Abstract Dental anxiety has a great impact on quality of dental treatment. There are various scales available that are used to assess the state of mind. Visual illusions are the phenomenon where the perception of image differs from reality. These can help to assess the exact psychodynamic state by directly evaluating brain processing. The aim of this article was to assess the efficacy of visual illusion tasks in evaluating the psychodynamic state of children aged 7 to 10 years prior to dental treatment. A total of 62 children aged 7 to 10 years were included in the study. They were asked to complete five visual illusion tasks prior to dental treatment in two trials by adjusting a comparison stimulus to match the standard stimuli. Baseline anxiety was assessed using the Venham anxiety score. The susceptibility index was checked for each task and the scorings were then correlated with Venham's anxiety scores. Intergroup comparison between susceptibility index and Venham's anxiety score was done using one-way analysis of variance and a highly significant difference was observed for all illusion tasks. Pearson's correlation showed a moderate correlation between child's anxiety score and susceptibility index of all visual illusion tasks. Visual illusion tasks can be effectively used for assessing the psychodynamic state of the children prior to dental treatment.
Abstract Periodontitis is an inflammatory condition that affects the supporting structures of teeth, including the gingiva, periodontal ligament, cementum, and alveolar bone. The diagnosis of periodontitis involves anamnesis, clinical examination, and radiographic assessment. Clinical attachment loss (CAL) measured through clinical examination and alveolar bone level (ABL) assessed via radiography are key metrics for diagnosis and therapy evaluation in periodontitis. Despite limited research on the correlation between CAL and ABL, existing studies provide inconclusive results. This review aims to determine the relationship between CAL and radiographic ABL measurements. The review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with the research question formulated using the PICO strategy. A comprehensive search of electronic databases, including Scopus, PubMed, and Web of Science, as well as manual hand-searches, was performed. Article screening involved evaluating titles and abstracts related to the topic, followed by selection based on predefined inclusion and exclusion criteria. The screening and filtering process occurred in multiple stages, including the removal of duplicates and a thorough analysis of titles, abstracts, and full texts of included articles. A total of 1,755 articles were retrieved from the electronic databases, and after duplicate removal and full-text selection, 10 articles met the inclusion criteria for this review. The risk of bias was evaluated using the Quality Assessment in Prognostic Studies tool. The reviewed studies consistently demonstrated a positive correlation between CAL and ABL, with correlation coefficients (r) ranging from 0.35 to 0.88. Parallel periapical radiography (r = 0.88) achieved the strongest correlation among two-dimensional methods, demonstrating the importance of image standardization and parallel positioning. Cone-beam computed tomography offers comparable high correlations and superior three-dimensional accuracy but remains limited by cost, accessibility, and radiation exposure. Bitewing and panoramic radiographs exhibited weaker associations due to geometric distortion, overlapping anatomy, and restricted coverage. In conclusion, a significant association exists between CAL and radiographic ABLs. Integrating both clinical and radiographic assessments yields the most accurate diagnosis.
Abstract Periodontal disease is highly prevalent worldwide, yet its burden and public health significance remain underestimated. In the current era, the application of artificial intelligence (AI) in dental health, particularly in periodontology, is poised to revolutionize diagnosis, treatment planning, and ultimately the management of periodontal disease. The aim of this narrative literature review is to explore how AI can improve clinical decision-making in periodontology and support personalized patient care. Specifically, it addresses the question: “How can AI be effectively integrated into periodontal practice to improve diagnosis, risk assessment, treatment planning, and patient care?”
Abstract This article aims to determine sesamin's cytotoxicity and anti-inflammatory effects on IL-1β-stimulated human gingival fibroblasts (HGFs). HGF cell lines were obtained from ATCC. Cell viability of sesamin (0.4–50 µM) or 0.05% (v/v) DMSO was assessed using the MTT assay for 24 and 48 hours. HGFs were treated with 0.5 ng/mL IL-1β alone or were coincubated with indicated sesamin concentrations (12.5, 25, or 50 µM) for 24 hours. The expression of IL-6, COX-2, and MMP-2 was analyzed by real-time PCR. The production of IL-6 and PGE2 was assessed using ELISA, as well as MMP-2 activity using gelatin zymography. The data were analyzed by one-way analysis of variance (ANOVA), followed by Tukey HSD post hoc to assess differences. All the tests were conducted at a significance level of 95% (p < 0.05). HGFs exhibited no cytotoxicity when treated with sesamin for 24 and 48 hours. Interestingly, cotreatment with sesamin for 24 hours significantly suppressed both IL-6 and COX-2 mRNA expression, as well as IL-6 and PGE2 production, compared with HGFs stimulated with IL-1β alone. Although MMP-2 activities showed a decreasing trend with cotreatment, these changes were not statistically significant. Sesamin exhibits potential anti-inflammatory and immunomodulatory effects by reducing the expression of inflammatory genes as well as the production of inflammatory cytokines and mediators in IL-1β-stimulated HGFs.
Abstract One of the compounds isolated from mangosteen peels is α-mangostin, a substance with numerous health benefits, such as anticancer, anti-inflammation, and antibacterial properties. Bacterial colonization on tooth surfaces is the frequent cause of oral infectious disorders such as periodontal diseases and dental caries. The objective of this study was to evaluate α-mangostin's potential as an herbal treatment for inhibiting the growth of bacteria in the oral cavity. In this study, the samples used were bacterial strains Prevotella intermedia, Peptostreptococcus, and Fusobacterium nucleatum, which are mostly found in oral cavity. These bacteria were then incubated at 37°C for 48 hours. The α-mangostin compound was then diluted to eight concentrations, namely, 100, 50, 25, 12.5, 6.25, 3.125, 1.56, and 0.78%. This was followed by planting using the spreading technique on agar media and a further 48 hours of incubation at 37°C. After that, colonies developing on agar medium were observed and counted. The data were then examined using statistical analysis Kruskal–Wallis test to determine significant differences between groups. It showed that at a concentration of ≥25%, there was no visible growth of P. intermedia and F. nucleatum bacterial colonies, whereas at a concentration of ≥12.5, there was no visible growth of Peptostreptococcus. In both P. intermedia and F. nucleatum bacteria, α-mangostin has a minimum inhibitory concentration (MIC) of 12.5% and a minimum bactericidal concentration (MBC) of 25%. α-mangostin has an MIC of 6.25% and an MBC of 12.5% when it comes to suppressing Peptostreptococcus bacteria.
Abstract Alveolar ridge preservation (ARP) procedures are crucial for minimizing physiological bone resorption. Dentin particles (DPs) obtained from extracted teeth, rich in type I collagen and growth factors like bone morphogenic proteins, offer a promising alternative by stimulating osteogenic cell response and enhancing bone regeneration. Platelet-rich fibrin (PRF) is a natural biomaterial that promotes micro-vascularization and wound healing, while collagen plug (CP) aids in osteogenesis and stabilizes grafting materials. This study aims to evaluate the efficacy of the combined use of DP, PRF, and CP in ARP to improve treatment outcomes Thirty-three mandibular extraction sockets were randomized into three groups: group A (DP + PRF + CP), group B (PRF + CP), and group C (empty control). Early wound healing was assessed using the Early Wound Healing Score at 10 ± 4 days. Radiographic changes in ridge width, buccal height, lingual height, and buccal bone thickness were measured using cone-beam computed tomography after 6 months. For inter-group comparisons, one-way ANOVA (analysis of variance) with Bonferroni post-hoc tests was employed to detect significant differences in bony dimensions among all three groups. Changes over time were assessed using repeated measures ANOVA, while associations between categorical variables were examined through Chi-square tests. Paired comparisons between specific time points were conducted with paired sample t-tests. Additionally, multinomial logistic regression analysis was performed to compare groups A and B against the reference group C. Early wound healing was comparable across all groups. Radiographically, group A (DP + PRF + CP) consistently showed the smallest dimensional reductions in ridge width, height, and buccal bone thickness, though these trends were not statistically significant in direct group comparisons. Notably, multinomial regression indicated that these ridge preservation parameters significantly predicted patient allocation to group A. No significant differences were found between healthy and controlled diabetic patients. DP + PRF + CP combination outperformed controls in ARP, with comparable early healing.
Abstract Focal disease is a process in which bacteria, bacterial toxins, and metabolites from a clinically asymptomatic inflammatory focus enter distant tissues via the bloodstream, causing disease symptoms. The origin of the disease is an inflammatory focus, which itself does not cause any clinical symptoms but is the source of symptomatic infection in distant tissues or organs. Focal disease tends to progress into a chronic state. In recent years, numerous scientific publications have highlighted the correlation between odontogenic inflammatory foci and the occurrence of diseases such as atherosclerosis, rheumatoid arthritis, neurodegenerative diseases, infective endocarditis, diabetes, and cancer. This literature review aims to present the latest evidence on the existence of focal disease and the correlation between the pathological oral flora and systemic diseases. In order to create this article, the PubMed database was searched, and 36 articles met the inclusion criteria.
Abstract While domiciliary dental care is not a new concept, the shift in healthcare delivery post-COVID-19, with aging populations and mobile care gaps, presents a critical unmet need. The need for patients with intellectual disability, physical limitations, and social and emotional deficits to maintain good oral hygiene, reduce pain, and achieve proper function. This approach applies to infants, children, and adults with special healthcare needs. Geriatric patients as well consistently face limited access to service while providers struggle with infection control outside the clinic. It is the usual role of the operator to come up with a diagnosis & dental care management plan and prioritize appropriate treatment. In the dental home, several more duties are deployed. It is necessary to select the best dental home arrangement for the patient that reduces risks and errors, maximizing safety and efficiency. In some cases where patient mobilization is impossible, the patient position is fixed under challenging settings and will dictate the position of the operator, assistant, and portable machine. Another duty at the dental home is to ensure proper communication between family members and coordinate the patient's future care. The review seeks to point out workflow guidelines, importance of effective communication, comprehensive safety guidelines in the use of mobile dental units MDUs and portable X-ray machines. In addition, propose ergonomic solutions, standardize procedures, and address practical challenges faced by professionals supported by global protocols and contextualized for underrepresented settings.
Abstract Periodontal disease is an inflammatory condition of the supporting tissues of the teeth, comprising the gingiva, cementum, periodontal ligament, and alveolar bone. The inflammatory and immune responses occurring in periodontal tissues serve a protective function; however, when dysregulated, they can significantly contribute to tissue destruction. If untreated, the disease may lead to tooth loss and diminished quality of life. Host response modulation therapy is an adjunctive treatment designed to address host–bacterial interactions. This study aims to explore the potential of Moringa oleifera leaf extract as a host modulation therapy (HMT), particularly in its role as an anti-inflammatory and wound-healing agent in periodontal disease. This study followed the scoping review methodology based on Joanna Briggs Institute (JBI) guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) reporting framework. Literature searches were conducted in PubMed, Scopus, EBSCOHost, ScienceDirect, and SpringerLink, with additional manual searches. Inclusion criteria were determined using the Population, Concept, and Context (PCC) framework recommended by JBI. Eleven articles fulfilled the inclusion criteria, comprising nine in vivo investigations involving animal models and two clinical studies involving humans. All included articles reported significant anti-inflammatory and wound-healing abilities of M. oleifera leaf extracts. The bioactive compounds in M. oleifera, recognized for their anti-inflammatory and antioxidant properties, support these actions and promote wound healing. This study demonstrated that M. oleifera leaf extract has potential as an HMT due to its ability to reduce proinflammatory cytokines and increase regenerative factors that support the wound healing process. The high antioxidant activity, particularly of polyphenolic compounds, also underlies both functions.
Abstract Temporomandibular joint disorders (TMDs) affect a substantial proportion of the population and represent the second most common musculoskeletal complaint after chronic low back pain. Arthrocentesis has emerged as an effective, minimally invasive, and cost-efficient treatment option for patients who do not respond adequately to conservative therapies such as nonsteroidal anti-inflammatory drugs, physiotherapy, and occlusal splints. Since its first description by Nitzan in 1991, both the technical aspects of arthrocentesis and the range of intra-articular agents used in conjunction with lavage have evolved considerably. Recent developments include single-needle and modified techniques, image-guided and navigation-assisted approaches, and the use of orthobiologic agents such as platelet concentrates and bone marrow-derived products. This narrative review summarizes contemporary diagnostic imaging and functional assessment methods, modern conservative treatment modalities, current arthrocentesis techniques, and up-to-date evidence on intra-articular pharmacologic and biologic agents. In addition, a pragmatic clinical decision-making framework is outlined to situate arthrocentesis within a stepwise management algorithm for TMDs. Overall, current data support arthrocentesis as a safe and effective option in selected patients; however, heterogeneity in techniques and injection protocols underscores the need for well-designed randomized controlled trials to establish standardized, patient-specific treatment pathways.
Abstract Guided tissue regeneration (GTR) uses a barrier membrane to inhibit soft tissue growth into damaged areas. The test membrane represents a third-generation GTR membrane, composed of calcium alginate for controlled bioactive release and zinc oxide nanoparticles (ZnO-NP) for antimicrobial activity. This study evaluated a novel calcium alginate–ZnO-NP membrane fabricated by electrospinning and compared its in vivo biocompatibility and biodegradation with a commercial SureDerm membrane. Fifty-four Sprague–Dawley rats were divided into three groups: a sham control without membrane implantation (group A), a commercial SureDerm membrane (group B), and a calcium alginate–ZnO-NP-based membrane (group C). ZnO-NP were synthesized using a sol–gel method, and the test membrane was fabricated by electrospinning. Material characterization was conducted prior to implantation. Each membrane specimen (1 × 1 cm) was implanted subcutaneously into the dorsal region. The animals were sacrificed at 7, 21, and 63 days. Biodegradation was assessed macroscopically (visibility) and microscopically (degradation), while biocompatibility was evaluated microscopically, following ISO 10993-6 standards. Data were analyzed using the Kruskal–Wallis test to compare membrane visibility and degradation. The calcium alginate–ZnO-NP membrane demonstrated a tensile strength of 3.90 ± 0.23 MPa and an elastic modulus of 47.40 ± 7.42 MPa. Scanning electron microscope –energy dispersive X-ray analysis confirmed a homogenous surface morphology with evenly distributed ZnO-NP. Based on the biocompatibility testing, the test membrane had a similar irritancy score as SureDerm membrane, with an overall irritancy score of minimal/non-irritant. Macroscopic visibility assessments revealed a higher degradation rate in the test membrane compared to SureDerm (p <0.001), which was confirmed by microscopic evaluations (p <0.001). The electrospun calcium alginate and ZnO-NP-based GTR membrane demonstrated biocompatibility equivalent to the SureDerm membrane. However, its biodegradation properties differed, showing a faster but clinically favorable degradation rate than SureDerm. These findings support its potential as a third-generation GTR membrane for periodontal applications.
Abstract Over the past decade, there has been a global increase in patients' concern for dental aesthetics, reflecting heightened awareness of the significance of oral appearance and its impact on self-confidence. The Gingival Black Triangle is the fourth dental aesthetic condition that dental patients complain about, and its reconstruction is very challenging in esthetic dentistry due to the limited blood supply in this area. This review aims to discuss various etiologies, limitations, surgical, and nonsurgical treatment modalities introduced in the literature for managing the gingival Black Triangle.
Abstract This national cross-sectional study investigated the role of YouTube as a supplementary learning tool for clinical procedures among undergraduate dental students in Malaysia. The study examined the frequency of use, the types of procedures most frequently searched, and students' reasons for relying on YouTube as a learning resource. A validated 22-item questionnaire was distributed online to students from 13 dental faculties under the Malaysian Dental Students' Association. The survey covered demographics, perceptions of video credibility, and reliance on YouTube for clinical learning. Data were analyzed using descriptive statistics and Chi-square tests to identify associations between variables. A total of 154 students participated. Of these, 60.4% reported being very likely to consult a YouTube video before performing a new clinical procedure. Convenience and accessibility were the most common reasons for use (17.3%). Prosthodontics (20.5%) was the most frequently viewed discipline, followed by endodontics (18.3%) and oral and maxillofacial surgery (15.8%). YouTube is widely used by Malaysian dental students to supplement clinical training, particularly for procedural learning. Concerns regarding content accuracy and reliability highlight the need for faculty guidance and evidence-based resources. Dental faculties should consider curating institutional video content and training students in critical appraisal of online resources. Integrating curated digital materials into curricula may strengthen clinical preparedness, student confidence, and competency.
Abstract Considering the increased use of digital workflows in restorative dentistry, abutments with computer-stored geometry aided by Computer-Aided Designing/Computer- Aided Manufacturing (CAD/CAM) technology systems for rapid restoration fabrication, also known as Ti-base abutments, have gained interest. This study aimed to evaluate the influence of the type of cement, aging, and implant connection on the retention of zirconia crowns cemented onto the Ti-base abutment. To accomplish this, the specimens were divided into four groups regarding implant connection and cement: Ti-base on External Hexagon (EH) connection (n= 20), Ti-base on Morse taper (MT) connection (n = 20), and temporary or definitive cement. All groups were evaluated with or without mechanical aging and underwent a tensile test to evaluate the retention strength. Data analysis was assessed using the Shapiro-Wilk, three-way analysis of variance (ANOVA) with repeated measures, and Tukey’s test (p < 0.05). The failure mode was also recorded. The MT connection presented a statistically significantly higher average retention strength than the EH connection. Groups with the definitive cement on MT connection presented the highest value compared with the temporary cement groups (565 N and 491 N, respectively). Most mixed failures were found for all groups. Overall, the mechanical aging reduced the retention strength of milled zirconia crowns cemented on Ti-base abutments. The definitive cement promoted higher retention strength on MT connection compared with EH.
Abstract Artificial intelligence (AI) has emerged as a promising tool in oral and maxillofacial surgery (OMFS), particularly in enhancing diagnostic accuracy, surgical planning, and risk prediction. This narrative review critically evaluates current AI applications across key clinical domains, including lesion detection and classification in diagnostic imaging, prediction of surgical difficulty and inferior alveolar nerve injury in impacted third molar surgery, cone-beam computed tomography–based bone assessment and implant planning, automated landmark detection and surgical simulation in orthognathic surgery, classification of temporomandibular joint disorders, and prognostic modeling in oral oncology. Despite encouraging results, most studies are based on retrospective, single-center datasets with limited external or prospective validation. Methodological heterogeneity, inconsistent outcome definitions, and insufficient integration into clinical workflows remain major barriers to translation. While AI demonstrates significant potential as a decision-support tool in OMFS, current evidence does not yet support widespread clinical implementation. Future research should prioritize robust validation strategies, clinically meaningful endpoints, and seamless integration into surgical practice.
Abstract This study aimed to develop and evaluate a deep learning-based model for automated detection and severity classification of dental caries on panoramic radiographs. A total of 500 panoramic radiographs were collected and divided into training (n = 400), validation (n = 50), and testing (n = 50) datasets. Two separate annotation sets were prepared to develop a caries detection and a severity classification model based on the International Caries Classification and Management System (ICCMS). Image annotation was performed using Roboflow and validated by two radiologists. Four variants of the YOLOv5 architecture (s, m, l, and x) were trained on Google Colab Pro for both tasks. Model performance was evaluated using confusion matrices at five confidence thresholds (10%, 20%, 30%, 40%, and 50%). Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false case distribution were then analyzed. The YOLOv5s and YOLOv5x variants achieved the highest overall performance for the 1-class caries detection model (recall 73.8%, precision 78.8%, mean average precision at IoU 0.50 [mAP50] 74.3%) and the 2-classes severity classification model (recall 55.8%, precision 61.0%, mAP50 54.8%), respectively. The 1-class detection model outperformed the severity classification model, with average accuracy, sensitivity, specificity, PPV, and NPV of 94.32%, 49.40%, 97.70%, 72.75%, and 95.99%, respectively, compared with 93.41%, 45.90%, 96.86%, 62.07%, and 95.91% for the 2-class model. The YOLOv5 model demonstrated reliable performance in the automated detection of dental caries and classification of lesion severity on panoramic radiographs, with stronger performance observed in detection, highlighting their potential as a supportive tool in clinical decision-making.
Abstract Mandibular gunshot injuries are devastating traumas that often result in extensive bone loss, soft tissue scarring, neurosensory dysfunction, and profound impairment of oral function. While reconstructive techniques restore skeletal continuity, persistent soft tissue deficiencies and relapse of vestibular depth frequently compromise prosthetic rehabilitation. A 43-year-old male military officer sustained a mandibular gunshot injury in 2017 and underwent multiple reconstructive surgeries, including plate fixation and plastic surgical interventions, at different centers. Upon presentation to our clinic, a staged treatment plan was implemented: removal of the superior segment of the reconstruction plate, technically demanding vestibuloplasty in a heavily scarred field, and stabilization with a custom-made clasp-retained acrylic vestibuloplasty splint. The splint, fabricated from heat-cured pink acrylic resin with metallic clasps engaging adjacent tooth, was worn continuously for 3 months to maintain vestibular depth. After mucosal stabilization, three implants were placed, with continued splint use for an additional 6 weeks postoperatively. A fixed implant-supported prosthesis was subsequently delivered. At 1-year follow-up, vestibular depth was preserved, implants were functional, and esthetic and functional outcomes were satisfactory. Importantly, the patient demonstrated strong compliance, expressed high satisfaction, and reported significant improvement in quality of life despite partial persistence of inferior alveolar nerve hypoesthesia. This case highlights the importance of a patient-specific, multidisciplinary approach to mandibular gunshot trauma. Combining staged soft and hard tissue surgery with individualized prosthetic planning and patient cooperation can successfully restore oral function, esthetics, and quality of life in complex trauma cases.
Abstract Oral surgery epidemiological studies are crucial for understanding the prevalence and distribution of oral and maxillofacial diseases. It can identify risk factors and help in the development of prevention and treatment strategies. This study aimed to identify the most common oral surgical diagnoses and treatments performed over a 6-year period. It also evaluated patient demographic patterns in relation to diagnoses and interventions, along with diagnosis–treatment correlations and yearly trends. This retrospective study analyzed records of 1,528 patients who underwent oral surgery between 2018 and 2023. Diagnoses and treatments were assessed for frequency. Patient age and sex distributions were evaluated across diagnoses and treatments. Trends over time were assessed using normalized frequency and linear regression. The most frequent diagnoses were pericoronitis (32%), short frenulum of the upper lip (19%), and retained root (18%). The most common treatments were surgical tooth extraction (59%), frenectomy (19%), and apicoectomy (13%). Frenectomy was more common in younger patients (<14 years) and females, while alveoloplasty was more frequent in older adults. A strong diagnosis–treatment association was found (p < 0.001). Year-to-year comparisons revealed a general decline in surgical procedures over the study period, particularly in 2020, although trends were not statistically significant. Pericoronitis, frenulum abnormalities, and retained root were the leading oral surgical diagnoses, with tooth extraction being the most common procedure. Diagnosis and treatment patterns varied significantly by age and gender. A nonsignificant decline in surgical volumes suggests post-pandemic shifts toward preventive care.
