International Journal of Dentistry最新文献

Introduction: Martensitic endodontic instruments, thanks to their flexibility, produce less apical transportation compared to austenitic instruments. Recently, a sequence of instruments featuring a dual thermal treatment applied separately to the tip and the shank was introduced with the aim of achieving a tip with enhanced cutting capacity and a more flexible body. The increased stiffness at the tip could potentially lead to greater apical transportation. The aim of this study was to compare apical transportation produced by SlimShaper (single thermal treatment) and SlimShaper PRO (dual thermal treatment) nickel-titanium (NiTi) instruments (Zarc4Endo, Spain) in standardized simulated canals.

Methods: Forty-four standardized J-shaped resin blocks were used, divided into two groups (n = 22): Group A (shaped with SlimShaper up to size 25/0.04) and Group B (shaped with SlimShaper PRO up to size 25/0.04). Each block was photographed before and after shaping, and the images were superimposed to evaluate apical transportation. Data normality was verified with the Shapiro-Wilk test, and homogeneity of variances was assessed with Levene's test. Since assumptions were met, comparisons between the two groups were performed using the independent Student's t test, with the level of significance set at p  < 0.05.

Results: Mean apical transportation was 0.08423 mm (SD 0.01049) for SlimShaper and 0.08609 mm (SD 0.01102) for SlimShaper PRO, with no statistically significant difference between groups (p = 0.57).

Conclusions: Under the conditions of this study, the dual-thermally treated SlimShaper PRO instruments did not produce greater apical transportation than the single-thermally treated SlimShaper instruments.

Introduction: Human papillomavirus (HPV) is associated with several types of oral lesions (OLs), including oropharyngeal squamous cell carcinoma (SCC), especially in HIV-positive individuals.

Objectives: To identify the prevalence and clinical implications of the alpha (α) and beta (β) genera of HPV in the oral cavity and oropharynx of HIV-positive men who have sex with men (MSM).

Methods: A cross-sectional study from January 2022 to May 2023 was performed. Ninety-four participants were included; their sexual habits, risk factors, HIV-1 viral load, and CD4⁺ T-cell counts were obtained. Exfoliative cytology was performed, and deoxyribonucleic acid (DNA) was extracted from the samples to identify α and β HPV genera through endpoint polymerase chain reaction (PCR). OLs associated with HPV infection were described, and histopathological and immunohistochemical findings for p16 were reported.

Results: A total of 71.3% of the participants were positive for any HPV genus (22.4% α-HPV and 49.2% β-HPV). The 6.3% had OLs associated with HPV, principally leukoplakia, and although six of nine samples were p16 positive, none were malignant.

Conclusion: The prevalence of HPV infection in the oral cavity and oropharynx in HIV + MSM was high; however, the associated OLs were infrequent and not malignant. Future studies are necessary to evaluate the clinical relevance of HPV infection and p16-positive OLs.

Orthodontic treatment often lasts around 20 months, and prolonged duration increases the risk of adverse events. Physical adjunctive interventions (PAIs) are proposed to accelerate tooth movement, but their efficacy remains uncertain. This umbrella review synthesized systematic reviews and meta-analyses of randomized clinical trials (RCTs) on PAIs published through March 2025 (PubMed, Web of Science, Scopus, Cochrane Library). Review quality was appraised with the A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2) and the Risk of Bias in Systematic Reviews (ROBIS) tools. Study overlap was quantified using the corrected Graphical Representation of Overlap for Overviews (GROOVE) method. Risk of bias in the primary studies was reassessed, when required, using the Cochrane Risk of Bias 2 (RoB 2) tool. Certainty of evidence was rated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Random-effects models were used when statistical heterogeneity was substantial (I ² > 50%); otherwise, fixed-effects models were used. Effect estimates are reported as mean difference (MD) with 95% confidence intervals (CIs). Seventeen systematic reviews (12 meta-analyses, 5 narrative) covering 76 RCTs were included. Vibration devices showed minimal or no clinically significant acceleration: leveling/alignment MD = 0.05 mm (95% CI: -0.38 to 0.49), canine retraction + 0.27 mm/month (95% CI: 0.19-0.35), en-masse retraction + 0.19 mm/month (95% CI: -0.25 to 0.63) (GRADE: moderate-very low). Low-level laser therapy (LLLT) shortened alignment by -58.4 days (95% CI: -88.6 to -28.2) and, in maxillary extraction, by -28 days (95% CI: -39 to -17), with early canine retraction gains (95% CI: +0.31 to +0.27 mm/month) (GRADE: moderate-very low). Light-emitting diode (LED) therapy showed + 0.005 mm/day (95% CI: -0.001 to 0.012) with small, non-significant monthly estimates (GRADE: low-very low). Bioelectric stimulation (BES) added + 1.78 mm at 3 months (95% CI: 0.99-2.57) (GRADE: low). Overall, methodological quality varied widely, with most reviews rated low to critically low by AMSTAR-2 and at high risk of bias by ROBIS. Vibration should not be the primary accelerator. Photobiomodulation (PBM) is the most promising clinical option, but it requires standardized protocols (wavelength, dose, schedule). BES is promising yet underpowered. Registration: PROSPERO CRD420251043659.

Background: We studied the posterior mandibular morphology to develop a new alveolar ridge morphology classification system for implant therapy. Current classification systems do not adequately address essential parameters such as the influence of lingual undercut on implant placement. They do not fully consider clinically important factors such as the shape of the alveolar ridge, the depth and angle of the lingual concavity, and the position of the inferior alveolar canal (IAC). This study was based on an existing classification system and culminated in the development of a new CPD classification system, with a primary focus on lingual concavity.

Material and methods: One hundred and ninety-five patients aged above 19 to over 70 years were included in this cross-sectional study. Cone-beam computed tomography (CBCT) volumes of 90 males and 105 females were analyzed to determine the width of the alveolar bone at the crest (Wc), width of the alveolar bone at the base (Wb), alveolar ridge height (Vcb), alveolar bone height below the Point P (Vb), alveolar bone height above the Point P (Vc), and lingual concavity depth and angle. These parameters were selected to determine the ridge shape and the presence/absence of an undercut. These values were also analyzed in relation to age, gender, presence/absence of the first molar, and presence/absence of the lingual concavity.

Results: The U-type (undercut) ridge was the most common (54.4% left; 52.1% right), followed by the P-type (parallel; 27.2% left; 33.5% right) and the C-type (convergent; 18.5% left; 14.4% right). Alveolar ridge height was correlated with age, gender, ridge type, presence of the first molar, and presence of an undercut. The width of the alveolar bone at the crest correlated with the presence of the first molar and ridge type. The lingual concavity depth correlated with the presence of the first molar, undercut, and ridge type.

Conclusions: We have developed and validated a new and comprehensive CPDU classification system for assessing the posterior mandible to enhance preoperative assessment for implant therapy by categorizing the alveolar ridge morphology into C-type, P-type, and D-type with or without undercut (U) based on the ridge shape, lingual concavity depth and angle, and IAC position.

Objectives: The aim was to compare the two-body wear behavior of four nanocomposites used for enamel replacement.

Materials and methods: Nanocomposite specimens (Estelite Asteria [EA], Enamel Biofunction [EBF], Neospectra [NS], Clearfil Majesty [CM]; n = 8 for each, diameter = 10 mm, height = 1.5-2 mm) were prepared in a custom-made mold according to the manufacturer's instructions. The degree of conversion (DC) was measured by Fourier transform infrared spectroscopy. Vickers hardness (VH) was measured on the top and bottom surfaces, and the VH ratio (VHR) was calculated. The specimens were aged using a thermocycling machine (10,000 cycles), followed by 120,000 chewing cycles. The mean volume loss (MVL), maximum wear depth (MWD), and surface roughness (SR) were assessed with a white-light interferometer. The tested surfaces before and after the wear test, along with the morphology of extracted fillers, were evaluated using scanning electron microscopy (SEM). Statistical analysis-ANOVA, Levene, Tukey, and Tamhane tests-was performed with SPSS Statistics version 28.

Results: CM exhibited a significantly higher VH compared to the other nanocomposites, both before and after aging. It also showed lower MVL, MWD, and SR than the other three tested nanocomposites.

Conclusions: VH and wear behavior are significantly affected by the filler parameters of nanocomposites.

Clinical significance: This study may assist clinicians in selecting resin-based composite (RBC) for occlusal rehabilitation. Based on this in vitro study, CM exhibited a lower wear rate than the other tested RBCs; therefore, it is worth considering its use for patients with higher bite forces.

Objective: To assess the performance of multimodal vision-language artificial intelligence models, optimised using quantisation-aware training, in triaging endodontic treatment needs. The focus is on the ability to interpret endodontic radiographs while tolerating common image capture errors, including cone cutting, elongation, foreshortening, horizontal misalignment, over- and under-exposure and artefacts.

Methods: In total 3600 dental were obtained across a 1-year period. Image augmentation techniques were applied to enhance model generalisability. Bootstrapped Language-Image Pretraining (BLIP), CLIP, Florence 2 and Paligemma multimodal models were fine-tuned using quantisation-aware training and evaluated using Bilingual Evaluation Understudy (BLEU), Recall-Oriented Understudy for Gisting Evaluation (ROUGE), Metric for Evaluation of Translation with Explicit ORdering (METEOR), Consensus-based Image Description Evaluation (CIDEr) and Loss Trends and Convergence.

Results: Quantisation-aware optimisation improved BLEU-4 by at least 17.3%, METEOR by at least 11.1%, ROUGE-L by at least 9.8% and CIDEr by at least 75.5% across all models. Quantisation reduced memory consumption by 87.5% while preserving diagnostic accuracy within a 0.5% error margin while correctly reproducing over 90% endodontic triage assessments made by practitioners.

Conclusion: Multimodal AI demonstrates tolerance to imaging inconsistencies and is capable of accurately triaging endodontic cases with minimal computational demands, without compromising diagnostic performance.

Introduction: This pioneering study delves into the dynamics of intraoral pressure, examining its consistency across different subjects and conditions. The null hypothesis is a different pressure at rest between the intraoral zone and the atmospheric pressure.

Materials and methods: Utilizing a novel apparatus and method, based on the concept of communicating vessels, the research aimed to measure resting intraoral pressure at the vestibular level.

Results: The findings revealed no significant variations in intraoral pressure across different individuals or under varying sectors of analysis or wakefulness versus sleep state. The average resting pressure in the oral vestibule was identified to be -1.25 mmHg, suggesting a residual relative negative pressure post-swallowing that could aid in various physiological functions.

Discussion: The values found align with previous studies on swallowing and with studies that have attempted to measure the intraoral pressure exerted by the muscles of cheeks and lips. The study further supports existing theories on peri-implant tissue maturation and the role of oral vacuum in promoting gingival growth. Specifically, it suggests a potential impact of the negative pressure gradient on gingival microcirculation as an explanation for the volumetric growth of gingival tissue.

Conclusion: Within the limitation of the present sample size, this research confirms the hypothesis related to intraoral pressure in understanding various physiological processes within the oral cavity, paving the way for further exploration in this domain with implications for dental and oral health practices.

Background: The loss of the first primary tooth is a significant early biological milestone in a child's development. As a novel experience, it often triggers a complex mix of excitement, confusion, and apprehension. Parents should focus on providing support to ensure this transition is viewed as a positive and reassuring event.

Aims: To report children's different emotions upon losing their first primary tooth and possible factors that may influence these emotions.

Study design: An online cross-sectional survey utilized social media and recruited 988 parents of children aged 5-8 years. Eligibility required that the child had experienced the exfoliation of at least one primary tooth.

Methods: Besides parental demographics, the study used a questionnaire to evaluate child-specific variables: sex, duration of tooth wiggle, and emotional state during exfoliation. History of traumatic dental injuries or caries-related visits and witnesses of siblings' tooth exfoliation were also recorded.

Statistics: Descriptive statistics, chi-square tests, and logistic regression tests were used.

Results: Of all parents, 54.6% reported positive emotions, and 30.4% reported negative emotions. Significantly higher positive emotions were found in children getting dental check-up visits (OR = 1.49, 95% CI: 1.07-2.07), and when the child witnessed tooth exfoliation in older siblings (odd ratio (OR) = 1.73, 95% confidence interval (CI): 1.29-2.32). Significantly more negative emotions were found in children attending public schools (OR = 1.41, 95% CI: 1.02-1.95), speaking one language (OR = 1.92, 95% CI: 1.29-2.87), having two or more siblings (OR = 1.42, 95% CI: 1.02-2.98), and having a negative attitude to a dental visit (OR = 1.68, 95% CI: 1.23-2.30).

Main conclusions: The majority of children associate the loss of their first primary tooth with positive emotions. Conversely, approximately one-third experience negative emotions. The emotional response is significantly influenced by child-related factors and previous dental visits.

Objectives: We aimed to analyze the trends of untreated caries in permanent teeth in Asia over the past 30 years, identify high-risk groups and areas of high prevalence, and explore strategies to mitigate this disease burden.

Methods: Data were extracted from the Global Burden of Disease (GBD) Database. The incidence, prevalence, years lived with disability (YLDs), and age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized YLD rate (ASYR) were analyzed. Spatial and temporal distributions of untreated caries in permanent teeth were also determined.

Results: For Asia, the crude incidence, prevalence, and YLDs showed increasing trends; ASIR remained constant; and ASPR and ASYR demonstrated decreasing trends. In 2019, the incidence and prevalence of untreated caries in permanent teeth peaked in the 20-24-year age group. The spatial "hot spots" for ASIR were South and East Asia, whereas the "cold spots" were West and Central Asia. The hot spots for ASPR and ASYR were in West Asia, whereas the cold spots were in East Asia.

Conclusions: Untreated caries in permanent teeth demonstrated significant geographical and demographic differences in Asia, revealing a relevant public health challenge. Intervention strategies based on dynamic changes are required to reduce the burden of dental caries in this region.

Background: Non-technical (soft) skills such as communication, professionalism, leadership and cultural competence are essential elements of patient-centred care, yet their integration into dental curricula remains inconsistent. To our knowledge, no bibliometric study has systematically mapped these global trends, leaving gaps in understanding and research. This study aimed to (i) conduct a comprehensive bibliometric mapping of global research trends on non-technical (soft) skills in dental education, highlighting thematic patterns, underrepresented domains and geographic disparities and (ii) demonstrate how these insights can be mapped to the curriculum, illustrated through an implementation case study from a Faculty of Dentistry in Thailand.

Methods: We conducted a bibliometric analysis of English-language articles and reviews from Scopus (upto February 9, 2025). Studies were included if they focused on non-technical (soft) skills training or assessment for dental students, faculty or practitioners. Using VOSviewer, Microsoft Excel and GraphPad Prism, the publication trends, sources, citations, geographic distribution and keyword co-occurrence were analysed. The quantitative findings were directly applied to contextualise a curriculum mapping exercise at the Faculty of Dentistry, Chulalongkorn University, Thailand.

Results: Analysis of 546 publications revealed a 40% increase in annual output over the last decade. Research was highly concentrated in high-income countries, led by the United States, with Africa and South America collectively contributing a meagre < 5%. Keyword analysis identified five thematic domains: i) professionalism/leadership, ii) communication skills, iii) personality/emotional intelligence, iv) education/assessment and v) behavioural sciences. Significant thematic disparities were evident, with communication skills being the dominant element while leadership, cultural competence and entrepreneurship were markedly underrepresented. Citation patterns mirrored these imbalances. The case study from Thailand served as an illustrative model demonstrating the integration of these underrepresented skills, such as leadership, conflict resolution and cultural sensitivity, across a 6-year curriculum through diverse pedagogical and assessment strategies.

Conclusion: This study provides the bibliometric map of non-technical (soft) skills research in dental education, revealing not only growth but also profound geographic and thematic imbalances. More importantly, it moves beyond analysis to present a dual-method framework: using global data to identify critical gaps and then providing a replicable model for curriculum intervention. This approach offers dental educators a data-driven blueprint for designing equitable, comprehensive and contextually relevant curricula that prepare graduates for the complex demands of modern healthcare.