Clinical Oral Investigations[JOURNAL]
Sun
200 papers
Are arch width measurements from Invisalign arch width tables reliable?
de-la-Rosa-Gay C, Valmaseda-de-la-Rosa S, Hernández-Mangas A … +3 more , Camps-Font O, Valmaseda-Castellón E, Figueiredo R
Clin Oral Investig · 2026 May · PMID 42126458 · Full text
INTRODUCTION: Despite being widely used for treatment planning, the accuracy of Invisalign arch width tables has not been independently assessed. The objective of this study was to assess whether the predicted and observ...
INTRODUCTION: Despite being widely used for treatment planning, the accuracy of Invisalign arch width tables has not been independently assessed. The objective of this study was to assess whether the predicted and observed arch width changes calculated from Invisalign tables are consistent with measurements obtained from STL models. METHODS: Thirty-five adults treated with Invisalign aligners were retrospectively selected. Arch width at the maxillary and mandibular canines, premolars, and first molars was measured on digital models (pretreatment, prediction and first-refinement) using Geomagic Control X. Predicted and observed expansions (difference between predicted or post-treatment and pretreatment arch widths), and their discrepancy, were compared with the corresponding values calculated from the ClinCheck arch width tables. Three references were selected: (1) the projection of the long axis of the tooth on the occlusal surface, (2) the buccal/mesiobuccal cusps, and (3) the most lingual point of the gingival margin. Normality was assessed with the Shapiro-Wilk test. Agreement was evaluated using Bland-Altman analysis with mixed-effects models to account for clustering of repeated measurements. RESULTS: 840 arch widths were analyzed (35 patients, 4 tooth pairs, 2 jaws, and 3 time points). Non-normality of inter-method differences was observed in predicted expansion (gingival and occlusal references) and in discrepancy (cusp reference) (p < 0.05). Non-parametric Bland-Altman analysis showed high agreement between Geomagic and ClinCheck measurements for predicted expansion, observed expansion, and discrepancy, with bias values ranging from - 0.49 to 0.2 mm. CONCLUSIONS: ClinCheck arch width tables showed strong agreement with independent metrological assessment, particularly with occlusal reference points [bias: 0.00 mm; limits of agreement: -0.80 to 1.01 mm]. CLINICAL RELEVANCE: ClinCheck arch width tables have been validated with an independent metrological assessment (Geomagic Control X). Predicted expansion, observed expansion, and discrepancy derived from arch width tables agreed with independent measurements using virtual casts.
Bidirectional association between edentulism and sarcopenia in Chinese middle-aged and older adults: a nationally representative longitudinal cohort study.
Li Z, Li J, Du K … +7 more , Zhang B, Liu Y, Shi H, Dong C, Du L, Ji F, Qin B
Clin Oral Investig · 2026 May · PMID 42118321 · Publisher ↗
BACKGROUND: Edentulism and sarcopenia are two prevalent ageing-related conditions, yet longitudinal evidence clarifying their bidirectional relationship remains limited. We investigated the reciprocal associations betwee...
BACKGROUND: Edentulism and sarcopenia are two prevalent ageing-related conditions, yet longitudinal evidence clarifying their bidirectional relationship remains limited. We investigated the reciprocal associations between edentulism and sarcopenia among Chinese middle-aged and older adults, and further examined potential age-dependent effects. METHODS: We used data from the nationally representative China Health and Retirement Longitudinal Study (CHARLS). Two longitudinal analytic cohorts were constructed: Cohort 1 included participants without sarcopenia at baseline (2011; n = 6,746) to evaluate whether edentulism predicts incident sarcopenia by 2015; Cohort 2 included participants without edentulism at baseline (2011; n = 7,193) to evaluate whether sarcopenia predicts incident edentulism by 2018. Sarcopenia status was classified using the 2019 Asian Working Group for Sarcopenia (AWGS) criteria based on handgrip strength, estimated appendicular skeletal muscle mass, and the five-times chair-stand test; severity was categorized as possible, confirmed, and severe. Edentulism was self-reported ("Have you lost all of your teeth?"). Multivariable logistic regression and ordinal logistic regression were applied with hierarchical adjustment for sociodemographic, health, and lifestyle covariates. Age × exposure interaction was tested, and the Johnson-Neyman technique was used to identify regions of significance. RESULTS: In Cohort 1, 390 participants (5.8%) developed sarcopenia during follow-up; cumulative incidence was higher among edentulous than non-edentulous participants (7.5% vs. 3.8%). In fully adjusted models, edentulism was associated with higher odds of incident sarcopenia (OR 2.13, 95% CI 1.35-3.37) and greater sarcopenia severity (ordinal OR 2.07, 95% CI 1.30-3.28). A significant age interaction was observed: the edentulism-sarcopenia association was statistically significant only below 64.05 years. In Cohort 2, 453 participants (6.3%) developed edentulism; incidence increased with baseline sarcopenia severity (5.2% in no sarcopenia to 14.8% in severe sarcopenia). After full adjustment, confirmed sarcopenia (OR 1.69, 95% CI 1.24-2.30) and severe sarcopenia (OR 1.85, 95% CI 1.22-2.82) predicted incident edentulism, whereas possible sarcopenia did not. CONCLUSIONS: This nationally representative study identified a robust bidirectional relationship between edentulism and sarcopenia in middle-aged and older Chinese adults. Edentulism was associated with an increased risk of developing sarcopenia, while confirmed and severe sarcopenia were predictive of incident edentulism. Age played a critical role in the edentulism-sarcopenia relationship, with a key threshold at 64.05 years, suggesting an earlier window for risk identification and prevention and supporting integrated "oral-muscle" screening strategies in primary care and community settings.
Correction to: Classification of the temporomandibular joint disc displacement without reduction using MRI in the mouth-opening position.
Liu X, Long X
Clin Oral Investig · 2026 May · PMID 42118176 · Publisher ↗
Abstract loading — click title to view on PubMed.
Comparison of rotary NiTi files with ultrasonic irrigation and manual K-files with syringe irrigation in primary molar pulpectomy: A retrospective cohort study.
Liu J, Yan K, Zheng Y … +2 more , Wang F, Hou X
Clin Oral Investig · 2026 May · PMID 42115501 · Full text
OBJECTIVE: Pulpectomy is the standard treatment for irreversibly inflamed or infected primary molars. It depends on effective root canal cleaning and shaping. Traditional manual preparation and irrigation techniques face...
OBJECTIVE: Pulpectomy is the standard treatment for irreversibly inflamed or infected primary molars. It depends on effective root canal cleaning and shaping. Traditional manual preparation and irrigation techniques face challenges when dealing with complex root canal systems in primary teeth. This study aims to retrospectively evaluate the clinical and radiographic outcomes of two rotary nickel-titanium file systems with distinct tapers (M3 and S3) combined with ultrasonic irrigation, compared to conventional manual K-files and syringe irrigation,inpulpectomy for primary molars. MATERIALS AND METHODS: A retrospective cohort study included patients aged 4- to 9-year who underwent RCT for mandibular primary molars at the Pediatric Dentistry Clinic of the Third Hospital of Hebei Medical University. Participants were categorized into three groups based on the instrumentation and irrigation protocol used: M3 rotary files with ultrasonic irrigation (n=98), S3 rotary files with ultrasonic irrigation (n=84), and manual K-files with syringe irrigation (n=78). Instrumentation time was measured using a digital stopwatch. Obturation quality was radiographically classified as optimal, underfilled, or overfilled. Postoperative pain was assessed at 24-, 48-, and 72 h using the Wong-Baker FACES scale. Clinical and radiographic outcomes at the 12-month follow-up were categorized as success, uncertain, or failure. RESULTS: The M3 rotary group showed the shortest instrumentation time (210.45 ± 6.85 s) and the highest rate of optimal obturation (87.1%), significantly outperforming the S3 and manual file groups (P<0.05). Both rotary systems led to significantly lower pain scores at 24 and 48 hours compared to manual instrumentation (P<0.01). No significant differences were observed in pain at 72 hours or in 12-month therapeutic success rates among the groups (P>0.05). CONCLUSIONS: This study demonstrates that combining modern NiTi rotary instrumentation (specifically the 0.04 tapered M3 system) with ultrasonic irrigation significantly outperforms conventional manual techniques in operative efficiency, obturation quality, and postoperative pain control. CLINICAL RELEVANCE: The integration of NiTi and ultrasound translates into a clinically superior, patient-beneficial protocol for primary teeth pulp therapy, optimizing procedural experience without compromising therapeutic success.
Comparison of W. Arnett's cephalometric analysis measurements performed using artificial intelligence and manual measurements.
Kula B, Polat ENA
Clin Oral Investig · 2026 May · PMID 42113321 · Full text
OBJECTIVES: This study aimed to compare the linear and angular Arnett cephalometric measurements obtained from WebCeph Premium™ with those from manual cephalometric analysis and to assess the reliability of the automated...
OBJECTIVES: This study aimed to compare the linear and angular Arnett cephalometric measurements obtained from WebCeph Premium™ with those from manual cephalometric analysis and to assess the reliability of the automated measurements. METHODS: Thirty-two pre-treatment lateral cephalograms of patients were randomly selected. Images were calibrated, 29 landmarks were manually traced, and 40 parameters were recorded by two orthodontists (6 angular, 34 linear). WebCeph Premium™ (version 2.0.0, AssembleCircle Corp., Gyeonggi-do, Republic of Korea) automatically identified landmarks and performed Arnett's cephalometric analysis. After 15 days, orthodontists reassessed the radiographs. Reliability and repeatability were evaluated using the intraclass correlation coefficient (ICC), which exceeded 0.95, indicating excellent agreement. Normality was assessed using the Shapiro-Wilk test, and group comparisons were performed with paired t-tests. RESULTS: For Researcher 1, initial ICC values ranged from 0.003 to 0.984 and final values from 0.617 to 0.996. For Researcher 2, initial ICC values ranged from 0.022 to 0.999 and final values from 0.601 to 0.999. Inter-observer ICC values ranged from 0.03 to 0.984, with most measurements showing high agreement. Manual tracing and WebCeph Premium™ showed high agreement, with ICC values ranging 0.913 and 0.995. CONCLUSIONS: WebCeph Premium™ demonstrates high concordance with manual Arnett analyses; however, further refinement of certain parameters is necessary to enhance AI precision. CLINICAL RELEVANCE: The utilization of WebCeph Premium™ within clinical settings has the capacity to enhance the efficiency of cephalometric analysis for orthognathic cases by minimizing manual workload and inter-examiner variability. This can result in more consistent and efficient treatment planning.
Single cone versus carrier-based obturation using a premixed bioceramic sealer in postgraduate master cohort: a 36 months retrospective evaluation.
Zamparini F, Spinelli A, Tosco V … +2 more , Gandolfi MG, Prati C
Clin Oral Investig · 2026 May · PMID 42113044 · Full text
To evaluate 36-month clinical outcome and occurrence of sealer apical extrusion events of teeth obturated with a premixed CaSi based sealer associated with a single cone technique or carrier-based technique. METHODOLOGY...
To evaluate 36-month clinical outcome and occurrence of sealer apical extrusion events of teeth obturated with a premixed CaSi based sealer associated with a single cone technique or carrier-based technique. METHODOLOGY: In this retrospective cohort study, consecutive healthy patients were treated by a postgraduate master cohort. Teeth were shaped with NiTi rotary or reciprocating instruments, irrigated with 5% NaOCl and 10% EDTA, final irrigation with sterile water. Root canals were obturated with a premixed bioceramic-based sealer (NeoSealer Flo, Avalon Biomed, Houston, TX, USA) using either a warm carrier-based technique (Thermafil, Dentsply, Konstanz, Germany) or a cold single-cone technique. Patients were included in a recall program and teeth were examined at 3, 6, 24 and 36 months. Clinical and radiographic data were obtained and the following parameters were evaluated: preoperative Periapical Index (PAI) score and signs/symptoms, PAI score at follow-up. Teeth were considered 'healthy' (PAI ≤ 2, no signs/symptoms) or with "endodontic lesion" (PAI ≥ 3, signs/symptoms present, retreated). Two calibrated examiners assessed outcomes blinded to preoperative status. Chi-square test evaluated the outcome between these two obturation techniques. Sealer Apical extrusion typologies and radiographic modifications were analysed through a computerized methodology on periapical radiographs. RESULTS: A total of 53 root canal treatments (48 subjects, mean age 45.4 ± 12.1 years) with a minimum 36 months follow-up were analysed. Of these, 29 were filled with single cone technique, while 24 were obturated with a carrier-based technique. At 36-month evaluation, healing rate was 88% and 93% with regards to carrier-based or single cone technique with no statistical differences (P>0.050). Apical extrusion was observed in 18/24 teeth of patients filled with carrier-based technique (75%) and 14/29 in teeth with cold technique (48.2%). Mean extrusion size was 1.49 mm. Significantly higher extrusion (in mm) was observed in teeth with PAI ≥ 3 and in Carrier-based group. Radiographic modification of apically extruded sealer was observed in 5 of 32 extruded cases (15.6%). CONCLUSIONS: Clinical outcome shows a high rate of survived and healed teeth with both type of obturation techniques. Apical extrusion of the sealer can be frequent when using carrier-based technique or in presence of large diameters and periapical radiolucencies.
Polymerizable inhibitor can reduce shrinkage stress of resin composite.
He J, Garoushi S, Lassila L … +1 more , Vallittu PK
Clin Oral Investig · 2026 May · PMID 42108310 · Full text
OBJECTIVE: The purpose of this study was to prepare dental resin composites (DRCs) with low shrinkage stress and limited leachable inhibitor content by incorporating a synthesized polymerizable inhibitor PBHT (2,6-di-ter...
OBJECTIVE: The purpose of this study was to prepare dental resin composites (DRCs) with low shrinkage stress and limited leachable inhibitor content by incorporating a synthesized polymerizable inhibitor PBHT (2,6-di-tert-butyl-4-(methacryloyloxy-ethyl-carbamate-methyl)phenol). METHOD: The PBHT was synthesized via the reaction between 2,6-di-tert-butyl-4-hydroxymethylphenol and 2-(methacryloyloxy)ethyl isocyanate. The structure of PBHT was confirmed by FT-IR and H-NMR spectra. The PBHT was added to the resin matrix of the DRCs at mass ratios of 1, 2, and 3 wt%. Double bond conversion (DC), volumetric shrinkage (VS), shrinkage stress (SS), flexural properties, water sorption (WS) and solubility (SL) of the prepared DRCs were investigated according to standard or referenced methods. The amount of leachable inhibitors in DRCs was determined by gas chromatography-mass spectrometry using the selected ion monitoring method. For comparative purposes, the DRCs containing the commercial inhibitor butylated hydroxytoluene (BHT) were also prepared, while a DRC without any extra inhibitor was used as the control. RESULTS: Adding PBHT to the resin matrix significantly reduced the DC of DRCs (p < 0.05). The PBHT lowered VS and SS of DRCs (p < 0.05), in contrast to BHT, which showed no significant effect (p > 0.05). Neither PBHT nor BHT affected flexural properties of DRCs (p > 0.05). The WS of DRCs was significantly increased after adding 3 wt% of either inhibitor (p < 0.05). While both PBHT and BHT significantly raised SL (p < 0.05), the PBHT-containing DRCs showed significantly lower SL than the BHT-containing ones at the same concentration (p < 0.05). Compared with the BHT-containing DRCs, PBHT-containing DRCs had lower leachable inhibitors (p < 0.05). SIGNIFICANCE: The PBHT-containing DRCs achieved low shrinkage stress and limited amount of leachable inhibitors. At the optimal concentration of 1 wt%, PBHT had no significant effect on the physicochemical properties other than SL.
AI-generated 3D models enhance CBCT interpretation of root canal anatomy among undergraduate and postgraduate students.
Fontenele RC, Santos-Junior AO, Dos Santos Cunha JG … +3 more , Porntaveetus T, Gaêta-Araujo H, Jacobs R
Clin Oral Investig · 2026 May · PMID 42096111 · Full text
OBJECTIVES: To evaluate the efficacy of artificial intelligence (AI)-driven three-dimensional (3D) anatomical models as an adjunct to cone-beam computed tomography (CBCT) for root canal assessment regarding diagnostic ac...
OBJECTIVES: To evaluate the efficacy of artificial intelligence (AI)-driven three-dimensional (3D) anatomical models as an adjunct to cone-beam computed tomography (CBCT) for root canal assessment regarding diagnostic accuracy, observer confidence, and time efficiency among undergraduate and postgraduate students. MATERIALS AND METHODS: In this observational diagnostic study, 26 observers (13 undergraduates and 13 postgraduates) evaluated 22 tooth roots with complex anatomy from nine CBCT scans under two conditions: CBCT alone and CBCT supplemented with AI-generated 3D anatomical models. Observers assessed the number of roots, root canals, and apical foramina, while confidence (5-point Likert scale) and assessment time were recorded. Each observer performed 132 assessments, totaling 3,432 evaluations. A reference standard was established by consensus between two specialists. A significance level was set at 5% (α = 0.05) for all statistical analyses. RESULTS: Augmenting CBCT with AI-generated 3D models significantly improved diagnostic accuracy for all parameters (p < 0.001). Root detection accuracy reached 100% in both groups. Root canal detection increased from 83% to 94% among undergraduates and from 88% to 99% among postgraduates, while apical foramina detection increased to 99% in both groups. Observer confidence significantly increased (p < 0.001), reaching a median score of 5 (IQR: 5-5). Workflow efficiency also improved (p < 0.001), with median assessment time decreasing from 102 s to 39 s for undergraduates and from 97 s to 24 s for postgraduates. CONCLUSION: AI-driven 3D anatomical models used with CBCT enhance diagnostic accuracy, observer confidence, and evaluation efficiency in endodontic assessment. However, multi-centre studies with larger, more diverse samples, particularly including cases with pronounced artefacts, would further support generalisability. CLINICAL RELEVANCE: AI-generated 3D anatomical models derived from CBCT scans may serve as a valuable adjunct for the interpretation of complex root canal anatomy, improving diagnostic accuracy, increasing observer confidence, and reducing assessment time. These findings support their potential role not only in clinical decision-making but also as an effective educational tool for training dental students and clinicians.
In vitro evaluation of the efficacy of a new orthodontic primer in metallic brackets cementation.
Carpio-Salvatierra B, Nuñez MA, Kusdra PM … +4 more , Montalli VM, Del Carmen Armas Vega A, Farago PV, Loguercio AD
Clin Oral Investig · 2026 May · PMID 42096090 · Full text
OBJECTIVE: To evaluate the efficacy of a new orthodontic primer (Ambar APS Ortho; FGM Dental Products, Joinville, SC, Brazil) on shear bond strength (SBS) and degree conversion (DC) of metallic brackets bonding. MATERIAL...
OBJECTIVE: To evaluate the efficacy of a new orthodontic primer (Ambar APS Ortho; FGM Dental Products, Joinville, SC, Brazil) on shear bond strength (SBS) and degree conversion (DC) of metallic brackets bonding. MATERIALS AND METHODS: 240 sound maxillary premolars were randomized into 24 experimental groups based on: (1) Orthodontic primer (Ambar APS Ortho, Orthoprimer and Transbond XT); (2) Light-curing time (3-seconds and 10-seconds); (3) Light-curing unit (Valo Cordless and Quazar); and (4) Storage condition (immediate time [IT] and after thermocycling [TC]). After each storage time, specimens were subjected to SBS testing at a crosshead speed of 1 mm/min until failure, and values were recorded in MPa. For DC (%) analysis, adhesive discs were prepared and evaluated using micro-Raman spectroscopy at IT only. SBS and DC data were analyzed using four and four-way ANOVA, respectively and Tukey's post hoc test (α = 0.05). RESULTS: Ambar APS Ortho showed significantly higher SBS values across both light-curing units compared to all other groups (p = 0.0001). For DC, Orthoprimer showed the lowest values, while Ambar APS Ortho achieved the highest. Across all primers, a 10 s light-curing exposure resulted in significantly higher DC values compared to 3 s (p < 0.0001). CONCLUSIONS: Ambar APS Ortho exhibited superior performance in both SBS and DC, for both 3 s and 10 s light-curing times as well as IT or AT, supporting its reliability for bonding metallic orthodontic brackets.
Treatment of gingival recession type 1 using coronally advanced flap with leucocytes-platelet rich fibrin: a randomized controlled trial.
Dos Santos NBM, Fernandes GVO, Marques T … +4 more , Sousa MC, Correia A, Vázquez MPB, Blanco-Carrión J
Clin Oral Investig · 2026 May · PMID 42096052 · Full text
OBJECTIVE: This study aimed to evaluate the clinical outcomes of gingival recession Type 1 (RT1) treatment using a coronally advanced flap (CAF) alone and in combination with L-PRF at 6 months. MATERIALS AND METHODS: A t...
OBJECTIVE: This study aimed to evaluate the clinical outcomes of gingival recession Type 1 (RT1) treatment using a coronally advanced flap (CAF) alone and in combination with L-PRF at 6 months. MATERIALS AND METHODS: A total of 70 RT1 from 19 patients were included. Participants were randomly assigned to the test group (TG, CAF + L-PRF, n = 42) and the control group (CG) (CAF alone, n = 28). Clinical parameters were assessed at baseline and at 6 months: the primary outcomes were percentage of root coverage (%RC) and complete root coverage (CRC); and the secondary outcomes included mean root coverage (MRC), changes in gingival thickness (GT) and volumetric tissue gain, recession area reduction, analgesic consumption, healing quality (the Inflammatory Proliferative Remodeling [IPR] score), and patient-reported outcome measures (PROMs). Statistical analyses were performed to determine differences between groups; a random-intercept mixed-effects model was used for all site-level outcomes. RESULTS: At six months, %RC was 89.30% ± 20.33% (TG) and 81.60% ± 27.93% (CG) (p > 0.05). For the TG and CG, respectively, %CRC was 73.81% and 57.14%; the mean GT gain was 0.16 ± 0.10 mm and 0.11 ± 0.10 mm (p = 0.08); the mean volume gain was 1.13 ± 1.25 mm and 0.86 ± 0.84 mm (p = 0.32); the mean number of pills taken was 1.67 ± 0.98 and 2.25 ± 1.02 (p = 0.04); the esthetic satisfaction was 95% ± 5% and 90% ± 7% (p = 0.31); willingness to undergo the procedure again: 93% ± 4% and 88% ± 6% (p = 0.22); sensitivity reduction: 85% ± 6% and 80% ± 8% (p = 0.19). There was no statistically significant difference in healing quality and PROMs. CONCLUSION: Both CAF alone and CAF combined with L-PRF yielded comparable clinical and volumetric outcomes in RT1 treatments. No statistically significant advantages were observed with the adjunctive use of L-PRF. CLINICAL RELEVANCE: Because CAF alone achieves high predictability for RT1 defects, the routine adjunctive use of L-PRF provides limited additional clinical benefits.
Comparison of antimicrobial photodynamic therapy protocols as adjunct treatment in the management of initial pericoronitis: a randomized, controlled, double-blind clinical trial.
Schalch TO, Ando-Suguimoto ES, Ferreira BS … +8 more , Mayer MAP, Motta LJ, Bussadori SK, Duran CCG, Fernandes KPS, Mesquita-Ferrari RA, Pavani C, Horliana ACRT
Clin Oral Investig · 2026 May · PMID 42095964 · Full text
OBJECTIVES: The aim of this study was to compare the effectiveness of two antimicrobial photodynamic therapy (aPDT) protocols using different methylene blue formulations in the treatment of initial pericoronitis. The res...
OBJECTIVES: The aim of this study was to compare the effectiveness of two antimicrobial photodynamic therapy (aPDT) protocols using different methylene blue formulations in the treatment of initial pericoronitis. The research question was whether the new methylene blue formulation provides superior clinical outcomes compared to the conventional formulation. MATERIALS AND METHODS: This randomized, controlled, double-blind clinical trial involved 34 healthy young patients with pericoronitis. The following groups were established: G1 (positive control, n = 17), irrigation with saline solution and aPDT with conventional methylene blue (0.005%, laser λ = 660 nm, 9 J per point, 318 J/cm²); and G2 (experimental, n = 17), using the same therapy but with a patented new formulation of methylene blue. Pain assessed using the Visual Analog Scale (VAS) was defined as the primary outcome. Secondary outcomes include mouth opening, edema, and quality of life (OHIP-14). Microbiological and immunological analyses were performed to complement clinical outcomes. All outcomes were assessed at baseline and on the fourth day after aPDT. RESULTS: Both groups showed statistically significant improvement in pain (G1: p = 0.022; G2: p = 0.001) and mouth opening (G1: p < 0.001; G2: p = 0.002) after treatment. However, no statistically significant differences were observed between the groups in final pain and mouth-opening outcomes (p = 0.845 and p = 0.318, respectively). CONCLUSIONS: Within the limitations of this study, both aPDT protocols were associated with improvements in clinical outcomes. No between-group differences were observed in clinical outcomes; differences were limited to microbiological and immunological parameters, with no clinical superiority of the new formulation. CLINICAL RELEVANCE: Both methylene blue formulations may be used as adjunctive treatment options for the management of initial pericoronitis. However, no additional clinical benefit was observed with the new formulation, and these findings do not support a change in current clinical practice.
The outcome of pulp revascularization of necrotic mature permanent teeth with periapical lesions using platelet-rich fibrin versus induced bleeding: a prospective preliminary randomized clinical trial.
Awawdeh L, Almesleh B, Hammouri H … +1 more , Al-Qudah A
Clin Oral Investig · 2026 May · PMID 42091722 · Publisher ↗
OBJECTIVES: The present study evaluated clinically and radiographically the effectiveness of Regenerative endodontic procedures (REPs) using platelet-rich fibrin (PRF) versus induced bleeding (IB) in treating mature necr...
OBJECTIVES: The present study evaluated clinically and radiographically the effectiveness of Regenerative endodontic procedures (REPs) using platelet-rich fibrin (PRF) versus induced bleeding (IB) in treating mature necrotic teeth. MATERIALS AND METHODS: Fifty patients with necrotic mature teeth with periapical lesions were randomly divided into two groups, Group 1, IB (n = 25), and Group 2, PRF (n = 25). Treated teeth were assessed clinically and radiographically at 6 and 12 months. Survival rate, success rate, and clinical outcome measures were analyzed. RESULTS: Survival rate was 98% at the 12-month follow-up period, with no significant difference between the groups (P=0.166). A statistically significant increase in periradicular healing was found in both groups at 6 and 12 months, compared to that at baseline (P< 0.001). A significant difference was found in final treatment success between the two groups (p = 0.0219). The IB group achieved a 100% success rate (23/23), while the PRF group showed a 75% success rate (18/24). The overall success rate was 85.4%. CONCLUSIONS: All teeth treated with either IB or PRF survived throughout the follow-up period. The preliminary results of this study showed comparable clinical outcomes between the two treatment modalities, although teeth treated with IB showed higher overall success rate than those treated with PRF this should be interpreted within the framework of early phase clinical evidence as the study was not adequately powered to confirm superiority. CLINICAL RELEVANCE: REPs may represent a viable treatment option for mature necrotic teeth, offering a biologically based approach that aims to restore tissue function. Longer follow-up as planned in the second phase of this study, will allow for a more definitive comparison between IB and PRF approaches.
Five-year clinical outcomes of root canal treatment using a calcium silicate-based sealer in teeth with apical periodontitis: a retrospective cohort study.
Cardinali F, Malvicini G, Sauro S … +4 more , Cernera M, Pontoriero DIK, Grandini S, Gaeta C
Clin Oral Investig · 2026 May · PMID 42071113 · Full text
OBJECTIVE: Hydraulic calcium silicate-based sealers (CSBSs) are increasingly used in endodontics, but evidence on their long-term clinical effectiveness remains limited. This retrospective study evaluated the 5-year outc...
OBJECTIVE: Hydraulic calcium silicate-based sealers (CSBSs) are increasingly used in endodontics, but evidence on their long-term clinical effectiveness remains limited. This retrospective study evaluated the 5-year outcomes of primary root canal treatments and retreatments performed with a CSBS in teeth with symptomatic apical periodontitis. MATERIALS AND METHODS: The sample consisted of 637 teeth with symptomatic apical periodontitis treated by a single experienced operator using a premixed CSBS (CeraSeal; Meta Biomed Co., Cheongju, South Korea) with the cold hydraulic condensation technique (CHC). Data were retrospectively collected from clinical charts and radiographic archives. Preoperative variables included sex, systemic health, tooth type, arch location, lesion size, pulpal diagnosis, sinus tract, and preoperative small perforation. Intraoperative factors comprised intracanal medication, apical diameter, obturation length, and sealer extrusion. Postoperative information included the type of coronal restoration. Follow-up evaluations were based on available radiographs and clinical notes at 1, 2, 3, 4, and 5 years. Outcomes were classified according to strict criteria (absence of symptoms and complete radiographic resolution) and loose criteria (absence of symptoms with complete or partial healing). Prognostic factors were investigated using bivariate associations and multivariate logistic regression models. RESULTS: Strict success rates increased progressively (80.2% at 1 year, 85.7% at 2 years, 86.8% at 3 years, 88.2% at 4 years, and 87.67% at 5 years). Loose success remained consistently high (99.2% at 1 year; 90.7% at 4 years, and 87.67% at 5 years). Higher baseline periapical index (PAI) scores significantly reduced odds of strict success at 2, 3, 4 years. Other factors, including age, sex, tooth type, treatment type, extrusion, and restoration, were not significant. CONCLUSIONS: CSBSs demonstrated favorable long-term outcomes. Preoperative lesion severity was the main prognostic factor, while demographic and procedural variables showed limited influence on long-term success. CLINICAL RELEVANCE: This study supports the long-term clinical reliability of CSBSs used with CHC in teeth with apical periodontitis. Preoperative lesion severity remains the primary prognostic factor influencing periapical healing over time.
Synergistic predictive value of T-stage and lymph node yield in guiding adjuvant radiotherapy decisions for pN1 OSCC without high-risk features: a multi-institutional retrospective cohort study.
Li B, Huang Y, Zhou H … +4 more , Guo C, Wei W, Cao W, Feng Z
Clin Oral Investig · 2026 May · PMID 42068453 · Publisher ↗
OBJECTIVES: This study aimed to identify a subset of patients with pN1 oral squamous cell carcinoma (OSCC) and no adverse pathological features who derive significant benefit from adjuvant radiotherapy (RT). MATERIALS AN...
OBJECTIVES: This study aimed to identify a subset of patients with pN1 oral squamous cell carcinoma (OSCC) and no adverse pathological features who derive significant benefit from adjuvant radiotherapy (RT). MATERIALS AND METHODS: In this multicenter retrospective study, 232 eligible pN1 OSCC patients were analyzed. Patients were stratified by T-stage (T1-2 vs. T3-4) and lymph node yield (LNY; high: ≥20; low: <20). The impact of adjuvant RT on survival outcomes was evaluated. RESULTS: A significant survival benefit from adjuvant RT was observed exclusively in the subgroup with advanced T-stage (T3-4) and low LNY (< 20), with improved disease-free survival (69.2% vs. 23.1%, p = 0.003), overall survival (76.9% vs. 38.5%, p = 0.012), and disease-specific survival (80.8% vs. 46.2%, p = 0.014). In contrast, no significant survival differences were found in the other T-stage/LNY subgroups. Furthermore, LNY alone did not independently predict prognosis or RT benefit in the overall cohort. CONCLUSIONS: This retrospective study suggests that pN1 OSCC patients with T3-4a stage disease and a low LNY (LNY < 20, levels I-III) may represent a subgroup that derives benefit from adjuvant RT. These exploratory findings suggest a practical model that warrants prospective validation to guide personalized therapy. CLINICAL RELEVANCE: This study provides clinical evidence to help refine the postoperative management of pN1 OSCC patients without high-risk features. It provides a practical stratification tool to guide personalized treatment decisions, aiming to optimize survival outcomes while reducing unnecessary radiotherapy.
Functionalized BMP-2-loaded microspheres combined with a PCL biomimetic scaffold for guiding root development in immature permanent teeth: fabrication and in vitro assessment.
Yang Z, Yang M, Ye J … +7 more , Lei X, Huo X, Qin Z, Qi L, Chen Y, Wang Y, Deng S
Clin Oral Investig · 2026 May · PMID 42068441 · Publisher ↗
OBJECTIVES: Pulp necrosis in immature permanent teeth arrests root development and compromises long-term prognosis. This study aimed to develop a multifunctional scaffold integrating structural biomimicry, mechanical mat...
OBJECTIVES: Pulp necrosis in immature permanent teeth arrests root development and compromises long-term prognosis. This study aimed to develop a multifunctional scaffold integrating structural biomimicry, mechanical matching, and sustained growth factor release for orderly root regeneration. MATERIALS AND METHODS: A poly(ε-caprolactone) (PCL) conical scaffold was fabricated via melt electrowriting (MEW) combined with mechanical winding. Bone morphogenetic protein‑2 (BMP‑2)-loaded microspheres were prepared and physically incorporated into the scaffold. The scaffold surface was modified with collagen. Human dental pulp stem cells (hDPSCs) were cultured on the scaffold to evaluate proliferation, adhesion, and osteogenic differentiation. RESULTS: The scaffold exhibited a trilayer "collagen-microsphere-PCL" architecture with mechanical compatibility (elastic modulus: 22.5 MPa; fracture strength: 5.29 MPa; elongation: 441.59%). Microspheres (2.86 ± 0.45 μm) showed a gradient distribution and sustained release (70-75% over 90 days). In vitro, the scaffold promoted hDPSC adhesion and proliferation and significantly enhanced osteogenic differentiation with elevated alkaline phosphatase activity, upregulated the expression of osteogenic-related genes, and increased protein levels. CONCLUSIONS: The scaffold integrates structural support, controlled growth factor delivery, and a bioactive interface, offering a promising strategy for root development in immature permanent teeth. CLINICAL RELEVANCE: By enabling physiological root development, the scaffold addresses a critical unmet need, offering a viable alternative to conventional root canal therapy.
Does endodontic treatment modify serum inflammatory markers of cardiovascular risk in individuals with asymptomatic apical periodontitis? a systematic review and meta-analysis.
Silva Araújo R, Abreu Fonseca Thomaz EB, da Silva Magalhães EI … +2 more , Balbinot Hilgert J, Carvalho Souza SF
Clin Oral Investig · 2026 May · PMID 42068431 · Full text
OBJECTIVE: Plasma inflammatory biomarkers linked to cardiovascular risk have been associated with asymptomatic apical periodontitis. However, it remains unclear whether endodontic treatment can reverse these alterations....
OBJECTIVE: Plasma inflammatory biomarkers linked to cardiovascular risk have been associated with asymptomatic apical periodontitis. However, it remains unclear whether endodontic treatment can reverse these alterations. This review evaluated the effect of endodontic treatment on inflammatory markers in individuals with asymptomatic apical periodontitis. MATERIALS AND METHODS: A comprehensive search was conducted in PubMed/Medline, Embase, Web of Science, Scopus, VHL, gray literature, and reference lists between October and November 2022, with an update in September 2025. Risk of bias was assessed using the Newcastle-Ottawa Scale, and the certainty of evidence using the GRADE approach. Random-effects meta-analysis estimated pooled mean differences (MD) and 95% confidence intervals (95%CI) for serum inflammatory markers concentrations between treated individuals and controls (α = 5%). RESULTS: The search identified 6,295 records; sixteen studies were assessed and eight included in the quantitative synthesis. All studies showed moderate risk of bias, and evidence certainty was very low. Meta-analysis suggested possible reductions in C-reactive protein (CRP) [MD = 0.76 (95% CI: - 0.15, 1.67)] , interleukin-6 (IL-6) [MD = 0.81 (95% CI:-0.27, 1.90)], and tumor necrosis factor-alpha (TNF-α) [MD = 1.04 (95% CI:-0.38, 2.46)] after endodontic treatment, with levels similar to control groups. CONCLUSION: Evidence, although limited, suggests endodontic treatment may lower serum CRP, IL-6, and TNF-α levels in asymptomatic apical periodontitis patients. CLINICAL RELEVANCE: Endodontic treatment of asymptomatic apical periodontitis may help reduce systemic inflammatory biomarkers associated with cardiovascular risk, reinforcing its potential role beyond local infection control.
Clinical performance of alkasite and glass-hybrid restorations compared with resin composite in class II cavities: a randomized clinical trial.
Işıklı K, Koc Vural U, Yalcin Cakir F
Clin Oral Investig · 2026 May · PMID 42067643 · Full text
OBJECTIVES: The aim of this randomized clinical trial was to evaluate the 18-month clinical performance of alkasite and glass-hybrid restorations compared with resin composite in Class II restorations. MATERIALS AND METH...
OBJECTIVES: The aim of this randomized clinical trial was to evaluate the 18-month clinical performance of alkasite and glass-hybrid restorations compared with resin composite in Class II restorations. MATERIALS AND METHODS: A total of 50 patients requiring at least three Class II restorations in premolar and molar teeth were recruited. Each patient received three restorations, which were randomly assigned to one of the following materials: an alkasite (Cention N, Ivoclar Vivadent), a glass-hybrid (Equia Forte HT, GC Corp.), or a resin composite (Gradia Direct Posterior, GC Corp.). Alkasite and glass-hybrid served as test groups while resin composite served as the control group. During the 18-month follow-up, restorations were scored at baseline, 6, 12, and 18 months using the FDI criteria. Data were analyzed using the Chi-square and Cochran's Q tests (α = 0.05). RESULTS: No significant differences were detected among the groups for esthetic, functional, or biological criteria over 18 months (p > 0.05). Regarding esthetic properties, the control group showed 100% success for all esthetic criteria at all recall visits, while the alkasite group maintained a 96% success rate at all time points, and glass-hybrid showed 98% success at 6 and 12 months and 92% at 18 months. Minor score-2 changes in color match and gloss were detected in the glass-hybrid and alkasite groups but were not significant (p > 0.05). For functional and biological outcomes, all groups achieved 100% success rates for all evaluated parameters. CONCLUSIONS: Alkasite and glass-hybrid groups exhibited clinical performance comparable to resin composite over the 18-month follow-up in Class II cavities. All materials demonstrated excellent functional and biological stability while achieving clinically acceptable aesthetic results.
Comparative evaluation of the cytotoxic effects of fluoridated and non- fluoridated toothpaste on the buccal mucosa: A 12 week follow up- a randomized controlled study.
Ravindran R, Elumalai A, Vijayarangan A … +3 more , Balachandran A, Mahalingam B, Chellapandi S
Clin Oral Investig · 2026 Apr · PMID 42053871 · Publisher ↗
BACKGROUND AND OBJECTIVES: Fluorides are included in oral hygiene products to combat dental caries. But the potential threats in using a fluoridated toothpaste and its effect on oral buccal mucosal cells still remains a...
BACKGROUND AND OBJECTIVES: Fluorides are included in oral hygiene products to combat dental caries. But the potential threats in using a fluoridated toothpaste and its effect on oral buccal mucosal cells still remains a debate. The objective of this study was to evaluate the cytotoxic effects of fluoridated and non- fluoridated toothpaste on the buccal mucosa over a 12 week follow up period. MATERIALS AND METHODS: This prospective double blinded parallel randomized clinical trial was conducted with 40 subjects. These participants were randomly assigned into two groups. 20 participants were given the fluoridated toothpaste and another 20 participants were given the non-fluoridated toothpaste. The participants were told to use the toothpaste for a period of 12 weeks. The buccal mucosal cell sampling was done after 12 weeks. All participants used the toothpaste for 12 weeks, which was already available in the market for this study (non-fluoride and 1400 ppm F for 12 weeks). RESULTS: The frequency of micronuclei showed statistically significant differences between the studied groups. The cellular changes in fluoridated subjects was not statistically significant (p = 0.087) and in non- fluoridated subjects also it was statistically not significant (p = 0.370). The nuclear changes in fluoridated subjects was not statistically significant (p = 1.000) but in non- fluoridated subjects it was statistically significant (p = 0.033). The intergroup comparison was not statistically significant (p = 1.000). Comparing two groups, statistically significant increase in the number of cells with cellular changes (p = 0.048) at 12 weeks of usage was observed, suggesting association between fluoride exposure and the presence of cellular changes. The micronuclei frequency between both the groups proved to be statistically significant (p = 0.0001*). There was a strong negative correlation between the type of toothpaste used and the number of micronuclei (r = − 0.853, p = 0.000), which was statistically significant. There was no significant correlation between gender and micronuclei (r = 0.098, p = 0.549) or cellular changes (r = 0.052, p = 0.752) Age shows no significant correlation with any of the parameters such as micronuclei (r = − 0.171, p = 0.291), nuclear changes (r = 0.038, p = 0.818), or cellular changes (r = − 0.051, p = 0.756). CONCLUSION: Based on the results of this study, it can be concluded that simultaneous application of fluoridated toothpaste and fluoride based oral hygiene products does lead to cytogenetic damage in buccal mucosal cells. CLINICAL RELEVANCE: The potential cytotoxic effects of fluoridated formulations on the oral mucosa, particularly under conditions of prolonged and repeated use, remain a matter of concern. This study evaluates whether fluoridated and non-fluoridated toothpastes exert differential effects on the buccal mucosa over an extended period, assisting clinicians in selecting dentifrices that ensure both caries prevention and the development of formulations suitable for individuals with mucosal sensitivity or existing oral pathologies.
In vitro evaluation of dentin surface alterations induced by a helical ultrasonic scaler tip using coherence correlation interferometry.
Yaita N, Maruyama K, Hoashi K … +1 more , Sato S
Clin Oral Investig · 2026 Apr · PMID 42053841 · Publisher ↗
OBJECTIVES: To evaluate the effects of a novel helical ultrasonic scaler tip (HUST) on dentin surface roughness and compare its performance with a non-helical ultrasonic scaler tip (NHUST) and a conventional hand scaler...
OBJECTIVES: To evaluate the effects of a novel helical ultrasonic scaler tip (HUST) on dentin surface roughness and compare its performance with a non-helical ultrasonic scaler tip (NHUST) and a conventional hand scaler (Gracey curette, GC). The HUST was designed to improve calculus removal efficiency while minimizing dentin surface damage. MATERIALS AND METHODS: This in vitro experimental study used standardized dentin blocks prepared from extracted human teeth to evaluate the effects of three instruments (HUST, NHUST, and GC). Surface roughness was quantified by measuring the total height of the profile (Pt) using a non-contact surface profilometer based on coherence correlation interferometry. Tip wear was assessed qualitatively using scanning electron microscopy. The sample size was determined based on preliminary experimental observations. Statistical analyses included the Shapiro–Wilk test for normality, followed by the Kruskal–Wallis test and Steel–Dwass post hoc comparisons. RESULTS: No visible wear was observed on either ultrasonic tip, even after 400 applications. Pt was significantly higher in the NHUST group (18.80 ± 6.21 μm) than in the HUST (10.26 ± 4.31 μm) and GC (6.05 ± 3.78 μm) groups (p < 0.01). No significant difference was observed between the HUST and GC groups. All experimental groups showed greater roughness than the polished control (3.29 ± 1.14 μm), but the HUST group exhibited significantly lower surface alteration than the NHUST group. CONCLUSIONS: The HUST resulted in lower dentin surface roughness than the NHUST. CLINICAL RELEVANCE: The HUST may contribute to safer ultrasonic instrumentation with reduced dentin surface alterations.
Evaluation of the marginal and internal fit of endocrown restorations fabricated by the CAD/CAM system using additive manufacturing technique.
Santos Brito EAD, Souza MM, Borges MSN … +6 more , Ramos MJL, Godoi-Lopes J, Cardoso L, Sousa-Neto MD, Chaves JFM, Tirapelli C
Clin Oral Investig · 2026 Apr · PMID 42053672 · Full text
OBJECTIVE: This study aimed to compare the marginal and internal fit of endocrowns with cavity depths of 3 mm and 5 mm, using two printable resins fabricated by additive manufacturing within a digital workflow. MATERIALS...
OBJECTIVE: This study aimed to compare the marginal and internal fit of endocrowns with cavity depths of 3 mm and 5 mm, using two printable resins fabricated by additive manufacturing within a digital workflow. MATERIALS AND METHODS: Thirty-two human mandibular molars were prepared for endocrowns with cavity depths of 3–5 mm and allocated into four groups (n = 8). Two printable resins (Biocrown Diamond and Voxel Print) were evaluated at both preparation depths. The restorations were designed using CAD software and manufactured by DLP-based additive manufacturing. Marginal and internal fit were assessed using micro-computed tomography (micro-CT) from standardized sagittal and coronal sections at predefined anatomical regions. Data were analyzed using two-way repeated-measures ANOVA followed by Tukey’s test (α = 0.05). RESULTS: Material and preparation depth influenced the marginal and internal fit of endocrown restorations, with a significant interaction with the anatomical region. The highest discrepancies were observed in the axio-occlusal angle, particularly for the 5-mm preparation groups. Significant differences between materials occurred at the axio-occlusal angle for 3-mm preparations and in the marginal gap for 5-mm preparations. No significant differences were detected in the pulpal regions. CONCLUSION: Endocrowns showed clinically acceptable marginal adaptation at both preparation depths. However, internal adaptation was region-dependent, with greater discrepancies in the axio-occlusal region. Both resins demonstrated acceptable behavior, although localized differences were observed according to preparation depth and anatomical region. CLINICAL SIGNIFICANCE: Preparation depth and printable resin type may influence the internal adaptation of additively manufactured endocrowns and should be considered during treatment planning.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe