Journal Of Dentistry[JOURNAL]
Sun
200 papers
Does air abrasion improve the retention of restorations in non-carious cervical lesions? An 18-month split-mouth randomized controlled trial.
Forville H, Coppla FM, Naupari-Villasante R … +6 more , Cochinski GD, Szesz AL, Favoreto MW, Matos TP, Loguercio AD, Reis A
J Dent · 2026 Sep · PMID 42144228 · Publisher ↗
OBJECTIVE: To evaluate whether dentin airborne-particle abrasion (APA) with aluminum oxide affects the retention and clinical performance of composite resin restorations in non-carious cervical lesions (NCCLs). METHODS:...
OBJECTIVE: To evaluate whether dentin airborne-particle abrasion (APA) with aluminum oxide affects the retention and clinical performance of composite resin restorations in non-carious cervical lesions (NCCLs). METHODS: This prospective, randomized, split-mouth, double-blind controlled trial included 63 participants and 126 restorations presenting at least two similar NCCLs. Restorations were randomized and allocated to either a control protocol using a universal adhesive in selective enamel etching mode and restored with bulk-fill composite resin, or to the same protocol preceded by APA preceded by airborne-particle abrasion with 50 μm aluminum oxide particles applied for 10 s at 5 bar pressure. All restorations were placed under rubber dam isolation using standardized procedures. Evaluations were performed at baseline, 6 months, and 18 months using FDI and modified USPHS criteria. The primary outcome was retention/fracture; secondary outcomes included marginal staining, marginal adaptation, postoperative sensitivity, and secondary caries. Survival was analyzed using Kaplan-Meier estimates and compared with log-rank tests. The primary inferential analysis used Cox proportional hazards regression with robust standard errors clustered by patient. Secondary outcomes were compared using McNemar's test (α = 0.05). RESULTS: After 18 months, six restorations were lost (Control: 1; APA: 5). Kaplan-Meier estimates showed high retention in both groups (Control: 96.7%, 95% CI: 92.4 to 100.0; APA: 90.3%, 95% CI: 83.3 to 98.0). The clustered Cox model indicated a higher, but not statistically significant, hazard of failure for the APA group (HR = 3.03; 95% CI: 0.74-12.37; p = 0.122). No significant differences were observed for marginal staining, marginal adaptation, postoperative sensitivity, or secondary caries. CONCLUSION: Under the parameters tested, dentin airborne-particle abrasion did not improve the clinical performance of composite restorations in NCCLs over 18 months. CLINICAL RELEVANCE: Air-abrasion of dentin in non-carious cervical lesions does not improve the clinical performance of composite resin restorations over 18 months, suggesting that this step may be unnecessary in routine practice.
Safety first: A mixed-methods exploratory study to quantify the hierarchy of clinical needs in computer-assisted implant surgery.
Lin Y, Choi Y, Wen Z … +2 more , Bao Z, Park W
J Dent · 2026 May · PMID 42142617 · Publisher ↗
OBJECTIVES: To map the intellectual structure of Computer-assisted implant surgery (CAIS) research (2015-2025) and quantify potential variations between academic research trends (e.g., emerging hotspots) and the practica...
OBJECTIVES: To map the intellectual structure of Computer-assisted implant surgery (CAIS) research (2015-2025) and quantify potential variations between academic research trends (e.g., emerging hotspots) and the practical priorities among senior clinicians in a mixed-methods exploratory study. METHODS: This is a sequentially designed study. First, 957 articles were analyzed using CiteSpace to visualize the research network, which was validated by an expert panel (N = 7). Second, 40 senior academic clinicians ranked these clusters using the Best-Worst Scaling (BWS) survey. The stability of the ranking hierarchy was verified using post-hoc bootstrapping (1000 resamples) and Monte Carlo simulations. RESULTS: Scientometric analysis identified "aesthetics" as the central structural hub, while the recent research frontier (2021-2025) was dominated by "advanced technologies" (e.g., Robotics, AR). However, the BWS revealed a distinct "perceived hierarchy of clinical needs" in this cohort. Bootstrapping confirmed a robust "safety first" tier: clinicians ranked "accuracy", "long-term follow-ups", and "complications" as the primary priorities. Notably, while scientometric trends indicated a recent academic surge in high-tech topics, "cutting-edge digital technologies" were ranked as a secondary priority in terms of immediate clinical urgency by this cohort. CONCLUSION: A nuance in focus was observed. While recent academic trends increasingly explore Phase 3 innovations, the surveyed senior clinicians currently prioritize foundational risk management before wider adoption. Methodologically, this integrated Scientometric-BWS approach established a reproducible template for future studies seeking to quantify clinical hierarchies across other dental disciplines. Future research demonstrating technical feasibility must simultaneously address safety predictability. CLINICAL SIGNIFICANCE: This study revealed that CAIS adoption among senior clinicians is driven by risk management rather than novelty. Technologies that fail to prioritize safety and precision, regardless of their innovative potential, are unlikely to be successfully integrated into clinical practice.
Clinical performance of 3D-printed resin versus prefabricated zirconia crowns in primary molars: A split-mouth clinical study.
Alper ES, Simsek H, Buyuk SK … +4 more , Kurt Demirsoy K, Ozcelik Eryilmaz E, Odabasi D, Turgut M
J Dent · 2026 May · PMID 42142616 · Publisher ↗
OBJECTIVES: This study aimed to compare the 12-month clinical performance of prefabricated zirconia crowns and 3D-printed resin crowns in primary molars. The null hypothesis was that no difference would be observed betwe...
OBJECTIVES: This study aimed to compare the 12-month clinical performance of prefabricated zirconia crowns and 3D-printed resin crowns in primary molars. The null hypothesis was that no difference would be observed between the two crown types. METHODS: This prospective split-mouth clinical study included 25 children (50 teeth) aged 4-9 years. In each participant, one mandibular primary molar was restored with a prefabricated zirconia crown and the contralateral molar with a 3D-printed resin crown. Clinical evaluations were performed at 3, 6, and 12 months, including crown retention, fracture, marginal integrity, gingival index, plaque index, proximal contact, occlusal wear, and color stability. Data were analyzed using non-parametric tests (p < 0.05). RESULTS: Both crown types demonstrated high success rates in terms of retention, fracture resistance, and proximal contact throughout follow-up, with no significant differences between groups (p > 0.05). Marginal integrity was comparable between groups. However, gingival and plaque index scores were significantly higher in the 3D-printed resin crown group at all time points (p < 0.05). Additionally, 3D-printed resin crowns showed significantly greater occlusal wear at 6 and 12 months (p < 0.001) and progressive discoloration over time (p < 0.001), whereas prefabricated zirconia crowns-maintained color stability and no occlusal wear. CONCLUSIONS: While 3D-printed resin crowns demonstrated comparable functional performance to prefabricated zirconia crowns, they were associated with inferior periodontal and esthetic outcomes. CLINICAL SIGNIFICANCE: 3D-printed resin crowns may represent a cost-effective functional alternative; however, their use requires careful consideration regarding plaque control, gingival health, and long-term esthetic stability.
Accuracy of dynamic navigation compared with static navigation for guided endodontic microsurgery: A randomised controlled trial.
Chen C, Zhang R, Qin L … +3 more , Lin Y, Zhang X, Meng L
J Dent · 2026 May · PMID 42142615 · Publisher ↗
OBJECTIVES: This study aimed to compare the accuracy of static navigation (SN)- and dynamic navigation (DN)-assisted endodontic microsurgery (EMS) in osteotomy and root-end resection. METHODS: This prospective, single-bl...
OBJECTIVES: This study aimed to compare the accuracy of static navigation (SN)- and dynamic navigation (DN)-assisted endodontic microsurgery (EMS) in osteotomy and root-end resection. METHODS: This prospective, single-blind, randomised clinical trial enrolled 18 patients who met the inclusion criteria and underwent EMS. Osteotomy and root-end resection procedures were performed using either SN or DN systems. Preoperative virtual plans were registered and compared with postoperative cone-beam computed tomography (CBCT) data to quantitatively assess surgical accuracy. The evaluated parameters included start-point deviation (SD), end-point deviation (ED), angular deviation (AD), root-end resection length deviation (RLD), and root-end resection angle deviation (RAD). RESULTS: A total of 18 patients (19 teeth, 20 roots) were included in the study, with 10 patients treated using SN and 8 using DN. Quantitative analysis demonstrated that the SN group exhibited significantly greater deviation in ED compared with the DN group (p = 0.02). No statistically significant differences were observed between the groups for SD, AD, RLD, or RAD (p > 0.05). CONCLUSION: Both DN- and SN-assisted approaches achieved clinically acceptable accuracy for EMS in osteotomy and root-end resection. DN demonstrated superior accuracy at the surgical endpoint, suggesting a potential advantage in complex cases involving proximity to critical anatomical structures, where precise apical localisation is essential. CLINICAL SIGNIFICANCE: These findings provide a scientific basis for optimising and promoting the broader clinical adoption of guided endodontic technologies.
In vitro evaluation of automated single-unit crown design using artificial intelligence: Design time, marginal misfit, dental morphology, and contact points.
Gonçalves LFF, Veríssimo MHG, de Miranda LM … +5 more , Troconis CCM, Afifi RR, Cavalcanti YW, Batista AUD, Pereira ALC
J Dent · 2026 May · PMID 42142614 · Publisher ↗
OBJECTIVE: To compare an artificial intelligence-based design workflow with a manual CAD workflow in terms of design time, vertical marginal misfit, dental morphology, and interproximal and occlusal contacts during singl...
OBJECTIVE: To compare an artificial intelligence-based design workflow with a manual CAD workflow in terms of design time, vertical marginal misfit, dental morphology, and interproximal and occlusal contacts during single-unit crown planning. METHODS: Standardized preparations for single-unit crowns were performed on a typodont (teeth 22, 24, and 26). After digital scanning, single crowns were designed (n = 60, 20 per tooth) using a manual CAD workflow (Exocad DentalCAD; exocad GmbH) (C-E) or an artificial intelligence-based design system workflow (Medit Link v2.4.4; Medit Corp.) (E-AI), according to randomized tooth allocation. Design time (in seconds), vertical marginal misfit (mm), and dental morphology (mm) were assessed digitally, followed by a physical evaluation of occlusal and interproximal contacts after 3D printing of the single-unit crowns. Data were analyzed using mixed-effects models, nonparametric tests, and chi-square tests for categorical outcomes, followed by adjusted residual analysis when appropriate, with a significance level of 5%. RESULTS: The E-AI workflow significantly reduced design time compared with C-E (p < 0.001), reducing planning time by approximately 8-15 min, depending on tooth type. Marginal discrepancies exceeding clinical thresholds were observed, as well as morphological deviations at the distal crest of single crowns for incisors (p = 0.020), with no differences observed for molars and premolars (p > 0.05). A significant difference was observed only for mesial interproximal contacts (p = 0.037), whereas distal interproximal (p = 0.136) and occlusal contacts (p = 0.247) did not differ between workflows. Clinically poor occlusal contacts predominated in both groups. CONCLUSION: Although the artificial intelligence-based design workflow markedly reduced design time, it did not improve key clinical parameters, as limitations related to marginal fit and occlusal contact quality remained in both workflows. CLINICAL RELEVANCE: The use of artificial intelligence-based design systems in prosthetic planning can enhance clinical efficiency by streamlining design steps and reducing operator dependence. This technology has significant potential for educational settings and clinical practice by enabling faster prosthetic planning, while still requiring professional oversight for occlusal refinement and marginal adjustment.
Experimental polymer-based toothpastes protection against enamel demineralization.
Garcia RM, Valdivia-Tapia AC, Eckert GJ … +4 more , Borges AB, Lippert F, Scaramucci T, Hara AT
J Dent · 2026 May · PMID 42142613 · Publisher ↗
OBJECTIVE: To evaluate the demineralization-inhibiting properties of 0.5% chitosan (CHI) and 2% sodium linear polyphosphate (LPP) alone or associated with fluoride (1350 ppm, NaF) and/or stannous (3500 ppm, SnCl) plus fl...
OBJECTIVE: To evaluate the demineralization-inhibiting properties of 0.5% chitosan (CHI) and 2% sodium linear polyphosphate (LPP) alone or associated with fluoride (1350 ppm, NaF) and/or stannous (3500 ppm, SnCl) plus fluoride ions in experimental toothpaste formulations. METHODS: Bovine enamel specimens were randomly allocated into 12 groups (n = 14) and subjected to a 5-day pH cycling period (3-h demineralization 2 × /d, 1-min 1:3 toothpaste slurry 2 × /d, remineralization all other times). Sections were analyzed using digital transverse microradiography (integrated mineral loss-ΔZ, lesion depth-L, and maximum mineral density of the lesion surface zone-SZ). The fluoride availability in the toothpaste slurry was measured using an ion-selective electrode. ANOVA was used to test for a group effect, followed by pair-wise comparisons using Fisher's Protected Least Significant Differences (alpha=0.05). RESULTS: For the ΔZ data, CHI and LPP in isolation did not differ from placebo [geometric means (confidence intervals); vol%min x µm]: [4561(3852,5401)] and [4582 (3890,5396)] vs. [5168(4369,6114)], respectively, (p ≥ 0.268), and did not provide additional protection when associated with F [1843 (1531,2219)], Sn [5080(4354,5926)] and F+Sn [2298(1860,2838)]. Sn-containing toothpastes did not differ from placebo (p ≥ 0.05). All F-based toothpastes resulted in less demineralization than F-free toothpastes. The L data followed similar trends to the ΔZ data. The SZ data showed that CHI and LPP did not differ from placebo: vol%min 1 (35,49) and 42 (34,51) vs. 46 (41,51), respectively (p > 0.243). When associated with F, only CHI [29(21,40)] presented less mineral content at the surface lesion, and the polymers did not provide additional mineral content at the surface layer when associated with Sn [38(34,44), p > 0.377], or F+Sn [15(36,57), p > 0.23]. For the mean mineral distribution for all lesions as a function of experimental toothpastes, some lesions showed surface softening without a clear lesion body (F), and some lesions showed a more pronounced (Placebo). The fluoride values ranged from 0 (Placebo) to 1490 (CHI+F). CONCLUSION: None of the polymers could enhance the protection provided by fluoride or fluoride plus stannous.
Accuracy and hallucination behaviors of artificial intelligence-based large language models for dental implant identification on radiographs.
Hlaing NHMM, Park K, Wan Q … +3 more , Lee SJ, Gallucci GO, Lee JH
J Dent · 2026 May · PMID 42142612 · Publisher ↗
OBJECTIVES: This study aimed to evaluate the accuracy and error patterns of four artificial intelligence-based large language models (LLMs) in identifying dental implant characteristics including implant level, connectio...
OBJECTIVES: This study aimed to evaluate the accuracy and error patterns of four artificial intelligence-based large language models (LLMs) in identifying dental implant characteristics including implant level, connection type, brand, and manufacturer, on radiographic images. METHODS: In total, 120 standardized radiographic images (60 periapical and 60 panoramic) representing six implant systems (Straumann BL, Straumann TL, Osstem TS [Hiossen ET], Osstem [Hiossen] US, Osstem [Hiossen] SS, and Dentium SuperLine) were retrospectively collected and analyzed. For each image, four multimodal LLMs (ChatGPT-5, ChatGPT-4o, Gemini 2.5 Pro, and Grok 4) were queried six times with a standardized prompt that requested the implant level, connection type, brand, and manufacturer. The primary outcome was response-level accuracy. Responses were classified as successful or unsuccessful identification; unsuccessful responses were further categorized as definitive incorrect (hallucination), tentative incorrect, ambiguous, or abstention. Statistical analysis used generalized estimating equations for accuracy and Chi-square tests for error types (α=0.05). RESULTS: Structural characteristics (implant level and connection type) were identified with accuracies ranging from 51.67% to 82.5%, whereas brand and manufacturer recognition remained consistently poor (4.17%-32.78%). Hallucinations represented the predominant error type (>87% of errors in all models), while ChatGPT-5 showed a comparatively higher rate of abstention and lower hallucination frequency. CONCLUSIONS: Current LLMs have limited capability for the definitive radiographic identification of dental implant systems, particularly for specific brands. Recent model iterations show a promising trend toward reduced hallucinations and increased reliability through abstention; however, their high error rates indicate that they can only be considered as supplementary tools requiring clinician verification. CLINICAL SIGNIFICANCE: Current LLMs are not sufficiently reliable for definitive radiographic implant identification, and their outputs should be interpreted with clinician verification. However, the increasing tendency of recent models to acknowledge uncertainty indicates promising progress toward safer clinical decision support systems.
Determinants of the incidence of clinical consequences of untreated dental caries among underprivileged schoolchildren: a two-year prospective cohort study.
Santos BMEBD, Vettore MV, Rebelo MAB … +5 more , Freitas MODS, Herkrath APCQ, Queiroz AC, Herkrath FJ, Pereira JV
J Dent · 2026 Sep · PMID 42140475 · Publisher ↗
OBJECTIVES: To investigate the influence of structural and intermediary determinants on the incidence of clinical consequences of untreated dental caries in schoolchildren. METHODS: A two-year prospective cohort study wa...
OBJECTIVES: To investigate the influence of structural and intermediary determinants on the incidence of clinical consequences of untreated dental caries in schoolchildren. METHODS: A two-year prospective cohort study was conducted with 329 twelve-year-old students from public schools in [Text blinded for peer review]. Socioeconomic status (family income, parents' schooling, number of goods, and number of rooms), psychosocial factors (oral health beliefs, sense of coherence [SOC-13], social support [SSA]) and number of decayed teeth were assessed at baseline. Use of dental services in the last 12 months and frequency of toothbrushing were registered at two-year follow-up. The incidence of clinical consequences of untreated dental caries was measured by the number of teeth with PUFA index (Pulpal involvement, Ulceration, Fistula, and Abscess) between baseline and the two-year follow-up. Structural equation modeling were used to test the model adapted from WHO (World Health Organization) conceptual framework on social determinants of health. RESULTS: The incidence of clinical consequences of untreated dental caries was directly predicted by dental caries at baseline (β = 0.338). Lower socioeconomic status (β = -0.019) indirectly predicted the incidence of clinical consequences of untreated dental caries via parents' sense of coherence, use of dental services and dental caries. Lower social support (β = -0.038) indirectly predicted the incidence of clinical consequences of untreated dental caries via use of dental services and dental caries. CONCLUSION: Strategies tackling structural determinants and intermediary factors should be considered in addressing the clinical consequences of untreated dental caries. CLINICAL SIGNIFICANCE: This study highlights that the clinical consequences of untreated dental caries in schoolchildren are primarily driven by baseline caries experience. Socioeconomic inequalities and psychosocial factors show modest associations with the outcome through indirect pathways mediated by behavioural and clinical pathways. Preventive strategies should prioritise early caries management alongside addressing social inequalities in oral heatlh.
A non-discoloring bioactive hydrogel for caries management: an in vitro study.
Yin IX, Ma VR, Chu CH
J Dent · 2026 Sep · PMID 42134620 · Publisher ↗
OBJECTIVE: To develop a novel anti-caries hydrogel with non-discolouring, antibacterial and mineralising properties. METHOD: The fCS/nSPS hydrogel was developed by incorporating nano strontium phosphosilicate (nSPS) into...
OBJECTIVE: To develop a novel anti-caries hydrogel with non-discolouring, antibacterial and mineralising properties. METHOD: The fCS/nSPS hydrogel was developed by incorporating nano strontium phosphosilicate (nSPS) into a functionalised chitosan (fCS) matrix, followed by ultraviolet-induced photocrosslinking. The hydrogel's phase formation and composition were identified by X-ray Diffraction spectroscopy (XRD), whereas its functional groups were detected by Fourier Transform Infrared spectroscopy (FTIR). Surface morphology was observed by Scanning Electron Microscopy (SEM). Antibacterial effects of fCS/nSPS were evaluated using minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Mineralising properties were studied using SEM and XRD on fCS/nSPS-treated dentine blocks after cariogenic challenge. Cytocompatibility of fCS/nSPS-treated dentine was tested towards human gingival fibroblasts (HGF-1). Dentine discolouration after intervention (ΔE) was quantified using colour spectrophotometry. Silver diamine fluoride (SDF) and deionised water were used as controls. RESULTS: NMR, XRD, FTIR, and SEM confirmed the synthesis of fCS/nSPS. The MIC/MBC values (mean±SD) of fCS/nSPS against Streptococcus mutans, Actinomyces naeslundii, and Lactobacillus acidophilus are 87±20/200±35, 129±38/373±80, and 110±36/253±53 µg/mL, respectively. SEM revealed a smooth mineralised surface on fCS/nSPS-treated dentine. XRD confirmed deposition of strontium phosphosilicate. HGF-1 viability (mean ± SD) of fCS/nSPS, SDF and Water group were 135.7±4.9 %, 0.5±0.1 % and 131.7±3.5 % (p < 0.001, SDF<fCS/nSPS, Water). The ΔE values (mean±SD) of fCS/nSPS, SDF, and water groups were 6.4±2.6, 47.7±6.6, and 7.5±2.0, respectively (p < 0.001; fCS/nSPS, Water<SDF). CONCLUSION: The developed fCS/nSPS hydrogel did not cause significant tooth discolouration, exhibited antibacterial activity, promoted dentine's surface mineral deposition, and was cytocompatible. These properties support further investigation of this material for non‑restorative caries management.
Perforating external root resorption with periodontal-derived osseous ingrowth: a radiographic mimic of internal replacement resorption.
Ricucci D, Tsukiboshi M, Milovidova I … +3 more , Qu Y, Gu L, Tay F
J Dent · 2026 May · PMID 42134619 · Publisher ↗
OBJECTIVE: Intraradicular mixed radiolucent and radiopaque changes within the root canal space are often diagnosed as internal replacement resorption. However, radiographs alone cannot confirm tissue origin or periodonta...
OBJECTIVE: Intraradicular mixed radiolucent and radiopaque changes within the root canal space are often diagnosed as internal replacement resorption. However, radiographs alone cannot confirm tissue origin or periodontal-endodontic communication. This study examined whether perforating external root resorption can establish a trans-radicular portal, permit periodontal-derived osseous ingrowth, and produce a radiographic mimic of internal replacement resorption. METHODS: This observational clinico-radiographic and histomorphological correlation study analysed 97 extracted permanent teeth in two cohorts: 44 carious teeth with pulpal infection and intraradicular resorption, and 53 anterior teeth with dental trauma. Assessment was performed with periapical radiographs and cone beam computed tomography (CBCT). Extracted teeth underwent serial sectioning and light microscopy, with bacterial staining when required. RESULTS: In the caries cohort, intraradicular resorption occurred in an infected, inflamed environment. Two teeth showed progressive internal inflammatory resorption with bacteria in dentinal tubules and necrotic tissue at the resorptive interface. No organised lamellar bone was identified in the canal space. In the trauma cohort, pulp canal obliteration was frequent. Four teeth showed a mixed radiolucent-radiopaque intraradicular pattern that radiographically mimicked internal replacement resorption. Serial CBCT and histology demonstrated a full-thickness portal linking the periodontal and endodontic compartments. Trabecular lamellar bone and marrow-like spaces were identified within the canal. Bacteria were absent in these cases. CONCLUSIONS: Some trauma-associated lesions diagnosed radiographically as internal replacement resorption are better interpreted as perforating external root resorption with periodontal-derived osseous ingrowth. Diagnosis, prognosis, and treatment planning should prioritise detection of trans-radicular communication using serial CBCT interpretation. CLINICAL SIGNIFICANCE: Trauma-related lesions that resemble internal replacement resorption may instead represent perforating external root resorption with periodontal-derived bone ingrowth. Careful serial CBCT review is therefore essential to identify trans-radicular communication, avoid misdiagnosis, refine prognosis, and guide management.
AI framework for dental shade matching under variable lighting conditions.
Tao R, Feng H, Liao P … +4 more , Li R, Li H, Chen H, Wang J
J Dent · 2026 May · PMID 42128088 · Publisher ↗
OBJECTIVE: Accurate tooth shade matching remains challenging because visual assessment is subjective and commercial spectrophotometers are sensitive to clinical conditions. Although artificial intelligence (AI) offers a...
OBJECTIVE: Accurate tooth shade matching remains challenging because visual assessment is subjective and commercial spectrophotometers are sensitive to clinical conditions. Although artificial intelligence (AI) offers a promising alternative, most AI-based methods have been developed and tested under controlled imaging conditions, with limited evidence in routine practice. Herein, we developed PerceptShade, an AI framework for image-based shade estimation from routine intraoral photographs captured under variable lighting and with diverse devices, including smartphones and digital cameras. METHODS: PerceptShade incorporates clinical perceptual principles by focusing on non-specular tooth regions, enforcing a brightness-first hierarchical judgment inspired by standard clinical shade-matching protocols, and learning perceptual similarity through Perceptual Consistency Optimization. The framework was trained and evaluated using 1553 shade-matching images from 357 patients, with 50 prospectively collected independent cases used for an observer study. The dataset included heterogeneous lighting and device conditions to reflect routine clinical conditions. RESULTS: PerceptShade achieved Top-1 and Top-3 accuracies of 79.12% and 96.44%, respectively, in the shade-matching test. In the independent observer dataset, PerceptShade achieved a Top-1 agreement of 76.0% with the Panel A consensus reference (95%CI: 61.8-86.9%), compared with 72.7% among independent expert observers (95%CI: 65.1%-80.3%). These Top-N recommendations may streamline digital shade-matching workflows and support clinical decision-making. CONCLUSION: PerceptShade is a novel framework integrating hierarchical clinical reasoning with illumination-robust representation learning for dental shade matching. In this image-based evaluation, it demonstrated stable performance across heterogeneous acquisition conditions and may support shade selection in routine clinical photography. CLINICAL SIGNIFICANCE: PerceptShade is an AI-based dental shade-matching framework inspired by clinicians' perceptual workflow. Using routine photographs acquired without device calibration, it provides shade recommendations for single-tooth restorations. It may support candidate-shade selection, although it requires an in-frame reference tab and may still be affected by challenging imaging conditions.
Impact of pre-freezing on palatal rugae-based postmortem identification: Discriminant classification of intraoral scans in an ex vivo porcine model.
Mikó S, Bak Á, Shahbazi A … +1 more , Vág J
J Dent · 2026 May · PMID 42128087 · Publisher ↗
OBJECTIVES: With the increasing integration of intraoral scanners into dental workflows, digitally archived palatal morphology may emerge as a valuable adjunctive tool for forensic human identification in situations wher...
OBJECTIVES: With the increasing integration of intraoral scanners into dental workflows, digitally archived palatal morphology may emerge as a valuable adjunctive tool for forensic human identification in situations where conventional primary identifiers are unavailable or compromised. This study evaluated the reliability of palatal soft-tissue identification from intraoral scans following progressive postmortem deterioration and pre-freezing conditions. METHODS: Eighteen porcine maxillae were utilized as an ex vivo model and divided into fresh and pre-frozen groups. Intraoral scans were obtained over a 20-day observation period to simulate postmortem conditions. To address the instability of conventional whole-surface registration in deteriorated tissues, a reference point-based alignment strategy using palatal rugae landmarks was developed. Five surface-deviation features derived from aligned scans were used for identity-versus-stranger classification via discriminant analysis. The influence of postmortem time, comparison type, and specimen condition was further evaluated using generalized linear mixed-effects models. RESULTS: The proposed ruga-based alignment achieved an overall classification accuracy of 82.5%, with 89.3% sensitivity and 79.0% specificity, while independent validation yielded 84.2% accuracy. Although surface deviation increased significantly over time (p < 0.001), reflecting progressive tissue deterioration, postmortem time did not significantly affect ruga-based classification performance (p = 0.343). Importantly, pre-frozen did not significantly affect surface deviation (p = 0.542). CONCLUSION: These findings indicate that palatal rugae-guided alignment of intraoral scans demonstrated reliable discriminatory performance under progressive postmortem deformation in this ex vivo porcine model. No statistically significant effect of pre-freezing was detected under the present experimental conditions. The results support the potential of ruga-based digital analysis as an investigational approach for postmortem identification workflows, while larger human validation studies are required before forensic implementation. CLINICAL SIGNIFICANCE: Routine acquisition of palatal soft tissue during intraoral scanning can provide an additional forensic benefit by enriching digital dental records. When antemortem scans are available, palatal morphology-particularly the rugae-can serve as a complementary feature for postmortem comparison, especially in delayed or compromised identification scenarios.
Accuracy and agreement of mobile applications in measuring gingival colour: a comparison with spectrophotometry.
Huerga Del Hoyo C, Lobato Carreño M, Flores Fraile J … +3 more , Leo Castela JI, Martín Casado AM, Gómez Polo C
J Dent · 2026 May · PMID 42119936 · Publisher ↗
INTRODUCTION: Mobile applications may offer an accessible alternative for objective gingival colour measurement; however, their accuracy compared with spectrophotometry remains unclear. OBJECTIVES: This study evaluated t...
INTRODUCTION: Mobile applications may offer an accessible alternative for objective gingival colour measurement; however, their accuracy compared with spectrophotometry remains unclear. OBJECTIVES: This study evaluated the accuracy and agreement between seven mobile applications and a reference spectrophotometer for gingival colour measurement using CIELAB coordinates and CIEDE2000 colour differences across different gingival regions. It also assessed whether discrepancies varied according to the region evaluated. MATERIALS AND METHODS: A SpectroShade Micro was used as the reference device. Seven applications were tested: four iOS apps using an iPhone 12 Pro Max and three Android apps using a Samsung Galaxy A52s 5G. Gingival colour was recorded in 250 participants with healthy gingiva in five regions: mesial papilla, distal papilla, free gingival margin, attached gingiva, and mucogingival line. CIELAB values were recorded in triplicate. Differences in L*, a*, b*, and ΔE were calculated and analysed statistically. RESULTS: All mobile applications showed relevant discrepancies compared with the spectrophotometer. The greatest differences were mainly observed in L*, with most applications recording higher lightness values. Android Color Picker AR and Android Colorimeter showed the largest chromatic discrepancies, particularly for a* and b*. OptiShade showed the smallest differences, although its results were still clinically unacceptable in more than 65% (n=163) of cases. Android applications exceeded 98% (n=246) unacceptable differences in all regions CONCLUSIONS: None of the evaluated applications achieved accuracy comparable to spectrophotometry for gingival colour assessment. Although OptiShade performed best, mobile applications cannot currently be considered reliable standalone tools. CLINICAL SIGNIFICANCE: These applications may be useful as complementary tools, but clinical judgement and validated dental-specific technologies remain essential.
Three years long-term impact of powered vs. manual toothbrushes on hypersensitivity and gingival recession: A randomized controlled trial.
Meister S, Hahn T, Cyris M … +4 more , Sutor S, Sälzer S, Dörfer CE, Graetz C
J Dent · 2026 Aug · PMID 42119935 · Publisher ↗
OBJECTIVES: Gingival recessions (GR) are often associated with dentin hypersensitivity (HYP) and can significantly affect patients' oral health-related quality of life. This subgroup-analysis of a previously published st...
OBJECTIVES: Gingival recessions (GR) are often associated with dentin hypersensitivity (HYP) and can significantly affect patients' oral health-related quality of life. This subgroup-analysis of a previously published study assesses the long-term effects of oscillating-rotating powered (PT) and manual toothbrushes (MT) on HYP in teeth with pre-existing GR and no interproximal attachment loss (RT1) over 36 months. METHODS: Ninety participants with RT1 were divided into PT-/MT-group (n = 47/n = 43). All participants brushed twice daily with the same fluoride toothpaste. HYP scores were reassessed for 180 index teeth (PT/MT: n = 94/n = 86); two teeth per participant. HYP was evaluated annually (T0(baseline), T1, T2 and T3) using tactile stimulus with a dental probe (HYP-S) and an air-jet (HYP-L) applied to the index teeth. RESULTS: At T3, HYP-L was significantly reduced in PT but not in MT (p = 0.014). From T0 to T3, 60 % of PT users showed a decrease in HYP-L, 6.4 % remained stable, and 33 % experienced an increase, whereas in MT, 36 % showed a reduction, 18.6 % remained stable, and 45.5 % experienced an increase. This was consistent with the GR stabilization reported in the primary analysis. Between T0 to T3 smokers showed a significantly greater reduction in HYP-L than non-smokers (-1.17(1.49) vs. 0.10(2.27); p = 0.006), regardless of toothbrush group. Male participants exhibited a more pronounced reduction in HYP-S compared to females (-0.09(1.85) vs. -0.04(1.11); p = 0.021). CONCLUSIONS: The tested powered toothbrush reduced HYP-L more than manual toothbrushing over 36 months; HYP-S was unaffected. Findings are exploratory and require confirmation. CLINICAL SIGNIFICANCE: Over 36 months, oscillating-rotating powered brushing was associated with a reduction in air-jet-induced dentin hypersensitivity at RT1-type gingival recession sites. The effect is small and exploratory; powered brushing appears safe in this population but should not be recommended on the basis of hypersensitivity reduction until confirmed in a trial prospectively powered for that endpoint. TRIAL REGISTRATION: This study was prospectively registered in the German Clinical Trials Register (DRKS00015133) on July 25, 2018.
Dental caries linked to gestational and early-life secondhand smoke exposure.
Patil SS, Cardenas A, Pillarisetti A … +12 more , Steenland K, Patil SS, Nuvvula SK, Navilebasappa A, Ghosh S, Balakrishnan K, Waller LA, Jabbarzadeh S, Peel J, Clasen TF, Barr DB, Puttaswamy N
J Dent · 2026 Sep · PMID 42114646 · Full text
BACKGROUND: Few studies have investigated how different exposure windows - gestational, early postnatal, and current - of secondhand smoke (SHS) contribute to early childhood caries (ECC). Understanding these critical wi...
BACKGROUND: Few studies have investigated how different exposure windows - gestational, early postnatal, and current - of secondhand smoke (SHS) contribute to early childhood caries (ECC). Understanding these critical windows is essential for designing targeted interventions. We evaluated the association between SHS exposure and ECC among preschoolers. METHOD: This study was nested within the prospective birth cohort (HAPIN trial) conducted in southern India (2018-2020). Comprehensive data on exposure, lifestyle, and health were collected at multiple maternal and child time points. Between April and September 2023, dental caries and current exposure were assessed in children aged 3 - 5 years by a trained dentist using standardized, calibrated methods. SHS exposure was measured using questionnaires and urinary nicotine metabolites (cotinine, 3-hydroxycotinine). Negative binomial hurdle models were used to assess associations between SHS exposure and ECC prevalence. RESULTS: Among 712 participants (mean age: 4.01 ± 0.45 years; 53.4% boys), 478 children (67.2%) were diagnosed with ECC. Children exposed to SHS (urinary nicotine equivalents - sum of cotinine and 3-hydroxycotinine) during the gestational period demonstrated significantly higher prevalence of caries than their unexposed counterparts, with an incidence rate ratio (IRR) of 1.29 (95% CI, 1.18-1.42); second trimester was identified as a critical exposure window. Similarly, postnatal exposure increased ECC risk (IRR, 1.19; 95% CI, 1.08-1.31). Paternal smoking significantly elevated ECC prevalence, with children whose fathers smoked ≥11 cigarettes/day showing higher odds of ECC (odds ratio (OR), 1.90; 95% CI, 1.10-3.41). Urinary nicotine metabolites exhibited a dose-response relationship with ECC, showing the strongest association during pregnancy. Children classified as slow metabolizers were more vulnerable to third-trimester SHS exposure (OR, 1.74; 95% CI, 1.15-2.64). CONCLUSION: SHS exposure from pregnancy through early childhood was linked to higher odds of developing dental caries. CLINICAL SIGNIFICANCE: Findings underscore another precarious health risk associated with SHS exposure and highlight the need for integrated oral-environmental health prevention strategies.
Corrigendum to "Association between HbA1c chairside values and periodontitis" [Journal of Dentistry 167C (2026)106563].
Ide M, Mainas G, Kansagra N … +6 more , Al-Zaeim I, Ang RN, Owen DR, Ghuman M, Cook RJ, Nibali L
J Dent · 2026 Aug · PMID 42108112 · Publisher ↗
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A new automated 3d facial soft tissue landmarking method via deep learning.
Bao H, He Z, Wu J … +5 more , Baxter J, Senhadji L, Shu H, Liu L, Yan B
J Dent · 2026 May · PMID 42103064 · Publisher ↗
OBJECTIVES: To propose and evaluate a novel deep learning (DL)-based facial soft tissue network (FST-Net) for the automatic detection of 34 commonly used three-dimensional (3D) soft tissue landmarks and eight measurement...
OBJECTIVES: To propose and evaluate a novel deep learning (DL)-based facial soft tissue network (FST-Net) for the automatic detection of 34 commonly used three-dimensional (3D) soft tissue landmarks and eight measurements. METHODS: A total of 297 patient cases were randomly allocated into training (n = 207), validation (n = 30), and testing sets (n = 60) for automated landmark detection through feature fusion and local coordinate regression. The model's performance in terms of landmark localisation and soft tissue measurements was evaluated. RESULTS: The mean radial error (MRE) of all 34 landmarks was 1.80 ± 1.81 mm. For the 28 landmarks with high operator reproducibility (Group 1 landmarks), the MRE was 1.25 ± 0.90 mm, whereas the six landmarks dependent on subjective judgement (Group 2 landmarks) had a larger average error (4.39 ± 2.57 mm). The model achieved successful detection rates (SDRs) within 2, 2.5, 3, and 4 mm of 72.16%, 80.69%, 85.10%, and 90.54%, respectively. By sub-region, lip landmarks had the highest accuracy (1.03 ± 0.69 mm), whereas bilateral cheek landmarks had the lowest (4.39 ± 2.57 mm). The average intra-class correlation coefficient (ICC) values for eight soft tissue measurements were 0.909 between manual and automated detection. Six out of the eight measurements had average errors below 2 mm or 2° CONCLUSION: These findings underscore the potential of deep learning in orthodontics, as exemplified by FST-Net, which offers significant improvements in the accurate and efficient detection of 3D soft tissue landmarks. The method for Group 1 landmarks achieved satisfactory results, whereas for Group 2 landmarks, further optimisation is needed to improve accuracy in future studies. CLINICAL SIGNIFICANCE: FST-Net can automate the detection of 34 commonly used 3D soft tissue landmarks to measure 3D facial characteristics accurately and efficiently, for diagnosis and treatment planning through feature fusion and local coordinate regression. It provides a rapid preliminary landmarking for distinct anatomical features, serving as an auxiliary tool to reduce manual workload, though clinician verification remains mandatory for lateral facial regions.
Modulation of the acquired enamel pellicle by hemoglobin: a scoping review.
Câmara JVF, Santos LA, Araujo TT … +1 more , Buzalaf MAR
J Dent · 2026 Sep · PMID 42103063 · Publisher ↗
OBJECTIVE: This scoping review investigates the potential of Hemoglobin in pellicle engineering, particularly regarding protection against erosion and bacterial adherence. DATA: Studies investigating the effects of Hemog...
OBJECTIVE: This scoping review investigates the potential of Hemoglobin in pellicle engineering, particularly regarding protection against erosion and bacterial adherence. DATA: Studies investigating the effects of Hemoglobin on pellicles formed by human saliva on enamel or dentin were included. SOURCES: A literature search was conducted in Medline and Web of Science up to February 2026. Only English-language research articles were considered. Hand-searching, including checking reference lists, was not conducted. STUDY SELECTION: A total of 3.225 records were identified. After removing duplicates, the titles, abstracts and full texts were screened, resulting in 8 included studies. All studies were conducted on enamel pellicles (n = 8). Hemoglobin demonstrated enamel-binding ability and modified the pellicle proteome by increasing acid-resistant proteins, enhancing resistance to erosion. Only one study evaluated the effects on bacterial adhesion and caries prevention. Combinations with sodium trimetaphosphate showed synergistic effects, though overall findings were mixed. CONCLUSIONS: Hemoglobin has emerged as a potential agent for altering the acquired pellicle to enhance protection against erosion. Nevertheless, the current evidence remains limited, highlighting the need for additional studies conducted under conditions that better reflect clinical reality. CLINICAL SIGNIFICANCE: Modification of the pellicle with Hemoglobin may improve its protective properties.
Digital fit and positional trueness analysis of a crown seated on additively manufactured casts fabricated using different manufacturing trinomials and build orientations.
Şencan B, Dönmez MB, Diken Türksayar AA … +1 more , Demirel M
J Dent · 2026 May · PMID 42103062 · Publisher ↗
OBJECTIVES: To evaluate the fit and positional trueness of a crown seated on additively manufactured casts fabricated using different manufacturing trinomials and build orientations. METHODS: A reference maxillary model...
OBJECTIVES: To evaluate the fit and positional trueness of a crown seated on additively manufactured casts fabricated using different manufacturing trinomials and build orientations. METHODS: A reference maxillary model with a prepared left first molar was digitized to design a reference crown. Resin casts were additively manufactured from the model scan using digital light processing (DLP) or stereolithography (SLA) at 0-, 30-, 45-, and 90-degree build orientations (n = 7). A zirconia crown was fabricated from the reference design and digitized alone and while seated on each cast using an intraoral scanner. Crown fit was assessed using the triple-scan protocol (average gap), and positional trueness was determined by measuring surface deviations (occlusal, buccal, palatal, mesial, and distal) relative to the original design position. Data were statistically analyzed (α = 0.05). RESULTS: The reference crown had the highest average gap when seated on SLA-90, followed by DLP-90 (P < 0.001). Combinations involving the DLP trinomial or 0- and 30-degree orientations generally led to lower positional deviations, whereas those with a 90-degree orientation tended to result in higher deviations (P ≤ 0.033). CONCLUSIONS: Although manufacturing trinomial and build orientation affected fit and positional trueness, average gap values remained below the clinically acceptable threshold except for SLA-90. Higher positional trueness was mostly observed when the crown was seated on DLP casts or casts printed at 0- or 30-degree orientations.
Influence of fluoride-doped calcium phosphates on the mineralisation, physicochemical properties and microbiological activity of glass ionomer cements.
Chou YF, Tsuchiya K, Moreno D … +6 more , Aparicio C, Martins K, Farrar P, Del Giudice C, Spagnuolo G, Sauro S
J Dent · 2026 Sep · PMID 42103061 · Publisher ↗
OBJECTIVES: This study evaluated the effects of incorporating fluoride-doped calcium phosphate (FDCP) into a glass ionomer cement (GIC) and a resin-modified glass ionomer cement (RMGIC) on their physicochemical propertie...
OBJECTIVES: This study evaluated the effects of incorporating fluoride-doped calcium phosphate (FDCP) into a glass ionomer cement (GIC) and a resin-modified glass ionomer cement (RMGIC) on their physicochemical properties, mineralisation potential, and antibacterial behaviour. METHODS: A conventional GIC (Riva SC, SDI Ltd., Australia) and RMGIC (Riva LC, SDI Ltd, Australia) were used to prepare experimental formulations containing different FDCP concentrations (SC 6%, SC 11 %, LC 13 %, and LC 18 %) and were compared with unmodified controls (SC-CTR, LC-CTR). Water sorption, solubility, uptake, pH, calcium and fluoride release, compressive strength and modulus, setting time, and microhardness were assessed. Mineral deposition on material surfaces and demineralised dentine was analysed using FTIR-ATR, SEM-EDX, and XRD after storage in artificial saliva (30 days). Antibacterial activity against Streptococcus gordonii was evaluated by metabolic activity, colony-forming units, and SEM. Cytotoxicity was assessed using human gingival fibroblasts. RESULTS: FDCP incorporation stabilised pH and influenced ion release behaviour in both materials. Increased mineral deposition was observed in FDCP-modified groups, with evidence of apatite-like precipitation, particularly in SC 11 %, LC 13 %, and LC 18 %. Improvements in long-term compressive strength and microhardness were mainly observed in the RMGIC formulations (LC 13 % and LC 18 %), as well as reduced bacterial metabolic activity and surface colonisation. However, reduced fibroblasts viability was also observed in all the tested groups under the test conditions. CONCLUSIONS: The incorporation of FDCP enhanced several functional properties of RGICs, particularly mineralisation and antibacterial behaviour, although some cytotoxic effects were also observed in all tested materials. CLINICAL SIGNIFICANCE: FDCP-modified GICs may improve the overal performance of GI-based restorative materials in clinical situations, as well as remineralisation and antibacterial activity.
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