Introduction: oral frailty has emerged as an important clinical concern associated with reduced oral health behaviours, less oral care motivation, compromised quality of diet, chewing and swallowing thereby the whole health. Frailty is a complex syndrome involving the decline of multiple interrelated systems. With advancing age, physiological reserves gradually diminish, and the presence of frailty accelerates this decline, ultimately compromising homeostatic mechanisms. This landscape brings the tool OFI-8, a patient reported outcome measure developed with propose to measure the oral frailty risk. Saliva is one of it s components and has very important role in the oral frailty with several aspects as hyposalivation, xerostomia and fluid quality. Purpose: Observing the findings about risks in oral frailty and the role of salivary aspects. Keywords: oral frailty, saliva, older people. Methods: Articles have been selected since 2020, published with contents about oral frailty and saliva, and 4 were elected to integrate this mini review. The searching was for the keyword’s oral frailty and saliva, and only studies based on evidence. Conclusion: Oral frailty and salivary aspects demonstrate a strong and consistent relationship in older adults.
Purpose: To describe two community-based oral health prevention initiatives implemented in Italy and to illustrate how oral health promotion can be integrated into primary care and municipal services in line with World Health Organization (WHO) strategies for non-communicable disease (NCD) prevention and health equity. Methods: This practice brief reports two descriptive experiences: (1) an oral health promotion program implemented within the Case della Comunità of ASST Valle Olona, where dental hygienists provide free, non-clinical oral health counseling as part of multidisciplinary primary care teams; and (2) a school-based oral health education initiative promoted by a municipality in Northern Italy in collaboration with primary schools and dental professionals. The initiatives are described based on program documentation and professional experience rather than on formal outcome evaluation. Findings: Both initiatives demonstrate the feasibility of low-cost, equity-oriented oral health prevention in community settings. The Case della Comunità program reached more than 200 individuals within the first three months of implementation and targeted different life stages. The school-based initiative ensured universal access to oral health education and promoted preventive behaviors through the involvement of children, educators, and caregivers. Outcome data are not yet available; planned monitoring includes behavioral indicators and basic clinical indices. Conclusion: Integrating oral health prevention into community-based services is feasible and policy-relevant. These experiences provide actionable examples for strengthening prevention, reducing oral health inequalities, and supporting the broader NCD agenda.
Mechanical torque-limiting devices (TLDs) are widely used in implant dentistry to ensure accurate preload application to prosthetic screws, thereby enhancing the mechanical stability of implant-supported rehabilitations. However, variations in torque delivery remain a clinical concern. This systematic review aimed to evaluate the accuracy of mechanical TLDs by analyzing In vitro studies published between January 2000 and June 2025. Following PRISMA 2020 guidelines, eligible studies were identified across four databases and assessed for methodological quality using a modified Joanna Briggs Institute tool. Results revealed significant discrepancies between the torque values delivered by TLDs and those specified by manufacturers, with spring-type mechanisms demonstrating greater accuracy than beam or friction-based types. Factors such as repeated use, autoclave sterilization, and device brand significantly affected performance, with torque deviations exceeding ±10% in many cases. These findings underscore the importance of routine calibration and highlight the need for clinicians to consider both device type and usage history in clinical protocols. Further research is recommended to assess real-world performance and to support the development of advanced TLDs with integrated calibration features.
Background: Displaced anterior teeth may be associated with periapical lesions and form an ortho-endo problem that requires special attention and careful planning. This case report documented the use of an intracanal medicament to stimulate the healing of a large periapical lesion and treat severely displaced incisors. Methods: A 13-year-old patient was presented with a 14x26 mm periapical radiolucency related to displaced incisors. After chemo-mechanical preparation, calcium hydroxide medicament was placed in the canals and changed every 2 weeks for 3 months. The canal was then freshly cleaned and filled with gutta‐percha and sealer. The coronal preparation was sealed with glass ionomer filling. Results: At the 24-month follow-up, the teeth were asymptomatic. The radiographs showed correction of the incisor displacement after bone regeneration, and a significant reduction in the lesion size. Conclusion: Conventional endodontics with an intracanal medicament can correct an ortho-endo problem in incisors with a large periapical lesion. Clinical significance: Dentists should not initiate orthodontic intervention for an endo-ortho problem until the periapical lesion has completely healed.
Surgical removal of third molars is the most common type of surgery in dentistry. It is estimated that more than 10 million third molar extraction surgeries are performed in Brazil each year, even considering that this intervention is mandatory for the Unified Health System (SUS) through the Dental Specialty Center (CEO). There are several protocols for performing the surgery, from the safe amount of anesthetic to the sections of the impacted tooth, in addition to the time variation depending on the degree of difficulty. This study is part of a bioequivalence clinical trial to evaluate the efficacy and safety of postoperative pain control after surgeries to remove impacted lower third molars in 231 participants of both sexes, aged 18 to 40. Among the exclusion criteria, two situations initially proved challenging: performing the surgical procedure in up to 50 minutes and using a maximum of two tubes of the anesthetic mepivacaine hydrochloride 2% with epinephrine 1:100,000. Therefore, the objective of this study was to evaluate, using standard anesthetic techniques, the average number of anesthetic tubes used that produced sufficient analgesia for the removal of impacted mandibular third molars, as well as the average time from intervention to suturing. It can be concluded that in 92.2% of cases, up to two tubes of anesthetic were sufficient for analgesia and completion of the surgical procedure in up to 50 minutes. In 18 participants (7.8%), more than two to four anesthetic tubes were required and the operative time was longer than 60 minutes.
Introduction: Orthodontic treatment in patients with a reduced periodontium (RP) poses a clinical challenge due to alterations in periodontal support-bone loss, dental migration, and a displacement of the center of resistance. These conditions increase the risk of tissue damage when conventional orthodontic forces are used. Finite element analysis (FEA) has emerged as a useful tool for studying stress distribution in supporting tissues and optimizing biomechanical planning in such cases. Objective: To review the available scientific evidence on the application of FEA in orthodontic biomechanics for patients with a reduced periodontium, assessing its clinical utility for therapeutic decision‑making. Methodology: A literature search was conducted in PubMed, Web of Science and Scopus using terms related to “finite element analysis,” “orthodontics,” and “reduced periodontium.” Original studies using FEA in three‑dimensional (3D) orthodontic models with simulated reduced periodontium, published between 2020 and 2025, were included. Animal studies, in vitro studies without clinical correlation, and duplicates were excluded. Results: Eleven studies were included, with models constructed using cone‑beam computed tomography (CBCT) or 3D scans. In all cases, FEA allowed the identification of critical stress areas, especially in the cervical region of the periodontal ligament (PDL). Forces exceeding 60g and movements such as rotation, tipping and bodily translation were associated with an increased risk of surpassing the physiological hydrostatic threshold, favoring resorption. Biomechanical approaches such as cantilevers, segmented arches and aligners with controlled displacements showed more favorable outcomes. Limitations: considerable methodological heterogeneity in models and the magnitudes of the forces, together with limited direct clinical validation, prevented quantitative synthesis. Conclusion: FEA is an effective tool for evaluating and predicting tissue responses to orthodontic forces in a reduced periodontium. Its clinical application enables personalized treatment planning, minimizes iatrogenic risks, and promotes an evidence‑based interdisciplinary approach. However, FEA should complement, not replace, clinical evaluation and judgment.
Background: Severe periodontitis is a chronic inflammatory disease characterized by progressive destruction of the tooth-supporting tissues, compromising both function and aesthetics. In patients with reduced periodontium, orthodontic treatment poses a therapeutic challenge, as strict inflammation control is required to prevent disease progression. Materials and Methods: This case report describes a 22-year-old female patient diagnosed with Stage III, Grade C generalized periodontitis, with a history of poorly controlled type 1 diabetes mellitus. The treatment plan included non-surgical and surgical periodontal therapy, followed by a strict maintenance program, and later orthodontic treatment with conventional fixed appliances. Results: Periodontal control allowed the reduction of inflammation and stabilization of the remaining periodontium. Orthodontic treatment achieved space closure, proper dental alignment, and occlusal stability without compromising periodontal health. The final evaluation showed bone stability, reduced probing depths, and adequate masticatory function. Conclusion: This case demonstrates that, with an interdisciplinary approach and a sequential treatment plan, it is possible to achieve functional and aesthetic rehabilitation in patients with advanced periodontitis and systemic comorbidities, provided that strict periodontal control is maintained.
Research around facial expression of emotions has only made significant progress in the last two decades, remaining closely connected to the emerging empirical knowledge in the field of non-verbal communication. Understanding the phenomenon of Pain experience involves and raises questions across various healthcare specialties, and therefore, it should be approached in a necessarily multidisciplinary manner, emphasizing the Biopsychosocial nature of the pain phenomenon. It is essential to implement the true biopsychosocial model from a Patient-centered perspective, in which the Dentist should position themselves, in essence, within the context of the Dentist-Patient Relationship as a "reader of the facial expressions" of the Patient, with the relationship established with the "Silent Patient" functioning as a "therapeutic analgesia" within the context of the Dentist-Patient relationship. Nevertheless, the major challenge facing the Dentist in relation to the subjective language of Pain is a matter of time availability, both due to the demands of healthcare institution management models, which allocate little time for Therapeutic dialogue, and the intrapsychic availability of both the Patient and the Healthcare Professional.
Background: Direct-Printed Aligners (DPAs) represent a recent advancement in the application of additive manufacturing in Dentistry. Among the technical factors affecting their clinical and laboratory performance, print orientation stands out for its influence on parameters such as geometric fidelity, mechanical strength, surface finish, and resin consumption. Despite this, oblique orientations remain widely adopted based on guidelines that are not always supported by scientific evidence, highlighting the need for a critical review of this practice. Materials and methods: A narrative review of the scientific literature was conducted to investigate the impact of three-dimensional print orientation on critical performance variables in DPAs. This review was conducted through searches in the PubMed, ScienceDirect, Springer Link, Scopus, Web of Science, and Cochrane Library databases. The selection included studies published in the last five years, in English idiom, investigating light-curable resins applied to Dentistry, with emphasis on DPAs. Exclusion criteria: studies addressing non-resin materials, applications unrelated to Dentistry, or that did not describe print orientation parameters were excluded. Results: The horizontal (0°) printing of DPAs has been associated with greater dimensional accuracy, reduced surface roughness, superior mechanical performance, and more efficient material usage. Although some studies have not identified statistically significant differences among various printing orientations, the evidence points to the technical and clinical advantages of the horizontal position. In contrast, inclined orientations for aligner printing, despite being recommended by manufacturers, have been linked to lower geometric fidelity, increased roughness, and poorer aesthetic appearance.
Sea levels are changing, rising due to the melting of large glaciers as a result of the increase in global temperatures caused by greenhouse gases. Like the seas, the natural environment is changing day by day as a result of the high levels of pollution that have been generated. In this regard, and for the same reason, the education provided in institutions that train dentists should be oriented toward the creation of a pro-environmental culture based on sustainable development.
This narrative review aims to describe and analyze the clinical and biological aspects of a sutureless extraction technique for maxillary third molars, with particular focus on tissue repair, postoperative inflammatory response, and clot stabilization. The analysis highlights the role of 0.12% chlorhexidine digluconate as an adjunctive agent in promoting hemostasis and secondary intention healing. Anatomical and physiological factors influencing postoperative outcomes are considered, especially the implications of avoiding excessive curettage in sockets without pathological tissue. Evidence from the literature suggests that, when appropriately applied, sutureless extraction may offer benefits such as reduced postoperative inflammation, favorable healing due to the medullary nature of the maxillary bone, and effective clot stabilization. Further clinical studies are needed to confirm the safety and effectiveness of this technique and to optimize postoperative protocols.
Objective: Germany has undergone a paradigm shift in dental care during the development of a modern dental care system. This study evaluates the effects of this shift on methods, oral health, treatment structures, patient behaviour, and costs over a span of fifty years. For comparison, we use Sweden as a benchmark country. Methods: Our investigation is a macro-analysis conducted from a population perspective, utilising existing representative data sources. The analytical tools include established measurements from the World Health Organization (WHO) and macroeconomic data from the Organization for Economic Co-operation and Development (OECD). Results: Following the redesign of the legal framework of the dental care system toward prevention and tooth retention from 1978 to 2000 and beyond, notable positive effects began to emerge quickly among the younger generation in the early 1990s, with significant improvements observed in young adults since 2003. Remarkable progress in senior dental health was first noted in 2014, leading to notible reductions in the burden of dental caries over the following decade. Compared to Sweden, Germany has made considerable strides in addressing the previous backlog in oral health among its citizens, especially among the youth. However, the overall dental health status of the Swedish adult population remains superior. The long-term changes in Germany's treatment structure roughly align with the observed progress in oral health, indicating a strong shift from prosthodontic procedures to preventive and tooth preserving services, a trend that continues today. Corresponding to improvements in oral health, the necessary macroeconomic resources for the dental sector significantly decreased by nearly 60% between 1980 and 2023, reflecting a similar but less pronounced cost trend in Sweden. Conclusion: The key finding is that both Germany and Sweden demonstrate that prevention and tooth retention in dentistry lead to superior oral health outcomes and more affordable macroeconomic cost structures. This approach is highly efficient in every respect. Despite the significant advancements in oral health across all ages in Germany, certain areas of dentistry still require increased attention. Specifically, there is a need to improve the proportion of cavity-free primary teeth and to address the persistently high incidence of tooth loss among adults over 40 years of age, which is likely associated with very high prevalence of periodontitis in individuals aged 40 to 65 and beyond. The field of periodontics necessitates an evaluation of current treatment practices in German dental offices. It is suggested that incentives be provided to further strengthen the preventive-oriented approach.
The presence of microorganisms on the surface and inside NDP® intracanal medication tubes was evaluated. This medication is commonly used in endodontic treatment due to its anti-inflammatory and antimicrobial action. The research was conducted through a laboratory experiment with 21 tubes previously used by dental students at the university clinic and one unused tube as a control. A test was performed by rolling the tube before and after use to investigate surface contamination, in addition to collecting internal contents, which were incubated in aerobic and anaerobic culture media. The results revealed that 57.14% of the tubes showed microbial growth in an aerobic environment, suggesting environmental contamination, and 42.86% in anaerobic conditions, indicating the possible presence of microorganisms from the oral microbiota. These findings highlight the contamination of the tubes mainly due to improper handling and incorrect storage, which can compromise the effectiveness of endodontic treatment and, more seriously, the patient's systemic health. It is concluded that the reuse of these tubes represents a significant biological risk and that strict disinfection protocols should be adopted. The single use of NDP® medication tubes is recommended, in addition to the development of reduced-volume packaging and immediate disposal, as a preventive measure to ensure biosafety in dental care.
This article offers a critical review of training programs in technological tools for university teachers, articulating international frameworks of digital competence, empirical evidence from Ibero-America, and a reference case with curricular design and implementation phases. The guiding question was what design and change management traits are associated with a higher likelihood of significant pedagogical adoption in higher education. Methodologically, a narrative review was conducted focusing on international normative and conceptual frameworks, empirical studies on the structure of digital competence in Ibero-America, and a complete university program. The results show that the most robust programs explicitly map activities and evidence to recognized descriptors, integrate authentic practices with feedback, and combine multiple literacies with criteria for media selection. There are ongoing gaps in pedagogical integration, repetitive use of resources, and resistance to change, which requires continuous support, micro-credentials based on evidence, and formative evaluation with valid and reliable instruments. Recommendations for curricular improvement and institutional scalability are proposed.
Intracanal medication is an essential step in endodontic treatment, playing a crucial role in the disinfection of the root canal system and the modulation of the inflammatory response. Among the available therapeutic options, the combination of Paramonochlorophenol, Rinossoro, and Polyethylene Glycol (PRP®) stands out as the drug of choice in cases of pulp necrosis. However, its commercial presentation in 1.8 mL tubes, often shared among multiple patients, raises concerns regarding compliance with biosafety principles. Given this context, the present study conducted the collection and microbiological analysis of PRP® samples used by students during endodontic procedures. The results revealed the presence of microbial contamination, indicating a possible failure in asepsis protocols. These findings suggest potential risks to clinical safety, reinforcing the need to review current practices for handling and storing this medication. Therefore, it is concluded that the shared use of PRP® tubes may represent a cross-contamination vector, requiring the implementation of stricter control measures or the adoption of individual dosing systems to ensure the safety of both patients and healthcare professionals.
This study aimed to identify, categorize, and analyze the main methods used to measure the temperature generated by implant drills during osteotomies, emphasizing their advantages, limitations, and clinical implications. A scoping review with integrative characteristics was conducted in accordance with the PRISMA-ScR guidelines. The search strategy included descriptors related to temperature, implant drills, and measurement techniques, applied across PubMed, Scopus, Web of Science, and SciELO databases. Studies published between 2000 and 2025 were considered, and 20 articles met the eligibility criteria. The identified measurement methods included thermocouples, infrared thermography, fiber optic sensors, digital pyrometry, and finite element analysis. Thermocouples remain the most widely used technique due to their low cost and high precision, although they are limited by reduced spatial resolution. Infrared thermography offers the advantage of being non-invasive but requires controlled environments and specialized equipment. Finite element models provide valuable theoretical predictions of thermal behavior but are highly dependent on material properties and boundary conditions. There is still no consensus regarding the most accurate method for assessing temperature during osteotomies, and methodological heterogeneity continues to hinder the establishment of clinical thresholds for thermal damage. Future studies should aim for methodological standardization and the development of real-time, non-invasive measurement technologies.
Dental students must study in a very challenging setting since the field demands regular patient connection, in-person practice, and both theoretical and clinical expertise. Stress among dental students is a well-documented issue that significantly affects their academic performance, mental health, and overall well-being. They encounter a variety of stressors during their school years, including demanding schedules, high workloads, and the need to balance studying fundamentals with developing technical clinical abilities. Other pressures, such managing patients, taking responsibility for patient care, and having trouble learning manual skills, surface during the clinical period. This review explores the prevalence, sources, and consequences of stress among dental students globally. It also evaluates coping mechanisms and institutional interventions aimed at mitigating stress. A systematic literature search was conducted across PubMed, MEDLINE, PsycINFO, and Cochrane Library for studies published. The findings highlight academic, clinical, and interpersonal stressors, gender differences, and regional variations in stress levels. The review underscores the need for institutional reforms, faculty training, and structured mental health support programs.
Introduction: Poor handling of irreversible hydrocolloids (alginates) and dental plasters by dental offices, laboratory technicians, and dentists causes differences in dimensional accuracy, affecting dental prosthetic rehabilitation. To obtain optimal results, the manufacturers' instructions regarding the handling variables of each product must be followed to the letter. Are there differences in the dimensional accuracy of working models made under different handling variables? Objective: To evaluate the differences in dimensional accuracy of irreversible hydrocolloids and plasters that affect dental prosthetic rehabilitation. Methodology: An experimental in vitro, prospective, cross-sectional, comparative study was conducted. The variables taken into account were: High and low dimensional stability alginate, water-powder ratio of alginate, casting in type III plaster, water-powder ratio of plaster, type of water and pH, imbibition, syneresis, plaster pouring time, type of mixture. The sample size was 40 models, similar to the oral cavity with their respective teeth. A duplicate of the master model was made in alginate and these were then poured and set in type III plaster. The procedure was performed following an established protocol with the manufacturer's instructions and without following any protocol. Then, measurements of three identical pieces of the master model and the duplicate model were taken with a digital caliper. The data obtained were tabulated in Excel, and significant differences between the models were sought according to each of the established variables. Results: The analysis of the information allowed the development of a protocol with the ideal technical instructions for handling these materials in order to optimize the processes and achieve more precise results and adaptability of the prosthetic devices in the short and medium term.
Chitosan, derived from chitin, has gained significant attention as a versatile biopolymer with broad applications. Chitin, a nitrogen-rich polymer, is abundant in the exoskeletons of arthropods, fungal cell walls, green algae, microorganisms, and the radulae and beaks of mollusks and cephalopods. Chitosan’s unique macromolecular structure, along with its solubility, biocompatibility, biodegradability, and reactivity, makes it a promising material for various fields. Its applications span medicine, pharmaceuticals, food, cosmetics, agriculture, textiles, paper, energy, and industrial sustainability. More specifically, chitosan and its derivatives have been explored in drug delivery, dentistry, ophthalmology, wound healing, bioimaging, tissue engineering, food packaging, coatings, preservatives, nutraceuticals, skincare, plant stress protection, controlled-release fertilizers, dye-sensitized solar cells, wastewater treatment, and metal extraction. This study aims to provide a comprehensive review of chitosan-based applications, highlighting their advantages and limitations, as well as addressing the main challenges and future research directions.
Mesiodens, the most common type of supernumerary tooth located in the anterior maxillary region, can lead to various dental complications, including altered eruption, malocclusion, and aesthetic concerns. This paper aims to examine the clinical characteristics, classification, and treatment modalities of mesiodens, focusing on the available management options, both conservative and surgical. A thorough review of the literature was conducted to assess the prevalence, types, and outcomes of treatments for mesiodens. The findings indicate that conical mesiodens are the most prevalent, although other variations, such as tuberculated and molariform mesiodens, are also observed. Treatment strategies depend on the type of mesiodens, the patient's age, and the presence of associated dental issues. Options include extraction followed by spontaneous eruption, orthodontic traction, or surgical repositioning. The paper concludes that while extraction remains the most common intervention, retaining mesiodens is an appropriate alternative when specific clinical criteria are met. Optimal treatment planning is crucial to ensure both functional and aesthetic success.
