Abstract Background Restoration of endodontically treated teeth (ETT) with significant coronal loss poses a challenge in clinical dentistry. Advances in CAD/CAM technology and biomimetic materials have introduced minimally invasive approaches, such as endocrowns and overlays, which can replace traditional post-core and crown approach. Aim The aim of this in-vitro study was to comparatively assess the mechanical behaviour of two restorative designs (endocrowns and overlays) fabricated from two CAD/CAM materials in endodontically treated mandibular molars. Materials and methods Thirty-six endodontically treated lower molars (n = 36) were split into two main groups based on restoration type (n = 18): endocrowns and overlays. Each group was further subdivided into two subgroups based on the CAD/CAM material (n = 9): lithium disilicate (Tessera) and indirect composite (Crios). Restorations were fabricated and bonded to their respective specimens following a strict bonding protocol with an adhesive resin cement (Bisco self-adhesive). Thermo-mechanical aging (Chewing Simulator CS-4, SD Mechatronic) was conducted to simulate oral conditions, followed by a universal testing machine's evaluation of fracture resistance. The test was stopped after fracture. Fractured parts were analysed to determine mode of failure. Data were analyzed using two-way ANOVA followed by Tukey’s honestly significant difference (HSD) test for pairwise comparisons (α = 0.05). Results All specimens survived the 5,000 chewing cycles, simulating early intraoral service. Fracture resistance test showed significantly higher fracture resistance for overlays (2048.46 ± 664.63 N) than endocrowns (1234.54 ± 338.50 N) (p = 0.002). Crios overlays exhibited the highest fracture resistance (2384.60 ± 631.10 N), significantly outperforming Tessera overlays (1712.33 ± 559.59 N) (p = 0.043) and endocrowns (1354.20 ± 346.88 N) (p = 0.004). No substantial material change was seen in endocrown restorations (p = 0.445). Conclusion Overlay restorations and indirect composite material (Crios) provide superior resistance to fracture compared to lithium disilicate overlays and endocrowns and may represent a reliable restorative option for endodontically treated molars.
Periodontitis is commonly known as a chronic inflammatory disease which adversely affects pulpal and periodontal tissues, including odontoblasts. Bone marrow mesenchymal stem cell-derived exosomes (BM-MSC-Exo) and nanocurcumin (NCUR) possess anti-inflammatory and regenerative properties; however, their combined effects on odontoblasts remain insufficiently explored. The research target was to assess the histological, histochemical, and anti-inflammatory effects of BM-MSC-Exo and NCUR-loaded BM-MSC-Exo on odontoblasts of LPS-induced periodontitis in rats. Twenty-eight male albino rats were assigned at random into four groups (n = 7 each): control, periodontitis, periodontitis treated with BM-MSC-Exo, and periodontitis treated with NCUR-loaded BM-MSC-Exo. Periodontitis was induced via intra-periodontal LPS injections. Histological evaluation was performed using hematoxylin and eosin staining, and collagen synthesis was analyzed using Masson’s trichrome stain. Morphometric analysis of newly formed collagen and enzyme-linked immunosorbent assay (ELISA) of interleukin-10 (IL-10) levels were conducted. Untreated periodontitis caused marked odontoblastic degeneration, reduced predentin thickness, and decreased collagen formation. Treatment with BM-MSC-Exo significantly improved odontoblastic architecture, enhanced collagen deposition, and increased IL-10 expression. NCUR-loaded BM-MSC-Exo demonstrated superior regenerative and anti-inflammatory effects, characterized by improved odontoblastic organization, increasing the area of newly formed collagen, and significantly elevated IL-10 levels compared with all other groups (p < 0.001). BM-MSC-Exo exerts regenerative effects on odontoblasts in periodontitis, which are further enhanced by NCUR loading. NCUR-loaded BM-MSC-Exo declares an encouraging cell-free medicinal strategy for regeneration of periodontal and pulpal tissues.
Pit and fissure sealants are widely used for caries prevention; however, their long-term success depends largely on retention. Giomer-based sealants containing surface pre-reacted glass ionomer fillers offer bioactive properties, yet concerns remain regarding their bonding durability when applied with mild self-etch primers. This randomized clinical trial evaluated the effect of bioactive glass air-abrasion pretreatment on the retention and caries preventive efficacy of a giomer-based sealant in young adults over 12 months. This parallel-arm randomized clinical trial included 96 participants, each contributing one eligible sound permanent molar (n = 48 per group). Participants were randomly allocated to either bioactive glass air-abrasion pretreatment followed by application of a giomer-based sealant (intervention group) or application of the same sealant without pretreatment (comparator group). Sealant retention and secondary caries incidence were evaluated at baseline, 6 months, and 12 months using Simonsen’s criteria, and modified United States Public Health Service (USPHS) criteria, respectively. The primary outcome was sealant retention at 12 months, whereas secondary caries incidence was assessed as a secondary outcome. Intergroup comparisons were analyzed using the Chi-square test. Intragroup comparisons were analyzed using Cochran’s Q test followed by multiple comparisons. Relative risk with 95 https://clinicaltrials.gov/ , (NCT06003452), 15-08-2023.
Conventional full-coverage anterior crown preparations for zirconia often require substantial enamel and dentine reduction and may concentrate palatal-cervical stresses, risking marginal discrepancy and compromised seal. A conservative “Mini-skirt” (MS) design that positions the palatal finish line coronally (above the cingulum) could preserve tooth structure and enhance adhesive support, but its thermo-mechanical performance under thermal cycling and fatigue loading remains unclear. To evaluate whether a conservative MS anterior preparation, with a palatal finish line above the cingulum, improves the thermo-mechanical behavior of generation-5 zirconia crowns compared with a conventional full-coverage (CF) design. Sixty extracted maxillary central incisors were randomly assigned to MS or CF groups (n = 30). Monolithic 4Y zirconia crowns were CAD/CAM-manufactured, air-abraded and adhesively luted. Specimens were thermocycled 10,000 times between 5 °C and 55 °C, then obliquely loaded at 45° for 1.7 × 10⁶ cycles (50 N, 2 Hz); survivors underwent static fracture testing (0.5 mm·min⁻¹). Marginal gaps were quantified from silicone replicas; failures were classified Grades I–IV (restorable = I–III). Finite-element models ( 1.3 M elements) reproduced boundary conditions to map stress. The MS preparation endured thermo-mechanical ageing markedly better than CF: 93.3
Early childhood caries (ECC) is one of the most common chronic conditions affecting children worldwide, with more than 530 million children affected. In Qatar, ECC prevalence among preschool children aged 4–5 years is reported at 89
This study aimed to evaluate the efficacy of Er: YAG laser treatment for glass-ceramic bonding to bleached enamel and to further investigate the potential mechanisms. This in vitro study included 132 molars, with each molar used to prepare a single specimen. A total of 48 enamel slices, 48 enamel blocks, and 36 embedded whole-tooth specimens were prepared. The specimens were randomly allocated to four groups: the Control group, hydrogen peroxide (HP) group, HP combined with sodium ascorbate (HP-SA) group, and HP combined with Er: YAG laser (HP-Er: YAG) group. They were subsequently evaluated for enamel surface morphology, residual hydrogen peroxide (H2O2) concentration, resin degree of conversion (DC), resin penetration, shear bond strength (SBS), and failure mode. SEM showed that the HP-Er: YAG group exhibited rough and irregular enamel surfaces, while the HP and HP-SA groups showed no obvious morphological changes. Compared with the HP group (109.60 ± 10.38 µmol/L), H2O2 concentrations were significantly lower in the HP-SA (51.05 ± 20.06 µmol/L) and HP-Er: YAG (29.96 ± 13.01 µmol/L) groups (P < 0.0001). The HP-Er: YAG group showed a lower concentration than the HP-SA group (P < 0.05).The DC of the HP-Er: YAG group (51.10 ± 7.02
This study aimed to compare the calcium hydroxide [Ca(OH)₂] removal efficiency of six irrigation‑activation techniques and conventional syringe irrigation (control) from simulated internal root‑resorptive cavities in vitro. Seventy single-rooted human teeth were standardized to a length of 18 mm, prepared, and split longitudinally. A standardized hemispherical resorptive cavity was created in each root half; the halves were then reassembled and filled with premixed Ca(OH)₂. Specimens were incubated for 7 days and randomly allocated (n = 10) to seven groups: (1) conventional syringe irrigation (control), (2) manual dynamic agitation (MDA), (3) XP‑Endo Finisher, (4) sonic EDDY, (5) sonic EQ‑S, (6) ultrasonic Irrisafe, or (7) ultrasonic Ultra X. In each irrigation protocol, two 30 s activations with 10 mL 2.5
Quantitative light-induced fluorescence (QLF) provides fluorescence-loss and red-fluorescence signals that may behave differently across devices, surfaces, and lesion thresholds. This study compared QrayCam Pro and QrayPen for occlusal and proximal caries in permanent posterior teeth. In this single-centre, paired in vivo diagnostic-accuracy and reliability study, 120 consecutively recruited adults underwent QrayPen and QrayCam Pro imaging. Multiple surfaces could be contributed by one participant. Surface-specific regions of interest in QA2 software generated maximum fluorescence loss (|ΔFmax|) and maximum red fluorescence (ΔRmax). Occlusal surfaces were classified using ICDAS and proximal surfaces using bitewing-based International Caries Classification and Management System (ICCMS)-oriented categories. Agreement was evaluated on 194 occlusal and 397 proximal paired measurements. Diagnostic analyses included 181 occlusal surfaces with complete ICDAS scores and all 397 proximal surfaces. AUC confidence intervals and paired AUC contrasts were estimated by 10,000 participant-cluster bootstrap resamples; Holm adjustment was applied across four paired contrasts within each surface-threshold family. At ICDAS ≥ 1, QrayCam |ΔFmax| and QrayPen |ΔFmax| yielded AUCs of 0.909 (95
Maxillary lateral incisor agenesis, peg-shaped lateral incisors, impacted canines, and cleft lip and palate frequently involve the maxillary lateral incisor–canine region and often show side-related distribution patterns. Whether trabecular bone structure within this region differs between sides in clinically healthy individuals remains unclear. This study evaluated right–left differences in maxillary trabecular bone structure using fractal analysis. Panoramic radiographs of 88 adults (43 males, 45 females; 18–40 years) with Class I occlusion and no dental, skeletal, or orofacial anomalies were retrospectively analyzed. Bilateral polygon-shaped ROIs were defined between the maxillary lateral incisor and canine roots. As methodological validation, standardized 20 × 20 pixel square ROIs were additionally analyzed. FD values were calculated using the ImageJ box-counting method. Inter-observer reliability was assessed by two independent oral and maxillofacial radiologists using the intraclass correlation coefficient (ICC) and Dahlberg error. Right–left comparisons were performed using paired-samples t-tests or Wilcoxon signed-rank tests. Associations with age and sex were also evaluated. Using anatomically defined freehand ROIs, FD values were significantly higher in the left maxillary region than in the right (0.77 ± 0.23 vs. 0.70 ± 0.25; mean paired difference = 0.07, 95
Ti-base abutments with angulated screw channel (ASC) designs have been developed to address the esthetic challenges associated with labial screw access in anterior implant-supported single crowns, as well as the ergonomic limitations caused by restricted mouth opening in posterior crowns. Despite their increasing clinical use, there is limited research evaluating the impact of this design on the fracture resistance of various monolithic restorative materials across different anatomical regions, particularly after aging. This study aims to investigate the effect of angled screw channel design on the fracture resistance of implant-supported single crown restorations made of different materials in different anatomical regions after long-term thermal aging. In the study, a total of 80 implant-supported single crown restorations were prepared and then divided into subgroups (n = 10) considering anatomical region (anterior/posterior), restoration material (monolithic zirconia/lithium disilicate), and screw channel design (straight 0°/angled 20°). Monolithic zirconia and lithium disilicate crowns were fabricated in the form of maxillary central incisors for anterior, and mandibular first molars for posterior specimens. After cementation on Ti-base abutments, the specimens were aged with 40,000 thermal cycles (5°C/55°C), and the fracture resistance of the crowns was subsequently determined using a universal testing machine under compressive loading. Fracture patterns were examined under a stereomicroscope. Three-way analysis of variance followed by a Bonferroni post hoc test was used in data analysis (α = 0.05). According to the results, anatomical region, restorative material, screw channel design, and the interactions between these variables had a significant effect on the fracture resistance of implant-supported single crown restorations (p < 0.001). The use of ASC design reduced the fracture resistance of the restoration material in all groups, regardless of anatomical region and material type (p < 0.001). In the anterior region, using the ASC design resulted in a statistically significant strength loss, which was similar across all materials. In the posterior region, although zirconia material showed significantly higher fracture strength than lithium disilicate, the strength loss was more pronounced. The fracture loads observed in all specimens remained within reported physiological bite force ranges under the present experimental conditions. In conclusion, although the ASC design offers clinical advantages for implant-supported restorations, its effect on reducing the mechanical strength of the restorative material should be taken into account in clinical practice. While the fracture loads observed in this study remained within physiological limits, further investigations under long-term and in vivo conditions are warranted.
Accurate preoperative assessment of the spatial relationship between mandibular third molars (M3Ms) and the inferior alveolar canal (IAC) is essential to minimize the risk of nerve injury. While panoramic radiographs (PRs) are routinely used as a first-line modality, their two-dimensional nature limits diagnostic reliability, often necessitating confirmatory cone-beam computed tomography (CBCT). We developed a dual-stream, transformer-enhanced multimodal (panoramic radiography + selected CBCT slices) deep learning framework designed as a clinician-in-the-loop system. The model jointly processes paired panoramic radiographs and operator-selected CBCT slices to simulate a realistic specialist consultation. Four widely used high-performance backbones (ConvNeXt, Swin Transformer, ResNet-50, and VGG16) were systematically evaluated on a dataset of 250 paired PR–CBCT cases. Model performance was assessed using F1-score, precision, recall, and area under the ROC curve (AUC). Model interpretability was explored using SHAP-based explainability analysis. Among the evaluated architectures, the ConvNeXt-based model achieved the highest overall performance, with a macro F1-score of 0.9478, precision of 0.9515, and recall of 0.9468. The learned embeddings showed good class separability, and explainability analyses highlighted anatomically meaningful regions consistent with established radiographic risk signs. The proposed multimodal 2D framework demonstrates competitive and robust classification performance. By integrating expert slice selection with automated feature extraction, the model functions as a standardized decision-support tool, aimed at reducing diagnostic variability in complex boundary cases where visual interpretation alone may be subjective.
Abstract Background Adequate peri-implant soft tissue thickness and keratinized mucosa width are crucial for implant health and aesthetics. Autogenous subepithelial connective tissue grafts (CTG) are the gold-standard for augmenting thin biotypes, but they require a second surgical site. This trial evaluated whether a human fascia lata allograft (FLA) or platelet-rich fibrin (PRF) membrane could comparably enhance peri-implant soft tissue phenotype and serve as less invasive alternatives of CTG. Methods Forty-five patients with a thin gingival phenotype (≤ 1 mm thickness) requiring upper anterior implant were randomly assigned to receive soft tissue augmentation with either (1) FLA allograft, (2) PRF membrane, or (3) CTG (control). Interventions were applied concurrently with implant placement in a standardized manner. Gingival thickness (GT) and keratinized tissue width (KTW) were measured at baseline and 6 months using transgingival probing and clinical indices. Labial bone thickness was assessed by cone-beam CT at implant placement and 6 months. Results Forty-five enrolled patients completed the study. All treatment modalities showed improvements in gingival and bone parameters, with the connective tissue graft consistently demonstrating the greatest gains. The median keratinized tissue width increased to 4.00 mm in the Connective Tissue Graft group, slightly higher than the Fascial Lata Allograft and Platelet-Rich Fibrin groups (3.75 mm). Gingival thickness showed significant increases in all groups, with the Connective Tissue Graft reaching 2.15 mm, followed by Fascia Lata Allograft (1.80 mm) and Platelet-Rich Fibrin (1.55 mm). Labial bone thickness also increased, with the Connective Tissue Graft achieving the highest mean value of 2.300 mm, and after 6 months, significant gains were observed in both this group ( p = 0.032) and in the Platelet-Rich Fibrin group ( p = 0.044), while Fascia Lata Allograft showed a smaller, non-significant increase. Conclusions Both fascia lata allograft (FLA) and PRF improved peri-implant soft tissue parameters, however the connective tissue graft (CTG) remains the gold standard for achieving the greatest thickness and best aesthetic results. FLA is a promising alternative that avoids a second surgical site with comparable outcomes, whereas PRF offers faster healing but lacks the volume necessary for significant tissue modification.
Abstract Background Screw loosening and implant-abutment interface (IAI) are critical for the long-term success of implant-supported restorations. This study aimed to evaluate the effect of abutment manufacturing technique on reverse torque values and micro-gap measurements at the implant-abutment interface. Methods Thirty dental implant-abutment-crown complexes (Implance, Verdent, Turkey) were randomly allocated into three groups ( n = 10 each) based on the abutment manufacturing technique: Group I—prefabricated titanium abutments (manufacturer-supplied, Implance, Verdent, Turkey; titanium grade 5 ) ; Group II—CAD-CAM-milled titanium abutments; Group III—3D-printed titanium abutments (Selective Laser Melting, SLM). All abutments featured an internal hexagonal connection with platform switching. All crown abutments were tightened to 25 Ncm and subjected to cyclic loading (100 N, 1.6 Hz, 250,000 cycles). Removal torque was measured before and after loading. Micro-gaps at the implant-abutment and abutment-screw interfaces were evaluated using scanning electron microscopy (SEM). Statistical analysis was performed using One-Way ANOVA with Tukey’s Post Hoc test for reverse torque and the Kruskal-Wallis test for gap measurements (α = 0.05). Results After cyclic loading, the 3D-printed (SLM) abutments exhibited significantly higher reverse torque values (11.08 ± 0.11 Ncm) compared to CAD-CAM-milled abutments (6.40 ± 0.79 Ncm) ( P < 0.001). Prefabricated abutments demonstrated the highest post-loading torque values (13.31 ± 0.31 Ncm). All intragroup comparisons showed statistically significant reductions from baseline ( P < 0.0001). No significant difference was found in implant-abutment interface gaps among groups ( P = 0.105). Conclusion Within the limitations of this study, prefabricated abutments demonstrated the highest reverse torque values after cyclic loading. 3D-printed abutments showed significantly greater resistance to torque loss compared to CAD-CAM-milled abutments, approaching the performance of prefabricated abutments. The implant-abutment fit was comparable across groups, suggesting that connection design may be more influential than manufacturing method for macroscopic fit. 3D-printed titanium abutments demonstrated significantly greater mechanical stability than CAD-CAM-milled abutments, approaching the performance of the gold-standard prefabricated abutments. This suggests that additive manufacturing may offer a clinically viable alternative to milling when both customization and mechanical integrity are required. However, clinical studies are needed to confirm these in vitro findings.
Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is the second most prevalent chronic pediatric condition worldwide. Its core ADHD symptoms—inattention, hyperactivity, and impulsivity—impair oral hygiene behaviors, and first-line medications such as methylphenidate may further increase oral disease risk. However, systematic epidemiological data on oral health status of children with ADHD remain limited in China. This study aimed to investigate oral health status of children with ADHD and identify factors associated with adverse oral health outcomes in this population. Methods This case-control study included 130 children with ADHD and 143 age-matched healthy controls (6–12 years old) recruited from Dezhou Maternal and Child Health Hospital, Shandong Province, China, between July and December 2025. Oral examinations assessed dental caries (using the DMFT index for permanent teeth and dmft index for primary teeth, collectively reflecting the mixed-dentition caries burden), caries activity (Cariostat), periodontal status (Plaque Index [PI], Modified Gingival Index [MGI]), malocclusion, and dental trauma. Parent-reported questionnaires collected data on oral health behaviors, socioeconomic characteristics, and medication use. Between-group differences were analyzed using the Mann-Whitney U test, chi-square test, and Fisher exact test. Multivariate logistic regression with backward likelihood ratio selection was used to examine factors associated with adverse oral outcomes after adjusting for confounders. The English versions of the questionnaires are provided in Supplementary Files 1 and 2. Results The ADHD group had significantly higher overall dental caries prevalence (80.77% vs. 52.45%, P < 0.001), higher median DMFT+dmft scores (3 vs. 1, P < 0.001), higher plaque index (PI) scores (2 vs. 1, P < 0.001), higher modified gingival index (MGI) scores (2 vs. 1, P < 0.001), and higher Cariostat values ( P < 0.0001) than the control group. In contrast, the fissure sealant rate was significantly lower in the ADHD group (6.15% vs. 47.29%, P < 0.001). Multivariate analysis showed that methylphenidate use (adjusted odds ratios [aOR] = 39.65, 95% CI : 15.79–271, P < 0.001) and frequent candy consumption ( aOR = 84.54, 95% CI: 12.2 –584, P < 0.001) were associated with higher odds of dental caries in the adjusted model. In contrast, a higher parental education level (college degree or above) was associated with lower odds of dental caries ( aOR = 0.10, 95% CI : 0.014–0.684, P = 0.019). Perfunctory toothbrushing ( aOR = 8.78, 95% CI : 3.12–24.71, P < 0.001) was associated with higher odds of poor oral hygiene (PI ≥ 2), whereas higher household income ( aOR = 0.29, 95% CI : 0.12–0.74, P = 0.009) and twice-daily toothbrushing ( aOR = 0.14, 95% CI : 0.05–0.43, P = 0.001) were associated with lower odds of poor oral hygiene (PI ≥ 2). For gingivitis (MGI ≥ 2), higher household income ( aOR = 0.33, 95% CI : 0.13–0.84, P = 0.019) and parental supervision of toothbrushing ( aOR = 0.11, 95% CI : 0.04–0.31, P < 0.001) were associated with lower odds of gingivitis, whereas longer disease duration ( aOR = 11.30, 95% CI : 3.78–33.75, P < 0.001) was associated with higher odds of gingivitis. Notably, the wide confidence intervals for these adjusted odds ratios indicate limited precision for quantifying exact effect magnitudes, and the case-control design precludes causal inference; all reported associations should therefore be interpreted with caution. Children with ADHD in this cohort exhibited significantly poorer oral health than healthy controls, characterized by higher rates of dental caries, poorer oral hygiene, and more severe gingival inflammation. These adverse oral health outcomes were associated with ineffective oral hygiene practices, frequent high-sugar dietary habits, ADHD-related neurobehavioral characteristics, and socioeconomic factors. Comprehensive oral health interventions integrating preventive clinical care, behavioral support, family involvement, and socioeconomic assistance are urgently needed for this population.
Preterm prelabor rupture of membranes (PPROM) is a multifactorial obstetric complication that contributes significantly to neonatal morbidity and mortality. Recent evidence suggests that systemic inflammation and periodontal health are critical determinants in the etiology of PPROM. However, conventional predictive methods often fail to integrate multidomain data for early risk assessment. This study aimed to develop an ANN-based model to classify PPROM status by integrating hematological inflammatory markers, periodontal indices, and maternal behavioral factors. A multilayer perceptron (MLP)-based artificial neural network (ANN) model was developed using data from 149 women (70 PPROM, 79 controls) and 24 input variables. Hematological parameters were derived from routine clinical blood tests obtained during late pregnancy or at hospital admission prior to delivery, while oral and periodontal indices were assessed within 24 h postpartum. Discriminative performance was evaluated using receiver operating characteristic (ROC) analysis (AUC, sensitivity, specificity), and mean squared error (MSE) was used as the training loss function. The ANN model demonstrated high predictive performance with an MSE of 0.049, an R2 value of 0.82, and an average deviation rate of -0.003
Abstract Background Osteoarthritis (OA) is a complicated autoimmune disease that often causes invasive inflammatory infiltration and serious articular destruction. The global prevalence of temporomandibular disorders (TMDs) is estimated to be around 30% of the population. Several clinical drugs have been reported to have adverse effects ranging from increased inflammation to liver cirrhosis. Even with the introduction of gene therapy, there is still a growing need for therapeutic alternatives for OA. This study aimed to evaluate the effect of dental follicle-derived stem cells (DFSCs) versus gold nanoparticles (AuNPs), on temporomandibular joint (TMJ) osteoarthritis induced by Complete Freund’s Adjuvant (CFA). Methods In this study, for osteoarthritis induction , twice intra-articular injections of complete Freund’s adjuvant (CFA) were performed, once at the beginning of the experiment and again after two weeks. After 4 weeks, the osteoarthritis animals were randomly allocated into three equal groups: osteoarthritis group, osteoarthritis group treated with Nanogold (AuNPs), and osteoarthritis group treated with Dental follicle stem cells (DFSCs). After one month, the TMJs were fixed and processed for staining with hematoxylin and eosin, and the disc thickness was assessed; results were statistically evaluated. Results The osteoarthritis group showed erosion of cartilage and subchondral bone and a thickened disc. Both DFSCs and AuNPs reduced the inflammatory signs. Though statistically non-significant, DFSCs showed a greater reduction in disc thickness. Conclusion This study’s results highlighted the potential use of DFSCs and AuNPs as a promising treatment in TMJ osteoarthritis.
This study aimed to evaluate the diagnostic accuracy of an artificial intelligence (AI)-assisted cone-beam computed tomography (CBCT) analysis system for predicting the spatial proximity of the inferior alveolar nerve (IAN) to impacted mandibular third molars (M3M), using expert radiologist assessment as the reference standard. A retrospective diagnostic accuracy study was conducted on an internal institutional cohort of 312 patients (mean age 28.21 ± 6.62 years; January 2021–December 2024). A deep learning system employing a modified U-Net architecture automatically segmented the IAN canal and M3M on CBCT and classified the IAN–M3M spatial relationship into three categories: no contact (> 2 mm), proximity (0–2 mm), and contact/overlap. Diagnostic accuracy was evaluated on an independent hold-out test set of 486 M3 sites (283 patients). Two senior oral and maxillofacial radiologists provided the reference standard. Sensitivity, specificity, PPV, NPV, AUC, and Cohen’s kappa were calculated; 95
Abstract Background Two-piece hybrid abutment crowns (HACs) are CAD/CAM-fabricated implant restorations adhesively bonded to prefabricated titanium bases (Ti-bases). Since adhesive bond represents a potential weakness, methods to enhance long-term durability are being investigated. The aim of this in vitro study was to evaluate the influence of additional macroretention, specifically a circumferential groove, incorporated into polymer-infiltrated ceramic network (PICN) and zirconia crowns, and two Ti-base sandblasting protocols on adhesive bond strength of HACs. Methods Ninety Ti-bases, 45 zirconia and 45 PICN crowns were divided into six groups ( N = 15). Prior to conventional cementation (Panavia V5, Kuraray) of zirconia control group (Z1), Ti-bases and internal crown surfaces were sandblasted (Al₂O₃; 50 μm; 1.0 bar) and treated with MDP primer. In PICN control group (H1), Ti-bases were sandblasted identically and pretreated with Adiva M-Prime. Internal surfaces of PICN crowns were etched (5% hydrofluoric acid) and primed with Adiva C-Prime. In Z2 and H2, a circular groove in the internal crown surface was prepared as a macroretention in addition to conventional pretreatment as performed in Z1 and H1. Z3 and H3 were also conditioned conventionally, as in Z1 and H1, but Ti-bases were sandblasted with 250 μm at 2.0 bar. After sandblasting, surface roughness values (RV) of Ti-bases were measured. Following thermocycling, tensile shear test was performed, and failure mode was analysed. Mean values were compared using t-test. Results RV differed significantly between differently blasted Ti-bases ( p < 0.001). Both crown materials achieved significantly higher mean pull-off forces (Z1: 1085 N ± 79; H1 = 664 N ± 68) in control groups than in groups with macroretention (Z2: 1017 N ± 65; H2 = 438 N ± 48) (Z: p = 0.024, H: p < 0.001), and significantly lower pull-off forces than in groups with rougher Ti-bases (Z3: 1298 N ± 98, H3: 744 N ± 64) (Z: p < 0.001, H: p = 0.0023). Conclusions Increasing pressure and grit size during corundum blasting of Ti-bases can achieve higher pull-off force for zirconia and PICN crowns. Additional macroretention, at least in the form used here, offers no advantage regarding bond strength.
Accurate dental age (DA) estimation is essential in pediatric dentistry, orthodontic treatment planning, and forensic practice; however, the applicability of international reference standards varies across populations. This study aimed to evaluate the accuracy of a population-adapted Nolla method for dental age estimation in children from northwestern Romania and to compare its performance with the original approach. A retrospective analysis was performed on 860 digital panoramic radiographs of children aged 3–15 years. Dental development was assessed using the Nolla staging system, and a third-degree polynomial regression model was developed to estimate chronological age (CA) based on the total Nolla score. Model performance was evaluated using coefficient of determination (R²), five-fold cross-validation, and non-parametric statistical tests. The original Nolla method underestimated CA by approximately 1.5 years. The population-specific model showed strong predictive performance (R² = 0.846; cross-validated R² = 0.84) and close agreement between estimated DA and CA (mean difference 0.000 ± 0.976 years; p = 0.983). Accuracy was stable across most age groups, although larger deviations were observed after 12 years. Girls showed slightly more advanced dental maturation than boys, but differences were clinically small. The proposed population-calibrated equation eliminates systematic bias and provides a reliable tool for dental age estimation in children from northwestern Romania, although external validation is recommended.
Diabetes is of great interest globally, given the associated health and economic costs. It may impact long-term systemic and oral health with unfavourable outcomes when undetected or poorly controlled, leading to various oral manifestations, including premature tooth loss and reduced quality of life. Early detection can enable early diagnosis, intervention and improve treatment and health outcomes. To synthesise evidence on risk‑targeted screening and early case‑detection protocols for Type 2 Diabetes (T2D) that incorporate HbA1c or glucose point-of-care testing (POCT) using finger‑stick (FSB) or gingival crevicular blood (GCB) with a clinical risk assessment, to ascertain the value and potential impact of chair-side testing if implemented in primary care dental settings. Electronic databases were searched using a pre-defined strategy, identifying 21 eligible studies; nine studies focused primarily on identifying at-risk individuals through finger-stick testing and twelve through gingival crevicular blood testing. Returned articles and grey literature were screened and used as supportive material for later discussion. A descriptive synthesis of 21 articles was undertaken, with focus of the review on multi-stage chair-side diabetes screening protocols incorporating risk questionnaires and periodontal examinations and HbA1c or glucose POCT testing. Chair-side HbA1c-or glucose POCT may identify potentially new T2D cases. Identification rates were shown to range between 20-66
