BACKGROUND:Dental caries is a prevalent chronic disease characterized by complex inflammatory responses in the oral environment. This case-control pilot study evaluated the analytical performance of an ultra-sensitive electrochemiluminescence multiplex assay (MSD S-PLEX®) for salivary cytokine profiling and explored whether combined cytokine signatures can discriminate dental caries lesions (CL) from healthy (H) and non-carious gingival inflammation (GI). METHODS:Unstimulated whole saliva from 65 individuals (H, CL, GI) was analyzed using the S-PLEX assay to quantify nine salivary cytokines (IL-1β, TNF-α, IL-6, IL-4, IL-10, IL-12p70, IFN-γ, IL-17, and IL-2). Group comparisons were performed using Mann-Whitney tests, and diagnostic performance was assessed by logistic regression and the area under the receiver operating characteristic curve. RESULTS:The assay showed high sensitivity and reproducibility. Cytokine profiling revealed selective elevation of certain cytokines in saliva from CL. Among the models tested, TNF-α + IL-17 provided the best discrimination between CL and H (AUC = 0.901, p < 0.001) and between CL and H + GI (AUC = 0.795, p = 0.0003). Inclusion of additional cytokines did not improve performance. However, discrimination between CL and GI was limited with TNF-α + IL-17, while IL-1β + IL-17 provided a modest but significant discrimination (AUC = 0.737, p = 0.004). CONCLUSION:This proof-of-concept study demonstrated the feasibility of ultrasensitive multiplex salivary cytokine profiling using the S-PLEX platform and revealed distinct cytokine signatures associated with clinically detected carious lesions. While preliminary, these findings support further investigation of salivary host-response biomarkers in caries research. Future longitudinal studies integrating comprehensive clinical, microbial, and immunological data together with detailed clinical characterization, including radiographic assessment and lesion severity evaluation, will be necessary to validate these associations and clarify their potential biological and clinical significance in caries research and their potential role in personalized caries management.
Abstract Objective This study aimed to determine and compare the possible proliferative and differentiative effects of extracellular vesicles (EVs) derived from human dental pulp stem cells (hDPSCs-EVs) and human blood plasma (hBP-EVs) on hDPSCs as an in-vitro assessment for their ability on endogenous hDPSCs for osteo-odontogenic differentiation Materials and methods hDPSCs were isolated from impacted third molars of healthy donors and characterized by flow cytometry. EVs were isolated from hDPSCs-conditioned media and human plasma using differential ultracentrifugation and characterized by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), bicinchoninic acid assay (BCA), and Western blotting (WB). hDPSCs were cultured in standard medium (control) or supplemented with 50 µg/mL hDPSCs-EVs or hBP-EVs. Proliferation was assessed by MTT assay. Mineralization was evaluated by Alizarin Red staining. Odontogenic differentiation was analyzed by quantitative real-time PCR for dentin sialophosphoprotein (DSPP) expression and immunocytochemical detection of osteocalcin (OCN). Results By flow cytometry, hDPSCs showed positive expression for CD90 and CD105 and negative expression for CD34 and CD45. Both EVs types demonstrated characteristic nanoscale morphology and EVs marker expression. hDPSCs-EVs significantly enhanced proliferation compared with hBP-EVs and control ( P < 0.001). Additionally, mineral deposition, DSPP expression, and OCN-positive area were markedly higher in the hDPSCs-EVs group than in the hBP-EVs and control groups ( P < 0.001). Conclusion Although hBP-EVs exhibited measurable regenerative activity, tissue-specific hDPSCs- EVs produced significantly greater proliferative and osteo-odontogenic effects. These findings suggest that EVs bioactivity is strongly influenced by cellular origin and highlight the importance of lineage-specific vesicles in optimizing cell-free regenerative strategies for endodontic applications
INTRODUCTION:Oral cancer patients undergoing surgical resection often develop extensive maxillofacial defects that compromise function, aesthetics, and quality of life. Three-dimensional (3D) printing has enabled the development of customized, patient-specific prostheses, offering improved precision in rehabilitation. However, the extent to which defect type and location influence prosthetic outcomes remains inadequately synthesized in the current literature. OBJECTIVE:To map and synthesize the available evidence on the impact of type of maxillofacial defect on outcomes of 3D-printed prostheses in oral cancer patients. INCLUSION CRITERIA:This review will include studies involving oral cancer patients with surgically acquired maxillofacial defects rehabilitated using a 3D-printed prosthesis. Studies involving intraoral and extraoral defects that report functional, clinical, prosthetic, or aesthetic outcomes of 3D-printed prostheses will be included. METHODS:A comprehensive literature search will be conducted across databases including PubMed, Scopus, Web of Science, Embase, and Cochrane Library using relevant keywords. Two independent reviewers will perform study selection through title/abstract screening followed by full-text review. Data will be extracted using a structured template recording the study characteristics, surgical defect characteristics, prosthetic rehabilitation details, and outcome measures. Findings will be synthesized descriptively and presented in tabular and narrative formats to identify the research gaps. The review will be conducted and reported in accordance with the PRISMA-ScR guidelines. REVIEW REGISTRATION:Open Science Framework https://doi.org/10.17605/OSF.IO/C8STU.
OBJECTIVE:To evaluate the sealing capabilities of mineral trioxide aggregate (MTA) and Geristore as retrograde filling materials in dry and saliva-contaminated environments. METHODOLOGY:Seventy-two extracted single-rooted premolars were included. Root canals were prepared and obturated following decoronation. Each root's apical 3 mm was removed, and via ultrasonic tips, uniform retrograde cavities were created. The teeth were divided into four groups (n = 18) at random: MTA dry, MTA wet, Geristore dry, and Geristore wet. After that, samples were submerged in methylene blue dye (1%) for 48 h. A stereomicroscope was used to examine the longitudinally sectioned roots at a magnification of 25.6×. The linear penetration of dye was measured using ImageJ software. Tukey's post hoc test and one-way analysis of variance (ANOVA) were used in SPSS data analysis. RESULTS:One-way ANOVA demonstrated a significant difference in dye penetration among the four groups (p < 0.001). In both dry (0.64 ± 0.42 mm) and wet (0.65 ± 0.32 mm) conditions, Geristore demonstrated similar sealing ability (p = 1.000). In contrast, MTA exhibited significantly lower dye penetration in dry conditions (0.47 ± 0.21 mm) than in wet conditions (1.13 ± 0.26 mm; p < 0.001), with the wet MTA group demonstrating the greatest microleakage. CONCLUSION:Geristore demonstrated consistent sealing ability irrespective of environmental conditions. Although MTA performed similarly in dry conditions, its sealing ability was significantly compromised by salivary contamination. Geristore may therefore be a more reliable root-end filling material when moisture control is difficult.
Abstract Background Gypsy, Romany, and Traveller (GRT) populations experience poor oral health, with a recognised unmet need for care compounded by multiple barriers to accessing dental services. This scoping review aims to identify and map the available evidence, as well as gaps in the literature, relating to oral health improvement and access to care among GRT populations in Europe. Methods Studies published in English relating to oral health improvement and/or access to care among GRT populations were included. Electronic databases searched comprised Embase (Ovid), Scopus (Elsevier), Web of Science (Clarivate), and Dentistry and Oral Sciences Source (EBSCOhost). In addition, a grey literature search was conducted. Titles and abstracts were screened against the eligibility criteria, followed by full-text screening, by two independent reviewers. Included studies were analysed using thematic analysis, and findings were tabulated to illustrate study characteristics and outcomes related to oral health improvement and access to care. Results Of the initial 436 search results, 18 publications met the inclusion criteria and were included in the review. Overall, there was a paucity of literature addressing oral health access and improvement among GRT populations, with even fewer evaluated programmes designed to address these challenges. Identified barrier-related themes included limited health literacy, structural barriers to accessing care, prohibitive costs, and population mobility, which affected continuity of care, routine engagement with services, and registration. Fewer facilitating factors were identified. Community health workers were most frequently reported as supporting access to services and promoting oral health within these populations. Interventions such as mobile dental units appeared effective but were resource-intensive. The most sustained benefits in GRT communities were associated with initiatives that fostered trust between communities, health services, and care providers. Conclusions GRT communities experience significant disadvantage in accessing dental care, with substantial barriers to meeting their treatment needs. To address the limited evidence base for oral health programmes, further research, particularly focused on oral health improvement, should be conducted with these populations.
BACKGROUND/OBJECTIVE:Oral health and nutritional status are closely interlinked through biological, functional, and behavioural pathways, yet the global research landscape connecting these domains has not previously been systematically mapped. This study aimed to provide a comprehensive bibliometric assessment of worldwide research linking oral health and nutritional status, identify influential publications, and analyze thematic developments over time. MATERIALS AND METHODS:Data were retrieved from the Science Citation Index Expanded (SCI-EXPANDED) within the Web of Science Core Collection. Publications from 1991-2024 were identified using a structured search strategy incorporating primary and extended terminology. Document characteristics, citation performance, authorship patterns, and publication indicators (TP, IP, CP, FP, RP, and SP) were analyzed alongside citation indicators (Cyear, TCyear, CPPyear). Author keywords were examined across three balanced time periods to identify major research foci. RESULTS:A total of 10,074 publications were identified, including 8747 articles. Global research activity increased steadily, with citation maturity typically reached after 13 years. The USA, UK, Japan, and China led in publication output, while international collaboration was associated with higher citation impact. The ten most-cited articles reflected epidemiological surveillance, methodological standardization, global oral disease burden, and clinical nutrition guidelines. Keyword analysis revealed five overarching subjects: epidemiology, nutrition-related determinants of oral function and disease, clinical and quality-of-life outcomes, intervention strategies, and vulnerable populations. CONCLUSIONS:This study provides the first global bibliometric overview of research linking oral health and nutritional status. Findings highlight an expanding, interdisciplinary field with growing methodological sophistication and public health relevance.
Abstract Aim Online oral-health misinformation and low-quality information are increasingly studied, but the dental evidence base remains fragmented across platforms, topics and measurement approaches. This scoping review mapped how online oral-health misinformation and information quality have been defined, measured and reported, and identified the extent to which patient-level outcomes have been directly examined. Methods A scoping review was conducted using the Arksey and O’Malley framework and reported in accordance with PRISMA-ScR. Searches of Scopus, Web of Science and Ovid Medline identified 864 records. After screening, 61 studies were included following exclusion of two non-English articles and three studies where AI chatbots were the primary object of analysis. Data were charted by platform, misinformation or information-quality construct, study design, uploader type, engagement measure, quality assessment method and evidence directness. A formal risk-of-bias assessment was not undertaken, consistent with the scoping review design. Results Research increased markedly from 2022 onwards, with YouTube the most frequently studied platform, followed by Instagram, websites and Facebook. Most studies were descriptive content audits that assessed information quality, reliability, readability, uploader type or engagement. Professional or institutional content often scored higher for quality, while lower-quality, commercial or lay content sometimes attracted greater platform engagement within individual studies. However, engagement measures indicated visibility or interaction only, and did not establish patient-level impact. Fluoride, root canal treatment, aesthetic dentistry, implants, orthodontics and do-it-yourself remedies were recurring topics. Conclusions Research on online oral-health misinformation and information quality is expanding, but remains dominated by descriptive audits of public online platforms. Direct evidence linking online exposure to patient trust, treatment decisions, care avoidance or clinical outcomes remains limited. Future studies should use clearer definitions, distinguish misinformation from information quality, and measure patient-level and intervention outcomes more directly.
BACKGROUND:Stomatognathic movement disorders (SMDs) are uncommon but clinically significant neurological conditions that frequently present with orofacial manifestations. Because affected patients may initially seek care from dental practitioners, limited awareness of these disorders could contribute to diagnostic confusion with temporomandibular disorders (TMDs) and may have implications for timely referral and appropriate patient management. This study evaluated dental practitioners' knowledge, diagnostic confidence, and educational preparedness regarding SMDs. METHODS:A cross-sectional survey was conducted among dental practitioners using a validated self-administered online questionnaire. Knowledge scores were calculated out of 25 points and expressed as percentages. Comparative analyses were performed across educational levels using one-way ANOVA, chi-square tests, and multivariable logistic regression. RESULTS:A total of 156 dental practitioners participated. Mean knowledge scores differed significantly across academic level (Bachelor: 44.05%, Master: 48.95%, Doctorate: 63.71%; p < 0.001). Doctoral-level education independently predicted adequate knowledge (OR = 8.54, 95% CI: 2.09-34.97; p = 0.003), whereas master's-level showed no significant effect. Knowledge gaps were observed in several domains, particularly in distinguishing SMDs from TMDs and in the management of oromandibular dystonia. Only a minority of participants correctly recognized that temporomandibular joint radiographs are not routinely required prior to treatment. Self-reported clinical confidence was generally low, with only 1.1% of general dentists reporting the ability to independently manage suspected SMD cases. Nevertheless, 94.9% of participants supported integrating SMD-related content into dental curricula. CONCLUSION:The surveyed dental practitioners demonstrated important knowledge gaps regarding SMDs. These findings highlight opportunities to strengthen undergraduate and continuing dental education in the recognition, differentiation from TMDs, and appropriate referral of patients with suspected SMDs.
INTRODUCTION:A 24-month longitudinal Dental Foundation Training (DFT) was piloted by Health Education England (HEE), now NHS Workforce, Training & Education (WT&E) from 2022-24 across London, Kent, Sussex and Surrey (KSS) region. This study evaluated the feasibility, strengths, and areas for improvement within the 24-month training model. METHODS:A mixed methods design compared the 24-month longitudinal scheme with the standard 12-month DFT over a two-year period. Purpose-designed questionnaires captured quantitative and qualitative feedback on key training elements, while focus groups explored trainees' expectations, experiences and perceived challenges in greater depth. RESULTS:Participants included 24 trainees on the 24-month longitudinal scheme and 63 foundation dentists undertaking the standard model. Trainees on the 24-month longitudinal scheme reported notable benefits, including broader clinical exposure across practice, community and hospital settings, improved confidence and enhanced preparedness for future career decisions. They also identified opportunities for improvement relating to logistical arrangements, aspects of induction, communication from training programme directors and timeliness of information on competencies and assessments. CONCLUSIONS:This evaluation shows that longitudinal DFT provides clear benefits for early-career dentists through enhanced skills, wider clinical exposure and improved career readiness. Insights from the pilot have positively informed curriculum refinement and regional service development.
Abstract Introduction Digital dentistry (DD) is increasingly integrated into clinical practice, yet limited research explores its implementation within undergraduate dental education in the UK. This study examined student and clinical supervisor (CS) experiences of digital intraoral scanning (DIOS) in a primary care dental school. Methods A qualitative study using semi-structured online interviews was conducted with 15 Bachelor of Dental Surgery (BDS) students and six CS in a dental school in Southwest England. Data were analysed using template analysis. Results Participants viewed DIOS as essential for preparing graduates for contemporary practice, while maintaining competence in conventional techniques. Students described DIOS as engaging, low-stress, and beneficial for patient interaction, whereas CS highlighted technical challenges, variable staff digital literacy, and organisational constraints. Key barriers included limited equipment, restricted access, time pressures, and variability in supervisor training. Reported benefits included improved patient experience, accuracy, and enhanced learning for visually oriented students. Participants recommended increased access, structured training, and broader integration of digital technologies. Conclusions DD teaching is positively received by students and valued by CS for preparing graduates for modern practice. However, successful integration requires investment in training, resources, and equitable access, alongside structured curriculum development to support consistent delivery.
BACKGROUND:Visual shade selection remains widely used in restorative and prosthetic dentistry and is influenced by interobserver variability, illumination conditions, and individual visual factors. However, the relationship between colour perception screening findings and shade-matching performance in undergraduate dental students remains insufficiently explored. OBJECTIVE:To assess colour perception screening findings and shade-matching performance among undergraduate dental students using the Ishihara test and practical shade-selection tasks. METHODS:An exploratory cross-sectional study was conducted including 80 fourth- and fifth-year dental students enroled in the prosthodontics course at the University of Barcelona during the 2017-2018 academic year. Colour perception was screened using the Ishihara 24-plate test. Shade-matching performance was evaluated through two practical tasks: pairing corresponding tabs from two Chromascop shade guides and selecting the reference shade of a ceramic crown. Incorrect responses, shade-selection discrepancies, and completion time were recorded. Statistical analysis included descriptive statistics and bivariate tests selected according to the type of variable and expected cell frequencies. RESULTS:Eighty students participated in the study (33.75% male, 66.25% female). Ishihara screening findings compatible with colour vision deficiency were observed in 2.5% of participants, while isolated incorrect plate responses were observed in a larger proportion of students. Shade-matching discrepancies were frequent in both practical tasks. Self-reported ophthalmological conditions were associated with a higher number of shade-selection discrepancies (p < 0.05). Longer completion times tended to be associated with more discrepancies, although this association was not statistically significant. No significant differences were observed according to sex. CONCLUSIONS:Within the limitations of this exploratory study, shade-matching discrepancies were common among undergraduate dental students and were not limited to participants with Ishihara screening findings compatible with colour vision deficiency. These findings support the relevance of structured training in colour science and shade selection during prosthodontic education. Further studies using standardized perceptual and instrumental reference methods are needed.
AIM:This randomized controlled clinical trial evaluated the effectiveness of guided endodontic microsurgery (GEMS) compared to conventional endodontic microsurgery (EMS) in critical anatomy regions. MATERIALS AND METHODS:Twenty-eight patients (ages 19-58 years) requiring endodontic microsurgery in critical anatomical regions were randomly allocated to guided surgery (n = 14) using 3D-printed surgical guides with trephine burs or conventional microsurgery (n = 14). Primary outcomes included surgical procedure time. Secondary outcomes were periapical lesion size measured by CBCT at 6, 12 months and success rate at 1-year follow-up and complications. statistical analysis employed independent t-tests and chi-square tests. RESULTS:The guided group demonstrated significantly shorter surgical time (18.21 ± 3.45 min vs 26.07 ± 4.29 min) (independent t-test, p < 0.001). Complete lesion resolution at 1 year was achieved in 92.9% of guided cases, compared with 71.4% in conventional cases (chi-square, p = 0.139). No complications were observed. CONCLUSIONS:Guided endodontic microsurgery using a 3D-printed surgical guide with trephine burs significantly reduces surgical time. The technique demonstrates a clinically relevant trend toward improved healing outcomes, supporting its adoption for complex endodontic surgical cases. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT05283252.
OBJECTIVE:Infants with cleft lip and/or palate (CL/P) may experience feeding difficulties that place them at increased risk of growth faltering. However, data comparing anthropometric outcomes between infants with CL/P and non-cleft infants in Indonesia remain limited. This study aimed to compare anthropometric indicators of undernutrition between infants with CL/P and infants without craniofacial anomalies evaluated at the same hospital. METHODS:This cross-sectional study included 174 infants aged <1 year (87 with CL/P and 87 without craniofacial anomalies). Anthropometric data were obtained from electronic medical records at a single cleft center and the paediatric department of the same hospital. Length-for-age z-scores (LAZ) and weight-for-length z-scores (WLZ) were calculated according to World Health Organization (WHO) Child Growth Standards. Stunting was defined as LAZ <-2 standard deviations (SD), and wasting as WLZ <-2 SD. Associations between CL/P and anthropometric status were analysed using χ² tests. RESULTS:The mean age was 6.0 ± 3.9 months in the CL/P group and 5.6 ± 2.6 months in the comparison group. Infants with CL/P had a significantly higher prevalence of stunting than infants without craniofacial anomalies (52.9% vs. 5.7%; P < 0.001). No significant difference was observed in wasting between the groups (2.3% vs. 2.3%; P = 0.069). Anthropometric status was not associated with cleft type (P = 0.989). DISCUSSION:Infants with CL/P demonstrated a substantially higher prevalence of stunting, an indicator of chronic growth restriction, whereas wasting, an indicator of acute undernutrition, did not differ between groups. These findings suggest that growth deficits in infants with CL/P may accumulate gradually over time rather than manifest primarily as acute nutritional deterioration. CONCLUSION:Infants with CL/P may be vulnerable to chronic growth restriction during early life. Strengthening early feeding assessment, nutritional surveillance, caregiver education, breastfeeding support, and multidisciplinary cleft care may help reduce growth faltering and improve outcomes.
Diabetes mellitus (DM) is one of the world's most common non-communicable diseases. DM is a group of metabolic disorders in which blood glucose levels increase due to reduced insulin production or action, resulting in hyperglycemia. Various anti-diabetic medications, including insulin, metformin, glimepiride, glipizide, and thiazolidinedione, are used to control hyperglycemia in diabetic patients. These anti-diabetic medications have been shown to affect the gingiva, bone, fibroblast cells, pulpal tissues, dental stem cells, saliva, teeth, and oral microbiome. Metformin (a biguanide), insulin, and oral sulfonylureas (glipizide and glimepiride) have regenerative and host-modulating effects. Metformin and insulin can promote the growth of osteoblasts (bone-forming cells) and periodontal ligament fibroblasts and enhance the differentiation of mesenchymal stem cells to repair the lost periodontal tissues. Metformin is used in both systemic and local forms as a gel or scaffolds along with periodontal therapy (scaling and root planing) and surgical procedures to promote repair of periodontal tissues, alveolar bone defects, furcation defects, and osseointegration of dental implants. Although the effect of metformin on oral tissues is well established, the role of other anti-diabetic drugs on the oral and periodontal tissues is not comprehensively discussed. Thus, this review aims to discuss the positive and negative effects of various anti-diabetic medications on the oral cavity.
OBJECTIVE:Dentin hypersensitivity (DH) is a common clinical condition characterized by transient, sharp pain arising from exposed dentinal tubules in response to external stimuli. The aim of this study was to evaluate and compare the efficacy of two toothpaste formulations: one containing 5% potassium nitrate alone and another combining 5% potassium nitrate with 2.18% aluminum lactate. MATERIALS AND METHODS:This was a parallel-group, randomized, double-blind, negative-control trial with 127 participants. Participants were randomly assigned to three groups (two test and one placebo). The Dentin Sensitivity Index (DSI) was assessed under tactile and air stimulation at baseline, immediately after brushing, and at 2 weeks, 4 weeks, 4 weeks plus 24 h, and 8 weeks. RESULTS:Compared with baseline, both test groups showed statistically significant reductions in DSI for both tactile and air stimulation at all time points immediately after use. From 2 weeks onward, the DSI of both test groups was significantly lower than that of the placebo group at all evaluated time points. Furthermore, the toothpaste containing 5% potassium nitrate combined with 2.18% aluminum lactate exhibited a greater effect than the potassium nitrate alone at specific time points: 4 weeks for air stimulation, 4 weeks plus 24 h for tactile stimulation, and 8 weeks for both types of stimulation. CONCLUSIONS:Both toothpaste formulations-5% potassium nitrate alone and 5% potassium nitrate combined with 2.18% aluminum lactate-demonstrated significant efficacy in reducing dentin hypersensitivity, with the combination showing greater improvement at several time points. CLINICAL TRIAL REGISTRATION:Trial registration: ISRCTN80733222.
Abstract Aims To evaluate the anti-plaque and anti-gingivitis efficacy and the safety of essential-oil-containing mouthrinses in people with diabetes, a group at high periodontal disease risk. Materials and methods This Phase IV, examiner-blind trial randomised 154 adults with type 1 (n = 15) or type 2 (n = 139) diabetes to use alcohol-containing essential oil (ACEO), alcohol-free essential oil (AFEO), or negative control mouthrinses alongside twice-daily brushing for 12 weeks. Assessments included a plaque index (TPI), gingival index (MGI), bleeding index (EBI), participant survey and adverse event monitoring. Results The essential-oil-containing mouthrinses (ACEO/AFEO) significantly reduced the primary endpoints of mean TPI (24.7%/13.2%) and mean MGI (37.2%/32.8%), versus the negative control, at Week 12 (p < 0.001). Both mouthrinses reduced EBI (68.7%/72.6%; p < 0.001), and participants reported better oral health experiences, versus negative control, at Week 12. Overall, 26.2% of participants were unaware of their elevated oral health risk due to diabetes, and 37.9% reported receiving no oral health guidance from healthcare providers. The mouthrinses showed good soft tissue tolerance. Conclusions Essential-oil-containing mouthrinses significantly improved periodontal health in people with diabetes, when compared with a negative control rinse, and may serve as a valuable adjunct to mechanical oral hygiene in this population. The identified knowledge gap highlights the need for collaboration between primary, diabetes and dental practitioners to enhance patient outcomes through integrated care.
AIM:Domiciliary dental care is the provision of dental care for those patients who are unable to attend a clinic due to a disability or impairment. This scoping review aimed to identify developments in the literature regarding the provision of adult domiciliary dental care. MATERIALS AND METHODS:The Arksey and O'Malley framework was used and findings were reported in line with PRISMA-ScR. Subject specific library support was used to produce a search strategy using MeSH (Medical Subject Headings) terms and key words to identify studies published in English between January 2009 and October 2025 relevant to the topic area. Database searching of Medline, Embase, PsycINFO and CINAHL was conducted alongside hand searching. RESULTS:In total, 45 primary research papers were included. Study types included qualitative research, observational studies and economic evaluations. Key themes identified included patient and staff reported barriers, facilitators to enable or improve domiciliary dental care and the role of dental team skill mix and education. DISCUSSION:There is currently an absence of rigorous research into dental care in domiciliary settings, likely due to ethical, financial and logistical complexity of undertaking research in this area. Research that has currently been undertaken is mainly focused on older patients living in care facilities. CONCLUSIONS:Domiciliary dental care is an essential service for patients unable to attend a dental clinic due to a significant disability or impairment. Whilst a formal quality assessment of individual studies is not carried out in scoping review methodology, the results of this review identified a number of barriers to its provision. Appropriate risk assessment, education and the effective use of technology were identified as possible facilitators. Further research is needed to enable the provision of evidence-based care to this vulnerable population.
OBJECTIVE:Clear aligners have become a popular alternative to fixed appliances because they offer esthetic advantages and potential improvements in periodontal health and pain management while enhancing quality of life (QOL). This systematic review and meta-analysis investigated the effects of clear aligners versus fixed appliances on established outcomes. MATERIALS AND METHODS:A systematic search was conducted in PubMed, Scopus, Cochrane Library, Embase, and ScienceDirect up to March 2025, along with gray literature and manual searching of key orthodontic journals. The eligible studies consisted of randomized controlled trials and observational studies that evaluated clear aligners against fixed appliances based on the plaque index (PI), gingival index (GI), probing depth (PD), pain intensity, and QOL. Researchers applied mean difference (MD) to PI, GI, and PD, while standardized mean difference (SMD) was used to evaluate pain intensity and QOL. Researchers evaluated heterogeneity using I² and publication bias while performing subgroup analyses centered on treatment duration. RESULTS:Thirty-two studies were included in the systematic review, of which 28 were included in the meta-analysis. Clear aligners significantly improved periodontal outcomes compared to fixed appliances, as shown by lower PI scores (MD = -0.437, 95% CI: -0.507 to -0.367, p < 0.001), GI scores (MD = -0.233, 95% CI: -0.296 to -0.170, p < 0.001), and PD scores (MD = -0.332, 95% CI: -0.431 to -0.234, p < 0.001). Patients treated with clear aligners experienced less pain than those treated with fixed appliances, particularly during the early treatment phase (SMD = -0.419, p < 0.001). Clear aligners significantly improved the QOF of patients at 1 week (SMD = -0.985, p < 0.001), 1 month (SMD = -0.829, p < 0.001), and end of treatment (SMD = -0.970, p < 0.001) compared with fixed appliances. Low to moderate heterogeneity was observed between groups for pain outcomes, while high heterogeneity was observed for short-term QOF comparisons. CONCLUSION:Clear aligners resulted in favorable periodontal indices compared with those of fixed appliances. They also led to less early pain and better QOF than fixed appliances, although these differences were mostly observed at the beginning of treatment. Clinicians should interpret these results cautiously because of heterogeneity, the inclusion of observational evidence, potential publication bias, and small pooled effects.
