Background/Objectives: Pulp canal obliteration (PCO) complicates endodontic access and increases the risk of procedural errors. This systematic review evaluated the accuracy and tooth-structure preservation of static-guided endodontics and dynamic navigation in teeth with PCO. Methods: This PRISMA 2020-compliant review was registered in PROSPERO (CRD420261403200) after review activities had begun. CENTRAL, Embase, MEDLINE, PubMed, and Scopus were searched from inception to 17 July 2026. Clinical and experimental studies of either technique in permanent human teeth with PCO or calcified canals were eligible; artificial or simulated tooth models were excluded. Risk of bias was assessed with design-specific tools (RoB 2, ROBINS-I, JBI, QUIN). Because designs, comparators, and outcome measures were not sufficiently comparable for pooling, findings were synthesized narratively. Results: Of 490 records identified, 56 studies were included. Guided approaches generally improved canal localization and trajectory accuracy and tended to reduce tooth-structure loss and procedural complications, particularly perforations, although structural preservation was not consistently superior. Procedure-time findings were heterogeneous. Conclusions: Static-guided endodontics and dynamic navigation improve the technical accuracy of access in teeth with PCO and may reduce measured tooth-structure removal and complications. Current evidence does not establish universal superiority over expert conventional access, and standardized long-term clinical trials are needed.
Background: Human immunodeficiency virus (HIV) remains a major global public health challenge. Although antiretroviral therapy has improved survival, long-term health outcomes, including oral health and quality of life, remain important. People living with HIV (PLWH) may experience oral disease and tooth loss, making removable prosthodontic rehabilitation an important yet underexplored aspect of care. This scoping review aimed to map the available evidence on removable prosthodontic needs, access to care, and clinical and patient-reported outcomes among PLWH, identifying evidence gaps and areas requiring further research. Materials and Methods: This scoping review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Electronic databases and manual reference screening were used to identify relevant studies. Nine studies met the inclusion criteria and were qualitatively synthesised due to methodological heterogeneity. Results: The included studies identified unmet prosthodontic needs and potential disparities in access to care, alongside socioeconomic disadvantage and poorer oral health-related quality of life (OHRQoL). Limited evidence suggested improvements in OHRQoL and masticatory function following removable prosthodontic rehabilitation. However, the evidence was insufficient to establish definitive treatment benefits. Findings on oral tissue health and local immune responses were particularly limited. Financial barriers, stigma, and healthcare inequalities were also reported as potential obstacles to accessing prosthodontic care. Conclusions: Removable prosthodontic care may help address the oral functional and rehabilitative needs of PLWH. However, limited evidence and methodological constraints preclude definitive conclusions about treatment effectiveness and long-term outcomes. Further adequately powered longitudinal and interventional studies are needed to evaluate clinical and patient-centred outcomes, clarify unmet needs, and inform equitable access to prosthodontic care.
Objectives: This study aimed to (i) compare the 28-day compressive strength of four bioceramic cements—Biodentine XP (BXP), NeoMTA2 (NMTA), ProRoot Mineral Trioxide Aggregate (MTA) (PMTA), and EndoSequence Bioceramic (BC) Root Repair Material (RRM) Fast Set Putty (EBC); (ii) evaluate fracture resistance following coronal perforation repair in a mandibular premolar three-dimensional model at bone levels above and below the perforation site using finite element analysis (FEA); and (iii) corroborate findings using extracted premolars following the same protocol. Methods: Cylindrical specimens (n ≥ 12/material) were fabricated and tested after 28 days using an Instron machine. A mandibular premolar underwent endodontic treatment, buccal perforation 3 mm below the cemento-enamel junction, restoration, and cone-beam computed tomography imaging. FEA models simulated a sound tooth (ST), an endodontically treated tooth (ETT), and perforated teeth repaired with each material. Von Mises stress distribution and tooth displacement were analyzed. Extracted premolars (n = 12) underwent perforation repair and fracture testing for FEA confirmation. Statistical analyses included one-way ANOVA and Kruskal–Wallis tests (α = 0.05). Results: BXP and PMTA demonstrated significantly greater compressive strength and elastic modulus than NMTA and EBC (p < 0.001). FEA showed no differences among repair materials, although perforation models differed from ST and ETT controls. Bone levels below the perforation increased maximum stress and displacement. Restored specimens failed at lower loads than intact teeth, and no material significantly improved fracture resistance. Conclusions: Perforation repair did not restore natural tooth biomechanics. Based on compressive strength and FEA findings, BXP and PMTA demonstrated the greatest theoretical reinforcement potential for premolars with coronal perforations.
Oral lichen planus (OLP) and oral lichenoid lesions (OLLs) are common oral mucosal diseases that may be difficult to differentiate due to their clinical and histological similarities. Despite overlapping features, they require appropriate diagnosis given different etiologies, management strategies, and prognoses. OLP is a chronic, immune-mediated disease of unknown etiology, typically presenting as bilateral, symmetrical reticular lesions, erosions, or plaques on the buccal mucosa, gingiva, and tongue. In contrast, OLLs classically manifest as unilateral, asymmetrical lesions often associated with identifiable causes such as contact allergens, medications, or systemic diseases. Histologically, both OLP and OLLs may exhibit basal cell degeneration and a subepithelial lymphocytic infiltrate; however, OLLs often display deeper, mixed-cell, and perivascular inflammation. Clinically, OLP usually follows a chronic course, poses therapeutic challenges, and requires long-term surveillance due to its malignant transformation potential. OLLs may resolve following identification and elimination of the inciting factor; however, persistent OLLs may also carry a risk of malignant transformation and therefore warrant regular follow-up. Accurate diagnosis of OLP and OLLs requires a comprehensive approach that includes thorough medical history, clinical, histological, and immunological examinations, with novel non-invasive imaging techniques potentially offering adjunctive diagnostic support. This narrative review aims to synthesize current knowledge on OLP and OLLs, with particular emphasis on their key diagnostic features.
Background/Objectives: Dental bleaching outcomes may vary according to patient-related factors. Age-related changes in dental tissues may influence bleaching efficacy, adverse effects, and patient-reported outcomes. This systematic review evaluated the influence of patient age on outcomes of vital tooth bleaching. Methods: The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420261473683). PubMed/MEDLINE, Embase, Cochrane Library, Scopus, LILACS, and OpenGrey were searched without date or language restrictions. Clinical studies assessing bleaching outcomes according to age were included. The primary outcome was color change; secondary outcomes included tooth sensitivity, gingival irritation, and patient-reported outcomes. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using GRADE. Because of clinical and methodological heterogeneity among the included studies, a meta-analysis was not feasible, and the findings were synthesized narratively. Results: Four studies involving 296 participants were included. Three reported greater color change in younger individuals in at least one protocol, whereas one found no age-related differences. Differences favoring younger participants were more frequent after in-office bleaching, while at-home bleaching with 10% carbamide peroxide showed comparable outcomes among age groups. Tooth sensitivity findings were inconsistent: three studies found no significant age-related differences, while one reported greater sensitivity in younger individuals. One study reported greater gingival irritation in younger participants, whereas oral health-related quality of life and most measures of esthetic self-perception did not differ between age groups. Certainty of evidence was very low for color change and tooth sensitivity. Conclusions: The available evidence suggests that age-related differences in bleaching-related color change may vary according to the bleaching protocol, with greater color change in younger individuals more consistently reported following in-office bleaching. However, the very low certainty of the evidence limits confidence in these findings. No consistent age-related differences were observed for tooth sensitivity, while findings for at-home bleaching were inconsistent and evidence regarding gingival irritation and patient-reported outcomes remains limited. Further well-designed clinical studies are needed to clarify the association between patient age and dental bleaching outcomes.
