This review provides a comprehensive overview of commercial zirconia cleansing agents designed for dental applications. It examines the characteristics of dental zirconia surface structure, the fundamentals of cleansing agents and their interaction mechanisms, and the impact of these agents on bond strength. Across the 17 included in vitro studies, rinsing with water left bond strength 8.6
Precision dentistry aims to integrate molecular biomarkers into clinical decision-making, enabling personalized prevention, diagnosis, prognosis, and treatment of oral diseases. Although many biomarkers have been identified, their use in dentistry is limited. This review critically assesses the evidence supporting biomarker-based precision dentistry, highlighting its clinical applicability, implementation challenges, and future directions for translating molecular diagnosis into personalized oral health care. Recent advances in multi-omics and multiplex technologies, biosensors, microfluidic platforms, liquid biopsies, artificial intelligence (AI), and point-of-care (POC) diagnostics have improved biomarker detection and analysis in oral cancer. Inflammatory, oxidative stress, genetic, epigenetic, proteomic, metabolic, and microbiological biomarkers have great potential for the early screening, diagnosis, risk stratification, prognostic evaluation, and treatment of periodontal disease, peri-implant disease, oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC), dental caries, and pulpal disease. However, most biomarkers remain in the exploratory or validation phase, and only a relatively small number have sufficient evidence to guide routine biomarker-based therapeutic decisions. Biomarker-based precision dentistry is an important step towards predictive, preventive, and individualized oral health care. However, biological variability, a lack of standardized analytical protocols, limited multicentre validation, regulatory barriers, reimbursement issues, and cost-efficiency concerns still limit its widespread implementation. Future progress will depend on robust clinical validation, evidence-based guidance, interdisciplinary cooperation, and mainstreaming validated biomarker platforms into routine practice. A schematic representation of biomarker-based precision dentistry, translational framework and clinical implications. Biological sources, biomarker classes, and diagnostic technologies support integrated biomarker discovery and subsequent clinical application, implementation, and personalized care. The framework also summarizes the anticipated clinical impact, key implementation challenges, and future priorities required for reliable translation into dental practice.
This narrative review aimed to critically synthesize and compare laboratory and clinical evidence regarding the behavior of indirect esthetic partial restorations, with emphasis on the translational relevance of in vitro findings to clinical outcomes. Evidence indicates that indirect partial restorations tend to perform well clinically over time, with high survival rates across materials and studies. Mechanical aspects such as fracture resistance and marginal fit are well studied in laboratories and somewhat align with clinical results. However, esthetic qualities such as color and translucency, along with surface finish and wear, are less frequently reported in both laboratory and clinical research, making full interpretation difficult. Moreover, variability in study methodologies, aging procedures, and assessment standards weakens the ability to directly compare lab findings with clinical outcomes. Indirect partial restorations represent predictable and effective treatmentoptions, although failures such as discoloration, fractures, marginal discrepancies,sensitivity, and secondary caries are documented. Most complications are manageableor repairable rather than catastrophic. Despite the contribution of laboratory studies tounderstanding material behavior, their direct extrapolation to clinical performanceremains limited due to methodological variability and insufficient standardization. Futureresearch should focus on clinically relevant experimental designs and improved alignmentbetween in vitro testing and standardized clinical evaluation criteria.
This literature review evaluates the application of marine-derived chitosan in oral surgery, with particular emphasis on its hemostatic and wound healing potential. This review outlines the biological requirements of oral surgical wounds and the material characteristics that render chitosan clinically relevant. It then examines the mechanisms through which chitosan contributes to hemostasis, including erythrocyte aggregation, platelet interaction, and adaptation to wound surfaces. Its role in wound healing is discussed in terms of its antimicrobial activity, inflammatory modulation, fibroblast support, angiogenic potential, and scaffold behavior. Particular attention is given to formulation-dependent performance, as chitosan can be developed into sponges, gels, membranes, hydrogels, and composite scaffolds for various clinical applications. The largest body of clinical evidence currently concerns extraction socket management, where chitosan-based dressings have been associated with a shorter time to hemostasis and improved early healing, mainly in comparison with gauze or cotton pressure. Original clinical studies are summarized in Table 3, which also records findings in which chitosan did not outperform comparator agents. Applications in periodontal surgery, implantology, and regenerative procedures are supported mainly by small clinical studies and preclinical data and remain less established. Marine-derived chitosan is a versatile oral biomaterial, and its performance depends on its intrinsic properties, formulation design, and clinical environment. Its derivation from crustacean shell processing waste additionally positions it as a sustainable biomaterial, although this same sourcing route introduces batch-to-batch variability that constrains clinical reproducibility.
Clonal haematopoiesis of indeterminate potential (CHIP) is an age-related process increasingly linked to chronic systemic inflammation and several inflammatory diseases. Periodontitis is a chronic inflammatory disease driven by dysbiotic oral biofilms and dysregulated host immune responses. This narrative review synthesises current evidence from immunology, cardiovascular biology, osteoimmunology, and periodontal medicine to explore the possible relationship between CHIP, inflammaging, and periodontal disease. Human and experimental evidence now provides convergent but not uniform support for a CHIP–periodontitis relationship. Wang et al. (2024) reported a borderline and imprecise association between DNMT3A-CHIP and more severe periodontitis in 4,946 community-dwelling adults and, in parallel, demonstrated accelerated inflammatory alveolar bone loss in a murine model. Yuan et al. (2026) further showed that ligature-induced periodontitis promotes expansion of haematopoietic Dnmt3aR878H/+ clones through a CCL17-associated feedback circuit. In contrast, a 2025 two-sample Mendelian randomisation study reported a nominally protective association between genetically predicted DNMT3A-CH and periodontitis, underscoring the heterogeneity and methodological limitations of the current evidence base. Current evidence supports a biologically plausible, potentially bidirectional CHIP–periodontitis axis, but the human evidence remains limited and directionally discordant. One cross-sectional human association study links DNMT3A-CHIP with more severe periodontitis, whereas the experimental evidence is predominantly murine and genetic epidemiological findings are not necessarily equivalent to acquired somatic clone behaviour. The CHIP–periodontitis relationship should therefore remain hypothesis-generating until validated in longitudinal human cohorts with direct somatic mutation profiling and rigorous periodontal phenotyping.
