BACKGROUND/AIMS:The growing use of generative artificial intelligence, especially chatbots, has motivated researchers to test the accuracy of health advice provided. Though there are studies comparing chatbot health advice for traumatic dental injuries (TDI), variable results have been reported. Hence, this systematic review aimed to assess contemporary chatbots for their ability to accurately and reliably provide responses to different types of questions related to emergency care of TDI. METHODS:The protocol was developed using the Cochrane Handbook and the Chatbot-Assessment-Reporting-Tool (CHART) statement and registered in the Open Science Framework. A literature search, based on the research question, was conducted in PubMed, EMBASE, Scopus, and Web of Science on September 19th, 2025, without any limitations. Screening of titles and abstracts and later full text, and data extraction were performed. These steps were followed by qualitative synthesis and meta-analysis. The quality of studies was assessed using their compliance with CHART. RESULTS:The review included 10 articles published in 2024 and 2025. Seven contemporary chatbots were evaluated with different themes and types of questions. Eight of the studies showed good compliance with CHART (≥ 75%). The overall pooled accuracy was 65% (95% CI 52%-78%, I2 = 88%) in ChatGPT-3.5, 79% (95% CI 61%-93%, I2 = 88.8%) in ChatGPT-4.0, and 70% (95% CI 60%-79%, I2 = 86.4%) in Gemini. CONCLUSION:Overall accuracy of chatbot-generated advice was moderate, with substantial variation depending on the type of questions assessed. The meta-analysis demonstrated a suggestive trend of higher accuracy for ChatGPT-4.0, followed by Gemini, Copilot P, and ChatGPT-3.5. However, these findings should not be interpreted as evidence of clinical reliability, as even limited inaccuracies in emergency dental trauma advice may contribute to delayed or inappropriate management and adverse outcomes.

AIM:To synthesize evidence on gingival diseases and conditions in children and adolescents (< 18 years) without known systemic disorder involvement, focusing on their distribution, aetiology, diagnosis, management and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS:A systematic review was carried out following PRISMA guidelines, including PubMed Central, Scopus, EMBASE and LILACS, up to January 2025. Clinical trials and observational studies addressing gingival diseases or conditions in healthy individuals under 18 years were included. RESULTS:The search identified 33,180 studies. Title and abstract screening narrowed these to 2264, of which 433 were full-text-reviewed. Ultimately, 269 studies, all restricted to biofilm-induced gingivitis, were included. Considerable heterogeneity was observed in diagnostic criteria and study quality. Dental biofilm-induced gingivitis was common (52%) and associated with poorer OHRQoL. Key determinants for gingival inflammation included socioeconomic status, oral hygiene behaviours, pubertal changes and malocclusion. Based on current evidence, effective management of gingivitis in children should combine supervised toothbrushing with a fluoridated toothpaste and school- or caregiver-based oral health education. Adjunctive use of chlorhexidine may provide additional benefit in certain clinical situations. CONCLUSION:Dental biofilm-induced gingivitis is frequent among children and adolescents and influenced by numerous determinants. Prevention and treatment should emphasise accessible, behaviour-focused and education-based strategies for biofilm control.

BACKGROUND/AIMS:Traumatic dental injuries (TDIs) frequently present with acute symptoms, yet many adverse outcomes manifest months or years later as medium- and long-term consequences. These sequelae, such as pulp necrosis with infection of root canal system, periapical radiolucency, and external inflammatory resorption, pose significant diagnostic and therapeutic challenges. Evidence describing such healing complications as the first presenting complaint remains limited. The aim of this study was to describe the pattern of such complications in children and adolescents reporting to a tertiary care hospital and to evaluate associated patient- and injury-related factors. METHODS:A hospital-based cross-sectional study was conducted on patients aged 6-18 years presenting with a history of TDI to permanent teeth and exhibiting clinical and/or radiographic signs of medium- and long-term complications. Standardized assessment protocols were followed, including NA0D classification for injury type, Miller's criteria for mobility, thermal and electric pulp testing for pulp sensibility, and radiographic evaluation using RVG and CBCT when indicated. Medium- and long-term consequences were categorized using established criteria. Statistical analysis included Student's t-test and ordered logistic regression. RESULTS:A total of 185 participants (218 teeth) were evaluated. Maxillary central incisors were most frequently affected (39.9%). The predominant injuries were enamel-dentin fractures (43.1%) and complicated crown fractures (41.3%). The most common medium- and long-term consequences were periapical radiolucency (90.3%), pulp necrosis with infection of root canal system (77.1%), and external inflammatory resorption (67.4%). Delay in reporting showed significant associations with discoloration, tenderness on percussion, and external inflammatory resorption (p < 0.01). Type of injury was significantly associated with multiple complications. Root maturity and age showed limited association. CONCLUSION:Medium- and long-term complications of TDIs predominantly involved pulp necrosis with infection of root canal system, apical pathology, and external inflammatory resorption. Longer delays in seeking care significantly increased the likelihood of adverse outcomes. The findings highlight the need for improved awareness, early emergency management, and future research focusing on combined injury patterns to better predict long-term prognosis.

BACKGROUND/AIMS:The prognosis of traumatic dental injuries (TDI) of permanent teeth depends on several factors related to the injury, patient characteristics, management, and follow-up protocols. When such injuries affect both hard dental tissues and the periodontium ("combination injuries"), the risk of adverse healing complications increases. However, a significant knowledge gap exists regarding the factors associated with their etiopathogenesis. Therefore, this systematic review aimed to evaluate the prognosis of traumatized permanent teeth affected by combination injuries. METHODS:An a priori protocol was registered in PROSPERO. A search strategy based on the research question was prepared, and the search was performed on PubMed, EMBASE, Web of Science, and Scopus on December 4, 2026. An additional grey literature search and reference search were also performed. Clinical studies reporting outcomes of permanent teeth with combination injuries and a follow-up greater than six months were included. Data extraction, risk of bias assessment, and meta-analysis were performed. The certainty of evidence was evaluated using GRADE. RESULTS:The electronic search of databases revealed 8190 records. Titles and abstracts of 4445 of them were evaluated, resulting in 177 studies for full-text screening. Finally, 10 of them could qualify for inclusion in the systematic review, and one more study was identified from reference searching. The incidence of pulp necrosis was high, with a pooled incidence of 42% (95% CI: 33%-52%, I2 = 87%) in teeth with crown fracture and luxation and 33% (95% CI: 26%-41%, I2 = 16.2%) in teeth with the combination of uncomplicated crown fracture and subluxation. Teeth with mature root development had a significantly higher risk of pulp necrosis (risk ratio = 1.70; 95% CI: 1.15-2.48). Other complications were less frequently reported. The overall certainty of evidence was very low. CONCLUSIONS:The pooled incidence of pulp necrosis among permanent teeth with combination injuries was 39%. Greater severity of luxation injury in any combination and mature status of the root showed a significantly higher risk of pulp necrosis and healing complications. The evidence base for the prognosis of combination injuries showed very low certainty, indicating the need for future studies addressing the limitations observed in the review.

BACKGROUND:Combination injuries or multiple traumatic dental injuries (TDI) affecting a single permanent tooth are clinically significant but remain underrecognized. Although the global prevalence of TDI is well documented, the epidemiology of combination injuries has not been clearly established. This systematic review and meta-analysis aimed to assess the prevalence and patterns of combination injuries in traumatized permanent teeth. METHODS:A review protocol was registered in PROSPERO (CRD1245967). Comprehensive searches of PubMed, EMBASE, Web of Science, and Scopus were conducted without language or date restrictions on December 4, 2025. Observational studies done in clinical settings involving patients older than 6 years with TDI in permanent teeth and reporting combination injuries were included. Two authors independently performed screening, data extraction, and risk of bias assessment using the Joanna Briggs Institute checklist. Random-effects meta-analyses were performed to estimate pooled prevalence and proportions of specific injury combinations. The certainty of evidence was evaluated using the GRADE framework. RESULTS:Thirty studies from 20 countries were included. Among 34,382 traumatized permanent teeth, 7161 presented with combination injuries. Reported prevalence ranged from 2.36% to 48.28%, with a pooled prevalence of 14% (95% CI: 11%-19%; I2 = 98.2%). Denmark demonstrated the highest pooled prevalence among countries represented by multiple studies. The most frequently reported combinations were enamel-dentin fracture with subluxation (25%) and enamel-dentin fracture with concussion (17%). Reporting terminology varied considerably, and many studies did not explicitly document combination injuries. While most studies had a low risk of bias, the overall certainty of evidence was very low. CONCLUSIONS:The pooled prevalence of combination injuries was 14%, with the highest country-specific prevalence reported in Denmark, and the most common pattern being enamel-dentin fracture combined with subluxation. Considerable variation in reporting terminology and the very low certainty of evidence highlight an urgent need for standardized nomenclature, calibrated diagnostic protocols, and well-designed studies to accurately capture the complexity of these injuries.

Purpose Selective caries removal (SCR) is increasingly recommended to preserve pulp vitality in primary molars, yet evidence from practice-based settings is limited. The aim of this study was to compare SCR to complete caries removal (CCR) in terms of restoration failure and tooth survival over 24 months. Methods A 2-arm practice-based randomized controlled trial was conducted in public and private dental clinics. Children aged 3–8 years with moderately deep carious lesions in primary molars were randomly allocated to SCR or CCR, with follow-up based on dental records at 12 and 24 months post-treatment. Primary outcomes were restoration failure, tooth extraction, and composite restoration failure defined as either event occurring. Secondary outcomes included pulpitis, abscess, secondary caries and emergency visits. Results A total of 262 restorations in 147 children were included (SCR n=126; CCR n=136). At 24 months, treatment groups showed no significant difference in the composite restoration failure rate (SCR 23.8% vs CCR 19.9%, p=0.545). Multi-surface restorations and younger age were associated with higher failure rates. Lack of anesthesia was associated with early restoration failure. Conclusion SCR and CCR showed similar clinical outcomes at 24 months when performed in routine clinical practice. Hence, operator- and case-related factors appear to be more important for restoration survival than choice of excavation method. Registry : ClinicalTrials.gov, TRN: NCT04614285, Registration date: 25 November 2020

Background/Objectives: Dental caries remains one of the most prevalent chronic diseases affecting children worldwide and continues to pose a substantial challenge to healthcare systems. Although the clinical consequences of paediatric dental caries are well documented, the associated economic burden has not been comprehensively synthesised. This systematic review aimed to evaluate and summarise the available evidence regarding the costs associated with dental caries in children and adolescents under 18 years of age. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251138979). MEDLINE via PubMed, Scopus, and Dentistry & Oral Sciences Source (EBSCOhost) were searched for studies published between January 2012 and July 2025. The MEDLINE and Scopus searches were conducted on 22 July 2025, and an additional search of Dentistry & Oral Sciences Source (EBSCOhost) was conducted on 19 August 2026. Eligible studies included peer-reviewed cost-of-illness studies, economic evaluations, cost analyses, cross-sectional studies, retrospective studies, and randomised controlled trials reporting economic outcomes related to the prevention or management of dental caries in individuals under 18 years of age. Methodological quality was assessed using the Drummond 10-item checklist. Data were extracted on study characteristics, population demographics, cost components, study perspective, and key findings. Reported costs were categorised as direct, indirect, and intangible costs where applicable. Due to substantial methodological heterogeneity among studies, a narrative synthesis was performed. Results: Seventeen studies met the inclusion criteria. Most studies focused on direct medical costs associated with restorative treatment, hospital-based dental care, and emergency services. Direct costs were consistently substantial across different healthcare settings, particularly for cases requiring advanced treatment or general anaesthesia. Preventive interventions were generally reported to be more cost-effective than curative approaches. Indirect costs, including caregiver productivity losses, were infrequently assessed, while no study comprehensively evaluated intangible costs. Considerable variation in study design, costing perspective, and reporting methodology limited direct comparison across studies. Conclusions: Dental caries in individuals under 18 years of age imposes a considerable economic burden, driven primarily by direct treatment costs. Preventive oral health strategies appear to provide greater economic value than treatment-focused approaches. The limited assessment of indirect and intangible costs suggests that the overall societal burden of paediatric dental caries is likely underestimated. Future research should adopt standardised and comprehensive costing methodologies to better support policy development and resource allocation in paediatric oral healthcare.

BACKGROUND:The objectives of this Focused Workshop were to update the epidemiology, aetiology, risk factors, diagnosis and management of gingival and periodontal diseases and conditions in children and adolescents, and to explore the applicability of the 2018 Classification in children and adolescents. METHODS:The Workshop discussions were informed by three specifically commissioned systematic reviews covering gingival and periodontal diseases and conditions, in systemically healthy children and adolescents, or in children and adolescents with systemic conditions. RESULTS:Over 70 genetic, congenital and acquired systemic conditions that impact the periodontal tissues were identified, with levels of evidence graded as very low, low or moderate. Gingival diseases and conditions in systemically healthy children and adolescents were identified, alongside local predisposing and systemic modifying factors. Periodontitis and other periodontal conditions in the 2018 Classification System also apply to children and adolescents; however, there are challenges with periodontal probing in the primary and mixed dentition. CONCLUSIONS:Periodontal tissues in children and adolescents differ from those in adults and require special consideration, accounting for their stage of development and predisposing and modifying factors unique to younger patients, which may confound accurate diagnosis, prognostication and management. Specific approaches to screening, examination and treatment are necessary for safe and effective management in this patient group.

IntroductionDental caries is a common chronic disease in children, influenced by biological, behavioral, and environmental factors, and modeling approaches provide a structured way to simulate disease progression, evaluate preventive or therapeutic interventions, assess economic outcomes, and inform policy. Despite increasing use of decision-analytic and simulation-based frameworks in pediatric dental caries, a comprehensive overview of model types, structures, and applications is lacking. The objective of this scoping review is to identify and describe state-transition and simulation-based modeling approaches used to simulate the progression of dental caries in children, including models applied to the evaluation of preventive or therapeutic interventions and economic outcomes, and to summarize their structural characteristics, applications, and methodological features.MethodsThis review includes studies of children and adolescents (birth to 18 years) from any health status or risk profile and in any geographic or clinical setting. Eligible studies described, developed, or applied state-transition or simulation-based models of dental caries progression, while studies limited to predictive, statistical, or cross-sectional approaches, as well as reviews and commentaries, were excluded. MEDLINE (PubMed) and Scopus were searched using a structured strategy, limited to English-language publications. Studies were screened and charted key model features independently by two authors.ResultsA total of 43 studies were included, most using state-transition approaches, primarily Markov cohort models and Markov microsimulations. Model structures ranged from simple caries presence to multi-state models incorporating enamel-dentin progression, ICDAS stages, or restorative pathways.DiscussionThese findings highlight how structural and methodological choices in caries modeling determine the scope of addressable research questions and underscore the need for standardized health-state classifications.RegistrationThis review was registered in the Open Science Framework, DOI 10.17605/OSF.IO/6BT7K.Systematic Review Registrationhttps://archive.org/details/osf-registrations-6bt7k-v1

Background: Periodontitis (PD) and rheumatoid arthritis (RA) are chronic inflammatory conditions, characterized by dysregulated immune response and excessive production of inflammatory mediators. The oral disease PD is triggered by periodontal pathogens, leading to the destruction of tissues surrounding the teeth, whereas RA is a systemic autoimmune disease primarily affecting the joints. The objective of this study was to investigate the prevalence of PD and map the profile of salivary and serum inflammatory mediators of patients with RA, with respect to periodontal severity (PD stage II and PD stage III/IV). Methods: For this cross‐sectional cohort study, 62 patients diagnosed with RA were recruited. All participants underwent a full‐mouth dental examination. Levels of various inflammatory mediators, including tumor necrosis factor (TNF) superfamily proteins, interferon (IFN) family proteins, regulatory T cell (Treg) cytokines, and matrix metalloproteinases were determined in saliva and serum samples from each participant using a human inflammation multiplex immunoassay panel. Results: In the current RA cohort, all participants were diagnosed with PD, of which 35.5% were classified as PD stage II and 64.5% as PD stages III/IV. Inflammatory mediator levels were significantly higher in both saliva and serum samples from patients with RA and PD stages III/IV, compared to those with RA and stage II within the same cohort. These included higher serum levels of sCD30, IL‐10, IL‐19, osteopontin and elevated salivary levels of BAFF/TNFSF13B and IFN‐ α 2. Additionally, APRIL/TNFSF13 levels were increased in both saliva and serum. Conclusions: Among the studied patients with RA, the majority exhibited severe PD (stage III/IV), underscoring the importance of periodontal prophylaxis and treatment for this group of patients. Higher levels of inflammatory mediators were observed in both saliva and serum in those with PD stages III/IV, suggesting a potential link between the severity of PD and systemic inflammation in RA. Further research is needed to explore the clinical implications of these findings.

BACKGROUND/AIMS:This update of previously conducted evidence mapping and quality analysis of systematic reviews related to dental traumatology aimed to assess the distribution of systematic reviews published in a period of past 54 months in various domains and subdomains and evaluate their quality. An attempt was also made to compare the trends of methodological and quality characteristics between the two Evidence Mapping studies. METHODS:An a priori protocol was prepared as per the recommendations of Global Evidence Mapping and registered in Open Science Framework. The boundary conditions were defined and a search was performed electronically by two authors on November 30, 2024 in PubMed, LILACS, Web of Science, Cochrane, Scopus, and EMBASE without any restrictions. EndNote Online was used to remove the duplicates and perform screening of titles and abstracts and the full texts. Data extraction was performed using a self-designed sheet and analyzed by the research group. AMSTAR-2 and ROBIS tools were used for assessing the quality of included systematic reviews. RESULTS:The evidence mapping included 66 systematic reviews that could be distributed in six domains. The maximum number of them were in Epidemiologic domain (n = 21) and the subdomain of "treatment protocols of permanent teeth" (n = 14). The conclusion of 27 SRs was graded as inconclusive. An a priori registration of protocol was done in 55 SRs, majority of reviews did not have any restrictions in search, and gray literature search was done in 39 SRs. The most common risk of bias (ROB) tool used was the Jonna Briggs Institute's Critical Appraisal Checklist. The ROB of 51 SRs was low as per ROBIS, and high level of confidence was exhibited by 24 SRs as per AMSTAR-2. CONCLUSION:The highest number of SRs was seen in the domain of epidemiology, followed by therapeutic and prognostic domains. As per ROBIS, 77.27% of SRs were found to have low ROB with a high level of confidence in 39.4% SRs as per AMSTAR-2. There was significant improvement in methodological and quality trends as compared to the previous Evidence Mapping.

Abstract Background Caries burden in children disproportionately affects minority and socioeconomically disadvantaged populations. Severe early childhood caries requiring general anesthesia (GA) is a significant concern, with high caries relapse rates in subsequent years. Aim To examine associations between parental psychosocial factors, children’s caries burden, and oral health-related quality of life (OHRQoL), including group differences, following a phone-based parental support intervention for children treated under GA for severe Early Childhood Caries (ECC). Methods Data were collected during a randomized controlled trial examining a phone-based parental support program. Parental stress was assessed using the Swedish Parenthood Stress Questionnaire (SPSQ), dental fear was measured with the Corah Dental Anxiety Scale (CDAS), and dental attitudes were evaluated using the Dental Beliefs Survey (DBS-R). Children’s OHRQoL was assessed using the Parental-Caregivers Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS). The Total Observed Caries Experience index was used to calculate the child’s cumulative caries burden. Unadjusted analyses were performed using t-tests, with effect sizes calculated as Cohen’s d. A two-step path analysis examined how parental factors, intervention, and baseline caries influenced caries burden at a one-year follow-up, while also assessing caries burdens impact on children's well-being. Results At the one-year follow-up, the intervention group demonstrated significantly improved OHRQoL with lower mean scores on the P-CPQ and FIS compared to the control group, indicating fewer oral health issues and less impact on family life. No statistical differences were found in parental stress, dental fears, or dental beliefs between groups. Path analysis identified baseline caries and treatment group as significant predictors of caries burden, while intervention group predicted better OHRQoL outcomes. The model explained 86.2% of caries burden variance and 12.9% of OHRQoL variance. Conclusion A phone-based parental support program significantly improved children’s OHRQoL, even with a higher caries burden in the intervention group at the one-year follow-up. Parental stress, dental fears, and attitudes showed no differences and did not predict caries burden. Preventing early childhood caries in high-risk groups remains challenging, highlighting the importance of preventive initiatives that empower parents and foster collaboration with key stakeholders to reduce severe ECC. Registered at https://clinicaltrials.gov/ Identifier: NCT02487043.

AIM:To assess the effect of a dental traumatology educational intervention on general dentists' knowledge. The study was conducted at Vestland County's Public Dental Service (PDS) in Western Norway. MATERIALS AND METHODS:All PDS dental clinics of Vestland County (n = 52) were purposively assigned to a control group receiving no intervention (CC, n = 19), a webinar group (IC1, n = 17), and a combined webinar and in-person physical course group (IC2, n = 16). To examine the effect of the intervention, participants received a post-intervention online questionnaire (Q2) with clinical cases. A generalized linear mixed-effects model (GLMM) was used to compare the individual proportion of correct answers in Q2 between the three groups of educational intervention, where the clinic was set as a random effect factor. Additionally, a GLMM with a binary response variable was used to analyze the answers to individual cases. p < 0.05 was considered statistically significant. RESULTS:The response rate was 57% (n = 94). The overall proportion of correct answers was 67.7%, 71.0%, and 75.0% for the CC, IC1, and IC2 groups, respectively. There was no statistically significant difference in the overall proportion of correct answers between the groups when accounting for the dependency structure caused by clinics. However, for the individual cases, the IC2 group had a statistically significantly higher proportion of correct answers in complicated crown fracture of the immature tooth (p = 0.02) and first aid after avulsion (p = 0.02) compared to the CC group. Furthermore, the IC2 group had a trend of difference in complicated crown fracture of the mature tooth (p = 0.09) compared to the CC group and in emergency treatment of root fracture (p = 0.08) compared with IC1. CONCLUSION:This study demonstrates that an educational intervention combining webinars with in-person interactive courses has a positive effect on general dentists' knowledge of dental trauma.

INTRODUCTION:Regenerative endodontic treatment (RET) aims to promote root maturation in necrotic immature teeth, where effective microbial disinfection is crucial for treatment success. This study evaluated the effect of calcium hydroxide (CH) and 2% chlorhexidine gluconate (CHD) as intracanal medicaments and their impact on bacterial loads and RET outcomes. METHODS:The material consisted of bacterial samples from 41 patients who participated in a previously conducted randomized controlled clinical trial comparing CH and CHD during RET. A total of 123 microbial samples were analyzed using real-time quantitative polymerase chain reaction (qPCR). Bacterial loads were assessed at three time points: before root canal disinfection (S1), after root canal disinfection (S2), and after intracanal dressing (S3). The microbial composition was evaluated at the kingdom (Eubacteria), phylum (Actinomycetota), and species (Enterococcus faecalis) levels. RESULTS:Significant reductions in bacterial loads were observed after root canal disinfection (S2) in both CH and CHD subgroups, regardless of treatment outcome. Further reductions after intracanal dressing (S3) occurred exclusively in the successful cases. Actinomycetota loads significantly decreased after root canal disinfection in the successful cases but remained unchanged after intracanal medication. The presence of E. faecalis after intracanal dressing was associated with failed RET (OR = 9.778; p = 0.0432), although no significant differences in the effectiveness of the intracanal medicaments were found. CONCLUSION:Both CH and CHD effectively reduced bacterial loads, with greater reductions linked to successful outcomes. The association between E. faecalis and failed RET suggests that this species may play a role in treatment outcomes. Further research, including microbiome profiling, is desirable to identify potential prognostic markers for failed RET.

BACKGROUND:Dentists require continuous professional development (CPD) to maintain and enhance the quality of their services. However, there remains a gap in our understanding of the most effective methods for delivering such professional education. OBJECTIVE:In order to develop CPD that is relevant and effective for general dentists, the aim of this study was to explore general dentists' experiences with and attitudes about two educational formats in dental traumatology: purely theoretical asynchronous webinars versus webinars complemented by an in-person, interactive course. DESIGN, PARTICIPANTS, AND SETTING:All general dentists in the public dental service (PDS) in the Vestland County of Western Norway participated in an educational intervention in dental traumatology between November 2022 and February 2023. We recruited dentists from a group that attended webinars alone (N = 31) and a group that participated in webinars combined with an interactive in-person course (N = 36), referred to as a combined approach. In total, 16 dentists agreed to participate in focus group discussions through the electronic platform Teams. The discussions were video recorded, and the transcripts were analyzed using thematic analysis. Prior to the focus group discussions, participants completed a questionnaire with demographic information and course evaluation. RESULTS:Participants represented diversity in clinical experience, age, gender, and they were overall satisfied with the content, organization, and learning outcomes of the given educational formats. Three themes emerged from the qualitative data analysis: Webinars offer flexibility but with limited learning outcomes; a combined approach supports knowledge application; balancing feasibility with participatory learning. While webinars in dental traumatology as an educational format offer accessibility and flexibility, the combined format made the general dentists reflect more, in addition to gaining ideas on better workflow as a team in their clinical settings. Regarding course design, results revealed the importance of well-structured content, interaction with relevant educators, and the need for a combined educational model. CONCLUSION:The study demonstrates that a combined educational format with high-quality content and a degree of interaction is the preferred method for CPD in dental traumatology for general dentists.

BACKGROUND/AIM:Most children and adolescents in Norway attend the Public Dental Service (PDS) where they are treated free-of-charge until the age of 19 years. Thus, general dentists employed in the PDS are the primary care providers for traumatic dental injuries (TDI) in young patients. This cross-sectional study assessed the knowledge of PDS general dentists on the acute management and follow-up of TDI and its socio-demographic and attitudinal covariates. MATERIALS AND METHODS:All general dentists employed in the Vestland County PDS, Western Norway, (N = 170) received an online questionnaire. Socio-demographic and professional profiles of respondents as well as attitudinal indicators were queried. Clinical case scenarios on emergency treatment and further follow-ups of TDI were used to calculate a dental trauma knowledge score (DTKS; range: 0-21). Mann-Whitney U tests and Kruskal-Wallis tests determined differences between the demographic subgroups. Logistic regressions determined the potential of single factors in explaining the variability in dental trauma knowledge. RESULTS:The response rate was 46%. Most participants (60.5%) had not participated in a TDI course after graduation but would like such a course (84.2%). Mean DTKS was 13.82 (±2.6). Knowledge scores differed significantly between age groups (p = .014) and years since graduation (p = .0018). Younger dentists and recently graduated dentists scored highest. Dentists under the age of 30 years scored higher than 30-39- and 40-49-year-old dentists in these areas: emergency treatment of crown fractures with pulp exposure, identification of complications after avulsion, and management of severe intrusive luxation injury. CONCLUSION:Younger dentists had a higher theoretical knowledge of TDI. Continuing professional development among dentists in the Norwegian PDS is needed for emergency treatment and complication management after TDI.

BACKGROUND/AIM:This study explored perceived challenges in the management of traumatic dental injuries (TDI) among general dentists in the public dental service (PDS) of Vestland County in Western Norway and their needs for improving treatment care for TDI patients. PARTICIPANTS AND METHODS:This qualitative study conducted three focus group discussions. We recruited a purposive sample of seven general dentists employed in the PDS in Vestland County in Western Norway. The three focus groups consisted of two, two, and three participants, respectively. The focus group discussion took place via the Microsoft electronic platform Teams, and it was visual, and audio recorded. Transcripts of the interviews were analyzed using systematic text condensation. RESULTS:The general dentists in this study experienced the management of TDI as a set of complex procedures that require good theoretical knowledge, clinical experience, skills, and teamwork. We were able to group these challenges into three results categories: (1) proficiency challenges, (2) the challenge of stress and discomfort during dental procedures, and (3) the challenge of the organization of the PDS. The participants also expressed the need for practical courses, calibration, and refresher courses in dental traumatology. Their needs fell into two categories: (1) regular, clinically relevant continuing professional development and (2) collective efforts in TDI management. CONCLUSION:Increasing awareness of the challenges in TDI management and addressing the need for improved dental treatment for TDI patients may lead to targeted programs to enhance dentists' knowledge and skills. There is considerable potential for training dentists in dental traumatology.

Traumatic dental injuries of permanent teeth result in multiple immediate and long-term consequences depending upon the severity of trauma, age of the patient, the status of root maturity, and the emergency care provided. The healing responses may get disturbed due to severe damage, loss of vascularity of the supporting structures, and infections. As a result, the prohealing mediators and pathways are overpowered by the destructive stimuli often manifested by an increased osteoclastic activity. Among the various late complications, the apical periodontitis or the periapical lesions are most worrisome for the patients and create clinical dilemma for the dentists. In the past, many such lesions were classified as cysts and subjected to surgical management. However, better understanding of lesion pathophysiology, three-dimensional imaging, and molecular pathways have established their inflammatory nature. The advancements in materials such as calcium silicates, and regenerative techniques have propelled the research related to non-surgical endodontic management as its clinical acceptability. The treatment largely follows the recommendations of regenerative medicine and is based on four principles: (a) establishing the drainage or an endodontic access to the area, (b) removal of most of the triggering agents such as necrosed pulp, toxins, and inflammatory mediators, (c) disinfection of the area, controlling inflammation and reversal of the acidic pH, and (d) maintenance of this infection/inflammation-free state for a long time through adequate sealing. This review aims to highlight the rationale of the approach, case selection, pathophysiology of the causation and healing, clinical protocols, and the limitations of non-surgical endodontic management of large periapical lesions secondary to traumatic dental injuries.

AIM or PURPOSE This study aimed to evaluate the comprehensive cytokine expression profile including cytokines, growth factors and chemokines in saliva of obese children with gingivitis. MATERIALS and METHOD One-hundred and eighteen children (60 obese and 58 normal weight; 8 to 12 years; 52 girls/66 boys) were classified into four groups based on their body mass and periodontal status; 1) obese children with gingivitis (OG, n=28); 2) obese children with healthy periodontium (OH, n=32); 3) normal weight children with gingivitis (NG, n=30); 4) normal weight children with healthy periodontium (NH, n=28). Body mass index (BMI) percentile, probing depth (PD), plaque index (PI) and gingival index (GI) were recorded. Ethical clearance was obtained from the Ethics Committee of the Faculty of Health Sciences, Aydın Adnan Menderes University (protocol no:2021/040). The protein content of saliva supernatants was analyzed by a 30-plex panel. Data analysis employed Brunner-Langer method. RESULTS While OG and OH groups had higher BMI percentiles compared to NG and NH groups (p<0.001), OG and NG groups had higher GI and PI scores compared to OH and NH groups (p<0.001). OG group had significantly higher in total chemokine and total multiplex analyte levels than NG group (p<0.05). Salivary interleukin (IL)-2, IL-13, monocyte chemoattractant protein-1 and fibroblast growth factor-basic levels in OG and OH groups were significantly higher than NG group (p<0.05). CONCLUSION(S) In saliva from obese children, a proinflammatory and chemotactic state is detectable, accompanied by increased gingival inflammation. However, whether elevated levels of cytokines and chemokines in the saliva can predict future systemic risks remains to be determined.

ABSTRACTPurposeSevere congenital neutropenia (SCN) is a raredisorder characterized by diminished neutrophil levels. Despite granulocytecolony‐stimulating factor (G‐CSF) treatment, SCN patients remain still prone tosevere infections, including periodontal disease—a significant oral healthrisk. This study investigates the host proteome and metaproteome in saliva andgingival crevicular fluid (GCF) of G‐CSF‐treated patients.Experimental DesignWe used label‐free quantitative proteomics on saliva and GCF samples from SCN patients before (n = 10, mean age: 10.7 ± 6.6 years) and after a 6‐month oral hygiene intervention (n = 9,mean age: 11.6 ± 5.27 years), and from 12 healthy controls.ResultsWe quantified 894 proteins in saliva (648 human,246 bacterial) and 756 proteins in GCF (493 human, 263 bacterial). Predominant bacterial genera included Streptococcus, Veillonella, Selenomonas, Corynebacterium, Porphyromonas, and Prevotella. SCN patients showed reduced antimicrobial peptides (AMPs) and elevated complement proteins compared tohealthy controls. Oral hygiene intervention improved oral epithelial conditionsand reduced both AMPs and complement proteins.Conclusions and Clinical RelevanceSCN patients have aunique proteomic profile with reduced AMPs and increased complement proteins, contributing to infection susceptibility. Oral hygiene intervention not onlyimproved oral health in SCN patients but also offers potential overall therapeuticbenefits.