European Journal of Dentistry最新文献

Temporomandibular disorders (TMDs) are a group of musculoskeletal and joint-related conditions affecting the temporomandibular joint (TMJ), masticatory muscles, and associated structures. They are among the most common causes of non-dental orofacial pain and functional impairment, significantly affecting quality of life. Despite advances in assessment and the development of standardized diagnostic systems such as the Research Diagnostic Criteria (RDC/TMD) and Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), accurate diagnosis remains difficult due to the multifactorial nature of TMDs, variability in symptoms, and subjectivity in pain reporting. Diagnostic accuracy is further limited by interexaminer variability, symptom overlap with other orofacial pain conditions, and restricted access to advanced imaging techniques. Artificial intelligence (AI) has emerged as a promising approach to address these challenges. Machine learning and deep learning algorithms can process complex imaging, clinical, and psychosocial data to improve diagnostic accuracy, consistency, and efficiency. AI-assisted imaging has shown strong performance in detecting disc displacement, degenerative changes, and other TMJ abnormalities, while predictive models based on symptoms, wearable sensors, and AI-driven decision-support tools are broadening diagnostic capabilities. This review summarizes current challenges in TMD diagnosis and highlights the growing role of AI in this field. Integrating AI technologies with established frameworks such as the DC/TMD may enable more objective, data-driven, and personalized diagnostic approaches. Ongoing interdisciplinary research, clinical validation, and ethical implementation are crucial for realizing AI's potential to transform TMD diagnosis and enhance patient outcomes.

Oral tongue cancer is among the most aggressive malignancies in the head and neck region, driven by a complex tumor microenvironment (TME) that fosters tumor progression, immune evasion, and therapy resistance. Conventional treatments often fail to address the stromal and immunological intricacies of the TME, highlighting the need for microenvironment-targeted therapies. One promising strategy involves the use of dental pulp stem cell-derived secretome (DPSC-Sec), which contains a broad range of bioactive molecules, cytokines, chemokines, growth factors, and extracellular vesicles enriched with regulatory microRNAs. This review explores the potential of DPSC-Sec as a reprogramming agent for modulating the TME in tongue cancer. Evidence suggests that DPSC-Sec may inhibit cancer-associated fibroblast activation, reprogram immunosuppressive cells, remodel the extracellular matrix, normalize aberrant angiogenesis, and regulate oncogenic signaling pathways. The therapeutic quality of DPSC-Sec is significantly influenced by priming methods, which can enhance its potency. While preclinical data are promising, clinical translation requires validation in orthotopic and immunocompetent models, GMP-compliant production, and thorough safety evaluation, especially regarding tumorigenicity and angiogenic effects. Integration with biomaterials, nanocarriers, or conventional therapies may further boost efficacy. This review consolidates current findings on DPSC-Sec and its mechanisms in TME modulation, underscoring its translational potential and future directions for developing targeted therapies in tongue cancer.

This article aims to evaluate the effect of load weight, unload time, and storage duration on microtensile bond strength (µTBS) of dual-cure resin cement to CAD/CAM composite.Forty-eight composite blocks (Grandio Blocs, n = 24 shade A1, and n = 24 shade A4) were randomly assigned to eight groups (n = 3 shade A1, and n = 3 shade A4) based on load weight (1, 3, 5, and 15 kg), and unload time (immediately before light curing or 10 minutes during/after light curing). Bonded blocks (n = 3/group) were sectioned into multiple sticks. Half of the sticks (n = 21) were tested after 24 hours, while the remaining 21 were stored in distilled water at 37°C and tested after 6 months. Sticks for film thickness were evaluated using a stereomicroscope (60 × ). However, the sticks for µTBS were pulled in tension at a 0.5-mm/min crosshead speed.Data were analyzed using ANOVA and the Games-Howell post hoc test (α = 0.05).There was no correlation between µTBS and FT (r = 0.035; p = 0.737). For the FT, only "unload time" had a significant effect (p < 0.001). For µTBS, "load weight," and "unload time" had no significant impact (p = 0.948 and p = 0.948, respectively). However, "storage time" significantly influenced the results (p < 0.001). Adhesive mode was significantly predominant (56.85%).Unload time is a crucial factor controlling the film thickness of the dual-cure resin cement. However, it does not affect the resin cement µTBS to CAD/CAM composite.Excessive seating load should be avoided when positioning CAD/CAM composite restorations, while a controlled short time may assist in preventing restoration rebound.

To evaluate and compare volumetric changes in sealers and porosity of root canals filled with bioceramic, silicone bioactive glass-based, and epoxy resin-based sealers over 60 days.Eighty extracted mandibular premolars were instrumented with ProTaper Next files (size 40/06) and randomly assigned to five groups (n = 16), each canal filled with one of the following sealers: AH Plus Jet (AHP Jet), GuttaFlow Bioseal (GFB), CeraSeal (CS), EndoSequence BC (ES BC), and AH Plus Bioceramic (AHP Bioceramic). All canals were obturated using the matched single-cone technique. The change in sealer volume and porosity was assessed by micro-CT (n = 10/group) at 2, 30, and 60 days post-obturation. Scanning electron microscopy (SEM) evaluated interfacial adaptation at each time point (n = 2/group/time).Sealer volumetric changes, open, and total pores were normally distributed (Shapiro-Wilk test, p > 0.05). Two-way repeated measures ANOVA evaluated the interaction between sealer type and post-obturation time on sealer volumetric change and porosity. One-way ANOVA compared differences among sealers at each time point. Changes within each sealer over time were assessed using paired t-tests for two time points or repeated measures ANOVA with Bonferroni post hoc tests for comparisons involving three time points. Kruskal-Wallis and Friedman tests analyzed the closed pores.After setting, AHP Jet exhibited volumetric shrinkage, whereas bioceramic and silicone bioactive glass-based sealers showed volumetric expansion; however, statistically significant volumetric changes beyond 30 days were observed only for GFB (p = 0.011). Regarding porosity, bioceramic and bioactive glass-based sealers demonstrated significant reductions from 2 to 30 days (p < 0.05), with reductions observed across all time points in GFB (p < 0.05), whereas AHP Jet showed a significant increase over time (p < 0.05). SEM showed good sealer-dentine adaptation, and a more homogeneous interface was found in GFB and bioceramic sealers over time.Within the limitations of this study, bioceramic and silicone bioactive glass-based sealers showed volumetric expansion and reduced porosity after obturation, whereas the epoxy resin-based sealer exhibited volumetric shrinkage with increased porosity.

Artificial intelligence (AI) is increasingly applied in restorative dentistry, but its role in assessing dental composite restorations is not yet well established. This scoping review evaluated how AI has been used to assess mechanical, esthetic, and diagnostic aspects of composite restorations. A systematic search of PubMed, Embase, Scopus, and Web of Science from 2020 to July 30, 2025, identified studies that applied AI to assess dental composite restorations. Fourteen studies met the inclusion criteria, and all but one had a low to moderate risk of bias. Reported AI applications included tooth shade matching, evaluating mechanical properties, classifying restoration types from images and radiographs, predicting clinical performance, assessing cure depth and microtensile bond strength to estimate debonding risk, and identifying factors associated with marginal microleakage. The highest reported predictive accuracies were achieved by an artificial neural network predicting abrasive wear (99.7% accuracy), adaptive boosting and multilayer Perceptron models predicting flexural strength and Vickers hardness (up to 99.0 and 98.9% accuracy, respectively), and extreme gradient boosting predicting mechanical properties (98.8-99.6% accuracy), each on task- and dataset-specific internal validation. Overall, current AI models show promise for supporting composite restoration evaluation but remain at an early, proof-of-concept stage. The use of small, often single-center samples and the absence of external validation suggest that their performance metrics may be overly optimistic and not yet ready for clinical application. Larger, multi-center datasets, transparent reporting, external validation, and formal assessments of clinical utility are needed before these tools can be considered for routine clinical application.

Resistance to post-bleaching staining and preservation of surface properties are critical to long-term durability of restorations. This study evaluated the effect of 32% hydrogen peroxide (H₂O₂) in-office bleaching gel on surface roughness (Ra), microhardness, and staining susceptibility of three hybrid computer-aided design/computer-aided manufacturing (CAD/CAM) materials compared with a feldspathic ceramic, subjected to a combined thermocycling-staining protocol.Slice specimens (n = 14/material) were prepared from hybrid ceramic materials: Vita Enamic (VE); Lava Ultimate (LU); Shofu Block HC (SB); and from a feldspathic ceramic material, VitaBlocs Mark II (VB), which served as the control. Seven slices per material underwent CIEDE2000 color difference analysis (ΔE₀₀) after simultaneous staining and thermocycling (1,000 cycles, 5-55°C), with or without a prior bleaching procedure using 32% H₂O₂ gel for three 15-minute cycles. The remaining slices were evaluated for surface roughness (Ra) and Vickers microhardness (VH) before and after bleaching with 32% H₂O₂.Data were analyzed using two-way ANOVA and the Tukey test (α = 0.05).The results showed that bleaching produced no significant changes in ΔE₀₀, Ra, or Vickers hardness number (VHN) for VE, LU, or SB (P > 0.05). VB alone showed a significant reduction in hardness (454 → 323 HV; p < 0.001). Post-staining ΔE₀₀ values remained below the 1.8 clinical acceptability threshold for LU and SB but slightly exceeded it for the non-bleached VE group (≤2.2) and were high for VB (>8). Regardless of bleaching, VB exhibited the greatest color change, whereas SB had the lowest hardness. Ra values for SB and VB were above the critical threshold for bacterial adhesion (0.02 µm).Although a single session of 32% H₂O₂ in-office bleaching significantly decreases the hardness of unglazed feldspathic ceramic, it does not compromise the surface integrity or color stability of hybrid CAD/CAM materials. Therefore, the tested hybrid materials can be safely subjected to 32% H₂O₂-based in-office bleaching without requiring surface pretreatment or postoperative replacement due to material degradation. However, restorative materials should be selected based on a comprehensive assessment of esthetic and mechanical performance to ensure long-term clinical success.

To describe the effect of short-term oral complications of head and neck cancer (HNC) radiotherapy on patients' quality of life (QoL). Radiotherapy is one of the most common HNC therapy modality, either as the primary therapy or in combination with others. However, high-dose radiotherapy can cause both short- and long-term oral complications. Short-term oral complications of radiotherapy include oral mucositis, hyposalivation, dysphagia, and sensory disturbances which can affect the patients' ability to speak, chewing, and swallowing, leading to weight loss and a decline in QoL, thus delaying the therapy process.This is a cross-sectional study at the Dharmais Cancer Hospital in March to April 2024, with a total of 53 participants. The data collected included participants' sociodemographic profiles, oral conditions, and oral health-related quality of life (OHRQoL) measured with the Oral Health Impact Profile 14 (OHIP-14) questionnaire, which was adapted to Indonesian language.Kendall and Spearman tests with a significance level of 5% were used to analyze the correlations between variables for bivariate analysis.Study participants consisted of 32 males (60.4%) and 21 females (39.6%), with the majority (22 participants, 41.5%) aged 46 to 55 years old. Nasopharyngeal cancer was reported to be the most prevalent HNC diagnosis in this study at 69.8%. All study participants (100%) experienced xerostomia and had clinical oral dryness as their short-term radiotherapy-related oral complications. The distribution of OHIP-14 scores showed that most of the participants (73.6%) had moderate OHRQoL. Xerostomia and dysphagia were shown to have statistically significant influence on OHIP-14 score (Spearman test, p < 0.05).The majority of HNC patients treated with radiotherapy in Dharmais Cancer Hospital have moderate QoL. Dysphagia and xerostomia were reported as the primary drivers of reduced QoL in our study, indicating potential key targets for preventive and management strategies in HNC radiotherapy patients.

This article aims to fabricate, characterize, and evaluate the mechanical strength and cytotoxicity of biphasic hydroxyapatite/calcium sulfate (HA/CS) blocks using partial hydrothermal conversion of gypsum blocks.Gypsum blocks were immersed in Na₃PO₄ solution under hydrothermal conditions at 150 °C for 6, 12, and 24 hours, denoted as 6-HA/CS, 12-HA/CS, and 24-HA/CS, respectively. After that, the phase composition was analyzed using X-ray diffraction. Diametral tensile strength (DTS), solubility in Tris-HCl buffer, and cytotoxicity on cell cultures were measured.Hydrothermal treatment produced biphasic HA/CS with increasing hydroxyapatite content. All HA/CS groups exhibited a significant reduction in DTS (∼0.5-0.7 MPa) compared with gypsum (2.06 MPa; p < 0.05). Solubility was lower in HA/CS than in gypsum (206.15 mg/L), with the 24-HA/CS group showing the lowest value (94.70 mg/L). Cytotoxicity testing demonstrated cell viability above 70% for all groups, meeting ISO standards of non-cytotoxicity.Partial hydrothermal conversion of gypsum block successfully produced biphasic HA/CS with tunable phase composition, reduced solubility, and acceptable cytotoxicity.

The stress distribution of teeth with periapical lesions, which are used as abutments in fixed prostheses, and its effect on the success of the restoration are not well known. This study investigates stress distribution in abutment teeth with periapical lesions and surrounding tissues under occlusal load using finite element analysis.Three models were constructed: (1) a healthy mandibular premolar, (2) a premolar with a periapical lesion restored using a fiber post and single crown, and (3) a similar premolar used as an abutment for a three-unit bridge. A static load of 300 N was applied at a 45-degree angle to the tooth's long axis, targeting the lingual slope of the buccal cusp. Stress and deformation were analyzed across all structural components, including dental tissues and the surrounding trabecular bone.The results demonstrated that, in model 2, stress propagation extended more prominently along the root surface and progressed apically, resulting in a higher stress concentration in the periapical lesion region (0.061 MPa) when compared with model 3 (0.054 MPa). Furthermore, the greatest deformation was also observed in model 2. Across all models, peak stress was consistently localized in the cervicobuccal collar region of the tooth.These findings underline the importance of prosthesis design in reducing the stress concentration in abutment teeth with periapical lesions and demonstrate the biomechanical advantage of splinted restorations over single crowns in cases with periapical lesions.

This research investigated the association between levels of salivary free amino acids (glycine and proline) and caries susceptibility in healthy children versus children with active caries, to inform future strategies for the detection and prevention of pediatric dental caries.The study had a case-control design and was conducted with 80 healthy children (8-10 years old) recruited from private and governmental primary schools in the Rusafa of Baghdad city, Iraq, classified according to their level of caries activity (active caries, n = 40; inactive caries, n = 40) based on their caries experience and Snyder test results. Then, unstimulated whole saliva was collected for amino acid analysis performed by reversed-phase high-performance liquid chromatography.Statistical analysis was conducted using the Shapiro-Wilk test for symmetric distribution of the quantitative variable, the independent t-test was utilized for making comparisons, and Pearson's correlation was used to verify if there is a linear relationship between two quantitative factors that are normally distributed.Glycine was the most abundant amino acid in the saliva, followed by proline from 113 components identified in the saliva. Glycine levels decreased significantly (p < 0.05) with the active caries group, regardless of gender differences. On the contrary, a significant positive correlation was established between increased levels of salivary proline (p < 0.05) and the active caries group.The higher salivary glycine and proline levels may serve as potential biomarkers for assessing caries susceptibility and informing preventive strategies.