Clinical Oral Investigations[JOURNAL]
Sun
200 papers
Early orthodontic traction does not compromise root development in inversely impacted maxillary central incisors: a three-year cone-beam computed tomography evaluation.
Yang L, Dong Z, Cheng Y … +2 more , Zhang Y, Wang X
Clin Oral Investig · 2026 Jun · PMID 42233985 · Publisher ↗
OBJECTIVES: To evaluate whether early orthodontic traction of inversely impacted maxillary central incisors with curved roots affects subsequent root development and labial/palatal alveolar bone support. MATERIALS AND ME...
OBJECTIVES: To evaluate whether early orthodontic traction of inversely impacted maxillary central incisors with curved roots affects subsequent root development and labial/palatal alveolar bone support. MATERIALS AND METHODS: A retrospective cone-beam computed tomography (CBCT)-based study was conducted in 42 children (7-9 years) with unilateral inversely impacted maxillary central incisors at Nolla stages 6-7 who underwent early orthodontic traction after space creation with a 2 × 4 appliance. Contralateral erupted incisors served as intra-individual controls. CBCT was performed pre-operatively, immediately after traction, and 3 years later. RESULTS: All 42 incisors were successfully tractioned and aligned into the dental arch. Straight-line root length of tractioned incisors remained shorter than that of contralateral controls at all time points (all p < 0.001) but increased significantly from baseline to post-traction and to 3-year follow-up (all p < 0.001). Curved root length was initially shorter in the affected teeth (p < 0.001) but did not differ from controls at 3 years (p = 0.466). Labial alveolar bone resorption was greater immediately after traction (p < 0.001), yet no significant difference was observed at 3 years (p = 0.070). Palatal bone levels did not differ between groups at either time point (both p > 0.05). CONCLUSIONS: Early traction of inversely impacted maxillary central incisors with curved roots does not impair root development or long-term labial or palatal alveolar bone support. CLINICAL RELEVANCE: Early orthodontic traction of inversely impacted maxillary central incisors can facilitate timely eruption and esthetic rehabilitation without compromising root maturation or long-term periodontal support.
Microleakage in 5Y-TZP zirconia ceramic crowns and the influence of deep margin elevation: a laboratory investigation.
Jansen L, Kern M, Wille S … +2 more , Schadte P, Passia N
Clin Oral Investig · 2026 Jun · PMID 42230405 · Full text
OBJECTIVES: To evaluate the effect of deep margin elevation (DME) on microleakage of 5Y-TZP ceramic crowns after thermomechanical loading. MATERIALS AND METHODS: Forty extracted molars were allocated to five groups (n = ...
OBJECTIVES: To evaluate the effect of deep margin elevation (DME) on microleakage of 5Y-TZP ceramic crowns after thermomechanical loading. MATERIALS AND METHODS: Forty extracted molars were allocated to five groups (n = 8). Standardized mesio-occluso-distal (MOD) tooth preprations were performed in all teeth and restored using two adhesive systems (one-bottle or two-bottle) in combination with two foundation restoration materials (auto-polymerizing or dual-polymerizing). Thirty-two molars received DME, while eight served as a control without DME. Following standardized tooth preparation, 5Y-TZP zirconia crowns were fabricated and bonded using an auto-polymerizing luting resin. While the specimens were stored in water for 150 days, they were subjected to thermomechanical loading with 37,500 thermal cycles (5 °C/55°C) and 1,200,000 mechanical cycles at 98 N in a chewing simulator. After loading, the specimens were immersed in fuchsine dye for 48 h, sectioned sagittally, and evaluated for dye penetration under an optical microscope. RESULTS: Significant differences in microleakage were observed at the foundation restoration margins. The dual-polymerizing foundation restoration material demonstrated significantly lower microleakage than the auto-polymerizing material. The one-bottle adhesive system performed significantly better than the two-bottle system. No microleakage was detected at the crown margin in any experimental group. CONCLUSION: Within the limitations of this laboratory study, the use of a dual-polymerizing foundation restoration material in combination with a one-bottle adhesive system showed favorable results for DME. CLINICAL RELEVANCE: Compared with surgical crown lengthening or orthodontic extrusion, DME may reduce patient morbidity and treatment time. Clearfil DC Core, in particular, demonstrated low microleakage at DME margins, with the choice of adhesive system significantly influencing outcomes.
Integrating deep learning techniques for analysis of chin morphology among Han Chinese individuals using a large cone-beam computed tomography dataset.
Xu B, Song C, Pan Y … +7 more , Li W, Nie K, Pei Y, Ma M, Yang T, Su H, Chen G
Clin Oral Investig · 2026 Jun · PMID 42228150 · Publisher ↗
OBJECTIVES: To characterize chin morphology and investigate its associations with sex, as well as various sagittal and vertical skeletal patterns. MATERIALS AND METHODS: A total of 743 cone-beam computed tomography (CBCT...
OBJECTIVES: To characterize chin morphology and investigate its associations with sex, as well as various sagittal and vertical skeletal patterns. MATERIALS AND METHODS: A total of 743 cone-beam computed tomography (CBCT) images (322 males, 421 females; aged 18-83 years) were analyzed to measure chin height, thickness, and width. An nnU-Net model was trained for automated chin segmentation using a subset of 304 images. The dataset was stratified into 18 categories based on combinations of sex and skeletal patterns (sagittal and vertical). Aligned average chin models were then constructed to facilitate morphological comparisons across these groups. RESULTS: Morphometric analysis revealed that males possessed significantly greater chin height (22.54 ± 3.06 mm vs. 20.87 ± 2.45 mm, p < 0.01) and width (51.25 ± 3.36 mm vs. 50.15 ± 2.87 mm, p < 0.01) than females, whereas no significant difference was observed in thickness. Regarding sagittal patterns, chin thickness emerged as the primary distinguishing feature; Class II individuals exhibited significantly thinner chins (4.74 ± 1.02 mm) compared to both Class I (5.16 ± 1.04 mm) and Class III (5.18 ± 0.98 mm) individuals (p < 0.01), a trend consistent across both sexes. In terms of vertical skeletal patterns, low-angle individuals were characterized by significantly greater chin thickness (5.26 ± 1.10 mm, p < 0.001) and width (51.40 ± 2.99 mm, p < 0.01), but reduced height (21.04 ± 2.74 mm, p < 0.001) relative to high-angle and average-angle groups. Comparative analysis of 3D average chin models corroborated these morphometric findings, providing visual evidence of distinct shape variations. CONCLUSIONS: This study systematically characterized chin morphology variations in relation to sex and skeletal patterns, establishing comprehensive average models specifically for the Han Chinese population. These findings provide a high-fidelity anatomical reference that can enhance diagnostic precision and treatment planning in orthodontics and orthognathic surgery. CLINICAL RELEVANCE: Chin prominence is a decisive factor in orthodontic treatment planning and facial profiling. Furthermore, chin thickness is closely correlated with the alveolar bone volume of the mandibular anterior teeth, acting as a primary anatomical constraint for tooth movement. This morphological insight is particularly critical for planning safe and stable orthodontic outcomes in patients with skeletal Class II or high-angle patterns, where bone support may be limited.
Adhesion of resin cement to 3D printed dental polymers: effect of layer thickness and air abrasion.
Zwicky P, Piccini M, Sener AA … +3 more , Souza LFB, Eyüboğlu TF, Özcan M
Clin Oral Investig · 2026 May · PMID 42217106 · Publisher ↗
OBJECTIVES: To assess the influence of layer thickness, silica-coating, and aging on surface roughness and resin cement adhesion to 3D-printed dental polymers. MATERIALS AND METHODS: Four photo-polymerized resins (Crownt...
OBJECTIVES: To assess the influence of layer thickness, silica-coating, and aging on surface roughness and resin cement adhesion to 3D-printed dental polymers. MATERIALS AND METHODS: Four photo-polymerized resins (Crowntec (S), 3Delta Etemp (D), TempPrint (GC), and NextDent C&B MFH (ND)) were printed under four layer conditions (polished, 20, 50, and 100 µm; N = 1280). Specimens were treated with or without silica-coating air abrasion (CoJet), bonded with resin cement (Panavia V5), and tested dry or after thermocycling (5,000 cycles). Surface roughness (Ra, Rz) and shear bond strength (SBS) were analyzed using three-way ANOVA and Tukey's test (α = 0.05). RESULTS: Material, layer thickness, and surface conditioning significantly affected surface roughness (p < 0.001), with material- and layer-dependent responses to silica coating. Roughness generally increased with layer thickness. For SBS, material and layer thickness were significant under both conditions (p < 0.05), while silica coating mainly benefited polished surfaces. ND and GC showed the highest SBS at 20 µm, S exhibited stable performance, and D showed the lowest bond strength. Thermocycling did not consistently reduce adhesion. CONCLUSIONS: Printing layer thickness and material composition are key determinants of surface roughness and bonding. Silica-coating was most effective on polished surfaces, and optimal adhesion was achieved with ND and GC printed at 20 µm. CLINICAL RELEVANCE: Tailoring printing resolution and surface conditioning improves adhesion to 3D-printed resin restorations.
Association between periodontal and geriatric health: a cross-sectional study.
Müller ML, Deschner J, Mohr M … +3 more , Mildenberger PC, Hardt R, Kiramira D
Clin Oral Investig · 2026 May · PMID 42217087 · Full text
OBJECTIVES: This cross-sectional study investigated the association between periodontal status and geriatric health parameters, a relationship that has received little attention in research to date. MATERIALS AND METHODS...
OBJECTIVES: This cross-sectional study investigated the association between periodontal status and geriatric health parameters, a relationship that has received little attention in research to date. MATERIALS AND METHODS: The periodontal health of 51 geriatric patients was assessed based on probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and approximal plaque index (API). General health was evaluated using the Tinetti Test, Mini-Mental State Examination (MMSE), handgrip strength test and the Barthel Index. Oral hygiene habits were evaluated using a structured questionnaire. RESULTS: CAL was significantly associated with patients fall risk determined by Tinetti Test. An increase in CAL corresponded with a decline in balance and gait (p < 0.05). BOP and API were also significantly associated with Tinetti Test (p < 0.05). Moreover, a decrease in CAL was significantly associated with an increased handgrip strength (p < 0.05). A significant inverse correlation was also found between API and MMSE (p < 0.05). The present study revealed no significant association between Barthel Index and periodontal parameters. CONCLUSIONS: The study suggests that a decline in periodontal health is associated with a deterioration in general health in older age, with the Tinetti Test potentially serving as a valuable geriatric parameter. CLINICAL RELEVANCE: These findings may promote the development of targeted preventive strategies focused on the periodontal health requirements of this hospitalised patient group.
Comparative evaluation of marginal gaps of lithium disilicate crowns measured using stereomicroscopy and micro‑computed tomography.
Dudley J, Min A
Clin Oral Investig · 2026 May · PMID 42215765 · Full text
OBJECTIVES: This study compared the marginal gaps of CAD-CAM lithium disilicate (LDS) crowns measured using two-dimensional (stereomicroscopy) and three-dimensional (micro-computed tomography) instruments at 12 and 360 m...
OBJECTIVES: This study compared the marginal gaps of CAD-CAM lithium disilicate (LDS) crowns measured using two-dimensional (stereomicroscopy) and three-dimensional (micro-computed tomography) instruments at 12 and 360 measurement points. MATERIALS AND METHODS: Twenty-four typodont model lower left first molars were prepared for LDS crowns by undergraduate dental students in a dental simulation clinic. An LDS crown was constructed for each preparation using a Trios 3 scanner / Sirona inLab MC X5 milling unit at a cement space of 100 μm. Each crown was placed onto its corresponding original tooth preparation, and the marginal gap was measured using stereomicroscopy and micro-computed tomography (micro-CT) at 12 and 360 selected measurement points. The mean marginal gap (MMG) was calculated using each measurement method. RESULTS: The MMG measured by stereomicroscopy was 82.54 μm with 12 measurement points and 85.74 μm with 360 measurement points. For micro-CT, the MMG was 96.56 μm with 12 points and 89.83 μm with 360 points. A two-way repeated-measures ANOVA demonstrated no significant main effect of measurement instrument (F₁,₂₃ = 0.35, p = 0.56, ηp² = 0.015) and no significant main effect of measurement density (F₁,₂₃ = 1.24, p = 0.28, ηp² = 0.051). There was no significant interaction between measurement instrument and measurement density (F₁,₂₃ = 0.87, p = 0.36, ηp² = 0.036). CONCLUSIONS: No statistically significant differences in MMG measurements were detected between stereomicroscopy and micro‑CT for LDS crowns under the present in vitro conditions. The number of measurements made did not significantly influence the marginal gap values obtained using either measurement instrument. CLINICAL RELEVANCE: The marginal accuracy of LDS restorations is critical for long-term clinical success. Assessing in vitro crown marginal gap using stereomicroscopy and micro-computed tomography provided comparable marginal gap measurements irrespective of the number of measurement points. Extending marginal gap measurements to in vivo studies is essential to substantiate clinical observations.
Mesh quality comparison of common three file formats derived from intraoral scans.
Elbashti ME, Çakmak G, Paz-Cortes MM … +4 more , Al-Haj Husain N, Abou-Ayash S, Roccuzzo A, Molinero-Mourelle P
Clin Oral Investig · 2026 May · PMID 42213258 · Publisher ↗
PURPOSE: To comparatively evaluate mesh quality metrics in PLY, STL, and OBJ files derived from native intraoral scans and exported using different mesh processing software, with emphasis on computational performance, ge...
PURPOSE: To comparatively evaluate mesh quality metrics in PLY, STL, and OBJ files derived from native intraoral scans and exported using different mesh processing software, with emphasis on computational performance, geometric fidelity, and mesh resolution. METHODS: Fifty maxillary and mandibular full-arch intraoral scan datasets were acquired using a Trios 4 intraoral scanner under clinical conditions. Native datasets were exported directly in PLY format without decimation, smoothing, or mesh optimization and designated as reference files. Each reference dataset was converted into PLY, STL, and OBJ formats using four mesh processing software packages (Meshmixer, Blender, MeshLab, and CloudCompare) under default export settings without mesh-altering procedures. Quantitative mesh evaluation was performed in MeshLab, including computational performance (loading time, export time, and file size), geometric accuracy (bounding box dimensions and surface area), and mesh resolution (total edge count and average edge length). Statistical analyses were conducted to compare differences among file formats and software platforms. RESULTS: Computational performance differed significantly across file formats (p < 0.001). Native PLY files demonstrated the fastest loading (median 293 MS) and export times (median 627 MS), whereas OBJ files exhibited the longest export durations (median 51,639 MS) and largest file sizes. STL files showed intermediate performance. In contrast, bounding box dimensions and surface area measurements showed no significant differences between reference and converted files (p = 1.000), indicating preservation of scale and anatomical coverage. Edge-based metrics also revealed no significant differences in total edge count or average edge length (p = 1.000), confirming maintenance of mesh resolution and tessellation density. CONCLUSION: File format significantly influences computational efficiency but does not affect geometric accuracy or mesh resolution when default export parameters are applied. PLY format demonstrated superior workflow performance while maintaining equivalent geometric and topological integrity across software platforms. CLINICAL SIGNIFICANCE: Under the specific conditions of this study, PLY, STL, and OBJ formats preserved global geometric properties during conversion, while PLY demonstrated superior computational efficiency and smaller file size. Within these constraints, the PLY format may be considered a preferred export option for intraoral scan data, as it can help streamline digital workflows in prosthodontics, orthodontics, and restorative dentistry, reducing technical bottlenecks and improving efficiency. However, clinicians and dental technicians may still exchange PLY, STL, and OBJ formats without concern for scaling distortion, and caution is warranted when generalizing these findings to other systems, non-default settings, or workflows involving mesh modification.
Beyond S-cross section design: mechanical properties, metallurgical features and shaping ability of two nickel-titanium rotary instruments in double curved canals.
Tres L, Só GB, de Oliveira Neto RS … +5 more , Duarte MAH, Troian-Michel CH, da Rosa RA, Alcalde MP, Só MVR
Clin Oral Investig · 2026 May · PMID 42213194 · Full text
OBJECTIVES: This study evaluated the metallurgical properties and shaping ability of two nickel-titanium instruments in artificial double-curvature canals. METHODS: 20 NiTi instruments (25 mm in length) with S-shaped cro...
OBJECTIVES: This study evaluated the metallurgical properties and shaping ability of two nickel-titanium instruments in artificial double-curvature canals. METHODS: 20 NiTi instruments (25 mm in length) with S-shaped cross-section design and different NiTi alloy were selected for analysis (n = 10, SPIN 25.06; n = 10 Rotate 25.06). The instruments were evaluated with respect to geometric design, differential scanning calorimetry, and shaping ability. Cyclic fatigue was also evaluated after three simulated clinical uses, comparing it to that of new instruments. Data were analyzed using parametric and nonparametric tests according to data distribution, with a significance level set at 5%. RESULTS: The instruments exhibited similar design features and different phase transformation temperatures. Rotate 25.06 presented lower metal mass volume and cross-sectional area than Spin 25.06 (P < 0.05). Rotate 25.06 resulted in lower canal deviation and better center ability than Spin 25.06 (P < 0.05). Spin 25.06 instruments demonstrated greater cyclic fatigue resistance (P < 0.05); however, after three simulated clinical uses, both instruments exhibited similar clinical fatigue resistance (P > 0.05). CONCLUSION: Although Spin 25.06 showed greater resistance to cyclic fatigue and better phase transformation temperature, Rotate 25.06 achieved superior shaping performance, promoting less deviation and better centering ability in the artificial double-curved root canals. CLINICAL RELEVANCE: Selection of NiTi instruments must consider cyclic fatigue resistance, shaping ability and metallurgical behavior. Our in vitro findings highlight the need of balancing instruments' properties to reduce procedural errors and optimize clinical outcomes.
Analysis of salivary metabolites and microbial characteristics in patients with dental fluorosis.
Zhai Y, Wang D, Li Z … +5 more , Cui T, Zhang R, Liu Y, Liu H, Liu S
Clin Oral Investig · 2026 May · PMID 42213186 · Full text
OBJECTIVES: This study aimed to characterize specific alterations in the salivary microbiome and metabolome associated with dental fluorosis (DF), using dental caries (DC) as a comparative pathology. MATERIALS AND METHOD...
OBJECTIVES: This study aimed to characterize specific alterations in the salivary microbiome and metabolome associated with dental fluorosis (DF), using dental caries (DC) as a comparative pathology. MATERIALS AND METHODS: A multi-omics analysis was performed on saliva samples from 99 individuals with DF, 100 with DC, and 100 healthy controls (HC). Lipidomic profiling and 16S rRNA gene sequencing were integrated, and the resulting datasets were analyzed using multivariate statistical approaches and correlation analyses. RESULTS: Clear separation was observed in both the molecular and microbial profiles of saliva among the DF, DC, and HC groups. The DF group showed significantly higher levels of LPA (18:4) and 15-oxoETE, along with enrichment of Enterobacter, Alloprevotella, Leptotrichia, Aggregatibacter, Klebsiella, Selenomonas, Peptostreptococcus, Peptostreptococcaceae_[XI][G-5], Actinomyces graevenitzii, Prevotella pallens, Leptotrichia buccalis, Desulfobulbus sp._HMT_041, Prevotella intermedia, Ruminococcaceae_[G-1] bacterium_HMT_075, and Peptostreptococcus stomatis. However, the core microbial taxa and the identified differential metabolites showed only weak correlations. CONCLUSIONS: The salivary microbiome and lipidomic profiles in individuals with DF differed significantly from those observed in both caries patients and healthy controls. The core microbial taxa and differential metabolites identified in the DF group were associated with various systemic diseases and inflammatory processes, respectively. CLINICAL RELEVANCE: The salivary multi-omics signatures identified in this study provide new insights into the potential long-term health risks associated with dental fluorosis.
Exploring orofacial myofunctional therapy and its core components in mixed-dentition anterior open bite: the ombit study.
Van der Straeten C, Van Lierde K, Verbeke J … +5 more , Philibert Q, Alighieri C, Corthouts M, De Pauw G, Bettens K
Clin Oral Investig · 2026 May · PMID 42213179 · Publisher ↗
OBJECTIVES: To explore the therapeutic effects of OMT in children with AOB in the mixed dentition phase, including a reduced form of OMT (focusing exclusively on breathing pattern and resting postures; OMT) and tradition...
OBJECTIVES: To explore the therapeutic effects of OMT in children with AOB in the mixed dentition phase, including a reduced form of OMT (focusing exclusively on breathing pattern and resting postures; OMT) and traditional OMT (also including strength training and correction of swallowing; OMT). MATERIALS AND METHODS: In this double-baseline, longitudinal study, eight children with AOB (mean age 8.1 years old) were randomly allocated to the OMT (n = 4) or OMT group (n = 4). Each participant received 7.5 h of OMT across 10 sessions. Outcomes included occlusal parameters, Photographic Open bite Severity Index (POSI) and Peer Assessment Rating (PAR) using 3D intraoral scans, orofacial function based on clinical and standardized assessment (Orofacial Myofunctional Evaluation with Scores; OMES), strength and endurance measurements, and oral health-related quality of life (child oral health impact profile - ortho; COHIP-ortho). RESULTS: Immediately post-therapy, anterior tongue strength had significantly increased in the full sample. At three-month follow-up, palatal volume, lateral lip endurance, and OMES function and deglutition scores had significantly increased, and vertical overbite had decreased. The PAR index showed a significant proportional reduction of 35% from baseline to the last follow-up moment (on average 6 months after therapy). The OMT group showed significantly lower rates of atypical tongue posture and interdental articulation at six-month follow-up. CONCLUSION AND CLINICAL RELEVANCE: This study took a first step in exploring the effectiveness of OMT components in mixed-dentition AOB. Measurable short- to mid-term functional and occlusal improvements were found, and comparable outcomes between protocols suggest that posture-focused OMT may be an efficient interceptive approach. Further research including randomized controlled trials with larger sample sizes is required to provide evidence on efficacy and long-term stability.
Longitudinal biomarker profiles during experimental gingivitis: a predictor of susceptibility.
Chew RJJ, Bissett SM, Jaedicke KM … +6 more , van der Merwe R, Lai CWM, Goh CE, Athey D, Taylor JJ, Preshaw PM
Clin Oral Investig · 2026 May · PMID 42213144 · Publisher ↗
OBJECTIVES: To explore longitudinal changes and prognostic applications of salivary IL-1β and MMP-8 in determining gingivitis susceptibility. MATERIALS AND METHODS: Twenty-seven systemically healthy adults with periodont...
OBJECTIVES: To explore longitudinal changes and prognostic applications of salivary IL-1β and MMP-8 in determining gingivitis susceptibility. MATERIALS AND METHODS: Twenty-seven systemically healthy adults with periodontal health or gingivitis were enrolled. Participants underwent a 3-week hygiene phase (V to V) with professional cleaning, followed by a 3-week experimental gingivitis phase (V to V), in a randomly selected maxillary quadrant. The resolution phase began at V, and participants received professional cleaning, resumed oral hygiene, and were reviewed 3 weeks later (V). At each visit, salivary IL-1β and MMP-8 levels were quantified, alongside clinical assessments of gingivitis index (GI), bleeding on probing (BOP), and plaque index (PI). Using clustering analysis, participants were classified as high and low gingivitis susceptibility according to the longitudinal profiles of BOP and mean GI. RESULTS: Ten and 17 participants had high and low gingivitis susceptibility, respectively. While there were no differences in the biomarker profiles during the experimental gingivitis phase, high susceptibility individuals were associated with a profile of elevated IL-1β and MMP-8 during the hygienic phase (p = 0.024) and increased salivary IL-1β at V predicted rapid development of gingivitis (p = 0.026). Incidentally, males were more susceptible despite no differences in demographic or biomarker profiles. CONCLUSION: Salivary biomarker profiles during the hygienic phase may offer insights into an individual's susceptibility to gingivitis. Additional research will be needed to validate these findings for the general population, translating these biomarkers into prognostic tools that enable personalised periodontal care. CLINICAL RELEVANCE: Salivary biomarkers may provide additional prognostic insight into gingivitis susceptibility.
Influence of silica nanoparticle sedimentation on the mechanical, surface properties and trueness of DLP-printed dental resin.
Ma Y, Jin G, Chen D … +4 more , Zhang Z, Liu Y, Lim JH, Kim JE
Clin Oral Investig · 2026 May · PMID 42212639 · Publisher ↗
OBJECTIVES: This study investigated the gravitational sedimentation of silica nanoparticles in DLP-printed dental resins and assessed its impact on filler distribution, DC, mechanical and surface properties and printing...
OBJECTIVES: This study investigated the gravitational sedimentation of silica nanoparticles in DLP-printed dental resins and assessed its impact on filler distribution, DC, mechanical and surface properties and printing trueness. MATERIALS AND METHODS: Dental resin containing 1 wt% SiNPs was printed via DLP printing into 1 mm-thick disks at build heights ranging from 1 to 15 mm above the platform. SiNP distribution was analyzed by SEM-EDS. DC, Vickers hardness, contact angle, surface roughness (Ra), and ΔE were measured and correlated with local Si concentrations (n = 5). The printed specimens from each build height were randomly assigned to different tests. Printing trueness (n = 15) was measured using digital superimposition analysis of dental crowns by RMS values. Dental resin without SiNPs served as controls. One-way ANOVA with Tukey's post-hoc test, linear regression and t-test were used for statistical analysis. RESULTS: SEM-EDS confirmed a linear increase in Si concentration with build height in the 1 wt% group (R = 0.8654). In the SiNP group, DC and hardness increased significantly with build height (R = 0.3680, R = 0.7964), while water contact angle and surface roughness decreased (R = 0.8432, R = 0.1505). Trueness decreased at higher build heights in the 1 wt% group (p < 0.05). The control group showed no such build height-dependent trends. CONCLUSIONS: Sedimentation during DLP induces predictable vertical nanoparticle gradients, which in turn systematically influence DC, mechanical strength, hydrophilicity, surface smoothness, and printing trueness. CLINICAL RELEVANCE: Nanoparticle sedimentation creates vertical property gradients within DLP-printed restorations. This causes heterogeneous mechanical and surface performance, potentially leading to localized weakness or marginal discrepancies. Clinicians should optimize print orientation to position functionally critical surfaces at appropriate build heights and implement mid-print homogenization to minimize sedimentation effects.
Patients' needs, expectations & concerns regarding clear aligner treatment.
Nemec M, Schwarz L, Schaller L … +5 more , Schweiger K, Lettner S, Reistenhofer B, Bertl K, Jonke E
Clin Oral Investig · 2026 May · PMID 42209717 · Full text
OBJECTIVE: Patients aiming for clear aligner therapy (CAT) have a distinct expectation regarding their orthodontic treatment. The aim of this prospective cohort study was to increase our knowledge on these specific patie...
OBJECTIVE: Patients aiming for clear aligner therapy (CAT) have a distinct expectation regarding their orthodontic treatment. The aim of this prospective cohort study was to increase our knowledge on these specific patients' needs, expectations, and concerns regarding CAT. METHODS: Patients, who were about to start CAT, were asked to answer both, a 32-item questionnaire addressing expectations regarding CAT, rated on a 10-point visual analogue scale, and the Oral Health Impact Profile (OHIP-14) questionnaire. In addition, demographic and clinical data were collected. RESULTS: A total of 82 patients participated (mean age 35 ± 12 years; 74.4% female). Patients strongly expected CAT to treat their malocclusion as effectively as orthodontic brackets (9.5 ± 0.9 points) and they would seek a second opinion if they were told treatment with CAT would not be possible (7.2 ± 3.3 points). In addition, patients appeared not willing to compromise on the planned treatment outcome, even if it would decrease treatment time (2.1 ± 2.3 points) or costs (2.4 ± 2.5 points). Further, they highly expected that the treatment result would endure for their lifetime (8.8 ± 2.1 points), they wanted to avoid visibility of orthodontic brackets (7.9 ± 2.8 points), prevent potential future problems (9.1 ± 1.5 points), and see a simulation of the expected treatment outcome (7.5 ± 2.9 points). The most important limitations with CAT expected by the participants were pain during treatment (7.7 ± 2.7 points) and restricted eating and drinking habits (7.3 ± 2.8 points). CONCLUSION: Patients considering CAT exhibit high expectations, particularly regarding treatment outcomes, aesthetics, and efficiency and they appear not willing to accept any compromise due to choosing CAT. CLINICAL RELEVANCE: Knowledge about these expectations can support our patient communication and thereby improve patients' satisfaction with the treatment outcome.
Association of serum lipid levels with incident periodontitis in a multicenter study.
Im YG, Baek HS, Baek HS
Clin Oral Investig · 2026 May · PMID 42207331 · Publisher ↗
AIM: To examine whether specific serum lipid abnormalities are associated with incident periodontitis. METHODS: We performed a retrospective, multicenter longitudinal study across 15 Korean hospitals mapped to the OMOP C...
AIM: To examine whether specific serum lipid abnormalities are associated with incident periodontitis. METHODS: We performed a retrospective, multicenter longitudinal study across 15 Korean hospitals mapped to the OMOP Common Data Model. Adults with ≥ 365 days of prior observation entered lipid-specific target or comparator cohorts on the index date: total cholesterol (TC) ≥ 200 vs. < 200 mg/dL; LDL-cholesterol (LDL) ≥ 130 vs. < 130 mg/dL; triglycerides (TG) ≥ 150 vs. < 150 mg/dL; and HDL-cholesterol (HDL) < 40 vs. ≥ 40 mg/dL. Within each hospital, 1:1 propensity-score matching balanced covariates. A 365-day lag preceded outcome surveillance to mitigate reverse causation. Incident periodontitis was identified using standardized diagnosis/procedure codes. Hospital-level Cox hazard ratios (HRs) were pooled using random-effects meta-analysis; negative-control outcomes with empirical calibration were conducted. RESULTS: Periodontitis cases were 533 vs. 492 in TC cohorts (pooled HR, 1.66; 95% CI, 1.38-1.99), 1,287 vs. 1,263 in LDL (1.37; 1.20-1.57), 1,535 vs. 1,452 in TG (1.27; 1.15-1.40), and 1,224 vs. 1,056 in HDL (1.39; 1.18-1.64). Calibration analyses did not indicate substantial residual systematic bias. CONCLUSIONS: In this large multicenter observational study, abnormal serum lipid profiles were associated with higher hazards of incident periodontitis. These findings support a possible link between lipid metabolism and periodontitis, but should be interpreted in light of the observational design. CLINICAL RELEVANCE: Serum lipid profiles may be associated with incident periodontitis and could be considered in future studies of periodontal risk assessment and integrated medical-dental care.
Immediate and short-term clinical outcomes of iRoot SP in root canal retreatment: a retrospective study.
Zhu Y, Hu J
Clin Oral Investig · 2026 May · PMID 42207328 · Publisher ↗
OBJECTIVE: To assess the immediate and short-term clinical efficacy of iRoot SP sealer with warm gutta-percha filling in root canal retreatment and analyze influencing factors. MATERIALS AND METHODS: This retrospective s...
OBJECTIVE: To assess the immediate and short-term clinical efficacy of iRoot SP sealer with warm gutta-percha filling in root canal retreatment and analyze influencing factors. MATERIALS AND METHODS: This retrospective study included patients undergoing root canal retreatment at the Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, between September 2021 and October 2022. Procedures were performed by two experienced endodontists. Clinical and radiographic data were analyzed to identify failure causes of primary treatment, evaluate immediate outcomes in 542 retreated canals, and determine factors influencing immediate (n = 230 teeth) and follow-up (n = 145 teeth) outcomes. Chi-square tests were used (α = 0.05), and 95% confidence intervals were calculated for success rates. RESULTS: Primary failures: sparse filling (43.5%) and underfilling (36.7%). Immediate adequate filling: 87.3%. Tooth type significantly affected treatment, filling, and extrusion rates (P < 0.05). Premolars had the highest filling and extrusion. Inter-operator differences existed for procedural parameters (P < 0.05) but not success. Overall follow-up success was 89.0% (loose criteria) and 58.6% (strict criteria). Descriptively, molars showed a high loose-criteria success (91.2%) but a low strict-criteria success (50.0%); these differences were not statistically significant. Preoperative radiolucency increased extrusion (29.7% vs. 14.6%) and reduced success under both criteria (loose: 86.2% vs. 100.0%; strict: 50.0% vs. 93.1%; all P < 0.05). 95% confidence intervals are reported in the full text. CONCLUSIONS: iRoot SP achieved 89.0% (loose criteria) and 58.6% (strict criteria) short-term success. Under loose criteria, molars achieved 91.2% success. Preoperative periapical radiolucency doubled sealer extrusion and reduced success under both criteria. CLINICAL RELEVANCE: iRoot SP achieved 89.0% success (loose criteria) and 58.6% (strict criteria) in short-term root canal retreatment. Molar retreatment should not be avoided due to complexity. Preoperative periapical radiolucency doubles sealer extrusion and predicts poorer outcomes, warranting modified placement technique and extended follow-up for lesions > 5 mm.
Remote assessment of caries, MIH, and plaque on intraoral 3D scan images: Findings from the LIFE Child study.
Stiller N, Schmidt J, Meigen C … +6 more , Messerschmidt A, Kiess W, Vogel M, Körner A, Schulz-Kornas E, Haak R
Clin Oral Investig · 2026 May · PMID 42207321 · Full text
OBJECTIVES: To evaluate the diagnostic agreement between clinical examinations and time-delayed remote diagnostic assessments of intraoral 3D scans (IOS) for detecting oral diseases in children and adolescents, validatin...
OBJECTIVES: To evaluate the diagnostic agreement between clinical examinations and time-delayed remote diagnostic assessments of intraoral 3D scans (IOS) for detecting oral diseases in children and adolescents, validating intraoral 3D scans as a tool in epidemiology studies. MATERIALS AND METHODS: A total of 511 participants aged 7.5-20.5 years from the LIFE Child cohort received standardized chairside clinical diagnostics followed by intraoral 3D scanning (TRIOS 5, 3shape). Two calibrated examiners independently performed blinded remote review of digital scans after a predefined latency period. Diagnostic parameters comprised caries (ICDAS II), MIH classification, restorative status, sealant status, and plaque accumulation quantified using the Plaque Index (PI). Primary outcomes were diagnostic agreement and interrater reliability, analysed by weighted percent agreement, Cohen's weighted Kappa and Bland-Altman plots. RESULTS: Very high agreement was observed between clinical and IOS-based assessments for caries experience (DMF-T: [Formula: see text]= 0.990, κ = 0.77; dmf-t: [Formula: see text]= 0.991, κ = 0.93) and for severity-graded caries lesions (ICDAS 3-4: [Formula: see text]= 0.998, κ = 0.69; ICDAS 5-6: [Formula: see text]= 1.000, κ = 0.87). Agreement for initial lesions (ICDAS 1-2) was lower than for the more advanced lesions ([Formula: see text]= 0.979, κ = 0.29). Fissure sealants and fillings showed excellent agreement ([Formula: see text]= 0.997, κ = 0.84 and [Formula: see text]= 0.998, κ = 0.71). MIH detection on at least one tooth showed very good agreement ([Formula: see text] = 0.932, κ = 0.83), with consistently high agreement across severity codes. Plaque assessment showed good agreement overall ([Formula: see text] = 0.898), with slightly higher agreement in anterior regions. Interrater reliability was substantial to excellent across parameters. CONCLUSIONS: Intraoral 3D scans enable reliable remote assessment of clinically relevant dental conditions in children and adolescents, particularly for advanced caries lesions and molar incisor hypomineralisation (MIH). CLINICAL RELEVANCE: Intraoral 3D scanning enables efficient remote evaluation in screening and epidemiological programs, prioritizing visually distinct or treatment-relevant findings, with slightly reduced alignment for early enamel findings.
Reduction in same-day readmission rate for orthognathic surgery with a new enhanced recovery after surgery protocol.
Bencherqui S, Lauwers F, Mure M … +4 more , Costes R, Bertin H, Corre P, Prevost A
Clin Oral Investig · 2026 May · PMID 42207307 · Publisher ↗
OBJECTIVES: A new Enhanced Recovery After Surgery (ERAS) protocol for orthognathic surgery, implementing standardized pre-, peri- and postoperative guidelines (i.e. systematic locoregional nerve blocks), was initiated in...
OBJECTIVES: A new Enhanced Recovery After Surgery (ERAS) protocol for orthognathic surgery, implementing standardized pre-, peri- and postoperative guidelines (i.e. systematic locoregional nerve blocks), was initiated in 2019 in our center. We evaluated how this ERAS protocol affected same-day discharge after orthognathic surgery. MATERIALS AND METHODS: A retrospective cohort study was performed on participants having undergone orthognathic surgery between 2015 and 2022 in our tertiary French department either via the former traditional non-ERAS or new ERAS protocol. The primary study endpoint was difference in unplanned same-day readmission (SDR) rate between protocol types. Multivariate logistic regression was used to identify predictors of SDR. RESULTS: A total of 511 participants were included: n = 212 (41.5%) followed the non-ERAS protocol and n = 299 (58.5%) the ERAS protocol. SDR was significantly higher in the non-ERAS group (38.2%) compared to the ERAS group (24.1%) (p < 0.001), corresponding to a 37% relative reduction in SDR. In multivariate analysis, later surgery end time (OR 1.2, p < 0.001), associated genioplasty (OR 2.1, p = 0.0013), maxillary osteotomy (OR 2.6; p = 0.0004), and combined osteotomy (OR 4.1; p < 0.0001) were independently associated with higher SDR. Conversely, ERAS protocol implementation remained protective (OR 0.5, p = 0.004). Interaction analysis demonstrated that ERAS protocol implementation significantly reduced the risk of SDR among patients undergoing combined osteotomy (OR 0.39; p = 0.039). CONCLUSIONS: ERAS protocol implementation reduced the risk of SDR with the greatest benefit observed for complex combined osteotomies. CLINICAL RELEVANCE: Our ERAS protocol is safe and effective for promoting outpatient orthognathic surgery, particularly by reducing complications after complex procedures.
Oral health and its association with dysphagia severity and nutritional vulnerability after stroke: a structural equation modeling study.
Kothari M, Alves-Costa S, Costa SA … +5 more , Kumar A, Nascimento GG, Nielsen JF, Svensson P, Kothari SF
Clin Oral Investig · 2026 May · PMID 42207201 · Full text
BACKGROUND: Oral health deterioration is common after neurological injury and may contribute to functional impairment beyond the oral cavity. In stroke rehabilitation, impaired oral conditions coexist with orofacial dysf...
BACKGROUND: Oral health deterioration is common after neurological injury and may contribute to functional impairment beyond the oral cavity. In stroke rehabilitation, impaired oral conditions coexist with orofacial dysfunction and dysphagia, yet the mechanistic pathways linking oral health to swallowing impairment and downstream nutritional consequences remain poorly defined. This study examined the interrelationships between oral health, orofacial function, dysphagia, and malnutrition using structural equation modelling (SEM). METHODS: Ninety-two stroke survivors admitted to a neurorehabilitation center underwent standardized assessments of oral health, orofacial function, dysphagia severity at admission, and nutritional screening at week 4. Oral health and orofacial function were modelled as latent variables. SEM was used to quantify pathways linking oral health to malnutrition risk, with bivariate comparisons stratified by dysphagia status. RESULTS: Poor oral health was significantly associated with reduced orofacial function (β = -0.41, p < 0.001), which in turn was associated with dysphagia severity (β = -0.51, p < 0.001). Dysphagia showed a direct association with malnutrition risk (β = 0.31, p = 0.031). While poor oral health exerted a direct effect on malnutrition risk (β = 0.33, p = 0.023), the indirect pathway linking poor oral health to malnutrition through orofacial dysfunction and dysphagia was not statistically significant (β = 0.063, p = 0.091). The model identified a coherent oral-orofacial-swallowing pathway consistent with nutritional vulnerability after stroke. CONCLUSION: These findings position oral health as an important factor associated with swallowing impairment and nutritional vulnerability after stroke within a modeled pathway. Integrating oral and orofacial assessments into post-stroke care may support earlier identification of patients at risk for functional decline and systemic complications. CLINICAL SIGNIFICANCE: Oral health deterioration was associated with malnutrition risk after stroke, directly and via impaired orofacial function and dysphagia. Integrating oral and orofacial function measures into routine post-stroke assessments may improve early risk stratification and support coordinated dental and rehabilitation care.
Helicobacter pylori and Porphyromonas gingivalis as risk factors for local oral and systemic disorders.
Kountouras J, Polyzos SA, Kazakos E … +2 more , Doulberis M, Vardaka E
Clin Oral Investig · 2026 May · PMID 42183915 · Publisher ↗
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Long-Term Changes Following Orthopedic Mandibular Advancement Therapy in Pediatric Obstructive Sleep Apnea: a 7-Year Follow-up Study.
Aydil SK, Kiyan E, Ersu R … +3 more , Kilicoglu H, Sayar G, Capan E
Clin Oral Investig · 2026 May · PMID 42178435 · Full text
STUDY OBJECTIVES: To evaluate long-term changes in craniofacial morphology, upper airway dimensions, and sleep-related parameters following monoblock mandibular advancement therapy in children with obstructive sleep apne...
STUDY OBJECTIVES: To evaluate long-term changes in craniofacial morphology, upper airway dimensions, and sleep-related parameters following monoblock mandibular advancement therapy in children with obstructive sleep apnea (OSA). METHODS: This longitudinal follow-up study included 13 children (mean age 10.97 ± 1.51 years) with OSA and mandibular retrognathia treated with a monoblock appliance. The mean duration of active treatment was 8.06 ± 1.29 months. Assessments were conducted at baseline (T1), post-treatment (T2), and 7 years after treatment (T3), including lateral cephalometric radiographs, polysomnography (PSG), and Pittsburgh Sleep Quality Index (PSQI) scores. Pharyngeal airway changes were analyzed using a standardized cephalometric protocol across 11 sagittal reference planes. Repeated measures ANOVA and nonparametric equivalents were applied for longitudinal comparisons. RESULTS: Increases in oropharyngeal and hypopharyngeal airway dimensions (S6-S10; referring to standardized sagittal measurement planes) observed after treatment were generally maintained over time. Skeletal parameters showed relative stability at follow-up. Although Apnea-Hypopnea Index (AHI) decreased significantly after treatment, an increase was noted at T3. The percentage of REM (Rapid Eye Movement) sleep showed no significant change between T1 and T2, whereas a statistically significant increase was observed at T3. PSQI scores improved initially and did not show significant long-term deterioration. CONCLUSIONS: This study provides long-term follow-up data on craniofacial, airway, and sleep-related changes in children with OSA treated with a monoblock appliance. Although partial recurrence of AHI was observed during adolescence, airway dimensions and skeletal parameters demonstrated relative stability over time. These findings suggest that structural adaptations may be maintained, while functional outcomes may vary during growth. Given the multifactorial nature of pediatric OSA, these results should be interpreted cautiously and warrant further investigation in larger longitudinal studies.
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