BDJ Open最新文献

Aim: This study aimed to evaluate the aesthetic preferences of traditional digital smile designs and artificial intelligence (AI)-generated smile designs among dentists, dental students, and laypersons, addressing gaps in previous research on the clinical acceptability of AI in prosthodontic aesthetics.

Materials and methods: A cross-sectional, questionnaire-based study was conducted via an online survey distributed across India between 2024 and 2025. A total of 320 participants, including dental students, dentists, and nondental professionals, were recruited on the basis of calculated sample size requirements. Smile designs were created for four clinical cases via Exo-CAD software, employing two methods: conventional manual design by prosthodontists and AI-based automated design. The participants evaluated paired smile designs and indicated their aesthetic preferences. Demographic data were also collected. Chi-square (χ²) tests were applied for statistical analysis, with a significance level set at p < 0.05.

Results: No significant differences in aesthetic preferences were observed based on sex, age, or occupation. Overall, manually crafted smile designs were consistently preferred across all the participant categories. However, AI-generated smiles for Cases 3 and 4 presented relatively higher acceptance rates (39.4% and 39.7%, respectively) than those for Cases 1 and 2 did. The findings suggest that while AI algorithms can achieve acceptable levels of aesthetic appeal, they still lack the human touch essential for capturing nuanced facial dynamics and emotional context.

Conclusion: Although AI-based smile design systems demonstrate promise in improving workflow efficiency and consistency, they are currently unable to replicate the individualized artistic judgment of experienced clinicians. Manual intervention remains critical for achieving truly personalized and aesthetically harmonious outcomes. Future approaches should consider hybrid models that combine AI automation with clinician-led customization to increase both the efficiency and patient satisfaction of smile aesthetics.

Background: Artificial Intelligence (AI) has become increasingly integrated into dental diagnostics, particularly for detecting carious lesions. While AI offers benefits such as improved accuracy and efficiency, its use raises important ethical concerns, including transparency, patient privacy, autonomy, diversity and accountability. This scoping review aims to identify these ethical concerns using a structured ethical framework.

Methodology: Three databases were searched for papers regarding caries detection using AI. An established ethical framework was used to screen each paper for potential areas of concern.

Results: A total of 351 abstracts were screened, of which 7 articles were included in this review. Each article was screened for established ethical principles including transparency, diversity, wellness, autonomy, privacy, accountability, equity, prudence, sustainable development, solidarity and governance. Diversity was the main ethical concern. Concerns related to accountability, equity and transparency were identified in 2 of the articles whereas ethical issue of privacy was identified in 4 of the articles. Only one study mentioned that no ethical approval was taken prior to commencement of study.

Conclusion: AI in caries detection faces ethical issues like data bias, privacy risks, and equity concerns, potentially leading to flawed AI models. These issues can be addressed by creating a more specialized ethical framework that is specific to AI in dentistry.

Clinical relevance: Understanding ethical challenges in AI-driven caries detection is critical to ensure accurate diagnostics, maintain patient trust, protect privacy, and support informed decision-making. Clinicians must be equipped to navigate these challenges as AI tools become more prevalent in dental practice.

Background: Virtual reality (VR) technologies are increasingly being adopted in dental education, particularly in restorative dentistry, due to their capacity to simulate realistic clinical scenarios and enhance student learning. However, despite the growing interest, the overall research landscape in this field remains unclear. This study aimed to conduct a bibliometric analysis to evaluate the most influential research contributions, publication trends, and collaborative patterns related to VR in restorative dentistry.

Methods: An advanced search of the Web of Science Core Collection (WoS-CC) database was performed on 29th October 2024 using a combination of keywords and Medical Subject Headings (MeSH) terms relevant to VR and restorative dentistry. Only original research and review articles in English were included. Bibliometric parameters such as citation metrics, authorship, institutional affiliations, countries of origin, and keywords were extracted and analyzed using Bibliometrix (R) and VOSviewer software.

Results: Out of 434 retrieved records, 62 articles met the inclusion criteria. A marked increase in publications was observed after 2019, with the USA, UK, and Netherlands emerging as the leading contributors. The most cited article received 73 citations, focusing on haptic simulators for motor skill acquisition. The Journal of Dental Education, the European Journal of Dental Education, and BMC Medical Education were among the most prolific journals. Despite global contributions, the analysis revealed limited interdisciplinary and international collaboration.

Conclusion: This bibliometric study highlights the increasing research activity surrounding VR in restorative dentistry and its potential to transform dental education. While considerable progress has been made, further high-quality research and broader collaborative efforts are necessary to address existing gaps and fully harness the capabilities of VR and related immersive technologies in dental education.

Objective: To evaluate the clinical performance of nitric acid associated with a mineral-enriched adhesive system compared to the conventional approach of phosphoric acid and a universal adhesive in cervical carious lesion restorations.

Materials and methods: Twenty-six individuals with 44 cervical anterior carious lesions were randomized into two equal parallel groups. The intervention group received a nitric acid etch (Clean and Boost dentin enamel cleanser, Vista Apex, USA) in conjunction with a mineral-enriched adhesive and a flowable composite liner (RE-GEN, Vista Apex, USA). Control group treated with phosphoric acid (Scotchbond Universal Etchant, 3 M ESPE), a universal adhesive (Single Bond Universal Adhesive, 3 M ESPE), and a standard liner (Filtek Supreme, 3 M ESPE). All cavities were restored using nanohybrid resin composite (Filtek Z350XT, 3 M ESPE). Postoperative sensitivity was assessed both qualitatively, using the modified USPHS criteria, and quantitatively, using a visual analog scale (VAS), as the primary outcome. In addition, clinical performance regarding marginal discoloration, adaptation, secondary caries, and retention was evaluated as secondary outcomes using modified USPHS criteria. Outcomes were assessed at 24 h, 6, 12, and 18 months. The data was statistically analyzed using intention-to-treat analysis. Intergroup comparisons were performed using the Chi-Squared test with a significance level (p ≤ 0.05), and intragroup comparisons were analyzed using Cochran's Q test with a confidence level of 95% and a study power of 80%. Relative risk was used to assess clinical significance. The survival rate was analyzed using the Kaplan-Meier and Log-rank tests. The study was conducted following the CONSORT 2025 guidelines.

Results: Both groups demonstrated similar performance in terms of postoperative sensitivity, retention, secondary caries, and marginal adaptation, as assessed using modified USPHS criteria. However, there was a significant increase in marginal discoloration within the phosphoric acid groups after 18 months. There was 50% less risk of sensitivity with nitric acid compared to phosphoric acid using the VAS scale (CI (0.2512 to 0.9953); p = 0.0485). The tested groups showed an equal survival rate (p = 0.3771).

Conclusion: Combining nitric acid with a mineral-enriched system is a promising approach for restoring cervical carious lesions.

Objectives: This study aimed to evaluate the effectiveness of using a flowable resin composite compared to periodontal pack in reducing postoperative morbidity after free gingival graft (FGG) harvesting.

Materials and methods: In this randomized controlled clinical trial, 34 patients requiring FGG were allocated into two equal groups. The intervention group received a flowable resin composite dressing over the palatal wound, while the control group received Coe-Pak. Postoperative pain was assessed using a Visual Analogue Scale (VAS) and mean analgesic consumption over 14 days. Secondary outcomes included wound size and color match of the healing site assessed at weeks 1, 2, 3, and 6.

Results: The control group reported significantly higher VAS pain scores than the intervention group on days 1-4 and 10 (p < 0.05), and highly significant differences on days 5, 6, 8, and 9 (p < 0.001). Analgesic use decreased significantly in both groups (p < 0.001), with no intergroup differences. Wound size and color match improvements were comparable between groups.

Conclusion: The application of flowable resin composite significantly reduces early postoperative pain following FGG harvesting without compromising healing outcomes. Its ease of application, patient comfort, and comparable clinical performance make it a promising alternative to traditional dressings. However, further investigations are warranted to confirm the biocompatibility of flowable resin composites and their impact on soft tissue healing.

Objectives: New tools aid in the diagnosis of diseases and thus help in advancing patient care. "Fractal Analysis" is a versatile method of applying nontraditional mathematics to patterns that are beyond understanding with traditional Euclidean concepts. This analysis can be used on radiographic and non-radiographic images in dentistry. In this review we aim to identify the usefulness of fractal analysis in dentistry in radiographic images, its applications and future scope.

Materials and methods: Articles published between 1992 and 2024 were retrieved through an electronic search of Medline via PubMed, Scopus, and Google Scholar databases. The search, which was limited to articles published in English, aimed to identify relevant studies by employing the following keywords: "fractal analysis," "dental radiographs," "mandibular," "panoramic radiographs," and "radiography." Ultimately, 76 articles that addressed the application of fractal analysis in dental radiographs were selected.

Results: Fractal analysis can reveal alterations in bone and in images of morphologically altered tissue, however no set values exist which could be used as a standard for diagnosing various conditions.

Conclusion: Fractal Analysis can potentially be used as an adjunct to diagnostic tests as it is shown to identify alterations in bony and trabeculae patterns.

Introduction: This study aimed to compare two different approaches for palatal wound healing following free gingival graft (FGG) harvesting: one involving Nano Bio-Fusion (NBF) gingival gel used in conjunction with a palatal stent, and the other using a palatal stent alone. Outcomes were assessed in terms of wound healing, post-operative pain, and patient satisfaction.

Methods: This parallel-grouped, two-arm, single-blinded, randomized controlled trial (RCT) included twenty-six patients with mucogingival defects that required harvesting an epithelialized free gingival graft (FGG). Patients were randomly allocated into either test group (NBF gingival gel and palatal stent; n = 13) or control group (palatal stent only; n = 13). Wound healing, the primary outcome, was evaluated over a 30-day period, while secondary outcomes included post-operative pain-measured using the Visual Analog Scale (VAS) and analgesic consumption-and patient satisfaction.

Results: In the test group, wound healing showed statistically significant higher healing index score than control group after 3 days (P = 0.017), then no statistical significance was noted. Regarding post-operative pain, the test group showed statistically significantly lower pain scores (VAS) than control group in the first week, followed by no statistical significance in the second week. In the third day, the test group showed statistically significant lower analgesic consumption dose (P = 0.024) with overall statistically significant higher satisfaction score than control group (P = 0.002).

Conclusion: Within the limitations of this study, the results suggest that NBF gingival gel may promote early-stage palatal wound healing, reduce postoperative pain and analgesic consumption during the first week, and enhance overall patient satisfaction.

Clinical trial registration: (NCT05442359 | | https://www.

Clinicaltrials: gov/ 30-June-2022).

Background: Lichen planus (LP) is a chronic inflammatory disease. Oral lichen planus (OLP) is a chronic inflammatory disease that affects the oral mucosa. Different clinical types of oral lichen planus can be diagnosed based on clinical presentation and histopathological features.

Aim: The present study aimed to assess the potential of salivary and serum leptin in the diagnosis of OLP.

Materials & methods: The study was conducted on 78 cases (i.e., 39 cases per group) with OLP. The subjects were systematically free. Salivary and serum leptin concentrations from patients exhibiting a classic OLP and from healthy controls were assessed.

Results: Salivary and serum leptin levels are higher in the OLP group. The participants in the study are older than those in the control group; therefore, the age difference between the two groups does not affect the study's results.

Conclusion: Salivary and serum leptin levels in OLP patients were higher than in healthy control subjects, suggesting a possible role in the process of OLP pathogenesis.

Background: White spot lesions (WSLs) is a caries lesion distinguished by white opacity due to subsurface enamel demineralization. These lesions resulting from a disparity between detrimental and protective factors and can continue to demineralize if untreated. Early diagnosis and remineralization can reverse WSLs, supporting minimally invasive dental care.

Aim: To compare and assess the color of WSLs through spectrophotometer after application of Self-assembling peptide P11-4, 2% Arginine Enriched Sodium Fluoride varnish and Functionalized Tri Calcium Phosphate Fluoride varnish.

Methods: This randomized controlled triple-blind clinical trial enrolled pediatric participants (ages 8-12 years) presenting with moderate caries risk as defined by CAMBRA (Caries Management By Risk Assessment) criteria, with visible white spot lesions (WSLs) on the labial surfaces of maxillary permanent anterior teeth, classified as ICDAS scores 1 or 2. A total of 39 WSLs were incorporated into the study and randomly allocated into one of the three groups 13/each. Group I: Self-assembling peptide P11-4 varnish (study group), Group II: Arginine-enriched Sodium Fluoride varnish (study group) and Group III: Tri Calcium Phosphate Fluoride varnish (positive control group). The color change ΔE of each WSL was quantified using a spectrophotometer at the baseline. Dimensions of WSLs were assessed by digital photography, remineralizing agents were applied then patients were recalled for further applications after 3 and 6 months and for WSLs assessment after 3, 6 and 9 months.

Results: All groups demonstrated progressive color improvement over time. At 3 months, Group I showed the least improvement (ΔE = 16.39 ± 3.04), followed by Group III (14.80 ± 3.11) and Group II (14.06 ± 4.46). By 9 months, Group II achieved (ΔE = 9.37 ± 3.79), and Group III (9.15 ± 2.74) surpassing Group I (12.21 ± 3.03). so both Group II and III ultimately outperformed Group I in color correction by the study's end. Group II achieved significantly greater WSL reduction (14.98 ± 7.55%) compared to both Group I (27.93 ± 8.98%) and Group III (22.32 ± 8.61%), with no significant difference observed between Groups I and III.

Conclusions: Although all the three tested materials demonstrated an enhancement in the color and dimension of WSLs, 2% of Arginine Enriched Sodium Fluoride showed the best results followed by Functionalized Tri Calcium Phosphate Fluoride varnish, while self-assembling peptide P11-4 showed the lowest results.