: Within the limitations of this short-term study, both implant systems showed favorable early outcomes following simultaneous lateral sinus floor elevation. The implant system with a mild apical taper showed higher primary and secondary stability in posterior maxillary sites with limited residual bone height. CLINICAL SIGNIFICANCE STATEMENT: In sites undergoing simultaneous LSFE, implants featuring a mildly tapered apex deliver greater primary stability, whereas early secondary stability and peri‑implant bone remodeling are comparable between the two groups. These results confirm that both implant systems achieve predictable short-term outcomes in posterior maxillary sites with limited bone volume. CLINICAL TRIAL REGISTRATION: Clinical Trials.Gov, ChiCTR2100042169.
The use of quality-of-life questionnaires in the assessment and management of dentin hypersensitivity: A systematic literature review.
V Q, S D
J Dent · 2026 Jun · PMID 42225223 · Publisher ↗
INTRODUCTION/OBJECTIVES: Dentin hypersensitivity (DH) negatively affects daily functioning and oral health-related quality of life (OHRQoL). This systematic literature review aimed identifing OHRQoL questionnaires used i...
INTRODUCTION/OBJECTIVES: Dentin hypersensitivity (DH) negatively affects daily functioning and oral health-related quality of life (OHRQoL). This systematic literature review aimed identifing OHRQoL questionnaires used in DH research (children, adolescent and/or adults) and describing their contexts of use and associated diagnostic criteria. DATA: Studies (interventional and observational) evaluating DH using OHRQoL questionnaires. SOURCES: Electronic searches were conducted in January 2026 in PubMed/MEDLINE, Scopus, Web of Science, EMBASE, the Cochrane Library and Google Scholar without restriction on publication date. STUDY SELECTION: Studies published in English that assessed DH using an OHRQoL questionnaire were included. Titles and abstracts were independently screened by two reviewers, followed by full-text assessment according to predefined eligibility criteria. RESULTS: Five OHRQoL questionnaires were identified, with Dentine Hypersensitivity Experience Questionnaire and Oral Health Impact Profile being the most frequently used. DH was most frequently diagnosed using evaporative stimulation, with pain intensity commonly assessed using visual analogue scales or Schiff score. Considerable heterogeneity was observed in OHRQoL questionnaires and diagnostic methods across studies. CONCLUSIONS: This review shows a need for standardisation in DH studies in terms of OHRQoL questionnaires and diagnosis tools; such standardisation would allow comparisons between DH studies, as DH is of particular interest nowadays with an increasing number of surveys (prevention, diagnosis, management, quality of life). CLINICAL SIGNIFICANCE: DH substantially affects patients' daily activities and well-being. Understanding how OHRQoL questionnaires are used in DH research may help clinicians and researchers select appropriate patient-reported outcome measures and improve treatment effectiveness and patient-centred care evaluation in clinical practice.
External validation of a mHealth tool for detecting gingival inflammation in community-dwelling older adults.
Chau RCW, Gong Z, Cheng ACC … +11 more , Mao K, Thu KM, Zhang R, Ling Z, Chang TH, Tan HJ, Tsang HS, Tonetti MS, Schwendicke F, Hsung RT, Lam WYH
J Dent · 2026 May · PMID 42217746 · Publisher ↗
OBJECTIVE: This study aimed to externally validate the screening performance of a pro-social (equitable, accessible), explainable AI (XAI)-guided mobile health (mHealth) tool, GumAI, that automated the analysis of smartp...
OBJECTIVE: This study aimed to externally validate the screening performance of a pro-social (equitable, accessible), explainable AI (XAI)-guided mobile health (mHealth) tool, GumAI, that automated the analysis of smartphone photographs to detect signs of gingival inflammation in community-dwelling older adults, a condition that is common yet often undiagnosed due to limited access to dental care. MATERIAL AND METHODS: Older adults (age 60+) were recruited from nine community centres. Frontal intraoral photographs were captured with smartphones and evaluated using an mHealth tool that classified gingival regions as "no inflammation" (health) in green, "mild changes/questionable" in yellow, or "inflamed" (diseased) in red at the pixel level. In this study, the screening performance was validated only for visible anterior teeth. Two calibrated periodontists independently assessed these photographs, annotated the regions of healthy/mild changes/questionable/diseased, and served as the benchmark for comparison. Performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, F1-score, and mean intersection over union (mIOU), were calculated by comparing the AI outputs to the benchmark. RESULTS: Of 262 invited older adults, 163 (62.21%) participated, and each centre recruited 17-44 participants. Inter-rater agreement between periodontists was substantial (Prevalence- and Bias-Adjusted Kappa (PABAK) = 0.62). GumAI exhibited sensitivity of 0.91 (95% CI 0.91-0.92), specificity of 0.87 (95% CI 0.87-0.87), PPV of 0.90 (95% CI 0.89-0.90), NPV of 0.89 (95% CI 0.89-0.89), accuracy of 0.89 (95% CI 0.89-0.89), F1-score of 0.90, and mIOU of 0.83. CONCLUSION: The mHealth tool demonstrated potential to detect visual signs of gingival inflammation in intraoral photographs of older adults in a community setting, with results comparable to those of periodontists' visual annotations. This supports its utility as a pro-social XAI screening solution for scalable, community-based oral health promotion, warranting further refinement and validation against clinical probing. CLINICAL SIGNIFICANCE: The mHealth tool enables non-invasive, readily accessible, and near-real-time detection of visual signs of gingival inflammation in intraoral photographs. This approach may facilitate early identification of individuals who require referral, support, home care reinforcement, and enable timely intervention for underserved older adults in community settings. Further clinical studies, including validation against periodontal probing, are needed to fully evaluate its potential to promote oral health through scalable community-based screening.
Corrigendum to "Temporal Trends in Large Language Model (LLM) Accuracy: A Meta-Analysis of Multiple-Choice Question Performance in Dentistry and Dental Education" [Journal of Dentistry 171 (2026) 106724].
Doubleday AF, Cheverko CM, Bolgova O … +24 more , Mavrych V, Mohamed FRR, Westrick J, Juarez L, Rush E, Solka KA, Byram JN, Becker R, Gomez V, Ganeng BKA, Hoffman LA, Roach VA, Brown KM, DeVaul N, Garnett CN, Herriott HL, Lufler RS, Mussell JC, Balta JY, Pascoe MA, Middleton JW, Duffy S, Stephens GC, Wilson AB
J Dent · 2026 Sep · PMID 42215383 · Publisher ↗
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Activated irrigation systems and postoperative pain after single-visit root canal treatment: A network meta-analysis.
Kohok MA, Pawar AM, Mandwe A … +2 more , Banga KS, Karobari MI
J Dent · 2026 May · PMID 42214656 · Publisher ↗
OBJECTIVE: To evaluate the comparative effect of irrigation activation systems on postoperative pain after single-visit nonsurgical root canal treatment using a systematic review and network meta-analysis. METHODS: A sys...
OBJECTIVE: To evaluate the comparative effect of irrigation activation systems on postoperative pain after single-visit nonsurgical root canal treatment using a systematic review and network meta-analysis. METHODS: A systematic search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, and clinical trial registries was conducted in accordance with PRISMA-NMA recommendations. Randomized and quasi-randomized clinical trials evaluating postoperative pain after single-visit root canal treatment with different irrigation activation protocols were considered eligible. The primary outcome was 24-h postoperative pain intensity. Secondary outcomes included pain at other postoperative time points, analgesic intake, flare-up incidence, and categorical pain severity. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence was assessed using the GRADE framework. A frequentist random-effects network meta-analysis was performed using standardized mean differences. RESULTS: Seven studies with extractable continuous 24-h postoperative pain data contributed to the primary network meta-analysis. Compared with conventional irrigation, laser-activated irrigation showed the largest reduction in 24-h postoperative pain (SMD = -1.21; 95% CI: -1.86 to -0.55; P-score = 0.993), followed by passive ultrasonic irrigation (SMD = -0.39; 95% CI: -0.86 to 0.08; P-score = 0.520) and sonic activation (SMD = -0.32; 95% CI: -0.85 to 0.22; P-score = 0.429). Conventional irrigation had the lowest P-score (0.058). The certainty of evidence ranged from low to moderate, with downgrading mainly due to imprecision, clinical heterogeneity, and limited direct evidence for some comparisons. Risk-of-bias assessment identified predominantly low-risk randomized trials, although some studies raised concerns related to deviations from intended interventions, incomplete blinding, or incomplete outcome reporting. CONCLUSIONS: Laser-activated irrigation may reduce 24-h postoperative pain compared with conventional irrigation after single-visit root canal treatment. The effects of passive ultrasonic irrigation and sonic activation were less certain. Treatment rankings should be interpreted alongside effect estimates, confidence intervals, risk of bias, clinical heterogeneity, and certainty of evidence rather than as independent evidence of clinical superiority. CLINICAL SIGNIFICANCE: Irrigation activation may influence early postoperative pain after single-visit root canal treatment. Current evidence suggests a potential short-term pain-reduction benefit with laser-activated irrigation, but the certainty of evidence remains limited. Clinicians should interpret treatment hierarchy cautiously and consider feasibility, cost, case complexity, and patient-related factors when selecting irrigation activation protocols.
Long-term outcomes of regenerative periodontal therapy and orthodontic treatment: 20-year results from a prospective study.
Roccuzzo A, Li Y, Salvi GE … +3 more , Stähli A, Imber JC, Roccuzzo M
J Dent · 2026 May · PMID 42214655 · Publisher ↗
OBJECTIVES: To evaluate the 20-year clinical outcomes of periodontal regenerative and orthodontic treatment for severely periodontally compromised teeth. METHODS: In this prospective study, 48 patients with Stage IV peri...
OBJECTIVES: To evaluate the 20-year clinical outcomes of periodontal regenerative and orthodontic treatment for severely periodontally compromised teeth. METHODS: In this prospective study, 48 patients with Stage IV periodontitis, each with at least one non-molar tooth (n = 48 test teeth) exhibiting pathologic migration and an associated intrabony defect characterized by probing depth (PD) of ≥ 7 mm, were consecutively included. The treatment protocol comprised: 1) supra/sub-gingival instrumentation (Step Ⅰ-Ⅱ); 2) periodontal regenerative surgery using enamel matrix derivative (EMD) alone or combined with a bone graft and membrane (Step Ⅲ); 3) orthodontic treatment initiated 8-12 months post-surgery to correct malposition (Step R); and 4) tailored supportive periodontal care (SPC) (Step Ⅳ). Clinical parameters were recorded at baseline (T0), 10-year (T10), and 20-year (T20) follow-up visits. RESULTS: Thirty-three patients (drop-out rate: 31.2%; n = 29 test teeth) completed the 20-year follow-up. The T20 estimated tooth survival was 89.1% (CI: 79.4-99.9%), while complication-free probability was 86.3% (CI: 75.7-98.3%). Overall, five test teeth experienced complications (1 pulp necrosis, 2 root fractures, 2 periodontal disease recurrence) and four were extracted during the 20-year period. All periodontal parameters significantly improved from T0 to T20: full-mouth plaque scores decreased from 48.8% to 14.6% (34.2 ± 19.3%; 95% CI: 27.3, 41.0; p < 0.001), and full-mouth bleeding scores dropped from 55.5% to 10.2% (45.4 ± 18.5%; 95% CI: 38.8, 51.9; p < 0.001). The number of sites with PD ≥ 7 mm was reduced from 25.8 to 0.9 (24.9 ± 17.0; 95% CI: 18.9, 30.9; p < 0.001). At the test tooth level, mean PD decreased from 6.3 mm to 3.0 mm (3.1 ± 1.4 mm; 95% CI: 2.6, 3.7; p < 0.001). Treatment success (i.e., tooth survival + PD ≤ 4 mm) was observed in 81.8 % of cases. CONCLUSIONS: The 20-year results demonstrate that orthodontic treatment subsequent to periodontal regeneration is a predictable strategy for long-term tooth preservation, provided it is integrated into a stringent and tailored supportive care program. This interdisciplinary approach does not compromise the benefits of regeneration and offers a viable alternative to tooth extraction. CLINICAL SIGNIFICANCE: This study revealed that the combination of peridoontal regeneration and orthodontic therapy can successfully preserve natural teeth in severe periodontitis cases over two decades, highlighting the critical role of a tailored SPC program.
An educational intervention for teaching bad news communication in dentistry: A pilot study in Italy.
Martins BNFL, Nucci L, Saldivia-Siracusa C … +7 more , Pedroso CM, Fiori F, Romano A, Lucchese A, Lopes MA, Santos-Silva AR, Di Stasio D
J Dent · 2026 May · PMID 42214654 · Publisher ↗
OBJECTIVES: This pilot single-center, non-randomized, one-group pre-post study evaluated the effect of a structured educational intervention on undergraduate and graduate dental students' self-perceived confidence in com...
OBJECTIVES: This pilot single-center, non-randomized, one-group pre-post study evaluated the effect of a structured educational intervention on undergraduate and graduate dental students' self-perceived confidence in communicating bad news in dentistry. METHODS: The study was conducted at the Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy. 4th-6th year undergraduate and graduate students attended an in-person SPIKES-based training including pre- and post-training confidence questionnaires, an introductory lecture, two simulation videos, and group discussions. All analyses were two-sided at an α level of 0.05. Pre- and post-training responses were compared using the Wilcoxon signed-rank test for paired ordinal data. RESULTS: A total of 100 undergraduate and 26 graduate students attended. The training program significantly increased students' confidence in communicating bad news: undergraduate students' levels of confidence increased statistically in 14 of the 16 scenarios (p<0.05), while for graduate students the item on treatment failure showed a statistically significant change from pre- to post-intervention (p=0.025). CONCLUSION: The present training model increased students' self-confidence in delivering bad news in several topics in dentistry. CLINICAL RELEVANCE: The study highlights communicating bad news as a key educational need and supports the incorporation of this topic into dental curricula.
Does sealer extrusion influence endodontic treatment outcomes? Retrospective evidence from root-level and within-tooth analysis.
Sinsareekul C, Chantarangsu S, Hiran-Us S
J Dent · 2026 May · PMID 42214653 · Publisher ↗
OBJECTIVES: This retrospective study aimed to evaluate the influence of sealer extrusion on treatment outcomes using a within-tooth comparative design and to identify associated prognostic factors. METHODS: A total of 12...
OBJECTIVES: This retrospective study aimed to evaluate the influence of sealer extrusion on treatment outcomes using a within-tooth comparative design and to identify associated prognostic factors. METHODS: A total of 126 patients who underwent nonsurgical root canal treatment in posterior teeth between 2020 and 2025 were included. Eligible cases had at least one root with sealer extrusion and other roots without extrusion with at least one year follow-up. Treatment outcomes were classified as success or failure using both strict and loose criteria. Comparisons between roots with and without sealer extrusion were performed using Chi-square, Fisher's exact, and McNemar tests. Univariate and multivariate multilevel logistic regression analyses were conducted to identify prognostic factors (P < 0.05). RESULTS: A total of 138 roots with sealer extrusion and 179 roots without extrusion were analyzed. Under strict criteria, roots with sealer extrusion showed a significantly lower success rate than those without extrusion (P = 0.037). No significant difference was observed using loose criteria (P = 1.000). In cases with pre-existing periapical lesions, roots without extrusion demonstrated a significantly higher rate of complete healing than those with extrusion (P = 0.021). Longer recall periods were associated with improved outcomes in roots with extrusion. CONCLUSIONS: Within the limitations of this study, sealer extrusion did not appear to have a clear adverse effect on treatment outcomes in teeth without pre-existing periapical lesions but may be associated with a tendency toward delayed periapical healing in teeth with periapical lesions under strict criteria. Thus, longer follow-up is recommended. CLINICAL SIGNIFICANCE: Sealer extrusion may be associated with delayed healing, particularly in teeth with pre-existing periapical lesions, rather than true treatment failure. A within-tooth design improves assessment accuracy. Clinicians should consider careful obturation and ensure longer follow-up periods, especially in cases with pre-existing periapical pathology.
Survival and complications of narrow-diameter implants supporting fixed restorations under immediate versus early or delayed loading: A systematic review and meta-analysis.
Pachiou A, Strauss FJ, Liguori MG … +3 more , Jung RE, Thoma DS, Naenni N
J Dent · 2026 Sep · PMID 42208798 · Publisher ↗
OBJECTIVES: To evaluate implant survival and complication rates of narrow-diameter implants (NDIs) supporting fixed restorations under immediate versus early/delayed loading protocols. DATA: Randomized controlled trials...
OBJECTIVES: To evaluate implant survival and complication rates of narrow-diameter implants (NDIs) supporting fixed restorations under immediate versus early/delayed loading protocols. DATA: Randomized controlled trials and non-randomized clinical studies reporting implant survival, marginal bone loss (MBL), biological, or prosthetic complications for immediately and early/delayed loaded NDIs were considered. SOURCES: Electronic searches of PubMed/MEDLINE, Embase, and Scopus were conducted up to January 2026. The study was conducted according to the PRISMA 2020 statement and registered prospectively in PROSPERO (CRD420250654797). STUDY SELECTION: Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Nine studies met the inclusion criteria for qualitative synthesis, of which seven provided sufficient data for meta-analysis. Random-effects meta-analyses were conducted when methodologically appropriate, and the certainty of evidence was assessed using the GRADE approach. CONCLUSIONS: Immediate loading of NDIs supporting fixed restorations may achieve implant survival outcomes comparable to early/delayed loading protocols. Short-term biological, prosthetic, and MBL outcomes appeared similar between loading strategies; however, the certainty of evidence was limited. A higher risk of long-term biological complications with immediate loading was observed, although this finding is based on limited evidence with very low certainty. CLINICAL SIGNIFICANCE: Immediate loading of NDIs may represent a viable and time-efficient treatment option for fixed restorations in appropriately selected cases. Given the limited certainty of long-term biological outcomes, careful case selection and long-term monitoring remain essential.
Long-term outcomes of ceramic crowns in adolescents and young adults with amelogenesis imperfecta: final follow-up of a randomized split-mouth controlled clinical trial.
Pousette Lundgren G, Vestlund GM, Dahllöf G
J Dent · 2026 May · PMID 42208797 · Publisher ↗
OBJECTIVES: Amelogenesis imperfecta (AI) causes functional, esthetic, and psychosocial problems. Although early prosthetic treatment has shown favorable medium-term outcomes, evidence on long-term performance remains lim...
OBJECTIVES: Amelogenesis imperfecta (AI) causes functional, esthetic, and psychosocial problems. Although early prosthetic treatment has shown favorable medium-term outcomes, evidence on long-term performance remains limited. This study assessed the ≥10-year clinical performance of Procera zirconia and IPS e.max Press crowns placed in adolescents and young adults with AI. METHODS: This study presents the final long-term follow-up of a previously published randomized, split-mouth, controlled clinical trial with patient blinding. In a single-center, double-blind design, 27 adolescents and young adults (aged 11-22 years) with AI received 227 ceramic crowns (119 Procera; 108 IPS e.max Press). Crowns were followed for a mean of 13.4 ± 1.0 years (range 11.0-15.3). Outcomes assessed included crown survival, restoration quality according to California Dental Association (CDA) criteria, tooth sensitivity measured on a visual analog scale (VAS), gingival health, and adverse events. Data were analyzed using Kaplan-Meier survival analysis, log-rank tests, chi-square tests, and nonparametric tests. RESULTS: After 13.4 years, overall crown survival was 97.8%, with no significant differences by crown material (p=0.110) or AI subtype (p=0.974). Among surviving crowns, 97.0% were rated CDA excellent or acceptable, and 76.1% exhibited excellent marginal integrity. Mean VAS sensitivity decreased from 4.6 before treatment to 0.9 at long-term follow-up (p<0.001), and gingival bleeding was lower than at baseline. Endodontic complications occurred in 3.1% of teeth, primarily associated with prior dental trauma. CONCLUSIONS: Ceramic crowns placed in adolescents and young adults with AI demonstrate excellent long- term survival, high clinical quality, and sustained symptom reduction. CLINICAL SIGNIFICANCE: Definitive ceramic crown therapy provides durable, long-term rehabilitation in young individuals with amelogenesis imperfecta.
Reverse compensation technique achieves accurate robotic-assisted implant surgery in the anterior maxilla: A prospective case series.
Fu XJ, Gu YX, Wu XY … +4 more , Liu BL, Tang ZC, Lai HC, Shi JY
J Dent · 2026 May · PMID 42208796 · Publisher ↗
OBJECTIVES: To evaluate the implant positional accuracy and clinical outcomes of robotic-assisted implant surgery using the Reverse Compensation Technique (RCT) in the anterior maxilla. METHODS: Patients requiring implan...
OBJECTIVES: To evaluate the implant positional accuracy and clinical outcomes of robotic-assisted implant surgery using the Reverse Compensation Technique (RCT) in the anterior maxilla. METHODS: Patients requiring implant placement and simultaneous guided bone regeneration in the anterior maxilla with sloped bone morphology (buccolingual bone inclination >45°) were recruited. The RCT approach was used to compensate for potential drill deviation during osteotomy preparation. Guided bone regeneration was performed to manage implant fenestration or dehiscence. Outcome measures included implant positional accuracy, blood perfusion, surgical duration, patient-reported and operator assessments, and adverse events. RESULTS: Eighteen patients with 27 implants were included. The mean global deviations at the implant platform, apex, and angle were 0.59 ± 0.31 mm, 0.60 ± 0.32 mm, and 1.60° ± 1.27°, respectively. Blood perfusion decreased immediately after surgery (from 187.46 ± 46.41 to 52.27 ± 16.92 LSPU, P < 0.001), rebounded above baseline by day 3 (248.69 ± 76.69 LSPU, P = 0.002), and plateaued through day 14 (P > 0.050). Patients reported high overall satisfaction (VAS: median=100.00, IQR=20.00), while operators reported moderate procedural difficulty (VAS: median=45.00, IQR=62.50). The mean times for preparation, implant surgery, and guided bone regeneration were 39.72 ± 15.56, 24.78 ± 16.46, and 30.83 ± 13.03 min, respectively. CONCLUSIONS: Within the limitations of this study, the RCT approach facilitated accurate robot-assisted implant placement in challenging anterior maxillary sites exhibiting sloped bone morphology. CLINICAL SIGNIFICANCE: The RCT allows operators to counteract deviations, enabling precise implant placement under complex anatomical conditions. This finding underscores that contemporary robotic systems function as surgical augmenting tools rather than as direct replacements for clinical expertise.
48-month clinical performance of an Alkasite restorative material versus resin composite in class II restorations: a randomized controlled trial.
Meral E, Kesim B, Öz FD … +1 more , Gürgan S
J Dent · 2026 May · PMID 42203100 · Publisher ↗
OBJECTIVES: To evaluate the 4-year clinical performance of an alkasite restorative material (Cention N) compared with a posterior resin composite in Class II restorations. METHODS: In this randomized, split mouth, double...
OBJECTIVES: To evaluate the 4-year clinical performance of an alkasite restorative material (Cention N) compared with a posterior resin composite in Class II restorations. METHODS: In this randomized, split mouth, double-blind clinical trial, 31 patients received 100 Class II restorations (n = 50 per group). Cavities were restored either with Cention N or with a posterior resin composite (G-ænial Posterior) applied using an universal adhesive with etch-and-rinse mode. Clinical evaluations were performed at baseline, 6, 12, 36 and 48 months according to modified USPHS criteria. Intergroup comparisons were conducted using chi-square tests. Changes over time were assessed using Cochran's Q and McNemar tests. Kaplan-Meier survival analysis was performed (95% CI: 0.434-5.455) (α = 0.05). RESULTS: At 48 months, recall rate was 58% which may be considered relatively low. No statistically significant differences were observed between the materials in terms of marginal adaptation (p = 0.880), marginal discoloration (p = 0.526), surface texture (p = 0.175), color match (p > 0.05), postoperative sensitivity, or secondary caries incidence. Kaplan-Meier analysis showed comparable survival rates (83.6% for Cention N and 88.4% for resin composite; log-rank p = 0.49). Minor deterioration over time occurred in both groups in terms of marginal adaptation, marginal discoloration and surface texture. CONCLUSIONS: Cention N demonstrated clinical performance and survival comparable to the posterior resin composite used in Class II restorations. CLINICAL SIGNIFICANCE: Cention N may represent a clinically acceptable, simplified restorative alternative for posterior applications, showing mid-term outcomes comparable to a posterior composite resin.
Deep learning-driven intraoperative assessment of pulp stumps for precision pulpotomy.
Zhang Q, Hu M, Peng J … +1 more , Wang X
J Dent · 2026 May · PMID 42203099 · Publisher ↗
OBJECTIVES: To develop and validate an automated artificial intelligence (AI) assessment framework based on the self-supervised DINOv2 vision transformer architecture, which objectively classifies intraoperative pulp stu...
OBJECTIVES: To develop and validate an automated artificial intelligence (AI) assessment framework based on the self-supervised DINOv2 vision transformer architecture, which objectively classifies intraoperative pulp stump images as "suitable" or "unsuitable" for capping during pulpotomy. METHODS: An AI model utilizing the DINOv2 architecture was trained on 443 high-resolution microscopic images of pulp stumps. The model's diagnostic performance was evaluated using an independent internal test set (n = 93) and an external test dataset consisting of images from the literature (n = 21). A human-machine comparative analysis was conducted across both test sets to evaluate the AI model's accuracy, sensitivity, and specificity against those of expert endodontists and novice general practitioners. RESULTS: The DINOv2 model achieved a cross-validation accuracy of 0.9398, significantly outperforming the classical supervised convolutional neural networks. The finalized model demonstrated high accuracy on the internal test set (0.9570) and encouraging performance on the external test set (0.8571). In the comparative analyses, the AI model's diagnostic accuracy was comparable to that of expert endodontists (p > 0.05) and significantly superior to that of novices (p < 0.05). Novices tended to over-diagnose capping suitability, demonstrating high sensitivity but notably low specificity (0.3750-0.5000). Conversely, the AI model maintained a balanced performance with high specificity. CONCLUSIONS: The self-supervised DINOv2 framework provides a promising proof-of-concept tool that accurately approximates expert visual judgement for intraoperative pulp stump assessment. By bridging the clinical experience gap and preventing overdiagnosis, it holds substantial promise for enhancing the precision and predictability of pulpotomy. CLINICAL SIGNIFICANCE: This study developed an AI-driven framework that demonstrates potential to assist clinicians in objectively assessing pulp stumps during pulpotomy. This tool offers a promising approach to mitigate the subjective limitations of visual inspection and reduces the risk of over-indicating vital pulp therapy by less experienced practitioners. This provides a new scientific basis for the precision and intelligence of pulpotomy.
Burnout in dentistry and its silent impact. A literature review.
Suárez-Calleja J, Gan RK, Martinez PL … +1 more , Tardón A
J Dent · 2026 May · PMID 42203098 · Publisher ↗
BACKGROUND: Burnout syndrome has been increasingly recognized as a significant occupational health concern in healthcare professions. Dentists face unique stressors including close patient contact, precision-demanding pr...
BACKGROUND: Burnout syndrome has been increasingly recognized as a significant occupational health concern in healthcare professions. Dentists face unique stressors including close patient contact, precision-demanding procedures, and often isolated working conditions. OBJECTIVES: To systematically review the prevalence of burnout syndrome among dentists internationally and in Spain, and to identify associated risk factors. METHODS: A systematic literature review was conducted in four electronic databases for studies published from January 1982 and December 2023. Studies were included if they assessed burnout in dentists using the Maslach Burnout Inventory (MBI), had sample sizes ≥ 30 participants, and provided quantitative prevalence data. RESULTS: A total of nineteen cross-sectional studies (reported in twenty publications) from thirteen countries across four continents were included. Burnout prevalence ranged from 3.4% to 41.4%, with significant geographic and methodological variability. Emotional exhaustion was the most frequently affected dimension (range: 20-61.3%). Interpretation of prevalence estimates is limited by substantial heterogeneity in burnout definitions and MBI cut-off criteria across studies. Key risk factors included high workload, lack of postgraduate training, private practice setting, insufficient organizational support, and female gender in some contexts. CONCLUSIONS: Burnout affects a substantial proportion of dentists worldwide, although reported prevalence varies widely depending on the definitions and cut-off criteria used. Evidence suggests that burnout in dentistry has a multifactorial etiology involving occupational, organizational, and individual factors. Importantly, the literature indicates potential implications for patient safety, as burnout-particularly emotional exhaustion-has been associated with self-reported clinical errors. Despite the growing body of observational research, there is a notable lack of studies evaluating preventive or therapeutic interventions, highlighting an important priority for future research. CLINICAL SIGNIFICANCE: Burnout is a prevalent occupational risk among dentists worldwide, affecting clinical performance, wellbeing, and patient care. Despite its impact, preventive strategies are scarcely studied. Highlighting key risk factors and regional variability emphasizes the urgent need for evidence-based interventions and preventive programs within dental practice and education.
A population-based study on the association between periodontitis, flossing behavior, and mortality.
Liu XF, Li YY, Ma S … +8 more , Yu LH, Jia SL, Xu KH, Wang Y, Chen JH, Wang KY, Gao P, Niu LN
J Dent · 2026 Sep · PMID 42203097 · Publisher ↗
OBJECTIVES: The benefits of regular dental flossing for oral hygiene are well-established. However, it remains unclear whether flossing confers additional advantages for overall health improvement. This study examined th...
OBJECTIVES: The benefits of regular dental flossing for oral hygiene are well-established. However, it remains unclear whether flossing confers additional advantages for overall health improvement. This study examined the association of flossing frequency with all-cause mortality, characterized the dose-response relationship between flossing frequency and mortality risk, and evaluated joint associations of periodontitis and flossing behavior with mortality. METHODS: This study analyzed 10,609 participants from the U.S. National Health and Nutrition Examination Survey 2009-2014 with documented periodontitis status and flossing behavior. Inverse probability of treatment weighting and Cox proportional hazards regression collectively served for estimating hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality through December 31, 2019. To characterize the dose-response relationship, a restricted cubic spline model was fitted within the weighted Cox framework. RESULTS: Any flossing was associated with 29.6% lower mortality risk (HR = 0.704, 95% CI: 0.583-0.849, P < 0.001). Restricted cubic spline analysis revealed an inverse dose-response association between flossing frequency and mortality risk, with HR declining to 0.675 (95% CI: 0.674-0.676, P < 0.001) for daily flossing. Relative to individuals with healthy periodontium without flossing, those with periodontitis without flossing had the highest mortality risk (HR=3.508, 95% CI: 2.475-4.971, P < 0.001), whereas those with periodontitis who flossed exhibited an attenuated hazard (HR=2.329, 95% CI: 1.676-3.236, P < 0.001). CONCLUSIONS: An inverse dose-response association was confirmed between flossing and all-cause mortality. This association was also observed among participants with periodontitis. Because flossing was self-reported at a single time point and residual confounding remains likely, these findings should be interpreted as hypothesis generating rather than causal. CLINICAL SIGNIFICANCE: Regular flossing was associated with lower all cause mortality, including among people with periodontitis. Clinically, this reinforces flossing as a simple, low cost preventive habit. However, the findings are observational and should not be interpreted as proof that flossing directly reduces mortality.
Accuracy is a behavior, not a number: a metrological reporting framework for complete-arch implant scanning.
Ruggiero G, Sorrentino R, Zarone F
J Dent · 2026 May · PMID 42190742 · Publisher ↗
OBJECTIVES: To propose a metrological reporting framework for complete-arch implant scanning studies, with the aim of improving cross-study comparability and prosthetically relevant interpretation. METHODS: Commonly repo...
OBJECTIVES: To propose a metrological reporting framework for complete-arch implant scanning studies, with the aim of improving cross-study comparability and prosthetically relevant interpretation. METHODS: Commonly reported accuracy endpoints in complete-arch implant scanning studies were critically examined and interpreted in relation to International Organization for Standardization (ISO) metrology terminology and the prosthetic requirement for rigid multi-implant seating. RESULTS: Four complementary reporting domains are proposed. First, global surface deviation should be reported after a clearly declared rigid registration, specifying both the alignment surface and the comparison surface. Second, site-specific deviation should be reported for each implant, scan body, or multi-unit abutment (MUA) region without repeating a local best-fit alignment at each site. Third, implant pose error should be reported as translational and angular deviation, preferably at the implant platform or MUA level when this information is available. Fourth, fit-related or region-of-interest descriptors should be used to describe clinically relevant local discrepancy, with preference for robust upper-tail and dispersion metrics such as the 95th percentile absolute deviation and standard deviation. Transparent reporting of reference data, preprocessing, registration strategy, measurement region, color-map settings, and statistical unit is also recommended. CONCLUSIONS: Complete-arch implant scanning accuracy cannot be fully described by a single numerical endpoint. A structured metrological framework may help distinguish global surface agreement, implant-level positional error, and clinically relevant fit-related discrepancy. CLINICAL SIGNIFICANCE: Clearer reporting of alignment strategy, measurement region, pose error, and fit-related descriptors may reduce confusion caused by non-equivalent outcomes and support more clinically meaningful interpretation of complete-arch implant scanning studies.
Prevalence of periodontal diseases in children and adolescents in Asian countries: A scoping review.
Charde P, Tan BL, Matoug-Elwerfelli M … +4 more , Philip N, Al Hadeethi T, Duggal M, Nazzal H
J Dent · 2026 May · PMID 42178105 · Publisher ↗
OBJECTIVES: Extensive research has explored the prevalence of periodontal diseases in adult populations, however there is a paucity of synthesised data focusing on its prevalence among children and adolescents particular...
OBJECTIVES: Extensive research has explored the prevalence of periodontal diseases in adult populations, however there is a paucity of synthesised data focusing on its prevalence among children and adolescents particularly in Asian countries. The objective of this scoping review was to analyse the available literature to evaluate the prevalence of periodontal diseases among children and adolescents in Asian countries. METHODS: A scoping review was conducted in accordance with the PRISMA-ScR guidelines and registered with Open Science Framework. Electronic searches of PubMed, Embase, Scopus, and Web of Science were carried out to include cross-sectional, cohort studies and national oral health surveys published from 2010 reporting gingival and periodontal outcomes in children and adolescents (≤18 years) residing in Asia. A narrative synthesis of the findings including study information, participants demographics and the prevalence of gingivitis, periodontitis was presented. RESULTS: 84 studies from 24 Asian countries were included. "Gingivitis" was the most commonly reported condition, with prevalence ranging from <10% to 100% across studies. "Periodontitis" was less frequently reported but was identified in adolescents in eight studies, with prevalence ranging from 0.7% to 44.5%. CONCLUSIONS: "Gingivitis" is highly prevalent among children and adolescents in Asia, and if left undiagnosed and untreated, "Periodontitis" may occur in a subset of this population. Periodontal assessment should be incorporated into routine dental assessment of school children for timely prevention. A critical issued in current primary studies is the considerable heterogeneity in methodology (i.e. diagnostic criteria, and indices used) and outcomes reported (i.e. socio-demographics, clinical findings). This should be rectified in future studies. CLINICAL SIGNIFICANCE: The high prevalence of periodontal disease in children and adolescents of Asian countries highlights the need for periodontal screening to detect reversible gingivitis at early stages and prevent disease progression. Therefore, the inclusion of periodontal assessment into routine oral health check-ups is required.
Routine oral health practices and all-cause mortality among older Japanese adults: A 6-year cohort study.
Wang K, Matsuyama Y, Kiuchi S … +3 more , Kusama T, Ho DSM, Aida J
J Dent · 2026 Sep · PMID 42178104 · Publisher ↗
OBJECTIVES: To examine whether multiple routine oral health practices reduce all-cause mortality, and how these associations are modified by sociodemographic, behavioral, and health related factors. METHODS: Data were de...
OBJECTIVES: To examine whether multiple routine oral health practices reduce all-cause mortality, and how these associations are modified by sociodemographic, behavioral, and health related factors. METHODS: Data were derived from the Japan Gerontological Evaluation Study (JAGES), with participants enrolled between 3 October and 14 November 2016. Participants who were not certified for long-term care insurance and completed the questionnaire version including oral health practice items were eligible; edentulous or not functionally independent individuals were excluded. Participants were categorized according to engagement in seven routine practices: toothbrushing ≥twice/day, use of interdental cleaner, tongue cleaner, toothpaste, mouthwash, and dental visits for treatment or checkups in the past 12 months. The outcome was all-cause mortality through 20 June 2023. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using inverse probability weighted Cox proportional hazard models, adjusting for confounding. For oral health practices exhibiting significant association, moderator wide analyses were conducted to explore potential effect modification by age, sex, education, income, smoking, alcohol consumption, body mass index, walking time, living status, self-rated health, number of teeth, and depression. RESULTS: During the 6-year follow-up, the mortality incidence rate was 17.3/1000 person-year among 9676 participants (46.5% male; mean age=73.7 ± 5.9 years). Significant risk reductions in all-cause mortality were observed for interdental cleaner use (HR=0.89; 95% CI=0.80-0.99) and tongue cleaner use (HR=0.77; 95%CI=0.68-0.87). No significant effect modification was detected. CONCLUSIONS: In this nationwide cohort study, the use of interdental and tongue cleaners was associated with lower all-cause mortality among community-dwelling Japanese older adults during 6 years of follow-up. CLINICAL SIGNIFICANCE: The results suggest that simple and low-cost practices may contribute to healthy longevity in ageing societies, and support further investigation into potential mechanisms, including pathways related to aspiration and respiratory infections.
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