Priscila Oliveira Miranda,1 Leonardo Santos Barros,1 Núbia Inocencya Pavesi Pini,2 Milagros Falcon Aguilar,3 Flávio Henrique Baggio Aguiar,3 Cecilia Pedroso Turssi,1 Roberta Tarkany Basting,1 Flávia Lucisano Botelho do Amaral,1 Waldemir Francisco Vieira-Junior31Restorative Dentistry Department, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil; 2Restorative Dentistry Department, State University of Maringá, Maringá, Paraná, Brazil; 3Restorative Dentistry Department, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, BrazilCorrespondence: Waldemir Francisco Vieira-Junior, Restorative Dentistry Department, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Av. Limeira, 901 - CEP 13414-903, Piracicaba, SP, Brazil, Tel +55192106-5220, Fax +19 3421-0144, Email waljr@unicamp.brPurpose: This study evaluated the effect of experimental solutions containing arginine or spray-dried chitosan on the microshear bond strength of bleached bovine enamel.Methodology: Enamel blocks (5× 5× 3 mm) were allocated into four groups (n=12): I) unbleached control; II) bleaching only; and bleaching followed by treatment with III) 8% arginine or IV) 2.5% spray-dried chitosan solutions for 5 min prior to adhesive procedures. Bleaching consisted of two sessions of 35% hydrogen peroxide (Whiteness HP, FGM) at a 7-day interval. Two restorations were built per block using a universal adhesive (Scothbond Universal Plus, 3M) and a nanofilled resin composite (Filtek Z350 XT, 3M). Specimens were tested for microshear bond strength (MPa), and failure mode analysis (%). Representative samples of predominant failure, as well as the arginine and chitosan powders, were evaluated by scanning electron microscopy (SEM).Results: Data were analyzed using generalized linear models, chi-square and Fisher’s exact test. The unbleached group showed higher MPa values than the bleached groups, which did not differ from each other (p = 0.004). Adhesive failure was the predominant fracture pattern with no significant differences among the groups (p = 0.203).Conclusion: Treatments with arginine or spray-dried chitosan did not differ from the control bleaching group and did not reduce adhesive failures. Neither solution effectively mitigated the immediate reduction in bond strength following bleaching.Keywords: antioxidants, microshear bond strength, tooth bleaching
The management of partial edentulism with severe occlusal disharmony and failed prosthodontic restorations requires careful multidisciplinary treatment. A 48-year-old male presented with defective restorations, marginal discrepancies, excess cement, poor contours, a collapsed occlusal plane, missing teeth, hyper-erupted posterior teeth, occlusal interferences, and localised stage II grade B periodontitis. After written informed consent, the treatment was completed in four phases: non-surgical periodontal therapy, endodontic retreatment with post-core reconstruction, selective extractions, and definitive fixed prosthodontic rehabilitation. A mounted diagnostic wax-up established the restored vertical dimension and group-function occlusal scheme. IPS e.max lithium disilicate crowns were bonded anteriorly, while monolithic zirconia crowns were cemented posteriorly. At the 4-week follow-up, the patient demonstrated complete resolution of periodontal inflammation, elimination of occlusal interferences, stable group function, and high satisfaction with masticatory function and smile aesthetics.
Purpose:To evaluate the influence of prosthetic material type on the survival of tooth-supported fixed dental prostheses by comparing metal-ceramic, all-ceramic, and zirconia restorations, as well as the associated technical and biological complications. Materials and Methods:A systematic review of the literature was conducted using PubMed, ScienceDirect, and Wiley Online Library databases for the period 2015-2026. The search strategy was based on keywords related to fixed dental prostheses. Seventeen studies were included after applying inclusion and exclusion criteria. Qualitative analysis of the data was performed owing to the methodological heterogeneity of the included studies. Results:Seventeen studies were included in this systematic review. Metal-ceramic restorations showed high survival rates, reaching 100% at 5 and 10 years in some studies. All-ceramic restorations demonstrated survival rates ranging from 88% to 100%, with excellent esthetic performance but mechanical variability depending on the material. Zirconia restorations showed variable survival rates, ranging from 71% to over 100%, depending on the study and follow-up duration, with a higher frequency of technical complications, particularly chipping of the veneering ceramic in layered restorations. Conclusion:Metal-ceramic restorations are a benchmark for clinical reliability. All-ceramic and zirconia restorations are effective alternatives, particularly when high esthetic demands are involved. Material selection should be individualized and based on biomechanical constraints, esthetic requirements, and patient-specific characteristics to optimize the long-term clinical outcomes.
Gholamreza Esfahanizadeh, Azita Mazaheri Tehrani, Arash Zarbakhsh, Emad Khatib, Elham GhaffariDepartment of Prosthodontics, Dental Branch, Islamic Azad University, Tehran, IranCorrespondence: Elham Ghaffari, Department of Prosthodontics, Dental Branch, Islamic Azad University, 4 Pasdaran Avenue, Tehran, 1946853314, Iran, Tel +989123338620, Email ghaffarielli@gmail.comBackground and Aims: Accurate torque delivery is critical for achieving proper implant preload and preventing screw loosening, yet torque wrenches may lose precision with repeated clinical use. This study aimed to assess how aging influences the torque accuracy of spring-type dental torque wrenches.Materials and Methods: Five new spring-type dental torque wrenches from Neodent® and Intra-Lock® were tested at their lower and upper torque limits. Torque was measured using a calibrated digital torque meter; each wrench was activated 10 times per setting, and the mean of three consistent readings was recorded. Mechanical aging was simulated through 1000 continuous tightening–loosening cycles at each wrench’s maximum torque. Torque measurements were repeated after 500 and 1000 cycles following the same protocol. Data were analyzed using one-way ANOVA (α = 0.05).Results: Both torque wrench brands showed a significant reduction in torque accuracy at the upper limit after 500 and 1000 mechanical aging cycles (p < 0.001). At 1000 cycles, upper-limit torque decreased by 0.67 N·cm (2.2%) for Intra-Lock and 0.55 N·cm (1.7%) for Neodent compared with baseline values. At the lower limit, a significant change was observed for Intra-Lock (p = 0.014), whereas no significant change was observed for Neodent (p = 0.132). Across all measurement stages, Neodent delivered significantly higher upper-limit torque than Intra-Lock (p = 0.020), whereas no significant difference was observed at the lower limit (p = 0.132).Conclusion: Within the limitations of this in vitro study, repeated mechanical aging significantly reduced torque accuracy at the upper torque limit, although the observed reductions were small in absolute terms and remained within commonly used clinical tolerance thresholds. These findings support routine monitoring and calibration of spring-type torque wrenches to maintain reliable torque delivery and implant stability.Keywords: dental implants, torque, equipment aging, spring-type torque wrenches
Background:Dental radiography is an indispensable diagnostic tool, yet many patients experience fear specifically associated with radiographic examinations. This phenomenon-dental radiophobia-represents an exaggerated fear of ionizing radiation in the dental setting. This review examines both patient-level fear and clinician-level radiophobia, which manifests as unfounded concern about low-dose radiation that impedes CBCT adoption. Methods:A narrative review was conducted using PubMed, Scopus, and Web of Science (2000-2025). Search terms included "dental radiophobia", "fear of dental X‑rays", and "dental radiography anxiety" combined with "prevalence", "risk factors", and "public health". Peer‑reviewed English‑language studies on human subjects were included. Data extraction was thematic. Results:General dental fear affects 10-20% of children/adolescents. In adults, meta‑analyses report a pooled prevalence of high dental anxiety of 18% (95% CI 10-30%) and dental phobia of 3%. For dental radiography, mean fear scores are low (0.8 ± 1.8 on a 0-10 visual analogue scale) but with high variance, and pain during intraoral procedures is a significant predictor. Key associated factors include female sex, younger age, lower education, prior painful radiographic experiences, limited radiation knowledge, and reliance on internet information. Clinician radiophobia (unfounded concern about low‑dose radiation) impedes CBCT adoption. Public health consequences include patient refusal of radiographs, avoidance of care, delayed diagnosis, increased oral disease burden, and medico‑legal liability. Conclusion:Dental radiophobia is a clinically relevant phenomenon with measurable prevalence, identifiable risk factors, and tangible public health implications. Effective management includes non‑pharmacological behavioral techniques, improved patient communication, and evidence‑based radiation risk communication. Future research should focus on validated instruments and targeted interventions.
Objective:To investigate the clinicopathological characteristics of oral reactive hyperplastic lesions (RHLs) and evaluate their association with habitual khat (Catha edulis) chewing in a Yemeni dental population. Methods:This cross-sectional clinicopathological study included 1197 Yemeni patients with 48 histopathologically confirmed RHLs. Demographic characteristics; periodontal status; oral hygiene; and behavioral habits, including khat chewing and smoking, were recorded. Clinical lesion features and histopathological diagnoses were assessed. Associations between khat-chewing status and clinicopathological variables were analyzed by using Pearson's chi-squared or Fisher's exact test, with statistical significance set at P < 0.05. Results:Habitual khat chewing was significantly associated with male gender (P = 0.015), smoking status (P = 0.002), and periodontitis (P = 0.005). Among lesion-related variables, lesion size was significantly associated with khat chewing, with lesions larger than 1 cm occurring more frequently among khat chewers than among nonchewers (P = 0.026). No significant associations were identified between khat chewing and lesion anatomical site (P = 0.604), clinical course (P = 1.000), or histopathological diagnosis (P = 0.762). Conclusion:Habitual khat chewing was associated with increased periodontal destruction and large oral RHLs but showed no association with lesion location, clinical behavior, or histopathological subtype. These findings suggest that khat acts as a chronic local irritant that may amplify reactive tissue proliferation without altering the underlying histopathological pattern of RHLs. Clinical Relevance:The assessment of khat-chewing habits should be incorporated into routine oral examinations because chronic exposure may contribute to increased lesion burden and periodontal deterioration.
Purpose:Temporomandibular disorders (TMD) are prevalent among dental students who are exposed to significant academic stressors. However, the relationship between stress severity and TMD symptomatology remains poorly characterized. This study assessed the prevalence of TMD symptoms, academic stress, and their associations among dental students. Methods:This multicenter, classroom-based survey invited 850 undergraduate dental students at five universities. Of 792 returned questionnaires (return rate, 93.2%), 756 were included in the final analysis (88.9% of those invited). TMD symptoms were screened with the Fonseca Anamnestic Index (FAI), academic stress with a locally adapted 10-item Dental Environment Stress Scale (DESS)-derived measure, and six selected Brief COPE items for coping strategies. The multivariable logistic model included age, gender, year of study, marital status, sleep duration, prior TMD diagnosis, screen time, caffeine intake, and physical activity. Results:FAI-positive TMD symptoms (FAI ≥20) were reported by 56.6% of participants. Academic stress was moderate in 43.8% and severe in 27.5% of the participants. In adjusted analysis, female gender (AOR=1.62, 95% CI: 1.15-2.29, p=0.006) and a self-reported prior TMD diagnosis (AOR=3.32, 95% CI: 2.15-5.12, p<0.001) were associated with current FAI screen positivity. Sleep deprivation (<5 h/night) was associated with higher stress (p<0.001), but not with TMD risk. Model performance was modest (Nagelkerke R2=0.105; Hosmer-Lemeshow p=0.724). The most frequently employed coping strategies were religious/spiritual beliefs (mean 3.38±0.75) and concentrating efforts (3.15±0.72). Conclusion:Self-reported TMD symptoms and academic stress were common and co-occurred in this sample. Because exposure and outcome were measured concurrently and no clinical TMD examination was performed, the associations are preliminary and should not be interpreted as causal, predictive, or diagnostic. Longitudinal studies incorporating DC/TMD examinations are needed before preventive or screening effects can be inferred.
Sirine Harrach, Morchad BouabidProsthodontics Department, International University of Rabat, Rabat, MoroccoCorrespondence: Sirine Harrach, Prosthodontics Department, International University of Rabat, Rabat, Morocco, Email sirine.harrach@uir.ac.maPurpose: To evaluate the influence of prosthetic material type on the survival of tooth-supported fixed dental prostheses by comparing metal-ceramic, all-ceramic, and zirconia restorations, as well as the associated technical and biological complications.Materials and Methods: A systematic review of the literature was conducted using PubMed, ScienceDirect, and Wiley Online Library databases for the period 2015– 2026. The search strategy was based on keywords related to fixed dental prostheses. Seventeen studies were included after applying inclusion and exclusion criteria. Qualitative analysis of the data was performed owing to the methodological heterogeneity of the included studies.Results: Seventeen studies were included in this systematic review. Metal-ceramic restorations showed high survival rates, reaching 100% at 5 and 10 years in some studies. All-ceramic restorations demonstrated survival rates ranging from 88% to 100%, with excellent esthetic performance but mechanical variability depending on the material. Zirconia restorations showed variable survival rates, ranging from 71% to over 100%, depending on the study and follow-up duration, with a higher frequency of technical complications, particularly chipping of the veneering ceramic in layered restorations.Conclusion: Metal-ceramic restorations are a benchmark for clinical reliability. All-ceramic and zirconia restorations are effective alternatives, particularly when high esthetic demands are involved. Material selection should be individualized and based on biomechanical constraints, esthetic requirements, and patient-specific characteristics to optimize the long-term clinical outcomes.Keywords: fixed dental prosthesis, clinical survival, metal-ceramic, all-ceramic, zirconia, prosthetic complications
Rawan AlrethiaDepartment of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi ArabiaCorrespondence: Rawan Alrethia, Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia, Tel +966554641631, Fax +966 016 3512056, Email ra.alrethia@qu.edu.saAbstract: The management of partial edentulism with severe occlusal disharmony and failed prosthodontic restorations requires careful multidisciplinary treatment. A 48-year-old male presented with defective restorations, marginal discrepancies, excess cement, poor contours, a collapsed occlusal plane, missing teeth, hyper-erupted posterior teeth, occlusal interferences, and localised stage II grade B periodontitis. After written informed consent, the treatment was completed in four phases: non-surgical periodontal therapy, endodontic retreatment with post-core reconstruction, selective extractions, and definitive fixed prosthodontic rehabilitation. A mounted diagnostic wax-up established the restored vertical dimension and group-function occlusal scheme. IPS e.max lithium disilicate crowns were bonded anteriorly, while monolithic zirconia crowns were cemented posteriorly. At the 4-week follow-up, the patient demonstrated complete resolution of periodontal inflammation, elimination of occlusal interferences, stable group function, and high satisfaction with masticatory function and smile aesthetics.Keywords: partial edentulism, full-mouth rehabilitation, iatrogenic failures, case report
Basem H AL-Huthaifi,1– 3 Ehab M Abdu,3,4 Abdullmalik N Al-Hamati,5 Mohammed M Al Moaleem,6 Khalid Aldhorae,1,7 Baker M Abdullah,3 Ali H Al-Surri,1 Helal Y Al-sabri,1 Saleh L Alnamer,1 Awab M Al-Hattami,1 Talal M Alghurbani,1 Mohannad A AL-Safani11Faculty of Dentistry, Ibn Al-Nafis University for Medical Sciences, Sana’a, Yemen; 2Orthodontic Department, Faculty of Dentistry, University of Sciences and Technology, Sana’a, Yemen; 3Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sana’a University, Sana’a, Yemen; 4Department of Oral Surgery, Collage of Dentistry, Al-Rasheed Smart University, Sana’a, Yemen; 5Faculty of Dentistry, University of Science and Technology, Sana’a, Yemen; 6Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia; 7Orthodontic Department, Faculty of Dentistry, Thamar University, Thamar, YemenCorrespondence: Abdullmalik N Al-Hamati, Faculty of Dentistry, University of Science and Technology, Sana’a, Yemen, Email abdullmalikalhamati85@gmail.com Basem H AL-Huthaifi, Faculty of Dentistry, Ibn Al-Nafis University for Medical Sciences, Sana’a, Yemen, Email basemuthanna@gmail.comPurpose: Temporomandibular disorders (TMD) are prevalent among dental students who are exposed to significant academic stressors. However, the relationship between stress severity and TMD symptomatology remains poorly characterized. This study assessed the prevalence of TMD symptoms, academic stress, and their associations among dental students.Methods: This multicenter, classroom-based survey invited 850 undergraduate dental students at five universities. Of 792 returned questionnaires (return rate, 93.2%), 756 were included in the final analysis (88.9% of those invited). TMD symptoms were screened with the Fonseca Anamnestic Index (FAI), academic stress with a locally adapted 10-item Dental Environment Stress Scale (DESS)-derived measure, and six selected Brief COPE items for coping strategies. The multivariable logistic model included age, gender, year of study, marital status, sleep duration, prior TMD diagnosis, screen time, caffeine intake, and physical activity.Results: FAI-positive TMD symptoms (FAI ≥ 20) were reported by 56.6% of participants. Academic stress was moderate in 43.8% and severe in 27.5% of the participants. In adjusted analysis, female gender (AOR=1.62, 95% CI: 1.15– 2.29, p=0.006) and a self-reported prior TMD diagnosis (AOR=3.32, 95% CI: 2.15– 5.12, p< 0.001) were associated with current FAI screen positivity. Sleep deprivation (< 5 h/night) was associated with higher stress (p< 0.001), but not with TMD risk. Model performance was modest (Nagelkerke R2=0.105; Hosmer-Lemeshow p=0.724). The most frequently employed coping strategies were religious/spiritual beliefs (mean 3.38± 0.75) and concentrating efforts (3.15± 0.72).Conclusion: Self-reported TMD symptoms and academic stress were common and co-occurred in this sample. Because exposure and outcome were measured concurrently and no clinical TMD examination was performed, the associations are preliminary and should not be interpreted as causal, predictive, or diagnostic. Longitudinal studies incorporating DC/TMD examinations are needed before preventive or screening effects can be inferred.Keywords: temporomandibular disorders, academic stress, dental students, Fonseca Anamnestic Index, dental environment stress scale, coping strategies
Purpose:This in vitro study evaluated the effect of cigarette smoke from three tobacco types on the color stability and surface roughness of a nanohybrid resin composite. Material and Methods:Sixty standardized Filtek Z350 XT nanohybrid resin composite discs were prepared and randomly allocated into three groups (n = 20) according to cigarette type: flavored tobacco, blond tobacco, and filterless tobacco. Baseline color and surface roughness measurements were obtained before smoke exposure. Color was assessed using the CIE L*a*b* system, and overall color change (ΔE) was calculated after the experimental period. Surface roughness was measured as arithmetic mean roughness (Ra, μm). The specimens were exposed to cigarette smoke using a custom-built smoking device under standardized conditions for 30 consecutive days, followed by final color and roughness measurements. Intergroup and intragroup comparisons were performed using appropriate parametric and non-parametric tests, with statistical significance set at p < 0.05. Results:All groups exhibited color alteration after smoke exposure. Mean ΔE values were 10.09 ± 1.78 for flavored tobacco, 13.19 ± 1.97 for blond tobacco, and 16.57 ± 3.74 for filterless tobacco, with significant intergroup differences (p < 0.001). The filterless tobacco group showed the greatest chromatic alteration. Surface roughness increased significantly within all groups after smoke exposure (all p < 0.001). Mean ΔRa values were 0.116 ± 0.039 μm, 0.139 ± 0.049 μm, and 0.148 ± 0.054 μm for flavored, blond, and filterless tobacco, respectively; however, intergroup differences in ΔRa were not statistically significant (p = 0.100). Conclusion:Cigarette smoke adversely affected both the color stability and surface roughness of the tested nanohybrid resin composite. Filterless tobacco produced the greatest color alteration, whereas all tobacco types significantly increased surface roughness without significant intergroup differences in ΔRa. Under the present experimental conditions, color change was more discriminative than surface roughness for detecting differences among cigarette types.
Introduction:The digital transformation in dentistry has profoundly changed the design protocols for fixed, tooth-supported prostheses. The integration of computer-aided design and manufacturing (CAD/CAM) technologies raises the question of their effectiveness compared to conventional methods. The objective of this systematic review is to analyze, through a review of the literature, the impact of the digital workflow on the design of fixed prostheses in comparison with the conventional workflow. Materials and Methods:A literature search was conducted in the PubMed and Scopus databases over a 10-year period (2016-2026). The following inclusion/exclusion criteria were applied: in vivo and in vitro studies focusing on tooth-supported fixed prostheses that evaluated either digital impressions or a fully digital workflow, comparing it to a conventional workflow. Studies were selected following the PRISMA chronology (identification, selection, eligibility, inclusion). Extracted data included: study characteristics, sample type, objectives, evaluated outcomes, quantitative results, measurement methods, and conclusions. Results:A total of 11 studies were included in this review. The analysis of the results highlights significant heterogeneity in methodologies and evaluation criteria, particularly regarding impression accuracy, marginal adaptation, chairside time, and reproducibility. Overall, the available data do not provide sufficient evidence to demonstrate the superiority of the digital workflow over the conventional workflow. However, some studies suggest comparable, or even superior, performance of the digital workflow under specific conditions. Conclusion:Digital design of fixed prostheses offers an alternative to traditional conventional methods. However, the lack of consensus and the heterogeneity of current data do not allow for the confirmation of its superiority. Standardized long-term clinical results are needed to confirm these findings and clarify the optimal indications for the digital workflow.
Nicole Roxana Modragon De los Santos, Raúl Antonio Rojas Ortega, Victor Moreno-PrietoSchool of Dentistry, Faculty of Health Sciences, Universidad Norbert Wiener, Lima, PeruCorrespondence: Victor Moreno-Prieto, School of Dentistry, Faculty of Health Sciences, Universidad Norbert Wiener, Av. Arequipa 444, Lima, 15046, Peru, Tel +51 954093722, Email victor1053644@gmail.comPurpose: This in vitro study evaluated the effect of cigarette smoke from three tobacco types on the color stability and surface roughness of a nanohybrid resin composite.Material and Methods: Sixty standardized Filtek Z350 XT nanohybrid resin composite discs were prepared and randomly allocated into three groups (n = 20) according to cigarette type: flavored tobacco, blond tobacco, and filterless tobacco. Baseline color and surface roughness measurements were obtained before smoke exposure. Color was assessed using the CIE L*a*b* system, and overall color change (ΔE) was calculated after the experimental period. Surface roughness was measured as arithmetic mean roughness (Ra, μm). The specimens were exposed to cigarette smoke using a custom-built smoking device under standardized conditions for 30 consecutive days, followed by final color and roughness measurements. Intergroup and intragroup comparisons were performed using appropriate parametric and non-parametric tests, with statistical significance set at p < 0.05.Results: All groups exhibited color alteration after smoke exposure. Mean ΔE values were 10.09 ± 1.78 for flavored tobacco, 13.19 ± 1.97 for blond tobacco, and 16.57 ± 3.74 for filterless tobacco, with significant intergroup differences (p < 0.001). The filterless tobacco group showed the greatest chromatic alteration. Surface roughness increased significantly within all groups after smoke exposure (all p < 0.001). Mean ΔRa values were 0.116 ± 0.039 μm, 0.139 ± 0.049 μm, and 0.148 ± 0.054 μm for flavored, blond, and filterless tobacco, respectively; however, intergroup differences in ΔRa were not statistically significant (p = 0.100).Conclusion: Cigarette smoke adversely affected both the color stability and surface roughness of the tested nanohybrid resin composite. Filterless tobacco produced the greatest color alteration, whereas all tobacco types significantly increased surface roughness without significant intergroup differences in ΔRa. Under the present experimental conditions, color change was more discriminative than surface roughness for detecting differences among cigarette types.Keywords: composite resin, dental materials, surface properties, cigarette smoking, tobacco products
Objective:To evaluate the relationship between sagittal temporomandibular joint (TMJ) spaces and skeletal class using cone-beam computed tomography (CBCT). Materials and Methods:Forty-eight CBCT scans were analyzed and equally distributed among skeletal class (I, II, and III) based on the Beta angle. Anterior (AS), superior (SS), and posterior (PS) joint spaces were measured on standardized sagittal reconstructions using an Instrumentarium OP300 unit. Condylar positional patterns were analyzed according to skeletal class. Results:Significant intergroup differences in joint space measurements were identified (p < 0.05), primarily on the right side. Skeletal Class II presented the greatest dimensions (AS: 2.67 ± 1.04 mm; SS: 3.03 ± 0.98 mm; PS: 2.58 ± 0.87 mm), consistent with a more posterior and inferior condylar position. Conversely, Skeletal Class III consistently exhibited the lowest values (AS: 1.85 ± 0.65 mm; SS: 2.12 ± 0.62 mm; PS: 1.74 mm), indicating reduced joint space dimensions. Conclusion:Sagittal evaluation using CBCT revealed that skeletal class influences joint space dimensions, with larger joint space dimensions observed in Skeletal Class II patients. Bilateral variations may reflect morphological adaptations associated with skeletal patterns.
Background:Chronic inflammatory gingival enlargement associated with orthodontic appliances may interfere with oral hygiene maintenance and orthodontic treatment. When non-surgical therapy is unsuccessful, gingivectomy may be indicated. Conventional scalpel and electrosurgical techniques are both established treatment modalities for gingival tissue excision, each with distinct clinical characteristics. This case report aims to describe the management of chronic inflammatory gingival enlargement in an orthodontic patient treated with conventional scalpel and electrosurgical gingivectomy. Case Presentation:A 14-year-old female undergoing orthodontic treatment presented with localized chronic inflammatory gingival enlargement affecting the maxillary teeth, which interfered with proper orthodontic bracket placement and oral hygiene maintenance. Following initial periodontal therapy, gingivectomy was performed using a conventional scalpel technique in the maxillary left region (teeth 23-24). At a subsequent visit, electrosurgical gingivectomy was performed in the maxillary right region (teeth 14-15) after discussion of alternative treatment options with the patient and her parent. Both procedures resulted in satisfactory healing and restoration of physiological gingival contours. The electrosurgical approach was associated with improved hemostasis and less patient-reported postoperative discomfort. Conclusion:Both conventional scalpel and electrosurgical gingivectomy resulted in satisfactory clinical outcomes in the management of orthodontic-associated chronic inflammatory gingival enlargement. In this patient, the electrosurgical approach was associated with improved hemostasis and less postoperative discomfort. However, these findings are limited to a single case and should be interpreted with caution.
Basem H AL-Huthaifi,1,2,* Ahlam H Al-Hababi,3,* Khalid Aldhorae,1,4 Asala Muharram,1 Abeer Dahaba,1 Asmaa Ghaleb,1 Rawan Tareq,1 Rawan Taha,1 Ehab M Abdu,1,5 Baker M Abdullah,5 Mohammed M Al Moaleem,61Faculty of Dentistry, Ibn Al-Nafis University for Medical Sciences, Sana’a, Yemen; 2Orthodontic Department, Faculty of Dentistry, University of Sciences and Technology, Sana’a, Yemen; 3Department of Periodontology, Faculty of Dentistry, Sana’a University, Sana’a, Yemen; 4Orthodontic Department, Faculty of Dentistry, Thamar University, Thamar, Yemen; 5Department of Oral and Maxillofacial Surgery, College of Dentistry, Sana’a University, Sana’a, Yemen; 6Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia*These authors contributed equally to this workCorrespondence: Basem H AL-Huthaifi, Faculty of Dentistry, Ibn Al-Nafis University for Medical Sciences, Sana’a, Yemen, Email basemuthanna@gmail.comBaker M Abdullah, Faculty of Dentistry, Ibn Al-Nafis University for Medical Sciences, Sana’a, Yemen, Email baker.amdullah@su.edu.yeBackground and Aim: Dental aesthetics has an increasing effect on young adults’ psychosocial well-being; this effect is particularly true for patient-facing professions, in which people’s appearance influences how others interact with them. However, there is currently limited evidence from conflict-affected, resource-poor settings regarding this relationship. The current study aimed to explore the relationship between the psychosocial effects of dental aesthetics and self-esteem and perceived need for orthodontic treatment among health sciences students in Sana’a, Yemen.Methodology: A cross-sectional, Internet-based survey was conducted among 300 health sciences students (18– 25 years) from public and private universities in Sana’a between August and September 2025. The survey included the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Rosenberg Self-Esteem Scale (RSES), and Aesthetic Component of the Index of Orthodontic Treatment Needs (IOTN-AC). Data were analyzed using SPSS version 26.0.Results: Of 385 targeted participants, 300 responded (70.7% female; mean age 22.3 years). The mean PIDAQ score was 2.40 ± 0.62, indicating a mild psychosocial impact based on established PIDAQ scoring conventions. Male students had significantly higher PIDAQ scores than females (2.52 ± 0.69 vs. 2.35 ± 0.56; p = 0.026). No statistically significant correlation was detected between PIDAQ and RSES scores in this sample (r = − 0.012, p = 0.834). Academic year progression predicted higher self-esteem (β = 0.281, p = 0.002). Self-perceived orthodontic need (IOTN-AC) showed a dose-response relationship with PIDAQ scores (definite need: 2.82 ± 0.41 vs. no need: 2.34 ± 0.35; p < 0.05).Conclusion: Dental aesthetics significantly affects psychosocial well-being among health sciences students in Yemen, with unexpectedly higher impact among male students. No direct association was found between dental aesthetics and global self-esteem in this sample. Academic achievement emerged as a predictor of self-esteem. Gender-sensitive screening and integrated wellness programs are recommended for resource-limited settings.Keywords: dental aesthetics, psychosocial impact, self-esteem, health sciences students, Yemen, gender differences, orthodontic treatment need
Purpose:Plaque accumulation is considered to be one of the main factors in various oral diseases. This study aimed to evaluate the effect of oral health counselling on plaque scores for Individuals with Special Health Care Needs (ISHCN) attending special care dentistry clinics. Patients and Methods:A prospective observational study was designed and consecutive sampling was used among the adult patients attending special care dentistry clinics at a University Dental Hospital. A total of 120 participants (61 males and 59 females between) aged between 16 and 69 years were enrolled in the study. Participation was voluntary, and recruits were selected after the application of a set of inclusion and exclusion criteria. The participants were categorized according to their specific health care needs. The subjects were assessed for plaque scores using the Silness-Löe Plaque Index for a period of six months. The first observation was noted at baseline and then every two weeks until the next three months. Finally, monthly plaque scores were recorded for the subsequent three months. Ten observations were recorded for each participant. All data were entered and analyzed using Statistical Package for Social Sciences (SPSS v.22) software. Results:The majority of the sample was comprised of the "Medically compromised group", followed by the "Intellectual disability" group. The overall baseline mean plaque index score was 2.68, which reduced significantly (p = 0.01) at the completion of 6 months period. Conclusion:The multi-component preventive oral health program and repeated follow up was associated with significant reduction in dental plaque scores among individuals with special health care need over six months.
Purpose: Excessive gingival display (EGD) resulting from altered passive eruption (APE) is a clinical condition that is commonly managed by esthetic crown lengthening to achieve stable and symmetrical gingival margins. Determining the appropriate gingival and osseous resection levels remains a key step in achieving predictable surgical outcomes. Although digitally printed resin guides have been widely discussed, clinical data regarding milled metal dual-purpose guides remain limited. Patients and Methods: This single case report (n=1) describes the digital workflow for designing and fabricating a dual-purpose cobalt-chromium surgical guide to assist both gingivectomy and osteoectomy. The guide dimensions were determined by superimposing cone-beam computed tomography (CBCT) data with intraoral scan files to identify the cementoenamel junction (CEJ). The guide was fabricated using a subtractive milling process and used during esthetic crown lengthening in a patient diagnosed with altered passive eruption type I. Results: The milled metal guide appeared to provide stable positioning during surgery and helped guide both soft-and hard-tissue resection. At 6-month follow-up, gingival margins remained stable, symmetrical contouring was achieved, patient satisfaction was high, and no immediate postoperative complications were observed. Conclusion: This report presents a CBCT-integrated workflow for dual-purpose surgical guidance. The rigidity of the milled metal framework may assist intraoperative stability and support favorable short-term clinical outcomes in this case.
Background:Children with neurodevelopmental disorders (NDD), especially autism spectrum disorder (ASD), are commonly characterized by sensory sensitivities, communication differences, and anxiety during dental treatment. These factors can reduce cooperation and prevent completion of care. This scoping review mapped recent evidence on non-pharmacological chairside strategies used to support pediatric dental management for children with NDD. Methods:This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic literature search was conducted in PubMed, Scopus, ScienceDirect, and SpringerLink for publications from 2020 to 2026. The search focused on non-pharmacological chairside behaviour management strategies for children aged 0-18 years with neurodevelopmental disorders in pediatric dental settings. Predefined keywords and the Population, Concept, and Context (PCC) framework were used to guide the search. Results:Six studies from Malaysia, California, China, Italy, Turkey, and Brazil were included. Most studies focused on autism spectrum disorder, with limited representation of other neurodevelopmental profiles. Five chairside strategy domains were mapped: Tell-Show-Do-based behavior guidance, desensitization often supported by video or point-of-view modeling, structured visual pedagogy, sensory-adapted dental environments, and protective stabilization or passive immobilization. Reported outcomes were heterogeneous and included cooperation ratings, procedural tolerance, observed distress, and physiological markers. Conclusion:Non-pharmacological chairside strategies for children with NDD show potential, particularly structured preparation, visual supports, and sensory-adapted environments. However, the evidence remains limited and methodologically heterogeneous. Standardized child-centered outcome sets and broader inclusion of non-ASD NDD subgroups are needed.
