BACKGROUND:Diabetes is a major public health challenge, affecting nearly 828 million people worldwide. Similarly, oral diseases such as dental caries, periodontal diseases, and oral cancers are highly prevalent, affecting approximately 3·7 billion individuals globally. Diabetes and oral diseases share common risk factors and studies suggest a potential relationship in which poor management of one potentially exacerbates the other. However, the direction, magnitude, and consistency of these associations remain unclear, and oral health remains largely overlooked in diabetes prevention and management strategies. The aim of this study is to systematically assess and synthesise the evidence on the longitudinal association between diabetes and oral diseases. METHODS:We conducted a systematic review and meta-analysis reported in accordance with PRISMA guidelines. We searched four electronic databases (Embase, PubMed, Web of Science, and LILACS) and grey literature from database inception to Oct 27, 2025. Eligible studies included longitudinal prospective studies examining associations between diabetes (type 1, type 2, or gestational) and core WHO oral diseases (periodontitis, dental caries, tooth loss or edentulism [complete tooth loss], and oral cancer). Random-effects meta-analyses were performed using the restricted maximum likelihood method to estimate pooled effect sizes with 95% CIs of hazard ratios (HRs) and risk ratio (RR). Methodological quality was assessed using the Newcastle-Ottawa Scale for cohort studies. FINDINGS:We screened 45 477 records and included 28 longitudinal studies from 16 countries, encompassing over 300 000 participants. Most studies were population-based and of moderate-to-high methodological quality. A bidirectional temporal association in incidence patterns was observed between diabetes and periodontitis. Individuals with periodontitis at baseline showed a 18-25% higher occurrence of newly incident type 2 diabetes during follow-up, and baseline diabetes status was associated with a higher newly incident cases of periodontitis, with pooled RRs indicating modest differences between groups. Tooth loss was also associated with newly incident type 2 diabetes over time (HR 1·12-1·20). Quantitative pooling was not feasible for edentulism outcomes; however, individuals who were edentulous at baseline showed a higher occurrence of newly incident type 2 diabetes (RR 1·30). Evidence regarding dental caries was scarce and heterogeneous, precluding meta-analysis. No longitudinal evidence was identified for oral cancer. INTERPRETATION:Findings from this longitudinal synthesis indicate associations between diabetes and oral diseases in both directions; however, the strength and consistency of evidence are asymmetric. Evidence suggests that people with periodontitis and edentulism are more likely to be diagnosed with type 2 diabetes than people without periodontitis and edentulism in the future. People with diabetes are more likely to be diagnosed with periodontitis than people without diabetes, but with less consistent evidence. Our findings support integrating oral health within interdisciplinary diabetes prevention and management strategies. FUNDING:WHO Oral Health Programme.

Objectives: To determine the most favourable Micro-Implant (MI) insertion site along the mandibular buccal shelf (MBS), using Cone Beam Computed Tomography (CBCT). Methods: This retrospective study assessed CBCT scans from 90 Portuguese patients (32 males and 58 females, aged 14 to 40 years). Paired MBS sites were determined. Comparative and correlation analyses were performed at p < 0.05. Results: A significant increase in MBS width was observed from the mesial to the distal direction (p < 0.001). Conversely, both the MBS steepness and cortical bone thickness significantly decreased from mesial to distal (p < 0.001). Significant negative correlation was also found between age and cortical bone thickness adjacent to the distobuccal cusp and distal tangent of both mandibular second molars (r <= -0.373, p <= 0.007). Furthermore, significant asymmetric differences were identified between the right and left MBS steepness as well as in the paired cortical bone thickness at the mesiobuccal cusp, buccal groove, and distobuccal cusp of the mandibular second molar (p <= 0.016). Conclusions: The results indicate that although there are sufficient MBS width and cortical bone thickness, vestibular to the mandibular second molar for MI insertion, the sites towards the distal root of the mandibular second molar are more favourable when considering MBS steepness. These findings are consistent for both sexes and apply to young and old individuals.

OBJECTIVES:This study compared the efficacy of Sonic (EDDY) and Er,Cr:YSGG (2780 nm) laser activation in eradicating Enterococcus faecalis biofilm formed in 3D-printed molar replicas with two mesial canals and one distal canal. MATERIALS AND METHODS:An in vitro design was implemented using 20 3D-printed mandibular molar replicas mimicking the natural canal morphology. Root canals were inoculated with E. faecalis and incubated for 21 days to allow the development of a mature biofilm. Three irrigation protocols were tested: Conventional needle irrigation (CNI), EDDY sonic activation (SA), and Er,Cr:YSGG (2780 nm) laser activation (LA). The control group was irrigated with phosphate-buffered saline (PBS) without activation. Residual bacterial load was quantified through colony-forming unit (CFU) counts and quantitative PCR (qPCR). Bacterial viability in the apical isthmus was assessed using fluorescence microscopy. A Student's t-test was performed to identify significant differences between CFU/mL values in groups, with significance set at 5% (p < 0.05). RESULTS:CFU counts of E. faecalis were significantly lower in the CNI, SA, and LA groups compared to the control (p < 0.05). In the SA and LA groups, bacterial counts were reduced to the lower detection limit (< log10 CFU/mL of 1.00), suggesting near-total bacterial elimination. qPCR and fluorescence microscopy corroborated these results, providing greater differentiation between the outcomes of sonic and laser activations. CONCLUSIONS:Er,Cr:YSGG (2780 nm) laser activation showed superior efficacy in endodontic disinfection by effectively eradicating E. faecalis biofilm, including in the challenging isthmus region, representing a promising method for complex root canal anatomies.

Background:Oral health behaviors play an essential role in maintaining oral health and preventing oral diseases, which are often neglected in older adults. This study aimed to investigate the prevalence of oral health behaviors and their associated factors in older adults. Methods:This cross-sectional study included participants aged 65 years or older who attended a university dental hospital in Portugal. Data were collected through a questionnaire on oral health behaviors, socioeconomic data, general health characteristics, self-perceived oral health and oral health-related quality of life. The oral clinical assessment included the Oral Hygiene Index-Simplified (OHI-S), the Decayed, Missing and Filled Teeth Index (DMFT), the Modified Community Periodontal Index, the presence of oral mucosal lesions, prosthetic presence, and prosthetic and treatment needs. Statistical analysis included descriptive and inferential methodologies. The association between potential risk indicators and oral health behaviors was assessed and modelled using logistic regression analysis. Results:A sample of 302 older adults participated in this study, and 56.0% were female. The mean age was 73.5 years (±5.8). Regarding oral health behaviors, 21.9% brushed less than twice a day, 52.1% did not use interdental devices and 49.3% last visited a dentist for treatment. Risk indicators for less frequent brushing were being male [OR = 3.00, 95% CI (1.65-5.47)], having a perceived prosthetic need [OR = 3.46, 95% CI (1.72-6.95)] and increased values of DMFT [OR = 1.15, 95% CI (1.08-1.22)]. Risk indicators for not using interdental devices were increased values of OHI-S [OR = 2.41, 95% CI (1.71-3.40)], being male [OR = 2.31, 95% CI (1.38-3.89)] and the presence of chronic diseases [OR = 1.87, 95% CI (1.03-3.39)]. Risk indicators for treatment being the reason for the last dental appointment were prosthetic presence [OR = 3.23, 95% CI (1.79-5.82)] and increased values of DMFT [OR = 1.06, 95% CI (1.01-1.11)]. Conclusion:Assessment of oral health behaviors and associated factors should be considered to guide future public health strategies to improve compliance with oral health care among older adults and to prevent oral diseases.

Gingivitis, the most common periodontal disease, is an inflammatory condition of the gingiva resulting from bacterial biofilm accumulation without periodontal attachment loss. Chlorhexidine (CHX) is the gold standard for chemical plaque control, yet its prolonged use is associated with undesirable side effects. Tea tree essential oil (TTO, Melaleuca alternifolia), with documented antimicrobial and anti-inflammatory properties, has emerged as a potential natural alternative. This exploratory randomized, controlled, triple-blind clinical trial evaluated the antimicrobial, cytotoxic, and clinical effects of a 1% TTO-based mouthwash compared with 0.12% CHX in 30 adults with plaque-induced gingivitis. Both mouthwashes significantly reduced plaque and gingival indices as well as bacterial counts after 15 days (p < 0.001), with no significant intergroup differences in clinical outcomes. CHX achieved a greater reduction in bacterial load, while TTO presented fewer adverse effects, limited to mild taste alteration and transient increase in salivary flow. Both formulations exhibited in vitro cytotoxicity, though clinical tolerance was high. These results suggest that, under the tested conditions, TTO formulation at 1% (v/v) exerts an antibacterial effect comparable to CHX, while displaying a dose-dependent pattern. Clinical Trial Registrationhttps://doi.org/10.17605/OSF.IO/B5HCD.

This study aimed to evaluate the chemical composition, radiopacity, and antimicrobial activity of five standardized (#25) commercially available gutta-percha points (ProTaper Gold, Zarc, Cerkamed, Autofit, and Reciproc R25), before and after a rapid disinfection protocol. The cones were divided into three groups: untreated (control), treated with sodium hypochlorite, and treated with sodium hypochlorite followed by ethanol rinsing. Significant compositional differences, as assessed by a solvent extraction method, were observed among brands, with gutta-percha content ranging from 11.6 to 17.5%, wax and/or resin from 1.2 to 4%, and inorganic fraction between 74.0 and 83.0%, with ZnO as the predominant component. Radiopacity determined via digital radiography varied among brands and showed a stronger correlation with ZnO content than with BaSO₄, challenging the common assumption that barium is the principal radiopacifying agent; Zarc exhibited the highest radiopacity, whereas Cerkamed showed the lowest. None of the gutta-percha points exhibited antimicrobial activity against Enterococcus faecalis and Staphylococcus aureus under standard clinical conditions, underscoring the necessity of proper disinfection procedures in clinical practice. The disinfection protocols produced minor changes in the wax/resin content of Cerkamed, Reciproc, Autofit, and ProTaper, with the effect being more pronounced in the latter two. In contrast, the metal oxide composition analyzis with wavelength dispersive X-ray fluorescence (WDXRF), showed that only Zark exhibits slight variations in ZnO, BaSO₄, SiO₂, and CuO. However, these changes remain insufficient to be considered clinically relevant. Importantly, no effect on the radiographic integrity of the gutta-percha cones was observed, confirming the safety and adequacy of the NaOCl-based disinfection protocols for clinical purposes.

Background There is limited information available regarding the bone volume in the sagittal dimension of the infrazygomatic crest (IZC) that is safe for the insertion of a temporary skeletal anchorage device. The objective of this study was to assess the sagittal bone availability when the anterior and posterior walls of the IZC reach an inclination of 45°. Methods A cross-sectional investigation was undertaken on 100 cone-beam computed tomography scans of 40 males and 60 females. A total of 20 landmarks were digitized for each IZC outline, 1 mm from the vestibular alveolar bone, and their x, y, and z coordinates were extracted. Afterward, the sagittal measurement of the IZC at which the curvature reached 45° was recorded. Symmetry of measurements was assessed using paired-samples t tests. In addition, these measurements were compared as a function of sex and age group (≤21 vs >21 years) using an independent-samples t test and the Spearman rank correlation coefficient test (P <0.05). Results There were no significant differences between paired sagittal measurements of the IZC (3.5 ± 1.5 mm on the right side and 3.6 ± 1.3 mm on the left side; P = 0.144), except for younger patients (P = 0.030). In addition, no significant differences were found between corresponding male and female measurements (P ≥0.149). A significant discrepancy was identified between the younger age group (3.2 ± 1.2 mm) and the older cohort (3.8 ± 1.6 mm) for the sagittal dimension of the right IZC (P = 0.038), with an estimated mean difference of 0.03-1.16 mm (95% confidence interval). A significant positive weak correlation was found between the sagittal dimension of the right IZC and age (ρ = 0.201; P = 0.045). Conclusions Sufficient IZC bone volume is available at an angle of 45° for inserting a temporary skeletal anchorage device, with no sex or side variation, except for the significantly greater sagittal dimension of the right IZC in older patients.

Background:Video recordings of patient-clinician interactions (PCIs) have become an integral tool in health professions education, with authentic opportunities to enhance clinical communication and decision-making skills. Despite their educational value, ethical and logistical challenges regarding their use remain underexplored. Objective:This scoping review aims to map the use of video-recorded PCIs in health education, categorizing types and educational purposes, examining applications across disciplines, and identifying ethical and logistical issues. Methods:Comprehensive searches were conducted in MEDLINE, Embase, and ERIC (Education Resources Information Center) databases, supplemented by gray literature, with the last search performed on October 30, 2024. Two independent reviewers screened and extracted data on study design, intervention characteristics, educational objectives, and barriers to implementation. Given the scoping review nature, risk of bias assessment was not conducted. Data synthesis involved descriptive analysis and thematic categorization of findings. Results:A total of 69 studies met inclusion criteria, predominantly from medical (n=28, 41%), dental (n=15, 22%), and nursing (n=8, 12%) education. Publication frequency increased over the past decade. Studies used varied video types, including authentic consultations, simulated encounters, and procedural recordings. Main educational aims focused on clinical skills, communication, professionalism, and reflective practice. Ethical reporting was inconsistent, with variable adherence to informed consent, patient privacy, and confidentiality standards. Common logistical barriers included limitations in technical infrastructure, data management, and curriculum integration. Conclusions:Video-recorded PCIs offer valuable educational resources but face challenges in ethical standardization and logistical feasibility. Future research should prioritize the development of ethical frameworks and standardized protocols, together with the evaluation of long-term educational and psychological outcomes, to support the responsible and scalable integration of PCI recordings into health education curricula.

The present observational study aimed to identify the prevalence of oral health issues in this population and explore the relationship between oral health and factors relevant to athletic performance. One hundred and fourteen elite athletes triaged at a Sports Dentistry department from a university clinic were included for oral health assessment, self-reported periodontitis, basic erosive wear examination, and dental caries experience. They answered a sociodemographic questionnaire, oral health impact profile 14 to measure OHRQoL and OHV scale. Descriptive and inferential statistics assessed oral health outcomes and demographic or sport-related factors. Multivariable logistic regression explored predictors of poor oral health outcomes. The results reveal a high prevalence of oral health issues among elite athletes, with over half of the participants (51.8%) presenting two or more pathological or functional findings. Periodontal disease (55.1%), particularly gingivitis (51.8%), and dental caries (47.4%) were the two most common conditions, affecting nearly half of athletes. This high prevalence of oral conditions did not associate with worse OHRQoL and OHV. These results suggest that elite athletes face unique challenges regarding oral health, with some sex differences in oral health behaviors. Despite the high prevalence of oral diseases, related quality of life and values did not show any association, possibly due to the low perception of athletes.

Background/Objectives: Streptococcus mutans (S. mutans) is a primary cariogenic bacterium contributing to biofilm acidogenicity and enamel demineralization. Conventional caries prevention relies mainly on mechanical plaque control and dietary modification, but probiotics have emerged as potential adjuncts for oral microbiota modulation. This pilot randomized controlled trial aimed to evaluate the short-term effects of a multi-strain probiotic containing Lactobacillus and Bifidobacterium on clinical and microbiological parameters associated with dental caries in children. Methods: A double-blind, randomized, placebo-controlled clinical trial was conducted in 40 children aged 6-14 years from a community setting. Participants were randomly allocated (1:1) to receive either probiotic or placebo lozenges for 30 days. Clinical assessments included the Gingival Index (GI), Plaque Index (PI), International Caries Detection and Assessment System (ICDAS), salivary pH, buffering capacity, and salivary S. mutans concentration. The study was preregistered (10.17605/OSF.IO/GKVUW) and ethically approved. Results: The intervention was well tolerated, with no adverse events reported and high participant acceptability. Despite there being no statistically significant differences in any clinical or microbiological parameter (p > 0.05), we found trends toward higher salivary pH, improved buffering capacity, and reduced S. mutans counts in the probiotic group. Conclusions: Short-term probiotic supplementation was safe and well accepted among children but did not produce statistically significant improvements in oral health parameters over 30 days. These findings highlight the feasibility of probiotic use in pediatric populations and support the need for larger, longer-term trials to clarify their potential role as adjuncts in caries prevention.

Background/Objectives: Oral cancer is a significant global public health concern. Understanding the prevalence and associated risk factors of oral lesions is essential for developing effective preventive strategies. This study aimed to assess the prevalence and risk factors of oral lesions submitted for biopsy in a Portuguese subpopulation. A retrospective cross-sectional analysis was conducted using data from patients who sought dental care at the Egas Moniz Dental Clinic (EMDC) in the Lisbon metropolitan area. Methods: Data analysis was performed on a sample of 264 patients who attended the EMDC between October 2016 and December 2019 to ascertain the presence of oral lesions, their different types, and their correlation with potential risk factors. The analysis included all patients who underwent biopsy, and their pathology reports were reviewed. Results: The prevalence of oral lesions was 10.3%, affecting 58.7% females and 41.3% males, with a mean age of 55 years. The most frequently biopsied site was the buccal mucosa (23.5%). Non-neoplastic lesions accounted for 75.0% of cases, while mesenchymal lesions were the most common neoplastic category (58.5%). The most prevalent diagnosis was fibroepithelial hyperplasia (36.7%). A statistically significant association was observed between neoplastic lesions and statin use, as well as between both neoplastic and non-neoplastic lesions and the use of antidiabetic medications. Conclusions: Oral lesions are prevalent, with non-neoplastic lesions being the most frequent. Understanding their nature, prevalence, and associated risk factors is crucial for early and accurate diagnosis, aiding in disease prevention and management.

Background/Objectives: Early tooth wear (TW) assessment prevents challenging and costly dental treatments. Knowledge of data on the prevalence and risk factors is crucial for developing preventive guidelines. This retrospective cross-sectional study aims to study the prevalence of TW in a sample of patients seeking a Screening and Emergency appointment at Egas Moniz Dental Clinic (EMDC) and its associated risk factors. Methods: Descriptive and logistic regression analysis were applied to data from a sample of 2266 patients, collected between 2021 and 2023, to ascertain the presence of tooth wear, its different types and its correlation with potential risk factors. Results: The prevalence of dental wear was found to be 54.7%, with attrition (24.1%) being the most prevalent lesion and erosion (2.7%) the least prevalent. Concerning the risk predictors for tooth wear, age (OR = 1.01–1.05, p < 0.05), decreased DVO (OR = 2.16, p = 0.028), antacids (OR = 7.07, p = 0.003), mastication difficulties (OR = 1.87, p = 0.039), drugs (OR = 2.38, p = 0.032) and use of mouthwash (OR = 1.47, p = 0.008) were positively associated. Gender (OR = 0.7, p = 0.015) was negatively associated, with females showing a 30% less risk than males. Conclusions: It was concluded that TW is prevalent and increases with age, underscoring the necessity for timely and accurate diagnosis to minimize its progression. Additionally, it is crucial to conduct a thorough evaluation of the risk factors involved to implement effective preventive measures and treatment strategies.

Abstract: Background/Objectives: This study aims to study the prevalence of tooth wear (TW) in a sample of patients seeking the Screening and Urgency appointment at Egas Moniz Dental Clinic (EMDC) and correlate TW with risk factors. Methods: The database created with the collected information was used for descriptive and inferential statistical analysis. Data from 2266 patients, collected between 2021 and 2023, was analyzed for the presence of tooth wear, its different types and its correlation with risk factors. Results: The prevalence of dental wear was found to be 54.7%, with attrition (24.1%) being the most prevalent lesion, and erosion (2.7%) the least prevalent. Concerning risk predictors for tooth wear, age, decreased DVO, antacids, mastigation difficulties, drugs and use of mouthwash were positively associated. Conclusions: It was concluded that TW is prev-alent and increases with age, underscoring the necessity for timely and accurate diagnosis to minimise its progression. Additionally, it is crucial to conduct a thorough evaluation of the risk factors involved, to implement effective preventive measures and treatment strategies.

Burning Mouth Syndrome (BMS) presents diagnostic and therapeutic challenges due to its unclear etiology and complex symptomatology. This study, part of a doctoral research project, explores diagnostic delay, triggering factors, and psychotropic medication use in BMS patients. By retrospectively analyzing 300 clinical records, the study offers insight into patterns of diagnosis and treatment, with a focus on differences related to age and sex. The findings contribute to a better understanding of BMS and emphasize the need for timely diagnosis, particularly in older adults, to improve patient outcomes.

IntroductionThe rising use of dental implants is accompanied by an expected increase in peri-implant diseases, particularly peri-implantitis (PI), which poses a significant threat to implant success and necessitates a thorough understanding of its pathogenesis for effective management.MethodsTo gain deeper insights into the role and impact of the peri-implant microbiome in the pathogenesis and progression of PI, we analyzed 100 samples of saliva and subgingival biofilm from 40 participants with healthy implants (HI group) or with co-occurrence of diagnosed PI-affected implants and healthy implants (PI group) using shotgun metagenomic sequencing. We identified the most discriminative species distinguishing healthy from diseased study groups through log ratios and differential ranking analyses.Results and discussionMogibacterium timidum, Schaalia cardiffensis, Parvimonas micra, Filifactor alocis, Porphyromonas endodontalis, Porphyromonas gingivalis and Olsenella uli were associated with the subgingival peri-implant biofilm. In contrast, Neisseria sp oral taxon 014, Haemophilus parainfluenzae, Actinomyces naeslundii, Rothia mucilaginosa and Rothia aeria were more prevalent in the healthy peri-implant biofilm. Functional pathways such as arginine and polyamine biosynthesis, including putrescine and citrulline biosynthesis, showed stronger correlations with PI-affected implants. In contrast, peri-implant health was characterized by the predominance of pathways involved in purine and pyrimidine deoxyribonucleotide de novo biosynthesis, glucose and glucose-1-phosphate degradation, and tetrapyrrole biosynthesis. Our findings reveal that healthy implants in PI-free oral cavities differ significantly in microbial composition and functional pathways compared to healthy implants co-occurring with PI-affected implants, which more closely resemble PI-associated profiles. This pattern extended to salivary samples, where microbial and functional biomarkers follow similar trends.

Objective:This study aimed to evaluate the micro-implant safest insertion site on the mandibular buccal shelf (MBS) without compromising the integrity of the mandibular canal (MC). Methods:This retrospective investigation included cone-beam computed tomography (CBCT) of 96 Portuguese patients (58 females and 38 males, average age of 25.5±10.2 years). Measurements were taken in four bilateral MBS sites buccal to the mandibular second molar; tangent to the distal surface (7D), distobuccal cusp tip (7CD), buccal groove (7S) and mesiobuccal cusp tip (7CM). The transversal MBS midpoint was also determined, and the maximum angulation from the transversal MBS midpoint was extracted relative to the true vertical plane. Subsequently, the distance from the MBS midpoint to the MC was calculated at this angulation. Descriptive and inferential statistical analyses were performed at p<0.05. Results:Significant correlations were observed among several variables and age, sex and bilateral asymmetry (p<0.05). The MBS transversal width and the distance from the MBS midpoint to the MC progressively increased in the posterior direction while the angulation decreased. Conclusion:The most appropriate micro-implant insertion location compared to the other MBS investigated sites, in the absence of impacted third molars, is adjacent to the distal surface of the second molar. This finding is consistent across all age groups, sexes, and insertion sides. However, due to the demonstrated variability, taking a CBCT scan prior to mini-implant insertion might be considered to minimize the risk of injury to the inferior alveolar nerve.

Background Chlorhexidine Gluconate (CHG) bathing is widely used in Intensive Care Units (ICUs) to reduce bacterial colonisation, yet its efficacy against fungal skin colonisation, particularly Candida spp., is not well understood. This study aimed to evaluate the impact of daily CHG bathing on Candida colonisation among ICU patients. Methods From 2020 to 2022, axillary/inguinal swabs were collected from 675 ICU patients across three units on admission (Day 1, D1), Day 5 (D5) and Day 8 (D8). Patients received daily CHG bathing (either 2% impregnated wipes or 4% liquid solution) from D1 to D5, followed by soap-and-water bathing from Day 6 to D8. Standard and molecular microbiological methods were used to identify fungal species, and colony-forming units (CFUs) were quantified. Colonisation rates and fungal burden were compared across time points and bathing protocols. Results A total of 988 swabs from 675 patients were collected, 675 on D1, 203 on D5 and 110 on D8. CHG bathing had no significant impact on Candida burden at individual time points, (D1, p = 0.223; D5, p = 0.939 and D8, p = 0.669). No significant differences in colonisation or fungal burden were observed between the use of 4% CHG solution and 2% CHG-impregnated wipes upon ICU admission. However, in the subgroup of 89 patients monitored longitudinally, a transient reduction in colonisation was observed during the CHG bathing period (D1-D5), followed by a significant increase during the soap-and-water period (D6-D8) (p = 0.005; between periods: p < 0.001). Among the 329 positive swabs, 274 yielded > 100 CFU/ml. High colony counts of C. albicans (> 1000 CFU/mL) were observed, with no significant association between colonisation levels and specific Candida species (p = 0.940). Conclusions CHG bathing demonstrated only a limited and transient impact on Candida colonisation in ICU patients. Colonisation rates rebounded after cessation of CHG use, suggesting ongoing acquisition during ICU stay. These findings highlight the need for additional or alternative infection control measures targeting fungal pathogens in critical care settings.

Artificial Intelligence (AI) applications in sports dentistry have the potential to improve early detection and diagnosis. We aimed to validate the diagnostic performance of AI-assisted software in detecting dental caries, periodontitis, and tooth wear using panoramic radiographs in elite athletes. This cross-sectional validation study included secondary data from 114 elite athletes from the Sports Dentistry department at Egas Moniz Dental Clinic. The AI software’s performance was compared to clinically validated assessments. Dental caries and tooth wear were inspected clinically and confirmed radiographically. Periodontitis was registered through self-reports. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), as well as the area under the curve and respective 95% confidence intervals. Inter-rater agreement was assessed using Cohen’s kappa statistic. The AI software showed high reproducibility, with kappa values of 0.82 for caries, 0.91 for periodontitis, 0.96 for periapical lesions, and 0.76 for tooth wear. Sensitivity was highest for periodontitis (1.00; AUC = 0.84), moderate for caries (0.74; AUC = 0.69), and lower for tooth wear (0.53; AUC = 0.68). Full agreement between AI and clinical reference was achieved in 86.0% of cases. The software generated a median of 3 AI-specific suggestions per case (range: 0–16). In 21.9% of cases, AI’s interpretation of periodontal level was deemed inadequate; among these, only 2 cases were clinically confirmed as periodontitis. Of the 34 false positives for periodontitis, 32.4% were misidentified by the AI. The AI-assisted software demonstrated substantial agreement with clinical diagnosis, particularly for periodontitis and caries. The relatively high false-positive rate for periodontitis and limited sensitivity for tooth wear underscore the need for cautious clinical integration, supervision, and further model refinements. However, this software did show overall adequate performance for application in Sports Dentistry.

This meta-research study aimed to compare the assessment of Cochrane's Risk of Bias (RoB) and RoB2 tools in dentistry trials. A sample 150 in vivo randomized clinical trials published between 2020 and 2022 was randomly selected from PubMed/Medline, Sco-pus, and EMBASE databases (50 per year). For each study, the impact factor, journal quartile, adherence to CONSORT guidelines, date information availability, and study model were recorded. The results showed that 33.3% of the studies were categorized as low risk of bias by both RoB and RoB2. However, 29.6% of the studies classified as low risk by RoB were downgraded to some concerns in RoB2, and 37% were downgraded to high risk. In the some concerns category, 25.9% were upgraded to low risk, 37% re-mained constant, and 37% were downgraded to high risk in RoB2. Among the high risk studies, 14.6% were upgraded to low risk, 26% to some concerns, and 59.4% remained constant in RoB2. The level of agreement between RoB and RoB2 was found to be low for dental studies. These findings highlight the differences between the two tools and the potential impact on the synthesis of evidence and decision-making processes in dental research.

Background/Objectives: this study aimed to study the association of dental caries and erosion in athletes with dietary and oral health habits. Methods: An observational cross-sectional study was conducted at the Sports Dentistry department of a university clinic. Intraoral examination included the International Caries Detection and Assessment System (ICDAS II) index and the Basic Erosive Wear Examination (BEWE). A questionnaire was completed with sociodemographic data, and dietary and oral hygiene habits. An inferential and multivariable regression analysis was performed to study the association of dental caries and erosion with confounding variables. Results: A total of 80 athletes were included. The prevalence of dental caries and erosion was 50.0% and 40%, respectively. Significant associations were observed between self-perceived oral health and caries lesions, with "Good" (-5.01, p < 0.001) and "Very good" (-5.46, p < 0.001) perceptions linked to fewer lesions. BEWE scores revealed significant associations with meal frequency uncertainty (-12.56, p = 0.014) and uncertainty about the last dental visit (8.82, p = 0.014). Self-perceived oral health as "Good" or "Very good" was associated with lower dental erosion (p < 0.010). Other demographic and behavioral factors were not significantly associated with caries or erosion. Conclusions: this cohort of athletes exhibited a high prevalence of dental caries and erosion, with associated dietary and oral hygiene habits. These results highlight the need for targeted dietary counseling and oral health education for athletes, whose nutritional needs may lead to increased consumption of sugar-rich diets.