International Dental Journal[JOURNAL]
Sun
200 papers
Symptoms and Knowledge of Dental Erosion Among Hong Kong Adults.
Sun IG, Liu X, Yin IX … +3 more , Zhang JJ, Deng X, Chu CH
Int Dent J · 2026 May · PMID 42202387 · Full text
OBJECTIVE: This study investigates self-reported symptoms and knowledge of dental erosion among adults in Hong Kong. METHODS: A 2-week online self-administered closed-ended questionnaire was conducted in 2025, with pre-v...
OBJECTIVE: This study investigates self-reported symptoms and knowledge of dental erosion among adults in Hong Kong. METHODS: A 2-week online self-administered closed-ended questionnaire was conducted in 2025, with pre-verified panel members aged 25 to 45 years invited via the Hong Kong Public Opinion Research Institute's online platform. The questionnaire collected demographic data, medical and dental history, self-reported symptoms, dietary habits, dental visits, management strategies for dental hypersensitivity, and knowledge about dental erosion. Multivariable binary logistic regression was performed to identify independent risk factors for high symptom burden (≥3 symptoms). RESULTS: Of the 2311 participants, 96% reported self-reported symptoms potentially related to dental erosion, with 1452 valid questionnaires analyzed. Among these, 50% were middle-aged (35-45 years) and 55% were female. The 2 most common symptoms were yellowing teeth (76%) and temperature or acid sensitivity (65%), with 36% reporting at least 3 of the 5 symptoms. Many (44%) had experienced symptoms for at least 3 years, but only 38% sought dental consultation. Almost half (41%) of participants had never heard of dental erosion, and among those aware, only 22% correctly answered all 3 knowledge questions. The median daily eating/drinking frequency was 6, with 20% reporting ≥9 episodes daily. Multivariable analysis identified middle age (aOR = 1.608, p < .001), acid reflux (aOR = 1.655, p = .001), frequent sour snack consumption (aOR = 4.658, p < .001), and frequent juice/fruit vinegar intake (aOR = 1.429, p = .041) as independent risk factors for high symptom burden. CLINICAL SIGNIFICANCE: This study highlights the need for increased public awareness and early intervention strategies to prevent dental erosion and its associated complications among Hong Kong adults.
Middle-Term Follow-Up Outcomes of the Customised Temporomandibular Joint-Skull Base Combined Prosthesis by 3D Printing.
Xu Q, Zhang Y, Wei X … +6 more , Huo L, Han Z, Bu L, Chen M, Zheng J, Yang C
Int Dent J · 2026 May · PMID 42202386 · Full text
INTRODUCTION: The combined lesions of the temporomandibular joint (TMJ) and skull base pose a considerable clinical challenge, frequently necessitating complex reconstructive procedures, yet established treatment protoco...
INTRODUCTION: The combined lesions of the temporomandibular joint (TMJ) and skull base pose a considerable clinical challenge, frequently necessitating complex reconstructive procedures, yet established treatment protocols remain insufficient. This case series aims to assess the middle-term clinical safety, accuracy, and efficacy of our own customised temporomandibular joint-skull base combined prosthesis by 3D printing. METHODS: This is a prospective single-centre consecutive case series study and planned to enrol 12 patients. Patients with TMJ-skull base combined lesions who visited the Department of Oral Surgery of our hospital from September 2016 to April 2024 were recruited. General conditions, clinical examinations, and radiological evaluations were conducted preoperatively and at 1 month, 3 months, 6 months, 1 year, 2 years, and possibly beyond 3 years postoperatively. Computed tomography scans were used to assess prosthesis position and bone contact. The 10 cm visual analogue scale (VAS) was used to assess pain, diet, and mandibular function. Objective evaluations included maximum internal opening, deviation of opening, and maximum mandibular forward and lateral movement. SPSS software was employed for data analysis. RESULTS: A total of 12 patients (6 females and 6 males, with an average age of 46.58 ± 12.17 years) were included; all patients underwent prosthesis implantation. After a follow-up period of 3.85 ± 2.63 years, patients showed no adverse symptoms such as infection and cerebrospinal fluid leakage. The occlusion and face type were stable. The prosthesis did not exhibit significant loosening, displacement, or fracture, and all had good bone integration. Postoperative pain, diet, mandibular function, and maximum internal opening underwent significant enhancement, whereas deviation of opening and mandibular movement towards the non-diseased side remained unchanged. CONCLUSION: The customised TMJ-skull base combined prosthesis developed in this study exhibited favourable mid-term clinical safety, accuracy, and efficacy in its application. CLINICAL RELEVANCE: Our findings offer promising prospects in and clinical translational value in terms of development of TMJ and skull base reconstruction technology in future.
Global Epidemiological Insights: Temporal Trends and Disparities in Oral Cavity Cancer Mortality in the United States, 1999-2024.
Wang X, Wang Y, He S … +3 more , Ma C, He Z, Huang X
Int Dent J · 2026 May · PMID 42202385 · Full text
BACKGROUND: Oral cancer constitutes a significant public health burden globally and has long been associated with substantial socioeconomic, racial, and regional disparities worldwide. Population-level mortality surveill...
BACKGROUND: Oral cancer constitutes a significant public health burden globally and has long been associated with substantial socioeconomic, racial, and regional disparities worldwide. Population-level mortality surveillance in high-income countries such as the United States can provide crucial epidemiological evidence and methodological references for global cancer control and prevention strategies. However, national-level updated evidence on long-term trends, subgroup heterogeneity, and pre- and post-COVID-19 pandemic trends in oral cancer mortality in the United States remains limited. This study assesses the temporal trends and differences in oral cancer mortality in the United States from 1999 to 2024. METHODS: Mortality data were extracted from the CDC WONDER Underlying Cause of Death database. Overall oral cavity cancer was defined using ICD-10 codes C00-C06, while subsite analyses focused on C02-C06. Adults aged 25 years and older were included. Joinpoint regression was used to analyse temporal trends in age-adjusted mortality rates (AAMRs, per 100,000 population) and to estimate annual percent change (APC) and average annual percent change (AAPC), with stratification by sex, region, and subsite. In addition, custom time intervals of 1999-2019 and 2020-2024 were specified to assess trend changes before and during the pandemic period. A supplementary age-stratified analysis comparing adults aged 25 to 44 years and those aged ≥45 years was also performed. RESULTS: Overall oral cavity cancer mortality exhibited one joinpoint in 2009. Mortality declined significantly from 1999 to 2009 (APC = -1.81%, 95% CI: -2.48% to -1.28%, P < .001), but increased significantly from 2009 to 2024 (APC=1.29%, 95% CI: 0.99% to 1.66%, P < .001), whereas the AAPC for the full study period was not statistically significant (0.04%, 95% CI:-0.11% to 0.19%, P = .624). Mortality rates were consistently higher in males than in females, and pairwise comparison showed that sex-specific trends were neither parallel nor coincident (parallelism P = .012; coincidence P = .001). All 4 U.S. Census regions demonstrated an initial decline followed by a later rebound, although only the Midwest showed a significant net increase over the full study period. Marked heterogeneity was observed across subsites: tongue cancer (C02) was the only subsite with a significantly increased AAPC over the full study period, whereas floor-of-mouth cancer (C04) and palate cancer (C05) showed sustained net declines. Custom interval analyses further demonstrated a declining trend before the pandemic (1999-2019; AAPC=-0.2709%, 95% CI:-0.4281 to -0.1087, P < .001) and an increasing trend during the pandemic period (2020-2024; AAPC=1.2879%, 95% CI: 0.9922 to 1.6558, P < .001). Significant sex-based differences were observed, with additional heterogeneity across regions and subsites. In supplementary age-stratified analyses, no significant joinpoint was identified among adults aged 25-44 years, whereas adults aged ≥45 years showed a significant reversal in mortality trend, suggesting that the overall mortality rebound was driven predominantly by the older age group. CONCLUSIONS: In the United States, oral cavity cancer mortality shifted from a declining trend to a sustained increase around 2009 and accelerated further during 2020-2024, indicating a biphasic rather than a simple linear pattern. Substantial heterogeneity was observed across sex, region, and subsite. Tongue cancer may have been a major contributor to the recent rebound in mortality, while the post-2020 trend reversal underscores the need to further examine the potential effects of diagnostic delay, disparities in healthcare access, and post-pandemic health system recovery on oral cavity cancer outcomes. Supplementary analyses further suggest that this mortality reversal was concentrated mainly in adults aged ≥45 years rather than in younger adults.
Prospective Pilot Clinical Study of High-Purity Magnesium Plates and Screws for Le Fort I Osteosynthesis.
Yang WF, Tai PCP, Qin L … +1 more , Leung YY
Int Dent J · 2026 May · PMID 42190437 · Full text
OBJECTIVES: This prospective clinical study aimed to evaluate the feasibility, safety, and clinical performance of an innovative high-purity magnesium (HP-Mg) plate and screw system for internal fixation in orthognathic...
OBJECTIVES: This prospective clinical study aimed to evaluate the feasibility, safety, and clinical performance of an innovative high-purity magnesium (HP-Mg) plate and screw system for internal fixation in orthognathic surgery. MATERIALS AND METHODS: Patients indicated for orthognathic surgery fulfilling the study criteria were invited to participate. HP-Mg plates and screws were developed for the first time for Le Fort I fixation in the maxilla, while standard titanium fixation was used in the mandible for comparison. Clinical outcomes, wound healing, neurosensory function, radiographic imaging, systemic complications, and plasma electrolyte levels were assessed over a one-year follow-up. RESULTS: Seven patients were included. HP-Mg plates and screws were systemically safe, with no evidence of hypermagnesemia or related neurosensory impairment. Two patients experienced smooth recovery; 3 developed mild complications (e.g., wound dehiscence, fistula) that were managed conservatively; and 2 required reoperations due to maxillary nonunion. Radiographically, HP-Mg plates and screws were not visible on plain X-rays but were detectable on CBCT, exhibiting reduced radiodensity compared to cortical bone. The complications were attributed to unoptimized plate geometry and rapid in vivo degradation. CONCLUSIONS: Although HP-Mg plates and screws represent a promising biodegradable alternative for internal fixation in orthognathic surgery, the observed complications highlight opportunities for further optimization-particularly in enhancing degradation profiles and mechanical strength. With ongoing research and continued improvements, Mg has the potential to become a reliable and effective option for internal fixation in maxillofacial surgery. CLINICAL RELEVANCE: While HP-Mg is a promising biodegradable alternative for internal fixation in orthognathic surgery, further optimization of implant design and degradation profiles is necessary.
Explainable Artificial Intelligence in Dentistry: A Systematic Review of Its Trust and Translation.
Thaweesapphithak S, Thongchotchat V, Alinejad-Rokny H … +3 more , Samaranayake L, Osathanon T, Porntaveetus T
Int Dent J · 2026 May · PMID 42184717 · Full text
INTRODUCTION AND AIMS: Explainable artificial intelligence (XAI) is a set of methods and processes that make the decisions of artificial intelligence (AI) models understandable to those who are not conversant with the te...
INTRODUCTION AND AIMS: Explainable artificial intelligence (XAI) is a set of methods and processes that make the decisions of artificial intelligence (AI) models understandable to those who are not conversant with the technology. This "black box" nature of complex AI models appears to be a primary barrier to their clinical adoption in health sciences, including dentistry. XAI is being touted as a solution to build clinician trust. This review critically assesses whether current dental XAI research is methodologically rigorous enough to substantiate claims of enhanced trustworthiness. METHODS: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, searching PubMed, IEEE Xplore, medRxiv, and Ovid for dental XAI studies (2015-2025). We assessed the risk of bias and applicability using QUADAS-2 and PROBAST. RESULTS: Nineteen of the 100 identified studies met the inclusion criteria. Although these studies used diverse XAI techniques, including image-based saliency methods (eg, Grad-CAM), feature attribution approaches (eg, SHAP), and local approximation methods (eg, LIME) across various dental specialties, quality assessment exposed significant limitations. Most (14 of 19) exhibited a high risk of bias, driven by small retrospective datasets, lack of external validation, and weak reference standards. Interestingly, only 1 study has evaluated the impact of XAI on human understanding. CONCLUSION: Current dental XAI research remains in a proof-of-concept phase, characterised by technical demonstrations based on low-quality evidence. The field has not yet substantiated claims that XAI enhances clinical trust or decision-making. To bridge this gap, future work must prioritise methodological rigour, external validation, and, most importantly, human-centred evaluations with dental professionals to measure the true impact of explainability on clinical workflows and patient care. CLINICAL RELEVANCE: Current dental XAI lacks the evidence quality required for clinical reliance. Practitioners should exercise caution, as these tools have not been proven to actually improve diagnostic accuracy or trust in daily practice. Until validated in real-world settings, XAI remains experimental technology rather than a standard of care.
Signalling Pathways and Mechanical Forces Interact in Craniofacial Development and Homeostasis.
Chen Y, Feng X, Wu H … +3 more , Duan Y, Han Y, Yu M
Int Dent J · 2026 May · PMID 42176498 · Full text
Craniofacial bones, as essential components of the human head, play a crucial role in both physiological function and morphological evolution through their development and the maintenance of homeostasis. Unlike skeletal...
Craniofacial bones, as essential components of the human head, play a crucial role in both physiological function and morphological evolution through their development and the maintenance of homeostasis. Unlike skeletal bones of the trunk, which originate from the mesoderm, craniofacial bones originate from the ectodermal neural crest, presenting challenges in directly applying findings from long bone studies. Their development occurs via intramembranous ossification, endochondral ossification, and specialized osteogenic patterns, and is co-regulated by both mechanical forces and molecular signalling pathways. The imbalances in these biomechanical regulatory mechanisms contribute to disruptions in craniofacial bone homeostasis, which can result in a range of developmental and acquired skeletal disorders. This review highlights recent advances in the molecular regulation of craniofacial bone development, examines the interplay between mechanical and genetic regulatory mechanisms, and discusses diseases associated with imbalances in craniofacial bone homeostasis, offering novel insights for the prevention and treatment of craniofacial bone disorders.
Advancing Antimicrobial Stewardship in Canadian Dentistry: Early Insights Into a Toolkit to De-implement Overprescribing.
Martine C, Sutherland S, Fulop C … +2 more , Born K, Singhal S
Int Dent J · 2026 May · PMID 42176497 · Full text
INTRODUCTION AND AIMS: Despite dentistry's contribution to antibiotic use and antimicrobial resistance, antimicrobial stewardship in Canadian dentistry remains at an early stage. As strategies focused on adherence to evi...
INTRODUCTION AND AIMS: Despite dentistry's contribution to antibiotic use and antimicrobial resistance, antimicrobial stewardship in Canadian dentistry remains at an early stage. As strategies focused on adherence to evidence-based care have shown limited success in changing prescribing behaviour, the focus has shifted to the de-implementation of low-value care. This study explored dentists' perspectives on an antibiotic prescribing toolkit and examined how it may support de-implementation. METHODS: An exploratory qualitative study employed focus groups with 16 dentists who attended toolkit webinars. Dentists who had not downloaded the toolkit were excluded. Discussions were recorded, transcribed, and analysed inductively. Findings were discussed in relation to stewardship and de-implementation research. RESULTS AND DISCUSSION: The analysis yielded 5 themes-clarifying a key message, reminding and providing a talking point, supporting difficult conversations, legitimising nonprescribing, and moving beyond "preaching to the choir"-that align with de-implementation strategies in dentistry and other health fields, including unlearning, extinction cues, substitution, counterconditioning, and champions. Participants highlighted the need for concomitant interventions, such as audit and feedback, education, software integration, and regulatory and professional engagement, to support de-implementation, consistent with the de-implementation literature. CONCLUSION: The toolkit shows potential to support the de-implementation of unnecessary dental antibiotic prescribing by introducing mechanisms that reduce reliance on low-value antibiotic use. Feedback suggests the toolkit helps shift outdated prescribing habits, manage patient expectations, and legitimise nonprescribing decisions. However, meaningful progress will require multilevel strategies. Future research should evaluate, using quantitative methods, whether the toolkit influences prescribing behaviours longitudinally, as well as whether its integration within broader stewardship interventions supports sustained de-implementation. CLINICAL RELEVANCE: This study identifies strategies to support responsible antibiotic use in dental practice. The findings show how the toolkit may serve as a practice-based resource by offering communication tools, reminders, and substitution strategies that help dentists manage patients without antibiotics, while reducing patient expectations and dentists' concerns about not prescribing.
Biomechanical Effects of Implant-Root Fragment Contact in the Socket Shield Technique: A Finite Element Analysis.
Ye Z, Zhang Y, Feng Z … +4 more , Shangguan G, Huang C, Chen X, Ye H
Int Dent J · 2026 May · PMID 42172860 · Full text
BACKGROUND: The socket shield technique (SST) is widely applied in implant treatments in aesthetic zones, demonstrating significant advantages in preserving hard and soft tissues. Although SST was developed to maintain a...
BACKGROUND: The socket shield technique (SST) is widely applied in implant treatments in aesthetic zones, demonstrating significant advantages in preserving hard and soft tissues. Although SST was developed to maintain alveolar bone and gingival architecture by retaining a buccal root fragment, its biomechanical implications - particularly under direct implant-fragment contact - and the optimal geometric parameters of the shield remain poorly defined. OBJECTIVE: This study utilized finite element analysis to evaluate the biomechanical behaviour of direct implant-root fragment contact in SST. METHODS: Three-dimensional finite element models of a maxillary anterior socket shield implant were constructed from cone beam computed tomography data. The residual root fragment was modelled with a uniform thickness of 1.5 mm, a length of 6 mm, and labial arc angles of 60°, 90°, 120°, 150°, and 180° at the alveolar crest level. An insertion torque of 30 N·cm and an occlusal load of 100 N were applied to simulate clinical loading conditions. Stress distribution, peak stress, and displacement in the residual root, periodontal ligament (PDL), implant, and surrounding bone interface were analysed by Abaqus software. RESULTS: Under insertion torque of 30 N·cm, the peak stress and displacement of the fragment and PDL decreased as the arc angle of the tooth fragment increased. The peak stress for a 60° fragment was 101.9 MPa, which decreased significantly to 75.48 MPa for a 90° fragment, and further to 69.62 MPa, 67.14 MPa, and 42.43 MPa for 120°, 150°, and 180° fragments, respectively. The stress concentration was located at the fragment area corresponding to the implant neck's maximum diameter. The PDL's peak stress decreased from 4.073 to 1.067 MPa, and fragment displacement decreased from 0.01651 to 0.007814 mm. Under a 100 N occlusal force, as the arc angle increased, the peak stress in the PDL and cortical bone increased, while the peak stress in the fragment and implant decreased. The PDL's peak stress was lowest (1.143 MPa) for a 60° fragment and highest (1.996 MPa) for a 180° fragment, both below the natural tooth's PDL peak stress of 2.472 MPa. Cortical bone stress peaked at 49.74 MPa for a 60° fragment, decreased for 90° and 120° fragments (47.77 and 47.62 MPa, respectively), and then increased significantly for 150° and 180° fragments (50.83 and 64.51 MPa). CONCLUSION: Within the limitations of this static finite element model, direct contact between the implant and a shield fragment with an arc angle of 120° to 150° appears to provide a favourable biomechanical environment. However, in vivo loading is cyclic and may result in long-term fatigue effects on living tissues and biomaterials that were not investigated in this study. Clinical studies are needed to validate these findings.
Advances in Nanozyme Engineering for Precision Oral Health Management.
Tong F, Feng F, Zhang L … +12 more , Lu F, Liu Z, Lin X, Xiao N, Han Y, Shen C, Wang Y, Sheng A, Liu X, Wei K, Zhao T, Ding C
Int Dent J · 2026 May · PMID 42167025 · Full text
INTRODUCTION AND AIMS: Despite recent advances in dental care, traditional treatments suffer from poor targeting, limited stability, and unsatisfactory regenerative efficacy. This review aims to clarify the multi-level i...
INTRODUCTION AND AIMS: Despite recent advances in dental care, traditional treatments suffer from poor targeting, limited stability, and unsatisfactory regenerative efficacy. This review aims to clarify the multi-level intervention targets of nanozymes for oral diseases, highlight their unique merits over conventional strategies, and provide a theoretical basis for developing novel precision oral therapeutic systems. METHODS: High-quality literature was retrieved from PubMed, Web of Science, and other core databases, including in vitro, in vivo, and emerging clinical studies on the design, function, and applications of nanozymes in oral diseases. CONCLUSIONS: Nanozymes demonstrate significant potential for targeted antibacterial therapy, oxidative stress regulation, and tissue repair within the complex oral microenvironment. Their integration with advanced delivery platforms enhances therapeutic precision. Future development should focus on multi-enzyme synergistic systems, improved biocompatibility, and clinical translation to realize their promise in precision oral medicine. CLINICAL SIGNIFICANCE: Nanozymes represent a paradigm shift from passive to active, dynamic oral therapeutics. They offer a promising strategy for managing biofilm-associated diseases (caries, periodontitis) and complex conditions (oral mucositis, cancer) with enhanced specificity and regenerative potential, potentially reducing antibiotic reliance and improving long-term treatment outcomes.
Community Participation and the Making of Brazil's National Oral Health Policy.
Narvai PC, Peres MA
Int Dent J · 2026 May · PMID 42167024 · Full text
INTRODUCTION AND AIMS: Community participation is recognized as a core attribute of equitable and effective health systems, yet its concrete influence on national oral health policy remains underexplored. Brazil offers a...
INTRODUCTION AND AIMS: Community participation is recognized as a core attribute of equitable and effective health systems, yet its concrete influence on national oral health policy remains underexplored. Brazil offers a unique case of a large, universal health system in which oral health policy has been shaped by institutionalized social participation. This study analyses how community participation influenced the formulation, implementation and institutionalization of Brazil's National Oral Health Policy (Política Nacional de Saúde Bucal - PNSB, "Brasil Sorridente"). METHODS: We conducted a qualitative documentary policy analysis guided by the public policy cycle model. We examined final reports of the three National Oral Health Conferences, minutes of the National Health Council and its Intersectoral Oral Health Commission (2003-2024), key legal and regulatory documents, and relevant academic literature. Documents were coded according to six policy phases-problem recognition and agenda setting, formulation, decision-making, implementation, evaluation and institutionalization-with particular attention to the role of participatory institutions and the tension between Collective Oral Health and Market Dentistry. RESULTS: Community participation was pivotal in defining oral health as a public problem and in placing it on the national health agenda during Brazil's democratic transition. Health conferences and councils later served as deliberative arenas where civil society, social movements and professional groups formulated and validated policy alternatives, culminating in the adoption of PNSB and its incorporation into the National Health Plan. During implementation, participatory institutions contributed to expanding the Oral Health Care Network, strengthening intersectoral actions such as water fluoridation, and sustaining epidemiological surveillance, while also contesting funding instability and market pressures. The enactment of Law No. 14,572/2023 consolidated PNSB as a State policy, explicitly reaffirming the role of community participation. CONCLUSION: Institutionalized community participation shaped all phases of Brazil's national oral health policy, contributing to its resilience and alignment with universal, equity-oriented principles despite political and economic fluctuations. CLINICAL RELEVANCE: Brazil's experience shows that participatory governance can help integrate oral health into universal health systems, support preventive and equity-focused care, and offer practical lessons for countries seeking to move beyond market-driven, treatment-centred dental services.
Efficacy of White Mineral Trioxide Aggregate in Regenerative Endodontic Procedures and Apexification for Immature Permanent Teeth: A Systematic Review and Meta-Analysis.
Li Z, Xu Y, An S … +7 more , Liu H, Liu L, Pan Y, Sun T, Kang S, Liu R, Zhang L
Int Dent J · 2026 May · PMID 42160814 · Full text
This study systematically reviews the efficacy of bioceramic-based treatments for non-vital immature permanent teeth in children. A systematic search retrieved 229 records, ultimately including 15 studies, focused on Whi...
This study systematically reviews the efficacy of bioceramic-based treatments for non-vital immature permanent teeth in children. A systematic search retrieved 229 records, ultimately including 15 studies, focused on White Mineral Trioxide Aggregate (WMTA) or other bioceramics used in apexification or Regenerative Endodontic Procedures (REP). A meta-analysis was conducted on WMTA's radiographic success and the comparative efficacy of platelet concentrates (PC) versus blood clot (BC) scaffolds. Data regarding clinical success, pulp sensibility, root development, and discolouration, were extracted. Risk of Bias (RoB) was evaluated using the RoB2 tool for RCTs. Evidence certainty was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. The meta-analysis of radiographic success included 6 studies, revealing a pooled proportion of 0.99 (95% CI: 0.96-1.00), though GRADE rated evidence certainty as very low due to serious risk of bias and imprecision. Comparative analysis of PC versus BC scaffolds (4 studies, 145 observations) showed a non-significant trend favouring PC (OR = 3.56, 95% CI: 0.87-14.52), but very low certainty due to indirectness and sparse data. Comparison of WMTA versus alternative bioceramics revealed 100% clinical success, though non-significant (OR = 0.18, 95% CI: 0.02-1.68), with moderate certainty downgraded only for imprecision. All analyses demonstrated no heterogeneity (I² = 0.0%). PC favoured root lengthening compared to BC scaffolds that promoted dentinal wall thickening, alternative bioceramics exhibited a significantly lower discolouration risk than WMTA (7.69% vs 58.33%, P = .01), and pulp sensibility restoration was achieved in 60% to 86% of cases across regenerative treatments. Bioceramic-based treatments achieve high success for non-vital immature permanent teeth in children, though evidence certainty ranges from very low to moderate. While therapeutic efficacy is comparable, alternative bioceramics reduce discolouration risk compared to WMTA, and scaffold selection influences root maturation patterns.
Salivary MicroRNA Reflects Neurodevelopment and Oral Health Traits in Children With Autism.
Omar O, AlJindan RY, Rajinder S … +2 more , Kamaraj B, AlHumaid J
Int Dent J · 2026 May · PMID 42160813 · Full text
INTRODUCTION AND AIMS: Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental condition associated with poor oral health in children. ASD lacks sensitive, non-invasive diagnostic tools, and the relationshi...
INTRODUCTION AND AIMS: Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental condition associated with poor oral health in children. ASD lacks sensitive, non-invasive diagnostic tools, and the relationship between neurodevelopment and oral health remains unclear. This observational study aimed to identify salivary microRNAs (miRNAs) differentially expressed between children with ASD and healthy controls and to determine whether these profiles are associated with dental caries and periodontal status. METHODS: Unstimulated saliva was collected from 26 children with ASD and 20 healthy controls and subjected to small RNA sequencing. Differentially expressed miRNAs were identified and functionally annotated. Oral health was assessed using dmft/DMFT and periodontal indices, and associations between miRNA expression patterns and clinical parameters were evaluated. RESULTS: A total of 125 salivary miRNAs were differentially expressed between ASD and control groups (FDR < 0.05). Principal component analysis showed clear group separation, with PC1 accounting for 46.5% of total variance. Several dysregulated miRNAs were linked to neurodevelopmental and immune regulatory pathways and overlapped with neurological and inflammatory conditions. After miRDB/SFARI filtering, 40 ASD-relevant miRNAs were prioritized, including 21 upregulated and 19 downregulated candidates; representative examples were hsa-miR-145-5p (log2FC 2.11, adjusted P = 1.74E-08) and hsa-miR-200a-5p (log2FC -0.58, adjusted P = 6.11E-06). Children with ASD had higher dmft/DMFT scores and poorer periodontal/behavioural outcomes, with dmft/DMFT differing significantly between groups (P = .02). In exploratory pooled-cohort regression analysis, miR-151a-3p and behaviour remained significant predictors of dmft/DMFT (adjusted R = 0.31, P = .003). CONCLUSIONS: Children with ASD exhibit a distinct salivary miRNA profile with increased caries burden and gingival inflammation, indicating shared molecular influences on neurodevelopment and oral disease susceptibility. CLINICAL RELEVANCE: Salivary miRNAs offer a non-invasive biomarker platform to support earlier ASD identification, individualized preventive dental strategies, and interdisciplinary management of this high-risk paediatric population.
Integration of Artificial Intelligence in Designing Removable Partial Dentures.
Alageel O
Int Dent J · 2026 May · PMID 42160812 · Full text
PURPOSE: The integration of artificial intelligence (AI) into prosthodontics represents a paradigm shift in the design and fabrication of removable partial dentures (RPDs). This study evaluates the current AI technologie...
PURPOSE: The integration of artificial intelligence (AI) into prosthodontics represents a paradigm shift in the design and fabrication of removable partial dentures (RPDs). This study evaluates the current AI technologies, including large language models such as ChatGPT, Copilot, Gemini, and DeepSeek, for designing RPDs. METHODS: Standardized prompts were submitted to four AI-assisted systems (ChatGPT, Copilot, Gemini, and DeepSeek) to generate RPD designs for 25 partially edentulous clinical scenarios based on Kennedy classifications. The outputs were compared with reference models (AiDENTAL), a validated retention prediction model, and evaluations by six blinded experts. Statistical comparisons were performed using a mixed-effects ordinal regression model (p < 0.05). RESULTS: Compared with the reference standards, Copilot and Gemini produced the most consistent and accurate RPD designs, whereas DeepSeek showed the greatest deviation, despite achieving the highest predicted retention scores. Expert evaluations confirmed that AiDENTAL achieved the highest overall design quality, followed by Copilot, whereas ChatGPT and DeepSeek demonstrated lower and more variable performances. CONCLUSIONS: The design of RPDs using different large language models, including ChatGPT, Copilot, Gemini, and DeepSeek, resulted in notable variations in the design output. AiDENTAL achieved the highest overall RPD design quality, whereas Copilot and Gemini produced the most consistent and accurate designs across all the evaluated criteria.
The Efficacy and Safety of Intranasal Dexmedetomidine Spray Followed by Nitrous Oxide for Paediatric Oral Procedures.
Xiao YJ, Zhang HY, Nie MD … +6 more , Liu GS, Peng W, Zhao JH, Hu ZH, Sun H, Wu Y
Int Dent J · 2026 May · PMID 42160811 · Full text
INTRODUCTION AND AIMS: The management of uncooperative children requiring complex outpatient oral procedures presents a significant clinical challenge. This study aimed to evaluate the safety and efficacy of intranasal d...
INTRODUCTION AND AIMS: The management of uncooperative children requiring complex outpatient oral procedures presents a significant clinical challenge. This study aimed to evaluate the safety and efficacy of intranasal dexmedetomidine (DEX) spray combined with nitrous oxide/oxygen (N₂O/O₂) inhalation sedation for the extraction of impacted supernumerary teeth in paediatric patients. METHODS: This retrospective clinical study enrolled uncooperative children aged 6 to 12 years (Frankl Scale score 2-3). Preoperative sedation was achieved using 2 µg/kg intranasal DEX spray. After sedation onset, heart rate (HR), blood pressure (BP), and oxygen saturation (SpO₂) were monitored. Throughout the procedure, N₂O/O₂ inhalation was administered to maintain a moderate sedation level, with HR, BP, SpO₂, and sedation depth recorded at 5-minute intervals. Postoperatively, patients were observed in the recovery room until all discharge criteria were met. RESULTS: All 63 patients (34 boys and 29 girls) cooperated with nasal hood placement and successfully underwent parental separation. Sixty children (95.24%) completed the procedure successfully, with 56 (88.89%) maintaining moderate sedation depth throughout. There were significant decreases in HR and BP (P < .001), while SpO₂ (P = .120) remained stable during procedures. Adverse events included drowsiness (5 cases, 7.94%), dizziness (2 cases, 3.17%), and hypotension (8 cases, 12.70%). Only one (1.59%) case experienced hypoxemia concurrently presenting with bradycardia and hypotension, which required brief clinical intervention. CONCLUSION: The combination of intranasal DEX spray and N₂O/O₂ appears to be a promising sedation technique for impacted supernumerary tooth extraction in paediatric patients, with minimal adverse effects rarely requiring clinical intervention. CLINICAL RELEVANCE: This protocol shows promise in addressing the challenge of non-cooperation prior to N₂O administration, and may offer an effective, convenient, and relatively safe approach for managing uncooperative paediatric patients undergoing complex oral surgery.
Corrigendum to 'Significance of methyltransferase-like 5 expression in oral squamous cell carcinoma' [Volume 76, Issue 3, June 2026, 109533].
Kajiya Y, Shima K, Shimojukkoku Y … +5 more , Oku Y, Tsuchiyama T, Higashimoto K, Kurihara-Shimomura M, Sasahira T
Int Dent J · 2026 May · PMID 42160810 · Full text
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Antibiotic Prescribing in Dental Practice: A Cross-sectional Survey in Trinidad and Tobago.
Kalemeera F, Hosein I, Maharaj S … +3 more , Ramkhalawan A, Nagassar RP, Naidu R
Int Dent J · 2026 May · PMID 42160809 · Full text
BACKGROUND: Antimicrobial resistance (AMR) is a global threat. Trinidad and Tobago used the World Health Organisation's Global Action Plan to develop its National Action Plan (NAP) against AMR. A review of the NAP showed...
BACKGROUND: Antimicrobial resistance (AMR) is a global threat. Trinidad and Tobago used the World Health Organisation's Global Action Plan to develop its National Action Plan (NAP) against AMR. A review of the NAP showed the need for use-based studies to direct interventions against AMR. This study was designed to provide evidence on dental prescribing habits, to support interventions against the emergence of antibiotic-resistant strains. METHODS: A cross-sectional study. A consent letter and questionnaire were developed in REDCap®, a link to which was sent to registered dentists. The questionnaire collected demographic information, knowledge of antibiotics and dental practice. SPSS version 22 was used for analysis: significance at a P-value <0.05 and the confidence interval at 95%. FINDINGS: Seventy-two dentists participated. For penicillin-allergic patients, 38.6% (24/62) reported prescribing clindamycin, and 4.8% (3/62) reported prescribing amoxicillin. A total of 9.8% (6/61) avoided antibiotic prescription in pregnancy. Actions taken for patients already on antibiotics varied greatly - assess, discontinue, continue and switch. Satisfactory individual-level compliance with prophylaxis guidelines was observed in 29.8% (17/56), 47% (21/45), and 20% (9/48) of participants for dental procedures, prosthetic joints, and cardiac conditions, respectively. Satisfactory individual-level compliance with guidelines on the therapeutic use of antibiotics for dental infections was observed in 74.1% (40/54). Satisfactory group-level compliance with prophylaxis guidelines was observed in 8/19 dental procedures and 2/14 cardiac conditions. Satisfactory compliance with guidelines on the therapeutic prescription of antibiotics was observed in 6/10 dental infections. No variable predicted compliance. CONCLUSION: The variability in compliance highlights a need for improved education and awareness. CLINICAL RELEVANCE: may impact antimicrobial stewardship activities, including production of training materials and development of local treatment recommendations.
Biomonitoring of Occupational Exposure to Mercury Among Dental Health Workers in LMICs: A Systematic Review.
Bensouda Korachi I, Menouni A, Duca RC … +3 more , Godderis L, El Jaâfari S, Filali-Zegzouti Y
Int Dent J · 2026 May · PMID 42160808 · Full text
Mercury exposure remains a significant occupational hazard for dental health workers, especially in low- and middle-income countries (LMICs), due to the continued use of dental amalgam. This systematic review synthesizes...
Mercury exposure remains a significant occupational hazard for dental health workers, especially in low- and middle-income countries (LMICs), due to the continued use of dental amalgam. This systematic review synthesizes the existing evidence on mercury exposure in dental professionals, focusing on biomonitoring data and associated health outcomes in LMICs. In December 2024, a comprehensive literature search was conducted across three electronic databases, PubMed, Scopus and Web of Science to identify primary research studies published from January 2014 onwards. Studies assessing occupational mercury exposure through biomonitoring in dental health workers were included. Nine studies, encompassing 524 dental professionals, met the inclusion criteria. Mercury biomonitoring was conducted using blood (n = 3), urine (n = 7) and hair samples (n = 2). Most studies reported elevated mercury levels in dental workers compared to control groups. Environmental monitoring data further indicated that mercury vapor concentrations in dental clinics may exceed recommended safety thresholds. However, current evidence regarding potential health effects associated with occupational exposure to mercury is inconclusive due to methodological limitations. Mercury remains an occupational hazard for dental health workers in LMICs. As dental amalgam continues to be used in resource-limited settings, implementing biomonitoring programs could enable early detection of mercury-related health issues, protecting workers' health until global mercury phase-down goals are achieved.
Regarding: The Role of Electrolytes in Muscle Pain Syndromes: A Systematic Review and Meta-analysis With Implications for Temporomandibular Disorder.
Jaiswal A, Arya M, Sharma DB
Int Dent J · 2026 May · PMID 42160807 · Full text
Abstract loading — click title to view on PubMed.
Secreted Peptidome Profiling of Human Dental Pulp Stem Cells-Conditioned Medium During Odontogenic Differentiation.
Huang Y, Liu S, Wu H … +4 more , Zhang Z, Chen H, Xie K, Bu S
Int Dent J · 2026 May · PMID 42155947 · Full text
INTRODUCTION AND AIMS: Odontogenic differentiation of human dental pulp stem cells (hDPSCs) is critical for pulp repair. This study aims to characterise the secretory peptidome of human dental pulp stem cells (hDPSCs) du...
INTRODUCTION AND AIMS: Odontogenic differentiation of human dental pulp stem cells (hDPSCs) is critical for pulp repair. This study aims to characterise the secretory peptidome of human dental pulp stem cells (hDPSCs) during odontogenic differentiation, thereby providing insights into potential dental pulp repair strategies. METHODS: We employed tandem mass tag labelling coupled with liquid chromatography-tandem mass spectrometry to compare the peptide profiles of undifferentiated and differentiated hDPSCs-conditioned medium (CM), followed by in-depth bioinformatics analysis. A Cell Counting Kit-8 assay was conducted to screen for functional peptides present in the hDPSCs-CM. 5-Ethynyl-2'-deoxyuridine staining, flow cytometry, transwell migration, alkaline phosphatase activity, and alizarin red S staining, quantitative real-time polymerase chain reaction, and Western blot analyses were performed to preliminarily investigate the functions of the selected peptide. RESULTS: A total of 90 peptides were differentially expressed in differentiated hDPSCs-CM compared with undifferentiated hDPSCs-CM. Gene Ontology analysis suggested that the differentially expressed peptides were closely associated with biological processes, including cell proliferation, growth, and reproduction. Kyoto Encyclopedia of Genes and Genomes enrichment analysis suggested that the precursor proteins of these peptides were significantly enriched in the PI3K-Akt signalling pathway, carbon metabolism, and extracellular matrix-receptor interactions. Furthermore, we identified a secreted peptide that promotes the proliferation, migration, and odontogenic differentiation of hDPSCs and named it P1DC (peptide 1 derived from CFL1 protein). CONCLUSIONS: Our study is the first to identify differentially expressed peptides between undifferentiated and differentiated hDPSCs-CM. Furthermore, we discovered a novel secreted peptide, P1DC, which significantly enhances hDPSC function.
Empowered Smiles Through Education and Motivation (e-SEM): A Theory-Driven Digital Oral Health Behaviour Intervention.
Acosta JM, Pisarnturakit PP
Int Dent J · 2026 May · PMID 42155946 · Full text
BACKGROUND: Oral health conditions, particularly dental caries and periodontal diseases remain highly prevalent yet preventable global public health concerns. School-based oral health education can improve knowledge and...
BACKGROUND: Oral health conditions, particularly dental caries and periodontal diseases remain highly prevalent yet preventable global public health concerns. School-based oral health education can improve knowledge and behaviours, but traditional approaches often lack engagement and sustainability. Digital media offers an opportunity to deliver interactive, theory-driven, and culturally appropriate interventions. This study developed and validated empowered smiles through education and motivation (e-SEM), a digital oral health behaviour intervention for Filipino schoolchildren based on the information-motivation-behavioural skills (IMB) model. METHODS: A methodological design was used in 3 phases: (1) elicitation through literature review and situational analysis; (2) development of culturally tailored digital materials including learning modules, animated storytelling, parent education content, and behavioural skills tools; and (3) expert content validation using Lawshe's Content Validity Ratio (CVR) and Content Validity Index (CVI), supplemented by qualitative feedback. Acceptability and usability were also assessed among parents and children using structured questionnaires. RESULTS: Expert validation demonstrated strong content validity across all components, with scale-level CVI ranging from 0.83 to 0.95. Digital learning modules and behavioural skills tools achieved the highest validity (CVI = 0.95), while animated storytelling videos showed comparatively lower scores (CVI = 0.83), indicating areas for refinement. Qualitative feedback supported the relevance and educational value of the intervention while highlighting the need to simplify language, improve pacing and enhance visual clarity. End-user evaluation showed high acceptability among parents (mean = 3.76/4.00) and high usability and engagement among children (mean = 2.77/3.00). CONCLUSION: The e-SEM programme demonstrated strong content validity and high acceptability, supporting its feasibility as a theory-driven digital oral health intervention for schoolchildren. Further refinement and effectiveness testing are recommended to evaluate its impact on oral health behaviours and outcomes.
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