Odovtos - International Journal of Dental Sciences
Odovtos – International Journal of Dental Sciences (Odovtos-Int J Dent Sc) is the official scientific publication of the Faculty of Dentistry, University of Costa Rica. The main objective of this peer-reviewed journal is to disseminate original and transcendental knowledge in the field of dentistry and its specialties. Odovtos-Int J Dent Sc primary readership consists of dentists, dental educators, academics, dental students, researchers, health professionals and general public interested in expanding their knowledge in the area. Our journal consider unpublished and original manuscripts in ENGLISH with a prominent focus on critical and innovative data, promoting major clinical, academic and scientific research, based on International Committee of Medical Journal Editors (ICMJE) recommendations. Odovtos - Int J Dent Sc offers Online-First publication, allowing frequent dissemination of its content. You can access our Journal Normalized Citation Impact and Citation Impact in InCites-Clarivate: Incites - Clarivate Citation Impact 2023 JCR Impact Factor list of Clarivate Analytics: 0.6. Qualis 3 SCOPUS WHY SUBMIT YOUR PAPER TO OUR JOURNAL? Odovtos – International Journal of Dental Sciences compromises to disseminate their contents worldwide, through collaborations with several Dental Schools, online databases, index and repositories, website, social media, among others. All submitted manuscripts are peer-reviewed based solely on the criteria of quality, innovation and pertinence. The pre-publication process is brief due to online submission. Moreover, Odovtos-Int. J. Dent. Sc. is an Online-First Journal, which allows frequent publication in Internet according to Open Access Initiative, favoring the diffusion of its content. Journal indexed: ODOVTOS is indexed in Clarivate Analytics with a 2023 JCR Impact Factor list of Clarivate Analytics: 0.6. <a href="https://www.scimagojr.com/journalsearch.php?q=21101088429&tip=sid&clean=0#:~:text=%3Ca%20href%3D%22https%3A//www.scimagojr.com/journalsearch.php%3Fq%3D21101088429%26amp%3Btip%3Dsid%26amp%3Bexact%3Dno%22%20title%3D%22SCImago%20Journal%20%26amp%3B%20Country%20Rank%22%3E%3Cimg%20border%3D%220%22%20src%3D%22https%3A//www.scimagojr.com/journal_img.php%3Fid%3D21101088429%22%20alt%3D%22SCImago%20Journal%20%26amp%3B%20Country%20Rank%22%20%20/%3E%3C/a%3E"> Our journal is also indexed in: Scopus SCIELO REDALYC DOAJ LATINDEX LILACS DIALNET ESCI-CLARIVATE ANALYTICS REDIB PERIODICA ICJME MIAR ROAD BIBLAT EUROPUB EBSCO PROQUEST ULRICHS COPAC PKP INDEX JOURNAL TOCS DRJI DAIJ J-GATE INDEX COPERNICUS
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Oral Care and Lifestyle Habits in Correlation with Glycated Hemoglobin in Type 2 Diabetes Mellitus
Type 2 diabetes mellitus is a multifactorial pathology and a major public health problem. The objetives were to determine the correlation between oral care practices according to glycated hemoglobin and to determine how lifestyle habits correlate with glycated hemoglobin in type 2 diabetes mellitus. An observational and cross-sectional study was carried out through a survey of 420 patients with type 2 diabetes mellitus. The participants were divided into two groups. With glycosylated hemoglobin greater than 7% as uncontrolled type 2 diabetes mellitus and with glycosylated hemoglobin equal to or less than 7% as controlled type 2 diabetes mellitus. It was found that in uncontrolled type 2 diabetes mellitus, 84.5% had bad practices and 90.0% bad lifestyle habits. Patients with uncontrolled type 2 diabetes mellitus who develop poor oral care practices had a mean glycosylated hemoglobin of 9.2%, 95% CI (7.4-11.0). Patients with uncontrolled type 2 diabetes mellitus who develop poor lifestyle habits had a mean glycosylated hemoglobin of 9.2%, 95% CI (7.4-11.0). There is a good and negative correlation between glycated hemoglobin and lifestyle habits (Rho=-0.774 and p<0.001). There is a moderate and positive correlation between glycated hemoglobin and oral care practices (Rho=0.561 and p<0.001). There is a moderate and negative correlation between oral care practices and lifestyle habits (Rho=-0.533 and p<0.001). It was concluded that a person with type 2 diabetes mellitus who maintains good oral care practices may improve their glycated hemoglobin values. The development of good lifestyle habits maintains a normal glycosylated hemoglobin.
HbA1c; Type 2 diabetes; Public health; Oral hygiene; Lifestyle; Hyperglycemia.
Copyright (c) 2026 Jorge R. Colchado-Carhuavilca, Dilma F. Leon-Morales, Carmencita Bardales-Hidalgo, Carla Figueroa-Mercado, Rosario L. Calle-Gonzales. https://creativecommons.org/licenses/by-nc-sa/4.0
Relationship of Periapical Radiolucencies with the Quality of Root Canal Treatment: A CBCT Study on an Iranian Population
This study aimed to assess the relationship of periapical (PA) radiolucencies with the quality of root canal treatment (RCT) using cone-beam computed tomography (CBCT) scans of an Iranian population. This cross-sectional study was conducted on 200 endodontically-treated teeth on CBCT scans retrieved from a radiology clinic in Qazvin, Iran. The sagittal, coronal, and axial views were evaluated by an endodontist and a trained senior dental student for root canal procedural errors and presence/absence of PA radiolucency in the respective teeth. The association of PA lesions with age, gender, jaw, tooth type, presence/absence of coronal restoration, and RCT quality was analyzed by the logistic regression model (alpha=0.05). The frequency of poor-quality RCT was 75.3% in teeth with a PA radiolucency, and 15.5% in teeth without it. A significant association was found between the quality of RCT and PA radiolucencies (P<0.001). Absence of coronal restoration also had a significant association with the presence of PA radiolucencies (P<0.001). Of the procedural errors, perforation, under- and over-obturation, low obturation density (voids), and canal transportation were significantly associated with the presence of PA radiolucencies (P<0.05). The RCT quality had a significant association with development of PA radiolucencies, such that procedural errors and absence of coronal restoration were associated with a significantly higher frequency of PA lesions.
Cone-beam computed tomography; Root canal therapy; Periapical periodontitis; Periapical granuloma.
Copyright (c) 2026 Maryam Abdollahi, Marjan Bolbolian, Maryam Tofangchiha, Pooya Rasti, Zahra Keshavarzi, Ahad Alizadeh, Rodolfo Reda, Luca Testarelli. https://creativecommons.org/licenses/by-nc-sa/4.0
CD44+ Cells Influence Oral Squamous Cell Carcinomas in Two Comparative Age Groups
Head and neck cancer (HNC) is the sixth most common malignancy worldwide, with high morbidity and mortality rates mainly due to delayed diagnosis. Cancer stem cells (CSCs) are involved in HNC progression and treatment response, carrying important therapeutic and prognostic implications. CD44, a transmembrane glycoprotein linked to cartilage, has been proposed as a CSC biomarker and is associated with cancer progression and poor survival. CSCs may also play a role in oral carcinogenesis among young individuals. This retrospective cross-sectional study aimed to identify CD44+ cells in oral squamous cell carcinoma (OSCC) across two age groups. Thirty-six OSCC cases from a teaching service for oral histopathological diagnosis were identified between January 2005 and December 2019. Cases were divided into two groups: young group (17 patients aged ≤ 40 years) and adult/elderly group (19 patients aged ≥ 41 years). Histological slides were obtained and stained using the hematoxylin and eosin technique and the immunohistochemical technique with anti-CD44 antibodies. In the young group, males predominated (70%) with the gingiva as the main site (9 cases), while the adult/elderly group had more females (52.5%), with eight cases on the tongue. Both groups primarily showed well-differentiated OSCC. In both groups, islands of CD44+ cells, characterized by large, basophilic nuclei and scant cytoplasm, were identified in the stroma. No significant association was found between CD44 immunoreactivity and age, sex, location, or differentiation degree (P > 0.05). The identification of CD44+ could contribute to improving the diagnosis and prognosis of oral cancer, and eventually offer targeted therapies.
Cancer stem cells; CD44+ cells; Oral cancer; Oral squamous cell carcinoma; Invasive tumor front.
Copyright (c) 2026 Francisco G. Villanueva-Sánchez, Patricia González-Alva, Diana I. Rivera-Reza, Luis A. Gaitán-Cepeda. https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Surgical and Non-surgical Periodontal Therapy on Renal Function and Inflammatory Biomarkers and Mortality in Patients with Chronic Kidney Disease: An Umbrella Review
Periodontitis and chronic kidney disease (CKD) share common pathophysiological mechanisms, with periodontitis acting as a chronic inflammatory comorbidity that exacerbates systemic inflammation in CKD patients. This study aimed to analyze the effect of surgical and non-surgical periodontal therapy on renal function, inflammatory biomarkers, and mortality in patients with CKD according to the available evidence. An umbrella review was conducted, including systematic reviews and meta-analyses from databases such as PubMed, Clinical Key, Scopus, Cochrane, Scielo, and Google Scholar. Methodological quality was assessed using AMSTAR-2, and reporting quality with PRISMA. Five systematic reviews and meta-analyses, encompassing 21 primary studies, were analyzed. The evidence indicates that periodontal therapy significantly reduces systemic inflammatory biomarkers like IL-6 and C-reactive protein, while also improving renal function markers, including an increased glomerular filtration rate. Non-surgical periodontal therapy was associated with a statistically significant reduction in mortality and cardiovascular-related morbidity, especially with intensive therapy and follow-up. These findings suggest that periodontal treatment may benefit renal health by reducing systemic inflammation and lowering mortality risks linked to cardiovascular complications. However, the heterogeneity of study designs and analyzed variables limits the ability to draw definitive conclusions. Future high-quality research is necessary to clarify these associations.
Biomarkers; Kidney failure; Periodontitis; Systematic review; Periodontal diseases; Umbrella review.
Copyright (c) 2026 nny Marcela Vivares-Builes, María Teresa Pertúz-Rondón, German Márquez-Toro, Carlos Pizarro-Herrera, Andrés Alonso Agudelo-Suarez, Carlos M. Ardila. https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of Different Concentrations of Triple Antibiotic Paste Used in Root Canal Disinfection on the In Vitro Formation of Enterococcus faecalis Biofilms
Enterococcus faecalis biofilms are a major cause of persistent endodontic infection and treatment failure. Triple antibiotic paste (TAP) is widely used, yet the optimal concentration that maximizes antibiofilm efficacy while minimizing cytotoxicity remains uncertain. This study aims to determine the minimum inhibitory concentration (MIC) of a modified TAP (ciprofloxacin–metronidazole–amoxicillin) against E. faecalis and to evaluate the effect of clinical and subinhibitory (sub-MIC) concentrations on in vitro biofilm formation. E. faecalis was cultured in brain heart infusion. MIC was determined by broth microdilution with resazurin as a viability indicator. Biofilm assays were performed in 96-well plates preconditioned for antibiotic adsorption. Standardized inocula were incubated 48 h (with medium renewal at 24 h). Biofilms were detached by sonication, serially diluted, drop-plated on BHI agar, and enumerated as CFU/mL. Percentage biofilm reduction was calculated relative to growth controls. Experiments were run in triplicate. The MIC of TAP against planktonic E. faecalis was 0.038 µg/mL. All concentrations tested reduced biofilm formation significantly versus MIC. Sub-MIC levels of 0.076 and 3.0 µg/mL produced similar reductions (p > 0.05). Higher sub-MIC concentrations—6.1, 24, and 49 µg/mL—achieved reductions approaching 100%, comparable to the clinical concentrations of 1000 and 2500 µg/mL (p > 0.05). Findings reveal a dose-dependent antibiofilm effect and highlight that some sub-MIC exposures can outperform the MIC for biofilm control. TAP exhibits a dose-dependent antibiofilm effect against E. faecalis, and concentrations below those commonly used clinically can markedly suppress biofilm formation in vitro. Sub-MIC levels equivalent to 1/1280, 1/640, and 1/160 of the MIC showed outstanding efficacy, suggesting the potential for lower-dose TAP protocols that preserve antibacterial activity while reducing adverse effects and antimicrobial resistance risk. Further studies must validate sub-MIC TAP regimens in multispecies biofilms and clinical settings.
Enterococcus faecalis; Biofilms; Anti-Bacterial Agents; Endodontics; Microorganisms; Root Canal Therapy.
Copyright (c) 2026 Eliana Pineda-Vélez, Claudia María Bedoya-Correa, Carlos M. Ardila. https://creativecommons.org/licenses/by-nc-sa/4.0
Optogenetics Era in Oral and Maxillofacial Field
Optogenetics is an interdisciplinary field that blends genomics and optical technology to regulate gene expression and biological processes. It offers advantages such as precise control over timing and placement, low invasiveness, and excellent efficiency. This procedure is enabled by photosensory proteins that have been genetically engineered to change form when exposed to light. As a result, optogenetic technologies provide important insights into a variety of biological mechanisms, ranging from subcellular and cellular processes to brain circuitry and behavioural patterns. This review will discuss the evolution of optogenetics and recent advances in its application in oral and maxillofacial studies. We will also look at how optogenetics has affected preclinical studies. While the scope of optogenetic techniques grows, obstacles remain in their application to oral and dental research.
Optogenetics; Genes; Oral; Maxillofacial.
Copyright (c) 2025 Nehad M. Abd-elmonsif, Sherif Gamal. https://creativecommons.org/licenses/by-nc-sa/4.0
Dentistry and Generation Z: Aspirations of Recent Graduates
Currently, the vast majority of dental students and recent graduates belong to Generation Z (born since 1996). They have been characterized by solving problems with their creativity and the use of technological resources. It is important to be aware of their perceptions regarding their experiences, future plans and aspirations. The aim of the study was to analyze the professional aspirations of recent graduates of Dentistry, belonging to Generation Z who studied at a University in Mexico. Descriptive, observational and cross-sectional study based on a survey developed in Google Forms, consisting of questions about demographic data, professional aspirations and motivations of recent graduates of Dentistry. The database was organized in Microsoft Excel. The final data were analyzed with STATISTICS software, using the chi-square test to compare proportions of categorical variables between groups. A value of p<0.05 was considered statistically significant. The sample of 107 responses consisted of 85 females and 22 males, and the average age was 23.7 years. The most important findings were that 100% of the recent graduates planned to continue with their dental profession, the majority had plans to start a Postgraduate Program and work in private practice as owners or associates. There were statistically significant differences regarding their mobility plans, and personal growth was identified as their main motivation. The findings of the study demonstrate that the recent graduates of Dentistry belonging to Generation Z are determined to continue their professional training with great efforts to carry out a quality clinical practice for the benefit of society.
Aspirations; Dental education; Generation Z; Recent graduates.
Copyright (c) 2025 Hiram Daniel López-Santacruz, Juan Manuel Guízar-Mendoza. https://creativecommons.org/licenses/by-nc-sa/4.0
Effectiveness of Distraction Techniques for Pain Management During Dental Anesthesia in Pediatric Procedures
To compare the effectiveness of distraction techniques in pain management during the administration of dental anesthesia in pediatric procedures. This observational, longitudinal, and descriptive study included a sample of 64 pediatric patients: 36 females (56.25%) and 28 males (43.75%), with an average age of 7.3±1.5 years. The participants were divided into two groups: one using audiovisual distraction (32 patients) and the other using audio distraction (32 patients). Pain levels were assessed using the Wong-Baker scale before and after the procedure, and the SEM scale during the procedure. Based on the SEM scale, no statistically significant differences were observed between the two techniques during the procedure (p>0.05), indicating equal effectiveness. Similarly, the Wong-Baker scale showed no statistically significant differences (p>0.05) in pain perception after the procedure between the two techniques. Both audiovisual and audio distraction techniques are effective for pain management during the administration of dental anesthesia in pediatric patients.
Child behavior; Behavior therapies; Dental anesthesia; Audiovisual aids; Visual analog scale.
Copyright (c) 2025 María José Bardales Martínez, Galadriel Avril Coronado Caycho, Rossmary Navarro-Betetta. https://creativecommons.org/licenses/by-nc-sa/4.0
Maxillofacial Fractures in a Hospital in the State of Chiapas, Mexico: Cross Sectional Study
Fractures of the maxillofacial complex represent one of the most relevant health challenges at present, given their high incidence and cost to public health. In order to analyze the management of maxillofacial fractures treated in a public hospital in Chiapas, Mexico, during 2022, a cross-sectional study was carried out through interviews, clinical reviews, and records of patients treated with some type of maxillofacial fracture during the study period in the aforementioned hospital. The necessary information was obtained to meet the objectives. The main etiology was traffic accidents (65.9%). The main affected area was the lower third of the face (65.9%). A statistical association was found between the imaging study used, fracture treatment, specialist intervention, and type of patient management with the anatomical area of the fracture. Therefore, the epidemiological characteristics found were similar to those reported in the international literature. The management given to the fractures was according to their location.
Community health indicators; Maxillofacial fractures; Public health case management; Epidemiology; Mexico.
Copyright (c) 2025 Juan Carlos Nájera-Ortiz, Juan José Hernández-Martínez, Guadalupe Cartas-Fuentevilla. https://creativecommons.org/licenses/by-nc-sa/4.0
Photobiomodulation and Antimicrobial Photodynamic Therapy as Adjuvant Strategies in Medication-Related Osteonecrosis of the Jaws: A Narrative Review
Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive and antiangiogenic therapies, characterized by persistent bone exposure, pain, and infection. Its multifactorial pathophysiology involves alterations in bone remodeling, angiogenesis, immune response, and local infection. In this context, light-based adjunctive strategies such as photobiomodulation therapy (PBM) and antimicrobial photodynamic therapy (aPDT) have emerged, showing promising outcomes in early stages of the disease. This narrative review examines the available scientific evidence on the use of PBM and aPDT in the prevention and treatment of MRONJ. A literature search was conducted in PubMed, Scopus, and Google Scholar up to April 2025. PBM acts by stimulating mitochondria and modulating inflammation, thereby enhancing wound healing and bone regeneration. aPDT combines localized antimicrobial effects with tissue biostimulation, proving effective in infected lesions resistant to antibiotics. Both therapies have demonstrated clinical benefits in early-stage MRONJ and in preventive settings, particularly when combined with minor surgical procedures and autologous biomaterials. Despite their potential, the current literature mainly consists of observational studies and case reports, which limits the strength of the evidence. Randomized controlled trials and standardized protocols are necessary to validate their routine use in clinical practice. PBM and aPDT represent safe, minimally invasive, and well-tolerated therapeutic options with relevant applications in patients at high risk of developing MRONJ or those with early-stage established disease.
Osteonecrosis; Jaw; Photodynamic therapy; Photobiomodulation; Bisphosphonates; Wound healing.
Copyright (c) 2025 Ramsés B. Palma Suarez, Manuel F. Concha Vera, Matías Dallaserra Albertini. https://creativecommons.org/licenses/by-nc-sa/4.0
Influence of Thermal Treatment on Fracture Due to Cyclic Fatigue of Rotary Files
The objective of this study aimed to assess the cyclic fatigue fracture of ZenFlexTM, ProTaper GoldTM, and HyFlexTM. EDM rotary files in simulated curved canals, along with evaluating their physicochemical properties and thermal behavior. A total of 69 instruments from three different NiTi rotary file systems were utilized: ProTaper GoldTM (08/25), HyflexTM EDM (08/25), and ZenflexTM (06/25). The analysis consisted of four phases: Phase 1 involved SEM observation to detect manufacturing defects; Phase 2 focused on cyclic fatigue-induced fracture in a curved canal with a 60° radius of curvature of 2 mm and a diameter of 1.5 mm; Phase 3 encompassed SEM observation of the fractured fragment and obtaining a fractographic study; Phase 4 included physicochemical characterization, such as equiatomic relationships by Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES), phase transformation by DSC, crystalline structure by X-ray diffraction, and morphological analysis by SEM. Microcracks and defects were observed on cutting edges of ZenFlexTM and ProTaper GoldTM files. The mean cycles to fracture were 2814.50±161.58, 2649.94±120.93, and 1362.89±88.33 for HyFlexTM, ZenFlexTM, and ProTaper GoldTM, respectively. Moreover, different phase transition temperatures were noted, with ZenFlexTM in the austenite phase, ProTaper GoldTM in martensite, and HyFlexTM in the R phase at room temperature, as corroborated by X-ray diffraction. Additionally, a quasi-equimolar relationship was observed for the different systems, with ZenFlexTM exhibiting a reduced helical angle, followed by HyFlexTM and ProTaper GoldTM. ZenFlexTM files demonstrated greater resistance to cyclic fatigue, which appeared to be attributed to their physicochemical properties, heat treatment, and design.
Austenite; Martensite; Cyclic fatigue; HyFlexTM EDM; ZenFlexTM; Protaper GoldTM.
Copyright (c) 2025 María Verónica Méndez-González, Amaury Pozos-Guillén, María Concepción Betanzos-Juárez, Alejandra Izquierdo-Orozco, César Gaitán-Fonseca, Vladimir Alonso Escobar-Barrios, Mariana Gutiérrez-Sánchez. https://creativecommons.org/licenses/by-nc-sa/4.0
Dental Findings in Goltz Syndrome: A Case Report and Literature Review
Goltz syndrome or Focal dermal hypoplasia, is a genetic polymorphic cutaneous disorder with highly variable anomalies affecting the eyes, central nervous system, urinary system, gastrointestinal system, cardiovascular system, and craniofacial and dental complex. It is transmitted as an X-linked dominant trait. Clinical signs include cutaneous atrophy and periorificial papillomas that commonly appear around the mouth, genitals, and/or anus, include onychodystrophy and cicatricial alopecia, bone disorders, such as syndactyly, ectrodactyly, and/or aplasia of fingers in the hands or feet, are present from birth, scoliosis, hypoplastic clavicles and ribs, and thoracic deformation. This syndrome is associated with dental abnormalities that may include malocclusion, oral papillomas, and enamel defects. It affects tissues derived from both the ectomesenchyme. The objective of this study was to provide a narrative review of the oral cavity findings described in Goltz syndrome and present a case report.
Goltz syndrome; Focal dermal hypoplasia; Oral manifestations.
Copyright (c) 2025 Adriana De la Torre, Santiago Torres-Morales, Juan Pablo López Salazar, Alexandra Mariño, Laura Sanabria. https://creativecommons.org/licenses/by-nc-sa/4.0
Protective Effect of Quinoa Extract on Periodontium and Serum YKL-40 Levels of Albino Rat Depression Model
The research was done to explore the influence of quinoa extract on periodontium, and to assess serum YKL-40 level in a depression rat model. An overall number of 30 male albino rats weighing170-180 g were used. Animals were grouped into three categories; group I: control group, group II: depressed group, group III: depressed group treated with 600 mg/kg body weight quinoa extract. The experimental duration extended to a period of 21 days. Blood samples obtained from the heart were transported to biochemistry tubes for ELISA analysis following euthanization. Mandibular molar region specimens were subjected to decalcification for histological evaluation. Quinoa extract ameliorated the degenerative changes of periodontium in the experimental depression model, increased body weight and serum serotonin level, and decreased serum cortisol and YKL-40 levels. Quinoa extract may be utilized as a preventative measure against the periodontal damage brought on by depression.
Depression; Periodontium; YKL-40; Quinoa extract.
Copyright (c) 2025 Nehad M. Abd-elmonsif, Sherif Gamal, Mona El Deeb. https://creativecommons.org/licenses/by-nc-sa/4.0
Knowledge-Aware Graph Neural Networks for TRPV1 Drug-Gene Associations in Periodontal Pain
TRPV1 (Transient Receptor Potential Vanilloid 1) is a critical protein in the pathogenesis of periodontal pain, activated by noxious stimuli and inflammatory mediators associated with periodontitis. This study investigates drug-gene interactions involving TRPV1 to elucidate its role in periodontal pain mechanisms. Knowledge Graph Neural Networks (KGNNs) were employed to model and analyze the complex relationships between drugs, genes, and pain receptors in periodontal tissues. By leveraging biological datasets, including TRPV1 channel activity, pain receptor interactions, and gene expression profiles, the study aims to identify potential therapeutic targets and strategies for personalized pain management in periodontal treatment. Differentially expressed genes (DEGs) were integrated with drug and gene associations to model biological systems and inform therapeutic development. The study utilized a gene expression dataset encompassing features such as gene similarity scores, adjusted p-values, and biochemical activity. A semantic similarity-based fusion approach was applied to enhance model performance by incorporating biological information layers, improving interaction modeling, and promoting efficient information propagation. Three graph-based models were employed: Graph Convolutional Network (GCN) as a baseline, Residual GCN (ResGCN) for stability, and Attention-based GCN (AttGCN) for dynamic node weighting. Among the models, ResGCN demonstrated superior performance with an accuracy of 93.75% and the lowest final loss, highlighting its robustness in predicting drug-gene associations. This outcome supports the potential utility of ResGCN in accurately modeling TRPV1-mediated pain mechanisms and guiding therapeutic decisions. The application of KGNNs has provided valuable insights into TRPV1 drug-gene interactions in the context of periodontal pain. The findings emphasize the potential for using ResGCN in therapeutic discovery and optimization. However, challenges such as data quality and biological complexity remain.
Periodontal pain; TRPV1; Graphs; Neural networks; Knowledge graphs.
Copyright (c) 2025 Pradeep K. Yadalam, Saravagya Sharma, Carlos M. Ardila. https://creativecommons.org/licenses/by-nc-sa/4.0
Enhanced Hierarchical Attention Network-Based Drug-Gene Association for Angiotensin Receptors in Periodontal Inflammation
Periodontal inflammation, a chronic condition affecting teeth and supporting structures, is linked to cardiovascular disease. The renin-angiotensin system plays a crucial role in inflammation and oxidative stress, with AT1 and AT2 receptors affecting vascular functions and inflammatory responses. This study aims to utilize angiotensin receptors in periodontal inflammation through enhanced hysterical attention network-based drug-gene association. Data preprocessing is crucial for ensuring the quality and reliability of drug and gene data, particularly in research involving angiotensin receptors, by identifying duplicates and correcting inconsistent formats. Cytoscape was utilized to import drugs and genes linked to angiotensin receptors, thereby constructing and analyzing a network. The Hierarchical Attention Network is an innovative framework for processing structured data with hierarchical relationships. It is suitable for tasks where features can be organized into multi-level structures. The network, with 1,172 nodes and 4,315 edges, has efficient communication, low density, significant connectivity variance, moderate centralization, and four connected components, with a 1.531-second analysis time. The model's R² score is 0.3631, indicating that the features can explain 36.31% of the target variable's variance. However, the model's predictions are about 0.8013 units away from actual values, suggesting room for improvement. Integrating hierarchical attention networks in deep learning models is promising for predicting drug and gene interactions in angiotensin receptors in periodontal inflammation.
Angiotensin; Cytoscape; Cardiovascular disease; Drug-gene associations; Periodontal inflammation; Deep learning; AT1/AT2 receptors.
Copyright (c) 2025 Pradeep K. Yadalam, Carlos M. Ardila. https://creativecommons.org/licenses/by-nc-sa/4.0
Digital Transfer of the Emergence Profile After Immediate Implant Placement with Hard and Soft Tissue Management
The purpose of this report is to describe a streamlined digital workflow to transfer conditioned emergence profiles after immediate implant placements with hard and soft tissue management. A 50-year-old woman with fractures in two maxillary premolars was treated by atraumatic extractions, immediate implant placements, guided bone regeneration with a particulate xenograft, and connective tissue grafting. Healing abutments were placed to support initial tissue maturation. After a 12-16-week healing period, the implants were activated, and screw-retained provisional restorations were delivered to condition the peri-implant mucosa. Once stable emergence profiles were achieved, at week 24, a digital protocol using three coordinated scans was implemented: (1) intraoral scan with the scan bodies, (2) intraoral scan with the provisional restorations in place, and (3) extraoral scan of the provisionals with a gingival barrier for alignment. The datasets were merged in CAD software to replicate critical and subcritical contours for the definitive prostheses. The three-scan protocol enabled an accurate transfer of the conditioned mucosal contours, facilitating the design of definitive implant-supported crowns with esthetic integration and tissue harmony. This approach avoided analog impressions and minimized digital complexity, suggesting a potentially efficient and biologically respectful workflow for soft tissue-driven implant rehabilitation in single-tooth or short-span cases. The digitally guided three-scan protocol provides a practical clinical method to replicate peri-implant mucosal contours following immediate implant placements and augmentations. Further studies are required to validate its reproducibility and long-term outcomes.
Dental implants; Intraoral scanner; CAD/CAM; Dental prosthesis design.
Copyright (c) 2025 Emil Correa Quispilaya, Consuelo Marroquín-Soto, César-Augusto Padilla-Avalos. https://creativecommons.org/licenses/by-nc-sa/4.0
The Histone Deacetylase Inhibitor Sodium Butyrate Stimulates Adipogenesis Through a Limited Transcriptional Switch in Periodontal Ligament-Derived Stem Cells
Adipogenic differentiation plays a crucial role in adipose tissue biology, an endocrine organ that regulates energy storage and hormone secretion. Dysfunction in this process contributes to metabolic diseases such as obesity and type II diabetes. In vitro models have been developed to investigate the mechanisms of adipogenesis, with periodontal ligament stem cells (PDLSCs) emerging as a promising model due to their multipotent capacity. Previous studies have shown that epigenetic manipulation can enhance the adipogenic response in various cell lines. Acetylation of lysine 9 on histone H3 (H3K9ac) is associated with the activation of key genes, such as PPARγ-2. In this study, we evaluated whether class I histone deacetylase inhibitors, such as valproic acid (VPA) and sodium butyrate (NaBu), both short-chain fatty acids, can increase H3K9 acetylation and influence adipogenic differentiation. We used 1, 4, and 8 mM VPA concentrations and 1, 2, and 5 mM NaBu to assess their effects on cell viability, morphology, H3K9ac distribution, and adipogenic differentiation. The results indicated that cells treated with 5 mM NaBu exhibited morphological changes, reduced viability, increased H3K9ac signal intensity, and enhanced intracellular lipid deposition. These results infer that inhibition of HDACs by NaBu increases plasticity toward adipogenesis of PDLSCs through a limited transcriptional change in their key genes.
Periodontal ligament stem cells; Histone acetylation; Adipogenesis; Histone deacetylase inhibitors.
Copyright (c) 2025 Anahí Torres-Nájera, Angélica Anahí Serralta-Interían, Rodrigo Arturo Rivera-Solís, Geovanny Nic-Can, Leydi Carrillo-Cocom, Beatriz Adriana Rodas-Junco. https://creativecommons.org/licenses/by-nc-sa/4.0
Root Canal Morphology in Permanent Anterior Teeth in a Peruvian Subpopulation Using Two Classification Systems: A CBCT Study
To evaluate the morphology of the root canal system in maxillary and mandibular permanent anterior teeth in the Peruvian population using two classification systems and cone-beam computed tomography (CBCT). A retrospective descriptive study. A total of 384 CBCTs from the database of Hannyx Dentomaxillofacial Radiology Consulting were used. The CBCT model used was NEWTOM, and the images were examined in sagittal, axial, and coronal views using the NNT NewTom software. A total of 384 subjects participated in this study. According to Vertucci and the new Ahmed Classification system, Type I, ¹MI¹, was the most common type in both maxillae, followed by Type III, ¹MI¹-²-¹ .The coding ¹MI¹-²-¹-²-¹, which does not have a classification in Vertucci, was present only in the right maxillary canine and the right and left central mandibular incisors, followed by ¹MI¹-² with Type V, present in the mandibular canines. The prevalence of root canal morphology variations in the mandibular central incisors was higher in females than in males, as well as in the right maxillary canines. Younger individuals showed more anatomical variations in the root canals compared to older patients. Female patients and younger individuals have a higher prevalence of root canal variations in mandibular anterior teeth.
Classification; Cone-Beam computed tomography; Dental pulp; Endodontics; Pulp cavity; Root canal.
Copyright (c) 2025 Adriana del R. Mas-Mixan, Cielo Y. Moreno-Valverde, Gisella G. Calero Hinostroza. https://creativecommons.org/licenses/by-nc-sa/4.0
Effectiveness and Safety Profile of Short-Term NSAIDs Protocols in Dental Implantology. A Systematic Review of Clinical Evidence
This systematic review aimed to assess the clinical effectiveness and biological safety of short-term non-steroidal anti-inflammatory drugs (NSAIDs) in managing postoperative pain following dental implant surgery. A comprehensive literature search was conducted across eight databases through March 2023, following PRISMA guidelines. Only randomized controlled trials (RCTs) evaluating short-term (≤7 days) NSAID use in patients undergoing dental implant placement were included. Outcomes assessed included postoperative pain, swelling, need for rescue medication, patient satisfaction, adverse events, and effects on osseointegration. Risk of bias was assessed using GRADE and OCEMB tools. Ten RCTs met the inclusion criteria. NSAIDs studied included ibuprofen, naproxen, meloxicam, piroxicam, lornoxicam, dexketoprofen, and diclofenac. Most studies reported reduced postoperative pain and lower need for rescue medication with NSAIDs compared to placebo. Several trials also found higher patient satisfaction and reduced swelling. No significant adverse effects on marginal bone loss or osseointegration were observed in the short term. Risk of bias varied: three studies were low risk, four had some concerns, and three had high risk due to inadequate blinding or unclear randomization.The short-term use of NSAIDs appears to be effective in reducing postoperative pain and swelling after dental implant placement without negatively affecting osseointegration. However, heterogeneity in study design, protocols, and outcomes prevented meta-analysis. Further high-quality RCTs with standardized protocols are needed to establish clear clinical guidelines.
Dental implants; NSAIDs; Postoperative pain; Osseointegration; Short-term analgesia.
Copyright (c) 2025 Mario Bueso-Ruiz, Mauricio Montero-Aguilar, Mauricio Montero-Aguilar, Vicente Esparza-Villalpando, Amaury Pozos-Guillén, Daniel Chavarría-Bolaños. https://creativecommons.org/licenses/by-nc-sa/4.0
Neural Network-Based Prediction of Hub Genes in the Interactome of Hereditary Gingival Fibromatosis: An AI-Driven Bioinformatics Study
Hereditary gingival fibromatosis (HGF) is a rare genetic disorder characterized by excessive gum growth, often presenting in childhood or adolescence. Symptoms include difficulties in speech, eating, oral hygiene, and psychological distress. Understanding the molecular mechanisms behind HGF is crucial for identifying potential therapeutic targets. This study aimed to predict interactomic hub genes in HGF using neural networks. We analyzed the GEO dataset GSE4250 using the geor2 tool to identify differentially expressed genes. Cytoscape and the CytoHubba plugin were employed to construct the interactome, ranking hub genes based on centrality scores. A neural network model with an 80:20 train-test split was used to predict hub and non-hub genes, achieving an AUC of 0.853, classification accuracy of 0.720, F1 score of 0.720, precision of 0.720, and recall of 0.720. The resulting network consisted of 147 nodes and 1092 edges, demonstrating moderate heterogeneity and connectivity. Ten key hub genes were identified, offering insights into the molecular basis of HGF. While the neural network model shows promising predictive capacity, further validation in larger cohorts is required. Adding predictive features and functional validation experiments could deepen understanding of HGF's biological mechanisms.
Hereditary gingival fibromatosis; Neural networks; Gene expression profiling; Protein-protein interactions; Hub genes; Protein interaction maps.
Copyright (c) 2025 Deepavalli Arumuganainar, Pradeep K. Yadalam, Carlos M. Ardila. https://creativecommons.org/licenses/by-nc-sa/4.0
Use of Ice Cream Containing Probiotic an Effective Way to Control Dental Caries?
To perform a systematic review to assess the decrease in bacterial counts of Streptococcus mutans in patients who used ice cream enriched with probiotics. Is registered in the PROSPERO platform, by the code CRD42022371298. The databases were Scopus, Web of Science, Embase, Pubmed, Medline, and Science Direct, through a search algorithm based on the following PICO question: P-individuals systematically healthy and free of caries, I-enriched diet with probiotics, C-diet with ice cream without probiotics, O-S. mutans count after the diet, being only original articles. After the inclusion of metadata in the Rayyan platform, the text were read by two independent researchers, with inter-examiner kappa >0.9, with a final sample of 5 articles. There was a significant reduction of S. mutans, with p-values between <0.001 and <0.005 for all studies analyzed, maintaining the decrease for up to 7 days, conserving it for 90 days after the diet protocol, but in this case without statistical difference. The use of ice cream containing probiotics to reduce the bacterial count of S. mutans is promising, but the ideal strain and the exact number of days for maintenance of the diet are still unknown.
Bifidobacterium lactis Bb-12; Lactobacillus acidophilus; Oral biofilm; Oral health; Streptococcus mutans; Oral Hygiene.
Copyright (c) 2025 Pedro Henrique Sette-de-Souza, Rebeca de Siqueira Amorim, Renata de Oliveira Cartaxo, Sara Isabel Cruz Silvério, Luiza Rayanna Amorim de Lima, Moan Jéfter Fernandes Costa. https://creativecommons.org/licenses/by-nc-sa/4.0
Selection Criteria for Radiographic Images in Dentistry: A Comprehensive Review of Updated Standards
Radiographic images play a crucial role in dentistry for diagnosis, treatment planning, and follow-up. However, due to the potential risks associated with ionizing radiation, such studies should only be conducted following a comprehensive patient history and clinical evaluation that justify their necessity. In the dentistry field, various radiographic techniques are available to acquire both intraoral and extraoral images, as well as two-dimensional and three-dimensional images. The selection of an imaging technique should be guided by its diagnostic efficacy, that is, how effectively it meets the patient's needs. Each imaging method possesses unique advantages and limitations, influenced by technical factors, and must be tailored to the specific diagnostic requirements of individual cases. This review aims to provide an evidence-based update on the criteria for choosing imaging techniques across the various areas of dental specialization.
Radiology; Diagnostic imaging; Panoramic radiography; Bitewing radiography; Cone-beam computed tomography; Radiation protection.
Copyright (c) 2025 Lucía Barba Ramírez, Ana Cecilia Ruiz-Imbert, Deivi Cascante-Sequeira. https://creativecommons.org/licenses/by-nc-sa/4.0
Pediatric Oral Oncology: A Brief Updated Review
Pediatric oral oncology represents a complex and challenging field within pediatric dentistry and oncology. This brief review aims to examine current understanding, diagnostic approaches, and treatment modalities for oral and maxillofacial malignancies in the pediatric population. Special emphasis is placed on early detection, multidisciplinary treatment strategies, and management of treatment-related complications. Recent advances in targeted therapies and their impact on survival rates are also discussed.
Mouth neoplasms; Children; Epidemiology; Early diagnosis; Disease management; Posttreatment complications.
Copyright (c) 2025 Saray Aranda-Romo, Arturo Garrocho-Rangel. https://creativecommons.org/licenses/by-nc-sa/4.0
Why Dental Anthropology Should be Taught in Dental Schools?: Ten Years Experience at the University of Costa Rica
Dentistry and anthropology are now more interconnected than ever, as teeth serve as critical evidence for studying ancient civilizations. Several topics in Dental Anthropology can be effectively integrated into dental school curricula. Currently, the absence of such training in undergraduate and postgraduate programs limits students’ understanding of teeth from a broader, interdisciplinary per-spective, thereby hindering the application of these insights in clinical practice. This article aims to provide an overview of what has been taught during the first ten years of introducing the basic concepts of Dental Anthropology at the Dental School of the University of Costa Rica. Similar projects implemented in Latin America are also discussed. Finally, it examines the achievements, challenges, and strategies to be implemented in the future.
Education; Dental anthropology; Undergraduate students; Prehispanic dentition; Indige-nous peoples; Costa Rica.
Copyright (c) 2025 Irene Valerio Alfaro. https://creativecommons.org/licenses/by-nc-sa/4.0
Monitoring a Static DMFT Index in Health: An AI Tool for Oral Public Health
Copyright (c) 2025 Bruno Gutiérrez, Jorge Bonilla, Piedad Delgado. https://creativecommons.org/licenses/by-nc-sa/4.0
Current View of the Clinical Management of Bruxism in Dentistry
Bruxism is a parafunctional activity involving repetitive movements of the masticatory muscles, often associated with stress, anxiety, and other psychosocial or physiological factors. This paper offers a comprehensive review of its clinical management, discussing diagnostic approaches and therapeutic strategies. Diagnostic methods include clinical examination, self-reported scales such as the CBA and PSS-14, electromyography, and polysomnography. Management requires an individualized, multidisciplinary approach. Occlusal splints remain the most widely used intervention for protecting dental structures. Botulinum toxin has shown efficacy in reducing muscle activity in severe cases, while physical therapies, acupuncture, and photobiomodulation (laser and LED) offer promising complementary options. LED therapy is emerging as a non-invasive alternative for pediatric patients. The findings suggest that early diagnosis and a personalized combination of conventional and alternative treatments can improve clinical outcomes. The integration of stress assessment tools and new technologies is essential for optimizing bruxism management in dental practice.
Bruxism; Diagnosis; Interdisciplinary communication; Phototherapy; Occlusal splints.
Copyright (c) 2025 Cristian Camilo Morales-Lastre, Ana Melissa Morales-Ramírez, Jorge H. Wilches-Visbal, Midian C. Castillo-Pedraza. https://creativecommons.org/licenses/by-nc-sa/4.0
Analysis of RANKL Expression Following Ethanol Administration During Orthodontic Force Application: An In Vivo Study
The prevalence of alcohol consumption is still quite high in worldwide. As more people become aware of malocclusion, it is also reasonable to expect that some orthodontic patients drink alcohol. Impacts of alcohol (ethanol) consumption on orthodontic force still unclear. Analyze the differences and effects of ethanol on RANKL expression in bone remodeling process during application of orthodontic force. This research was in vivo study, involving twenty-five Wistar rats, fitted with a closed coil spring and then divided into 5 groups; negative control group A (without force and ethanol) on day 0; group K1 (K=given orthodontic force) on day-3 and K2 on day-14, and group P1 (P=given force and 20% ethanol) on day-3 and P2 on day-14. Furthermore, animals were sacrificed, preparations were made and Immunohistochemistry (IHC) was examined to calculate RANKL expression, then data analysis using independent-t and regression test. Independent sample t-test showed, K and P group had significantly differences of RANKL expression on day 3 and 14 (p<0,05). Regression test results showed duration of ethanol administration significantly affected the level of RANKL expression (p<0,05). There were differences in RANKL expression after alcohol administration and there were effects of ethanol on RANKL expression in bone remodeling process during application of orthodontic force. It’s speculated that ethanol increases osteoclastogenesis, which accelerates orthodontic movement, but more study required.
Orthodontic force; Ethanol; Alcohol; RANKL; Tooth movement; Bone remodellng.
Copyright (c) 2025 Dwayne Daniel Fredrick Rehatta, Ardiansyah S. Pawinru, Zulfiani Syachbaniah, Baharuddin M. Ranggang, Eddy Heriyanto Habar, Eka Erwansyah. https://creativecommons.org/licenses/by-nc-sa/4.0
The Effect of Various Mouthwashes on the Surface Roughness and Discoloration of Provisional Fixed Materials
This study aims to evaluate the effects of mouthwashes on surface roughness and discoloration of provisional materials produced by different methods. Disk-shaped specimens were prepared from conventional [acrylic- and composite-based (PEMA and BCR)] and digital methods (CAD/CAM milling and 3DP). Specimens were divided into 4 subgroups (Kloroben, Meridol, Aloe vera, and artificial saliva as control). Color and surface roughness (Ra) values were measured by spectrophotometer and profilometer at baseline and after mouthwash application. Color changes (∆E00 and ∆Eab) were calculated using L, a, and b values. In artificial saliva, the 3DP group's ∆E00 values were higher than CAD/CAM milling. ∆E00 and ∆Eab of the BCR group were higher than others after Meridol immersion. In Aloe vera, ∆E00 and ∆Eab values of the BCR group were higher than CAD/CAM milling. Ra values of BCR increased after all solutions, and 3DP increased after Aloe vera immersion. CAD/CAM milling and PEMA subgroups, artificial saliva, and Kloroben subgroups of BCR material exhibited clinically acceptable values (∆E00≤2.25). CAD/CAM milling specimens (except Kloroben) and PEMA artificial saliva group (∆Eab) also showed clinically acceptable values. Ra values of CAD/CAM milled (artificial saliva and Kloroben subgroups) and all 3DP subgroups were below the threshold (0.2 µm) for plaque accumulation.
3D printing; CAD/CAM; Temporary; Color; Surface properties.
Copyright (c) 2025 Zeynep Sahin, Nazire Esra Ozer. https://creativecommons.org/licenses/by-nc-sa/4.0
Efficacy of Bone Marrow Aspirates in Bone Regeneration Compared to Conventional Bone Grafts- A Systematic Review
The search for a superior bone graft substitute compared to the gold standard of harvesting autogenous bone grafts has plagued dentists for decades. With the advent of tissue engineering, the search has been aimed at bone graft substitutes with osteogenic potential and osteoinductive and osteoconductive properties. Bone Marrow Aspirates (BMAs) have evolved as a potential adjunct to conventional bone grafts that can substantially enhance the bone regeneration potential of these materials. This systematic review aims to explore and assess the literature on the efficacy of bone marrow aspirates in new bone formation. An electronic search of PubMed, Web of Science, and Scopus databases was conducted to identify articles that evaluated the efficacy of bone marrow aspirates for new bone formation, published until September 2022, and a supplementary manual search of references from these articles was also conducted. Case reports, case series, commentaries, letters to the editor, narrative or systematic reviews, and articles in languages other than English were excluded from consideration. The articles were assessed against the ROB-II tool for Randomised Controlled Trials (RCTs) for risk of bias assessment. GRADE assessment based on the Cochrane Handbook for quality assessment and a summary of findings table were used to present the results. In a comprehensive electronic search of 150 articles from the three databases, seven studies assessed new bone formation in healthy partially edentulous patients who underwent bone regeneration with bone marrow aspirates compared to conventional bone grafts - autogenous harvested bone, allogenic, and alloplastic substitutes. This review concludes that adding bone marrow aspirates results in comparable results to bone graft alone. The results must be interpreted cautiously owing to their 'low quality' GRADE assessment. Future research with a greater sample size, homogenous populations, and comparable digital imaging and software may provide results that can be aptly applied to broader populations.
Bone grafts; Bone marrow aspirates; Bone regeneration; New bone formation, Osteogenic potential; Osteoinductive properties; Osteoconductive properties.
Copyright (c) 2026 Hannah Kadic, Kamran H. Awan, Shilpa Bhandi, Frank W. Licari, Chiara Bramucci, Shankargouda Patil, Luca Testarelli, Dario Di Nardo. https://creativecommons.org/licenses/by-nc-sa/4.0
Sociodemographic Factors in University-Based Dental Care: A Study at the School of Dentistry, University of Costa Rica (2019-2024)
Equitable access to dental care remains a challenge in Costa Rica. The School of Dentistry at the University of Costa Rica (FODO-UCR) addresses this issue by providing clinical services integrated with academic training, supported by the SMILE digital health record system. To analyze the sociodemographic profile of patients treated at FODO-UCR between 2019 and 2024, based on data recorded in the SMILE System. This was a quantitative, descriptive, and cross-sectional study. Clinical and sociodemographic data from all patients registered in the SMILE System between 2019 and 2024 were analyzed. Descriptive statistics and Chi-square tests were used to assess differences in categorical variables. A total of 25,465 patients received care. The majority were female (58.5 %), aged 18-30 and 31-40, and resided in San José (65.2 %). The primary reason for seeking care was self-initiative (64.3 %). Most patients were Costa Rican and had incomplete primary or secondary education. The study identified consistent patterns of access based on gender, age, and place of origin. These findings can inform institutional strategies aimed at promoting equity and guiding planning efforts in university-based oral healthcare.
Health services accessibility; Demography; Universities; Electronic health records; Costa Rica.
Copyright (c) 2025 Adrián Gómez-Fernández, Alejandra Hernández-Mata. https://creativecommons.org/licenses/by-nc-sa/4.0