Background:Determine the statistical report quality of articles published in dental journals according to the level of impact of the journal and the study design.Methods:A random sample of original articles published in four journals of General Dentistry indexed in Scopus was evaluated, two high-impact (quartile 1) and two medium-impact (quartile 3). The study design was recorded as observational, experimental, or other. The quality of each report was assessed through seven statistical error indicators. Two statisticians independently evaluated the articles and then contrasted their results; in the case of discrepancies in the ratings, they reached an agreement to establish a consensual criterion. Chi-square, Fisher's exact, Mann-Whitney U, and Kruskal-Wallis tests were applied with post hoc Dunn-Bonferroni correction.Results:The presence of at least one statistical error was high (85.6%), with 123 (83.7%) and 44 (91.7%) articles in high- and medium-impact journals, respectively. Two statistical errors were more common (32.3%). We found a relationship between the presence of some errors (P = 0.009) and the number of statistical errors (P = 0.011) with the study design.Conclusions:There is a low-quality statistical report of the evaluated dental articles, as errors are very common; among these errors, inaccurate descriptions of the P values and a lack of justification for the sample size were the most common. The observational studies were also of higher quality than the experimental studies.
Intentional replantation (IR) is a strategic treatment modality involving the deliberate extraction and reinsertion of a tooth following extraoral endodontic management. It is particularly valuable in cases where conventional retreatment or periapical surgery is contraindicated or has previously failed. This case series (n = 3) presents three children managed with IR and contemporary biomaterials to enhance periapical healing. Regenerative adjuncts, including platelet-rich fibrin, chitosan, and xenograft bone grafts, were placed to support hard and soft tissue repair. Teeth were atraumatically extracted, followed by retrograde sealing using Biodentine, and subsequently replanted with minimal extraoral time. Stability was ensured using custom acrylic splints. At the 24-month follow-up, all cases exhibited resolution of periapical pathology, preservation of periodontal architecture, and maintenance of functional integrity, although one case displayed slight radiographic evidence of external resorption. These findings emphasize that, when executed with meticulous treatment planning and the use of bioactive materials, IR can serve as a predictable, conservative, and biologically sound approach for preserving natural dentition in growing patients.
Context:Early childhood caries remains a significant public health concern globally. Caries risk assessment (CRA) tools are essential for early identification and prevention, yet comparative evidence in young children is limited. Aim:To compare three CRA tools - American Academy of Pediatric Dentistry (AAPD), American Dental Association (ADA) and Caries Management by Risk Assessment (CAMBRA) - in children aged 1-6 years. Settings and Design:Cross-sectional study at a tertiary care dental hospital in South India. Materials and Methods:One hundred and nineteen children (61 males, 58 females; mean age 2.8 ± 0.9 years) were examined. All three CRA tools were applied simultaneously by a single calibrated examiner. Risk categories were compared across age groups (<3 years vs. ≥3 years) and gender. Statistical Analysis Used:Cohen's kappa coefficient assessed inter-tool agreement. Chi-square and Fisher's exact tests compared distribution (P < 0.05). Results:AAPD identified significantly more high-risk children (4.2%) than ADA and CAMBRA (0.8% each), most pronounced in children under 3 years (5.1% vs. 0%). ADA and CAMBRA showed almost perfect agreement (κ = 0.885, 98.3%), while AAPD showed moderate agreement with ADA (κ = 0.596) and CAMBRA (κ = 0.520). No significant differences were observed across age groups or gender (p > 0.05). Conclusion:All three tools are effective for pediatric CRA with varying sensitivity. AAPD may be more sensitive for early risk detection in toddlers, while ADA and CAMBRA demonstrate higher concordance. Tool selection should be guided by clinical context and whether sensitivity or specificity is prioritized.
Context Background:Marginal adaptation is a key determinant of the longevity and clinical success of fixed dental prostheses. Polyether ether ketone (PEEK), a high-performance polymer, has recently gained interest as an alternative to zirconia due to its favorable mechanical, esthetic, and biological properties. Aims:To evaluate and compare the marginal adaptation of computer-aided design and manufacturing (CAD-CAM) monolithic PEEK and zirconia crowns cemented on natural teeth after simulating 6 months of clinical service. Settings and Design:An in vitro comparative pilot study was conducted using 28 extracted mandibular molars divided into two groups (n = 14): Group I (PEEK) and Group II (Zirconia). Materials and Methods:Crowns were fabricated using CAD-CAM and cemented with self-adhesive resin cement. All specimens underwent thermocycling (120,000 cycles) and cyclic loading, followed by silver nitrate dye penetration. Sectioned specimens were examined under a scanning electron microscope (SEM) to assess vertical and horizontal marginal gaps. Statistical Analysis Used:Data were analyzed using SPSS v20. Normality was tested with the Shapiro-Wilk test, showing nonnormal distribution. The Mann-Whitney U test compared groups, with significance set at P < 0.05 (α = 0.05). Results:Group I (PEEK) showed mean horizontal and vertical marginal gaps of 35.09 ± 16.79 μm and 32.71 ± 17.85 μm, respectively, while Group II (Zirconia) showed 25.88 ± 23.45 μm and 26.53 ± 8.69 μm. Differences were statistically insignificant (P > 0.05). Conclusions:Both PEEK and zirconia exhibited clinically acceptable marginal adaptation after simulated clinical aging. PEEK demonstrates comparable marginal accuracy to zirconia and can serve as a viable restorative alternative.
Kabuki syndrome (KS) is a rare, multisystemic congenital disorder characterized by distinct craniofacial features, musculoskeletal abnormalities, and varying degrees of intellectual disability. While diagnosis is primarily clinical, the underlying molecular variability often leads to delayed identification. Given that orodental anomalies are among the earliest quantifiable markers of the syndrome, the dental professional occupies a critical position in the diagnostic pathway. This report describes a female patient presenting with pathognomonic craniofacial traits, including arched supraorbital ridges, a prominent nose, broad nasal bridge with a flattened tip, thick eyebrows and eyelashes, large low-set ears, and prominent lips with an elongated philtrum. Intraoral examination revealed significant dental manifestations, specifically an anterior open bite, retained primary teeth, and anomalies such as missing teeth and impacted teeth. These findings served as the primary clinical indicators that facilitated a multidisciplinary referral and subsequent genetic confirmation. The high prevalence of specific dental findings - estimated to affect over 70% of KS patients - underscores the pivotal role of the dentist in early recognition. By identifying these oral phenotypes during routine examinations, dental practitioners can bridge the diagnostic gap, ensuring timely genetic testing and the initiation of comprehensive, coordinated management.
Background:Orthodontic relapse remains a persistent biological concern, predominantly attributed to early posttreatment activation of osteoclasts. This study aimed to assess the potential of a simvastatin-loaded carbonate hydroxyapatite (CHA) nanoemulsion in attenuating osteoclastogenesis and improving alveolar bone stability following orthodontic treatment. Materials and Methods:An in vivo randomized controlled experimental design was conducted using 32 male Wistar rats (Rattus norvegicus, 200-250 g). Orthodontic tooth movement was initiated with a 30 cN nickel-titanium closed-coil spring for 7 days, followed by 7 days of stabilization. After appliance removal, rats were divided into control and experimental groups. The treatment group received local intrasulcular application of statin-CHA nanoemulsion (0.05 mg simvastatin +0.1 mg CHA/15 μL) on days 0, 4, and 7. Alveolar bone specimens were harvested on days 0, 1, 7, and 14 for histological examination (H and E staining). Data were analyzed using two-way analysis of variance followed by Tukey's post hoc test (P < 0.05). Results:Osteoclast numbers peaked on day 1 in both groups but were significantly lower in the treatment group (17.25 ± 0.95) than in controls (30.00 ± 1.15; P < 0.001). Suppression of osteoclast activity persisted up to day 14 (P < 0.05). Conclusion:Simvastatin-loaded CHA nanoemulsion effectively inhibits osteoclast differentiation during orthodontic relapse, representing a biologic strategy for improving postorthodontic stability.
Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal disorder characterized by multiple dental and skeletal abnormalities. While isolated case reports exist, this case is unique due to its clear familial inheritance pattern and the need for urgent surgical dental intervention in a symptomatic young adult, thereby contributing new clinical insights to the limited literature on CCD. A female patient in her early 20s presented with pain and pus discharge in the mandibular left posterior region for 3 months. Extraoral findings included short stature, frontal bossing, hypertelorism, midfacial hypoplasia, and hypoplastic clavicles. Intraoral examination revealed generalized microdontia, malalignment, multiple carious teeth, and a partially erupted mandibular left third molar with pericoronitis. A positive family history of similar skeletal features in her father and sibling raised suspicion of a syndromic diagnosis. Imaging studies showed open cranial sutures, underdeveloped maxilla, and an impacted mandibular molar with surrounding bone resorption. Differential diagnoses such as Down's syndrome, Gardner's syndrome, pycnodysostosis, and mandibuloacral dysplasia were ruled out, and a final diagnosis of CCD was established. The patient underwent surgical extraction of the third molar, excision of the associated follicular tissue, and socket curettage. Histopathology confirmed chronic nonspecific inflammation. Healing was uneventful with complete resolution of symptoms. The present case report underscores the importance of early diagnosis and timely dental intervention in patients with CCD. A multidisciplinary approach that includes dental, surgical, and genetic considerations is essential for improving both functional outcomes and quality of life in affected individuals.
Chronic renal disease (CRD) is a progressive, irreversible loss of renal mass and function, posing a significant health concern. Secondary hyperparathyroidism caused by hypokalcemia in CRD often leads to renal osteodystrophy (ROD), a bone pathology resulting from alterations in mineral metabolism. ROD typically occurs early in renal failure and progresses as kidney function deteriorates. Marked jaw enlargement remains a rare but severe complication of the ROD, causing significant facial disfigurement. This case series highlights the four cases of ROD with extensive orofacial involvement, emphasizing the importance of early diagnosis and management.
Neuropathologic chewing is an involuntary chewing reflex characterized by repetitive, forceful jaw movements, often leading to self-inflicted oral trauma. This case report aims to describe the dental management of a 13-year-old male with GNAO1-associated disorder presenting with severe neuropathologic chewing and resulting oral trauma. A novel, custom-designed three-dimensional (3D)-printed intraoral appliance was fabricated to protect the oral tissues. The appliance prevented further self-inflicted injury and supported tissue healing, significantly improving the patient's quality of life. This case highlights the role of personalized dental intervention in managing neuropathologic chewing. It emphasizes the potential of 3D printing as an innovative and effective solution for complex neurogenetic disorders and underscores the importance of interdisciplinary care in pediatric dental management.
Aim: The purpose of this randomized controlled trial was to evaluate and compare the clinical and radiographic success of Biodentine and Bioceramic putty as pulp medicaments following diode laser-assisted and conventional pulpotomy in primary molars. Materials and Methods: Forty-eight primary molars in children aged 4-9 years were randomly assigned into four groups (n = 12 each): Conventional pulpotomy with Biodentine, conventional pulpotomy with Bioceramic, laser-assisted pulpotomy with Biodentine, and laser-assisted pulpotomy with Bioceramic. Clinical and radiographic outcomes were evaluated at 1, 3, and 6 months using Zurn and Seale criteria (2008). Data were analyzed with one-way ANOVA, with significance set at P < 0.05.Results:All groups showed favorable clinical and radiographic success at 6 months. The laser-Bioceramic group demonstrated the highest overall success (83.2%), followed by laser-Biodentine (75%) and conventional Bioceramic (75%), whereas conventional Biodentine showed comparatively lower success (50%). Differences among groups were not statistically significant (P > 0.05). Conclusions: Both Biodentine and Bioceramic were effective pulpotomy medicaments in primary molars, with Bioceramic showing slightly better outcomes. Laser-assisted pulpotomy provided additional clinical benefits, particularly in enhancing hemostasis and healing, although the differences were not statistically significant.
Fracture of an endodontic instrument during an endodontic procedure is a common complication, but displacement of the separated instrument either inside or by the side of the inferior alveolar canal is very rare. This case report presents nonsurgical retreatment of a symptomatic, previously endodontically treated mandibular left first molar tooth with internal root resorption. The unique feature of this case report is the presence of a separated endodontic instrument entirely beyond the root apex and located deep within the body of the mandible. Under rubber dam isolation, access cavity preparation was carried out, and previous root canal obturating materials were removed. Intracanal dressing with calcium hydroxide was placed for two visits, and in the subsequent visit, the root canals were obturated. The periapical lesion healed at 24 months of follow-up. The separated endodontic instrument was monitored regularly through clinical and radiographic examinations, and the patient remained asymptomatic during this period.
Conical telescopic overdentures have a self-centering insertion path, which differs from parallel-walled telescopic designs. This biomechanical characteristic minimizes lateral stresses on abutment teeth, which may allow for better prosthesis placement in patients with upper extremity weakness. A 69-year-old female patient presented with concerns regarding the poor condition of her remaining teeth (15, 14, 13, 25, 33, and 41) and requested prosthodontic rehabilitation while preserving the existing dentition. Clinically, the patient reported weakness in her upper extremities, with difficulties in grasping, holding objects, and performing controlled movements. Given these functional limits, conical telescopic crowns were chosen to provide a double-crown system with favorable load distribution and abutment protection. A maxillary conical telescopic overdenture, paired with a mandibular full overdenture, was intended to allow for independent insertion and removal. This case illustrates that conical telescopic overdentures can be a practical and patient-centered treatment option for individuals with upper extremity weakness.
Background: Today, caries prevention approaches in dentistry are no longer limited to mechanical treatments; they are increasingly focused on the development and evaluation of various remineralizing agents aimed at reversing early lesions. Our study aimed to evaluate the surface roughness of different remineralizing agents on teeth with initial caries. Methods: Nine groups of bovine enamel specimens with initial enamel caries (n = 81) were randomly assigned: APF (xylitol-containing fluoride gel), FV (CPP-ACP-containing fluoride gel), BF (fluoride varnish), CR (self-assembling peptide P-11-4), TM (CPP-ACP paste), GG (herbal toothpaste), RJ (xylitol-containing gel), TP (toothpaste), and C (Control). The materials were used in a professional (APF, FV, BF, and CR) or daily (TM, GG, RJ, and TP) regimen. The pH cycle was applied to enamel samples for a period of 6 days. Surface roughness (Ra) values were measured after the initial caries formation (first measurement) and after the application of remineralization agents (second measurement). Scanning electron microscopy images were also taken in the last stage. Ra values were analyzed statistically both inter- and intra-groups. Results: In the TM and TP groups, the decrease in Ra value was statistically significant (P < 0.05). The daily regimen group had a lower Ra value in the second measurement than in the first (P < 0.001). Furthermore, the daily regimen group had a lower Ra value than the professional regimen group in the second measurement (P < 0.001). Conclusions: Daily remineralization agents were found to be more effective in reducing enamel surface roughness. TM and TP were found to be the most effective.
The study aimed to present the fabrication and clinical use of a customized cranial stent made with three-dimensional (3D) reconstruction, 3D printing and replicated using heat-cured clear acrylic resin for rehabilitating a posttraumatic cranial defect. Cranial defects can result from trauma, surgical intervention, or congenital conditions, leading to neurological vulnerability, facial deformity, and psychosocial distress. Conventional reconstruction methods, such as autologous bone grafts and titanium meshes, often demand extensive intraoperative adjustments and still fail to achieve complete marginal adaptation. With advances in 3D digital technologies, patient-specific cranial prostheses can now be designed with greater accuracy, offering improved functional and esthetic outcomes while reducing surgical time. A patient presented with a cranial defect on the upper left side of the skull 6 months after a road traffic accident and neurosurgical intervention. Computed tomography data were used to digitally reconstruct the defect, and a 3D prototype was printed in polylactic acid. This served as a template for replicating the cranial stent in heat-cured clear acrylic resin. The stent was processed using conventional laboratory techniques, finished, polished, and perforated to allow fluid seepage. Presurgical verification on the 3D model confirmed accurate marginal adaptation. After ethylene oxide sterilization, the stent was surgically placed and fixed with titanium plates. Postoperative scans showed complete coverage, and at 15 days, the patient reported no discomfort, with improved craniofacial esthetics. Customized cranial stents fabricated with digital reconstruction and conventional prosthodontic methods provide accurate adaptation, restore cranial symmetry, and improve patient comfort and esthetics.
A 13-year-old girl presented for treatment due to dental crowding. Upon examination, horizontal impaction of her mandibular second molars could be detected. Based on the patient's chief complaint, along with the results of the examination and analysis, orthodontic treatment involving the extraction of four premolars was performed. The mechanism of activated extra-length (AEL) nickel-titanium (NiTi) archwires was employed for molar uprighting. This technique involved placing crimpable stops on NiTi archwires, with a spacing 2-3 mm wider than the inter-bracket distance between first and second molars, leveraging the inherent resilience of the archwires to facilitate the desired molar movement. Upon completion of the treatment, uprighting of the horizontally impacted second molars was successfully achieved, with all teeth properly aligned, leading to improved occlusal function and smile esthetics. This case report validates that the utilization of AEL NiTi archwires can accomplish uprighting of mesially tilted molars through a well-planned anchorage design.
Background: During endodontic treatment, exposure of coronal dentin to various endodontic chemical substances (ECS) impacts its structural integrity, thereby affecting therapy’s success. This study employs preendodontic dentin hybridization (PEDH) to shield the coronal dentin from ECS. Aim: This study evaluates the influence of chemicals used during endodontic therapy on coronal dentin microhardness and resin–dentin microshear bond strength (µSBS) and the protective effect of PEDH. Methodology: Eighty square-shaped coronal dentin specimens were divided into four groups according to the time of chemical exposure: Control: No exposure to ECS. Late Dentin Hybridization (LDH): Exposed to ECS followed by dentin hybridization (DH); PEDH: DH followed by ECS; Ultrasonic LDH (ULDH): ECS followed by Ultrasonic repreparation then DH. Ten samples in each group were restored with composite and subjected to shear stresses under a Universal testing machine. The remaining 10 samples were tested for microhardness using a Vickers micro indenter. Statistical Analysis: Data were analyzed with one-way analysis of variance and Tukey’s test. Results: LDH causes a significant reduction in bond strength compared to all groups. The PEDH group exhibits µSBS and microhardness values close to the control group. ULDH group showed increased bond strength values compared to the LDH group, but exhibited a significant reduction in microhardness values compared to all experimental groups. Conclusion: Chemical exposure deteriorates properties of coronal dentin, thereby reducing µSBS and microhardness, whereas PEDH acts as a shield on coronal dentin, which effectively preserves its properties, producing outcomes close to untreated controls without the need for ultrasonic repreparation.
This study presents a novel, minimally invasive "tri-pouch" technique for maxillary ridge augmentation, utilizing the periosteal membrane as a natural guided tissue regeneration barrier. Three compartments - between gingiva and periosteum, sub-periosteal, and intraosseous - are created, with graft material placed in biologically favorable spaces to enhance vascularization, eliminate synthetic membranes, and preserve blood supply. Preliminary results indicate improved graft stability, reduced morbidity, and enhanced soft tissue integration.
Aneurysmal bone cysts (ABCs) are expanding osteolytic lesions rarely found in the maxilla. They usually occur after trauma or alterations in local hemodynamics. Secondary ABCs can occur due to vascular changes and inflammation caused by existing periapical infection. A 25-year-old male patient reported with the chief complaint of recurrent swelling and pus discharge in his upper front tooth region for 3 months. He gave a history of trauma 16 years ago. He had undergone root canal treatment in his upper front tooth 4 years ago. Preoperative radiograph and cone-beam computed tomography showed the presence of a large periapical radiolucency and an unusual radio-opaque foreign body. Endodontic therapy was initiated, and a 5 mm mineral trioxide aggregate plug was given. Thorough periapical curettage was done. Histopathological analysis gave a diagnosis of ABC, and scanning electron microscopy analysis identified the foreign body as zinc oxide cement. Follow-up examination showed distinct radiographic healing with a decrease in the size of the lesion. Accurate diagnosis, achieved through a combination of radiographs and histopathology, is crucial for ensuring complete lesion removal and reducing the risk of recurrence.
Introduction:Periodontitis is a prevalent inflammatory disease driven by dysbiotic microbial consortia. Red-complex pathogens (Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) and emerging taxa (Filifactor alocis and Aggregatibacter actinomycetemcomitans) are central contributors, yet their virulence mechanisms remain incompletely defined. Objective:To construct protein-protein interaction (PPI) networks of key periodontopathogens and identify conserved as well as pathogen-specific virulence hubs. Methodology:High-confidence PPI networks were generated for 1136 proteins across the five pathogens. Network topology was analyzed to identify hubs, and enrichment analyses were performed to map functional clusters. Results:Hub proteins such as guaA, metG, pheT, lysS, thrA, rplA, purD, and rpsH demonstrated significant interactions with accessory proteins. Conserved hubs, including guaA and ileS, were shared across pathogens and were essential in purine biosynthesis and aminoacyl-tRNA ligation. Pathogen-specific hubs comprised gingipains (P. gingivalis), leukotoxin (A. actinomycetemcomitans), and dentilisin (T. denticola). Functional clustering revealed adhesion, peptidoglycan biosynthesis, and immune modulation pathways. Conclusion:PPI networks provide system-level mechanistic insights into pathogen virulence, revealing conserved vulnerabilities and species-specific mechanisms.
Background: The microRNA-223 (miR-223)/FBXW7/FBXO8 molecular network governs ubiquitin-proteasome proteostasis, a cardinal process in cellular protein turnover. Dysregulation amplifies inflammatory cascades and expedites tissue degradation. This study elucidates stage-specific expression divergences of miRNAs-223 and its cognate F-box regulators in periodontitis. Materials and Methods: This observational study enrolled 100 participants, categorized into five groups comprising periodontally healthy individuals and patients with Stage I–IV Grade B periodontitis. Gingival crevicular fluid (GCF) was collected using calibrated microcapillary pipettes. Total RNA was isolated from the GCF specimens, followed by complementary DNA (cDNA) conversion. Expression levels of miRNAs-223, FBXW7, and FBXO8 across all groups were assessed through the real-time quantitative PCR methodology. In silico target prediction analyses for miRNAs-223 and functional enrichment analyses were performed using the bioinformatic tools. Results: Expression analysis of GCF across Groups A (Healthy) to E (Stage IV) revealed statistically significant upregulation of miR-223 (25.38 ± 2.56; P = 0.001), accompanied by marked downregulation of FBXW7 (0.02 ± 2.05; P = 0.001) and FBXO8 (0.11 ± 2.04; P = 0.02). miR-223 levels positively correlated with clinical parameters, while FBXW7 and FBXO8 showed inverse correlations, strengthening with disease severity. Notably, miR-223 exhibited significant negative associations with both F-box proteins. Receiver operating characteristic analysis confirmed its diagnostic utility (AUC 0.919), highlighting miR-223 as a potential molecular signature for periodontal disease. Conclusion: The pathophysiological derangement of the miR-223/FBXO8/FBXW7 signaling axis is entwined with aberrant proteolytic dynamics in periodontal pathology, accentuating the indispensable role of F-box–dependent ubiquitin-mediated degradation and positioning this molecular ensemble as a promising conduit for therapeutic stratagem.
