Objectives: The objectives of this study were to investigate whether cone-beam computed tomography (CBCT) provides additional benefit in assessing periodontal infrabony defect topography, and whether assessment accuracy differed between clinicians in periodontology with different levels of experience. Background: A comprehensive assessment of the periodontal condition usually comprises clinical periodontal examination and two-dimensional radiographic evaluation. Whilst periapical radiographs are the most frequently employed for radiographic assessment of periodontal bone loss, they have some limitations in assessing infrabony defects. As a result, CBCT has been gaining attention recently as an adjunctive periodontal diagnostic modality that can overcome these limitations. It is well established that the use of CBCT for periodontal diagnosis is not routine and should only be reserved for judicious case selection in accordance with the as low as reasonably achievable (ALARA) principle. Given these considerations, studies evaluating whether CBCT provides any additional benefit in the assessment of periodontal infrabony defects remain limited, and no formal guidelines currently exist regarding its role or implementation in postgraduate periodontal education. Methods: Forty-six participants (26 residents and 20 specialists in periodontology) from three European Federation of Periodontology (EFP)-accredited centres were invited: King’s College London (KCL), United Kingdom; KU Leuven, Belgium; and The University of Hong Kong (HKU), Hong Kong SAR, China. The participants were required to complete two case-based questionnaires on infrabony defect assessment, with a two-week washout period in between. Eight complex cases were presented, once with periodontal charting and periapical radiography (Questionnaire S1), and once with CBCT images in addition to the conventional data (Questionnaire S2). For all eight cases, an HKU panel performed reference-standard intra-surgical or CBCT measurements against which the participants’ answers were scored. Results: Forty participants returned the questionnaires (25 residents and 15 specialists). The response rate was, therefore, 87.0%. Participants assessed the infrabony defects more accurately in Questionnaire S2 compared with Questionnaire S1 (the mean scores [%] were 69.8 ± 11.9 and 63.5 ± 11.8 respectively); the mean difference was statistically significant (p < 0.001). When comparing residents and specialists, the mean difference in scores (%) was 0.5 (95% CI: −7.4–8.5) for Questionnaire S1 and −2.5 (95% CI: −10.4–5.5) for Questionnaire S2, with neither difference reaching statistical significance (p > 0.05). However, a larger study is required to draw more definitive conclusions about differences between clinician groups. Conclusions: CBCT, adjunctive to conventional periodontal diagnostics, provided statistically significant additional benefit in assessing infrabony defect topography by increasing assessment accuracy. However, whether the magnitude of this improvement is clinically meaningful requires further research. This study shows that between residents and specialists in periodontology, there was no statistically significant difference in the accuracy of infrabony defect topography assessment; nonetheless, given the limited sample size, further work is needed to clarify potential between-group differences. Whilst keeping the ALARA principle in mind, this study highlights the need for further investigation into the value of CBCT in complex periodontal cases, emphasises the importance of defining its role in postgraduate periodontal education, and underscores the need for a larger-scale study involving additional EFP-accredited centres to enable more robust conclusions.
Objectives: This systematic review aims to compare the forces and moments generated by thermoforming aligners and direct-printed aligners in guiding tooth movement in orthodontic patients, evaluating their impact on orthodontic outcomes. Methods: A systematic search was conducted in PubMed, Web of Science, and Scopus databases, covering studies on thermoforming and direct-printed aligners from inception to October 2024. Eligible studies included randomized controlled trials, quasi-experimental studies, and observational studies assessing forces and moments generated by these aligners on teeth. In vitro studies pertinent to the topic were also considered. Data extraction focused on study characteristics, aligner details, force and moment measurements, and clinical outcomes. Quality assessment utilized the ROBINS- I for Risk of Bias. The review has been registered on PROSPERO CRD42024620341. Results: A total of nine studies met the inclusion criteria. Findings indicate that thermoforming aligners, while effective in initial force application, exhibit significant force decay over time due to material stress relaxation. In contrast, direct-printed aligners maintain more consistent force levels, potentially resulting in more predictable and sustained tooth movement. Both aligner types vary in their ability to control force direction and magnitude, with direct-printed aligners showing advantages in customization and force retention. Conclusions: The biomechanical properties of thermoforming and direct-printed aligners offer distinct advantages and limitations. Direct-printed aligners may enhance clinical predictability and reduce treatment time through consistent force application, though further research is necessary to validate these benefits in clinical settings. This review underscores the importance of material selection and fabrication method in optimizing orthodontic outcomes.
Background/Objectives: Dental biofilm formation on prosthetic materials contributes to oral diseases and material degradation. This pilot study evaluated the feasibility of combining time-domain optical coherence tomography (TD-OCT) and non-contact atomic force microscopy (NC-AFM) to characterize biofilm-associated optical and surface changes in dental prosthesis materials following antiseptic treatment. Methods: Acrylic resin, composite resin, and stainless-steel specimens were inoculated with Streptococcus mutans biofilms and exposed to water, Orahex, and Watsons mouthwash. TD-OCT was used to obtain extinction coefficient (EC) and optical thickness measurements, while NC-AFM was performed on Orahex-treated specimens to assess nanoscale surface morphology. EC distributions were analyzed descriptively from valid TD-OCT A-scans. Results: Within the examined specimens, EC distributions varied following biofilm formation and antiseptic treatment, with material-dependent responses. Composite resin exhibited the clearest reduction in EC following Watsons treatment, whereas acrylic resin and stainless-steel specimens showed more variable responses. Physical thickness remained relatively stable, while NC-AFM observations of the Orahex-treated specimens supported the TD-OCT findings by demonstrating corresponding surface morphological changes. Conclusions: This pilot study demonstrates the preliminary feasibility of integrating TD-OCT with NC-AFM for non-destructive evaluation of biofilm-associated optical and surface changes in dental prosthesis materials. The findings are descriptive and exploratory, highlighting the potential of TD-OCT for monitoring prosthetic materials while emphasizing the need for future studies incorporating independent biological replicates and complementary biological validation techniques.
Objectives: To evaluate the corrosion behavior and surface characteristics of four nickel-containing orthodontic archwires (stainless steel (SS), superelastic nickel–titanium (NiTi), copper–nickel–titanium (CuNiTi), and multiforce NiTi) under unused, in vitro artificial saliva-immersed, and clinically used (in vivo) conditions. Methods: Rectangular SS, NiTi, CuNiTi, and multiforce NiTi archwires were analyzed in the following three conditions: as received, after one week of immersion in artificial saliva (pH 6.4), and after clinical use for 6–8 weeks. Corrosion behavior was assessed using cyclic voltammetry (CV), open-circuit voltammetry (OCV), and electrochemical impedance spectroscopy (EIS). Surface morphology was examined by scanning electron microscopy (SEM). Results: Corrosion behavior was dependent on archwire type and exposure condition. SS archwires exhibited reduced impedance response after clinical use, indicating passive-film degradation. In the clinically used NiTi specimen, pronounced electrochemical instability was observed, characterized by a deep OCV transient, slow repassivation, and SEM evidence compatible with localized pitting corrosion. In the CuNiTi specimens, minimal differences were observed between the unused and clinically used conditions, which may be consistent with stable passive-film integrity in these specimens. In the multiforce specimen, clinical use was associated with a higher impedance response than the unused and saliva-immersed conditions of that same specimen. In the saliva-immersed specimens, possible passive-film formation and a higher impedance response were observed relative to the other conditions of the same specimens, but these did not reproduce the electrochemical and morphological changes observed after clinical use. Conclusions: In vitro artificial saliva immersion does not reliably replicate in vivo aging of nickel-containing orthodontic archwires. Corrosion behavior evolves during clinical service in an archwire-specific manner, with NiTi archwires showing susceptibility to clinically induced surface degradation.
Background/Objectives: Directly printed orthodontic appliances rely mostly on vat-photopolymerisation resins; pre-polymerised thermoplastics processed by fused deposition modelling (FDM) and selective laser sintering (SLS) are a less-explored, single-component route, but are poorly characterised. This study compared six thermoplastic material–process systems, supplied for biomedical or dental use, using a single intraoral-simulating protocol. Methods: Thin specimens (25 × 5 × 0.6 mm) of polyethylene terephthalate glycol (PETG), polycarbonate (PC), polyamide (PA), polyether-ether-ketone (PEEK) and a thermoplastic copolyester elastomer (TPC) printed by FDM, and of polyamide 12 (PA12) by SLS, underwent three-point bending and 10 min stress relaxation at 37 °C in artificial saliva (n = 5). Differences were assessed using the Kruskal–Wallis test with Dunn post hoc comparisons (Holm correction), and Fourier-transform infrared (FTIR) spectroscopy was used to compare virgin and printed materials for the five FDM polymers. Results: Apparent flexural moduli were 989 (PA12), 750 (PC), 687 (PEEK), 509 (PETG), 85 (PA) and 32 MPa (TPC), a very large material effect (ε2 = 0.95), with post hoc comparisons separating only the extremes of that range. Relaxation over 10 min ranged from 2.6% (PC) to 22.1% (PA12) among the five materials in which it could be quantified, with TPC falling below the load-cell resolution; expressed as force, PA12 lost the most (0.86 N) and yet still delivered 3.01 N, which was above the initial force of PEEK, PETG, PA and TPC, though not separable from that of PC, which retained 97.4% of its own. Virgin and printed spectra were concordant (Pearson r ≥ 0.986, against ≤ 0.80 between different materials). Conclusions: The PA12/SLS system was the stiffest, followed by PC and PEEK, but, as the only laser-sintered material, its polymer and process effects cannot be separated. PETG and PC combine useful stiffness with accessible FDM; PA and TPC are far more compliant. These specimen-level findings provide a screening basis for selecting material–process systems for printed orthodontic appliances, preceding device-level validation.
Background/Objectives: Accurate selection of stainless steel crown (SSC) size is essential for successful restoration of primary molars. Conventional crown selection relies on a trial-and-error approach, which may increase chair time and reduce clinical efficiency. Preoperative digital radiographic measurements may provide an objective adjunct for predicting SSC size; however, evidence supporting their agreement with clinically selected crown sizes remains limited. This study aimed to evaluate the agreement between preoperative digital radiographic measurements and clinically fitted SSC size in primary molars, and to assess whether this agreement is influenced by dental arch or tooth type. Methods: This retrospective cross-sectional study analyzed archived patient records and preoperative digital radiographs of pediatric patients who received SSCs on primary molars. Mesiodistal tooth dimensions were measured and converted to SSC sizes according to manufacturer guidelines. The clinically fitted and cemented crown size, as recorded in the patient chart, served as the reference standard against which radiographically predicted size was compared. Intra-examiner reliability was assessed using the intraclass correlation coefficient. Associations were analyzed using chi-square tests and binomial logistic regression (p ≤ 0.05). Given repeated teeth within patients, the primary logistic regression model was additionally re-fit using generalized estimating equations (GEEs) with an exchangeable working correlation structure and robust standard errors, and prediction error was further characterized using near-miss accuracy, direction of bias, weighted kappa, and Bland–Altman analysis. Results: A total of 152 primary molars from 71 patients were included. Intra-examiner reliability was excellent (ICC = 0.99). Radiographic prediction agreed with the clinically fitted crown size in 33.6% of cases, and 69.7% of predictions fell within one crown size of the cemented crown. Agreement was significantly higher for mandibular molars than maxillary molars (p = 0.010) and varied by tooth type (p < 0.001). Mandibular molars were more likely to show accurate prediction (OR = 2.52; 95% CI: 1.23–5.17); this association remained statistically significant after accounting for within-patient clustering using GEEs with an exchangeable correlation structure (OR = 2.46; 95% CI: 1.10–5.49; p = 0.029). Maxillary first molars showed a systematic under-prediction of exactly two crown sizes in 97% of cases (mean bias −2.00), identifying a specific, correctable calibration problem. Conclusions: Preoperative digital radiographic measurements show moderate agreement with clinically fitted crown size and may serve as a useful adjunct to clinical judgment for SSC size selection, particularly for mandibular molars. Because the reference standard reflects clinical judgment itself rather than an independent anatomical gold standard, these findings should be interpreted as a concordance analysis, and further prospective work is needed before efficiency benefits can be confirmed.
Background/Objectives: Patients with fixed orthodontic appliances are at increased risk of plaque accumulation, gingivitis, and caries because brackets and bands hinder mechanical hygiene. This study evaluated whether regular home use of dual-light antibacterial photodynamic therapy (aPDT) supports oral hygiene during fixed orthodontic treatment in adolescents. Methods: In a single-center, randomized, assessor-blinded trial, forty-one adolescents starting fixed orthodontic treatment were randomised to a Control group (standard hygiene) or a Test group (standard hygiene plus home-use dual-light aPDT). Visible Plaque Index (VPI%), Bleeding on Probing (BOP%), and Orthodontic Plaque Index (OPI) were assessed at baseline and 12 weeks by an assessor blinded to allocation. After two protocol-driven exclusions, 39 participants (20 Test group, 19 Control group) were analysed. Site-level proportions were compared using the chi-square test. Results: VPI decreased in both groups, with a larger mean within-group reduction in the Test group (−7.0%) than in the Control group (−3.7%); exploratory site-level analysis showed a greater reduction in plaque-positive sites in the Test group at 12 weeks (p < 0.001). BOP increased in both groups but to a smaller extent in the Test group (mean +2.4% versus +5.7%), and a higher proportion of Test-group participants maintained BOP ≤ 10% (85% versus 58%); bleeding-positive sites were lower in the Test group at 12 weeks (p < 0.001). The Test group also showed a flatter distribution of OPI scores around orthodontic brackets. No device- or protocol-related adverse events were reported. Conclusions: In adolescents undergoing fixed orthodontic treatment, regular home use of dual-light aPDT was safe and associated with better site-level plaque and bleeding control, with directional but non-significant trends at the participant level. The findings support further evaluation of dual-light aPDT as an adjunct to mechanical hygiene during this vulnerable treatment period.
Background/Objectives: Orofacial laserology is being increasingly incorporated into contemporary dental practice, yet its integration into dental education remains inconsistent. National evidence regarding institutional readiness for integrating orofacial laserology into dental curricula remains limited. This study examined the current status of orofacial laserology education in Thailand. Methods: A national cross-sectional survey was conducted between May and July 2026 among all accredited Thai dental schools. Academic leaders and full-time lecturers completed a structured online questionnaire addressing curriculum implementation, educational delivery, competency assessment, institutional readiness, perceived barriers, and future priorities. Descriptive and non-parametric statistical analyses were performed. Results: Fifteen of 18 dental schools (83.3%) participated, yielding 38 respondents. Undergraduate orofacial laserology education showed limited curricular integration, whereas postgraduate programs demonstrated broader implementation, particularly in hands-on, supervised clinical, and competency-based training. Institutional readiness did not differ between academic leaders and full-time lecturers (p > 0.05). Across historical phases of institutional establishment, perceived importance (p = 0.743) and interinstitutional collaboration (p = 0.800) were comparable, whereas institutional readiness differed significantly (p = 0.008), with regional pioneer dental schools reporting higher readiness than expansion-phase and contemporary dental schools. The principal barriers were insufficient qualified instructors, limited curriculum integration, and high equipment costs. Faculty development, funding and equipment support, and national competency frameworks were identified as the highest priorities. Conclusions: Orofacial laserology education in Thailand remains heterogeneous, with broader implementation in postgraduate than undergraduate programs. Strengthening faculty capacity, competency-based curricula, institutional support, and national collaboration may facilitate more consistent integration of orofacial laserology into dental curricula.
Background: Reconstruction of craniofacial bone defects caused by tumor removal, infection, congenital anomalies, or trauma remains a major challenge. Recent advances in artificial intelligence (AI), digital imaging, and additive manufacturing have enabled personalized treatment strategies. This review discusses AI-driven workflows from cone-beam computed tomography (CBCT) image acquisition to implant fabrication using patient-specific bioceramics. Methods: Several electronic databases were searched, including Scopus, PubMed, ScienceDirect, and Web of Science. A peer-reviewed article published between 2015 and 2026 was considered for inclusion. This review provides an overview of AI applications in craniofacial tissue engineering, including CBCT image segmentation, three-dimensional reconstruction, virtual surgical planning, computer-aided design/computer-aided manufacturing (CAD/CAM), topology optimization, finite element analysis, and three-dimensional bioceramic scaffold printing. Results: AI improves accuracy, efficiency, and reproducibility of craniofacial reconstructions when used in conjunction with AI-assisted workflows. Through automated image segmentation and anatomical modeling, operator dependence can be reduced, and predictive algorithms can optimize biomechanical properties. CAD/CAM and 3D printing are used to manufacture bioceramic implants with controlled porosity, mechanical integrity, and enhanced osteoconductive properties. AI-driven predictive models have demonstrated potential for supporting material selection, manufacturing quality control, and treatment planning; however, their ability to reliably predict long-term postoperative outcomes requires further validation through prospective clinical studies. Data standardization, algorithm transparency, regulatory approval, clinical trial validation, and ethical considerations remain challenges. Conclusions: AI, CBCT imaging, computational modeling, and advanced bioceramic manufacturing are being combined to create an end-to-end digital workflow for personalized reconstruction. Clinical studies must be conducted prospectively to maximize the therapeutic potential of these technologies.
Background/Objectives: In institutionalized older adults, we examined the concordance between self-reported xerostomia and chairside salivary dysfunction and explored whether a smaller subset of Xerostomia Inventory items could retain comparable screening performance. Methods: This cross-sectional study included institutionalized older adults. The 11-item Xerostomia Inventory was compared with a six-marker chairside whole-saliva panel, with all variables scaled 0 (normal) to 1 (pathological). We measured how closely symptoms tracked each objective marker, how well the questionnaire identified hyposalivation, and whether fewer questions could be comparable with the full 11-item inventory. Results: The study included 90 participants, with a mean age of 79.5 years; 55.6% were women. Symptoms tracked every marker in the expected direction (correlation τ-b 0.32 to 0.62). The questionnaire identified objective hyposalivation with an area under the ROC curve of 0.87 (95% CI 0.78–0.96) and substantial chance-corrected agreement (Cohen’s κ 0.69, 95% CI 0.51–0.87). A five-item short form reproduced the objective findings as well as the full questionnaire did (cross-validated R2 0.56 ± 0.03 versus 0.56). Conclusions: In this high-prevalence institutional cohort, self-reported symptoms agreed with graded salivary function more closely than the older discordance literature would suggest, though still within the range of recent studies rather than beyond it. A five-item subset, chosen for its alignment with the objective salivary axis rather than for internal consistency, recovered as much as the full inventory, which points to a short, function-oriented score as a plausible first-stage screen. We would treat this short form as a candidate first-stage screening approach that requires external validation, rather than as a replacement for objective salivary assessment or as a validated replacement for the Xerostomia Inventory.
Background: Dental caries remains a globally prevalent biofilm-mediated disease driven by microbial dysbiosis and progressive enamel demineralization. The traditional “drill and fill” paradigm has increasingly given way to biologically informed preventive frameworks emphasizing ecological management. Methods: This narrative review synthesizes 134 studies (2016–2026) retrieved from PubMed, Web of Science, Scopus, and Google Scholar to evaluate emerging caries prevention strategies across three domains. Results: Three interrelated domains of advancement were identified. First, microbial ecological modulation—including probiotics, prebiotics, and targeted antimicrobial peptides—aims to restore oral microbiome homeostasis by disrupting cariogenic virulence without eliminating commensal flora. Second, nanomaterial-based targeted interventions utilizing stimuli-responsive carriers and biofilm-penetrating nanoparticles enable site-specific drug delivery with enhanced therapeutic efficacy. Third, precision-guided strategies incorporating caries risk assessment models and salivary biomarker diagnostics facilitate individualized prevention protocols. Conclusions: These findings demonstrate a fundamental paradigm shift from indiscriminate microbial eradication to equilibrium-driven, ecology-centered disease management. Future directions include AI-assisted personalized prevention, chairside microbiome diagnostics, and smart responsive biomaterials for sustained caries control.
Background: Epstein–Barr virus (EBV) enters the human body via saliva. EBV-encoded latent membrane protein-1 (LMP-1) activates the mitogen-activated protein kinase (MAPK) pathway. MAPK signaling pathway activation due to the BRAF-V600E mutation is widely known as a major event in the pathogenesis of ameloblastoma. It is unclear whether EBV infects ameloblastoma and is involved in the pathogenesis of ameloblastoma. We investigated the relationship between LMP-1 and BRAF-V600E mutant protein expression in ameloblastoma by immunohistochemistry. Methods: We examined a total of 334 samples (ameloblastoma 117 samples, odontogenic keratocyst 127 samples, dentigerous cysts 45 samples, and dental follicle 45 samples). Ephrin type-A receptor 2 (EphA2), BRAF-V600E mutant protein, and γH2AX expression were confirmed by immunohistochemistry. We confirmed that the positive cases of BRAF-V600E mutant protein and γH2AX segregated based on LMP-1 expression: high grade (HG) and low grade (LG). Results: EphA2 expression was high in all lesions. The positive rate of BRAF-V600E mutant protein expression was significantly higher in ameloblastoma, and the positive rate of BRAF-V600E mutant protein in LMP-1 HG cases (71.9%) was significantly greater than in LG cases (39.6%) in ameloblastoma. The positive rate of γH2AX expression was significantly higher in ameloblastoma than in the other lesions. The positive rate of BRAF-V600E mutant protein in LMP-1 HG cases (71.9%) was significantly greater than in LG cases (39.6%) in ameloblastoma. Conclusions: BRAF-V600E mutant protein and γH2AX expression in ameloblastoma were significantly higher in LMP-1 HG cases than in LG cases.
Background: Accurate reproduction of occlusal anatomy is a critical determinant of the clinical performance of posterior composite restorations. The present study compares marginal adaptation in Class I composite restorations completed using a Kool-Dam STAMP, a flowable-composite STAMP, or conventional hand-carving techniques. Methods: Sixty extracted caries-free molars were randomly allocated to three experimental groups (n = 20). Two fixed marginal sites per tooth (mesial and distal) were measured at four measurement time points: immediately after restoration, before thermocycling, and after 10,000, 30,000, and 50,000 cumulative thermal cycles (5 °C/55 °C; 20 s dwell time). The two site-level values were averaged within each tooth for the primary analysis. A linear mixed-effects model included technique, measurement time point, and the technique-by-time-point interaction, with a random intercept for tooth. Results: No significant interaction was observed between restorative technique and measurement time point, indicating that changes in marginal gap over time were not statistically significant among the three techniques (likelihood-ratio χ2(6) = 1.43, p = 0.964). The overall effect of the technique was also not significant (χ2(2) = 1.26, p = 0.532). In contrast, marginal-gap measurements increased considerably across the four measurement time points (χ2(3) = 218.52, p < 0.001), indicating progressive increases in marginal gaps with thermal ageing. Following the Holm adjustment, no pairwise comparisons between techniques at any individual time point achieved statistical significance. Conclusions: In the present in vitro study, no statistically significant differences in marginal-gap values were detected among the Kool-Dam STAMP, flowable-composite STAMP, and conventional hand-carving techniques. The study was not designed to demonstrate equivalence or noninferiority; therefore, the absence of a statistically significant difference should not be interpreted as evidence that the techniques are equivalent. These findings suggest that the STAMP approach may be a useful technique for reproducing occlusal morphology while maintaining marginal fit. However, further clinical studies are needed to confirm its long-term performance in vivo.
The practice of contemporary dentistry requires not only technical skills but also the development of soft skills, such as communication, empathy, and ethical and professional values. Although the importance of these skills is increasingly recognized, the perceptions of dental students in Romania regarding their relevance to their future professional practice remain insufficiently explored. Objectives: The study aimed to assess the perceptions of final-year students at the Faculty of Dentistry in Iași regarding the importance of soft skills, in relation to their demographic characteristics, professional motivations, and preferences regarding their future practice settings, as well as to identify distinct profiles through cluster analysis. Material and Methods: The study included 205 students in their fourth through sixth years at the Faculty of Dentistry in Iași, who anonymously completed a 26-item questionnaire rated on a Likert scale from 1 to 5. The statistical analysis included the chi-square test, Ward’s method, and k-means clustering. Results: Ethical and professional values, artistic skills, and empathy were most frequently rated as “very important.” Female students assigned significantly higher scores than male students to empathy, ethical and professional values, personal characteristics, and communication (p < 0.05–0.001). Professional independence, financial stability, and professional prestige were the main motivations for career choice. Cluster analysis identified four distinct profiles, with significant differences based on gender, professional motivations, and preferences regarding future practice. Conclusions: Students place a high value on soft skills, with differences based on gender and professional profile. The results support the integration of these skills into university education, to complement specialized clinical training.
Objectives: To evaluate the inter- and intra-observer reliability of three methods for measuring root canal curvature and the reliability of canal visibility ratings on periapical radiographs over repeated calibration rounds. Materials and Methods: A total of 360 clinical periapical radiographs were divided into six batches and independently evaluated by three observers. Root canal curvature was measured using the Schneider, Weine, and a novel tangency-based method, while canal visibility was classified on a three-category scale. Inter- and intra-observer reliability were assessed using intraclass correlation coefficients (ICC). Agreement between observers was evaluated using Bland–Altman analysis, and differences between measurement methods were compared using repeated-measures analysis. The association between canal visibility and inter-observer measurement differences was assessed using Spearman rank correlation. Results: Inter-observer reliability for curvature measurements was predominantly good to excellent across all methods, with no consistent improvement over successive calibration rounds. Intra-observer reliability, assessed in one observer, was excellent (ICC 0.90–0.97). Measurement method significantly influenced angle values, with the Weine method producing larger angles than the Schneider and tangency-based methods, whereas the latter two showed comparable results. Agreement on canal visibility remained fair to moderate, and reduced canal visibility showed a weak but significant association with greater inter-observer differences in curvature measurements. Conclusions: All three methods demonstrated comparable inter-observer reliability, although the Weine method yielded systematically larger curvature angles. Agreement did not consistently improve over repeated calibration rounds. Reduced canal visibility may increase measurement variability and should be considered when interpreting root canal curvature on periapical radiographs.
Background/Objectives: Accurate assessment of gingival thickness (GT) is important for periodontal and implant treatment planning. Methods: In this method-comparison study based on prospectively collected clinical data from 2012, GT was assessed at standardized buccal sites using cone beam computed tomography (CBCT), bone sounding (BS), an earlier-generation pulse–echo ultrasound (US) device, and direct digital caliper (CA) measurement. Of 53 acquired CBCT scans, 12 (23%) were non-evaluable because the buccal soft tissues could not be reliably delineated, leaving 41 sites from 41 patients for analysis. A ±0.30 mm clinical comparison margin, based on the difference used in the original sample-size calculation, was applied to interpret agreement. Results: Mean comparator-minus-CBCT biases were −0.19 mm for BS (95% limits of agreement [LoA], −0.98 to 0.61 mm), −0.16 mm for US (95% LoA, −0.83 to 0.51 mm), and −0.71 mm for CA (95% LoA, −1.99 to 0.56 mm). Although BS and the tested US device showed smaller average differences from CBCT than CA, the LoA for all comparisons exceeded this margin. Phenotype classification was exploratory because only four sites were classified as thin by CBCT. Conclusions: BS and the tested pulse–echo US device showed smaller average differences from CBCT than CA; however, the limits of agreement for all comparisons exceeded this margin, so none of the comparator methods can be considered interchangeable with CBCT. The 23% non-evaluable CBCT rate and the device- and protocol-specific nature of the findings limit their generalizability to current-generation systems.
Background: To date, several studies have confirmed the fact that over 700 species of microbiota interacts with host, modulating immunity, controlling the homeostasis environment, and thus maintaining systemic condition. Dysbiosis in the subgingival biofilm can initiate chronic inflammation of the gingiva, potentially progressing to periodontitis. Advances in DNA sequencing analysis of the subgingival microbial community have shown that periodontal treatment causes a microbial shift in subgingival plaque, affecting the taxonomic composition (disease- and health-associated taxa). Yet, none of these have been investigated in Indonesia. Objective: The objective was to profile the composition of oral microbiome in Indonesian population with healthy, gingivitis, and periodontitis status. Further, we analyzed the subgingival bacterial alteration following the therapy in periodontitis group. Methods: Twelve subjects consisting of healthy, gingivitis, and periodontitis patients were included. Additionally, the periodontitis group was observed at baseline, 1-month, and 3-month. Subgingival dental plaque were sampled and 16S rRNA NGS analysis was performed. Alpha (Chao1, Shannon, and Simpson indices) and beta diversity (PCoA plots based on Bray–Curtis dissimilarity) were observed. Microbiota composition at the genus and species levels was analyzed. Results: No statistically significant differences (p > 0.05) were found for Chao1, Shannon, and Simpson indices amongst groups and in periodontitis patients across the observation. At the genus level, PCoA plots based on Bray–Curtis dissimilarity revealed that the clinical status accounted for 21.9% of the total variation (R2 = 0.219, p = 0.197), while at the species level, it accounted for 19.8% (R2= 0.198, p = 0.281). Periodontitis samples across all timepoints showed no distinct clustering at either the genus 7.6% (R2 = 0.076 p = 0.097) or species levels 9.7% (R2 = 0.097 p = 0.995). Top five subgingival microbiota at the genus and species levels in all groups showed definite pattern of composition. Although no significant association was found (p > 0.05), it described that Veillonella parvula, Campylobacter gracilis, and Capnocytophaga granulosa were more abundant in healthy subjects than in gingivitis and periodontitis. Prevotella oris and Selenomonas noxia were less abundant in healthy subject than in gingivitis and periodontitis. In periodontitis subjects, Prevotella intermedia was increased by the therapy at 1 month and reduced again at 3 months. On the other hand, Capnocytophaga granulosa was increased by the therapy at 1 and 3 months. Hoylesella loescheii was reduced by the time. Porphyromonas gingivalis was reduced at 1 month and increased again at 3 months. Discussion: The result showed that the number of alpha diversity was notably higher in the gingivitis and periodontitis groups compared to health group, supporting a trend toward increased community richness and evenness in diseases states. The microbial richness and evenness remained relatively stable across the evaluated periods within periodontitis cohort. Oral microbial composition defines the periodontal status and disease. More abundance of Red Complex bacteria is associated with disease-associated condition. Pathogen re-colonization may occur 3 months after the therapy. Conclusions: These findings suggest that maintaining health-associated microbiome may be beneficial to the clinical status. Periodontal recall may be addressed from 1 to 3 months after the therapy to avoid bacterial re-colonization. Suppressing bacterial dysbiosis and regulating periodontal homeostasis are the main key in managing periodontal treatment.
Background/Objectives: Basic sciences form the conceptual foundation of dentistry, yet their delivery in dental curricula varies worldwide. As demographic shifts, growing healthcare complexity and scientific advances continue to reshape the dental profession, renewed attention to how these subjects are taught has become essential. This comparative narrative review aims to examine different approaches to basic science education in dentistry, exploring variation in curricular structure, depth, timing and pedagogical strategies across diverse dental schools. Particular emphasis is placed on models of vertical, horizontal and spiral integration, the alignment of basic sciences with clinical training and the implications of instructional design for long-term knowledge retention and professional competence. Methods: PubMed and Google Scholar were searched from November 2025 to June 2026 using terms related to dental education, curriculum integration and geographic regions. Sources were selected based on predefined relevance criteria rather than through systematic screening. Published literature was supplemented by structured outreach to faculty representatives using a standardised set of questions. Of the 25 dental schools contacted, nine responded, and five were included. Results: Across the programs examined, a structure of approximately two preclinical years followed by clinical training remained the most common. Early clinical exposure appeared to strengthen student confidence and professional identity. Heavy workload and curricular overload were recurring challenges in the dental curricula examined. Conclusions: The findings suggest that although curriculum integration is widely recognised as essential, no single model appears to be universally superior. Its effectiveness likely depends on the quality of implementation and faculty coordination. However, the lack of independent evaluation studies limits the ability to draw conclusions about the long-term effectiveness of different educational approaches. The review highlights the need for independent and systematic evaluation of dental curricula.
Background/Objectives: Dental caries remains one of the most prevalent and preventable childhood diseases worldwide. Despite universal access to free dental care in Saudi Arabia, preventable oral diseases remain common, highlighting persistent gaps in oral health literacy and preventive behaviours among children. Male students consistently demonstrate poorer oral health knowledge and practices than their female counterparts, yet they remain understudied. This study aimed to assess oral health knowledge, attitudes, and practices (KAP) among male primary school students in Al Lith city, Saudi Arabia, and to identify their associated sociodemographic determinants. Methods: A school-based analytical cross-sectional study was conducted during the 2023–2024 academic year in Al Lith city, Makkah Province, Saudi Arabia. A total of 430 male students aged 10–13 years from grades five and six were recruited via multistage cluster sampling from 8 randomly selected schools. A validated, interviewer-administered, Arabic-language questionnaire assessed knowledge (18 items), attitudes (12 Likert-scale items), and practices (12 items) related to oral health, alongside sociodemographic data. The study was designed and reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Data were analysed using IBM SPSS Statistics version 27. Descriptive statistics and multivariable logistic regression were performed. Results: Of the 430 participants, 83.3% were aged 11–12 years, 89.8% were Saudi nationals, and 89.1% resided in intact, two-parent households. Knowledge deficits were widespread: only 8.4% correctly identified the recommended timing of sweet consumption, 20.2% understood dental plaque, and 28.6% recognised the protective role of fluoride. Attitudes were generally positive, with 80.1% agreeing that teeth should be brushed twice daily and 71.6% endorsing regular dental visits; however, 60.3% held that dental attendance was necessary only when pain was present. Substantial practice gaps were also evident: only 33.3% brushed for the recommended two minutes, and 12.6% had never visited a dentist. In multivariable analysis, low household income was independently associated with better oral health knowledge (adjusted odds ratio [AOR] = 2.22; 95% confidence interval [CI]: 1.04–4.74; p = 0.039), divorced parental status was independently associated with positive oral health attitudes (AOR = 5.40; 95% CI: 1.28–22.79; p = 0.022), and older age was independently associated with poorer oral health practices (AOR = 0.72; 95% CI: 0.55–0.93; p = 0.014). Conclusions: Male primary school students in Al Lith demonstrated generally positive oral health attitudes but significant deficits in knowledge and preventive practices. Comprehensive, school-based oral health promotion programmes that address key misconceptions, actively engage parents, and integrate culturally accepted practices—such as miswak use—with evidence-based preventive guidance are needed.
Background: Vertical implant positioning may influence peri-implant health outcomes and long-term stability; however, the impact of baseline vertical implant positioning relative to adjacent teeth remains unclear. The aim of this systematic review and meta-analysis was to assess the association between baseline vertical implant positioning and peri-implant clinical and radiographic outcomes. Methods: The Cochrane Central Register, PubMed, SCOPUS, and Web of Science were searched. Vertical implant positioning relative to adjacent teeth was assessed using two radiographic reference distances: implant platform to cemento-enamel junction (IP–CEJ) and implant platform to adjacent interproximal alveolar bone level (IP–ABL). The primary outcome was peri-implant marginal bone loss (MBL). Secondary outcomes included implant survival and success rates, peri-implant mucositis and peri-implantitis prevalence. Risk of bias was assessed using the Moga checklist, and certainty of evidence was evaluated according to GRADE. Results: Four studies including 267 implants fulfilled the inclusion criteria. The pooled mean baseline IP–CEJ and IP–ABL distances were 4.69 mm (95% CI 2.05 to 7.32) and 2.13 mm (95% CI 1.29 to 2.98), respectively. The pooled mean marginal bone loss after at least 12 months, based on three studies, was 0.21 mm (95% CI −0.28 to 0.70). Conclusions: The available evidence is insufficient to determine whether baseline IP–CEJ or IP–ABL distances are associated with peri-implant outcomes or to identify an optimal range of vertical implant positioning. The findings should be interpreted cautiously because the certainty of evidence is very low, highlighting the need for prospective studies with long-term follow-up.
