BACKGROUND:Implant placement in the posterior maxilla is often limited by insufficient bone height. This report demonstrates a minimally invasive, guided crestal sinus lift using the Hiossen OneCAS hydraulic system. CASE DESCRIPTION:A 74-year-old female presented with a non-restorable maxillary molar. Extraction, ridge preservation, and guided crestal sinus augmentation were performed using the Hiossen OneCAS system. Implants were simultaneously placed at the molar and premolar sites with successful osseointegration and prosthetic rehabilitation. The guided approach minimized complications and achieved favorable stability and esthetic outcomes despite limited crestal bone height (4.02 mm). PRACTICAL IMPLICATIONS:The Hiossen OneCAS system represents a feasible, minimally invasive approach for guided hydraulic sinus elevation and implant placement in atrophic posterior maxillae, reducing surgical morbidity while supporting prosthetically driven accuracy. Long-term prospective studies are needed to establish predictability and functional outcomes.
OBJECTIVES:The aim of this in vitro study was to evaluate the dentin bond strength of different flowable glass ionomer-based liner materials without surface pretreatment. METHOD AND MATERIALS:Twenty-one extracted human molars were randomly assigned to three groups (n = 7), each receiving a different material (Groups A-C). Mid-coronal dentin surfaces were prepared and standardized using silicon carbide paper to create a uniform smear layer. Three flowable glass ionomer-based liner materials were applied without any surface pretreatment or adhesive system. Cylindrical specimens (2 mm diameter × 2 mm height) were light-cured according to the manufacturers' instructions. After 24 hours of storage at 37 °C and 100% humidity, shear bond strength was measured using a universal testing machine at a crosshead speed of 1 mm/min. Failure modes were evaluated under a stereomicroscope and scanning electron microscopy. Data were analyzed using the Kruskal-Wallis test (α = .05). RESULTS:The mean [±SD] bond strength values were 12.76 [±5.5] MPa for Group A, 12.74 [±6.6] MPa for Group B, and 19.25 [±7.9] MPa for Group C. Although Group C showed numerically higher values, no statistically significant difference was found among the groups (P = .13). Adhesive and mixed failure modes were predominantly observed, whereas cohesive failures were rare. CONCLUSION:Within the limitations of this in vitro study, the evaluated flowable glass ionomer-based liner materials exhibited comparable immediate dentin bond strength under simplified application conditions without surface pretreatment.
INTRODUCTION:The use of lasers in dental implant procedures raises questions regarding the preservation of keratinized tissues and implant outcomes. AIM:This study aimed to compare the clinical effects (pain and impression time) and soft tissue healing (keratinization, peri-implant probing, bleeding, and healing) of diode lasers and scalpels used during second-stage dental implant surgery. MATERIALS AND METHODS:A Prospective randomized clinical trial with a 1:1 allocation ratio was conducted. This study included 30 patients, each with a single, fully osseointegrated implant. Patients were categorized into two groups. The study group underwent second-stage implant surgery using a 970 nm diode laser. In the control group, implants were exposed using a conventional surgical blade. A comparison between the diode laser and conventional scalpel groups was made based on clinical outcomes (pain and impression time) and soft tissue healing (keratinization, peri-implant probing, bleeding, and healing). Data were analyzed using a paired t-test. RESULTS:Pain intensity significantly decreased from immediate postoperative to 7 days in both scalpel (49.87±6.78, t=28.48, df=14, p<0.001) and diode laser (7.67±7.58, t=3.91, df=14, p=0.002) groups. Immediately after surgery, pain scores were significantly higher in the scalpel group compared with the diode laser group (94.53±4.45 vs. 46.93±5.85, t=25.076, df=26.151, p<0.001). Although pain decreased in both groups by day 7, the scalpel group continued to exhibit significantly greater pain (44.67±5.96 vs. 39.27±3.73, t=2.974, df=23.513, p=0.007). Impression time (p=0.231) and gingival keratinized tissue (p=0.736) did not differ significantly between the scalpel and diode laser approaches. At week 6, the scalpel group exhibited a significantly higher mean periimplant bleeding index (2.60 ± 0.507) compared with the laser group (0.667 ± 0.258, p < 0.001). However, after 12 weeks, no significant difference was observed (1.58 ± 0.19 vs. 1.55 ± 0.21, p = 0.748). Laser surgery produced significantly better early wound healing at all intervals (p < 0.001), while intraoperative bleeding was more common with the scalpel technique than with the diode laser (100% vs. 66.7%, p = 0.042). CONCLUSION:Compared with the scalpel method, the diode laser method resulted in a significant reduction in pain intensity, improved wound healing, and less peri-implant bleeding during the second-stage dental implant surgery.
OBJECTIVE:This study examined whether generative artificial intelligence is able to identify and classify gaps in partially dentate jaws according to Kennedy's system and subsequently plan clasp-retained removable dentures. MATERIAL AND METHODS:Data from one hundred partially dentate jaws were extracted from the patient records management system at the Department of Prosthetic Dentistry of the University Medical Center Hamburg-Eppendorf, Germany, and anonymized. The generative artificial intelligence tools that were included in the study comprised OpenAI's customizable "GPTs" (GPT-4o model) and "o1-preview". After prompt engineering and training the GPTs with subject-specific information, three prompts were sent to the models stating the missing teeth in one jaw and requesting a gap analysis, Kennedy classification and planning of clasp-retained removable dentures. The prosthetic planning was also handled by a dentist. A statistical analysis was performed using Cohen's kappa, McNemar's test, Chi-Square Test and standardized residuals (significance level: 0.05). RESULTS:o1-preview correctly identified the gaps in significantly more cases than GPTs (83% vs. 14%, p < .001) and made fewer and different types of errors. o1-preview correctly classified more cases according to their Kennedy class (90%) than GPTs (40%). The degree of agreement with the dentist's treatment plan was 1% for o1-preview and 6% for the GPTs. CONCLUSION:While ChatGPT is not yet capable of reliably planning treatment, these results demonstrate its potential for use in dental diagnostics. For effective integration into clinical workflows, automated workflows through software solutions in dental practices, as well as the option of enhanced prompt insertion, are essential.
OBJECTIVES:To compare the clinical performance of resin infiltration and different pit and fissure sealants in young permanent molars. METHOD AND MATERIALS:This split-mouth randomized controlled trial evaluated 128 permanent molars with non-cavitated occlusal lesions (ICDAS 0-2) in 32 children aged 7-14 years. Teeth were randomly allocated to four groups (n = 32/group): resin infiltration (Group A), moisture-tolerant resin sealant (Group B), flowable nanohybrid composite (Group C), and combination of group A and C (Group D). Outcomes assessed were ICDAS scores, DIAGNOdent values, marginal integrity, marginal discoloration, retention at baseline, 6, and 12 months using generalized estimating equations (GEE) (P < .05). RESULTS:Significant reduction or stabilization in ICDAS scores occurred over time across all groups (P < .001). Group A demonstrated significantly higher likelihood of ICDAS stabilization than Group C (OR = 1.85; 95% CI = 1.10-3.12; P = .021). Group D showed significantly lower lesion progression than Group B (OR = 1.72; 95% CI = 1.05-2.95; P = .034). At 12 months, retention was high, with only 6 teeth requiring revision (Group A: n = 1; Group B: n = 2; Group C: n = 3; Group D: n = 0). No significant intergroup differences in DIAGNOdent values or marginal integrity were observed (P > .05). CONCLUSION:All four evaluated modalities demonstrated significant short-term cariostatic activity. Infiltration-based approaches, particularly the combination approach, demonstrated superior clinical performance by yielding minimal lesion progression, high retention rates, and the lowest incidence of clinical revision in high-caries-risk children.
Post-operative graft infection and subsequent acute maxillary sinusitis are infrequent complications following sinus floor elevation (SFE). However, inadequate management may result in persistent infection with only subtle residual symptoms. This case study presents three patients who developed persistent subclinical graft-related infection following SFE. Patient 1 underwent staged implant placement (2 implants) after lateral SFE, whereas the other two underwent simultaneous implant placement and SFE (4 implants in patient 2, 2 implants in patient 3). Between 2 and 3 weeks postoperatively, all patients developed signs and symptoms suggestive of acute infection. Initial symptoms were partially relieved by pharmacologic treatment and superficial debridement, but subtle sinonasal symptoms persisted. Six months later, CBCT revealed sinus opacification and ostial blockage in all patients, indicating unresolved infection. Surgical management consisted of partial graft removal, preservation of consolidated grafted areas, and intentional sinus membrane puncture and drainage. Implant placement was successfully performed in patient 1, and one implant was removed in patient 3 due to infection-related poor-quality tissue around the implant. Histologic examination demonstrated necrotic bone and chronic inflammatory changes. The retained implants remained functional without further complications during follow-up (patients 1 & 3: 1 year, patient 2: 2 years). It is important to recognize that persistent subclinical infection may remain after resolution of acute graft infection. If residual sinonasal symptoms linger, they should not be neglected, and appropriate reassessment should be considered. In carefully selected cases, the present surgical approach may represent a treatment option, although further evidence with longer-term data is needed.
OBJECTIVES:The aim of this article is to review the general adverse events from the administration of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and emphasize the oral and maxillofacial sequelae. METHOD AND MATERIALS:A search of the literature was performed on the general and oral and maxillofacial adverse events of GLP-1 RAs from the electronic databases of PubMed and Google Scholar from January 2021 through May 2026, along with articles cited within these culled references. Sought publications included review articles, controlled clinical investigations, case series, and case reports. The online Food and Drug Administration Adverse Event Reporting System was also examined for GLP-1-related adverse events. RESULTS:The most common adverse events attributed to GLP-1 RAs were gastrointestinal symptoms, predominately nausea, emesis, and diarrhea. Relevant articles also identified a multitude of adverse events that occurred within the oral and maxillofacial region, related to gastroesophageal reflux disease, nasopharyngitis, taste disturbances, xerostomia, and promotion of a gaunt-like facial expression. CONCLUSIONS:Adverse events, secondary to intake of GLP-1 RAs, may overlap with various disorders and promote challenges to establish etiology. Thus, clinicians should consider GLP-1 RAs in the differential diagnosis of various pathoses affecting oral and maxillofacial structures. Timely recognition of gastroesophageal reflux disease and other oral and maxillofacial adverse events potentially implicated with intake of these agents may improve patient outcomes.
OBJECTIVES:The postpartum period is marked by significant biologic, social, and emotional changes that may affect maternal self-care, including oral health maintenance. This study explores the impact of periodontal inflammatory status on mental health status in postpartum women. METHOD AND MATERIALS:In this cross-sectional study, postpartum mothers were recruited within 6 weeks to 6 months after delivery. Clinical periodontal parameters and sociodemographic variables were measured, and mental health was assessed using the standard 38 items Mental Health Inventory. Multiple linear regression analysis was performed to examine the relationship between periodontal parameters and Mental Health Index (MHI) scores. Mediation analysis explored potential mediators affecting the association. RESULTS:In total, 128 mothers were recruited in the study. The study population was stratified into three categories according to the quartiles of the mean MHI scores. A statistically significant difference was seen in the periodontal parameters among the three groups (P .05). After adjusting for sociodemographic variables, bleeding on probing (β = -0.437) and clinical attachment loss (β = -0.470) remained the only statistically significant predictors of MHI. Both were negatively associated with MHI, indicating poorer mental health with worsening periodontal condition. Bleeding on probing significantly mediated the relationships between education, occupation, socioeconomic status, family characteristics, and mental health, accounting for approximately 70% to 90% of the total effect. CONCLUSION:Periodontal inflammation was identified as a mediating factor in the relationship between sociodemographic factors and mental health status during the postpartum period.
OBJECTIVE:This in vitro study investigated the effect of immediate dentin sealing and provisional cements on the microtensile bond strength of resin-bonded glass-ceramic to dentin. METHOD AND MATERIALS:Occlusal surfaces of 60 maxillary premolars were cut perpendicular to the long axis of the teeth to expose dentin. A total of 60 pressable lithium disilicate glass-ceramic specimens (e.max Press, Ivoclar) were fabricated in the laboratory. Prepared teeth were classified into six groups according to dentin conditioning as follows: Group 1, freshly cut dentin (control group; C); Group 2, immediate dentin sealing (IDS); Group 3, immediate dentin sealing plus resin-based provisional cement (IDS-RC; Provitemp, Itena Clinical); Group 4, immediate dentin sealing plus conventional provisional cement (IDS-CC; NETC, Meta Biomed); Group 5, dentin without sealing plus resin-based provisional cement (C-RC); and Group 6, dentin without sealing plus conventional provisional cement (C-CC). Universal adhesive (Tetric N-Bond Universal, Ivoclar) was used for IDS, and provisional restorations were temporarily inserted to prepared teeth using provisional cements. Test groups (IDS-CC, IDS-RC, C-CC, and C-RC) were covered with provisional restorations and kept in a water bath for 2 weeks. Intaglio surfaces of ceramic specimens were etched using 9.5% hydrofluoric acid for 15 seconds then rinsed with water and ultrasonically cleaned for 3 minutes in 99% alcohol and air dried. Universal primer (Monobond N, Ivoclar) was applied immediately to the etched intaglio surfaces. Self-adhesive resin cement (Multilink Speed, Ivoclar) was mixed and applied to the intaglio surfaces of ceramic restorations. Ceramic restorations were bonded to conditioned teeth, and excess cement was removed. All specimens were light-polymerized for 20 seconds from four directions. Bonded specimens were artificially aged as follows; 1 hour after bonding, specimens of all test groups were stored in a water bath at 37°C for 5 months followed by thermal cycling for 5,000 thermal cycles to simulate clinical conditions. The microtensile bond strengths were recorded in MPa. Tukey HSD test (P ≤ .05) was used for statistical analysis. RESULTS:Compared to the control group (C) (6.37 ± 3.26 MPa), immediate dentin sealing significantly increased microtensile bond strength (P .05) for the following groups: IDS (13.76 ± 7.72 MPa), IDS-RC (15.24 ± 5.60 MPa), and IDS-CC (13.99 ± 6.98 MPa). However, provisional cementation did not significantly affect microtensile bond strength for groups C-RC (5.08 ± 2.91 MPa) and C-CC (4.45 ± 1.92 MPa) (P >.05). CONCLUSION:Immediate dentin sealing had a significant impact on resin bonding to lithium disilicate glass-ceramic.
OBJECTIVE:The aim of this study was to explore the physical and clinical efficacy of different suture materials used following impacted third molar surgery. METHOD AND MATERIALS:This retrospective study included patients who underwent mandibular third molar extraction and fulfilled the inclusion criteria. A total of six types of sutures were evaluated: silk, PGLA, PGLA-c, PET, PTFE, and PGCL. Wound healing, pain, and suture-related factors such as ease of manipulation, ease of removal, knot security, and plaque accumulation were evaluated. RESULTS:Sixty-two teeth in 58 patients (20 males, 38 females) with a mean age of 19.87 ± 4.25 years were included. No statistically significant differences were observed among sutures in terms of wound healing, ease of manipulation, and pain, whereas statistically significant differences were observed regarding knot security (P .001), plaque accumulation (P .001), and ease of removal (P = .017). After 1 week, the highest knot security was observed in the PTFE suture, and the lowest was observed in the PGLA suture. Silk suture was found to be the easiest to remove compared to other materials. CONCLUSIONS:With the data gathered from this study, it can be concluded that suture materials used in impacted third molar surgery have a limited effect on wound healing and pain; however, they show clinically significant differences in terms of knot security, plaque accumulation, and ease of suture removal.
OBJECTIVES:Peri-implant mucositis is a reversible inflammatory condition that may progress to peri-implantitis if untreated. Professional mechanical plaque removal (PMPR) is the standard therapy, although complete resolution is not always achieved. This review aimed to evaluate the effectiveness of chemical and pharmacologic adjunctive therapies to PMPR in peri-implant mucositis management. METHOD AND MATERIALS:A literature search was conducted in PubMed and Scopus up to March 2025. Randomized controlled trials including adult patients with peri-implant mucositis, reporting bleeding on probing changes, and with a minimum follow-up of 3 months were included. Nine randomized controlled trials (414 patients) were qualitatively analyzed. RESULTS:PMPR alone resulted in significant reductions in bleeding on probing and probing depth, but complete disease resolution was inconsistent. Adjunctive therapies, including chlorhexidine, local antibiotics, sodium hypochlorite, probiotics, and bioactive agents, showed intra-group improvements. However, additional benefits over PMPR alone were limited and often not statistically significant. Study heterogeneity in diagnostic criteria, outcome definitions, and treatment protocols limited comparability. CONCLUSIONS:PMPR remains the gold standard for peri-implant mucositis treatment. Adjunctive therapies may provide additional clinical benefits in selected cases, but their routine use is not supported by consistent evidence. Standardized randomized controlled trials with long-term follow-up are needed.
OBJECTIVE:The management of pain in dental procedures is crucial, as local anesthetic injections may induce patient anxiety and discomfort. Various techniques including Vibraject and Dentapen have been devised to alleviate injection discomfort. This study aimed to assess patient-reported pain perception levels during local anesthetic administration in the maxilla using Vibraject-assisted injection and the Dentapen system in ramp-up mode. METHOD AND MATERIALS:A total of 40 participants were enrolled in the study, with each participant receiving two different injections, thereby evaluating 80 sites in total. Participants were randomly assigned to undergo both types of injection, one on either side of the maxilla, next to the first molar. Pain intensity was evaluated using the visual analog scale (VAS) immediately following each injection, and heart rate measurements were recorded pre- and post-local anesthetic administration. The patients' preferences for injection methods were also documented. RESULTS:Analysis revealed a higher preference for Dentapen (62.5%) compared to Vibraject (37.5%). Heart rate measurements showed a statistically significant increase after Dentapen injection (P = .010), while insignificant differences were observed in heart rate measurements between Vibraject and overall heart rate measurements (P > .05). The mean VAS score for Vibraject (2.175) was slightly higher than Dentapen (1.550), although this difference did not reach statistical significance (P = .105). CONCLUSIONS:Dentapen was favored by the majority of participants. Results revealed a significant increase in heart rate following Dentapen injection. However, there was an insignificant difference in pain perception between the two methods. These findings emphasize the importance of patient preferences during local anesthesia administration.
OBJECTIVES:The aim of the present study was to conduct bidirectional two-sample Mendelian randomization (MR) to explore causality between systemic diseases and periodontitis amid confounding factors. METHOD AND MATERIALS:Genome-wide association study (GWAS) summary statistics were obtained from the IEU OpenGWAS project, FinnGen consortium, and GLIDE consortium. The exposures included a range of systemic diseases, such as diabetic ketoacidosis, coronary heart disease, myocardial infarction, stroke, coronary atherosclerosis, diabetic nephropathy, diabetic neuropathy, diabetic retinopathy, cataracts, nonalcoholic fatty liver disease, osteoporosis, and cardiac arrhythmia, and the outcomes were periodontitis and chronic periodontitis. The primary analytical method was inverse-variance weighted (IVW) MR, complemented by MR-Egger, weighted median, and weighted mode methods. Sensitivity analyses, including MR-PRESSO, MR-Egger intercept test, and Cochran's Q test, were performed to assess the robustness of the findings. RESULTS:In the forward MR analysis, no significant evidence was found to support a causal effect of genetic liability to the selected systemic diseases on the risk of periodontitis or chronic periodontitis (all P > .05). In the reverse MR analysis, a genetically predicted causal relationship was identified, suggesting that periodontitis is a risk factor for osteoporosis (IVW, OR 1.16, 95% CI 1.01-1.33, P = .031). No other significant causal effects of periodontitis on the other studied diseases were found. Sensitivity analyses did not detect significant horizontal pleiotropy for the positive finding. CONCLUSION:Novel evidence is provided suggesting that periodontitis may causally increase the risk of osteoporosis. These findings highlight the systemic impact of oral health and suggest that preventing and treating periodontitis could be a potential strategy in osteoporosis management. Clinically, integrating periodontal screening into the risk assessment protocols for patients susceptible to osteoporosis may optimize early intervention and multidisciplinary patient management.
OBJECTIVE:To assess the impact of periodontitis and associated factors on self-perception of oral health among Brazilian male crack cocaine users in withdrawal treatment. METHOD AND MATERIALS:A cross-sectional study was conducted with 242 adult male crack cocaine users in rehabilitation programs in two municipalities in Paraná, Brazil. Periodontal status, oral health behavior, addiction history, socioeconomic, and sociodemographic data were analyzed. Self-perceived oral health-related quality of life (OHRQoL) was assessed by the short form of the Oral Health Impact Profile (OHIP-14), cross-culturally adapted and validated for the Brazilian population. Descriptive statistical analysis and univariate and multiple Poisson regression were performed. RESULTS:The periodontal parameters were observed: probing depth ≥ 4 mm in 20.2% of crack cocaine addicts, clinical attachment level ≥ 4 mm in 23.6%, bleeding on probing in 90.9%, gingival bleeding in 96.3%, plaque and calculus in equal frequencies of 97.1%. Periodontitis was diagnosed in 63% of the sample and the mean OHIP-14 score was 24. All individuals with periodontitis presented impact on OHRQoL. Periodontal inflamed surface area (PISA) was significantly correlated with OHRQoL (r = 0.18; P = .007). In the multiple regression model, the prevalence of a negative impact on perception of oral health was statistically different among individuals with metallic taste in the mouth (prevalence ratio = 1.11; 95% CI = 1.03-1.20) and tooth mobility (prevalence ratio = 1.09; 95% CI = 1.00-1.18). CONCLUSION:Periodontitis may be associated with OHRQoL and high scores of OHIP-14 in crack cocaine users in withdrawal treatment, regardless of socioeconomic, demographic, behavioral, and other oral conditions. (Quintessence Int 2026;57:460-469; doi: 10.3290/j.qi.b6982838).
Surgical derotation is a technique in which a severely rotated tooth is surgically derotated inside the socket to its desired position. This procedure is typically performed on maxillary anterior teeth with immature root apices. It is a simple and cost-effective treatment modality compared to a conventional orthodontic procedure with immediate esthetic improvement. This article documents four cases, where severely rotated maxillary central incisor/s are surgically derotated and followed up both clinically and radiographically for a minimum period of 18 months with relatively successful outcomes. Conclusion: Surgical derotation can be a viable alternative to the conventional orthodontic derotation technique for severely rotated maxillary anterior teeth with open apex. Judicial selection of cases with proper planning, handled by an efficient clinician, is of paramount importance.
OBJECTIVES:This study evaluated the effect of polymerization mode on dentin bond strength of universal adhesives applied using etch-and-rinse (ER) and self-etch (SE) strategies, before and after thermocycling. METHOD AND MATERIALS:A total of 120 human molar dentin specimens were prepared and assigned to 12 groups (n = 10) according to adhesive polymerization type (light-cured, chemically cured, and dual-cured), application mode (ER and SE), and storage condition (24 hours or thermocycled). After adhesive application and composite build-up, half of the specimens were tested after 24 hours, while the remaining specimens underwent 5,000 thermocycles. Shear bond strength (SBS) was measured using a universal testing machine, and failure modes were evaluated. Data were analyzed using three-way ANOVA and Bonferroni post hoc tests (α = .05). RESULTS:Thermocycling significantly reduced SBS values in all groups (P .001). In contrast, neither adhesive type (P = .065) nor application mode (P = .11) had a significant effect on bond strength. No significant interactions were found among the variables (P > .05). Failure mode analysis revealed predominantly adhesive and mixed failures, with an increase in adhesive failures after thermocycling. CONCLUSION:Polymerization mode and application strategy did not significantly influence dentin bond strength, whereas thermocycling reduced the durability of the adhesive interface. These findings suggest that aging-related factors may play a more critical role than differences in curing mechanism or application strategy. Clinically, the selection of polymerization mode alone may not be critical for bonding performance.
OBJECTIVES:Dental anxiety (DA) is the fifth most common type of anxiety and leads to avoidance strategies that impact oral health and health-related quality of life. This study aimed at examining the prevalence of epidemiologically significant dental diseases, including dental caries, periodontitis, and tooth loss, according to DA severity. METHOD AND MATERIALS:Younger adults (35- to 44-year-olds) and younger seniors (65- to 74-year-olds) with available data on self-reported DA using the modified DA scale (MDAS) were selected from the cohort of the population-representative 6th German Oral Health Study (DMS • 6). The prevalence of oral diseases was compared among participant groups with different levels of DA (no/mild, moderate, and severe/phobia). RESULTS:Among younger adults and younger seniors, 26.4% and 22.8% reported DA, respectively. In these age groups, 9.5% and 7.6% reported severe DA or phobia, respectively, and the prevalence was higher among women in both age groups. Although the overall decayed, missing, filled teeth scores did not differ significantly according to DA levels, the number of untreated caries lesions and missing teeth increased with increasing anxiety levels. In younger seniors, the number of restored teeth and filled and sound teeth index decreased with increasing DA severity. Similarly, periodontal treatment needs and prevalence of advanced periodontitis (stage III and IV) increased with higher DA levels. Moreover, the number of missing and non-replaced missing teeth increased significantly with DA, whereas edentulism was not significantly different between the DA groups. CONCLUSION:The prevalence of dental caries, periodontitis, and missing teeth increases with even moderate DA and is worse in patients with severe DA/phobia. (Quintessence Int 2026;57(Suppl):S118-S125; doi: 10.3290/j.qi.b6955509).
