Journal Of Dentistry[JOURNAL]
Sun
200 papers
Non-thermal plasma for dental zirconia surface modification: a narrative review.
Luo M, Liu Z, Hu X … +3 more , Cao Y, Song K, Du X
J Dent · 2026 May · PMID 42097444 · Publisher ↗
OBJECTIVES: Zirconia surface inertness causes insufficient bonding with resin cement, limited osseointegration, and challenging oral repair and implantation. This review explores nonthermal plasma (NTP)-mediated surface...
OBJECTIVES: Zirconia surface inertness causes insufficient bonding with resin cement, limited osseointegration, and challenging oral repair and implantation. This review explores nonthermal plasma (NTP)-mediated surface modification to enhance resin bond strength and improve osseointegration by regulating the physicochemical properties of zirconia. DATA AND SOURCES: This narrative review was conducted in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA). Relevant studies were identified through electronic searches of PubMed, Web of Science, and Google Scholar databases. STUDY SELECTION: Search terms included "non-thermal plasma" OR "cold atmospheric plasma" AND "zirconia" AND "bond strength" OR "surface modification" OR "biocompatibility". Studies investigating the physicochemical, mechanical, and biological effects of NTP on zirconia were included after applying predefined inclusion criteria. CONCLUSIONS: NTP enhances zirconia-resin adhesion by optimizing surface chemistry and wettability without inducing phase transformations. However, long-term stability requires hybrid strategies that integrate mechanical abrasion, chemical primers, and plasma activation. Future efforts must standardize NTP parameters, such as gas type, power, and duration, and validate clinical protocols using aging-resistant designs and randomized trials. CLINICAL SIGNIFICANCE: NTP surface modification may offer a clinically relevant adjunct to conventional zirconia pretreatment methods by improving surface reactivity and bonding performance, with potential implications for enhancing the longevity of zirconia-based restorations.
Artificial intelligence for detection of root canal fillings and evaluation of obturation quality on dental radiographs: A systematic review.
Guimarães HHDSD, Matos KN
J Dent · 2026 Aug · PMID 42092623 · Publisher ↗
OBJECTIVES: To systematically evaluate evidence on artificial intelligence (AI) for root canal filling (RCF) detection and radiographic assessment of obturation quality. DATA: Eligible studies assessed AI-based models fo...
OBJECTIVES: To systematically evaluate evidence on artificial intelligence (AI) for root canal filling (RCF) detection and radiographic assessment of obturation quality. DATA: Eligible studies assessed AI-based models for RCF detection and/or obturation quality assessment using dental radiographs and cone-beam computed tomography (CBCT). SOURCES: PubMed, Embase, Scopus, ClinicalTrials.gov, Cochrane Library, Web of Science, Google Scholar, and Open Science Framework were searched up to March 2026. STUDY SELECTION: Studies evaluating AI-based models for RCF detection and/or obturation quality assessment were included. Data were synthesized qualitatively. Risk of bias was assessed with QUADAS-2 and certainty of evidence with GRADE. Thirteen studies were included, comprising 12,513 examinations from periapical, panoramic, bitewing, and CBCT images. For RCF detection, sensitivity ranged from 0.85 to 1.00 and specificity from 0.92 to 1.00. For obturation quality assessment, sensitivity ranged from 0.79 to 1.00 and specificity from 0.99 to 1.00, with better performance in periapical radiographs and CBCT than panoramic radiographs. Risk of bias was mainly related to patient selection and lack of external validation, and substantial heterogeneity was observed. CONCLUSIONS: AI-based models show promise for RCF detection, whereas performance for obturation quality assessment is more variable and modality-dependent. AI may serve as an adjunct in endodontic radiographic evaluation. CLINICAL SIGNIFICANCE: AI-based systems may affect clinical workflows through automated radiographic pre-screening, image interpretation support, and real-time second-opinion validation. These tools may reduce interpretation time, improve diagnostic consistency, and support detection of endodontic findings, particularly in high-volume settings. External validation and prospective studies are required before routine clinical implementation.
Explainable artificial intelligence in endodontics: Concepts, clinical applications, and future directions.
Turky M, Samaranayake L, Osathanon T … +1 more , Dummer PMH
J Dent · 2026 Aug · PMID 42086142 · Publisher ↗
OBJECTIVES: An inherent `black box` nature of artificial intelligence (AI) remains a significant barrier to clinical adoption. Explainable artificial intelligence (XAI) has emerged as an approach to enhance transparency...
OBJECTIVES: An inherent `black box` nature of artificial intelligence (AI) remains a significant barrier to clinical adoption. Explainable artificial intelligence (XAI) has emerged as an approach to enhance transparency and interpretability. This narrative review evaluates the evolving role of XAI, with particular emphasis on its current applications, prospective utility in endodontics, and inherent challenges. DATA AND SOURCES: A search was conducted across databases, including PubMed and Scopus, covering literature up to April 2026. The retrieved studies were subsequently synthesised narratively. STUDY SELECTION: Studies on the discourse surrounding XAI were reviewed, including the technical foundations of XAI, applications of XAI in dentistry and endodontics, the benefits and challenges of XAI in endodontics, and research gaps and future directions in XAI for endodontics. CONCLUSION: The investigation of XAI in endodontics remains relatively limited. The literature review highlights the necessity of XAI systems that are methodologically rigorous, clinically relevant, and ethically sound, with their development supported by well-designed prospective studies. XAI development should be advanced as a transformative framework that strengthens the speciality's evidence base and enables interpretable, equitable, and precisely tailored treatment strategies. XAI has the potential to support more transparent, personalised, and reliable endodontic care. CLINICAL SIGNIFICANCE: By enhancing the transparency of AI systems, XAI have the potential to improve clinical decision-making in endodontics and contribute to the delivery of high-quality, patient-centred care.
Quantifying the environmental impact potential from periodontal health to disease: Findings from a life cycle assessment study.
Duane B, Martin N, Mulligan S … +3 more , Mackenzie L, Dewaele J, Wedel L
J Dent · 2026 Sep · PMID 42086141 · Publisher ↗
OBJECTIVE: To quantify environmental impacts of periodontal health and diseases, ranging from at home preventive care to dental treatments. METHODS: A Life Cycle Assessment was conducted to quantify environmental impacts...
OBJECTIVE: To quantify environmental impacts of periodontal health and diseases, ranging from at home preventive care to dental treatments. METHODS: A Life Cycle Assessment was conducted to quantify environmental impacts of daily at home oral care routines using either an electric or manual toothbrush, plus toothpaste and floss, and environmental impacts of clinical treatments for patients with gingival health and varying stages of diagnosed periodontal disease. RESULTS: As periodontal disease severity increases, so does the overall environmental impact due to more visits, treatments and energy used at clinic. For the average patient, the environmental impact (including carbon footprint) from in-clinic treatment is approximately 2-4x higher compared to at-home preventive care routines with either manual or electric toothbrush, and 10x higher for patients with more severe forms of periodontal disease. At home, there is no statistical difference between using a manual and electric toothbrush across all impact categories. CONCLUSIONS: The environmental implications from periodontal health/disease are best assessed by analysis that includes at-home routines and in-clinic disease management; the latter is the dominant emission source. Effective at-home oral hygiene routines aid in preventing disease and are considered beneficial to mitigate the environmental impacts from periodontal disease treatment in dental clinics. CLINICAL SIGNIFICANCE: From a clinical perspective, the findings reinforce the importance of effective preventive oral hygiene in limiting disease progression and reducing the need for resource intensive periodontal treatment. By integrating environmental and clinical considerations, this study highlights that maintaining periodontal health delivers dual benefits for both patient outcomes and sustainable dental care delivery.
In vitro assessment of the antibacterial properties of novel chemomechanical caries removal agents and their impact on bonding performance to resin composite restorations.
Al-Badri H, Al-Taee LA, Hashem D … +3 more , Ahmed KE, Banerjee A, Al-Shammaree SA
J Dent · 2026 Aug · PMID 42086140 · Publisher ↗
OBJECTIVES: To assess the antibacterial efficacy of novel bromelain-containing chemomechanical caries removal (CMCR) agents and their effect on the bonding strength of residual dentine to an adhesive resin composite rest...
OBJECTIVES: To assess the antibacterial efficacy of novel bromelain-containing chemomechanical caries removal (CMCR) agents and their effect on the bonding strength of residual dentine to an adhesive resin composite restoration. METHODS: The antibacterial efficacy of three formulated CMCR gels, comprising 30 % bromelain (F1), 30 % bromelain with 0.1 wt.% chloramine-T (F2), and 30 % bromelain with 1.5 % chlorhexidine (F3), was evaluated in comparison to Brix 3000, specifically against Streptococcus mutans and Lactobacillus acidophilus species. A total of 120 extracted permanent molars exhibiting natural carious lesions were randomly allocated into six groups based on excavation techniques; hand excavation, rotary excavation, Brix 3000, F1, F2, and F3. The microshear bond strength (µSBS) of the residual dentine to resin composite was assessed after two-time intervals. The morphological assessment was conducted using scanning electron microscopy (SEM). RESULTS: F3 demonstrated the most pronounced statistically significant antimicrobial efficacy against both bacterial species (p < 0.001), as well as the highest statistically significant immediate µSBS to the residual dentine (p < 0.001). In contrast, F2 exhibited the highest µSBS mean value post aging (p < 0.001), along with the greatest percentage of mixed and cohesive failures. This was accompanied by the presence of a well-integrated hybrid layer and numerous elongated resin tags within the residual dentine. CONCLUSION: The novel bromelain-based CMCR gels, particularly when combined with chlorhexidine, demonstrated a remarkable antimicrobial efficiency. In contrast, the formulation containing chloramine-T exhibited superior prolonged bonding performance. CLINICAL SIGNIFICANCE: These novel formulations present a promising strategy for caries management and enhance the longevity of adhesive restorations.
Tooth loss is associated with subsequent brain white matter degradation up to over a decade.
Tian Q, Qi X, Greig EE … +5 more , Landman BA, Davatzikos C, Resnick SM, Wu B, Ferrucci L
J Dent · 2026 Aug · PMID 42082094 · Full text
OBJECTIVES: Tooth loss is linked to cognitive impairment and cognitive decline in older adults. Whether tooth loss is associated with loss of brain structure is unknown, particularly with respect to white matter integrit...
OBJECTIVES: Tooth loss is linked to cognitive impairment and cognitive decline in older adults. Whether tooth loss is associated with loss of brain structure is unknown, particularly with respect to white matter integrity, which is vulnerable to inflammation and vascular pathology. METHODS: We examined the associations between clinically assessed tooth loss and subsequent changes in brain atrophy and microstructural integrity over an average follow-up of 4.8 (SD=3.6) years in 375 Baltimore Longitudinal Study of Aging participants (mean age=65.5 years, 53.6% women, average tooth loss: 3) using linear mixed-effects models, adjusted for age, sex, race, and scanner site. Brain volumes and microstructural integrity were assessed via 3T MRI volumetric scans and DTI, respectively, over up to 12 years between 2008 and 2020. RESULTS: More tooth loss was cross-sectionally associated with a larger 4th ventricle, smaller brain volumes in temporal areas, greater deep white matter signal abnormalities, and lower white matter integrity in the corpus callosum. Longitudinally, each tooth loss was associated with a faster increase in diffusivity in the corpus callosum and corona radiata (all p < 0.01), suggesting loss of microstructural integrity. Tooth loss was also associated with higher white blood cell counts, neutrophil counts, and erythrocyte sedimentation rate, greater increases in white blood cell and neutrophil counts and greater decrease in albumin over time (all p < 0.05). Adjustment for these markers did not alter the associations with neuroimaging outcomes. CONCLUSION: Tooth loss may indicate subsequent white matter degradation, independent of inflammation markers. Future studies are warranted to elucidate the biological mechanisms driving these associations. CLINICAL SIGNIFICANCE: Within aging, tooth loss may indicate an unfavorable brain structure which overlaps with the Alzheimer's disease signature and indicate long-term degradation of white matter integrity and increased inflammation.
Oral and dental complications and management in head and neck cancer patients: An umbrella review.
Craig R, O'Kane R, Rodriguez J … +3 more , Scambler S, Conway D, Gallagher J
J Dent · 2026 Aug · PMID 42082093 · Publisher ↗
OBJECTIVES: To synthesise evidence on oral and dental side-effects experienced by head and neck cancer (HNC) patients, assess the strength and quality of existing systematic reviews, evaluate the evidence for prevention...
OBJECTIVES: To synthesise evidence on oral and dental side-effects experienced by head and neck cancer (HNC) patients, assess the strength and quality of existing systematic reviews, evaluate the evidence for prevention and management interventions and identify key gaps to inform future research. DATA: Systematic reviews (with/without meta-analysis) published from 2015 onwards involving adults with HNC reporting oral/dental complications and/or interventions were included. SOURCES: MEDLINE (OVID), Embase, Cochrane Database of Systematic Reviews and Scopus were searched (19 June 2025). Two reviewers screened and extracted data independently. STUDY SELECTION: An umbrella review (PROSPERO CRD420251063188) was conducted following JBI/Cochrane guidance and reported in line with PRISMA 2020. Methodological quality was assessed using AMSTAR-2 and primary-study overlap quantified using corrected-covered-area (CCA). Owing to heterogeneity, findings were synthesised narratively by domain. CONCLUSIONS: A total of 131 systematic reviews were included, with most rated as low or critically low confidence. Oral mucositis was the most frequently reported complication, followed by xerostomia, dysphagia, trismus, dental caries, and dysgeusia; osteoradionecrosis was less common. Preventive and therapeutic interventions are widely studied but largely supported by low-quality evidence. Photobiomodulation was associated with reduced oral mucositis, while intensity-modulated radiotherapy was associated with reduced xerostomia and mandibular osteoradionecrosis. Overall, the evidence base is fragmented and of low confidence. Standardised outcome measures and high-quality prospective studies are needed to strengthen the evidence base and improve survivorship care. CLINICAL SIGNIFICANCE: Head and neck cancer patients experience a high burden of oral complications, yet dental management strategies are supported by limited high-quality evidence. This review highlights key areas of uncertainty and reinforces the need for multidisciplinary, evidence-based care, while identifying priorities for research to improve long-term oral health and quality of life.
Temporal trends in large language model (LLM) accuracy: A meta-analysis of multiple-choice question performance in dentistry and dental education.
Doubleday AF, Cheverko CM, Bolgova O … +24 more , Mavrych V, Mohamed FRR, Westrick J, Juarez L, Rush E, Solka KA, Byram JN, Beacker 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 Aug · PMID 42066887 · Publisher ↗
OBJECTIVES: Studies have investigated the potential applications of Large Language Models (LLMs) in dental education. As LLMs evolve, it is necessary to determine the extent to which their accuracy improves before they c...
OBJECTIVES: Studies have investigated the potential applications of Large Language Models (LLMs) in dental education. As LLMs evolve, it is necessary to determine the extent to which their accuracy improves before they can be integrated into dental curricula and clinical practice. This meta-analysis investigates the performance of LLM versions on text-based single-best-answer multiple-choice questions (MCQs) in dentistry over time and assesses the impact of question type and source on LLM accuracy. MATERIALS AND METHODS: Typical guidelines for reporting systematic reviews and meta-analyses were followed. Study eligibility followed the PICO (Population, Intervention, Comparison, Outcomes) model. Included records were published between January 2022 and August 2025. Screenings and data extractions were performed by two reviewers, with disagreements resolved by a third reviewer. Proportional meta-analysis was used to determine the pooled accuracy of LLM versions across studies. Meta-regression explored sources of heterogeneity. RESULTS: Twenty-seven articles met the inclusion criteria. Over time, LLM accuracy in answering dentistry MCQs has significantly improved (p<0.001). Heterogeneity across all LLMs was high (≥90%). OpenAI's models (ChatGPT-3.5, 4, and 4o or newer) significantly outperformed competitors (p<0.001). Question type (stem-only vs. clinical vignette + stem) and question source (locally developed, for-profit commercial product, or free resources) did not significantly affect accuracy. CONCLUSIONS: As LLMs evolve, their accuracy on MCQs is improving, increasing their potential as supplemental tools in dental education.
Influence of the number of implants on the accuracy of complete-arch impressions: In vitro comparison of photogrammetry and intraoral scanners using a coordinate measuring machine.
Robert N, Albert A, Bechet E … +1 more , Lamy M
J Dent · 2026 Sep · PMID 42066886 · Publisher ↗
OBJECTIVE: To evaluate the influence of the number of implants on the accuracy of complete-arch implant impressions using different photogrammetry systems and an intraoral scanner, and to assess the effect of scan body r...
OBJECTIVE: To evaluate the influence of the number of implants on the accuracy of complete-arch implant impressions using different photogrammetry systems and an intraoral scanner, and to assess the effect of scan body repositioning on impression reproducibility. METHODS: Three maxillary stone casts containing four, six, and eight implants, respectively, were manufactured. Impressions were obtained using four techniques: extraoral photogrammetry (PG), navigated photogrammetry (NPG), intraoral photogrammetry (IPG), and intraoral scanner (IOS). For each configuration, ten impressions were recorded under fixed scan body conditions and ten with two repositioned scan bodies. A coordinate measurement machine provided reference coordinates. Linear deviations were assessed by the root mean square (RMS, mm) and the angular deviation was calculated as the mean of absolute angular deviations (MEAN-D, °) using custom-developed software. Experimental data were analyzed using linear regression analysis (p < 0.05). RESULTS: Photogrammetry systems demonstrated superior accuracy to intraoral scanning. PG achieved the lowest linear deviation (0.037 mm) followed by IPG (0.057 mm) and NPG (0.077 mm), whereas IOS exhibited the highest deviations (0.099 mm). Mean angular deviation (MEAN-D) was 0.16° (PG), 0.40° (IPG), 0.33° (NPG), and 0.78° (IOS). Regression analyses showed that RMS increased with the number of implants, while MEAN-D decreased. Significant differences were found between all impression techniques, while scan body repositioning had no clinically meaningful effect across systems. Overall precision (CV) was 24.9 % for RMS and 28.6 % for MEAN-D, and for both parameters precision was highest for PG and lowest for IOS. CONCLUSIONS: Under the conditions of this in vitro study, photogrammetry provides superior accuracy (trueness and precision) compared to intraoral scanning for complete-arch implant impressions. The number of implants influences accuracy, whereas scan body repositioning has minimal effect. CLINICAL SIGNIFICANCE: These findings highlight the in vitro performance of photogrammetry systems and their potential applicability in complete-arch digital implant workflows.
Microbial alteration after intensive fluoride varnish treatment in children with early childhood caries: An exploratory study.
Li Y, Zhang L, Paster BJ … +1 more , Xiao J
J Dent · 2026 Aug · PMID 42061740 · Publisher ↗
OBJECTIVE: In this study, we aimed to evaluate the effect of an intensive fluoride varnish (FV) regimen on oral microbial communities in children with early childhood caries (ECC). METHODS: Twenty-six children, aged 2 to...
OBJECTIVE: In this study, we aimed to evaluate the effect of an intensive fluoride varnish (FV) regimen on oral microbial communities in children with early childhood caries (ECC). METHODS: Twenty-six children, aged 2 to 5 years, diagnosed with early-stage ECC, were included. They were treated with 5% NaF varnish three times over 2 weeks. Pooled supragingival plaque samples (n = 70) were collected and used for extracting total bacterial DNA. The microbial composition was analyzed using the Human Oral Microbe Identification Next-Generation Sequencing (HOMINGS) method. RESULTS: Analysis of 6172,618 high-quality 16S rRNA amplicons revealed significant changes in the relative abundance of oral microbiome taxa at the phylum level immediately after FV treatment (p = 0.021). Although the relative abundance of several known cariogenic species decreased, none of the shifts were statistically significant at the 1-week visit or persisted at the 2-week visit. At the genus level, children with higher mutans streptococci levels showed higher relative abundance of Bacteroidetes, Firmicutes, and Spirochaetes (p = 0.001, p = 0.023, and p = 0.001), respectively. At the species level, FV treatment significantly increased the relative abundance of Corynebacterium durum (p = 0.009) and Neisseria sicca (p = 0.031) but did not significantly disrupt commensals within the microbial community. CONCLUSIONS: Intensive FV application alone does not significantly alter the core oral microbiome of children with untreated ECC. The treatment may temporarily reduce the cariogenic microbial burden immediately after treatment. However, the long-term effects of FV on the oral microbiome still remain uncertain.
Efficacy, pH, and enamel effects of an over-the-counter non-hydrogen peroxide gel for at-home tooth bleaching.
Jiménez-Díez D, Carneiro TS, Monzón C … +5 more , Barbosa LMM, Favoreto MW, Loguercio AD, Fuentes V, Ceballos L
J Dent · 2026 Aug · PMID 42061739 · Publisher ↗
OBJECTIVES: To evaluate the bleaching efficacy of an over-the-counter, non-hydrogen peroxide at-home gel based on phthalimidoperoxycaproic acid (PAP) combined with papain and bromelain, compared with a 10% carbamide pero...
OBJECTIVES: To evaluate the bleaching efficacy of an over-the-counter, non-hydrogen peroxide at-home gel based on phthalimidoperoxycaproic acid (PAP) combined with papain and bromelain, compared with a 10% carbamide peroxide (CP) gel and a negative control. Gel pH and enamel effects were also assessed. METHODS: Seventy enamel specimens from 35 sound human molars were randomly allocated to five groups (n = 14). The PAP gel (White Night) and 10% CP gel (Pola Night) were applied daily for 3 or 6 h over 28 days; an untreated group stored in artificial saliva served as control. Color coordinates (L*, a*, b*) were recorded using a spectrophotometer at baseline and after 7, 14, 21, and 28 days. The Whiteness Index (ΔWI), CIELab (ΔE), and CIEDE2000 (ΔE) differences were calculated. Gel pH was measured hourly for 6 h using a calibrated microelectrode. Enamel micromorphology was examined by SEM. Data were analyzed using two-way repeated measures ANOVA (α = 0.05). RESULTS: The PAP gel showed higher ΔWI values than the control from day 14 onward, with no additional increase thereafter. The CP gel produced higher ΔWI values than both PAP and control from day 7, with progressive increases. No differences between the 3- and 6-hour protocols for either the PAP or CP groups were detected. PAP maintained an alkaline pH, whereas CP showed slightly acidic values. No relevant enamel alterations were observed. CONCLUSIONS: The PAP gel produced a bleaching effect after 14 days, independent of application time, although less effective than 10% CP. Both gels showed no detectable enamel surface damage.
'Aryldiazonium-based surface functionalization enhances the bond strength between PMMA and cobalt-chromium or carbon fiber prosthetic frameworks'.
Haroyan-Darbinyan E, Rivero González MA, Celemin-Viñuela A … +2 more , Jóves-Méndez GJ, Castillo-Oyagüe R
J Dent · 2026 Aug · PMID 42061738 · Publisher ↗
OBJECTIVES: This laboratory study investigated the effect of aryldiazonium-based surface functionalization on the tensile bond strength (TBS) between polymethyl methacrylate (PMMA) and cobalt-chromium (Co-Cr) or carbon f...
OBJECTIVES: This laboratory study investigated the effect of aryldiazonium-based surface functionalization on the tensile bond strength (TBS) between polymethyl methacrylate (PMMA) and cobalt-chromium (Co-Cr) or carbon fiber (CF) prosthetic framework materials. METHODS: Forty specimens were fabricated and allocated into four groups (n = 10): Co-Cr treated with metal primer (AC), diazonium-grafted Co-Cr (DC), CF treated with bonding resin (FA), and diazonium-modified CF (FD). Specimens were thermocycled (5000 cycles; 5-55 °C; dwell time: 30 s) and subjected to tensile bond strength testing using a universal testing machine. Failure modes were analysed by stereomicroscopy and scanning electron microscopy (SEM-EDS). Statistical analysis was performed using one-way ANOVA followed by Bonferroni post hoc tests (α = 0.05). RESULTS: The AC group exhibited the significantly lowest TBS values in the study (p < 0.001). No significant differences were observed among DC, FA, and FD groups (p > 0.05). Diazonium-treated specimens predominantly showed cohesive or mixed failure patterns, whereas adhesive failures were prevalent in the metal-primer group CONCLUSIONS: The use of diazonium salts as surface primers may increase the bond strength of prosthetic framework materials such as Co-Cr or carbon fiber to acrylic resin. CLINICAL SIGNIFICANCE: Aryldiazonium surface functionalization may improve the bonding performance of PMMA to both metallic and carbon fiber frameworks, representing a promising strategy for enhancing the durability of prosthetic framework-resin interfaces.
Are there Hawthorne-like participation effects in oral-hygiene research? Evidence from longitudinal plaque mapping.
Ganss C, Jung K
J Dent · 2026 Sep · PMID 42049110 · Publisher ↗
OBJECTIVES: To investigate Hawthorne-like research participation effects on toothbrushing-related plaque outcomes. The data source was a longitudinal flossing study without toothbrushing instruction. METHODS: This second...
OBJECTIVES: To investigate Hawthorne-like research participation effects on toothbrushing-related plaque outcomes. The data source was a longitudinal flossing study without toothbrushing instruction. METHODS: This secondary analysis used disclosed-plaque intraoral scans from 37 subjects (23.1±3.2 years) obtained at four pre-flossing time points over 4 weeks. Plaque coverage (P%) was quantified planimetrically on oral (i.e. lingual/palatal) and vestibular (i.e. buccal/labial) surfaces of the Ramfjord teeth (FDI 16, 21, 24, 36, 41, 44). Linear mixed-effects models tested changes over time and, in a more differentiated model, surface and tooth-group interactions. Baseline tertiles of participant-level P% were used to assess heterogeneity in trajectories. Plaque dynamics (Gain/Loss/Stable areas) were derived from binary plaque masks and summarised across baseline-referenced intervals (T1-T2, T1-T3, T1-T4). RESULTS: Overall P% did not change from T1-T4 (p=0.527). P% was higher on oral than vestibular surfaces (p<0.001), with no evidence that time trends differed by surface or tooth group (all interactions p≥0.315). Trajectories were similar across baseline P% tertiles (time×tertile p=0.794). Loss and Gain areas were stable across intervals (Loss p=0.435; Gain p=0.343) and did not differ by baseline tertile (p≥0.327). Stable areas decreased from 38.3% (T1-T2) to 34.9% (T1-T3) and 33.8% (T1-T4) (interval p<0.001). CONCLUSIONS: Across multiple analytical perspectives, there was little evidence that study participation produced clinically relevant changes in toothbrushing-related plaque outcomes. CLINICAL RELEVANCE: Over short follow-up, toothbrushing-related plaque outcomes appeared largely stable despite repeated study participation, providing context for interpreting longitudinal plaque measurements in oral-hygiene research.
Attenuation behavior of blue (laser) light in dentin: A literature-based evaluation regarding the validity of the Bouguer-Beer-Lambert law for dental applications.
Lusche I, Frentzen M, Wierichs RJ … +1 more , Meister J
J Dent · 2026 Aug · PMID 42044723 · Publisher ↗
BACKGROUND: Knowledge about light propagation in dental hard tissue is indispensable in aesthetic dentistry and therapeutic applications of lasers. Since the blue (laser) wavelength is suitable for oral surgery, reducing...
BACKGROUND: Knowledge about light propagation in dental hard tissue is indispensable in aesthetic dentistry and therapeutic applications of lasers. Since the blue (laser) wavelength is suitable for oral surgery, reducing bacteria in dentinal structures and light curing of composite resin fillings, this study aims to examine the attenuation properties for the wavelength of approx. 450 nm in dentin and to determine a clinically relevant attenuation coefficient. MATERIAL AND METHODS: As a basis to evaluate an optical attenuation coefficient in coronal human dentin it was necessary to compare the optical transmittance of our own measurement for dentin thicknesses of 0.5 and 1 mm with transmittance values from studies with similar experimental setups. PubMed, Web of Science, Cochrane, Google Scholar and Scopus served as databases for data acquisition. 11 studies using various blue light sources (tungsten halogen, LED, diode laser, xenon and standard illuminants) around the spectral region 450 nm were gathered to determine optical transmittance values. Data (n = 30) in the thickness range of 0.2 mm up to 6 mm dentin were investigated regarding a possible applicability of the Bouguer-Beer-Lambert law for describing the attenuation behavior of anisotropic dentin in interaction with light of blue wavelength. RESULTS: The distribution of the extinction values of all the cited studies illustrates a linear rising trend with increasing dentin thicknesses with the result of applicability of the BBL-law in a first approximation. Based on the transmittance values, a mean attenuation coefficient of 1.22 mm was determined, which corresponds to an attenuation of approx. 70%. This allows the determination of an apparent optical penetration depth of 0.8 mm for light in the blue wavelength range in coronal dentin. CONCLUSIONS: The results show that, despite the inhomogeneous structure of the dentin, the Bouguer-Beer-Lambert law provides a reliable order of magnitude for determining the optical penetration depth of blue light in dentin. CLINICAL SIGNIFICANCE: Clinical laser applications require an understanding of the light propagation of defined wavelengths in biological tissues to protect adjacent structures, amongst other things. The established therapeutically relevant mean attenuation coefficient of 1.22 mm for the blue wavelength of approx. 450 nm in dentin is a further step towards ensuring the safe use of photonic technologies in dentistry.
Antiseptic mouthwashes as a potential strategy for controlling oral dysbiosis: Antimicrobial effect against opportunistic pathogens.
Korbecka-Paczkowska M, Paczkowska-Walendowska M, Cielecka-Piontek J … +1 more , Karpiński TM
J Dent · 2026 Sep · PMID 42035980 · Publisher ↗
OBJECTIVES: Oral dysbiosis is increasingly recognized as a clinically relevant condition associated with oral diseases, systemic complications, and the emergence of antimicrobial-resistant microorganisms. Antiseptic-cont...
OBJECTIVES: Oral dysbiosis is increasingly recognized as a clinically relevant condition associated with oral diseases, systemic complications, and the emergence of antimicrobial-resistant microorganisms. Antiseptic-containing mouthwashes are widely used as adjunctive, non-antibiotic tools in oral hygiene; however, comparative data on their activity against dysbiosis-associated microorganisms and their clinical efficiency at formulation-relevant concentrations remain limited. METHODS: In this study, the antimicrobial activity of commercially available mouthwashes containing octenidine dihydrochloride (OCT), chlorhexidine digluconate (CHX), polyhexamethylene biguanide (PHMB), and cetylpyridinium chloride (CPC) was evaluated against Gram-positive and Gram-negative bacteria and Candida spp. associated with oral dysbiosis. Minimum inhibitory concentrations (MICs) were determined by broth microdilution and expressed both as product dilutions and active compound concentrations. Clinical relevance was assessed using the Clinical Efficiency of MIC (CEMIC) index. RESULTS: OCT-containing mouthwashes demonstrated the lowest MIC and CEMIC values and the most consistent antimicrobial activity against all tested microorganisms. CHX-based formulations showed high activity against Gram-positive bacteria and Candida spp. but were markedly less effective against Gram-negative pathogens. PHMB exhibited lower antimicrobial potency; however, its CEMIC values indicated clinical efficiency at formulation-relevant concentrations. CONCLUSIONS: The results demonstrate in vitro antimicrobial activity of antiseptic mouthwashes against microorganisms associated with oral dysbiosis and suggest that they may have potential as non-antibiotic adjuncts, although this requires clinical validation. CLINICAL SIGNIFICANCE: This study demonstrates that antiseptic mouthwashes, particularly those containing octenidine, chlorhexidine and polyhexanide, effectively control oral dysbiosis at commercial concentrations. By using the CEMIC index, our findings provide evidence-based guidance for non-antibiotic oral care, reduce antimicrobial resistance risk, and support improved oral health.
An injectable κ-carrageenan hydrogel carrier maintains antibiofilm activity while supporting dental pulp-derived stem cell viability in a dentin-based model.
Alajlan MA, Lambarte RNA, Sumague TS … +1 more , Niazy AA
J Dent · 2026 Aug · PMID 42031358 · Publisher ↗
OBJECTIVES: To evaluate the antibiofilm activity of a κ-carrageenan hydrogel (κC) used alone or as a carrier for calcium hydroxide (CH) against mono- and dual-species dentin biofilms, and to assess its cytocompatibility...
OBJECTIVES: To evaluate the antibiofilm activity of a κ-carrageenan hydrogel (κC) used alone or as a carrier for calcium hydroxide (CH) against mono- and dual-species dentin biofilms, and to assess its cytocompatibility in dental pulp-derived stem cells (DPSCs) within a regenerative endodontic model. METHODS: Antibiofilm activity was examined in vitro using monospecies and dual-species cultures of Fusobacterium nucleatum and F. nucleatum + Porphyromonas gingivalis exposed to 2.5% κ-carrageenan hydrogel, CH, or κC+CH, with assessment of broth turbidity and crystal violet biomass. An ex vivo regenerative endodontic model was established using infected dentin segments, and specimens were treated with 2.5% κ-carrageenan hydrogel, CH, or κC+CH. Antibiofilm effects were assessed using alamarBlue™ (resazurin-based) viability assay, confocal Live/Dead imaging, and scanning electron microscopy. Cytocompatibility was evaluated in dental pulp-derived stem cells by MTT, Live/Dead imaging, and alkaline phosphatase activity. RESULTS: κC reduced bacterial viability, while CH showed greater antibacterial activity at later time points. In the ex vivo dentin model, CH and κC+CH reduced biofilm viability relative to control, with κC+CH showing sustained activity in both mono- and dual-species conditions. Quantitative analysis showed reduced biofilm biomass with CH and κC+CH, while κC alone was similar to the control. CH decreased DPSC viability, whereas κC+CH maintained viability near control levels and increased alkaline phosphatase activity. CONCLUSIONS: κC hydrogel showed antibiofilm activity while supporting DPSC viability. When used as a carrier for CH, κC maintained strong antibiofilm activity and showed improved cytocompatibility relative to CH alone, supporting further evaluation in regenerative endodontic-relevant models. CLINICAL SIGNIFICANCE: A κ-carrageenan carrier may improve early antibiofilm activity of calcium hydroxide while reducing its cytotoxicity toward dental pulp stem cells.
Accuracy of smartphone-based photogrammetry for full-arch implant position transfer: a controlled in vitro comparison with scan body-based intraoral scanning.
Gianfreda F, Raffone C, Martelli M … +3 more , Pieralli S, Bollero P, Caponio VCA
J Dent · 2026 Sep · PMID 42031357 · Publisher ↗
OBJECTIVE: To evaluate and compare the accuracy, defined as trueness and precision, and the acquisition time of digital impressions for edentulous full-arch implant position transfer obtained using conventional scan bodi...
OBJECTIVE: To evaluate and compare the accuracy, defined as trueness and precision, and the acquisition time of digital impressions for edentulous full-arch implant position transfer obtained using conventional scan bodies and a novel smartphone-based photogrammetry system. METHODS: A maxillary edentulous model with four multi-unit abutment replicas was scanned using two acquisition methods: (1) an intraoral scanner with conventional scan bodies and (2) a smartphone-based photogrammetry system (PIC APP, iPhone 16 Pro). Each workflow was repeated 20 times. A high-accuracy industrial scanner served as the reference dataset. Accuracy was assessed using centroid root mean square deviation (CRMS), body root mean square deviation (BRMS), and angular deviation. Acquisition time was also recorded. Statistical comparisons were performed using the Mann-Whitney U test (α = 0.05). RESULTS: Smartphone-based photogrammetry demonstrated significantly lower CRMS trueness (54.8 ± 6.57 µm) compared with conventional scan body-based intraoral scanning (244.13 ± 162.65 µm, p < 0.001). BRMS values were also significantly lower for the photogrammetry workflow (31.70 ± 14.15 µm vs. 67.62 ± 40.52 µm, p < 0.001). Angular deviation was slightly greater with photogrammetry (0.54° ± 0.03 vs. 0.39° ± 0.13, p = 0.001), although both remained within clinically acceptable limits. Acquisition time was longer for the smartphone-based workflow (97 vs. 50 s, p < 0.001). CONCLUSION: Within the limitations of this in vitro study and with reference to the intraoral scanning workflow evaluated, the smartphone-based photogrammetry system demonstrated trueness and precision values compatible with the requirements for full-arch implant position transfer accuracy. Compared with conventional scan body-based intraoral scanning, the system showed reduced linear deviations and greater consistency in implant position transfer under controlled experimental conditions. CLINICAL SIGNIFICANCE: Smartphone-based photogrammetry may represent a promising digital approach for implant position acquisition in full-arch rehabilitations. Its use of widely available mobile hardware and reduced system complexity suggests potential advantages in accessibility compared with conventional photogrammetry systems. However, the clinical performance, economic impact, and workflow efficiency of this technology must be confirmed with prospective clinical trials and dedicated cost-benefit analyses before definitive clinical recommendations can be made.
Trends and life-course trajectories in the burden of oral frailty from midlife to later life: a 13-year population-based study in Korea.
Go H, Kim EK, Kuboniwa M … +1 more , Choi YH
J Dent · 2026 Aug · PMID 42025904 · Publisher ↗
BACKGROUND: This study investigated temporal trends and life-course trajectories in the burden of oral frailty (OF) and severe oral frailty (SOF) in Korea. METHODS: Adults aged ≥40 years who participated in the Korea Nat...
BACKGROUND: This study investigated temporal trends and life-course trajectories in the burden of oral frailty (OF) and severe oral frailty (SOF) in Korea. METHODS: Adults aged ≥40 years who participated in the Korea National Health and Nutrition Examination Survey from 2007 to 2019 were included. OF (≥2 components) and SOF (≥3 components) were defined across four domains: number of teeth, chewing ability, pronunciation, and oral hygiene. Crude and age-standardized prevalence estimates were calculated. Age-period-cohort (APC) effects were assessed using survey-weighted logistic regression. Joinpoint regression were evaluated to derive average annual percent change (AAPC). RESULTS: The survey-weighted prevalence OF declined from 22.71 % to 18.93 %, and SOF from 9.91 % to 7.26 % among Korean adults aged ≥40 years (AAPC: OF -5.64 %, SOF -7.11 %; p < 0.05). Age-standardized prevalence also declined from 20.89 % to 15.72 % for OF, and from 8.92 % to 5.83 % for SOF. Cohort-by-period analyses revealed that the 1962-1965 birth cohort showed a significant increase in OF between 2007 and 2015, and in SOF between 2007 and 2019. Age-by-cohort analyses indicated rising prevalence among individuals in their 40s-50 s, contrasting with declining patterns in older cohorts (p < 0.001). APC model showed consistent age and cohort effects, but weaker period effects. CONCLUSIONS: Although the overall burden OF and SOF has declined in Korea, increasing prevalence during midlife highlights the 40s-50 s as a critical window for preventive intervention along the frailty trajectory. CLINICAL SIGNIFICANCE: Despite overall reductions in the burden of oral frailty, the rising prevalence among individuals in midlife underscores the importance of early detection and preventive oral health strategies in adults in their 40 s and 50 s. Targeted interventions during this critical life stage may help delay progression to severe oral frailty and reduce long-term functional disability in later life.
A potent dual-targeting antimicrobial peptide specifically against Streptococcus mutans biofilms.
Wei J, Chen Z, Li S … +7 more , Zhou S, Riaz A, Ma S, Li Y, Shu T, Niu H, He J
J Dent · 2026 Jul · PMID 42025903 · Publisher ↗
INTRODUCTION: Dental caries, which are caused primarily by Streptococcus mutans biofilms, demand targeted antimicrobial strategies to overcome the limitations of broad-spectrum agents such as chlorhexidine (CHX). Here, w...
INTRODUCTION: Dental caries, which are caused primarily by Streptococcus mutans biofilms, demand targeted antimicrobial strategies to overcome the limitations of broad-spectrum agents such as chlorhexidine (CHX). Here, we designed and synthesized a chimeric peptide (PMF) integrating three functional domains to achieve species-selective anti-microbial and anti-biofilm activities. METHODS: The antimicrobial peptides were chemically synthesized, and their biological activities were assessed. These included hemolytic and cytotoxic effects, antibacterial activity against planktonic bacteria, and antibiofilm properties. Antibacterial activity against planktonic bacteria was determined by MIC, MBC, time‑kill kinetics, and live/dead staining. Antibiofilm properties were evaluated by biofilm imaging, post‑antibiofilm effect, and crystal violet quantification. We further investigated their mechanisms of action, focusing on membrane disruption via nucleotide leakage, PI uptake, and zeta potential measurements. The damage to biofilms was also examined by assessing membrane potential and using scanning electron microscopy. RESULTS: PMF exhibited potent efficacy against S. mutans (MIC/MBC = 1.56/3.13 μM) while sparing commensals (S. sanguinis/S. gordonii MIC >100 μM). At 25 μM, a 15 min treatment inhibited 4 h biofilm growth without affecting commensal growth. Time-killing assays demonstrated the superiority of PMF over CHX. For 24 h biofilms, PMF outperforms CHX in terms of destruction efficiency and suppresses biofilm formation at sub-MIC doses. Mechanistic studies revealed that PMF employs electrostatic interactions to bind bacterial membrane lipids, which compromises membrane integrity and causes nucleic acid leakage in planktonic bacteria. For biofilm bacteria, PMF induced membrane depolarization and disrupted EPS, exposing embedded bacteria and leading to their lysis. CONCLUSIONS: This dual-targeting peptide achieves precise S. mutans elimination while maintaining microecological balance. CLINICAL SIGNIFICANCE: This work offers a promising translational framework for next-generation anti-caries therapies, enabling targeted and effective prevention and treatment approaches in clinical settings.
Digital fabrication accuracy and fit analysis of additively and subtractively manufactured zirconia fixed dental prostheses.
Trikoili E, Dönmez MB, Ünlü Kurşun B … +4 more , Yertutan Z, Çakmak G, Kahveci Ç, Yilmaz B
J Dent · 2026 Sep · PMID 42013974 · Publisher ↗
OBJECTIVES: To compare the fabrication accuracy and fit of three-unit fixed dental prostheses (FDPs) manufactured additively from a 3Y-TZP slurry with those manufactured subtractively from a translucent or a strength-gra...
OBJECTIVES: To compare the fabrication accuracy and fit of three-unit fixed dental prostheses (FDPs) manufactured additively from a 3Y-TZP slurry with those manufactured subtractively from a translucent or a strength-gradient zirconia. METHODS: Forty-five three-unit posterior FDPs were fabricated either additively from a 3Y-TZP slurry (Cera-P, AM) or subtractively from a translucent (4Y-TZP, n!ce Zirconia HT, SM-HT) or a strength-gradient zirconia (3/5 Y-TZP, IPS e.max ZirCAD Prime, SM-SG) (n = 15). Surface deviations (external, intaglio, marginal, and overall) and average gaps (fit) of the FDPs were digitally analyzed. Data were analyzed with one-way analysis of variance and Tukey (surface deviations) or Tamhane tests (average gaps). Precision was defined as the average of measured values from the mean value, and analyzed similar to each outcome (α = 0.05). RESULTS: AM FDPs exhibited the highest deviations across all surfaces but the lowest gaps (P < 0.001) and no significant differences were detected between SM-HT and SM-SG (P ≥ 0.360). There was no difference in the precision of measured deviations (P ≥ 0.057). When the precision of average gap values was considered, AM FDPs had higher values than SM-SG FDPs (P = 0.024). CONCLUSIONS: AM FDPs demonstrated the lowest fabrication trueness, while SM-SG and SM-HT FDPs had similar fabrication accuracy. Although AM FDPs exhibited improved fit, their fit precision was inferior to SM-SG FDPs, whereas SM-SG and SM-HT FDPs had similar fit accuracy. The fit of all FDPs remained within clinically acceptable limits. CLINICAL SIGNIFICANCE: Tested additively manufactured three-unit posterior fixed dental prostheses may be alternatives to those subtractively manufactured from translucent and strength-gradient zirconia, as their fit was clinically acceptable. However, lower fabrication trueness and reduced fit precision may result in increased adjustment time for additively manufactured restorations.
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