Clinical Oral Investigations[JOURNAL]
Sun
200 papers
Evaluating AI diagnostic accuracy in approximal dental caries detection on bitewing radiographs.
Giannakopoulos K, Kavadella A, Paraskevis D … +3 more , Arhakis A, Makrygiannakis MA, Kaklamanos EG
Clin Oral Investig · 2026 Apr · PMID 42050285 · Full text
OBJECTIVES: To evaluate the diagnostic accuracy of the Diagnocat™ artificial intelligence (AI) system for caries detection on bitewing radiographs compared with expert human examiners, with emphasis on differences betwee...
OBJECTIVES: To evaluate the diagnostic accuracy of the Diagnocat™ artificial intelligence (AI) system for caries detection on bitewing radiographs compared with expert human examiners, with emphasis on differences between enamel and dentin lesions. MATERIALS AND METHODS: A sample of 100 digital bitewing radiographs (1540 surfaces) was retrospectively selected from the European University Cyprus dental clinic database using a systematic backward screening method. Radiographs were obtained with a standardized phosphor plate system and anonymized before analysis. Two independent experts (operative dentistry and oral radiology) established the reference standard. AI and human assessments were binarized (caries/no caries; enamel/dentin) and compared. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated, and statistical significance was tested across detection categories. RESULTS: Diagnocat™ showed high specificity (94.3%, 95% CI: 92.4%–96.0%) and NPV (96.1%, 95% CI: 94.7%–97.3%), with an overall accuracy of 91.6% (95% CI: 89.7%–93.4%). Sensitivity was moderate (73.1%, 95% CI: 65.9%–79.9%), and PPV was 64.7% (95% CI: 57.7%–71.5%). Agreement with the expert consensus was substantial (Cohen’s κ = 0.638). For enamel lesions, sensitivity and specificity were 73.3% (95% CI: 62.8%–82.7%) and 92.9% (95% CI: 91.0%–94.7%) with moderate agreement with the consensus (Cohen’s κ = 0.492) and for dentin lesions they were 72.8% (95% CI: 61.8%–83.8%) and 92.8% (95% CI 90.9%–94.6%) with moderate agreement with the consensus (Cohen’s κ = 0.468). NPV remained high (≥ 98.0%), while PPV was low (42.0% and 39.2%), across lesion types. Detection patterns differed significantly between AI and the reference standard (p < 0.001). CONCLUSIONS: Diagnocat™ demonstrated good diagnostic performance in ruling out caries. However, its overall lower sensitivity emphasizes the need for clinician oversight, especially in detecting early-stage disease. CLINICAL RELEVANCE: This study offers an independent validation of Diagnocat™ using bitewing radiographs. It demonstrates lesion-depth–specific insights, showing that while AI is highly reliable for excluding disease, its predictive value remains limited.
Vücut kitle indeksinin mandibular kemik mimarisi üzerindeki etkileri: retrospektif fraktal boyut ve radyomorfometrik analiz.
Ispir NG, Akay G, Gungor K
Clin Oral Investig · 2026 Apr · PMID 42043673 · Full text
OBJECTIVE: This retrospective study aimed to evaluate mandibular bone mineral density and bone trabecular structure using fractal dimension (FD) analysis and radiomorphometric indexes on dental panoramic radiographs, and...
OBJECTIVE: This retrospective study aimed to evaluate mandibular bone mineral density and bone trabecular structure using fractal dimension (FD) analysis and radiomorphometric indexes on dental panoramic radiographs, and to determine whether the results differed between groups with varying body mass index (BMI) levels. MATERIALS AND METHODS: Panoramic radiographs of 127 individuals aged 18–45 (84 females and 43 males, with a mean age of 30.37 ± 8.4 years) were retrospectively selected from clinical records. Individuals were divided into four groups based on their BMI percentiles: normal, underweight, overweight, and obese. FD measurements, Mental Index (MI), and Panoramic Mandibular Index (PMI) were evaluated. Kruskal-Wallis Test, Pearson Chi-Square Test, and Wilcoxon Test were used in the comparison of parameters. RESULTS: MI and PMI values differed significantly among BMI groups (p = 0.005 and p = 0.025, respectively). Specifically, obese individuals had higher MI and PMI values compared to those in the other BMI categories. A statistically significant difference was also observed in FD premolar-canine values among BMI categories (p < 0.001). However, no significant differences were found for FD premolar-molar, FD angulus, and FD condyle values across BMI groups (p > 0.05). CONCLUSIONS: Mandibular cortex thickness (MI) values were thicker in obese and overweight adults, and PMI values were higher in obese individuals compared to lean individuals. However, only FD values measured in the premolar-canine region were observed to be lower in lean individuals compared to the other groups. CLINICAL RELEVANCE: The study findings demonstrate that BMI values significantly affect mandibular cortical bone structure. Structural differences in cortical and trabecular bone may impact surgical procedures such as implant planning. Therefore, mandibular bone structure should be assessed preoperatively in cases of obesity and underweight to optimize primary stability and long-term success.
Cracked teeth: a review of etiology, traditional detection methods, and novel diagnostic techniques.
Zeng J, Liu Y, Liu X … +6 more , Chai Y, Zhang H, Li H, He J, Zhang C, Xu S
Clin Oral Investig · 2026 Apr · PMID 42043600 · Publisher ↗
OBJECTIVE: Cracked teeth are a common oral disease that often causes tooth pain. However, its clinical manifestations are subtle and complex, leading to difficulties in early diagnosis, and current detection methods also...
OBJECTIVE: Cracked teeth are a common oral disease that often causes tooth pain. However, its clinical manifestations are subtle and complex, leading to difficulties in early diagnosis, and current detection methods also have several limitations. Therefore, this review systematically summarizes emerging detection techniques, aiming to overcome existing diagnostic challenges and promote the advancement of rapid, precise, and non-invasive diagnostic approaches for cracked teeth. MATERIALS AND METHODS: This review is based on a systematic search of relevant data from databases including PubMed, Scopus, and Web of Science covering the period from the January 2015 to December 2025, and also incorporates content from authoritative literature such as that of the American Association of Endodontists (AAE). RESULTS: It summarizes common clinical detection methods for cracked teeth and focuses on delineating novel examination techniques and recent advances in this field. CONCLUSION: Current clinical diagnosis primarily relies on visual examination with optical microscopy, supplemented by probing, bite tests, and imaging aids like periapical radiographs (PA) or cone-beam computed tomography (CBCT). However, these conventional methods have several limitations, including heavy reliance on clinician experience, susceptibility to interference from metallic restorations, and difficulty in accurately assessing crack depth. With advancements in novel detection technologies, the localization and diagnosis of cracked teeth are becoming more precise. These new techniques not only effectively overcome artifacts caused by metallic restorations but also enable the evaluation of crack depth. Furthermore, they can facilitate automated crack identification and pulpal status assessment. In recent years, the integration of artificial intelligence with diagnostic methods for cracked teeth has been explored, aiming to develop rapid, accurate, and non-invasive diagnostic strategies. CLINICAL RELEVANCE: This review systematically summarizes emerging detection technologies, highlighting their features and current limitations. It aims to provide new perspectives for the clinical diagnosis of cracked teeth and contribute to refining the existing clinical diagnostic framework.
Trends in adverse drug reaction reporting by dentists: a 15-year analysis of German pharmacovigilance data.
Halling F, Lutz R, Meisgeier A
Clin Oral Investig · 2026 Apr · PMID 42043582 · Full text
OBJECTIVES: Dentists frequently encounter adverse drug reactions (ADRs) in their day-to-day work. Despite the legal obligation in Germany to report ADRs, systematic evaluations of dental pharmacovigilance data remain sca...
OBJECTIVES: Dentists frequently encounter adverse drug reactions (ADRs) in their day-to-day work. Despite the legal obligation in Germany to report ADRs, systematic evaluations of dental pharmacovigilance data remain scarce. This study aimed to analyze ADR reports submitted by dentists to the Drug Commission of the German Dental Association. MATERIALS AND METHODS: All ADR reports submitted between 2010 and 2024 were analyzed according to year, medication class, and affected organ system. Incidence rates per dentist were calculated and trends over time were assessed using Poisson regression analysis. RESULTS: A total of 983 ADR reports were included. Antibiotics accounted for the majority of reports (59.4%), followed by local anesthetics (15.7%). The most frequently affected organ systems were the skin (39.8%) and the gastrointestinal tract (21.7%). On average, 65.5 reports were submitted annually. The overall incidence rate was 91.7 reports per 100,000 dentist years, declining by 9.5% annually over the study period. Clindamycin had the highest incidence of ADR reports (26.7 per 100,000 dentist years) but also the steepest annual decrease (–17.1% per year). CONCLUSION: The proportion of ADRs reported by dentists is low compared with the expected number of ADRs, indicating substantial underreporting. A significant decline in reporting was observed over time. Consistent with previous studies, antibiotics and cutaneous reactions predominated. The reduction in clindamycin-related ADR reports reflects a substantial decrease in clindamycin prescriptions in Germany. CLINICAL RELEVANCE: Mandatory spontaneous reporting remains essential for dental pharmacovigilance. However, implementing digital tools and low-threshold reporting systems could improve the quantity and quality of future ADR reports.
Correction to: Effectiveness of fissure sealants following different silver fluoride application protocols in MIH-affected molars: randomized clinical study.
Cayiroglu N, Ballikaya E, Unverdi GE … +1 more , Cehreli ZC
Clin Oral Investig · 2026 Apr · PMID 42036499 · Full text
Abstract loading — click title to view on PubMed.
Bite through pain - an experimental pain force-controlled study on EMG-activity of the masseter muscle.
van Dijk JP, Terebesi S, Schindler HJ … +4 more , Svensson P, Eiglsperger U, Lapatki BG, Giannakopoulos NN
Clin Oral Investig · 2026 Apr · PMID 42032284 · Full text
OBJECTIVES: Aim of this high-density surface electromyography (EMG) study was to evaluate the effect of experimentally-induced pain in the masseter on the performance of a constant vertical bite-force. MATERIAL AND METHO...
OBJECTIVES: Aim of this high-density surface electromyography (EMG) study was to evaluate the effect of experimentally-induced pain in the masseter on the performance of a constant vertical bite-force. MATERIAL AND METHODS: Twenty healthy participants performed two ramp-and-hold contractions at baseline and after an injection of either hypertonic saline (HS) or, as control, isotonic saline (IS) based on random assignment. The measurement was repeated after 15 min. with IS or HS, respectively. The target level of vertical bite-force was 15% of maximum voluntary contraction registered using an intra-oral device. RESULTS: The average root-mean-square (RMS) values showed significantly lower (p<0.001) EMG activity for all selected monopolar (14.9%) and bipolar (17.1%) derivations for the HS condition despite unchanged mean force. Bipolar EMG RMS values for the contralateral masseter did not change significantly. The centre of mass obtained from the interpolated monopolar RMS amplitude map showed a mean shift away from the injection site of 0.85mm (p<0.001). CONCLUSIONS: Experimental pain induced a general reduction of RMS EMG amplitude of the ipsilateral masseter and a small but significant shift away from the site of injection. CLINICAL RELEVANCE: The masticatory motor system seems to possess a unique adaptability to produce a constant force despite the presence of experimentally induced pain. This could represent a feature of the high resilience and adaptability of the stomatognathic system in acute painful conditions.
Comparison of fracture resistance and microleakage of direct and indirect restorations in endodontically treated molars with extensive coronal loss : Comparison of endocrown restorations made by different methods in endodontically treated teeth.
Akan E, Kahvecioğlu F
Clin Oral Investig · 2026 Apr · PMID 42032095 · Publisher ↗
OBJECTIVES: This study aimed to compare the fracture resistance and microleakage of direct composite endocrowns, indirect composite endocrowns, and fiber-reinforced indirect composite endocrown restorations placed on end...
OBJECTIVES: This study aimed to compare the fracture resistance and microleakage of direct composite endocrowns, indirect composite endocrowns, and fiber-reinforced indirect composite endocrown restorations placed on endodontically treated mandibular molars with extensive coronal loss in vitro. MATERIALS AND METHODS: Seventy-eight mandibular molars were endodontically treated and randomly divided into three groups (n = 26): Group 1—direct composite endocrown restorations, Group 2—indirect composite endocrown restorations, and Group 3—fiber-reinforced indirect composite endocrown restorations. Following thermocycling, 13 specimens from each group were subjected to fracture resistance testing, while the remaining 13 specimens were evaluated for microleakage. Fracture loads were recorded in Newtons (N). Fracture patterns and microleakage scores were assessed. Data normality was verified using the Shapiro–Wilk test, and statistical analysis was performed using one-way ANOVA followed by post hoc tests (α = 0.05). RESULTS: No statistically significant differences were observed in fracture resistance among the groups (Group 1: 2459.2 ± 382.5 N; Group 2: 2453.7 ± 409.6 N; Group 3: 2257.3 ± 527.6 N; p > 0.05). However, indirect composite endocrown restorations (Group 2) demonstrated significantly more favorable fracture pattern scores compared with direct composite endocrowns (Group 1) (p < 0.05). Regarding microleakage, direct composite endocrowns exhibited significantly higher leakage scores than both indirect composite and fiber-reinforced indirect composite endocrown restorations (p < 0.05). CONCLUSIONS: Within the limitations of this in vitro study, all tested restoration types demonstrated fracture resistance values exceeding normal masticatory forces. Indirect and fiber-reinforced indirect endocrown restorations showed improved marginal sealing performance compared with direct composite endocrowns. CLINICAL RELEVANCE: Fiber-reinforced indirect composite endocrowns may represent a conservative and adhesive restorative option for endodontically treated molars with extensive coronal loss. The adhesive bonding approach allows stress distribution without the need for post placement, potentially preserving remaining tooth structure.
Wisdom teeth removal and anterior alignment stability after orthodontic treatment-a systematic review.
Amberg S, Kroeger A, Houlston E … +2 more , Şen S, Kebschull M
Clin Oral Investig · 2026 Apr · PMID 42029940 · Full text
OBJECTIVE: Tertiary crowding is common after orthodontic treatment. The role of third molars in their development remains a subject of controversy. We aim to evaluate whether third molar removal affects long-term anterio...
OBJECTIVE: Tertiary crowding is common after orthodontic treatment. The role of third molars in their development remains a subject of controversy. We aim to evaluate whether third molar removal affects long-term anterior alignment after orthodontic treatment. MATERIAL AND METHODS: A systematic search was conducted in PubMed, Embase, Cochrane Library, and Google Scholar. Manual searches reference lists of included studies, selected orthodontic journals, and recent reviews. Included studies specifically addressed the following PICOT question: PICOT: In patients who do not wear retention devices after orthodontic treatment (P), does the extraction of wisdom teeth (I) compared to patients who retained their wisdom teeth (C) have an impact on the prevention of crowding (O) after at a minimum follow-up of one year after the end of the retention phase (T)? Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers. RESULTS: Four studies met all inclusion criteria. All of them reported an increase in anterior crowding over time, regardless of third molar status. No statistically significant differences were found between groups. One study observed a smaller reduction in arch length in the extraction group. Overall, study quality was limited due to heterogeneity in treatment protocols, retention strategies, and measurement methods. CONCLUSION/CLINICAL RELEVANCE: Based on the very low certainty of evidence, there is no consistent indication that the presence or agenesis/removal of third molars meaningfully influences post-treatment anterior crowding. Therefore, routine prophylactic extraction for this purpose is not supported by the currently available evidence. Registration. PROSPERO: CRD42024546851.
Non-surgical root canal treatments in a public dental service: Characteristics of patients, teeth and operators from a 16-year register-based study.
Väisänen M, Palotie U, Furuholm J … +1 more , Tseveenjav B
Clin Oral Investig · 2026 Apr · PMID 42029902 · Full text
OBJECTIVES: According to Finnish population-based studies, 27% of dentate adults have at least one tooth with apical periodontitis (AP), and 61% have at least one root canal treated teeth (RCTT). The objective of this re...
OBJECTIVES: According to Finnish population-based studies, 27% of dentate adults have at least one tooth with apical periodontitis (AP), and 61% have at least one root canal treated teeth (RCTT). The objective of this retrospective register-based study was to assess the prevalence of non-surgical root canal treatments (nsRCTs) performed at public dental service (PDS) of the City of Helsinki, and to describe the patient-, tooth- and operator-related factors of these treatments. MATERIAL AND METHODS: Data were extracted from electonic patient files used by Helsinki PDS between 2002 and 2017. NsRCTs were identified based on dental treatment codes on nsRCT initiation and root canal filling. RESULTS: A total of 166 218 teeth were identified with a treatment code for nsRCT. Of these, 81.4% was completed; 18.6% uncompleted nsRCTs. Younger adults and women more frequently received nsRCTs, compared with older counterparts and men (p < 0.001). At tooth level, molars received more nsRCTs than anterior teeth or premolars (p < 0.001). Most of the nsRCTs were initiated as planned treatment compared to those initiated at emergency visits, and performed by general dentists (GDs). CONCLUSION: A substantial number of nsRCTs were performed annually at Helsinki PDS. The proportion of uncompleted nsRCTs was high, indicating inefficient use of resources. Our findings of patient-, tooth- and operator-related characteristics could provide new insights into the epidemiology of endodontics in a public dental care service. CLINICAL RELEVANCE: While nsRCT is a common procedure in dentistry, findings from 16-year register-based study could support clinicians and decision-makers for their evidence-based treatment and management.
Voltage-tunable plasma-activated water: a strategy for combating peri-implantitis via dual-path biofilm disruption and vascular regeneration.
Lang Y, Mei H, Zhang J … +4 more , Hu C, Pang Z, Chen Y, Xue C
Clin Oral Investig · 2026 Apr · PMID 42029737 · Publisher ↗
OBJECTIVES: Peri-implantitis therapy requires both effective biofilm eradication and subsequent tissue regeneration. This study aimed to develop a voltage-gated plasma-activated water (PAW) system with switchable bioacti...
OBJECTIVES: Peri-implantitis therapy requires both effective biofilm eradication and subsequent tissue regeneration. This study aimed to develop a voltage-gated plasma-activated water (PAW) system with switchable bioactivities to address these dual needs and evaluate its efficacy for potential application in peri-implantitis management. MATERIALS AND METHODS: PAW was generated using a dielectric barrier discharge system across a voltage spectrum of 33–46 kV. Its antibacterial activity was assessed against Porphyromonas gingivalis and multi-species biofilms on titanium surfaces, quantified via colony-forming unit (CFU) counts and visualized using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). The pro-angiogenic potential was evaluated through endothelial cell viability, migration, and tubule formation assays. RESULTS: High-voltage PAW (46 kV, 30 min) achieved a > 6.0-log reduction of P. gingivalis and induced structural collapse of multi-species biofilms. In contrast, low-voltage PAW (36 kV, 15 min) significantly enhanced endothelial cell viability to 118.5% [116.8-120.2] (padj = 0.003), and accelerated both cell migration and tubulogenesis. CONCLUSIONS: This study demonstrates that PAW’s biological functionality can be precisely tuned via modulation of activation voltage. The same platform can be switched between a potent antibacterial state and a pro-regenerative state, enabling adaptive bioactivity suited to the staged therapeutic requirements of peri-implantitis. CLINICAL RELEVANCE: The voltage-gated PAW system presents a promising, affordable strategy for dual-phase peri-implantitis therapy. It offers clinicians a potential non-antibiotic tool to first disinfect implant surfaces and then promote vascular healing, which is critical for improving clinical outcomes in implant dentistry.
Effectiveness and influencing factors of strip-cushioning transcrestal sinus floor elevation: a clinical retrospective study.
Deng C, Rao C, Song W … +3 more , Xing Y, Hu C, Man Y
Clin Oral Investig · 2026 Apr · PMID 42026350 · Publisher ↗
OBJECTIVES: To evaluate effectiveness of the strip-cushioning TSFE with simultaneous implant placement; and to investigate its potential influencing factors, including anatomical variations. The primary outcome was endo-...
OBJECTIVES: To evaluate effectiveness of the strip-cushioning TSFE with simultaneous implant placement; and to investigate its potential influencing factors, including anatomical variations. The primary outcome was endo-sinus bone gain (ESBG) before prosthesis. MATERIALS AND METHODS: This retrospective study assessed ESBG and crestal bone level (CBL) using cone-beam computed tomography (CBCT) before surgery (T0), immediately after surgery (T1), and before prosthesis (T2), along with peri-apical radiographs at prosthesis (T3) and during post-loading follow-ups (T4 to T6). One-way repeated measures ANOVA assessed bone height changes. Univariate and multivariate generalized linear mixed models (GLMM) identified the factors influencing ESBG and Schneiderian membrane perforation rate. RESULTS: A total of 88 patients with 107 implants were included. Bone height under sinus floor significantly increased at five peri-implant positions from T0 to T1 and T2. The mean ESBG was 5.55 mm (T1) and 4.62 mm (T2). GLMM revealed the first molar site (p = 0.036) and RBH < 5 mm (p < 0.001) were significantly associated with higher ESBG. Schneiderian membrane perforation occurred in 12 sites (11.2%). T1 ESBG/mesiodistal elevation width (MEW) > 0.8 was significantly associated with higher perforation risk (p = 0.011). ESBG and CBL significantly declined during post-loading follow-ups (T4 to T6) compared to T3. CONCLUSIONS: The strip-cushioning technique led to radiographically detectable ESBG before prosthesis, which appeared related to RBH and implant site. Membrane perforation was more likely with a higher T1 ESBG/MEW ratio. Notably, as challenging anatomical variations did not adversely affect these outcomes, this technique may be considered a viable option in demanding clinical situations. CLINICAL RELEVANCE: The strip-cushioning TSFE should be considered a viable option for sinus floor elevation in cases with challenging maxillary sinus anatomical variations.
Comparison between patient-specific implants and hand-bent plates in mandibular reconstruction.
Linderkamp ML, Papazacharias E, Lewandowski T … +7 more , Bettag SA, Mast J, Lentge F, Jehn P, Neuhaus MT, Gellrich NC, Korn P
Clin Oral Investig · 2026 Apr · PMID 42026228 · Full text
OBJECTIVES: Alloplastic reconstruction is often required following segmental mandibular resection (SMR). Hardware-associated complications, especially hardware fractures, almost invariably necessitate explantation. Recen...
OBJECTIVES: Alloplastic reconstruction is often required following segmental mandibular resection (SMR). Hardware-associated complications, especially hardware fractures, almost invariably necessitate explantation. Recent advances in manufacturing techniques promise potential advantages over traditional methods, including increased fracture resistance. However, to date, there is no scientific evidence confirming whether these benefits translate to real-life clinical conditions. MATERIALS AND METHODS: A total of 210 patients underwent SMR followed by alloplastic reconstruction between 2007 and 2019 at Hannover Medical School. The indications for SMR were tumor (n = 208; n = 196 squamous cell carcinoma) and osteoradionecrosis (n = 2). The mean patient age was 60.61 years, with a range of 14 to 89 years. The cohort comprised 146 male patients (69.52%) and 64 female patients (30.48%). Of these, 113 patients underwent reconstruction using hand-bent reconstruction plates (RP), while 97 received patient-specific implants (PSI). The incidence of hardware-related complications (HRC) was compared between the RP and PSI groups. RESULTS: HRC occurred in 72 cases (34.29%). Exposure of the implant accounted for 47 cases (22.38%) while fractures occurred in 18 cases (8.57%), showing no significant difference between PSI and RP. Time from diagnosis until resection and reconstruction was not delayed due to the use of PSI. CONCLUSIONS: The choice of alloplastic manufacturing method does not affect HRC rates. PSI is offering benefits beyond fracture resistance and does not delay SMR. CLINICAL RELEVANCE: HRC remain challenging and may additionally impair patients' quality of life. In particular, hardware fractures often necessitate additional surgical interventions, underlining the need to identify the factors that contribute to their occurrence. To the best of the author's knowledge, this is the largest cohort study comparing RP and PSI with respect to HRC.
Efficacy of artificial saliva in preventing oral changes in patients admitted to the ICU: a controlled clinical trial.
Martins ED, Rebouças NIC, Dos Santos SQM … +8 more , Pereira TBF, da Câmara RO, do Rosário Avelino Bezerra Silva M, Guará AMB, Queiroz ACG, de Almeida AR, De Santis Ferreira L, da Silveira EJD
Clin Oral Investig · 2026 Apr · PMID 42026217 · Full text
OBJECTIVE: To evaluate the effect of prophylactic artificial saliva application on the prevention of oral changes in patients admitted to the Intensive Care Unit (ICU). MATERIALS AND METHODS: This controlled clinical tri...
OBJECTIVE: To evaluate the effect of prophylactic artificial saliva application on the prevention of oral changes in patients admitted to the Intensive Care Unit (ICU). MATERIALS AND METHODS: This controlled clinical trial was conducted in an ICU between October 2024 and May 2025. Patients were assigned to an Experimental Group (EG), which received topical artificial saliva after standard oral hygiene, and a Control Group (CG), which underwent oral hygiene only. Statistical analyses were performed using Jamovi, SPSS, and Stata. Fisher’s exact test, Kaplan–Meier survival analysis with log-rank test, and Poisson regression were applied, adopting a significance level of p < 0.05. RESULTS: Among the 46 patients analyzed (21 in EG and 25 in CG), oral changes occurred in 61% during hospitalization. The Control Group developed significantly more lesions than the Experimental Group (p = 0.023), showing a 29% higher occurrence of changes. Oral candidiasis (24.1%) and dry mouth (20.2%) were more frequent in the CG, whereas traumatic ulceration predominated in the EG (51.6%). CONCLUSION: The prophylactic use of artificial saliva was associated with a lower occurrence of oral changes in critically ill patients and may represent a simple and potentially cost-effective supportive intervention in the ICU setting. CLINICAL RELEVANCE: The findings suggest that prophylactic use of artificial saliva may contribute to reducing oral complications in critically ill patients. As a simple and low-cost intervention, it has the potential to support oral care strategies in ICU settings; however, further studies are needed to confirm its effectiveness and inform clinical protocols.
Construction and validation of a patient-centered data governance platform for multimodal dental implant data management.
Chen S, Zeng P, Chen Y … +7 more , Zhu Y, Gong Z, Lin Y, Xie R, Chen Z, Shi M, Chen Z
Clin Oral Investig · 2026 Apr · PMID 42024292 · Publisher ↗
OBJECTIVES: To address the challenge of managing diverse multisource data in dental implantology, this study aimed to construct and validate a patient-centered, time series-based data governance framework. MATERIALS AND...
OBJECTIVES: To address the challenge of managing diverse multisource data in dental implantology, this study aimed to construct and validate a patient-centered, time series-based data governance framework. MATERIALS AND METHODS: We established a dental implant time series model and defined a unified dental implantation standard dataset. A MySQL-based governance platform was developed with a user-friendly interface. Usability was evaluated through a within-subject crossover study involving 8 implant dentists performing four representative clinical tasks and comparing the platform against conventional tools, with outcomes measured by task completion time and System Usability Scale (SUS) scores. Additionally, the framework’s utility was assessed through its application in research and education. RESULTS: The standard dental implantation dataset contained 715 common data elements for interpreting multisource heterogeneous dental implant data. The dental implant platform allowed users to perform various patient data management tasks, effectively organizing multimodal data along the dental implant time series. Usability testing demonstrated significant efficiency and user satisfaction gains: task completion time decreased by 21.9–38.1% across all the scenarios (P < 0.05), with mean SUS scores of 76.88 ± 4.77, indicating high clinical acceptability. In addition, we explored the research utility of the data in evidence-based epidemiological studies and artificial intelligence applications. CONCLUSION: This study establishes a validated, standardized framework for clinical data governance that significantly improves clinical data management efficiency and user satisfaction, offering a replicable model for specialty-specific medical data governance. CLINICAL RELEVANCE: The platform enhances real-world data accessibility providing high-quality structured data to support clinical decision-making, education, and future AI applications in implant dentistry.
Correction to: Comparison of injectable platelet-rich fibrin, titanium platelet-rich fibrin, and 0.8% hyaluronic acid applications versus periodontal dressing alone in wound healing after gingivectomy and gingivoplasty operations: randomized controlled clinical study.
Atagün ÖS, Bahar ŞÇ, Şen SC … +4 more , Ustaoğlu G, Özcan E, Güzel ZC, Inceöz M
Clin Oral Investig · 2026 Apr · PMID 42024196 · Full text
Abstract loading — click title to view on PubMed.
Soft tissue changes in upper incisors from tooth movements using a new measurement method based on digital scans superimposition in adult patients.
Sastre-Buades L, García-Sanz V, Tarazona-Álvarez B … +5 more , Zamora-Martínez N, Camañes-Gonzalvo S, Montiel-Company JM, Paredes-Gallardo V, Bellot-Arcís C
Clin Oral Investig · 2026 Apr · PMID 42024173 · Full text
OBJECTIVE: To develop a novel digital method to quantify changes in the free gingiva following tooth movement, to measure upper incisor movements by superimposing pre- and post-treatment intraoral scans, and to explore t...
OBJECTIVE: To develop a novel digital method to quantify changes in the free gingiva following tooth movement, to measure upper incisor movements by superimposing pre- and post-treatment intraoral scans, and to explore the relationship between tooth movements and gingival changes. MATERIALS AND METHODS: An observational and descriptive-analytical study was conducted on 31 patients, analyzing 124 upper central and lateral incisors. Dental movements (protrusion, retrusion, retroclination, proclination, extrusion, intrusion, rotation, and inclination) and gingival changes (apical or coronal migration) were quantified by superimposing intraoral scans using GOM Inspect and Geomagic Wrap software. RESULTS: Changes in crown proclination were associated with coronal displacement of the clinically visible gingival margin (r = 0.560), whereas changes in crown retroclination were associated with apical displacement (r = - 0.275). A positive association was also observed between apical displacement and age (r = 0.216). No significant associations were found for tipping, rotation, extrusion, or intrusion. CONCLUSIONS: A digital STL-based method was used to quantify crown tooth movement and relative changes in the position of the clinically visible gingival margin. Changes in crown proclination and retroclination were associated with coronal and apical displacement of the gingival margin, respectively, and should be interpreted as correlational findings. CLINICAL RELEVANCE: This digital method allows precise assessment of gingival changes during orthodontic treatment, helping clinicians predict and minimize soft tissue alterations related to incisor movements.
Microbiome in adult severe caries and cross-kingdom biofilms validation.
Jiang L, Tang Y, Xu L … +5 more , Wei Y, Liu M, Che X, Xin R, Zhu Y
Clin Oral Investig · 2026 Apr · PMID 42024170 · Publisher ↗
OBJECTIVES: Adult severe caries (ASC) is a form of rampant caries that develops in adulthood, causing severe impairment of oral function and reducing quality of life. However, the pathogenic mechanism of ASC remains uncl...
OBJECTIVES: Adult severe caries (ASC) is a form of rampant caries that develops in adulthood, causing severe impairment of oral function and reducing quality of life. However, the pathogenic mechanism of ASC remains unclear. This study aimed to identify the core microbiota in patients with ASC and preliminarily investigate the microbial interactions and pathogenicity of key ASC-associated core microorganisms. MATERIALS AND METHODS: Saliva samples were collected from 7 adult patients with severe caries and 6 caries-free volunteers for metagenomic analysis. Based on microbiome profiling results, an in vitro cross-kingdom biofilm model composed of Streptococcus mutans (S. mutans), Candida albicans (C. albicans) and Veillonella parvula (V. parvula) was established to simulate a high caries-risk microenvironment. Scanning electron microscopy (SEM), crystal violet (CV) staining, and live/dead bacterial staining were used to evaluate biofilm formation. Acid production assays, acid stress challenge tests, confocal laser scanning microscopy (CLSM) and qRT-PCR were performed to analyze the acidogenicity and synthesis of extracellular polysaccharides (EPS). Additionally, atomic force microscopy (AFM) was used to assess the surface roughness of demineralized dentin slices. RESULTS: Metagenomic analysis revealed significant enrichment of C. albicans and V. parvula in the saliva of patients with high caries susceptibility. The in vitro cultured cross-kingdom biofilms exhibited enhanced growth and EPS synthesis compared with single-species S. mutans biofilms. Moreover, cross-kingdom biofilms significantly increased surface roughness of demineralized samples, with a stronger effect than single- and dual-species biofilms. CONCLUSIONS: Colonization by C. albicans and V. parvula increases biofilm biomass, enhances microbial survival under stress, and elevates biofilm virulence, which induces demineralization of dentin slices in vitro. CLINICAL RELEVANCE: This study demonstrates that the interspecies interactions among caries-related microorganisms in ASC patients confer enhanced virulence and cariogenicity, providing novel insights for the investigation and prevention of high caries susceptibility.
Automated detection of C-shaped canals in mandibular second molars from panoramic radiographs: comparing single and ensemble convolutional neural networks within a 2-stage pipeline.
Çakmak YE, Er K
Clin Oral Investig · 2026 Apr · PMID 42020627 · Full text
OBJECTIVES: This study aimed to develop and validate a two-stage deep-learning workflow that automatically localizes mandibular second molars on panoramic radiographs and classifies C-shaped canal presence as an explaina...
OBJECTIVES: This study aimed to develop and validate a two-stage deep-learning workflow that automatically localizes mandibular second molars on panoramic radiographs and classifies C-shaped canal presence as an explainable, clinically deployable decision-support tool. MATERIALS AND METHODS: A total of 1,252 panoramic radiographs (2015–2025) were retrieved from a digital archive. Stage 1 employed YOLOv8 to detect teeth #37 and #47. Stage 2 applied three CNNs (DenseNet-169, EfficientNet-B6, ConvNeXt-Base) and ensemble approaches to classify C-shaped canals on YOLO-derived crops. Data were split 70/15/15 for training/validation/testing. Detection was evaluated using IoU and mAP; classification via accuracy, sensitivity, specificity, F1-score, and AUC. Pairwise AUC comparisons used DeLong test with Bonferroni correction. Grad-CAM provided visual explanations. RESULTS: YOLOv8 achieved high localization performance, reliably supplying regions of interest to classifiers. ConvNeXt-Base demonstrated the most consistent discrimination with top-tier accuracy and F1-score. A binary EfficientNet-ConvNeXt ensemble performed comparably to the best individual model, while the tertiary ensemble showed no improvement. DeLong analysis revealed statistically significant AUC advantage of ConvNeXt-Base over DenseNet-169 for tooth #47 after correction. CONCLUSIONS: This two-stage pipeline enables accurate, automation-ready detection of C-shaped canals from routine panoramic radiographs, potentially informing patient triage and CBCT indication decisions. Multicenter validation is warranted before clinical deployment. CLINICAL RELEVANCE: This AI system offers a practical screening tool using existing panoramic radiographs to identify high-risk patients, potentially improving treatment planning efficiency, reducing unnecessary CBCT referrals, and alerting clinicians to complex anatomy before endodontic therapy.
Enhanced efficacy of oral hygiene instructions during motivational interviewing using intraoral scanner technology: a randomized clinical trial.
Lanzetti J, Ferrati F, Crupi A … +3 more , Gibello U, Roccuzzo A, Pera F
Clin Oral Investig · 2026 Apr · PMID 42020615 · Publisher ↗
OBJECTIVES: To investigate the efficacy of an intra-oral scanner (IOS) as adjunctive tool to perform oral hygiene instructions during motivational interviewing (MI). METHODS: A randomized controlled clinical trial (RCT)...
OBJECTIVES: To investigate the efficacy of an intra-oral scanner (IOS) as adjunctive tool to perform oral hygiene instructions during motivational interviewing (MI). METHODS: A randomized controlled clinical trial (RCT) was performed in patients diagnosed with periodontitis Stage I-II, Gade A-B. Full Mouth Plaque Score (FMPS) (primary outcome) and Full Mouth Bleeding Score (FMBS) were recorded ad baseline (T0). Consequently, test group was scanned with an IOS, a digital 3D model created and was used during MI including oral hygiene instructions (OHI), while control patients received MI only. After ≥ 66 days (mean: 72 days) (T1), FMPS and FMBS as well as patients’ level of adherence and concordance by means of dedicated questionnaires were assessed and compared to T0. RESULTS: A total of 80 patients (mean age 58.2 ± 15.2; 47 female; 62 non-smokers; 18 light smokers) were randomized and available for analysis. Mean FMPS change was 16.65 ± 22.95 for the test group and 6.98 ± 19.41 for the control group (p = 0.045), while FMBS change was 6.77 ± 7.30 for the test group and was 4.64 ± 12.87 for the control group (p = 0.366). Time for MI was 24.02 ± 1.60 min (Test group) and 22.52 ± 1.79 (Control group) (p < 0.001). Patients’ adherence, recorded as interdental care, showed a statistically significant difference in favor of the test group (test group: “yes”=37 (92.5%); “no”=3 (7.5%); control group: “yes”=23 (57.5%); “no”=17 (42.5%) (p < 0.001)). CONCLUSION: Within the limits of this RCT, the implementation of IOS to generate digital three-dimensional models of patients’ dentition demonstrated potential for improving the effectiveness of OHI during a single-session MI in terms of FMPS reduction. CLINICAL SIGNIFICANCE: The incorporation of intraoral scanning technology may represent a beneficial visual adjunct that strengthens patient-clinician communication and could contribute to enhanced self-performed oral hygiene, improved plaque control, and increase patient adherence.
Retraction Note: Adjunctive therapea - a promising method in the treatment of periodontal disease.
Margaryan V, Aghasyan E, Yessayan L … +3 more , Khachatryan H, Bollen C, Hakobyan G
Clin Oral Investig · 2026 Apr · PMID 42020599 · Publisher ↗
Abstract loading — click title to view on PubMed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe