Journal of dentistry最新文献_第6页

Orthodontic adhesives incorporated with strontium-containing fluorapatite for improved remineralizing effect 正畸粘接剂加入含锶氟磷灰石改善再矿化效果

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-21 DOI: 10.1016/j.jdent.2026.106518

Ji-Yeon Hong , Ji-Eun Kim , Jae-Sung Kwon

Objectives

This study aimed to develop novel orthodontic adhesives with remineralization effect to prevent white spot lesions (WSLs) by adding strontium-containing fluorapatite (Sr-FAp), fluorapatite (FAp), and strontium-containing hydroxyapatite (Sr-HAp).

Methods

The particles were synthesized and characterized. The experimental groups consisted of a commercial control (CC), control (30 wt % resin matrix + 70 wt % glass filler), and experimental groups with 17.5 wt % of filler replaced by Sr-FAp, FAp, or Sr-HAp. The brackets were bonded to the enamel surface and the shear bond strength (SBS) and adhesive remnant index were tested. The release of calcium (Ca), phosphorus (P), strontium (Sr), and fluoride (F) ions from adhesive specimens in distilled water was evaluated after 15, 30, 60 days. The remineralization effect was observed the microhardness and surface morphology using scanning electron microscopy with energy dispersive spectroscopy.

Results

Except for the FAp, no significant differences in SBS were observed (p > 0.05). Ion release results showed Ca, P, Sr, and F ions were detected in the Sr-FAp group up to 60 days. The Sr-FAp group showed the highest microhardness (p < 0.05), and the largest amount of fluorapatite-like layer (Ca/P: 1.69) was formed after 60 days of immersion.

Conclusion

The Sr-FAp group showed acceptable SBS while exhibiting the highest microhardness and the most pronounced formation of a fluorapatite-like layer, indicating its effectiveness in preventing WSLs during orthodontic treatment.

Clinical significance

The orthodontic adhesive containing Sr-FAp offers potential clinical benefits by preventing demineralization and promoting remineralization of the enamel surface surrounding orthodontic brackets.

目的通过添加含锶氟磷灰石（Sr-FAp）、氟磷灰石（FAp）和含锶羟基磷灰石（Sr-HAp），开发具有再矿化作用的新型正畸粘接剂，预防白斑病变（wsl）。方法合成并对其进行表征。实验组由商业对照组（CC）、对照组（30 wt %树脂基质+ 70 wt %玻璃填料）和实验组（17.5 wt %填料由Sr-FAp、FAp或Sr-HAp代替）组成。将托槽与牙釉质表面粘接，测定其剪切粘接强度（SBS）和粘接残余指数。分别于15、30、60天后对黏附标本在蒸馏水中的钙（Ca）、磷(P)、锶（Sr）和氟(F)离子的释放进行评价。利用扫描电镜和能谱仪观察了再矿化效果的显微硬度和表面形貌。结果除FAp外，两组间SBS差异无统计学意义（p > 0.05）。离子释放结果显示，在Sr- fap组中，Ca、P、Sr和F离子的释放时间长达60天。Sr-FAp组显微硬度最高（p < 0.05），浸泡60 d后形成的氟磷灰石样层数量最多（Ca/ p: 1.69）。结论Sr-FAp组的SBS可接受，显微硬度最高，氟磷灰石样层形成最明显，表明其在正畸治疗中预防WSLs的有效性。含有Sr-FAp的正畸粘接剂具有防止牙槽牙釉质脱矿和促进牙釉质再矿化的潜在临床价值。

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引用次数: 0

Sealant vs laser for caries and post-eruptive breakdown prevention in MIH molars: 18-month randomized controlled clinical trial 封闭剂与激光预防MIH磨牙龋齿和爆发后破裂：18个月随机对照临床试验

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-21 DOI: 10.1016/j.jdent.2026.106519

Marwa Baraka , Ghada Elwardani , Chukwuebuka E. Ogwo

Background

Molar Incisor Hypomineralisation (MIH) is a qualitative enamel defect affecting one to four permanent first molars, with or without incisors, predisposing teeth to post-eruptive breakdown (PEB) and atypical caries.

Aim

To assess the effectiveness of Fuji TRIAGE glass ionomer sealant versus Er,Cr:YSGG laser therapy (LT) in the prevention of caries progression and post-eruptive breakdown (PEB) in MIH-affected molars.

Methods

In this two-arm, parallel, randomized clinical trial, 136 children aged 6–9 years with erupted first permanent molars affected by MIH, were enrolled. Affected molars were randomly assigned to Group 1: laser therapy (n = 68) or Group 2: Fuji TRIAGE glass ionomer sealant (n = 68). The primary outcomes dental caries and PEB, as well as the secondary outcome - sealant retention, were evaluated at 3, 6, 12, and 18 months. Associations were analyzed using Generalized Estimating Equations with adjustment for repeated measures and confounders (p < 0.05).

Results

Over 18 months, caries progression increased slightly (22%) with no significant difference between laser and sealant groups (RR = 1.22, p = 0.210). At baseline, laser therapy showed lower PEB risk when compared to the sealant treatment (OR = 0.004, p < 0.001). However, over 18 months, there was 32% higher odds of PEB in laser therapy versus Fuji TRIAGE (OR = 1.319, p < 0.001). Sealant retention declined from 95.6% to 55.9%, and the sealant loss doubled PEB risk (OR = 2.15, p < 0.001). Both treatments reduced pain and anxiety, with sealants offering slightly greater immediate comfort (β = -1.5, p < 0.001).

Conclusions

Fuji TRIAGE offered more sustained protection against PEB compared to laser therapy, while both showed similar caries prevention in MIH-affected molars.

Clinical significance

Fuji TRIAGE provides stronger long-term protection against PEB in MIH molars when compared to laser therapy with similar caries prevention effects; baseline risk factors and sealant retention remain crucial to overall preventive success.

磨牙门牙低矿化（MIH）是一种质性牙釉质缺陷，影响1 - 4颗恒磨牙，不论是否有门牙，都容易导致牙齿出现出牙后破裂（PEB）和非典型龋齿。目的比较Fuji TRIAGE玻璃离子密封剂与Er，Cr:YSGG激光治疗（LT）在预防mih牙磨牙龋病进展和爆发后破裂（PEB）中的效果。方法在这项双组、平行、随机临床试验中，纳入136名6-9岁患MIH的第一恒磨牙出牙儿童。受影响的磨牙随机分为两组：第一组：激光治疗（n = 68）；第二组：Fuji TRIAGE玻璃离子密封剂（n = 68）。在3个月、6个月、12个月和18个月时评估龋齿和PEB的主要结果，以及次要结果-密封剂潴留。使用广义估计方程对重复测量和混杂因素进行校正（p < 0.05）。结果18个月后，激光组与封闭剂组龋病进展略有增加（22%），差异无统计学意义（RR = 1.22, p = 0.210）。在基线时，激光治疗与密封剂治疗相比，PEB风险较低（OR = 0.004, p < 0.001）。然而，在18个月后，激光治疗与Fuji TRIAGE相比，PEB的几率高出32% （OR = 1.319, p < 0.001）。密封剂保留率从95.6%下降到55.9%，密封剂丢失的PEB风险增加了一倍（OR = 2.15, p < 0.001）。两种治疗方法都减轻了疼痛和焦虑，其中密封剂提供了稍大的即时舒适（β = -1.5, p < 0.001）。结论与激光治疗相比，fuji TRIAGE对PEB具有更持久的保护作用，两者对mih感染磨牙的龋预防效果相似。与激光治疗相比，富士TRIAGE对MIH磨牙的PEB具有更强的长期保护作用。基线风险因素和密封剂保留对整体预防成功仍然至关重要。

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引用次数: 0

BEWE 2.0: Basic erosive tooth wear examination revisited: Introducing an additional level for more severe erosive tooth wear BEWE 2.0：重新检查基本腐蚀牙齿磨损：为更严重的腐蚀牙齿磨损引入额外的水平。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-19 DOI: 10.1016/j.jdent.2026.106514

David Bartlett , Saoirse O Toole , Vince Chen , Marko Kuralt , Marília Afonso Rabelo Buzalaf , Riaz Yar , Jonathan Creeth , Shamir Mehta , Nicola West , Manal Awad , Ester Hoekstra , Richard Clarke-Irons , Adrian Lussi

The Basic Erosive Wear Examination (BEWE) was proposed in 2008 as a screening tool for tooth wear. The original aim was to create a simple, convenient screening tool to prompt a clinician to record tooth wear. It was not intended to be accurate and was matched to the basic periodontal examination (BPE). Since that time it has been incorporated into dental practice software and has been adopted by Dentists. But the original screening tool created a ceiling effect, particularly at grade 3 which marked a significant progression from slight wear over the surface to almost complete obliteration of the tooth from wear. There was also low reproducibility between scores 0 and 1. The BEWE 2.0 addresses these issues and proposes a single additional score of level 4 to include 2 mm loss of crown height or 2mm horizontal wear along the cervical margin alongside clarifying the differences between scores 0 and 1.

基本侵蚀磨损检查（BEWE）于2008年提出，作为牙齿磨损的筛查工具。最初的目的是创造一个简单，方便的筛查工具，以提示临床医生记录牙齿磨损。它不是为了准确，而是与基本牙周检查（BPE）相匹配。从那时起，它已被纳入牙科实践软件，并已被牙医采用。但最初的筛选工具产生了天花板效应，特别是在3级时，这标志着从表面轻微磨损到几乎完全消除牙齿磨损的显著进展。得分0和1之间的重现性也很低。BEWE 2.0解决了这些问题，并提出了一个额外的4级评分，包括2毫米的冠高度损失或2毫米的颈椎边缘水平磨损，同时澄清了0分和1分之间的差异。

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引用次数: 0

Aromatherapy with essential oils to reduce anxiety, pain, and discomfort during in-office dental procedures: A scoping review 芳香疗法与精油减少焦虑，疼痛和不适在办公室牙科手术：范围审查。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-19 DOI: 10.1016/j.jdent.2026.106515

Reinaldo Adelino de Sales Junior, Anderson Kaian de Lima Maniçoba, Mariana Silva de Bessa, Bárbara Faria de Sá Barbosa, Patrick Wesley Marques de Boa, Boniek Castillo Dutra Borges

Objectives

To map, analyze, and summarize the available clinical evidence on the use of aromatherapy with essential oils to manage anxiety and pain during dental procedures, and to identify gaps and directions for future research.

Methods

This scoping review followed the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidelines. Clinical trials from any year and language that assessed whether aromatherapy reduced anxiety or pain in dental settings were included. Studies without a control group were excluded. Searches were conducted in PubMed, Web of Science, Scopus, and Embase in June 2025.

Results

Twenty clinical trials involving 3460 participants were included. Eleven essential oils were investigated, with lavender being the most frequently studied (n = 13). Most studies assessing anxiety reported favorable trends associated with aromatherapy (n = 17), whereas studies evaluating pain generally reported no significant differences between groups (n = 7). Substantial heterogeneity was observed regarding intervention protocols, delivery methods, dosages, and outcome measures. Only one study employed an olfactory control, limiting interpretation of whether observed effects were attributable to essential oils or to odor masking in the dental environment.

Conclusions

Aromatherapy with essential oils might demonstrate potential to reduce anxiety during dental care. However, its validation in dentistry requires greater methodological standardization and the inclusion of olfactory control groups.

Clinical relevance

Aromatherapy may offer potential benefits as an adjunctive approach to improve patient experience, particularly anxiety-related outcomes, during dental care; however, current evidence remains heterogeneous and inconclusive.

目的：绘制、分析和总结有关使用精油芳香疗法治疗牙科手术期间焦虑和疼痛的现有临床证据，并确定未来研究的差距和方向。方法：本综述遵循乔安娜布里格斯研究所（JBI）的方法学和PRISMA-ScR指南。任何年份和语言的临床试验评估芳香疗法是否减少了牙科环境中的焦虑或疼痛。没有对照组的研究被排除在外。检索于2025年6月在PubMed， Web of Science， Scopus和Embase进行。结果：纳入20项临床试验，涉及3460名受试者。研究了11种精油，薰衣草是最常被研究的（n = 13）。大多数评估焦虑的研究报告了与芳香疗法相关的有利趋势（n = 17），而评估疼痛的研究通常报告两组之间没有显著差异（n = 7）。在干预方案、给药方法、剂量和结果测量方面观察到实质性的异质性。只有一项研究采用了嗅觉控制，限制了观察到的效果是归因于精油还是牙科环境中的气味掩蔽的解释。结论：精油芳香疗法可能显示出减少牙科护理期间焦虑的潜力。然而，其在牙科的验证需要更大的方法标准化和嗅觉对照组的纳入。临床相关性：芳香疗法作为一种辅助方法可能提供潜在的益处，以改善患者的体验，特别是在牙科护理期间与焦虑相关的结果；然而，目前的证据仍然是不一致和不确定的。

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引用次数: 0

The distributional impact of the UK soft drinks industry levy on dental care costs: An extended cost-effectiveness analysis 英国软饮料行业对牙科保健费用征税的分布影响：扩展的成本效益分析。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-16 DOI: 10.1016/j.jdent.2026.106511

Salomon-Ibarra CC , Toffolutti V , Wu J , Bernabe E

Objective

To evaluate the dental healthcare benefits among children and the financial impacts of the soft drinks industry levy (SDIL) as well as the distributional effects of benefits and costs across different socioeconomic groups in England, using real-world data.

Methods

We conducted an extended cost-effectiveness analysis (ECEA) to evaluate the impact of the SDIL on: (i) averted dental treatment activity and hospitalisations in children under 18 years, (ii) associated NHS cost savings and (iii) the distributional impact across deprivation quintiles, covering the period from April 2018 to December 2024. Dental treatment activity was obtained as courses of treatment (CoTs) by treatment bands from NHS Dental Statistics, while admissions for caries-related extractions were from Hospital Episode Statistics. Five separate interrupted time series models were fitted for CoTs (bands 1–3 and urgent care) and hospitalisations. Averted treatment was calculated as the absolute difference between predicted and counterfactual trends.

Results

3.48 (95% CI: 1.50, 5.67) million CoTs were avoided, saving £124.75 (48.32, 210.34) million. The largest reductions were in the second least deprived and middle quintiles whereas CoTs increased in the two most deprived quintiles. Furthermore, 53,093 (43,119, 62,209) dental hospitalisations were averted, saving £76.61 (60.22, 91.17) million. Reductions were observed across all deprivation quintiles, with the largest reductions among the two most deprived groups.

Conclusion

Dental treatment activity and dental hospitalisations among children fell following implementation of the SDIL, generating NHS cost savings in England. Differences by area deprivation were consistent with expected shifts in caries distribution and reductions in socioeconomic inequalities in childhood dental caries achieved through the SDIL.

目的：利用真实世界的数据，评估儿童牙科保健的好处和软饮料行业征税（SDIL）的财务影响，以及在英国不同社会经济群体的收益和成本的分配效应。方法：我们进行了扩展成本效益分析（ECEA），以评估SDIL对以下方面的影响：(i)避免了18岁以下儿童的牙科治疗活动和住院治疗，（ii）相关的NHS成本节约，以及（iii）剥夺五分位数的分配影响，涵盖2018年4月至2024年12月。牙科治疗活动以疗程（CoTs）的形式从NHS牙科统计数据中获得，而与龋齿相关的拔牙入院人数来自医院事件统计数据。5个独立的中断时间序列模型拟合了CoTs（1-3级和紧急护理）和住院情况。避免治疗被计算为预测趋势和反事实趋势之间的绝对差异。结果：避免了348万（95% CI: 1.50, 567）万个CoTs，节省了124.75（4832,21034）万英镑。减少最多的是第二贫困和中等贫困的五分之一，而两个最贫困的五分之一的cot增加了。此外，避免了53093（43119,62209）例牙科住院治疗，节省了7661（6022,9117）万英镑。在所有贫困五分之一的人群中都观察到下降，其中两个最贫困的群体下降幅度最大。结论：在实施SDIL后，儿童的牙科治疗活动和牙科住院率下降，从而节省了英格兰NHS的成本。区域剥夺的差异与通过SDIL实现的龋齿分布的预期变化和儿童龋齿的社会经济不平等的减少是一致的。

{"title":"The distributional impact of the UK soft drinks industry levy on dental care costs: An extended cost-effectiveness analysis","authors":"Salomon-Ibarra CC , Toffolutti V , Wu J , Bernabe E","doi":"10.1016/j.jdent.2026.106511","DOIUrl":"10.1016/j.jdent.2026.106511","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the dental healthcare benefits among children and the financial impacts of the soft drinks industry levy (SDIL) as well as the distributional effects of benefits and costs across different socioeconomic groups in England, using real-world data.</div></div><div><h3>Methods</h3><div>We conducted an extended cost-effectiveness analysis (ECEA) to evaluate the impact of the SDIL on: (i) averted dental treatment activity and hospitalisations in children under 18 years, (ii) associated NHS cost savings and (iii) the distributional impact across deprivation quintiles, covering the period from April 2018 to December 2024. Dental treatment activity was obtained as courses of treatment (CoTs) by treatment bands from NHS Dental Statistics, while admissions for caries-related extractions were from Hospital Episode Statistics. Five separate interrupted time series models were fitted for CoTs (bands 1–3 and urgent care) and hospitalisations. Averted treatment was calculated as the absolute difference between predicted and counterfactual trends.</div></div><div><h3>Results</h3><div>3.48 (95% CI: 1.50, 5.67) million CoTs were avoided, saving £124.75 (48.32, 210.34) million. The largest reductions were in the second least deprived and middle quintiles whereas CoTs increased in the two most deprived quintiles. Furthermore, 53,093 (43,119, 62,209) dental hospitalisations were averted, saving £76.61 (60.22, 91.17) million. Reductions were observed across all deprivation quintiles, with the largest reductions among the two most deprived groups.</div></div><div><h3>Conclusion</h3><div>Dental treatment activity and dental hospitalisations among children fell following implementation of the SDIL, generating NHS cost savings in England. Differences by area deprivation were consistent with expected shifts in caries distribution and reductions in socioeconomic inequalities in childhood dental caries achieved through the SDIL.</div></div>","PeriodicalId":15585,"journal":{"name":"Journal of dentistry","volume":"166 ","pages":"Article 106511"},"PeriodicalIF":5.5,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Edentulism and all-cause mortality among middle-aged and older people in China: A 9-year cohort study 中国中老年人无牙症和全因死亡率：一项为期9年的队列研究

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-16 DOI: 10.1016/j.jdent.2026.106512

Qiuping Zhou , Jing Kang , Walter Yu Hang Lam , Colman McGrath

Objectives

To investigate the association between edentulism and all-cause mortality over a 9-year period and explore how edentulism influences mortality risk in the presence of chronic diseases.

Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS), encompassing six waves from 2011 to 2020. Edentulism was assessed via self-reports of ‘loss of all natural teeth’. Covariates included demographic status, behavioural factors, and chronic disease history (14 diseases). Kaplan–Meier survival analyses illustrated mortality rates by edentulism status, while Cox proportional hazards models estimated hazard ratios (HRs) for all-cause mortality, adjusting for relevant covariates. Sub analyses explored all-cause mortality risk in the presence of different chronic diseases.

Results

A total of 11,883 individuals of median age 58.8 (IQR 51.9, 66.3) were included in the analyses with 94,648 person-years of follow-up. After adjustment for covariates, edentulism exhibited a higher risk of all-cause mortality over the 9-year period (HR 1.25; 95 % CI, 1.11–1.41). Sub analyses identified that edentulousness was associated with increased mortality risks among patients diagnosed with kidney disease (HR = 1.71; 95 % CI, 1.11–2.65), memory-related diseases (HR = 1.61; 95 % CI, 1.00–2.60), dyslipidemia (HR = 1.70; 95 % CI, 1.13–2.56), heart disease (HR = 1.43; 95 % CI, 1.09–1.87) and arthritis (HR = 1.33; 95 % CI, 1.09–1.62).

Conclusion

Edentulism is associated with an increased risk of all-cause mortality over a 9-year period, having accounted for demographic, behavioural and chronic disease factors. Furthermore, edentulism is associated with an increased mortality risk among several chronic diseases.

Clinical significance

The results highlight the importance of considering oral health status in health assessments and mortality risks.

目的：调查在9年的时间里，牙齿治疗与全因死亡率之间的关系，并探讨牙齿治疗如何影响慢性疾病患者的死亡风险。方法：数据来源于中国健康与退休纵向研究（CHARLS），包括2011年至2020年的六波。通过“失去所有天然牙齿”的自我报告来评估龋病。协变量包括人口统计状况、行为因素和慢性病史（14种疾病）。Kaplan-Meier生存分析显示了假牙状态的死亡率，而Cox比例风险模型估计了全因死亡率的风险比（hr），并对相关协变量进行了调整。亚组分析探讨了存在不同慢性疾病的全因死亡率风险。结果：共有11,883名中位年龄为58.8岁（IQR为51.9,66.3）的患者纳入分析，随访94,648人年。调整协变量后，在9年的时间里，假牙患者的全因死亡率更高（HR 1.25; 95% CI, 1.11-1.41）。子分析发现edentulousness与死亡率增加有关风险患者诊断为肾病(HR = 1.71;95%可信区间,1.11 - -2.65),与内存相关疾病(HR = 1.61;95%可信区间,1.00 - -2.60),血脂异常(HR = 1.70;95%可信区间,1.13 - -2.56),心脏病(HR = 1.43;95%可信区间,1.09 - -1.87)和关节炎(HR = 1.33;95%可信区间,1.09 - -1.62)。结论：考虑到人口、行为和慢性病因素，在9年的时间里，长牙症与全因死亡风险增加有关。此外，在一些慢性疾病中，假牙与死亡风险增加有关。临床意义：该结果强调了在健康评估和死亡风险中考虑口腔健康状况的重要性。

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引用次数: 0

Development of entrustable professional activities for competency-based prosthodontic specialty training programmes 开展可信赖的专业活动，开展以能力为基础的口腔修复专业培训计划。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-16 DOI: 10.1016/j.jdent.2026.106509

Fatemeh Amir-Rad , Susan Morison , Nabeel Alsabeeha , Nabil Zary , Gerry McKenna

Objectives

This study aimed to develop and validate a set of Entrustable Professional Activities (EPAs) for prosthodontics specialty training using a structured multi-step approach.

Methods

An initial list of EPAs was generated through a comprehensive literature review, examination of prosthodontics competency standards, and an asynchronous online nominal group technique involving national prosthodontists and a dental education expert. This process was used to develop and confirm the EPA set. The EPAs were then evaluated for quality and structure using the Equal rubric, resulting in the refinement and confirmation of relevant EPAs. Subsequently, a two-round modified Delphi method was employed, engaging prosthodontics educators from multiple countries in a consensus-building process. In the modified Delphi rounds, panellists reviewed a predefined list of EPAs and provided quantitative ratings and qualitative comments on indispensability (Round 1–2), title clarity (Round 1–2), specification/limitations (Round 1–2), information supporting entrustment decisions (Round 2), and expected entrustment level at each stage of training (Round 2). Based on median ratings and content validity index analysis the EPAs were revised accordingly. Aggregated scores for each EPA and synthesised group feedback for consensus development were provided in Round 2.

Results

The expert group confirmed 11 of the 20 initially identified EPAs. All 11 preliminary EPAs reflected activities that were deemed essential to the clinical practice of prosthodontists. Based on median ratings and content validity index analysis, 8 EPAs needed revision. A high degree of consensus among experts was reached in the second Delphi round. The final set of 11 EPAs provide a succinct and comprehensive overview of the core tasks of specialist prosthodontists.

Conclusion

This study developed 11 EPAs for prosthodontics specialty training programmes, representing an essential first step toward developing a structured assessment system for prosthodontic trainees.

Clinical significance

This study provides a further step towards competency-based specialty training in prosthodontics.

目的：本研究旨在开发和验证一套可信赖的专业活动（EPAs），采用结构化的多步骤方法进行修复学专业培训。方法：通过全面的文献回顾、口腔修复能力标准的审查，以及由国家口腔修复专家和牙科教育专家参与的异步在线名义小组技术，生成初步的epa名单。该过程用于开发和确认EPA集。然后，使用平等准则对环境保护措施的质量和结构进行评估，从而对相关环境保护措施进行细化和确认。随后，采用两轮改进的德尔菲法，让来自多个国家的修复学教育工作者参与建立共识的过程。在修改后的德尔菲轮次中，小组成员审查了预先定义的环境评估清单，并对不可或缺性（第1-2轮）、标题清晰度（第1-2轮）、规格/限制（第1-2轮）、支持委托决策的信息（第2轮）和每个培训阶段的预期委托水平（第2轮）提供定量评级和定性评论。根据中位数评分和内容效度指标分析，对环境评价指标进行了相应的修订。在第二轮中提供了每个EPA的综合得分和共识发展的综合小组反馈。结果：专家组确认了20个初步确定的环境影响因子中的11个。所有11个初步EPAs都反映了被认为对口腔修复医师的临床实践至关重要的活动。根据中位数评分和内容效度指标分析，有8份epa需要修订。专家们在第二轮德尔菲中达成了高度共识。最后一套11 EPAs提供了专家修复牙医的核心任务的简要和全面的概述。结论：本研究为义齿学专业培训项目制定了11个EPAs，为义齿学学员建立结构化评估体系迈出了重要的第一步。临床意义：本研究为以能力为基础的口腔修复学专业培训提供了进一步的途径。

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引用次数: 0

Does localized irradiance of poly-wave LED influence the bonding performance of universal adhesives to dentin? 多波LED的局部辐照度是否影响通用胶粘剂与牙本质的粘合性能？

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-16 DOI: 10.1016/j.jdent.2026.106513

E Sutil , M Wendlinger , AFM Cardenas , FSF de Siqueira , CJ Soares , S Geraldeli , AD Loguercio

Purpose

This study evaluates how different wavelength ranges emitted by a poly-wave LED curing light violet (405 nm) and blue (445 and 465 nm) affect the microtensile bond strength (μTBS), nanoleakage (NL), and in situ degree of conversion (DC) of universal adhesives applied to dentin.

Methods

Eighty caries-free human molars were randomly assigned to four groups according to two variables: (1) Adhesive system (Ambar Universal APS [AMU], Scotchbond Universal [SBU] and (2) application mode (etch-and-rinse [ER] or self-etch [SE]). To control tooth dependency, each tooth quadrant of every tooth was allocated to a different wavelength range (405, 445 and 465 nm) and identified accordingly during light-curing with the Valo unit (1400 mW/cm²). Afterwards, resin composite fillings were placed, and each quadrant was sectioned to obtain resin-dentin bonded beams (0.8 mm²). These beams were tested for μTBS, NL, and DC. Data for μTBS (MPa), NL (%), and DC (%) were analyzed using three-way ANOVA and Tukey's test (α=5%).

Results

For AMU and SBU, no significant differences were observed among the 445-nm and 465-nm wavelength ranges (p > 0.05) for all outcomes. However, light curing SBU with 405-nm LED resulted in significantly lower μTBS and DC values and higher NL values compared with 445 and 465 nm LEDs (p < 0.01). AMU exhibited higher μTBS and DC values than SBU (p = 0.001). No significant differences were found between SE and ER application strategies (p > 0.05).

Clinical significance

Bonding to dentin may be locally compromised when universal adhesives relying on the conventional camphorquinone/amine photoinitiator system are light-cured with poly-wave LEDs that exhibit non-uniform spectral distribution.

目的：研究多波LED光紫光（405nm）和蓝光光（445 nm和465 nm）对牙本质通用胶粘剂微拉伸结合强度（μTBS）、纳米渗漏（NL）和原位转化度（DC）的影响。方法：80颗无龋人磨牙根据2个变量随机分为4组：(1)粘接剂系统（Ambar Universal APS [AMU]、Scotchbond Universal [SBU]）和(2)应用方式（蚀刻-冲洗[ER]或自蚀刻[SE]）。为了控制牙齿依赖，在Valo单元（1400mW/cm2）光固化过程中，将每颗牙齿的每个牙齿象限分配到不同的波长范围（405、445和465nm），并进行相应的识别。然后放置树脂复合填充物，对每个象限进行切片，得到树脂-牙本质结合梁（0.8 mm2）。对这些光束进行了μTBS、NL和DC测试。μTBS （MPa）、NL（%）和DC（%）数据采用三因素方差分析和Tukey检验（α=5%）进行分析。结果：对于AMU和SBU，在445 nm和465 nm波长范围内，所有结果均无显著差异（p > 0.05）。与445和465 nm LED相比，405 nm LED光固化SBU的μTBS和DC值显著降低（p < 0.01）， NL值显著提高（p < 0.01）。AMU的μTBS和DC值高于SBU （p = 0.001）。SE与ER应用策略间无显著差异（p < 0.05）。临床意义：使用光谱分布不均匀的多波led光固化，依靠传统樟脑醌/胺光引发剂体系的通用粘接剂与牙本质的结合可能会局部受损。

{"title":"Does localized irradiance of poly-wave LED influence the bonding performance of universal adhesives to dentin?","authors":"E Sutil , M Wendlinger , AFM Cardenas , FSF de Siqueira , CJ Soares , S Geraldeli , AD Loguercio","doi":"10.1016/j.jdent.2026.106513","DOIUrl":"10.1016/j.jdent.2026.106513","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates how different wavelength ranges emitted by a poly-wave LED curing light violet (405 nm) and blue (445 and 465 nm) affect the microtensile bond strength (μTBS), nanoleakage (NL), and in situ degree of conversion (DC) of universal adhesives applied to dentin.</div></div><div><h3>Methods</h3><div>Eighty caries-free human molars were randomly assigned to four groups according to two variables: (1) Adhesive system (Ambar Universal APS [AMU], Scotchbond Universal [SBU] and (2) application mode (etch-and-rinse [ER] or self-etch [SE]). To control tooth dependency, each tooth quadrant of every tooth was allocated to a different wavelength range (405, 445 and 465 nm) and identified accordingly during light-curing with the Valo unit (1400 mW/cm<sup>2</sup>). Afterwards, resin composite fillings were placed, and each quadrant was sectioned to obtain resin-dentin bonded beams (0.8 mm<sup>2</sup>). These beams were tested for μTBS, NL<em>,</em> and DC. Data for μTBS (MPa), NL (%), and DC (%) were analyzed using three-way ANOVA and Tukey's test (α=5%).</div></div><div><h3>Results</h3><div>For AMU and SBU, no significant differences were observed among the 445-nm and 465-nm wavelength ranges (<em>p</em> > 0.05) for all outcomes. However, light curing SBU with 405-nm LED resulted in significantly lower μTBS and DC values and higher NL values compared with 445 and 465 nm LEDs (<em>p</em> < 0.01). AMU exhibited higher μTBS and DC values than SBU (<em>p</em> = 0.001). No significant differences were found between SE and ER application strategies (<em>p</em> > 0.05).</div></div><div><h3>Clinical significance</h3><div>Bonding to dentin may be locally compromised when universal adhesives relying on the conventional camphorquinone/amine photoinitiator system are light-cured with poly-wave LEDs that exhibit non-uniform spectral distribution.</div></div>","PeriodicalId":15585,"journal":{"name":"Journal of dentistry","volume":"166 ","pages":"Article 106513"},"PeriodicalIF":5.5,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Simulated bone for dental implant in vitro testing: A systematic review 牙种植体模拟骨的体外测试：系统综述。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-15 DOI: 10.1016/j.jdent.2026.106508

Ulysses Lenz , Pedro Henrique Wenz Tretto , Jason Alan Griggs , Alvaro Della Bona

Objective

To evaluate methodological factors in the fabrication of simulated bone for dental implant testing and assess their relationship with reported clinical failure patterns.

Method

A systematic search was conducted in MEDLINE/PubMed, Scopus, and Web of Science following PRISMA. In-vitro studies published from 2015 on mechanically testing single-unit implants with simulated bone materials were included. Two reviewers performed screening, data extraction, and RoBDEMAT appraisal. Disagreements were resolved by a third reviewer. A narrative synthesis categorized bone material characteristics, bone loss simulation, loading angulation, and implant connection type, analyzing their influence on reported outcomes.

Results

From 2,472 records, 91 studies met the inclusion criteria. Most studies used single-layer simulated bone (81/91), predominantly autopolymerizing resins, while 10 employed two-layer cortical–cancellous bone analogs. Bone loss was mostly simulated using 3 mm (n=41). Loading was commonly applied at 30° (n=61), followed by 0° (n=21). The most frequent outcomes were screw loosening (n=21), screw fracture (n=19), abutment fracture (n=19), crown/veneer fracture (n=19), and implant fracture (n=19). Off-axis loading (30–45°) combined with crestal bone loss (∼3mm) tended to shift failures from screw/abutment to implant fractures. Conclusions: Reported laboratory failures partly align with clinical observations. Simulated bone loss level, bone stiffness and loading angle can influence failure patterns in dental implant testing. ISO 14801 and related standard protocols require update to better reflect current clinical data.

Clinical significance

Current laboratory tests do not fully reproduce contemporary peri-implant bone stability, limiting their clinical applicability. More realistic bone analogs may improve the clinical relevance of in-vitro studies.

目的：评价牙种植体试验中模拟骨制作的方法学因素及其与临床失败模式的关系。方法：系统检索PRISMA后的MEDLINE/PubMed、Scopus和Web of Science。纳入了2015年发表的关于用模拟骨材料机械测试单单元植入物的体外研究。两名审稿人进行筛选、数据提取和RoBDEMAT评估。分歧由第三位审稿人解决。一个叙述性综合分类骨材料特性，骨丢失模拟，加载角度，种植体连接类型，分析它们对报道结果的影响。结果：在2472份记录中，91项研究符合纳入标准。大多数研究使用单层模拟骨（81/91），主要是自聚合树脂，而10个研究使用双层皮质松质骨类似物。骨丢失主要用3 mm模拟（n=41）。加载通常在30°（n=61），然后是0°（n=21）。最常见的结果是螺钉松动（n=21）、螺钉断裂（n=19）、基牙断裂（n=19）、冠/贴面断裂（n=19）和种植体断裂（n=19）。离轴载荷（30-45°）加上嵴骨丢失（~ 3mm）倾向于将螺钉/基台骨折转移到种植体骨折。结论：报告的实验室失败部分符合临床观察。模拟骨损失水平、骨刚度和加载角度会影响牙种植体试验的失效模式。ISO 14801和相关标准协议需要更新，以更好地反映当前的临床数据。临床意义：目前的实验室测试不能完全再现当代种植体周围的骨稳定性，限制了其临床适用性。更现实的骨类似物可能会提高体外研究的临床相关性。

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引用次数: 0

Effect of internal connection parameters on the fatigue limit of narrow-diameter implants – a finite element study 内连接参数对窄径种植体疲劳极限影响的有限元研究。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry

Pub Date : 2026-01-15 DOI: 10.1016/j.jdent.2026.106510

Renan Brandenburg dos Santos , Ulysses Lenz , Jason Alan Griggs , Alvaro Della Bona

Objective

To evaluate the influence of internal connection parameters on the fatigue limit of narrow-diameter dental implants using finite element analysis (FEA).

Methods

A narrow-diameter dental implant (3.0 mm, Morse taper connection) and its corresponding abutment and screw were scanned using micro-computed tomography (micro-CT). High-resolution 3D models were reconstructed (Simpleware, Synopsis), and six geometric parameters defining the internal connection were extracted. A reference 3D assembly was built in SolidWorks, and systematic dimensional variations (±20%) of the six design parameters were introduced based on a Taguchi orthogonal array (DOE++, Reliasoft), resulting in 27 modified assemblies. Static FEA was performed in ABAQUS according to ISO 14,801:2016 geometry. Fatigue performance was estimated using Fe-safe software, and sensitivity analyses were conducted to identify the most influential parameters on the predicted fatigue limit.

Results

The reference model presented a fatigue limit of 193 N. Dimensional optimization based on FEA improved the fatigue limit up to 295 N, representing a 52.3% increase compared to the original design, with the cervical opening diameter (CID) showing a significant effect on fatigue performance.

Conclusions

Systematic variation of internal connection geometry significantly affected the fatigue resistance of narrow-diameter implants. Identifying critical parameters enables the development of more durable and reliable implant–abutment assemblies, maximizing the treatment success in anatomically compromised sites.

Clinical significance

Optimizing the internal geometry of narrow-diameter implants can improve load distribution, minimize mechanical complications, and increase the longevity of implant-supported rehabilitations in areas with reduced bone volume.

目的：应用有限元分析方法评价内连接参数对窄径种植体疲劳极限的影响。方法：采用微型计算机断层扫描（micro-CT）对直径3.0 mm的窄种植体（莫尔斯锥度连接）及其相应的基牙和螺钉进行扫描。重建高分辨率三维模型（Simpleware、synosis），提取定义内部连接的6个几何参数。在SolidWorks中建立参考三维装配体，并基于田口正交阵列（DOE++, Reliasoft）引入6个设计参数的系统尺寸变化（±20%），得到27个修改后的装配体。根据ISO 14801:2016几何标准，在ABAQUS中进行静态有限元分析。利用Fe-safe软件对疲劳性能进行了估计，并进行了敏感性分析，以确定对预测疲劳极限影响最大的参数。结果：参考模型的疲劳极限为193 N，基于有限元分析的尺寸优化将疲劳极限提高到295 N，比原设计提高了52.3%，其中颈开口直径（CID）对疲劳性能有显著影响。结论：内连接几何形状的系统性变化对窄径种植体的抗疲劳性能有显著影响。确定关键参数可以开发更耐用和可靠的种植基台组件，最大限度地提高解剖受损部位的治疗成功率。临床意义：优化窄径种植体的内部几何形状可以改善负荷分布，减少机械并发症，延长骨体积减少区域种植体支持康复的寿命。

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引用次数: 0