International Dental Journal[JOURNAL]
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200 papers
Biomechanical Analysis of Mandibular Implant-Supported Overdentures With Different Retention Materials.
Li J, Zhang W, Qu Z … +4 more , Chen Q, Wang J, Xu J, Zhang X
Int Dent J · 2026 Jun · PMID 42269279 · Full text
PURPOSE: The aim of this study is to evaluate the biomechanical effects of different modulus of elasticity retentive materials (titanium [Ti]; polyetheretherketone [PEEK] and polyetherketoneketone [PEKK]) on mandibular i...
PURPOSE: The aim of this study is to evaluate the biomechanical effects of different modulus of elasticity retentive materials (titanium [Ti]; polyetheretherketone [PEEK] and polyetherketoneketone [PEKK]) on mandibular implant-supported overdentures. METHODS: A finite element model of a mandibular 2-implant overdenture was constructed. Attachment housings were simulated in Ti, PEEK or PEKK, paired with retentive inserts of nylon, PEEK or PEKK. Three occlusal loading conditions were simulated: a 100 N vertical load on the left first molar (centric occlusion), a 100 N oblique load on the same site (lateral occlusion), and a 100 N vertical load on the bilateral mandibular central incisors (50 N per tooth, protrusive occlusion). The stress distribution across all structures of the implant-supported overdenture and the denture displacement were analysed. RESULTS: (1) The Ti-housing/PEKK-insert configuration produced the lowest denture base stress and displacement but the highest stress on implants, abutments, and peri-implant bone, (2) Under all 3 loading conditions, bone tissue stress predominantly concentrated in the cortical bone near the implant cervix; implant stress mainly focused on its internal region connected to the abutment; denture stress primarily accumulated at the contact area between the tissue-facing surface of the denture base and the attachment housing, (3) In intergroup comparisons, oblique loading conditions showed the highest stress values for the implant, abutment, peri-implant bone tissue and denture base. CONCLUSION: Nylon, PEEK and PEKK are all viable retentive insert materials. Nylon is preferable for reducing stress on implants and bone, whereas PEEK or PEKK inserts better enhance prosthetic stability and reduce denture base fracture risk.
Revisiting and Aligning Oral Health Prevention Strategies in Iran With Global Recommendations: Policy Brief.
Hessari H, Darabi F, Shabani M
Int Dent J · 2026 Jun · PMID 42250452 · Full text
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Forkhead Box O1 Promotes Osteogenesis of Periodontal Ligament Stem Cells Via Glycolysis-Related Metabolic Reprogramming.
Zou J, Guo J, Zeng Q … +4 more , Liang Z, Gui L, Huang X, Lin J
Int Dent J · 2026 Jun · PMID 42247869 · Full text
INTRODUCTION AND AIMS: Predictable periodontal regeneration is limited by variability in the osteogenic capacity of candidate cell sources. This study aimed to investigate whether forkhead box O1 (FoxO1) enhances the ost...
INTRODUCTION AND AIMS: Predictable periodontal regeneration is limited by variability in the osteogenic capacity of candidate cell sources. This study aimed to investigate whether forkhead box O1 (FoxO1) enhances the osteogenic differentiation of periodontal ligament stem cells (PDLSCs) via glycolysis-related metabolic reprogramming. METHODS: PDLSCs stably overexpressing FoxO1 were established, and osteogenic differentiation was evaluated by analysing osteogenic marker expression, ALP staining intensity and extracellular matrix mineralization. RNA sequencing and gene-set enrichment analyses were performed to identify FoxO1-related transcriptional programs. Glycolytic activity was assessed by measuring glucose levels, lactate production, 2-NBDG glucose uptake and the expression of key glycolytic enzymes. The contribution of glycolysis-related metabolism to FoxO1-driven osteogenic differentiation was examined using rotenone and dichloroacetate (DCA). FoxO1 activity was pharmacologically inhibited using AS1842856. RESULTS: FoxO1 overexpression significantly enhanced osteogenic differentiation of PDLSCs, as evidenced by increased osteogenic marker expression, ALP staining intensity and matrix mineralization (P < .05). Transcriptomic profiling revealed significant enrichment of glycolysis-related gene sets in FoxO1-overexpressing PDLSCs (P < .05). Functionally, FoxO1 reduced glucose levels, increased lactate production and 2-NBDG uptake, and upregulated key glycolytic enzymes at the mRNA and protein levels (P < .05). FoxO1 inhibition partially attenuated these glycolysis-related changes and reduced RUNX2 and OCN expression during osteogenic induction. Rotenone-induced glycolytic shift further enhanced the osteogenic differentiation of PDLSCs (P < .05). Notably, DCA treatment attenuated the FoxO1-driven osteogenic enhancement (P < .05). CONCLUSION: These findings identify FoxO1 as a metabolic regulator that promotes osteogenic differentiation of PDLSCs through glycolysis-related metabolic reprogramming. CLINICAL RELEVANCE: Targeting FoxO1-regulated glycolytic metabolism may represent a novel strategy to enhance stem cell-based periodontal regeneration.
Association Between Glyco-Lipid Seven-Factor Index, a Novel Composite Glyco-Lipid Index, and Periodontitis: A Cross-Sectional Study.
Su H, Zhang K, Zhang H … +7 more , Li Y, Zhu J, Chen Y, Yu R, Li W, Li B, Xu Y
Int Dent J · 2026 Jun · PMID 42247868 · Full text
BACKGROUND: The glyco-lipid seven-factor index (GLM7) is a recently developed composite indicator comprising seven conventional biomarkers related to glycosphingolipid metabolism. Accumulating evidence suggests that GLM7...
BACKGROUND: The glyco-lipid seven-factor index (GLM7) is a recently developed composite indicator comprising seven conventional biomarkers related to glycosphingolipid metabolism. Accumulating evidence suggests that GLM7 demonstrates favourable diagnostic performance in cardiovascular disease, diabetes mellitus, liver disease, malignancies, and multimorbidity. However, its potential relevance to oral health-related conditions has not yet been investigated. MATERIALS AND METHODS: This cross-sectional study analysed data from 4008 participants enrolled in the National Health and Nutrition Examination Survey (NHANES) 2009 to 2014 cycles. GLM7 was defined as the exposure variable, while periodontitis served as the outcome of interest. Multivariable logistic regression models and restricted cubic spline analyses were employed to examine the association between GLM7 and periodontitis. In addition, subgroup and interaction analyses were conducted to assess the robustness of the findings. RESULTS: After full adjustment for confounding variables, GLM7 was positively associated with periodontitis (OR = 1.19, 95% CI: 1.04-1.37). Subgroup analyses suggested that the association was more evident in individuals without hypertension, while restricted cubic spline analysis revealed an approximately linear relationship between GLM7 and periodontitis. CONCLUSION: An elevated GLM7 level was associated with a higher prevalence of periodontitis. As a composite index based on routinely measured glyco-lipid metabolic markers, GLM7 may have potential utility in identifying individuals with a higher likelihood of periodontitis, which broadens the scope of application of this emerging metabolic indicator.
A Longitudinal Study of Antimicrobial Resistance in Oral Bacterial Isolates From Periodontitis Patients in Taiwan.
Kung JC, Lai CH, Chen PH … +7 more , Lan TH, Shih CJ, Yan DY, Kao LT, Yang WT, Tseng BS, Yang TY
Int Dent J · 2026 Jun · PMID 42242012 · Full text
INTRODUCTION AND AIMS: The oral cavity harbours a complex microbial ecosystem that plays a critical role in periodontal health and disease. Despite growing concerns over antimicrobial resistance (AMR), long-term surveill...
INTRODUCTION AND AIMS: The oral cavity harbours a complex microbial ecosystem that plays a critical role in periodontal health and disease. Despite growing concerns over antimicrobial resistance (AMR), long-term surveillance of antibiotic susceptibility in oral bacteria remains limited. This study aimed to assess the temporal trends in AMR among oral bacteria isolated from periodontitis patients in Taiwan over a 14-year period, with emphasis on genus-specific, Gram-specific, and sex-related patterns. METHODS: A total of 980 bacterial isolates were obtained from 466 periodontitis patients between 2008 and 2021. E-strip testing was performed for six antibiotics: amoxicillin, ciprofloxacin, clindamycin, metronidazole, minocycline, and amoxicillin-clavulanic acid. Susceptibility data were analysed by year and bacterial genus. RESULTS: Polymicrobial infections were predominant (98.1%), and resistance rates increased significantly over time, particularly for metronidazole (from 37.8% to 90.9%) and ciprofloxacin (from 33.1% to 51.5%). Streptococcus, Peptostreptococcus, and Capnocytophaga were more prevalent in females, while Neisseria, Fusobacterium, and Pseudomonas were more common in males. High resistance rates were observed in Neisseria, Escherichia, and Staphylococcus, with over 80% of some isolates resistant to multiple agents. CONCLUSION: Our findings reveal a progressive rise in AMR among oral bacteria and highlight the need for localized antibiotic stewardship in dentistry. This is the first long-term oral AMR surveillance study in Taiwan and offers a foundation for updating empirical treatment guidelines and informing public health policy. CLINICAL RELEVANCE: This study provides long-term, real-world AMR data for oral bacteria in Taiwan. The findings support more informed antibiotic selection in periodontal therapy and highlight the need to re-evaluate empirical use of metronidazole and fluoroquinolones in routine dental practice.
The Effect of miR-129-5p on the Proliferation and Osteogenic Differentiation of Human Dental Pulp Stem Cells.
Yang F, Zhang Z, Qiu X … +1 more , Lv H
Int Dent J · 2026 Jun · PMID 42242011 · Full text
OBJECTIVE: To investigate the role of microRNA-129-5p (miR-129-5p) in the proliferation and osteogenic differentiation of human dental pulp stem cells (hDPSCs). MATERIALS AND METHODS: Differential expression analysis was...
OBJECTIVE: To investigate the role of microRNA-129-5p (miR-129-5p) in the proliferation and osteogenic differentiation of human dental pulp stem cells (hDPSCs). MATERIALS AND METHODS: Differential expression analysis was performed using the GEO dataset GSE138180 to identify differentially expressed genes during the osteogenic differentiation of hDPSCs. Primary hDPSCs were isolated and cultured using the tissue block method combined with enzymatic digestion, and their stemness was characterized by alizarin red staining, oil red O staining, and flow cytometry. The expression dynamics of miR-129-5p at different stages of osteogenic induction were detected by quantitative real-time PCR (qRT-PCR). hDPSCs were transiently transfected with miR-129-5p mimic, negative control (mimic-NC), miR-129-5p inhibitor, or negative control (inhibitor-NC), and the transfection efficiency was verified by qRT-PCR. Cell proliferation was assessed by the CCK-8 assay. The expression of osteogenic-related genes (alkaline phosphatase [ALP], collagen type I [COL1], runt-related transcription factor 2 runt [RUNX2]) and proteins (ALP, osteopontin [OPN]) was measured using qRT-PCR, immunofluorescence, and Western blot, while mineral deposition was evaluated by alizarin red and alkaline phosphatase staining. RESULTS: Differential expression analysis revealed that miR-129-5p expression was significantly downregulated after 14 days of osteogenic induction compared with the control group. The primary cultured cells formed mineralized nodules and lipid droplets, were positive for CD90 and CD73, and were negative for CD45 and CD34. The expression of miR-129-5p continued to decrease after 7 and 14 days of osteogenic induction. Overexpression of miR-129-5p suppressed hDPSC proliferation, downregulated the expression of ALP, COL1, RUNX2, and OPN, and reduced mineral deposition. Conversely, inhibition of miR-129-5p promoted cell proliferation, enhanced the expression of osteogenic-related genes and proteins, and increased mineral deposition. CONCLUSION: Inhibition of miR-129-5p promotes the proliferation and osteogenic differentiation of hDPSCs, suggesting that reduced miR-129-5p expression is associated with enhanced osteogenic potential and may have implications for pulp tissue engineering. CLINICAL RELEVANCE: This study investigated how miR-129-5p modulates the proliferation and osteogenic differentiation of hDPSCs. The findings elucidate its potential role in the regeneration of the pulp-dentin complex and indicate its therapeutic potential for dental tissue repair.
Should Artificial Intelligence Literacy Be Integrated in Postgraduate Endodontic Programs?
Turky M
Int Dent J · 2026 Jun · PMID 42242010 · Full text
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Artificial Intelligence-Mediated Teledentistry for Ageing Populations: Toward Intelligent Intermediary Support in Home-Based Oral Care.
Mosaddad SA
Int Dent J · 2026 Jun · PMID 42235409 · Full text
The rapid ageing of the global population is reshaping oral health care delivery, with increasing numbers of older adults receiving care in home-based or dependent settings where access to dental services remains limited...
The rapid ageing of the global population is reshaping oral health care delivery, with increasing numbers of older adults receiving care in home-based or dependent settings where access to dental services remains limited. Although teledentistry has emerged as a potential solution, its current implementation is constrained by passive communication models, variable diagnostic reliability, and limited usability among elderly patients. Evidence suggests that the effectiveness of remote dental assessment depends less on the communication modality than on image quality, patient guidance, and clinician-patient interaction. In parallel, artificial intelligence (AI) has demonstrated expanding roles in elderly health care as a supervisor, communicator, and decision support system, yet its integration into dentistry remains largely limited to diagnostics. This Perspective proposes a shift in which AI functions as an intelligent intermediary, structuring communication, guiding data acquisition, and supporting clinical triage. Despite challenges in adoption and ethics, AI-mediated teledentistry may enable a transition toward patient-centred oral health care.
Liposomal Salvianolic Acid B Enhances ALA-PDT in Oral Leucoplakia via ROS and AKT/mTOR Signalling.
Zhang Y, Zhao X, Han X … +4 more , Shen X, Huang R, Liu W, Wu L
Int Dent J · 2026 Jun · PMID 42235408 · Full text
Salvianolic acid B (SalB), a major component of Danshen, the ancient Chinese herb Salvia miltiorrhiza Bunge, has demonstrated inhibitory effects against various solid tumours. Our previous study explored a SalB-loaded na...
Salvianolic acid B (SalB), a major component of Danshen, the ancient Chinese herb Salvia miltiorrhiza Bunge, has demonstrated inhibitory effects against various solid tumours. Our previous study explored a SalB-loaded nanocarrier as a photosensitizing formulation for photodynamic therapy (PDT) in vitro in oral leucoplakia (OLK) and oral cancer cells. This study aims to explore the underlying mechanisms and in vivo effects. In this study, different concentrations of SalB and 5-aminolevulinic acid (ALA) were incorporated into liposomes to synthesize the nano-photosensitizer (nano-SalB-ALA). Reactive oxygen species (ROS) levels in Cal27 and Leuk1 cells were evaluated by DCFH-DA staining, and the intracellular distribution of fluorescently labelled liposomes was visualized by confocal laser scanning microscopy (CLSM). Western blot was used to analyse the expression of PI3K/AKT/mTOR signalling proteins. In addition, a 4NQO-induced OLK mouse model was used to evaluate in vivo effects. Based on the most obvious intracellular ROS fluorescence signals and the greatest reduction in PI3K/AKT/mTOR signalling pathway expression observed in the nano-SalB-ALA (10 mg SalB@250 µM ALA) group, we selected it for subsequent in vitro analyses. Both in vitro and in vivo, nano-SalB-ALA PDT inhibited the PI3K/AKT/mTOR signalling pathway. These results indicate that SalB, in a nano-photosensitizer formulation, modulates ROS levels and PI3K/AKT/mTOR signalling, which may contribute to the enhanced efficacy of PDT for OLK. This study may provide new strategies for improving the efficacy of PDT for OLK in clinical practice.
Dental Antibiotic Prescribing Practices and Antimicrobial Resistance Knowledge in Singapore.
Low JQ, Taylor M, Loh BJK … +3 more , Chew JRJ, Teoh L, Goh CE
Int Dent J · 2026 Jun · PMID 42229148 · Full text
INTRODUCTION AND AIMS: While dental antibiotic prescribing accounts for approximately 10% of all antibiotic prescriptions across human healthcare worldwide, up to 80% are inappropriate. These contribute to the growing gl...
INTRODUCTION AND AIMS: While dental antibiotic prescribing accounts for approximately 10% of all antibiotic prescriptions across human healthcare worldwide, up to 80% are inappropriate. These contribute to the growing global health threat of antimicrobial resistance (AMR). Effective antibiotic stewardship requires an up-to-date understanding of antibiotic prescribing practices and knowledge. This study aimed to assess the antibiotic prescribing practices, knowledge and attitudes among dentists in Singapore. METHODS: A survey was distributed in 2024 to dentists using convenience sampling through the mailing lists of professional dental organisations. Appropriate use was assessed by comparing the responses with dental prescribing guidelines and stratified by clinical specialty. Multivariable logistic regressions were used to identify dentist characteristics predicting appropriate prescribing. RESULTS: Two hundred and eighty dentists completed the questionnaire. Appropriate antibiotic prescribing varied widely, ranging from 6.5% to 97.7% across clinical scenarios. The lowest appropriate prescribing rates were observed for periodontal scenarios (30.4% ± 37.5%). Rates were similarly low for oral surgery scenarios (34.0% ± 29.0%) but higher for restorative (58.3% ± 28.6%) and for the management of medically complex patients (56.6% ± 18.0%). When faced with nonclinical pressures (eg, patient request for antibiotics, lack of a definitive diagnosis), only 21.1% to 37.5% practised appropriate prescribing. In multivariable regressions, locally trained dentists, those in the public sector, and those with fewer years of experience showed higher rates of appropriate prescribing. CONCLUSIONS: Although dentists recognised the importance of appropriate antibiotic use and the threat of AMR, many demonstrated inappropriate prescribing and gaps in their understanding of AMR. Future training interventions could increase awareness of recently published local guidelines and offer digital resources to address knowledge gaps and meet training demand. Implementation strategies are also needed to translate interventions into practice. CLINICAL RELEVANCE: Understanding antibiotic prescribing practices, knowledge, and attitudes among dentists in Singapore can guide targeted interventions to enhance antibiotic stewardship within the dental profession.
Differential Associations of Human Herpesviruses With Oral Bacteria and Periodontitis Severity: A Cross-Sectional Analysis.
Zhao M, Zhou J, Yang W … +6 more , Li R, Wang J, Peng Y, He Y, Zhou H, Ye Q
Int Dent J · 2026 Jun · PMID 42229147 · Full text
INTRODUCTION AND AIMS: The polymicrobial synergy and dysbiosis model is increasingly recognized as a key pathogenic factor in periodontitis. Human herpesviruses (HHVs), including EBV, HCMV, and HSV-1, have been linked to...
INTRODUCTION AND AIMS: The polymicrobial synergy and dysbiosis model is increasingly recognized as a key pathogenic factor in periodontitis. Human herpesviruses (HHVs), including EBV, HCMV, and HSV-1, have been linked to periodontitis development. However, current research lacks sufficient evidence to clarify the correlation between HHVs, periodontitis progression, and periodontal microbiota. This study aimed to investigate the association between HHVs in gingival crevicular fluid (GCF) and periodontitis severity, as well as the correlation patterns between viruses and periodontal microbiota. METHODS: A total of 339 subjects (64 healthy controls, 275 periodontitis patients) were stratified according to the 2018 periodontitis classification criteria. Viral loads were quantified by quantitative real-time PCR (qPCR), and microbial communities were analysed via high-throughput 16S rRNA sequencing. RESULTS: HCMV and EBV loads were significantly positively correlated with clinical parameters including probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP) (all P < .001), and their infection status was closely associated with periodontitis staging. HSV-1 showed no significant association with any periodontal indicators (P > .05). In the EBV/HCMV coinfection group, 92.9% of patients were classified as stage II-IV periodontitis, suggesting potential combined viral associations with disease severity. Microbiome analysis revealed significantly higher microbial diversity in the HCMV-H compared to the HCMV-L. HCMV load was positively correlated with known pathogens such as Porphyromonas gingivalis and Tannerella forsythia, as well as novel associated bacteria (eg, Schwartzia succinivorans, Peptostreptococcus stomatis). Functional prediction showed significant enrichment of microbial metabolic pathways in HCMV-H patients, including Helicobacter pylori infection and isoquinoline alkaloid biosynthesis. CONCLUSION: HCMV is strongly associated with periodontitis severity and bacterial dysbiosis, while EBV acts as an independent risk factor correlated with periodontitis severity. In contrast, HSV-1 shows no significant association with periodontitis severity. This study provides new evidence for the polymicrobial pathogenesis of periodontitis and highlights virus-bacteria associations as potential therapeutic targets, although further longitudinal studies are needed to establish causality.
Dental Complications in Antithrombotic Patients: Evidence From a Nationwide Cohort and a Single-Institution Dataset.
Kim J, Yoon JH, Huh J … +6 more , Park GU, Gwak SY, Choi Y, Kim JY, Shim CY, Park W
Int Dent J · 2026 Jun · PMID 42224838 · Full text
INTRODUCTION AND AIMS: This study aimed to evaluate the incidence and risk factors of postoperative bleeding and systemic complications occurring following dental procedures in patients undergoing antithrombotic therapy,...
INTRODUCTION AND AIMS: This study aimed to evaluate the incidence and risk factors of postoperative bleeding and systemic complications occurring following dental procedures in patients undergoing antithrombotic therapy, using a nationwide cohort and single-institution clinical data. METHODS: This retrospective cohort study analysed data from the (1) National Health Insurance Service-National Sample Cohort, representing 2.2% of the Korean population and (2) Severance Clinical Research Analysis Portal 2.0 at Yonsei University Dental Hospital. The study included adults aged ≥30 years who were diagnosed with cardiovascular disease and received dental treatment from 2015 to 2019. RESULTS: Among 714,397 dental treatment cases in the National Health Insurance Service-National Sample Cohort, systemic bleeding and thromboembolic complications requiring hospitalization or resulting in death occurred in 0.30% and 0.06% of cases following dental treatment. In the single-institution dataset (n = 1,878), postoperative bleeding occurred in 2.18% of cases. Hypertension and diabetes mellitus were associated with systemic bleeding. Patients who received thrombolysis had a higher risk of thromboembolic complications, and vitamin K antagonists with heparin bridging were significantly associated with postoperative bleeding. Tooth extraction and implant surgery with bone grafting were associated with higher risks of postoperative bleeding, but implant placement without bone grafting was not significantly associated. CONCLUSION: VKAs with heparin bridging and implant surgery with bone grafting were associated with higher risks of postoperative bleeding and systemic complications. In contrast, the relatively low bleeding risk with single antiplatelet therapy and implant placement alone that dental procedures may be performed with an acceptable safety profile in patients receiving antithrombotic therapy. CLINICAL RELEVANCE: This study provides real-world evidence on dental and systemic complications following dental procedures in patients receiving antithrombotic therapy. Procedural invasiveness, antithrombotic management, and patient comorbidities were relevant factors for complication risk and may support risk stratification and procedural planning in dental practice.
Differential Expression Analysis of Key Inflammatory Mediators in Irreversible Pulpitis for Diagnostic Biomarkers.
Bhat R, D'souza SP, Shetty P … +4 more , Padavu S, Rai P, Krishna Kumar B, Shetty S
Int Dent J · 2026 May · PMID 42217380 · Full text
INTRODUCTION AND AIMS: The diagnosis of pulpal inflammatory conditions poses significant challenges in clinical endodontics, requiring precise differentiation between reversible and irreversible states. This study invest...
INTRODUCTION AND AIMS: The diagnosis of pulpal inflammatory conditions poses significant challenges in clinical endodontics, requiring precise differentiation between reversible and irreversible states. This study investigated the differential expression patterns of 10 inflammatory genes: LCP2, PTPRC, CXCL8, TNFα, IL6, CCL2, MMP9, NOD2, ICAM1, and TLR8 in irreversible pulpitis as potential molecular diagnostic biomarkers. METHODS: In this prospective cross-sectional analytical investigation, pulp tissue samples were collected from 30 subjects with irreversible pulpitis and 10 control subjects with healthy pulp tissue from orthodontically indicated extractions. Clinical diagnosis followed standardized American Association of Endodontists guidelines by two calibrated endodontists (Cohen's kappa >0.85). RNA isolation utilized TRIzol methodology, followed by quantitative Real-Time PCR analysis with GAPDH normalization and >2-fold change threshold for differential expression. RESULTS: Analysis revealed varying frequencies of differential gene expression, with CCL2 demonstrating the highest frequency (63.3%, P = .001587), followed by MMP9 (60%, P = .001453), TNFα and IL6 (56.7% each), CXCL8 and NOD2 (53.3% each), TLR8 (46.7%), ICAM1 and PTPRC (43.3% each), and LCP2 (36.7%). Concurrent differential expression of all 10 markers occurred in 3.3% of cases. Significant correlations were identified between gene expression and clinical parameters, particularly CXCL8 with thermal hyper-response (r = 0.641, P < .001), TLR8 with thermal hyper-response (r = 0.758, P < .001) and pain type (r = 0.379, P = .039), and TNFα with visual analogue scale pain intensity and thermal hyper-response. CONCLUSION: Six genes (MMP9, CXCL8, TNFα, IL6, CCL2, NOD2) demonstrated statistically significant upregulation with notable correlations between specific genes and clinical manifestations. These preliminary findings suggest potential utility as diagnostic biomarkers, though clinical implementation requires validation through larger cohort studies. CLINICAL RELEVANCE: This molecular profiling approach addresses critical limitations in current endodontic diagnostics with 30% to 40% diagnostic inaccuracies. The identified inflammatory gene signatures provide quantifiable molecular evidence that could enhance clinical decision-making in determining vital pulp therapy vs conventional root canal treatment. Implementation through point-of-care diagnostic platforms may reduce diagnostic uncertainty and facilitate evidence-based endodontic therapy.
Effect of Continuous Nursing Based on IKAP Theory on Periodontal Indicators and Self-Management Ability of Patients With Periodontal Disease.
Yao X, Cheng Z
Int Dent J · 2026 May · PMID 42217379 · Full text
Periodontitis, a chronic inflammatory disease affecting over a billion people globally, requires effective long-term self-management for successful outcomes. However, a significant gap persists between patient knowledge...
Periodontitis, a chronic inflammatory disease affecting over a billion people globally, requires effective long-term self-management for successful outcomes. However, a significant gap persists between patient knowledge and sustained behavioural change. This review proposes and synthesizes evidence for a paradigm shift in periodontal care: continuous nursing based on the Information-Knowledge-Attitude-Practice (IKAP) theory. We deconstruct the IKAP framework as a sequential cascade where targeted Information is converted to personalized Knowledge, shaping positive Attitudes to ultimately drive sustained Practice. Continuous nursing operationalizes this model through a triphasic approach: pre-clinical digital preparation, in-clinic catalytic skill-building and motivational interviewing, and post-clinical reinforcement via tele-nursing and smart technology. Synthesized evidence from recent trials and reviews indicates that this approach leads to clinically meaningful improvements in periodontal indicators (e.g., probing depth, bleeding on probing) and significantly enhances patients' self-management ability, self-efficacy, and oral health-related quality of life. By integrating behavioural science with chronic care management, IKAP-based continuous nursing bridges the intention-behaviour gap, offering a superior, patient-centered model for achieving durable periodontal health and empowering patients in their long-term care journey.
Complications and Survival of Teeth Restored With Crowns Following Crown Lengthening: A Retrospective Cohort Study.
Alhabashi A, Amir-Rad F, Ghorbani P … +4 more , Abuzayeda M, Khamis AH, Elbishari H, Shah M
Int Dent J · 2026 May · PMID 42214320 · Full text
PURPOSE: The aim of this retrospective cohort study was to evaluate the complications and survival of teeth after single-crown restoration following surgical crown lengthening. MATERIALS AND METHODS: Patients who underwe...
PURPOSE: The aim of this retrospective cohort study was to evaluate the complications and survival of teeth after single-crown restoration following surgical crown lengthening. MATERIALS AND METHODS: Patients who underwent surgical crown lengthening prior to receiving single-crown restorations by postgraduate residents at Dubai Dental Hospital, between January 2011 and January 2021 were contacted to participate in the study. The restored teeth were clinically and radiographically examined. Demographic data, patient- and tooth- related details, prevalence of prosthodontic, periodontal, and endodontic complications, as well as failure rates with underlying reasons, were documented and analysed. RESULTS: A total of 179 teeth from 81 patients were included in this study. Statistical analysis revealed a survival rate of 96.8% at 5 years and 95% at 10 years. Among surviving teeth, clinically significant complications of prosthodontic, endodontic and periodontal origin occurred in 8.8%, 11.2%, and 15.9% of cases, respectively. Regular dental attendance emerged as a protective factor against complications in multivariable analysis (OR = 0.38; p = .013). CONCLUSION: Within the limitations of this study, compromised teeth treated with crown restorations following crown lengthening showed a high long-term survival rate. CLINICAL RELEVANCE: The high survival rate of teeth preserved through crown lengthening prior to crown restoration provides valuable evidence to support clinical decision-making regarding the rehabilitation of structurally compromised teeth with unclear prognosis.
Periodontal Disease Burden in China and G20 Nations: Insights From the Global Burden of Disease 2023 Study.
Zhang Y, Xu X, Wang X … +3 more , Tang Y, He F, Li J
Int Dent J · 2026 May · PMID 42214319 · Full text
AIMS: This study aimed to compare the periodontal disease burden between China and G20 countries from 1990 to 2023, to identify temporal trends using joinpoint regression, to quantify the respective contributions of popu...
AIMS: This study aimed to compare the periodontal disease burden between China and G20 countries from 1990 to 2023, to identify temporal trends using joinpoint regression, to quantify the respective contributions of population growth, aging, and epidemiological changes through demographic decomposition analysis, and to forecast the future burden to 2033 using autoregressive integrated moving average (ARIMA) models. METHODS: Leveraging the most recent Global Burden of Disease Study (GBD) 2023 data, we analysed incidence and disability-adjusted life years (DALY). Joinpoint regression characterized trends. Demographic decomposition analysis quantified contributions from population growth, aging, and epidemiological changes. Future burden was projected using ARIMA models. RESULTS: The burden varied substantially across G20 nations. In 2023, China showed a moderately high burden with age-standardized incidence rate of 950.20 per 100,000 and DALY rate of 68.5 per 100,000, with marked male predominance (ratio ∼1.2:1) and peak in 45-59 years. Joinpoint analysis revealed an overall slight decline in China's incidence (AAPC = -0.13) but a notable increase during 2010-2014 (APC = 4.79). Decomposition analysis identified aging as the main driver of increased incident cases in China (contributing 67.12% of 7.65 million increase), whereas population growth dominated in G20 countries (+120.87% contribution). ARIMA projections suggest China's DALY rates may stabilize around 64-65 per 100,000 by 2033, while G20 rates remain persistently higher at approximately 78 per 100,000. CONCLUSION: Periodontal disease burden in China is primarily driven by population aging, while population growth is the main factor in G20 countries. Tailored public health strategies are essential for each context. CLINICAL RELEVANCE: From a public health perspective, these findings highlight need for targeted population-level strategies: In China, resource allocation should prioritize high-risk groups (e.g., middle-aged males and the elderly). In G20 countries, health planning should address persistent high DALY burden through integrated non-communicable disease prevention programs targeting shared risk factors.
Pharmacovigilance Analysis of Drug-Induced Stomatitis: Insights From Twenty-One Years of Real-World Data.
Liu Z, Peng L, Wang S … +5 more , Liu Z, Hu L, Wang H, Yu M, Zhou Y
Int Dent J · 2026 May · PMID 42214318 · Full text
BACKGROUND: Stomatitis is a common oral disease that seriously affects patients' quality of life. However, the risk of drug-induced stomatitis has not been systematically evaluated based on large-scale real-world data. O...
BACKGROUND: Stomatitis is a common oral disease that seriously affects patients' quality of life. However, the risk of drug-induced stomatitis has not been systematically evaluated based on large-scale real-world data. OBJECTIVES: To identify and validate high-risk drugs associated with drug-induced stomatitis, characterize the baseline features and time-to-onset heterogeneity of drug-induced stomatitis, preliminarily explore underlying mechanisms and provide evidence for clinical risk management. METHODS: This pharmacovigilance study used the FDA Adverse Event Reporting System (FAERS, 2004 Q1-2025 Q3). Disproportionality analysis (ROR, PRR, IC, EBGM), multivariable logistic regression, and time-to-onset (TTO) analysis were applied to identify high-risk drugs. RESULTS: A total of 55,735 stomatitis reports were screened from 58,209,958 records. The majority were female (62.1%), aged 40-80 years, from the United States (55.5%), and reported by health professionals (58.3%). We identified 366 suspicious drugs and confirmed 222 high-risk drugs. The strongest signals were found in antineoplastic and immunomodulatory agents, followed by alimentary tract, nervous system, and anti-infective drugs. TTO analysis showed obvious heterogeneity in onset time among different drug categories. CONCLUSION: This study first systematically identifies high-risk drugs associated with drug-induced stomatitis. The main mechanisms involve mucosal epithelial injury, barrier repair disorder, local irritation, and immune imbalance. These results provide evidence for clinical risk management, rational drug use, and early intervention.
Letter to the Editor on Artificial Intelligence-Driven Segmentation of 3 Oral Diseases.
Xu S, Jin H
Int Dent J · 2026 May · PMID 42208204 · Full text
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Craniofacial Health Care in Southeast Asia: The Unfinished Agenda of Universal Health Coverage.
Nalabothu P, Marya A, Allareddy V
Int Dent J · 2026 May · PMID 42208203 · Full text
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Neurosensory Disturbances Related to the Inferior Alveolar Nerve Amongst Patients With Mandibular Medication-Related Osteonecrosis of the Jaw (MRONJ): A Clinical and Radiological Overview.
Ko YY, Yang WF, Leung YY
Int Dent J · 2026 May · PMID 42202388 · Full text
INTRODUCTION AND AIMS: The aims of this study were to evaluate the clinical and radiological characteristics of patients diagnosed with mandibular medication-related osteonecrosis of the jaw (MRONJ) and to examine its as...
INTRODUCTION AND AIMS: The aims of this study were to evaluate the clinical and radiological characteristics of patients diagnosed with mandibular medication-related osteonecrosis of the jaw (MRONJ) and to examine its associations with neurosensory disturbances (NSD) related to the inferior alveolar nerve. METHODS: A retrospective review was conducted of all patients diagnosed with MRONJ who had undergone cone-beam computed tomography (CBCT) or computed tomography (CT) imaging in the Department of Oral and Maxillofacial Surgery at the Prince Philip Dental Hospital between January 2013 and August 2024. Clinical characteristics and the radiological manifestations of the mandibular canal were extracted. Statistical analyses were carried out with the significance level set at 5%. RESULTS: A total of 61 patients with 65 MRONJ lesions were included, of which 21 lesions (32.3%) exhibited neurosensory disturbances. The most common radiological manifestation of the MC was osteosclerotic (60%) and osteolytic changes (60%), followed by sequestration (46.2%). Multivariate logistic regression analysis identified active infection (adjusted OR 4.91, 95% CI: 1.14-21.2, p = .033) and sequestrum impingement (adjusted OR: 6.17, 95% CI: 1.76-21.7, p = .005) as significant associations of NSD. Four out of 15 patients with active infection and preintervention NSD presented with complete resolution of NSD following the elimination of the infection. CONCLUSION: Approximately one-third of mandibular MRONJ lesions presented with NSD. Sequestration impinging on the MC and active infection are associated with the presence of NSD. CLINICAL RELEVANCE: The removal of sequestrum and treatment of infection may lead to an improvement in pre-intervention NSD; therefore, the inferior alveolar nerve should not be sacrificed routinely during the operation.
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