International Dental Journal[JOURNAL]
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200 papers
Comparison of five different Light-Cured Pulp Capping Materials to a Hydraulic Calcium Silicate Cement: A Long-Term Physicochemical Study.
Schuster L, Dammaschke T, Trusca R … +4 more , Motelica L, Ehmke B, Ficai D, Ficai A
Int Dent J · 2026 May · PMID 42090949 · Full text
OBJECTIVES: Hydraulic calcium silicate cements (HCSCs) are the gold standard for vital pulp therapy, although they have a prolonged setting time. Light-cured flowable composite resins containing calcium silicate or calci...
OBJECTIVES: Hydraulic calcium silicate cements (HCSCs) are the gold standard for vital pulp therapy, although they have a prolonged setting time. Light-cured flowable composite resins containing calcium silicate or calcium hydroxide powder are promoted as an alternative. The aim of this study was to compare the physicochemical properties of 5 light-cured pulp capping materials (LCPCMs) (Calcimol LC, TheraCal LC, ReViCal, MTA PulpCap, and Pulprotec MTA) with HCSC (Biodentine). METHODS: Cylindrical specimens (51.472 mm; n = 13/material/time) were stored in 5 mL Hanks' Balanced Salt Solution in a Thermoshaker at 37 °C with constant shaking. After 1, 3, 7, 14, 28, and 180 days of immersion, the pH value and conductivity of the solution, the solubility of the samples, and the surface properties of the specimens (scanning electron microscopy, energy dispersive x-ray, x-ray diffraction, Fourier transformation infrared spectroscopy) were analysed. Statistical analysis was carried out using the Fisher exact test and the 2-sample t test in addition to 1-way analysis of variance. RESULTS: The pH value of Biodentine was significantly higher than that of the LCPCM at every time point examined (P < .05). On scanning electron microscopy, hydroxyapatite-like structures were visible on the surface of Biodentine after 7 days, whereas this was not the case for the LCPCM. The energy dispersive x-ray revealed that significantly more calcium was found on the surface of Biodentine than in the LCPCM (P < .05). X-ray diffraction was able to detect hydroxyapatite on the surface of Biodentine, while all materials showed calcite on their surfaces. Fourier transformation infrared spectroscopy confirmed these findings and showed polymeric structures in the LCPCM. SIGNIFICANCE: The physicochemical properties of HCSC (Biodentine) examined in this study are superior to those of LCPCM.
Association of OPG, TNF-α, and IL-1B Gene Variants With Periodontitis in a South African Population.
Kabbashi S, Ngwa NE, Holmes H … +2 more , Prince Y, Chetty M
Int Dent J · 2026 May · PMID 42086006 · Full text
AIM: This study aimed to investigate candidate single-nucleotide polymorphisms linked to periodontitis susceptibility in a Western Cape cohort, providing insights into population-specific host genetic factors. MATERIALS...
AIM: This study aimed to investigate candidate single-nucleotide polymorphisms linked to periodontitis susceptibility in a Western Cape cohort, providing insights into population-specific host genetic factors. MATERIALS AND METHODS: This observational case-control study recruited a total of 150 South African participants. Saliva samples were genotyped using the OpenArray QuantStudio 12K Flex qPCR System. Genotype and allele frequencies were assessed for Hardy-Weinberg equilibrium and tested for associations with clinical variables and disease status using Chi-square tests and logistic regression adjusted for age, gender, and smoking. RESULTS: A total of 24 SNPs were analysed. Several genotypes showed suggestive associations with periodontitis risk prior to multiple testing correction. The OPG + 1181 CG, RANKL RL2 AG, and IL-17A + 197 GG genotypes were linked to higher plaque score. The TNF-α -238 GG genotype was associated with lower bleeding score and reduced disease risk (OR = 0.157, 95% CI: 0.039-0.638, P = .010), while IL-1B -511 GG genotype corresponded with a reduced disease risk (adjusted OR = 0.216, 95% CI: 0.054-0.867, P = .031). Conversely, OPG + 1181 CC was related to increased disease risk under multiple models (adjusted OR = 20.42, 95% CI: 1.95-213.9, P = .012). These associations lost significance after correction for multiple testing. Ethnicity-based subgroup analysis revealed differences in genotype distribution, while smoking status showed no effect. CONCLUSION: Genetic variants may influence periodontitis susceptibility, underscoring the importance of population-specific risk profiling and the need for replication in larger cohorts to support targeted diagnostics in resource-limited settings.
Altered Salivary Microbiome and Increased Immune Markers in Mouth-Breathing Children: Implications for Oral Health.
Zhang J, Wang X, Wang W … +2 more , Cao Y, Wang G
Int Dent J · 2026 May · PMID 42068861 · Full text
OBJECTIVE: To investigate the impact of mouth breathing (MB) on the salivary microbiome in children by comparing the differences in biochemical indicators, immune proteins and microbial community structure between mouth-...
OBJECTIVE: To investigate the impact of mouth breathing (MB) on the salivary microbiome in children by comparing the differences in biochemical indicators, immune proteins and microbial community structure between mouth-breathing children and nose-breathing children, as well as among mouth-breathing children with different malocclusion types. METHODS: Saliva samples were collected from 30 mouth-breathing children (MB group) and 10 nose-breathing children (control group), aged 8 to 12, between August 2023 and August 2024. The MB group was further subdivided into Angle Class I, II and III malocclusion subgroups, with 10 cases each. Ion concentrations were measured using an automatic biochemical analyser, pH was determined using a pH metre, immune protein levels were assayed by enzyme-linked immunosorbent assay and the structure and diversity of the salivary microbiota were analysed using 16S rRNA high-throughput sequencing. RESULTS: Compared with the control group, the MB group showed no significant difference in salivary pH (P > .05), but a significantly lower chloride ion (Cl⁻) concentration (P < .05). Conversely, the concentrations of secretory immunoglobulin A (SIgA) and peroxiredoxin-5 (PRDX5) were significantly higher in the MB group (P < .05). No statistically significant differences in these indicators were observed among the different malocclusion subgroups. Spearman correlation analysis revealed a positive correlation between PRDX5 and SIgA concentrations (rs = 0.808, P < .001) and negative correlations between both PRDX5 and SIgA concentrations and Cl⁻ concentration (rs = -0.588 and -.600, respectively; P < .001) in the MB group. Microbiota analysis indicated that the species richness (Chao1 index) of the salivary microbiota was significantly higher in the MB group. At the genus level, the relative abundances of Dialister, Streptobacillus, Anaeroglobus and Scardovia were significantly increased in the MB group (P < .05). CONCLUSION: MB alters the physicochemical properties of children's saliva, triggering an enhanced local immune response and a state of oxidative stress. This leads to dysbiosis of the salivary microbial community, characterised by a higher abundance of pathogenic bacteria associated with dental caries and periodontal disease and shows a correlation with pathogens linked to upper respiratory tract inflammation. These findings suggest that MB may impact oral and potentially systemic health by disrupting the oral microenvironment.
Reframing Periodontitis: A Concise Review of Shifting Paradigms and Contemporary Clinical Practice.
Padmakumari KMC, Koppolu P, Tilakaratne A
Int Dent J · 2026 Apr · PMID 42066494 · Full text
INTRODUCTION AND AIMS: Periodontitis is a highly prevalent, chronic inflammatory disease that progressively destroys tooth-supporting structures, significantly impacting systemic health and patient quality of life. Given...
INTRODUCTION AND AIMS: Periodontitis is a highly prevalent, chronic inflammatory disease that progressively destroys tooth-supporting structures, significantly impacting systemic health and patient quality of life. Given its global public health implications, a current, evidence-based understanding of periodontitis management is essential, particularly as therapeutic strategies have evolved rapidly. This paper critically traces the evolution of periodontitis management from historical paradigms to modern, evidence-based practices, highlighting how shifting conceptual frameworks have reshaped clinical decision-making and patient care. METHODS: A structured narrative literature review was conducted, analysing recent clinical studies, systematic reviews, updated classification systems, and internationally recognised treatment guidelines. RESULTS: This review highlights emerging paradigm shifts in the aetiopathogenesis, risk factors, and treatment of periodontitis. Advances in diagnostic tools and classification systems now enable refined, risk-informed, and personalised care pathways. Despite these improvements, the global prevalence of periodontitis remains high. Given that periodontitis is largely preventable, this work aims to re-engineer current therapeutic strategies to prioritise robust preventive measures. This approach is combined with updated, validated clinical protocols for curative treatment, aiming to drastically reduce the global burden of disease and its systemic impact. CONCLUSION WITH CLINICAL RELEVANCE: Current evidence-based guidelines underscore a shift toward personalised periodontal care, emphasising tailored, patient-specific management over 'one-size-fits-all' protocols. Future research must prioritise refining diagnostic precision and validating innovative, preventive strategies to bridge the gap between scientific advancements and everyday clinical practice.
Malignant Transformation Risk in Patients With Oral Leukoplakia and Type 2 Diabetes Mellitus.
Yang FR, Fang JK, Lan QY … +3 more , Lu Y, Hua H, Zhou PR
Int Dent J · 2026 Apr · PMID 42066493 · Full text
INTRODUCTION AND AIMS: Oral leukoplakia (OLK) is the most common oral potentially malignant disorder, with a malignant transformation rate of up to 9.8%. Type 2 diabetes mellitus (T2DM) is associated with increasing canc...
INTRODUCTION AND AIMS: Oral leukoplakia (OLK) is the most common oral potentially malignant disorder, with a malignant transformation rate of up to 9.8%. Type 2 diabetes mellitus (T2DM) is associated with increasing cancer risk. However, risk factors for malignant transformation in OLK-T2DM patients remain undefined. This study aimed to identify these factors and develop prediction models integrating glycaemic and clinical indicators. METHODS: A retrospective nested case-control study was conducted in a real-world OLK-T2DM cohort (2013-2025). Cases (n = 55) with histologically confirmed malignant transformation to oral squamous cell carcinoma were matched 1:2 by age and sex with controls (n = 110) without transformation. Glycaemic control (fasting plasma glucose [FPG], haemoglobin A1c [HbA1c]) was the main exposure. Risk factors were analysed using univariable analyses, multivariable conditional logistic regression, multivariable stratified Cox regression models and machine learning models. RESULTS: Suboptimal glycaemic control (HbA1c > 7% or FPG > 7.2 mmol/L) was strongly associated with malignant transformation, with each 1 mmol/L increase in FPG raising malignant transformation risk by 60% to 174% according to the results of multivariable stratified Cox regression models for the risk of malignant transformation. Moderate and severe oral epithelial dysplasia (adjusted hazard ratio = 399.43, P = .021) was also an independent predictor. By integrating glycaemic and clinical indicators, machine learning models achieved stable predictive performance (area under the receiver operating characteristic curve up to 0.78; accuracy up to 76.91%). CONCLUSION: Suboptimal glycaemic control was independently associated with increased malignant transformation risk in OLK-T2DM patients after adjustment for key confounders. This association was consistent across both regression and machine learning models. CLINICAL RELEVANCE: These findings underscore the importance of early monitoring and strict glycaemic management, and suggest that incorporating glycaemic indicators into risk prediction tools may help improve the identification and management of high-risk patients.
Gingiva-Derived Decellularised Extracellular Matrix Hydrogel Supports Osteogenic and Angiogenic Phenotypes of 3D STRO-1 GMSC/HUVEC Spheroids In Vitro.
Liu Y, Zheng X, Qiao W … +8 more , Wen S, Lin Y, Gan Y, Zhao Y, Chen Z, Wang R, Huang X, Rong M
Int Dent J · 2026 Apr · PMID 42066492 · Full text
INTRODUCTION AND AIMS: Stem cell-based bone tissue engineering is often limited by insufficient osteogenic differentiation and inadequate vascularisation, largely attributable to the absence of a biomimetic stem cell nic...
INTRODUCTION AND AIMS: Stem cell-based bone tissue engineering is often limited by insufficient osteogenic differentiation and inadequate vascularisation, largely attributable to the absence of a biomimetic stem cell niche. This study aimed to develop a human gingiva-derived decellularised extracellular matrix hydrogel (G-dECM) as a supportive microenvironment for three-dimensional (3D) coculture spheroids of STRO-1⁺ gingival mesenchymal stem cells (sGMSC) and human umbilical vein endothelial cells (HUVEC), thereby promoting the expression of osteogenic and angiogenic markers. METHODS: Human gingival tissue was processed through decellularisation, enzymatic digestion, and sol-gel transformation to prepare G-dECM hydrogel. Composite 3D sGMSC/HUVEC spheroids (GHS) were generated and encapsulated within G-dECM. Morphological assessment, viability evaluation, and osteogenic differentiation analyses were conducted. Transcriptomic profiling was performed to identify G-dECM-associated regulatory signalling pathways. RESULTS: G-dECM exhibited a porous, collagen-rich structure enriched with bioactive ECM proteins. Encapsulation of GHS within G-dECM enhanced cellular viability, promoted the expression of osteogenic and angiogenic markers, and improved spheroid structural integrity compared with matrix-free controls. Transcriptomic analysis revealed activation of TGF-β/SMAD and BMP signalling pathways associated with osteogenic differentiation. CONCLUSION: G-dECM provides a biomimetic stem cell niche that supports the osteogenic and angiogenic phenotypes of 3D sGMSC/HUVEC spheroids, establishing an integrated regenerative graft system combining seed cells, scaffold, and endogenous signalling cues. CLINICAL RELEVANCE: This G-dECM-based composite graft strategy offers a promising translational approach for the regeneration of alveolar bone defects associated with periodontal disease, trauma, or tooth extraction.
H19 Promotes Odontogenic Differentiation of Human Dental Pulp Cells via miR-103a-3p-Mediated PIK3R1/AKT and KLF4 Pathways.
Zhang J, Lin L, Dong H … +7 more , Wang B, Chen X, Wang C, Lin L, Zhong J, Zheng G, Jiang Q
Int Dent J · 2026 Apr · PMID 42066491 · Full text
BACKGROUND: The regeneration of functional dentin is a critical clinical goal for preserving tooth vitality after injury, with odontoblastic differentiation of human dental pulp stem cells (hDPSCs) being central to this...
BACKGROUND: The regeneration of functional dentin is a critical clinical goal for preserving tooth vitality after injury, with odontoblastic differentiation of human dental pulp stem cells (hDPSCs) being central to this reparative process. While the long noncoding RNA H19 is recognised as a key regulator of dentin repair, its downstream regulatory network is complex and incompletely mapped. Beyond the previously established H19/miR-140-5p/BMP2 axis, this study identifies a distinct and parallel pathway in which H19 promotes odontoblastic differentiation by downregulating miR-103a-3p, which in turn targets the PIK3R1/AKT and KLF4 signalling cascades. Our findings reveal that these two downstream networks operate independently, further elucidating the multifaceted role of H19 in dentin regeneration. METHODOLOGY: In this study, we used lentiviral vectors to stably overexpress H19 in hDPSCs. Bioinformatic analysis and dual-luciferase reporter assays were employed to validate the interactions between H19 and miR-103a-3p, as well as between miR-103a-3p and its target mRNAs, including phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) and Kruppel-like factor 4 (KLF4). And qPCR and Western blot were used to investigate the expression pattern of H19 and the potential signalling axis of H19 and key odontogenic markers. Then, alkaline phosphatase and alizarin red S staining were used to evaluate odontogenic differentiation capacity. Finally, a heterotopic pulp regeneration model was established. And HE staining, Masson staining, immunofluorescence and immunohistochemistry were performed to verify the mechanism of H19 regulating odontogenic differentiation in vivo. RESULTS: In vitro, H19 promoted odontogenic differentiation of hDPSCs, while miR-103a-3p inhibited them. Both PIK3R1 and KLF4 were identified as direct targets of miR-103a-3p. Ectopic expression of either PIK3R1 or KLF4 restored the odontogenic differentiation capacity of hDPSCs suppressed by miR-103a-3p. Mechanistically, PIK3R1 promoted odontogenesis by activating the PI3K/AKT signalling pathway, whereas KLF4 acted independently as a transcriptional regulator. In vivo, H19 overexpression drove odontoblastic differentiation of hDPSCs by inducing the expression of its downstream targets, PIK3R1 and KLF4. CONCLUSION: Our findings indicated that H19 promoted odontogenic differentiation of hDPSCs by modulating the miR-103a-3p-PIK3R1/AKT and miR-103a-3p-KLF4 axes, underscoring their therapeutic potential for pulp regeneration.
Student Performance in Bitewing Caries Detection: Artificial Intelligence Versus Alternative E-learning.
Nagyová V, Blaňár D, Kybic J … +2 more , Schwendicke F, Tichý A
Int Dent J · 2026 Apr · PMID 42066490 · Full text
INTRODUCTION AND AIMS: This study compared 3 methods for teaching caries detection in bitewings: a prerecorded lecture, a preannotated dataset, and an artificial intelligence (AI)-based web application. METHODS: Fifty-tw...
INTRODUCTION AND AIMS: This study compared 3 methods for teaching caries detection in bitewings: a prerecorded lecture, a preannotated dataset, and an artificial intelligence (AI)-based web application. METHODS: Fifty-two dental students annotated carious lesions in 50 bitewings using minimum bounding boxes. After initial annotations, students were divided into 3 groups according to the training method: the Lecture Group (n = 16) received a prerecorded lecture on caries detection in bitewings, the Dataset Group (n = 17) had access to 50 bitewings annotated by a dentist, and the AI Group (n = 19) used an AI-based web application. After training, all students annotated caries in 50 previously unseen bitewings. Student annotations before and after training were compared to a reference standard of 3 experienced dentists. The evaluation was stratified according to the training method and stage of studies: preclinical (n = 16), junior clinical (n = 15), and senior clinical (n = 21). RESULTS: All training methods significantly improved the mean number of errors, intersection over union of matching annotations, and accuracy. Sensitivity increased significantly in the Dataset Group (from 0.62 ± 0.14 to 0.78 ± 0.08) and the AI Group (from 0.68 ± 0.15 to 0.73 ± 0.12), as opposed to the Lecture Group, where a significant increase in specificity was observed (from 0.94 ± 0.09 to 0.96 ± 0.05). The stage of studies impacted the results; the extent of improvement decreased with increasing clinical experience. CONCLUSION: While the 3 training methods varied in their impact on the confusion matrix components, they yielded comparable overall improvements. The AI-based web application could serve as an educational tool for caries detection in bitewings, especially for dental students with limited clinical experience. CLINICAL RELEVANCE: This study shows that learning bitewing caries detection with an AI tool yields improvements comparable to other tested e-learning methods. Evaluating and comparing established e-learning and AI teaching methods is key to optimising AI-assisted education for better learning outcomes in dental training.
Sal-hDPSCs Transplantation Alleviates Hypoxic-Ischaemic Ferroptosis in Neonatal Rats Via the FSP1-CoQ Axis.
Xu K, Li Y, Gao S … +5 more , Fang X, Zhang X, Zhang X, Wang F, Wang X
Int Dent J · 2026 Apr · PMID 42061105 · Full text
OBJECTIVE: To investigate the therapeutic effects and mechanisms of salidroside-pretreated human dental pulp stem cells (Sal-hDPSCs) on hypoxic-ischaemic brain damage (HIBD) in neonatal rats, providing a scientific basis...
OBJECTIVE: To investigate the therapeutic effects and mechanisms of salidroside-pretreated human dental pulp stem cells (Sal-hDPSCs) on hypoxic-ischaemic brain damage (HIBD) in neonatal rats, providing a scientific basis for clinical application of hDPSCs. METHODS: An oxygen-glucose deprivation (OGD) model was established in hDPSCs. Cell viability and migration were assessed by CCK-8 and wound healing assays. The HIBD model was induced in neonatal rats using the Rice-Vannucci method and at 24 hours post-induction, hDPSCs or Sal-hDPSCs were transplanted. At 72 hours post-transplantation, cortical pathology was examined by HE and Nissl staining; Fe²⁺, malondialdehyde (MDA), superoxide dismutase (SOD) and CoQ levels were measured; mitochondrial morphology was observed by transmission electron microscopy; and glutathione peroxidase 4 (GPX4)/ferroptosis suppressor protein 1 (FSP1) expression was detected by immunofluorescence and Western blot. Neurobehavioural function was evaluated at 28 days using novel object recognition and mesh tests. In PC12 cells subjected to OGD, the effects of conditioned medium from hDPSCs or Sal-hDPSCs, with or without the FSP1 inhibitor iFSP1, were assessed by measuring Fe²⁺, MDA, reactive oxygen species, CoQ and GPX4/FSP1 expression. RESULTS: Sal pretreatment (20 μM) significantly enhanced hDPSC viability and migration after OGD. In HIBD rats, neuronal damage, elevated Fe²⁺ and MDA decreased SOD activity, reduced GPX4/FSP1 expression and CoQ level and typical ferroptotic mitochondrial changes were observed. Both hDPSCs and Sal-hDPSCs transplantation improved these alterations, with Sal-hDPSCs showing greater efficacy. Neurobehavioural outcomes were also significantly improved in the treatment groups. In vitro, Sal-hDPSCs-CM markedly reduced Fe²⁺, MDA and reactive oxygen species, upregulated GPX4/FSP1 and increased CoQ in OGD-exposed PC12 cells; these effects were abolished by iFSP1. CONCLUSION: Sal pretreatment enhances the survival and migratory capacity of hDPSCs under hypoxic-ischaemic conditions, thereby improving their therapeutic efficacy. Moreover, Sal-hDPSCs alleviate HIBD by inhibiting ferroptosis via the FSP1-CoQ axis.
From Framework Inventory to Reporting Architecture: Next Steps for Dental AI Reporting Standards.
Mourão CF, Juliasse LE
Int Dent J · 2026 Apr · PMID 42061104 · Full text
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Dental Pulp Stem Cells for the Management of Plaque Biofilm-Associated Infections : A Review.
Aliniay-Sharafshadehi S, Sheykhhasan M, Sharifi K … +5 more , Ansari-Mohseni A, Yousefi MH, Afkhami H, Mehdipour A, Aghaali M
Int Dent J · 2026 Apr · PMID 42061103 · Full text
This structured narrative review synthesises current evidence (2000-2025) on the antimicrobial, immunomodulatory, and regenerative properties of dental pulp stem cells (DPSCs) in the context of plaque-induced gingivitis...
This structured narrative review synthesises current evidence (2000-2025) on the antimicrobial, immunomodulatory, and regenerative properties of dental pulp stem cells (DPSCs) in the context of plaque-induced gingivitis and oral biofilm infections. We systematically reviewed peer-reviewed literature from PubMed, Scopus, and Web of Science via keywords related to DPSCs, oral biofilms, antimicrobial peptides (eg, β-defensins, LL-37), and immunomodulation. Unlike conventional antimicrobial therapies that solely target pathogen eradication, DPSCs offer a dual-function strategy: (1) direct microbial control through the secretion of antimicrobial peptides that disrupt Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and (2) resolution of inflammation via macrophage M2 polarisation, suppression of IL-1β/TNF-α (Interleukin-1β and Tumor Necrosis Factor-α), and microbiome rebalancing. Additionally, DPSCs support periodontal tissue regeneration through trophic signalling and differentiation into periodontal lineage cells. Critically, no clinical trials to date have evaluated DPSCs for the management of gingivitis. This review highlights DPSCs as promising, antibiotic-sparing therapeutic candidate and outlines key knowledge gaps for future translational research.
In Vitro Shear Bond Strength of Additively Manufactured Denture Base Resins to Hard Chairside Reline Materials.
Yoo JH, Kim J, Park Y … +1 more , Kim JH
Int Dent J · 2026 Apr · PMID 42054793 · Full text
INTRODUCTION AND AIMS: Reliable bonding between additively manufactured denture base resins and hard chairside reline materials is essential for long-term clinical performance, yet evidence under simulated aging conditio...
INTRODUCTION AND AIMS: Reliable bonding between additively manufactured denture base resins and hard chairside reline materials is essential for long-term clinical performance, yet evidence under simulated aging conditions remains limited. This in vitro study evaluated the shear bond strength (SBS) of two hard chairside reline materials to conventional polymethyl methacrylate (PMMA) and two additively manufactured denture base resins under thermocycling conditions simulating relining at denture delivery and after clinical service. METHODS: One heat-polymerized PMMA resin and two additively manufactured denture base resins composed of urethane dimethacrylate (UDMA) and methacrylate ester monomer (MA) were bonded to Tokuyama Rebase II (R) or Ufi Gel Hard (U), forming six material combinations. Specimens were assigned to three conditions: non-thermocycling (NT), thermocycling before relining (TB), or thermocycling after relining (TA). Ten specimens were prepared per subgroup (n = 180). Specimens that exhibited complete debonding during thermocycling were assigned an SBS value of 0 MPa and included in the analysis. SBS was measured using a universal testing machine, and failure modes were classified. Data were analysed using appropriate statistical tests (α = 0.05). RESULTS: SBS was significantly influenced by denture base resin type, reline material, and thermocycling condition (P < .05). U demonstrated higher SBS than R across all denture base resins. Under NT conditions, the MA-U group showed the highest SBS (6.78 ± 1.57 MPa), and the UDMA-R group showed the lowest (1.41 ± 0.49 MPa). After thermocycling, 80% of UDMA-R and 20% of MA-R specimens debonded, whereas no failures occurred in the U groups. R predominantly exhibited adhesive failures, while U mainly showed cohesive or mixed failures. CONCLUSION: Within the limitations of this in vitro study, bonding performance between denture base resins and hard chairside reline materials was influenced by material compatibility and thermal aging. U demonstrated greater resistance to thermally induced debonding than R. CLINICAL RELEVANCE: Appropriate selection of hard chairside reline materials for additively manufactured dentures can provide bonding performance comparable to conventional PMMA.
Association Between Health Literacy, Oral Health Literacy, and Periodontal Disease.
Kanchana-At S, Ruengorn C, Bandhaya P
Int Dent J · 2026 Apr · PMID 42054792 · Full text
INTRODUCTION: Inadequate health literacy and oral health literacy may adversely impact an individual's capacity for disease management, including the management of periodontitis. AIM: This study investigated the associat...
INTRODUCTION: Inadequate health literacy and oral health literacy may adversely impact an individual's capacity for disease management, including the management of periodontitis. AIM: This study investigated the association between health literacy (HL), oral health literacy (OHL), and periodontal disease severity. METHODS: A cross-sectional analytical study was conducted in Chiang Mai Province. Demographic data, oral health behaviours, and periodontal status were collected. Periodontal disease severity was classified according to the 2018 American Academy of Periodontology/European Federation of Periodontology (AAP/EFP 2018) criteria. Health literacy was assessed using the General Health Literacy Scale for Thai people (GHLS), and OHL was measured using the Thai version of the Rapid Estimate of Adult Literacy in Dentistry (ThREALD-30). Associations were analysed using ordinal logistic regression, adjusting for potential confounders. RESULTS: A total of 247 participants were included (mean age: 45.42 ± 15.92 years). The mean HL and OHL scores were 180.63 ± 24.79 and 27.50 ± 2.46, respectively. Most participants (58.70%) were diagnosed with stage III or IV periodontitis. No significant association was observed between the HL scores and periodontal disease severity. In contrast, OHL scores were significantly associated with periodontal disease severity (Crude OR 0.69; 95% CI: 0.58-0.81, p < .001). After adjusting for potential confounders, OHL remained significantly associated with periodontal disease severity (adjusted OR 0.82; 95% CI: 0.68-0.99, p = .039). CONCLUSIONS: Oral health literacy was significantly associated with periodontal disease severity, whereas HL showed no such association. CLINICAL RELEVANCE: These findings emphasize the critical role of evaluating and enhancing OHL in improving periodontal health outcomes at the population level.
The Burden and Risk Factors of Head and Neck Cancers in G20 Countries, 1990-2023.
Xiao H, Wang X, Yan X … +2 more , Feng G, Ma R
Int Dent J · 2026 Apr · PMID 42054791 · Full text
BACKGROUND: Head and neck cancers (HNC) rank as the sixth most common cancers globally, yet comprehensive epidemiology among the Group of Twenty (G20) nations is lacking. METHODS: This secondary analysis of Global Burden...
BACKGROUND: Head and neck cancers (HNC) rank as the sixth most common cancers globally, yet comprehensive epidemiology among the Group of Twenty (G20) nations is lacking. METHODS: This secondary analysis of Global Burden of Disease 2023 data systematically assessed the spatiotemporal trends, population disparities and risk-attributable burden (excluding viral factors) of age-standardised rates for HNC across G20 countries. Future trends were forecast using an autoregressive integrated moving average (ARIMA) model. RESULTS: In 2023, lip and oral cavity cancer (LOCC) presented the highest burden among HNC subtypes across the G20, with an age-standardised incidence rate (ASIR) of 4.52 per 100,000, corresponding to 283,441 new cases. India carried the highest burden of LOCC, China that of nasopharyngeal carcinoma (NPC) and France that of laryngeal and other pharyngeal cancers (LC/OPC). From 1990 to 2023, LOCC and OPC incidence rose overall while LC and NPC declined. South Korea showed the fastest NPC increase, while the United Kingdom had the steepest rise in LOCC/OPC. China recorded the most significant reductions in NPC age-standardised mortality and disability-adjusted life year rates (ASMR and ASDR), whereas France showed the sharpest decline in LOCC/OPC. Indonesia was the sole country with consistent increases across all subtypes. Although males are predominantly affected, female incidence was higher for NPC in the United Kingdom and for LOCC/OPC in Saudi Arabia. The HNC burden concentrates in elderly populations, with tobacco and alcohol as leading risk factors, though their contributions vary by country and sex. Projections to 2038 indicate likely increases in OPC and NPC incidence, with LOCC remaining the predominant contributor. CONCLUSION: Marked regional, sex and age disparities in HNC burden and risk factors exist across G20 nations. CLINICAL RELEVANCE: These disparities provide an evidence base to mobilise health-development assistance and to design precise, differentiated transnational control strategies.
Effect of Micro-Osteoperforations on Orthodontic Tooth Movement: A Systematic Review and Meta-Analysis.
Heidari A, Mojiri S, Azarbayjani M … +1 more , Khamisi N
Int Dent J · 2026 Apr · PMID 42054790 · Full text
BACKGROUND: While micro-osteoperforations (MOPs) have been proposed as a potential solution for the slow pace of orthodontic treatment, their effectiveness is widely debated. This meta-analysis was designed to assess whe...
BACKGROUND: While micro-osteoperforations (MOPs) have been proposed as a potential solution for the slow pace of orthodontic treatment, their effectiveness is widely debated. This meta-analysis was designed to assess whether MOPs are a clinically effective and safe tool, and to explore how they might be best applied. METHODS: Based on the protocol registered prospectively in PROSPERO (CRD42025633088), a systematic search was conducted in PubMed, Embase, Scopus, Cochrane CENTRAL and key grey literature. Randomized controlled trials were synthesized using random-effects meta-analysis; extensive subgroup and meta-regression analyses were conducted to explore heterogeneity. The certainty of evidences was rated with the GRADE framework. RESULTS: Thirty-nine trials encompassing 1025 participants suggested a substantial acceleratory effect (SMD = 1.66; 95% CI: 1.27-2.05). Meta-regression suggested that the standardized effect may decrease with longer follow-up (β = -0.168 SMD units per week) and protocols that repeated MOPs approximately every 4 weeks were associated with ∼0.54 mm of cumulative movement (study-level association). In metric-specific analyses, MOPs appeared to improve anterior alignment measured by Little's Irregularity Index by 1.24 mm during the first month with no statistical heterogeneity (I² = 0%). No clear evidence of increased root resorption or clinically important periodontal deterioration was observed. Pain was minimal overall, though it was associated with the number of perforations performed. CONCLUSION: Moderate-certainty of evidence suggests that a protocol-driven approach-specifically, repeating a trio of shallow buccal perforations every 4 weeks is associated with accelerated tooth movement. However, substantial heterogeneity warrants cautious interpretation of the precise magnitude of this effect.
Sagittal and Vertical Changes After Aligner Versus Acrylic Splint Expansion in Mixed Dentition: A Prospective Trial.
Lu L, Zhang L, Li C … +2 more , Lei L, Lu Y
Int Dent J · 2026 Apr · PMID 42048976 · Full text
INTRODUCTION AND AIMS: The efficacy of acrylic splint expander (Splint) and Invisalign First aligners (First) in increasing transverse width in mixed dentition have been well documented, but little is known about their s...
INTRODUCTION AND AIMS: The efficacy of acrylic splint expander (Splint) and Invisalign First aligners (First) in increasing transverse width in mixed dentition have been well documented, but little is known about their sagittal and vertical effects. Since sagittal and vertical changes are particularly critical in growing patients, the objective of this study was to assess and compare the sagittal and vertical treatment effects of First and Splint in mixed dentition with transverse maxillary deficiency. METHODS: Sixty subjects were included after propensity score matching (PSM) from initial 163 cohort: the Splint group (n = 20), the First group (n = 20), and the Natural Growth (Natural) group (n = 20). Lateral cephalograms were acquired before the initiation of treatment (T0) and at a minimum of one year after treatment (T1). Sixteen cephalometric variables were assessed to detect differences within and between groups from T0 to T1. Intra-group analyses were conducted using paired t-tests, while inter-group comparisons were performed using analysis of variance (ANOVA). Statistical significance was set at P < .05. RESULTS: In all groups, a significant increase (P < .05) were observed in ANS-Me, N-Me, and S-Go during the T1-T0 period. In the Splint group, ANB and NA-PogA significantly decreased (P < .05), whereas SNB significantly increased (P < .05). In the First group, both overjet and overbite significantly decreased (P < .05), with a greater reduction observed compared to the other two groups (P < .05). No significant differences were found in the remaining variables, either within or between the groups. CONCLUSIONS: Splint therapy improved skeletal relationships, resulting in reduced facial convexity. First therapy produced a pronounced reduction in overjet and overbite primarily through dentoalveolar effects.
Quantitative and Qualitative Evaluation of a Confidence-Aware Transformer-Based Super-Resolution Framework for Panoramic Radiographs.
Lee J, An CH, An SY … +2 more , Kim EK, Kwon YE
Int Dent J · 2026 Apr · PMID 42048975 · Full text
OBJECTIVES: This study aimed to develop and evaluate a confidence-aware transformer-based super-resolution framework, termed CAT-PRSR, to enhance image quality and diagnostic reliability in panoramic dental radiographs....
OBJECTIVES: This study aimed to develop and evaluate a confidence-aware transformer-based super-resolution framework, termed CAT-PRSR, to enhance image quality and diagnostic reliability in panoramic dental radiographs. METHODS: A total of 1078 anonymised panoramic radiographs were retrospectively collected (950 for training, 128 for testing). The CAT-PRSR framework integrating a transformer-based SR backbone with a confidence-aware training strategy was developed. The model generates a high-resolution output with pixel-wise uncertainty estimation, allowing adaptive learning focused on diagnostically relevant regions while minimising over-enhancement in noise-sensitive areas. Model performance was evaluated using 6 quantitative metrics - peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), spatial correlation coefficient (SCC), natural image quality evaluator (NIQE), learned perceptual image patch similarity (LPIPS), and Fréchet inception distance (FID)-and mean opinion score (MOS) assessment. Based on quantitative performance, 4 representative state-of-the-art SR models were selected for comparison at 4×, 6×, and 8× magnifications. RESULTS: CAT-PRSR demonstrated superior performance across all metrics and magnification levels. It achieved the highest peak signal-to-noise ratio (36.41 at 4 ×, 36.19 at 6 ×, and 33.73 at 8 ×) and the lowest FID (1.77, 9.29, and 2.09, respectively), outperforming all comparison models. In MOS evaluations, CAT-PRSR maintained diagnostic utility scores statistically comparable to ground truth images (P > .05), while other models showed significant degradation (P < .001). CONCLUSION: The proposed CAT-PRSR framework demonstrated potential to enhance panoramic radiograph resolution by integrating pixel-level fidelity with improved diagnostic reliability. CLINICAL RELEVANCE: The CAT-PRSR model may enhance the diagnostic reliability of panoramic radiographs acquired under low-resolution conditions, supporting more accurate clinical decision-making and serving as a reliable imaging resource for AI-driven dental research.
Elevated C-reactive Protein Levels and Malignant Transformation Risk in Patients With Oral Mucosal Diseases.
Kang JH
Int Dent J · 2026 Apr · PMID 42048974 · Full text
INTRODUCTION AND AIMS: Chronic inflammation is recognised as a hallmark of cancers. This multicentre cohort study investigated the influence of elevated serum C-reactive protein (CRP) levels on the malignant transformati...
INTRODUCTION AND AIMS: Chronic inflammation is recognised as a hallmark of cancers. This multicentre cohort study investigated the influence of elevated serum C-reactive protein (CRP) levels on the malignant transformation risk of oral inflammatory diseases and lesions with malignant potential utilising the Observational Medical Outcomes Partnership Common Data Model. METHODS: This retrospective, observational cohort study included the data from 9 medical centres. CRP levels recorded within 30 days of oral diseases diagnosis were analysed. A meta-regression identified 0.269 mg/dL as the optimal threshold for predicting malignancy. Patients were classified into elevated CRP (CRP ≥ 0.269 mg/dL) and control (CRP < 0.269 mg/dL) groups. Cox proportional hazard models were applied to estimate risk of developing oral squamous cell carcinoma (OSCC), followed by 1:1 and 1:2 propensity score matching and pooled meta-analyses. RESULTS: In total, 10029 individuals with oral diseases and available CRP data were included, comprising 4142 and 5887 in the elevated CRP and control groups, respectively. Overall, 204 individuals (2.03%) progressed to OSCC, with higher incidence in the elevated CRP group (2.32%) compared with controls (1.83%). Elevated CRP was significantly associated with increased OSCC risk in both 1:1 (HR = 1.79 [95% CI 1.08-2.95]), and 1:2 propensity score matching models (HR = 1.55 [95% CI 1.01-2.38]). CONCLUSIONS: Elevated CRP levels, indicative of systemic inflammation, were linked to an increased risk of malignant progression in patients with inflammatory oral conditions and lesions with malignant potential. Understanding the role of inflammation may help assess OSCC risk and improve prevention.
Institutional Research Stratification in Global Dental Schools: A 10-Year Bibliometric Comparison Across QS Ranking Tiers.
Yeung AWK, Tsoi JKH
Int Dent J · 2026 Apr · PMID 42048973 · Full text
OBJECTIVE: To compare the research performance and publishing practices of the Top 50 and Next 50 dental schools ranked by the QS World University Rankings by Subject: Dentistry, and to identify institution‑level bibliom...
OBJECTIVE: To compare the research performance and publishing practices of the Top 50 and Next 50 dental schools ranked by the QS World University Rankings by Subject: Dentistry, and to identify institution‑level bibliometric characteristics associated with higher ranking performance. METHODS: QS Dentistry subject ranking data (2023-2025) were used to identify 100 dental schools, stratified into Top 50 and Next 50 groups based on multi‑year ranking stability. Institution‑level bibliometric indicators for 2016-2025 were retrieved from SciVal, using Dentistry (ASJC) as the subject filter to define the literature set. Twenty indicators capturing research productivity, citation impact, collaboration patterns, policy influence and journal quartile distribution were analysed. Group comparisons used Welch's t‑tests for individual indicators and χ tests for distributional comparisons (collaborative mode; journal quartiles). False discovery rate correction was applied within each analytic family. RESULTS: Across 2016-2025, the Top 50 schools outperformed the Next 50 in 10 indicators, including scholarly output, citation count, citations per publication, policy‑document citations and multiple collaboration‑impact metrics (all FDR‑adjusted P < .05). The Top 50 schools published a significantly higher proportion of their output in Q1 journals (58.0% versus 52.6%) and engaged more frequently in international collaboration (47.0% versus 44.3%). Correlation analysis showed that citations per publication positively correlated with international collaboration, Q1 publishing and top‑percentile citation indicators. Exploratory analyses showed that the ratio of scholarly output in Q1 journals declined stepwise from the Top 10 to ranks 12-20, 21-50 and 51-100. CONCLUSION: Top‑ranked dental schools are distinguished by greater publication volume, higher citation impact, stronger international collaboration and more frequent publishing in Q1 dental journals. These research findings offer directions for dental schools aiming to enhance their research performance and competitiveness within the QS ranking framework.
Effect of Intracapsular Pressure on Pulp Sensitivity in Teeth Affected by Jaw Cysts: A Clinical Study Combined With Finite Element Analysis.
Zhou W, Mao C, Lin Y … +4 more , Lu M, Lai Y, Wang C, Chen W
Int Dent J · 2026 Apr · PMID 42048972 · Full text
AIM: The objective of this research was to explore the relationship between intracapsular pressure (ICP) and pulp sensitivity in teeth affected by jaw cysts and to examine clinical and radiographic factors associated wit...
AIM: The objective of this research was to explore the relationship between intracapsular pressure (ICP) and pulp sensitivity in teeth affected by jaw cysts and to examine clinical and radiographic factors associated with variations in ICP. METHODS: This retrospective study included 60 patients with jaw cysts confirmed by radiographic and histopathological examinations. Radiographic data, ICP and pulp sensitivity were collected and analysed for correlation. In addition, finite element analysis (FEA) was applied to simulate the biomechanical effects of ICP on the apical neurovascular bundle. Linear correlation analysis, independent-samples t test and variance analysis were used for statistical analysis. RESULTS: Elevated ICP was significantly associated with reduced pulp sensitivity, particularly in teeth with root apices positioned 0 to 1 mm from the cystic cavity (P = .001, r = 0.30). The relat ionship between ICP and cyst volume proved site-specific: negative in the mandible (P = .016, r = -0.13), positive in the anterior maxilla (P = .002, r = 0.54) and nonsignificant in the posterior maxilla (P = .654, r = 0.17). FEA modelling confirmed that high ICP induces mechanical deformation of the apical neurovascular bundle, providing a biomechanical mechanism for reduced pulp sensitivity. CONCLUSIONS: Increased ICP was associated with reduced pulp sensitivity in teeth affected by jaw cysts. Preoperative radiographic evaluation may help estimate ICP and guide decisions for pulp-preserving treatment strategies.
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