Radiographic evaluation of orodental anomalies in a Thai population: prevalence, supernumerary teeth characteristics, and associations.

Friday, August 8, 2025

Orodental anomalies encompass conditions affecting tooth number, morphology, and eruption patterns, with supernumerary teeth being particularly significant due to their potential to disrupt occlusion, eruption, and alignment. This study aimed to identify and characterize these anomalies in a Thai population using panoramic radiographs. Data analysis revealed 56.0% prevalence of orodental anomalies, with tooth impaction being the most common (37.4%), followed by periapical radiolucency (13.5%) and hypodontia (5.1%). Supernumerary teeth were identified in 1.2% of cases, most commonly as single (76.7%), unerupted (70%), and supplemental-type teeth (76.7%). Significant associations were found with microdontia (p < 0.001) and tooth impaction (p < 0.002), but these associations were not statistically significant when adjusted for gender. The study identified a range of orodental anomalies, highlighting the need for thorough radiographic evaluation in cases presenting with eruption disturbances or tooth size anomalies. These findings underscore the importance of incorporating anomaly screening in routine dental radiography and warrant multicenter investigations for broader generalizability. Orodental anomalies, including supernumerary teeth, are associated with various complications, and their prevalence varies by population and age. The study also focused on characterizing supernumerary teeth, which were significantly associated with other anomalies such as impaction and microdontia in bivariate analysis, though this association was not confirmed by logistic regression. Despite this, the observed co-occurrence highlights the need for comprehensive radiographic assessment in these conditions. The study aimed to investigate orodental anomalies in a Thai population using panoramic radiographs, providing a broader adult dataset and including less commonly analyzed locations. A retrospective observational study identified and characterized supernumerary teeth, including their clinical and radiographic features. The findings emphasize the necessity of thorough radiographic evaluation and suggest the need for further research on these conditions. The study also highlighted the importance of systematic assessment and standardization in dental radiography.

Labels: BMC Oral Health

The effect of polyvinylpyrrolidone sodium hyaluronate gel on palatal wound healing after free gingival graft surgery: a randomized controlled clinical trial.

Thursday, August 7, 2025

This study evaluates the effects of polyvinylpyrrolidone sodium hyaluronate gel (Gelclair®) on palatal wound healing, pain, and bleeding following free gingival graft surgery (FGG). Thirty-two patients underwent FGG and were randomly assigned to two groups: the test group received Gelclair® and chlorhexidine mouthwash, while the control group received only chlorhexidine. Patients were assessed at first, third, seventh, fourteenth, and twenty-eighth postoperative days using the Visual Analog Scale (VAS), Wound Healing Index (WHI), hydrogen peroxide (H₂O₂) bubbling scores, and bleeding situations. Friedman and Wilcoxon signed-rank tests were used for repeated measures and between-group comparisons. H₂O₂ test values decreased over time in both groups, with significant differences observed in H₂O₂ test values on days 7, 14, and 28 compared to the control group. WHI values increased similarly, showing significant improvements in both groups. VAS pain, chewing, and burning scores were also significantly lower in the test group on days 1, 3, 7, and 14 compared to the control group. Control groups reported higher bleeding rates on day 1 compared to the test group (p < 0.001). The study suggests that Gelclair® promotes wound healing and reduces discomfort and bleeding in the palatal donor area after FGG. NCT06610331; Retrospectively registered on 23/09/2024. Free gingival grafts (FGGs) are often used in periodontal plastic surgery to address gingival and peri-implant soft tissue defects and restore keratinized gingiva [1]. FGGs are considered the gold standard for treating gingival recession [2], augmenting peri-implant soft tissue, and preserving the alveolar ridge [3, 4]. Due to its anatomical advantages and optimal tissue thickness, the palatal keratinized mucosa is recommended as the ideal donor site for FGG [5]. After FGG surgery, the palatal donor site undergoes secondary wound healing [6]. One of the major postoperative challenges for patients is the morbidity associated with the palatal donor site [7]. Pain is the most common postoperative complication, with some patients recalling this discomfort even a decade after the procedure [8]. Other potential palatal complications include prolonged bleeding, necrosis, infection, and delayed wound healing, often due to injury to the greater palatine artery during surgery [7]. Numerous clinical studies have focused on improving palatal wound healing and reducing patient discomfort [9, 10, 11, 12]. Hyaluronic acid (HA) is a connective tissue component found in the periodontal ligament and gingival tissues, exhibiting bacteriostatic, anti-inflammatory, and antioxidant properties [13]. With its remarkable moisturizing, retention, and viscoelastic capacities, HA contributes to essential structural, rheological, physiological, and biological functions. Due to its anti-immunogenic and non-toxic characteristics that support periodontal wound healing, it is widely used in reconstructive periodontal soft tissue surgery [14]. An in vitro study demonstrated that the film form of HA enhances adhesion upon contact with water, facilitating its penetration into tissues and supporting the prolonged functional effect of HA within the tissue [15]. Supporting this finding, an in vivo animal study showed that the HA film structure promoted palatal wound healing both clinically and histologically in experimentally induced palatal wounds in rats [16]. Gelclair® is a film form bioadhesive oral gel commonly used to treat painful oral lesions. This viscous gel contains polyvinylpyrrolidone (PVP), sodium hyaluronate, and glycyrrhetinic acid. The chemical structure of PVP allows it to adhere to mucosal surfaces and form a protective film. Sodium hyaluronate which is a type of HA salt; improves tissue lubrication and hydration due to its high water-holding capacity and viscoelastic properties. Glycyrrhetinic acid supports wound healing through its anti-inflammatory effects. Together, these three components in Gelclair® provide hydration and lubrication to damaged tissues in the oral cavity and protect nerve endings from physical stimuli [17].

Labels: BMC Oral Health

The effects of masseter muscle morphology on occlusion and TMJ in adult skeletal Class II patients: a CBCT study.

Tuesday, August 5, 2025

This study investigated the correlation between masseter muscle morphology, occlusion, and TMJ characteristics in adult patients with skeletal Class II malocclusion. Eightty-seven participants were evaluated, divided into four groups based on their skeletal Class II profile. CBCT scans were performed before and after orthodontic treatment, allowing for the assessment of masseter morphology, occlusion, and TMJ variables. Significant intergroup differences were observed in masseter morphology indexes (TMM, CSAMM) and occlusion indices (AU6, AL6, TU6, etc.), as well as TMJ variables (AJS, SJS, etc.). The masseter muscle's morphology was found to significantly influence occlusion and TMJ characteristics, affecting occlusal planes, curves, condylar position, and articular fossa morphology. These findings suggest that masseter muscle function plays a critical role in stomatognathic dysfunction and highlight the importance of CBCT-based muscle assessments in orthodontic planning. Skeletal Class II malocclusion, characterized by mandibular retrusion (70% of cases), results from factors like mandibular underdevelopment and functional issues such as steep occlusion planes. Muscle imbalances and posterior-inferior rotation can contribute to the Class II pattern, while the masseter, a primary masticatory muscle, influences occlusion force distribution. The study's findings inform myofunctional therapy in adult orthodontic care, while BTX-A injections show potential improvements in masseter thickness and molar height. The study was approved by the Clinical Research Ethics Committee, with informed consent provided to participants. All participants were informed of the study's purpose and provided written consent. The sample was divided into four groups based on ANB and MP-SN angles, and CBCT scans were performed on both before and after orthodontic treatment. All data were analyzed using One-Way ANOVA and Pearson correlation. The masseter muscle's thickness and cross-sectional area were measured and analyzed twice, with a one-week interval between measurements. The study highlights the importance of CBCT-based assessments in understanding and improving occlusion and TMJ conditions in Class II patients.

Labels: BMC Oral Health

Evaluation of remineralization potential of bioactive glass varnishes in white spot lesions: a comparative in vitro study

Thursday, July 31, 2025

White spot lesions represent the first clinical sign of dental caries and can be reversed using various remineralizing agents. This study aimed to synthesize different bioactive glass varnishes and assess their remineralizing effects on white spot lesions compared to fluoride varnish and a synthesized nanosilver fluoride varnish. Seventy-two extracted human teeth were used, divided into seven groups with varying varnish compositions. Statistical analysis using one-way and repeated measures ANOVA showed that the nanosilver-containing bioactive glass varnish (Group E) had the highest mineral gain percentage, followed by fluoride-containing bioactive glass (Group D) and nanosilver fluoride (Group F). Scanning electron microscopy revealed the development of new crystals in these groups, with bioactive glass varnishes showing comparable remineralizing efficacy to fluoride varnishes. The fluoride and nanosilver-containing bioactive glass varnishes demonstrated higher remineralizing potential compared to the standard fluoride varnish and nearly the same effect of the nanosilver fluoride varnish. Dental caries is the leading cause of dental pain and a chronic infectious disease, involving demineralization and remineralization processes. The white spot lesions, the earliest phase of enamel demineralization, can be repaired through remineralization. Bioactive glass materials, when exposed to body fluids, release calcium and phosphate ions, forming amorphous calcium phosphate (HA) and eventually hydroxyapatite (HA). Incorporating fluoride and silver nanoparticles into bioactive glass enhances remineralization activity, with silver nanoparticles showing superior bactericidal and anti-inflammatory properties. This study synthesizes bioactive glass varnishes and evaluates their remineralizing effects, highlighting the importance of bioactive glass in remineralizing dental caries.

Labels: BMC Oral Health

Professional biofilm management in supportive periodontal therapy—a longitudinal study of RC vs. AP effectiveness

Wednesday, July 30, 2025

Professional mechanical biofilm reduction is a cornerstone of supportive periodontal therapy (SPT) for periodontitis. This study evaluated the effectiveness of two methods—rotating polishing rubber cups (RCs) and air-polishing (AP) devices—in periodontitis patients. Including 430 patients with average age 60.7 years, the study found that both methods were similarly effective in stabilizing or improving periodontal sites with PPD ≥ 5 mm. However, AP showed greater advantage in preventing PPD ≥ 5 mm deterioration in molars with furcation involvement, while RC interventions were more effective in preventing deterioration in these sites. The study highlights that both methods are effective in maintaining periodontal stability, though RC may be more favorable in specific cases. The results emphasize the importance of individualized interventions, particularly in complex root anatomy, and suggest that repeated subgingival AP application is clinically safe and effective. The study was conducted over a 5-year period, with SPT sessions once a year, and involved a comprehensive analysis of clinical parameters like PPD, furcation involvement, BOP, and dental status. All data were collected by experienced specialists following institutional guidelines.

Labels: BMC Oral Health

Impact of ISB material and angulation on digital implant impression accuracy: PEEK vs. Titanium, 0° vs. 30°.

Intraoral scanners (IOS) have revolutionized implant dentistry, offering a quicker, more efficient, and patient-friendly alternative to traditional impression methods. Digital impressions using IOS technology are increasingly common, providing significant advantages over conventional techniques, such as reduced time, enhanced comfort, and preventing material distortion. However, accuracy depends on factors including ISB material and angulation. The study evaluated the combined effect of ISB material (PEEK vs. Titanium) and angulation (0° vs. 30°) on trueness and precision of digital impressions. A factorial design was used to assess these factors, and results showed that ISB configuration significantly influenced trueness (P < 0.001) and precision (P < 0.001). PEEK ISBs demonstrated higher trueness and precision than Titanium ISBs, with PEEK 30° showing the highest trueness and PEEK 0° the best precision. Angulation did not significantly affect trueness for Titanium ISBs. The study highlights that both ISB material and angulation are critical factors, with PEEK consistently outperforming Titanium. Clinicians should consider these factors when selecting materials and IOSs for optimal accuracy. The present study aimed to assess the impact of ISB material and angulation on digital impression accuracy, leading to significant findings on their combined effect.

Labels: BMC Oral Health

Orthodontic treatment significantly improves gingival symmetry in patients with mild anterior crowding and skeletal Class I malocclusion.

The study investigates the effects of orthodontic treatment on gingival morphology symmetry in patients with mild anterior crowding and skeletal Class I malocclusion. Using digital intraoral scans, the researchers measured parameters such as mean deviation distance (MDD), root mean square (RMS), and percentage within tolerance. Significant statistical differences were observed in these measurements before and after orthodontic treatment, with a p-value < 0.001. No significant differences were found between the post-orthodontic group and the control group in most gingival symmetry parameters. However, a statistically significant difference was observed in the changes of MDD and RMS across tooth positions. Orthodontic treatment enhanced gingival contour symmetry in patients with mild anterior crowding and skeletal Class I malocclusion. A comparison of the gingival morphology symmetry in anterior teeth between post-orthodontic patients and healthy individuals revealed no statistically significant differences. This study was approved by the Biomedical Research Ethics Committee of Stomatology Hospital of Fujian Medical University (approval no. 2024-14). A smile is a reflection of coordinated facial movements, and achieving an aesthetically pleasing smile primarily requires consideration of facial aesthetics, which enables dental professionals to develop a treatment approach from the aesthetic perspective. Psychological and anthropological studies show that symmetrical faces are generally perceived as attractive and healthy [1]. Although facial symmetry enhances attractiveness, smile symmetry plays a more critical role in aesthetic perception. Studies show that a symmetrical smile enhances aesthetic resonance by reducing visual tension, while slight facial asymmetry adds charm through its personalized characteristics. Therefore, smile symmetry contributes more to overall aesthetic appeal and pleasure than facial symmetry [2]. A beautiful and symmetrical smile results from the harmonious integration of facial aesthetic factors [3] and oral aesthetic factors [4], with oral symmetry playing a decisive role in the visual appeal of a smile [5,6,7]. Darby’s study demonstrated that oral symmetry can significantly enhance the beauty and pleasantness of a smile, even when there are slight asymmetries in other facial areas [8]. Similarly, well-aligned teeth and symmetric gingival morphology are considered key factors in enhancing the harmony of a smile [9,10,11,12,13]. In oral aesthetics research, Pham and Nguyen [14] further confirmed that symmetry in gingival morphology significantly impacts the visual attractiveness of a smile. Zhang [15] indicated that the dynamic symmetry of the gingival contour during smiling greatly influences the perception of gingival aesthetic parameters. Collectively, these studies highlight the crucial role of gingival symmetry in improving the aesthetic appeal of a smile, which complements overall smile symmetry. In orthodontic treatment, the alignment of teeth and aesthetic improvement in patients with malocclusion are often the primary concerns of both clinicians and patients. However, the critical factor of gingival symmetry changes is frequently overlooked. Maxillary anterior crowding (MxAC) is a common issue in orthodontic treatment [16], characterized by labial or buccal displacement of the canines and palatal displacement of the lateral incisors [17]. This type of malocclusion is mainly caused by a mismatch between tooth size and arch length, not only leading to functional problems [18] but also significantly impacting the patient’s aesthetic appeal [19]. Orthodontic treatment can typically improve the symmetry of tooth alignment and enhances overall aesthetics [20]. However, existing studies indicate that in some orthodontic patients, after teeth are properly aligned, the visual aesthetic balance may be compromised due to asymmetry of the gingival margin in either the vertical or horizontal planes [21, 22]. This asymmetry can reduce the aesthetic outcome of orthodontic treatment and negatively affect patient satisfaction. At the same time, we understand that laser therapy has potential in reshaping gingival contours and enhancing gingival symmetry [23, 24]. Currently, most research on smile aesthetics in malocclusion patients focuses on the impact of orthodontic treatment on tooth symmetry, while the symmetry and changes in gingival morphology before and after orthodontic treatment have not received sufficient attention. With advancements in digital oral scanning technology, obtaining high-precision and reproducible 3D models of the oral cavity now provides comprehensive three-dimensional data on tooth and gingival morphology [25]. Through reverse engineering techniques and 3D surface matching algorithms, deviation analyses can be conducted to derive three-dimensional symmetry assessments [6, 26,27,28]. A review of the current literature indicates that there are limited methods or studies available that objectively assess gingival morphological symmetry within the dental arches of orthodontic patients before and after treatment. This study aims to assess changes in gingival morphological symmetry before and after orthodontic treatment in patients with mild anterior crowding and skeletal Class I malocclusion using digital models, to explore the impact of orthodontic treatment on gingival symmetry. The null hypotheses of this study are: (1) There is no significant difference in gingival contour symmetry in patients with mild anterior crowding and skeletal Class I malocclusion before and after orthodontic treatment; and (2) After orthodontic treatment, gingival symmetry in patients with mild anterior crowding is not significantly different from that of individuals with normal occlusion. The current retrospective study was ethically reviewed and approved by the Biomedical Research Ethics Committee of Stomatology Hospital of Fujian Medical University, China (approval no. 2024-14).

Labels: BMC Oral Health

Evaluation of Endocan biomarker levels in peri-implant crevicular fluid: a cross-sectional study.

Tuesday, July 29, 2025

This study evaluates Endocan, an endothelial-derived protein, for its ability to discriminate between healthy and pathological peri-implant tissues and its diagnostic potential in peri-implant disease. A cross-sectional analysis of 62 peri-implant sites from 62 individuals, including 31 healthy sites, was conducted using clinical and radiographic parameters. The PICF was collected using a paper point methodology, and Endocan was quantified via enzyme-linked immunosorbent assay. Statistical analysis included multivariable linear regression models to assess associations between disease status and Endocan levels, adjusting for demographic factors. Results showed that healthy sites had the lowest Endocan levels (643.66 ± 128.49 ng/L), while peri-implantitis sites showed significantly elevated concentrations (841.83 ± 62.72 ng/L, p < 0.001). Peri-implant mucositis sites were not significantly different from healthy sites. Modeling revealed that peri-implantitis correlated with increased Endocan concentrations (B = 187.74, p < 0.001), while peri-implant mucositis showed no significant association. The study suggests that Endocan could serve as a biomarker for peri-implantitis, distinguishing between advanced pathology and mucositis. However, minimal research has examined Endocan concentrations in peri-implant tissues, and its potential for distinguishing between different stages of peri-implant disease remains unexplored. The null hypothesis assumes no significant variation in Endocan between healthy and pathological peri-implant locations. To assess and compare Endocan values in peri-implant crevicular fluid (PICF) between healthy and diseased peri-implant locations. To assess whether Endocan levels differ between peri-implant mucositis and peri-implantitis.

Labels: BMC Oral Health

ATP6V0A4 as a novel prognostic biomarker and potential therapeutic target in oral squamous cell carcinoma

Monday, July 28, 2025

Increasing evidence indicates that the dysregulation of ATP6V0A4 is linked to aggressive behaviors in various types of cancer, including oral squamous cell carcinoma (OSCC). This study integrated data from the Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) database to identify key molecular mechanisms. Using univariate Cox regression and LASSO regression, a prognostic model was constructed, complemented by random forest algorithms to identify core genes. A multi-omics analysis strategy was employed, including pan-cancer expression profiling, protein atlas validation, GO/KEGG enrichment, and clinicopathological feature correlation analysis, as well as tumor immune microenvironment assessment and immunotherapy response prediction models. Experimental validation involved RT-qPCR to measure ATP6V0A4 expression in OSCC cell lines and plasmid transfection to establish overexpression models. The study found that low ATP6V0A4 expression is significantly associated with poor prognosis in OSCC patients, with the expression level showing a close correlation with clinical T staging. Additionally, the expression status of ATP6V0A4 is linked to the distribution and function of various immune cells in the tumor microenvironment. In vitro experiments demonstrated that overexpression of ATP6V0A4 suppresses tumor cell proliferation, migration, and invasion. OSCC patients with low ATP6V0A4 expression exhibit higher sensitivity to drugs like GDC0810, GSK591, and MK8776. This discovery provides new insights and potential therapeutic strategies for combination therapy in OSCC. Oral squamous cell carcinoma (OSCC) remains one of the most aggressive malignancies with a 5-year survival rate of 55–60% [1], significantly lower than other cancers like breast (89%) and colorectal (65%). With an aging population, its burden is projected to exceed 500,000 cases by 2035. Current protocols include surgical resection, radiotherapy, and chemotherapy, but postoperative complications are severe. Targeted immunotherapies against EGFR and PD-1/PD-L1 pathways have shown preliminary efficacy, but only 15–20% of patients benefit. Therefore, identifying specific molecular markers and mechanisms is needed for precision medicine in OSCC. V-ATPase is a multisubunit complex with a cytosolic catalytic domain (V1) and a transmembrane proton channel domain (V0). The V0 domain contains four a-subunit isoforms that regulate enzyme localization in different cellular membranes. ATP6V0A4, encoding the a4 isoform, exhibits tissue-specific expression, mainly in the kidney and epididymis. It mediates the polarized localization of V-ATPase in plasma membrane of renal α-intercalated cells, contributing to H⁺ secretion in renal tubules [7]. Recent studies show ATP6V0A4 not only acidifies acidic organelles like lysosomes and endosomes but also plays roles in vital processes such as transport, protein processing, and cotransport, as well as physiological functions like urinary acidification and bone metabolism regulation [9]. Emerging evidence highlights dual functions of ATP6V0A4 in tumor progression. In breast cancer models, high ATP6V0A4 expression was observed in invasive MDA-MB-231 cells, while siRNA-mediated gene silencing suppressed their invasive capacity [7]. Treatment with specific V-ATPase inhibitors also inhibited invasive phenotype in these cells [10]. Mechanistic studies in metastatic hepatocellular carcinoma showed that downregulation of ATP6V0A4 suppressed proton pump activity and extracellular acidification rate, leading to dual suppression of tumor growth and metastasis [11]. Notably, ATP6V0A4 expression in renal cell carcinoma suggests heterogeneous regulatory patterns across tumor types. These discrepancies may be due to factors like pH homeostasis in the tumor microenvironment, activation of invasion signaling pathways, and reprogramming of cellular energy metabolism. However, the mechanism and role of ATP6V0A4 in OSCC remain poorly understood. This study aims to clarify the role of ATP6V0A4 in OSCC and its underlying mechanisms to provide novel therapeutic targets for this disease. The corresponding clinicopathological characteristics and prognostic information of OSCC patients, including gender, age, and stage, were downloaded from the TCGA GDC database. Samples with primary sites "lip", "hard palate", "gingiva", "base of tongue", "floor of mouth", "other and ill-defined sites in lip, oral cavity and pharynx", "other and ill-defined sites of tongue", and "other and unspecified sites in oral cavity" were selected for analysis. Among them, 32 normal and 397 cancer samples were used. OSCC sequencing data were downloaded from GSE25099, a GPL5175 platform with 79 samples. The R package "limma" was used for DEG analysis. The study found that low ATP6V0A4 expression is significantly associated with poor prognosis, with the expression level showing a close correlation with clinical T staging. The expression status of ATP6V0A4 is linked to the function and distribution of various immune cells in the tumor microenvironment. In vitro experiments indicated that overexpression of ATP6V0A4 suppresses tumor cell proliferation, migration, and invasion. Patients with low ATP6V0A4 expression have higher sensitivity to drugs like GDC0810, GSK591, and MK8776. This discovery provides novel insights and potential therapeutic strategies for combination therapy in OSCC. Oral squamous cell carcinoma (OSCC) remains one of the most aggressive malignancies with a 5-year survival rate of 55–60% [1], significantly lower than other cancers like breast (89%) and colorectal (65%). With an aging population, its burden is projected to exceed 500,000 cases by 2035. Current standard treatment protocols include surgical resection, radiotherapy, and chemotherapy, but postoperative complications are severe. Targeted immunotherapies against EGFR and PD-1/PD-L1 pathways have shown preliminary efficacy, but only 15–20% of patients benefit. Therefore, identifying specific molecular markers and mechanisms is needed for precision medicine in OSCC.

Labels: BMC Oral Health

The effect of adenoid hypertrophy on growth and development in children aged 7–12: a 15-year study.

Sunday, July 27, 2025

The study analyzed radiographic data from 348 children aged 7–12 years undergoing orthodontic examination, assessing adenoid hypertrophy, growth development, and dental age using panoramic and lateral cephalometric radiographs. Adenoid hypertrophy was identified in 29.8% of patients, with significant differences in growth development levels and dental ages observed in the study group compared to the control group. Key findings indicated higher values in specific radiographic parameters (SNA, SNB, ramus height, face height ratio, and mandibular plane angle) in the study group, while Nolla dental ages were significantly delayed in patients with adenoid hypertrophy. The findings suggest that adenoid hyperplasia may negatively impact growth development, though no significant differences were found in chronological age between study groups. A multidisciplinary approach is recommended to address the effects of adenoid hyperplasia, as it can influence both dental and maxillofacial development. Growth and development are critical in treatment planning, and while some developmental differences exist within the same chronological age, biological age assessments through factors like bone age and dental maturation stages are essential. The study highlights the importance of these factors in evaluating growth and development in children, emphasizing the need for early intervention and comprehensive care.

Labels: BMC Oral Health

Clinical evaluation of 3D-printed splints in the treatment of temporomandibular disorders

Saturday, July 26, 2025

A study evaluated the effects of 3D-printed occlusal splints on TMD patients, measuring occlusal time (OT) and asymmetry in occlusal force (AOF) over three months. Key findings showed significant reductions in OT and AOF across four time points, with improvements in joint space, EMG, and VAS scores. The T-scan guided occlusal splint improved occlusal equilibration and TMJ function, while the anterior space decreased and posterior space increased. The T-scan accurately identified abnormal contact points, contributing to better treatment outcomes. Despite controversies, 3D-printed splints improve clinical symptoms by altering occlusion and jaw position. Digital technology enhances manufacturing quality and stability, while intraoral scanning reduces time and improves patient comfort. The study involved 18 TMD patients, with inclusion and exclusion criteria set to ensure accurate results. The T-scan device, used in real-time to assess occlusal contact, provided reliable data for occlusion analysis and treatment adjustment.

Labels: BMC Oral Health

Cone-beam computed tomography evaluation of root proximity in orthodontic miniscrew implants and its correlation with interradicular failure

Orthodontic miniscrew anchorage has led to a paradigm shift in orthodontics by reducing unwanted movement of anchoring teeth. The study evaluated root proximity in orthodontic miniscrew implants using CBCT, revealing that 52.4% of miniscrews failed within one month after placement. Chi-square and logistic regression analysis showed a significant correlation between root proximity and miniscrew failure, with 2.1 times higher likelihood in those with root proximity. This study confirms root proximity as a major factor in interradicular miniscrew failure and suggests a novel approach for measuring root proximity in CBCT for predicting failure. Miniscrews, as a widely used TAD, have proven effective for various insertion sites and purposes, with their design and material being well-engineered. The success rate of miniscrews has been consistently stable, with a recent systematic review showing 89.87% in maxilla and 79.24% in mandible. However, their success rate is still relatively low compared to dental implants, necessitating consideration in treatment planning. Clinical studies have investigated factors like root proximity, age, experience, and bone contact, but the measurement was either a distance or a binary classification. The amount of root proximity area was not evaluated in previous studies, and there has been no attempt to assess the relationship between proximity and miniscrew failure.

Labels: BMC Oral Health

Impact of different polishing techniques on surface roughness, gloss, and microhardness of zirconium oxide reinforced flowable bulk-fill resin composite: an in vitro study

The evaluation of surface roughness (SR), surface gloss (SG), and microhardness (VMH) of flowable bulk-fill composites reinforced with zirconium oxide fillers showed that the use of these fillers improved mechanical and physical characteristics such as surface roughness, gloss, and microhardness. The impact of material type and polishing system on these properties was significant, with surface roughness being only influenced by the polishing system. Dental resin composites are becoming popular due to their esthetic and environmental benefits, while their polymerization shrinkage is reduced. Bulk-fill composites have advantages in time-saving procedures and improved flowability, which enable easy cavity adaptation. Surface characteristics like roughness, gloss, and microhardness affect durability and clinical outcomes, and proper finishing and polishing techniques are essential for achieving a smooth and aesthetically pleasing surface. The use of different polishing systems and fillers enhances these characteristics, and proper F/P techniques ensure the best surface finish.

Labels: BMC Oral Health

Dental Anxiety in Children with and Without Disabilities: A Study in Trinidad and Tobago Reveals Patterns and Interventions

The study investigated whether dental fear and anxiety (DFA) differed among children with and without disabilities in Trinidad and Tobago. It examined the prevalence of moderate and high levels of DFA in children aged 6–18 years, using a cross-sectional survey conducted between July 2022 and February 2023. The sample included 201 parents/caregivers from children with and without disabilities, assessed using the Modified Dental Anxiety Scale (MDAS) and other covariates such as gender, age, ethnicity, accompanying adult, reasons for visits, dental attendance, and child's oral health rating. Results showed that children with disabilities had higher rates of moderate DFA compared to those without, with a significant increase in DFA levels in the 6–12 age group compared to the 13–18 group. Similarly, children with disabilities exhibited higher proportions of moderate anxiety levels than those without. Consistent with prior findings, the study highlighted that DFA is a common issue among children, affecting approximately one-third of young children globally. The findings suggest that dental fear and anxiety techniques can reduce the development and persistence of these conditions. Children with and without disabilities were found to have similar levels of anxiety in caregivers, with higher trait anxiety levels correlating with greater anxiety levels. The study emphasizes the importance of early identification and intervention in children with disabilities, as well as the role of caregivers in supporting their oral health. The study aims to provide insights into the prevalence and management of DFA in children with disabilities and highlights the need for further research in this area.

Labels: BMC Oral Health

24-month randomized controlled clinical trial assessment of surface texture, color stability, and marginal discoloration of sonic-activated bulk-fill resin composite (BFRC) according to USPHS and FDI criteria

The study assessed the surface texture, color stability, and marginal discoloration of sonic-activated bulk-fill resin composite (BFRC) compared to non-sonic-activated BFRC over 24 months, using two evaluation criteria. Sixty restorations each in the Sonicfill 3 and X-tra fill groups were evaluated at baseline, 3, 6, 12, and 24 months. Clinical outcomes were non-significant between the two groups, with all restorations considered clinically successful by USPHS or FDI criteria. The surface texture, color stability, and marginal discoloration of both tested BFRCs were considered clinically successful, either with or without sonic energy. The criteria used were reliable, comparable, and suitable for evaluating RC restorations. The study registered at www.clinicaltrials.gov and has a unique identification number NCT04926883. The current use of resin composites as dental restorations is increasing, with adhesive restorative materials offering minimal invasiveness and preserving tissues. Evidence supports the success of direct and light-polymerized RC restorations in posterior teeth [1]. Their advantages include affordability, longevity, and aesthetic and mechanical properties, which meet patients' increasing aesthetic expectations [2, 3]. Manufacturers improve physical and optical properties of RCs to mimic natural teeth and make handling easier [4]. Despite these improvements, polymerization shrinkage remains a challenge. While there are ideas to reduce this, placing RC materials with a 2-mm layering technique is recommended [1, 5, 6]. However, deep cavity restoration with incremental technique requires time, and postoperative sensitivity may occur [7]. The BFRC was designed to handle a single increment of 4–5 mm for efficiency. Shorter curing times and deeper cure depth can result from optimizing the light-curing composite’s photo-initiator system, reducing layers and minimizing polymerization shrinkage [7, 8]. Sonicfill RC, introduced with a sonically activated handpiece, reduces its viscosity, allowing for thicker restorations. Although less translucent than conventional BFRCs, depth of polymerization does not depend solely on translucency [9]. One drawback is color change due to intrinsic or extrinsic factors, making shade selection and color stability crucial for long-term restorability [4]. The Ryge or USPHS criteria and their modifications play important roles in evaluating clinical performance and applicability of restorations [10, 11, 12, 13, 14, 15, 16]. The success rate of restorations according to these criteria depends on their clinical acceptability. The USPHS and FDI guidelines are the most commonly used criteria for evaluating RC restorations [10, 11, 12, 17, 18, 19]. Criteria such as color matching, marginal discoloration, surface structure, retention, marginal integrity, anatomic form, secondary caries, and postoperative sensitivity are clinically significant for dental restorations. The defined properties according to modified USPHS criteria are evaluated with Alpha, Bravo, Charlie, and Delta scores, where Alpha indicates the best score and Delta the worst [12].

Labels: BMC Oral Health

Retrospective panoramic radiograph evaluation of acute leukemia patients with fractal analysis.

Friday, July 25, 2025

The aim of this study is to examine changes in the trabecular structure of jaw bones in acute leukemia (AL), which can cause extensive osteopenia using Fractal Analysis (FA). Panoramic images of 45 patients with AL, who had no additional disease affecting the bone, were used as the case group. Control images of 45 patients without bone disease were used for analysis. For each image, 4 regions of interest (ROI) were identified in two anterior and two posterior areas of the mandible. FA was applied to these ROIs, and results were analyzed statistically. The case group showed significantly lower FA values compared to the control group. Gender had no effect on FA values, and there was no correlation between age, blood values, or FA values. The changes in bone structure from AL can be detected with FA, and gender and age had no impact on FA values. There is no correlation between blood values and FA values. AL causes osteopenia, leading to reduced trabecular complexity, as trabecular jawbone has a high bone turnover rate. Diseases affecting internal organs may show signs in dental structures. Dentists may first suspect systemic diseases based on early signs in oral cavity. Oral structures such as teeth, jaws, oral mucosa, and temporomandibular joints can be affected by metabolic, endocrine, or vascular disorders. Leukemia, a significant blood disease, involves malignant anomalies in hematopoiesis. When normal hematopoiesis is disrupted, mutations occur in early precursors, leading to uncontrolled proliferation. These malignant cells spread throughout the body [1, 2]. Although leukemia classification is complex, it is clinically divided into acute and chronic forms. Acute leukemia (AL) is particularly significant as it is the most common malignancy in childhood. The disease progresses rapidly without treatment, often with a poor prognosis. Radiographically, extensive osteopenia of bones can be seen in AL. Jaw involvement is more common in developing teeth and manifests as rarefied osteitis in periapical regions. Radiographic features include poorly defined radiolucent areas and, in some cases, onion-skin-like periosteal new bone formation. Destruction of the cortical border of lamina dura and follicular structures may occur, and erupting teeth may change position [1, 2]. Panoramic imaging (PI) is a two-dimensional diagnostic tool used to evaluate large areas of the jaws. PI is simple, practical, and cost-effective. Beyond assessing dental structures, bone morphology can be analyzed, and various methods are used for analysis. Fractal analysis (FA) is a statistical texture analysis technique based on fractal mathematics, measuring self-similarity and complexity. It measures shapes—curves, points, and surfaces—that cannot be represented by conventional geometry but exhibit fractal features. FA has been used to describe shapes in biological images. It is non-invasive, accessible, and cost-effective. As a result, its use in medicine and dentistry continues to grow. The validity and reliability of FA in dental studies have been reported, especially in evaluating bone structure. Many studies have explored FA's use to detect osteoporotic changes in the jaw bones associated with metabolic diseases. The image of internal alveolar bone resembles a lattice formed by thin spicules, trabeculae, and lamellae. Trabecular bone features a branching structure with fractal characteristics, such as self-similarity and scale invariance. Measuring fractal dimensions using fractal geometry allows information on subtle changes in three-dimensional trabecular bone to be obtained from two-dimensional images using FA values [14]. This enables detection of changes in bone structure from two-dimensional images using fractal parameters. Various pathological conditions may alter anatomical structures, and these changes can be detected with fractal parameters [12, 16]. The aim of our study was to examine changes in the trabecular structure of jaw bones affected by AL using FA.

Labels: BMC Oral Health