Frontiers in dental medicine最新文献

Objective: The evidence on postoperative pain and clinical outcomes in patients receiving primary non-surgical root canal therapy with bioceramic vs. resin-based sealers was compiled in this comprehensive review from systematic reviews and meta-analyses.

Methods: The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42023461029). Systematic reviews included randomized or quasi-randomized trials of adult patients having treatment with either sealer type for postoperative pain, and used validated scales. Screening, data extraction, and quality assessment by A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) were completed independently by two reviewers and review overlap was measured with the Corrected Covered Area (CCA). Where feasible, de novo random-effects meta-analyses were conducted to estimate standardized mean differences (SMD) in pain at 24 and 48 h. Heterogeneity was measured using the I ² statistic and certainty of evidence with GRADE.

Results: Seven reviews (2020-2024) met eligibility, five with quantitative synthesis. Pooled analyses showed no significant differences in pain between sealer types within the first 6-48 h. Detected differences were small and clinically negligible. Both sealers showed similar analgesic use and flare-up rates. Methodological quality ranged from moderate to low; certainty of evidence for early pain was moderate and low for pain at >48 h due to study inconsistency and imprecision.

Conclusions: Bioceramic sealers offer only a minimal, clinically insignificant reduction in early postoperative pain compared to resin-based sealers. Both nevertheless remain suitable options for reducing patient discomfort. Future studies should standardize pain evaluation, include retreatment cases, and explain clinically significant findings.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023461029, PROSPERO CRD42023461029.

Aim: Bone regeneration in oral and maxillofacial surgery remains a clinical challenge, particularly in cases of severe alveolar atrophy or large post-pathological bone defects. Autologous biomaterials including dentin grafts processed with the Tooth Transformer® device and platelet concentrates such as Concentrated Growth Factors (CGF), PRF, i-PRF, and TPRF-have gained attention due to their biocompatibility and regenerative potential. However, no direct head-to-head clinical studies comparing these autologous approaches are currently available.

Materials and methods: This review was conducted according to PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus and Web of Science for clinical studies published in English between January 2010 and December 2025. Eligible designs included randomized trials, prospective/retrospective studies, and case series with ≥5 patients. Owing to the paucity of CGF-only studies, the comparison was broadened to include platelet concentrates (CGF/PRF/L-PRF/i-PRF/TPRF). Outcomes included bone volume gain, radiographic density, histologic new bone formation, healing time, implant survival, and postoperative complications.

Results: The search yielded 1,004 records; 10 studies met the inclusion criteria. Autologous dentin grafts demonstrated favorable volumetric stability and bone density compatible with mature bone, while platelet concentrates consistently improved early healing, angiogenesis, and trabecular organization-particularly in contained defects. Substantial methodological heterogeneity and the absence of direct comparative trials precluded quantitative synthesis.

Conclusions: Autologous dentin grafts and platelet concentrates appear to play complementary roles: the former provides a structural scaffold for three-dimensional augmentation, whereas the latter enhances biological healing and tissue maturation. Combined protocols show promise but require validation through well-designed, multicenter randomized controlled trials.

Growing evidence links chronic systemic inflammation, particularly from periodontitis, to neurodegenerative processes, which have been reported to share common pathways. Early detection of neurodegenerative diseases such as Alzheimer's disease is crucial, given that underlying neuropathological processes evolve silently for decades before diagnosis. The gingival crevicular fluid (GCF), a serum-derived exudate from the gingival sulcus, mirrors both local periodontal inflammation and systemic conditions. Its molecular composition-rich in cytokines, enzymes, oxidative stress markers, and microbial metabolites-makes it a potential source of biomarkers reflecting neuroinflammatory pathways. This review discusses the biological rationale and emerging evidence supporting the use of GCF as a functionalized biofluid for early detection of dementia or asymptomatic neurodegeneration. By integrating advances in biosensing and lab-on-a-chip technologies, GCF analysis could become a minimally invasive, point-of-care approach to identify individuals at risk of neurodegenerative diseases. Exploring this oral-brain connection may open new perspectives in preventive medicine and personalized diagnostics.

Purpose: To assess the diagnostic accuracy and treatment planning agreement among Jordanian dentists when using teledentistry.

Methods: Thirty children underwent dental examinations. Standardized intraoral photographs and brief case histories from pediatric patients were compiled into clinical case scenarios. Eight representative cases were selected and presented in a Google Forms survey to licensed dentists in Jordan. Participants reviewed the cases, providing clinical diagnoses and proposing treatment plans. Responses were analyzed to determine diagnostic accuracy and agreement on treatment planning.

Results: Diagnostic agreement was highest for cases with distinct clinical presentations. Case #5 (early childhood caries) showed the highest agreement at 92.1%, followed by Case #3 (avulsion; 91.1%) and Case #6 (ectopic eruption; 85.1%). Treatment planning agreement followed a similar pattern. The highest concordance was reported for Case #4 (molar-incisor hypomineralization; 64.4%) and Case #7(Functional class III/anterior crossbite 59.4%).

Conclusion: Teledentistry enables high diagnostic accuracy among Jordanian dentists, especially in pediatric cases with well-defined presentations. However, the observed variability in treatment planning highlights the need for standardized clinical guidelines and targeted professional development to optimize teledentistry's integration into routine dental care.

Objective: This meta-analysis assessed the efficacy of various anesthetic protocols for symptomatic irreversible pulpitis, comparing techniques and agents to identify the optimal anesthesia approach.

Methods: We conducted a comprehensive search of the Cochrane Library, PubMed, Web of Science, Scopus, and Embase databases up to July 10, 2025, identifying relevant studies based on predefined inclusion and exclusion criteria. The primary outcome was the success rate of anesthesia. Data extraction and quality assessment were performed using a pre-designed form and the revised Cochrane Risk of Bias Tool. A fixed-effect model was used for meta-analysis when heterogeneity was low (I ² ≤ 50%, p ≥ 0.1); otherwise, a random-effects model was adopted. Additionally, another model was employed for validation, and the results from both models were compared to derive more reasonable conclusions. Publication bias was assessed using funnel plots and the Egger test.

Results: Fourteen RCTs were included in the meta-analysis. Pooled analysis showed that modified anesthetic protocols for SIP were 3.62 times more successful than conventional inferior alveolar nerve block (IANB) using standard 2% lidocaine with epinephrine (OR = 3.34; 95% CI: 2.49-4.48). Studies conducted in Iran had the highest success rate (OR = 4.31; 95% CI: 3.59-5.17, p < 0.001). Inferior alveolar nerve block (IANB) was more effective than buccal infiltration (OR = 4.03; 95% CI: 3.38-4.81, p < 0.001), and 4% articaine demonstrated the highest efficacy (OR = 4.18; 95% CI: 2.85-6.16, p < 0.001).

Conclusion: This meta-analysis assessed the efficacy of various anesthetic protocols for SIP, comparing techniques and agents to identify the optimal anesthesia approach.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/recorddashboard, PROSPERO database CRD42025638427.

Background: The objective of this study was to assess the level of Streptococcus mutans in the saliva and plaque of infants with a high caries risk.

Methods: A self-administered parental questionnaire was used to identify one-year-old infants with high caries risk and to collect demographic information, the parents' and infants' oral health related behaviors. Saliva and plaque samples were collected from the participating infants. The real-time polymerase chain reaction assays were used to detect the quantity of MS in infants' saliva and plaque. A clinical examination was conducted to record the caries experience and oral hygiene level of infants.

Results: 579 high caries risk infants were recruited. The mean MS count in saliva and plaque was 0.08 ± 0.48 (×10⁷) CFU/mL and 5.72 ± 91.93 (×10⁷) CFU, respectively. Only a few infants had high MS% (>0.03%) in total bacterial count in plaque (4.8%) or saliva (7.3%). The MS level in plaque was found to have a significantly positive association with the prevalence of infants with a white spot or cavitated lesion (P = 0.039), but not for the MS level in saliva. Infants from families with 2 or more children (P = 0.029) and those who had been fed 7 times or more per day (P = 0.020) had a higher likelihood of having a high MS level (MS% > 0.03%) in dental plaque.

Conclusions: MS level in plaque and saliva was generally low among infants. The MS level in plaque showed a clearer association with the onset of dental caries than the salivary MS level in young children.

Background: Large bone deformities pose significant challenges in regenerative periodontal surgeries. A healthy underlying bone and the osteoinductive effect of the surrounding environment are the primary factors that influence bone regeneration. Collagen and hydroxyapatite are universally used bone substitutes owing to their excellent biocompatibility and biodegradability. Innovations in the osteoinductive properties of hydroxyapatite and its use in different modified forms, combining it with other materials, may result in enhanced biomechanical properties. This research utilized domestic chicken eggshells to synthesize hydroxyapatite and fish scales to extract collagen. The novel composite graft was prepared by integrating both materials. The beneficial effects of the composite graft on the healing and regeneration of bone were assessed in the calvarial bone of Wistar rats both radiographically and histomorphometrically.

Methods: Hydroxyapatite was synthesized from domestic chicken eggshells using the chemical precipitation method. Collagen was extracted from the scales of Rohu fish. The novel composite material was prepared by direct mixing and lyophilization, with further mixing with glycerol to attain an appropriate consistency. After preliminary characterization, bone regeneration was assessed in surgically created critical bone defects in rats. Radiographic bone fill was assessed using cone beam computed tomography, which was followed by histomorphometry. The bone regenerative capacities of the two novel materials were compared with empty control sites and a commercially available standard bone graft (Bio-Oss).

Results: The novel materials displayed significantly superior regenerative capacity both radiographically and histomorphometrically when compared to empty controls, but the regenerative ability was lower when compared to the standard bone graft material (Bio-Oss) over 90 days. A trend of increased new bone formation and significantly higher radiodensity was observed in the sites treated with the composite graft compared to the empty control (p < 0.0001) and eggshell-derived hydroxyapatite groups (p < 0.01). Moreover, Bio-Oss exhibited a marginal improvement in radiodensity compared to the composite graft (p < 0.05).

Conclusion: The composite graft demonstrated improved bone regeneration and radiodensity in the surgically created critical-sized defects. Hence, it can be considered a promising material for the regeneration of periodontal and peri-implant defects. Further laboratory and clinical studies may be required to confirm its osteoinductive properties.

Monochromatic resin composite, a novel dental restorative material, is now increasingly utilized in dental restorations, especially for anterior teeth. Its benefits include appealing aesthetics and ease of handling. Achieving a natural tooth color match with monochromatic resin composites can be challenging, but recent advancements in color selection programs have significantly improved the accuracy and consistency of color matching in dental restorations. The paper aims to systematically analyze the key factors affecting the color matching of monochrome resin composite, including the optical properties of the material itself, clinical operation skills, external environmental factors and individual differences. Research indicates that the transparency of monochrome resin composites, light scattering characteristics, particle size distribution, and other factors all influence color matching accuracy. High-transparency resins are prone to color variations in low-light environments, while the wavelength, intensity, and curing duration of light sources during material hardening significantly affect color stability and final appearance. Additionally, clinical factors such as resin thickness and lamination techniques impact the final color presentation. External environmental factors-including oral lighting conditions and background color variations-also affect the color harmony between restorations and adjacent natural teeth. Unlike traditional layered resin composite, monochromatic resin composite exhibits color changes under illumination due to the "chameleon effect" and "mixing effect". This simplifies the procedure and reduces the time required. They are particularly well-suited for correcting minor imperfections and restoring front teeth. However, monochromatic resin composites are not suitable for restorations requiring significant color variation. Therefore, alternative restorative techniques are utilized to improve color precision. The paper summarizes the factors affecting color matching of monochrome resin composite, which provides a theoretical basis for subsequent clinical practice and research. Meanwhile, with the development of material science and technology, the performance of monochrome resin composite in aesthetic restoration has been improved, so as to better meet the requirements of patients.