European Journal of Dentistry最新文献

Pediatric dental stress is a common barrier to effective treatment, often resulting in behavioral management challenges and long-term avoidance of dental care. Wearable technology, such as smart watches capable of measuring heart rate variability (HRV), may offer real-time, noninvasive tools to assess stress in clinical settings. This study aimed to evaluate physiological stress responses in children undergoing different dental procedures by analyzing HRV across treatment phases.Eighty children aged 5 to 10 years (mean age = 7.2 ± 1.6 years) were randomly assigned to four treatment groups: dental hygiene, dental restorations with anesthesia, restorations without anesthesia, and sealant application. Stress levels were measured using Garmin smart watches that analyze HRV and convert the data into a stress score from 0 to 100. Stress was recorded at three time points-beginning, during, and end of the procedure-for a total of nine measurements per patient. A two-way repeated measures ANOVA was used to evaluate the effects of treatment type and phase, along with post hoc tests and linear regression to assess age-related stress variation.While the type of treatment alone did not significantly influence stress levels, stress varied significantly across treatment phases (p = 0.0249), with a strong interaction between treatment and phase (p = 0.0004). Post hoc analyses revealed that dental hygiene led to a significant reduction in stress over time (p < 0.05), whereas restorations with anesthesia caused a significant increase in stress during the procedure (p = 0.0011). No significant changes were observed for restorations without anesthesia and sealant application. Age was inversely correlated with stress (p = 0.0003), although it explained only a small proportion of variance (R ² = 0.0527).The study confirms that pediatric dental stress is influenced by both the procedure type and the treatment phase. Smart watches represent a practical tool for monitoring stress in real time. These findings highlight the importance of tailoring behavior management strategies to the procedure and the patient's age, promoting individualized and stress-reducing approaches in pediatric dental care. From a clinical perspective, wearable stress monitoring can assist pediatric dentists in real-time identification of anxiety peaks, allowing timely behavioral adjustments and potentially improving treatment outcomes and patient cooperation.

In-house printing of clear aligners (CAs) may represent a new revolution in CA therapy, providing a solution for the several limitations associated with indirect manufacturing. This study compared the changes in surface roughness and light transmittance (T%) of directly printed (DP) and thermoformed (TF) CAs after exposure to in vitro aging and different cleaning methods.A total of 48 aligners were fabricated using either multilayer thermoplastic polyurethane (CA Pro + , Scheu Dental; Iserlohn, Germany) or direct three-dimensional-printed resin (Tera Harz TC-85, Graphy; Seoul, Korea). CAs were aged in vitro (thermocycling and artificial saliva) and cleaned for 14 days with the following methods: Polident tablets, an electric toothbrush, Pril dish soap, an ultrasonic cleaning machine, and distilled water. Subsequently, alterations in surface roughness and T% were investigated using atomic force microscopy and spectrophotometry, respectively. This study was conducted from January to July 2025 at the Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq, with additional laboratory work at the University of Technology/Ministry of Science and Technology.Data analysis included descriptive statistics, independent t-tests, one-way analysis of variance, and post hoc tests (Tukey's honestly significant difference or Games-Howell).Compared with the DP aligners, the TF aligners presented greater T% under all conditions, with the highest T% in the as-received condition. The TF and DP aligners showed the lowest T% in ultrasonic cleaning and control conditions, respectively. When excluding the as-received group, most cleaning methods showed statistically significant differences in T%. The surface roughness of the TF aligners was consistently lower than that of the DP aligners, with significant differences observed between the Polident and control groups.Cleaning methods altered the optical and morphological properties of both aligners. Customized cleaning methods are required for CAs.

Oral squamous cell carcinoma (OSCC) is one of the most aggressive malignancies of head and neck cancer associated with severe morbidity and high mortality rates. While conventional treatment modalities are effective in eliminating cancer cells, they frequently result in adverse side effects. Research continues to explore plant-based therapeutics with selective cytotoxicity against cancer cells. Goniothalamus umbrosus is traditionally used among medicinal folks and has shown potential in its anticancer properties. This study aims to explore the role of G. umbrosus hexane extract (GUHE) in inducing apoptosis by elucidating its mechanism of action in OSCC (HSC-3) while comparing its effect on human gingival fibroblast (HGF) cells.The expression of proapoptotic gene (Bax) and antiapoptotic gene (Bcl-2) in HSC-3 and HGF cell lines that had been pretreated with GUHE was evaluated by RT-qPCR. The activity of caspase-3 protein was quantified by ELISA assay.RT-qPCR analysis revealed that GUHE significantly upregulated the Bax expression by 1.69-fold and downregulated Bcl-2 expression by 42% in the HSC-3 cell line. The activity of caspase-3 protein was significantly increased in HSC-3 treated with GUHE. The expression of Bax and Bcl-2 genes and caspase-3 protein activity was not significantly modulated in GUHE-treated HGF.GUHE selectively induced apoptosis by activating the mitochondrial apoptosis pathway in the HSC-3 cell line without being detrimental to the HGF cell line. This highlights its promising effect as a targeted therapeutic agent for OSCC therapy.

Prostatitis is the most prevalent urological condition in young adult men and may progress to prostate cancer, representing a significant public health concern. A high prevalence of inflammatory prostate disorders exists without a clearly identifiable cause. This article aimed to investigate the potential association between periodontal status and prognosis in men diagnosed with prostatitis and to evaluate whether oral health influences urological treatment outcomes.A cross-sectional clinical study was conducted on 172 adult patients with prostatitis who provided written informed consent. Participants were assigned to two groups based on bleeding index (BI): Group A (GA, n = 84), BI >7%, and Group B (GB, n = 88), BI ≤7%. All subjects underwent comprehensive periodontal assessment and nonsurgical periodontal therapy, with follow-up at 30 and 120 days.At baseline, GA showed significantly greater probing depths on proximal surfaces and higher BI values than GB (p < 0.01). Posttreatment, BI improved significantly in both groups, although GA maintained higher residual bleeding (p = 0.002). Mean posttreatment prostate-specific antigen (PSA) levels did not differ significantly between groups; however, PSA decreases occurred more frequently in GB (61.5%) than in GA (28.6%, p = 0.039), while PSA increases were more common in GA (57.1% vs. 15.4%, p = 0.005). Overall, 29.4% of patients exhibited lower PSA levels after periodontal therapy.While no direct association was found between periodontal status and absolute posttreatment PSA values, healthier periodontal conditions were linked to more favorable PSA trends. These findings suggest that periodontal health may contribute to PSA stability in men with prostatitis. Larger, longitudinal studies are warranted to clarify potential mechanistic links between oral and prostatic inflammation.

This study aimed to evaluate untouched canal areas, canal transportation, and centering ability of WaveOne Gold, R-Motion, and Reciproc Blue systems with different apical sizes and tapers using micro-computed tomographic (micro-CT) analysis.Thirty mesial roots of mandibular molars with single curvature were selected and assigned to three groups (n = 10): WaveOne Gold (25/.07v and 35/.06v), R-Motion (25/.06 and 40/.04), and Reciproc Blue (25/.08v and 40/.06v). All canals were prepared in two sequential stages with small and then larger instruments of the same system. Micro-CT scans were performed before, between, and after instrumentation. Reconstructed images (NRecon v.1.6.10, Bruker) were used to assess untouched canal walls, canal transportation, and centering ratio at 3, 5, and 7 mm from the apex.Shapiro-Wilk test was used for normality. One-way ANOVA with Tukey's post hoc test and paired t-tests were applied (α = 5%).Preoperative canal volume and surface area showed no significant differences among groups (p > 0.05). All systems demonstrated similar shaping performance regarding untouched areas, transportation, and centering ability in both preparation stages (p > 0.05). A significant reduction in untouched canal walls was observed after the second preparation stage in all groups (p < 0.05).Despite similar shaping outcomes among systems, the second preparation stage significantly reduced untouched canal walls, supporting its potential role in improving root canal cleaning efficacy.

This article evaluates the feasibility of manufacturing customized three-dimensional (3D)-printed hydroxyapatite (3DHA) bone block grafts using binder jetting for alveolar ridge augmentation prior to implant placement.Cone-beam computed tomography (CBCT) scans of the alveolar ridge from eight patients with horizontal ridge defects were converted to STL files to generate 3D models. These models were used to design and fabricate patient-specific 3DHA bone block grafts using binder jetting. The 3D-printed grafts underwent micro-CT (μCT) scanning, generating μSTL files, which were compared with the original computer-aided design models using inspection software. Dimensional accuracy in three axes (x, y, z) and discrepancies between the 3DHA grafts and ridge defect geometries were assessed. The 3DHA grafts were clinically evaluated for effectiveness in augmenting alveolar ridge defects.Percentage relative differences between the original STL files and those from μCT were -2.72, -7.24, and -3.26% for width, length, and height, respectively. Root mean square deviation was 0.19 ± 0.04 mm overall, -0.22 ± 0.25 mm for the margin area, -0.08 ± 0.18 mm for the inner area, and 0.03 ± 0.11 mm for the contour. Mean gap distances at the defect site were 0.19 ± 0.22 mm (marginal) and 0.37 ± 0.12 mm (internal), which are within clinical acceptable ranges. Clinical application showed no need for intraoperative graft adjustment. At 6 months postaugmentation, bone volume increased from 164.4 ± 37.87 mm³ (initial μCT) to 169.2 ± 39.38 mm³ (follow-up CBCT), though this change was not statistically significant (p = 0.0538). The mean dimensional change was 0.30 ± 0.14 mm.In this pilot study, 3DHA bone block grafts demonstrated acceptable dimensional accuracy and were successfully used for alveolar ridge augmentation, indicating their potential for patient-specific applications.

The objective of this systematic review and network meta-analysis (NMA) was to verify the effectiveness of photodynamic therapy (PDT) compared with other treatments in controlling gingival inflammation in patients undergoing treatment with fixed orthodontic appliances. An electronic search was performed in six databases and gray literature through clinical trials. The outcome of interest was the decrease in gingival inflammation, microbiological culture, and inflammatory cytokines. We conducted a random and fixed effects Bayesian NMA based on the smallest residual effect using mean difference and its credibility intervals (CI) as effect measures for the different outcomes. Six randomized clinical trials (RCTs; 173 patients) were included. It was demonstrated that treatment with PDT (MD, -0.10; 95% CI, -0.14 to -0.05) was more effective in reducing the Gingival Index compared with ultrasound (US). PDT + US treatment was superior or similar compared with US (MD, -0.36; 95% CI, -0.87 to 0.14) for decreasing Tannerella forsythia. In NMA, all treatments had very low certainty, demonstrating a lack of certainty regarding efficacy. The CI crossed the null effect line for treatments on the outcomes of Plaque Index, Gingival Bleeding Index, and Porphyromonas gingivalis; in probing depth, this occurred for the PDT-US treatment (0.15: -0.09, 0.38), and Fusobacterium nucleatum, except for the PDT-US treatment (0.65: 0.0, 1.29), demonstrating very serious inaccuracy. We conclude with very low certainty that there is no strong evidence to support PDT in this treatment. The patient can benefit from either US or PDT.

Candida species are common oral commensals that can become opportunistic pathogens under specific conditions. Most research centers on medically compromised individuals, leaving a gap in understanding oral colonization patterns in healthy populations. This study aimed to investigate the impact of oral conditions and dental restorations on salivary candidal load in healthy individuals.Ninety-seven participants were divided into five groups based on the oral environment as follows: Group 1: participants with healthy mucosa and restoration-free teeth; Group 2: participants with dental fillings, conventional crowns, and fixed partial dentures; Group 3: removable dentures and appliances-positive control; Group 4: participants with tongue-coating abnormalities. Group 5: participants with partially erupted third molars. Saliva samples were collected and analyzed for Candida species using culture methods and colony-forming units per milliliter (CFUs/mL). Candida albicans (C. albicans) was present in 49.5% of samples, predominantly in Group 2 (73.7%). Non-albicans Candida (NAC) was detected in 67% of samples, exhibiting minimal intergroup variation. Age, gender, ethnicity, plaque, and calculus scores significantly influenced the growth of C. albicans and NAC, with older males and Asians exhibiting higher fungal loads. Group 2 demonstrated a significant increase in C. albicans CFUs (10 × ) compared with the negative control. NAC load (CFUs/mL) was notably higher in participants with impacted molars. Age, oral health, and sociodemographic factors were key predictors of salivary C. albicans and NAC loads, with worse oral hygiene correlating to increased NAC growth.This study highlights the impact of the oral environment on the salivary Candidal load in disease-free populations, in particular. The presence of complex fillings, crowns, or fixed partial dentures has the most significant impact on C. albicans loads. However, the impacted molar has the most significant effect on NAC. The growth of both C. albicans and NAC was affected by the age, socioeconomic status, and oral hygiene status of the patient. Recognizing the colonization patterns in these individuals can aid in selecting restorative materials and preventive measures to reduce colonization and excessive salivary carriage. Further research is needed to explore the long-term implications of these findings on oral and systemic health.

Alveolar bone defects in dentistry-caused by trauma, congenital anomalies, and periodontal disease-can substantially impair oral health and tooth function. These effects pose significant challenges in dentistry, and current gold-standard treatments such as autogenous bone grafting have notable limitations. Stem cell from human exfoliated deciduous teeth (SHED) has great potential for bone tissue engineering. The aim of this study was to evaluate the effect of SHED seeded in polymethylmethacrylate (PMMA)-hydroxyapatite (HA) scaffolds on the expression of osteogenic markers in alveolar bone defects.A total of 24 male Wistar rats had their maxillary incisors extracted, and the resulting defects were randomly assigned to three groups: (1) no treatment (control), (2) defects treated with PMMA-HA, and (3) defects treated with SHED seeded in PMMA-HA scaffolds. Immunoreactivity of BMP2, RUNX2, ALP, TGF-β, OCN, OPG, RANK, and RANKL was assessed.Immunohistochemical results showed upregulated expression of BMP2, RUNX2, ALP, TGF-β, OCN, and OPG and downregulated expression of RANK and RANKL in rats treated with SHED-seeded PMMA-HA scaffolds compared with control and defects treated with PMMA-HA only groups.SHED seeded into PMMA-HA scaffolds effectively influenced the expression of several osteogenic markers, such as BMP2, RUNX2, ALP, TGF-β, OCN, OPG, RANK, and RANKL, in alveolar bone defects. These findings indicate that the combination of SHED and PMMA-HA scaffolds could potentially become a promising regenerative alternative to autogenous bone grafting in alveolar bone defects.

The aim of this study was to newly develop a silicon carbide polishing paste that was comparable to or more effective than diamond polishing paste for the final polishing step of zirconia.Fifty-two zirconia specimens were prepared, and polished with silicon carbide sandpaper to generate initial surface roughness. The surface roughness at baseline (Ra value) was measured by a profilometer and the specimens were randomly divided into six groups, which the first group (n = 2) was used to study the surface morphology at baseline. The second to fifth groups (n = 10/group) were polished for 30 seconds with different ratios of silicon carbide paste; silicon carbide:glycerin by weight: 1:1 (SiC1), 1.5:1 (SiC1.5), 2:1 (SiC2), and 2.5:1 (SiC2.5) according to their groups. The sixth group (n = 10) was polished for 30 seconds with diamond paste (Dia). Afterward, the Ra values were remeasured at every 30-second polishing interval up to a total polishing time of 120 seconds. Scanning electron microscopy (SEM) was used to examine the surface morphology of postpolished specimens and the abrasive particles.The differences in mean Ra values were analyzed using two-way repeated analysis of variance followed by least significant difference post hoc analysis. All tests were conducted at a significance level of 5% (p < 0.05).Within each group, the mean Ra values significantly decreased with longer polishing time (p < 0.05), except the SiC2.5 group at 120 seconds. Increasing silicon carbide concentration significantly decreased the Ra values (p < 0.05), with the exception of the SiC2.5 group. After 120 seconds, the SiC2 group demonstrated the lowest mean Ra value. The surface images investigated by SEM corresponded with their Ra values.Polishing zirconia with a silicon carbide paste, silicon carbide:glycerin ratio of 2:1 by weight, for 120 seconds, yields the smoothest postpolished surface. Furthermore, the mean Ra value obtained with this paste is statistically comparable to that of the diamond paste. Thus, silicon carbide paste has the potential to be an efficient alternative to diamond paste for chairside polishing of zirconia.