Dentistry Journal最新文献

Background/Objectives: The use of cannabidiol (CBD) as an antimicrobial and antifungal agent has gained interest in medicine, with studies suggesting potential against various microorganisms. However, its effectiveness against oral pathogens remains underexplored in dental research, highlighting the need for further studies. This scoping review summarizes current evidence on the antimicrobial properties of CBD in dental and oral health. Methods: A systematic search was conducted across seven databases (PubMed, the Cochrane Library, Scopus, Embase, Web of Science, SciELO, and LILACS) up to January 2025. The inclusion criteria encompassed studies that explored the effects of CBD on oral microbiology (in vitro and in vivo in animal models), regardless of language or year of publication. The gray literature was evaluated in the Google Scholar database. Results: A total of 1284 articles were identified, of which 10 met the inclusion criteria for this scoping review. These studies, published between 2019 and 2025, primarily focused on bacterial and fungal cultures. The most commonly used methods were the minimum inhibitory concentration test and counting colony-forming units. The contact methods between CBD and bacterial/fungal cell cultures were either dilution or direct contact. Conclusions: CBD shows promising antimicrobial properties against a range of oral bacteria and fungi, suggesting its potential application in managing oral health conditions.

Objectives: Maxillary nerve block via the greater palatine canal (GPC) offers the potential for profound regional anesthesia of the maxilla but remains underutilized due to anatomical variability and technical complexity. The aim of this study was to explore the clinical feasibility, accuracy, and anesthetic effectiveness of a computer-guided approach by using CBCT-based surgical guides to access the pterygopalatine fossa via the GPC. Methods: Thirty-one patients underwent the procedure with patient-specific guides designed from cone-beam computerized tomography (CBCT) and intraoral scans. A 27G needle was directed through the guide to deliver 1.8 mL of 2% lidocaine with epinephrine 1:80.000. Pulpal anesthesia was assessed via electric pulp testing (EPT), and soft tissue anesthesia via pressure algometry at predefined oral and facial sites. Success was defined as absence of EPT response at maximum output and pressure pain threshold ≥ 700 g. To assess variations in anesthetic efficacy among multiple related groups, Cochran's Q test and McNemar's test were employed. Results: Successful needle placement was achieved in 30 out of 31 patients (96.7%) using the computer-guided approach, with a mean of 1.45 insertion attempts per case. Complete palatal soft tissue anesthesia was achieved in all subjects across the tested sites (100%). Pulpal anesthesia was most effective in posterior teeth, with success rates of 96.7% for first molars and 93.3% for first premolars, while the central incisor showed a reduced success rate of 50%. Transient visual disturbances occurred in three patients (10%), with no other adverse effects reported. Conclusions: These findings support the use of computer-guided GPC block as a method for achieving maxillary nerve anesthesia. Although anesthetic spread to anterior and buccal regions was limited, the technique demonstrated consistent effectiveness in the posterior maxilla, highlighting its potential utility in complex dental and surgical interventions requiring deep and long-lasting regional anesthesia.

Background: Maintaining daily optimal dental hygiene, especially in medically vulnerable patients with periodontitis, remains challenging in dental practice. Mobile apps and other digital tools might offer useful support alongside traditional advice. Objectives: This study aimed to develop a mobile health app, PerioSupportPro, that helps patients improve their daily plaque control habits. It also reports on the pilot testing of the app's usability and users' perception in a small patient group. Methods: The app was created by a mixed team including periodontists, psychologists, developers, and data protection specialists. The first version included reminders, gamified elements, video tutorials, and motivational messages. After internal testing, a group of 18 patients tested the app and completed a feedback questionnaire that assessed usability (Q3-Q5), educational impact (Q6-Q8), motivation (Q9-Q11), and overall satisfaction (Q12-Q14). Cronbach's alpha was used to check internal consistency, and non-parametric tests were applied for basic statistical comparisons. Results: The motivation section of the questionnaire showed acceptable consistency (α = 0.784), while usability and educational impact had lower values (α = 0.418 and 0.438). No clear differences were found between age groups. Satisfaction was positively associated with reminders and motivational items. Most appreciated features included reminders, the simple interface, and short videos. Based on the input provided by the questionnaire, a few improvements were made, and a second version of the app was prepared. Conclusions: Early user responses show that PerioSupportPro may help motivate and guide patients in their oral hygiene routine. While still in an early phase, the app seems well-received and ready for future clinical validation with more users.

Introduction: Odontogenic keratocyst (OKC) is a locally aggressive cystic lesion derived from remnants of the dental lamina. It is most commonly located in the posterior mandible, while maxillary involvement is rare and poses diagnostic and surgical challenges due to its proximity to critical anatomical structures. This case report describes the surgical management of a maxillary OKC with an uncommon localisation. Methods: A 50-year-old male presented with an asymptomatic swelling in the posterior maxilla. Cone beam computed tomography (CBCT) revealed a well-defined unilocular radiolucency extending toward the maxillary sinus floor. Surgical management included complete enucleation and peripheral curettage, followed by histopathological confirmation. The defect was left to heal naturally through bone regeneration without the need for grafting. Results: Intraoperatively, a thin pearly white cystic capsule and buccal cortical thinning were observed, consistent with OKC. The lesion was enucleated intact, without rupture or sinus perforation. Histology confirmed the diagnosis. Postoperative healing was uneventful, with radiographic follow-up at one month showing favourable healing changes. Conclusions: Careful surgical planning combined with advanced imaging facilitates safe and effective management of OKCs in uncommon maxillary sites. Enucleation with peripheral curettage provided satisfactory short-term outcomes. Long-term follow-up remains essential due to the risk of recurrence.

Background/Objetives: Zygomatic implants are an effective solution for the prosthetic rehabilitation of atrophic maxillae, but their placement can alter maxillary sinus anatomy and influence surgical outcomes. This study presents a computational algorithm for automated segmentation and volumetric assessment of the maxillary sinus from cone-beam computed tomography (CBCT) images, offering a reproducible and clinically oriented tool. Methods: Six sinus samples from four patients undergoing pterygoid or zygomatic implant surgery were analyzed. The algorithm was designed to integrate image binarization, surface detection, and iterative reconstruction to delineate sinus boundaries and compute volumes with minimal operator dependence. Results: Postoperative analyses consistently revealed reductions in sinus volume, with relative changes ranging from 1.1% to 24.5%, validated by expert review. Conclusions: These results demonstrate the feasibility of algorithm-driven volumetric assessment as a non-invasive approach to support surgical planning and monitor anatomical changes. Although limited by the small sample size, this pilot study establishes a foundation for further research and highlights the clinical potential of computational methods to enhance precision and safety in zygomatic implantology.

Background: Class II malocclusion is one of the most prevalent dentoskeletal disorders, usually caused by mandibular retrusion. The Invisalign^® Mandibular Advancement System is an aesthetic, comfortable alternative to conventional braces for growing patients allowing mandibular projection and dental alignment. This retrospective study assessed the effectiveness of the Invisalign^® Mandibular Advancement (MA) System in growing patients with mandibular retrognathia. Methods: At treatment onset, seventeen patients were divided into the following two groups according to the aligner system used and cervical vertebral maturation stage: the Invisalign^® First group (CVM2), and the Invisalign^® Teen group (CVM3, some transitioning to CVM4), all treated with the Comprehensive Package. Treatment efficacy was evaluated through cephalometric analysis, occlusal classification, and three-dimensional tooth movement assessment. Cephalometric evaluations were performed pre-(T0) and post-treatment (TF). In addition, a clinical follow-up during the retention period was conducted to assess post-treatment stability. Results: Significant dentoalveolar and skeletal changes were observed in both groups. The Teen group showed greater mesial movement of the lower molars (3.57 ± 1.26 mm) compared to the First group (1.34 ± 0.48 mm; p < 0.001). Conversely, the First group showed greater distal movement of the upper molars (2.24 ± 0.64 mm) compared to the Teen group (1.35 ± 0.69 mm; p = 0.002). The PAR index showed significant reductions in both groups (p < 0.001), and although the Teen group achieved greater improvements, the First group demonstrated a clinically relevant reduction (23.60 vs. 19.43 points), despite two severe cases that did not achieve full Class II correction. Conclusions: Both the Invisalign^® First and Comprehensive Package for teens systems improved occlusion and skeletal patterns. These findings support the MA System as an effective option for correcting Class II malocclusion during growth.

Background: Stackable metallic or magnetic multi-template systems translate a prosthetically (facially) driven plan into each surgical phase of full-arch rehabilitation. Our objective was to map and critically describe the clinical applications, accuracy, and short-term outcomes of stackable/sequential guides and to illustrate the operational steps with a standardized magnet-retained case. Methods: Following a prospectively registered protocol (OSF, June 2025), we performed a scoping review in accordance with and PRISMA guidance. PubMed, Scopus and Embase were searched to 26 June 2025 for primary human studies using stackable or sequential static guides to place ≥4 implants per arch with immediate (≤72 h) loading. Duplicate-independent screening and data-charting captured guide design, planning platform, surgical accuracy, implant survival, prosthetic outcomes and patient-reported measures. A single non-analytic clinical vignette was included solely to illustrate the facially driven stackable workflow. Results: Eight studies (five countries, 2021-2025) encompassing 351 implants and one additional clinical case met the inclusion criteria. Mechanical indexing predominated (7/9 protocols); only two papers, including our case, used magnetic retention. Mean coronal and angular deviations, reported in two cohorts, were 0.95 mm/2.8° and 0.87 mm/2.67°, respectively-well within accepted thresholds for full-arch guided surgery. Immediate loading was achieved in 100% of arches; cumulative implant survival was 97.1% after 3-12 months. Patient-reported satisfaction exceeded 90 mm on VAS scales when measured. Our case demonstrated 0.90 mm/2.95° accuracy, 100% implant stability ≥ 35 N cm and uneventful provisionalisation at 12 weeks. Conclusions: Early clinical reports show clinically acceptable accuracy and high short-term survival with streamlined workflow. However, evidence remains heterogeneous and short-term; prospective multi-centre studies with standardized accuracy metrics, ≥3-year follow-up, validated PROMs, and cost-effectiveness analyses are still needed.

Background/Objectives: Certain components of natural products help maintain the oral microbiota balance, thereby promoting oral health. This study aimed to identify natural components with anticariogenic properties by analyzing evidence from in vivo studies. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was performed across multiple databases and included English-language studies published between 2013 and 2025. The review included intervention and comparative studies that examined the effects of dietary habits involving natural components in participants of any age, with or without dental caries. Results: A total of 77 studies were included in the review, most of which were clinical trials conducted in pediatric populations. To assess the impact of the interventions, most studies measured outcomes such as Streptococcus mutans levels, dental caries incidence, and salivary pH, among other parameters. The most frequently studied components included probiotics, plant extracts, sugar substitutes, propolis, arginine, dairy products, among others. Significant effects were most reported on biological risk factors (72.8%). In addition, 16.9% of the studies reported a statistically significant reduction in clinically diagnosed dental caries. Conclusions: This review identified preliminary evidence suggesting that certain natural compounds may play a role in modulating cariogenic factors. However, further high-quality studies are needed to strengthen the evidence base and confirm these findings. The protocol for this review was registered on the Open Science Framework platform.

Background/Objectives: Sclerostin is a glycoprotein produced by osteocytes that regulates osseous remodeling, particularly in the context of orthodontic tooth movement. The purpose of the current systematic review is to assess the effect of orthodontic tooth movement (OTM) on sclerostin expression (SE) in the alveolar bone matrix (ABM). Methods: Indexed databases including PubMed, Embase and Web of Science were searched without time and language restrictions up to and including March 2025. Results: Seven studies performed on 8- to 12-week-old male rodents were included. The magnitude of orthodontic forces ranged from 10-120 g. Distalization and mesialization of the maxillary first molar were performed in one and six studies, respectively. In two studies, SE was increased on the compression and tension sides during OTM. In one study, SE is increased and decreased on the compression and tension sides, respectively; and another reported no difference in SE on the compression and tension sites during OTM. Two studies did not report data on SE on the control-sites (sites unexposed to OTM). Sample-size estimation was not performed in any of the included studies. All studies had a high risk of bias (RoB) and low certainty of evidence (CoE). Conclusions: Sclerostin may play a regulatory role in ABM during OTM. However, current evidence is limited by methodological inconsistencies, high RoB, and low CoE. Well-designed, power-adjusted studies using standardized protocols are required to establish reproducible findings and assess the translational potential of SE in orthodontics.

Background: The development of calcium silicate materials and new techniques have resulted in significant clinical benefits in endodontics and microapical surgery. The objective of this investigation was to analyze the percentage of dentinal tubule penetration of two retrograde obturation techniques in microapical surgery, namely the conventional technique and the lid technique. Methods: 60 single-root human teeth were selected, which were divided into two groups (n = 30). These teeth were subjected to an endodontic procedure using the single-cone technique. They were prepared with apicoectomy and 3 mm apical retrocavity and then obturated using two retrograde obturation techniques with bioceramic materials: TotalFill RRM fast set Putty^® (RRM) using the conventional technique and TotalFill BC Sealer HiFlow^® (HiFlow) and RRM using the lid technique. The teeth were selected and evaluated using 1 mm portions in the apical third. In each case, the images were obtained using a Leica TCS SP8 Confocal Microscope (CLSM). The extent of penetration into the dentinal tubule regions was measured using AutoCad^®. Results: Statistical analyses were performed using the Levene test (p ≤ 0.05) and Student's t-test (p ≤ 0.05). Analysis of the penetration area of calcium silicate materials into the dentinal tubules revealed that the relative penetration percentages were higher when using the conventional technique with the RRM than the lid technique with RRM + HiFlow in the apical third evaluated. Conclusion: The conventional technique yields significantly better outcomes, showing statistically significant differences in the percentage of penetration into the intratubular area compared to the lid technique.