The objective of this systematic review was to synthesize evidence on the early clinical exposure (ECE) and its effectiveness, student experiences, and outcomes in undergraduate dental education. In August 2025, the systematic search was carried out in PubMed, Scopus, and Web of Science. The quantitative, qualitative, and/or mixed-methods peer-reviewed studies evaluating ECE to undergraduate dental students were included. Summary synthesis of included studies was carried out. The risk of bias and quality assessment was assessed with Cochrane Risk of Bias 2, ROBINS-I tool, Joanna Briggs Institute, and Critical Appraisal Skills programme. Nine studies (2007- August 2025) from a range of countries were included. ECE interventions were chairside demonstration, peer-assisted shadowing, simulation, clinical/community placements, and hybrid models. There is evidence of effectiveness of ECE in knowledge, psychomotor skills, and affective domains. In addition, student experiences were reported as positive and significant increases in satisfaction, confidence, motivation, clinical reasoning and other learning gains such as professional identity, empathy, and communication. Six out of nine included studies were non-randomized studies. All the non-randomized studies were reported methodological biases, including small single-center samples, self-report measures, short follow-up periods, and rated as some concern and high risk of bias. ECE in undergraduate dental education promising contribution to the cognitive, psychomotor, and affective domains and reduces transition stress to clinical training. However, presence of methodological bias in included studies undermines the evidence. Future studies with robust objective performance measures, multicentre designs, and longitudinal follow-up should be carried out to better establish the educational and clinical impact of ECE in dental education.
Early distinction between oral squamous cell carcinoma (OSCC) and possibly malignant disorders (PMDs) has been one of the most important diagnostic issues that may involve invasive biopsies. Therefore, it is of interest to assess the usefulness of salivary lactate dehydrogenase (LDH) and matrix metalloproteinase-9 (MMP-9) as non-invasive biomarkers of early detection. Spectrophotometry and ELISA were used in analyzing saliva samples of 135 participants (50 OSCC, 45 PMDs, 40 controls). The level of LDH and MMP-9 was much greater in OSCC than in PMDs and controls and demonstrated very high diagnostic accuracy (AUC > 0.89). Simultaneous biomarker measurement had better sensitivity and specificity indicating their possible use as well-grounded, non-invasive measures of screening oral cancer in its early stages.
Background Porphyromonas gingivalis (P. gingivalis) is a key pathogen in chronic periodontitis that drives dysbiosis and tissue destruction. Anaerobic culture often underestimates fastidious bacteria, whereas real-time polymerase chain reaction (RT-PCR) can provide higher sensitivity and accurate quantification. This study compared both methods for detecting and quantifying P. gingivalis in subgingival plaque from patients with chronic periodontitis and healthy controls. Methodology In total, 32 participants (16 with chronic periodontitis and 16 healthy) were included. Pooled subgingival plaque samples were analyzed by anaerobic culture on selective media and by RT-PCR targeting the 16S rRNA gene with a TaqMan probe and standard curve quantification. Clinical parameters were recorded (probing depth (PD), clinical attachment loss (CAL), and gingival index (GI)), and data were analyzed using t-tests, chi-square tests, Pearson's correlation, and diagnostic metrics. Results Participants with chronic periodontitis had significantly higher clinical parameters (PD = 6.38 ± 0.96 mm, CAL = 3.63 ± 1.09 mm, GI = 2.50 ± 0.22; all p = 0.001) and P. gingivalis loads (culture = 82.13 ± 54.26 CFU/mL, p = 0.031; RT-PCR = 97.44 ± 59.02 CFU equivalents/mL, p = 0.039) than controls. Bacterial load showed moderate positive correlations with clinical parameters (r = 0.35-0.42, p < 0.05). RT-PCR detected P. gingivalis in 59.4% of samples versus 50% by culture, achieving 100% sensitivity and 90.6% accuracy. Conclusions RT-PCR is more sensitive than culture for P. gingivalis detection, supporting its use for improved periodontal diagnosis and risk assessment.
Alveolar osteitis (AO) is a common and painful complication following mandibular third molar extraction, often resulting in delayed healing and increased postoperative morbidity. Platelet-rich fibrin (PRF) has been proposed as a biologically active adjunct that can enhance socket healing and stabilize postextraction blood clots. This systematic review and meta-analysis aimed to evaluate the effectiveness of PRF in preventing AO after mandibular third molar extraction. A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and Google Scholar from database inception to the most recent update. Randomized controlled trials comparing PRF application with no PRF or conventional extraction care and reporting AO incidence were included. Data extraction and risk-of-bias assessment were performed independently using the Cochrane Risk-of-Bias 2 tool. A meta-analysis was conducted using a random-effects model, and effect estimates were expressed as risk ratios (RRs) with 95% confidence intervals (CIs). Sensitivity analysis for unmeasured confounding was performed using the E-value approach. Seven randomized controlled trials involving 776 extraction sites (388 PRF and 388 control) were included. The meta-analysis demonstrated a significant reduction in AO incidence with PRF application (RR = 0.33; 95% CI = 0.20-0.55; p < 0.05), corresponding to an approximately 67% reduction in relative risk. Heterogeneity among studies was negligible, and funnel plot inspection, along with Egger's test, suggested a low likelihood of publication bias. The certainty of evidence for the primary outcome was rated as moderate. Sensitivity analysis yielded an E-value of 5.51, indicating the robustness of the observed effect to potential unmeasured confounding. Within the limitations of the available evidence, PRF appears to be a safe and effective adjunct for reducing the incidence of AO following mandibular third molar extraction. Further standardized, high-quality trials are warranted to optimize the clinical protocols and confirm the long-term benefits.
Background Dental caries and oral candidiasis are among the most common oral diseases and are primarily associated with Streptococcus mutans and Candida albicans. Growing concerns regarding antimicrobial resistance and the adverse effects of synthetic antimicrobial agents have increased interest in plant-derived alternatives. This study evaluated and compared the antimicrobial efficacies of aqueous extracts of Abrus precatorius and Achyranthes aspera against Streptococcus mutans and Candida albicans. Methodology An in vitro experimental study was conducted using aqueous extracts from the leaves of Abrus precatorius and Achyranthes aspera. The antimicrobial activity against Streptococcus mutans (ATCC 25175) and Candida albicans (ATCC 10231) was assessed using the agar well diffusion method. Chlorhexidine and nystatin served as positive controls for antibacterial and antifungal testing, respectively, and distilled water served as the negative control. Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Data were analyzed using one-way analysis of variance followed by Tukey's post-hoc test and independent-samples t-test. Results Significant differences in antimicrobial activity were observed among the groups (p < 0.001). Against Streptococcus mutans, Abrus precatorius demonstrated a larger mean zone of inhibition (18.42 ± 1.58 mm) than Achyranthes aspera (15.16 ± 1.47 mm), although chlorhexidine exhibited the greatest antibacterial activity (24.31 ± 1.32 mm). Similarly, against Candida albicans, Abrus precatorius produced a larger inhibition zone (16.87 ± 1.36 mm) than Achyranthes aspera (13.92 ± 1.41 mm), whereas nystatin showed the highest antifungal activity (22.74 ± 1.24 mm). Abrus precatorius also demonstrated significantly lower MIC values against both microorganisms, indicating a greater antimicrobial potency. Conclusions Both aqueous plant extracts exhibited significant antibacterial and antifungal activity. Abrus precatorius showed superior antimicrobial efficacy compared to Achyranthes aspera; however, both extracts were less effective than the standard antimicrobial agents. These findings suggest the potential application of these herbal extracts in the development of oral healthcare products.
