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 Our journal consider unpublished and original manuscripts in ENGLISH with a prominent focus on critical and innovative data, promoting major clinical, academic and scientific research, based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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Microhardness According to Surface, Distance and Time of Photopolymerization of a Bulk-Fill Resin: In Vitro Study
This study compared Vickers microhardness (VHN) according to the surface, distance and time of photopolymerization (PP) of Tetric® N-Ceram Bulk Fill (TNCBF). An in vitro study was performed of 80 cylindrical samples (4 mm×4 mm) randomly distributed into 8 groups according to distance (0 and 3 mm) and time (10, 20, 30, 40 s) of LED PP 1470 mW/cm2. The depth of cure was adequate when the ratio of tripled VHN (Kg/mm²) between lower/upper surfaces was>0.8. Statistical analysis was performed with the three-way ANOVA test with post hoc Tukey and Tamhane (p<0.05). The effect on VHN was highly significant when individually analyzed by the surface, time and distance of PP and interaction time × distance of PP (p<0.001). The average depth exceeded 80% of VHN regardless of the distance and time of PP. The VHN was higher at a distance of 0 mm compared to 3 mm at 10 and 20 s of PP regardless of the surface (p<0.001). The VHN was similar at all times with a PP distance of 0 mm (p≥0.377) and increased at 20 s with a PP distance of 3 mm (p≤0.001). The surface, distance and time of PP affected the hardness of TNCBF, which can have an impact on its clinical performance. The depth of cure using VHN results were favorable with 20 s of PP at a distance of 0 mm for a thickness of 4 mm of TNCBF.
Composite resins; Dental healing lights; Dental materials; Hardness; Polymerization, Time factors.
Copyright (c) 2026 María José Loayza-Gallegos, Gino Hernan Vidalón-Romo, Julissa Amparo Dulanto-Vargas. https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of High-Power Curing on Polymerization Shrinkage and Microhardness of Composite Resins
The polymerization shrinkage (PS) and microhardness of dental composite resins, are known to be significantly influenced by the intensity of the curing light and the thickness of the material. However, the specific effect of high-power curing mode on composite resins has not been fully clarified. This study investigated the effect of the curing mode using high-power curing unit (VALO) on the volumetric shrinkage and microhardness of nanohybrid composites. SonicFill 3 and OptiShade were polymerized using standard and high-power curing modes with the VALO Cordless. A total of 60 specimens were prepared using Teflon molds with a diameter of 8 mm and a thicknesses of 2 mm and 4 mm. The microhardness values were measured using a Vickers hardness tester (Innovatest,Maastricht,Holland). Forty specimens were prepared for volumetric shrinkage ratios. PS was measured using a video imaging device (Acuvol Volumetric Shrinkage Analyzer; Bisco Inc., Schaumburg, IL, USA). The curing mode affected the microhardness of each composite material. Pertaining to microhardness of the nanohybrid composite materials, there were significant differences between thicknesses and light-curing modes (p<0.05). For the volumetric shrinkage, differences were measured between the materials based on the curing mode. High-power curing of a bulk-fill composite resulted in the lowest PS value. Increasing the layer thickness negatively affected the hardness of the composite resins.
Composite resins; Dental curing lights; Dental materials; Hardness tests; Polymerization; Mechanical stress.
Copyright (c) 2026 Nur Selen Öztürk, Mustafa Demirci, Safa Tuncer, Neslihan Tekçe, Özge Duman Özbilgi. https://creativecommons.org/licenses/by-nc-sa/4.0
Social Determinants of Oral Health in Old Age. A Vulnerable Group in Mexico
Copyright (c) 2026 Guillermo Cruz Palma. 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
Biomechanical Evaluation of Anterior Implant-Supported Fixed Bridges Combined with Distal-Extension Removable Partial Dentures
This study compared the biomechanical performance of anterior two implant-supported fixed prostheses combined with distal-extension removable partial dentures (DERPDs) classified as Mandibular Kennedy Class I, incorporating metal clasps and extracoronal precision attachments, against conventional Locator®- and bar-attached implant overdenture prostheses under vertical and oblique bilateral posterior biting forces using three-dimensional finite element analysis. Four prosthetic designs with different retention systems were analyzed: an overdenture with a Locator® attachment, an overdenture with a bar attachment, an anterior implant-supported fixed bridge retaining a removable partial denture with clasp retention, and an anterior implant-supported fixed bridge retaining a removable partial denture with a precision attachment. Stress values and distributions were compared among the models using three-dimensional (3D) finite element analysis (FEA). Clasp attachments exhibited the lowest stress concentrations, while precision attachments showed the highest stress values. Overdentures with bar attachments demonstrated higher stress concentrations compared to Locator® attachments. Clasp-type attachments induced less stress on implants and peri-implant tissues while causing greater posterior tissue stress compared to extracoronal precision attachments in DERPDs. It can be considered a viable treatment for patients seeking an anterior implant-supported fixed bridge for esthetic and psychological reasons, and this can increase the patient's self-confidence.
Dental implants; Clasp; Precision attachment; Bar; Locator®; Removable partial denture; Finite element analysis.
Copyright (c) 2026 Mesut Tuzlalı, Esma Başak Gül Aygün, Mustafa Kocacıklı, Hilal Şiriner Gümüş, Nagehan Baki. https://creativecommons.org/licenses/by-nc-sa/4.0
Assessment of Knowledge in Adherence to Infection Control During Radiographic Procedures Among Dental Students and Dental Practitioners
Infection control in oral radiology is essential for preventing cross-contamination, but compliance differs among dental professionals. This study assessed knowledge and adherence to infection-control measures during radiographic procedures among dental students and practitioners. A cross-sectional questionnaire survey was conducted among 392 participants (students and practitioners). The validated tool covered domains of hand hygiene, personal protective equipment (PPE), protective over gloves, sterilization, and use of plastic barriers. Descriptive statistics summarized practices. Pearsons χ2 tested between-group differences, and binary logistic regression was performed to identify predictors of adherence. Statistical significance was set at p<0.05. Only 39.0% of participants demonstrated adequate adherence (≥70% of practices followed). Adequacy was slightly higher among students (39.8%) than among practitioners (36.6%). Logistic regression showed that students had significantly higher odds of PPE use (OR 1.72, 95% CI 1.40-2.11), sterilization of devices (OR 1.61, 95% CI 1.32-1.98), and plastic barrier use (OR 1.65, 95% CI 1.34-2.02). No significant differences were found between hand hygiene and over-glove use. Both students and practitioners demonstrated only moderate adherence to infection-control practices in radiology, with notable gaps in pre-glove hand hygiene and protective over-glove use. To strengthen consistent infection-control measures, targeted training for practitioners and curriculum reinforcement for students are recommended.
Infection control; Oral radiology; Dental students; Dentists; Hand hygiene; Personal protective equipment; Sterilization.
Copyright (c) 2026 Prasanth Rajesh, Sabitha Gokulraj, Kumar Appusamy, Venkataraman Subhalakshmi. https://creativecommons.org/licenses/by-nc-sa/4.0
Association Between Access to Oral Health Information and Use of Fluoride Toothpaste with at Least 1000 PPM in Peruvian Children
Oral health education is assumed to improve knowledge and behaviors regarding fluoride toothpaste use. However, dental caries prevention requires comprehensive strategies that integrate dental examinations, provision of fluoride toothpaste, and preventive treatments.To analyze the association between access to oral health information and the use of fluoride toothpaste with a concentration of ≥1000 ppm in Peruvian children under 12 years of age. A cross-sectional analysis was conducted using nationally representative 2023 ENDES data, including 23,613 children. Independent variables were access to oral health information and its provider; the dependent variable was fluoride toothpaste use (≥1000 ppm). Covariates included wealth index, natural region, health insurance, altitude, area and place of residence, age, and sex. Multilevel Poisson regression estimated prevalence ratios (PR) and 95% confidence intervals (CI).In bivariate analyses, appropriate fluoride toothpaste use was significantly associated with information provider (p<0.001), natural region (p<0.001), altitude (p<0.001), wealth index (p<0.001), age (p<0.001), area (p=0.030), and place of residence (p=0.041). Children living in the coastal region, at lower altitudes, from wealthier households, and older age groups had higher prevalence of use. However, in multivariate analysis, access to oral health information was not significantly associated with appropriate fluoride toothpaste use (coef.: –0.01; PR: 1.00; 95% CI: 0.97–1.04; p=0.808). Access to oral health information was not linked to fluoride toothpaste use ≥1000 ppm among Peruvian children under 12 years, while geographic and socioeconomic factors played a significant role. Educational strategies alone may be inadequate without tackling structural barriers. Strengthening regulations, aligning policies with clinical guidelines, and ensuring equitable access are crucial. This first 2023 ENDES-based analysis offers valuable national evidence to guide targeted interventions and oral health policy.
Oral health; Health education; Child; Dentifrices; Health disparities; Social determinants; Fluoride use.
Copyright (c) 2026 Eunji Oh-Aguilar, María Claudia Garcés-Elías, Neila C. Quiroz-Silva, Jesely H. Torres-Ramirez, Roberto A. León-Manco. https://creativecommons.org/licenses/by-nc-sa/4.0
Knowledge of HPV-Associated Head and Neck and Oral Cancers Among Health Care Students in Mexico
To assess the knowledge of students in health care-related programs at a public university in Mexico regarding human papillomavirus (HPV) and its association with head and neck and oral cancers. An institution-based descriptive cross-sectional study was conducted using bivariate and multivariate analyses. A representative sample of 323 students completed a questionnaire on sociodemographic characteristics, sexual history, and knowledge of HPV, HPV-related cancers, and the HPV vaccine. Participants were aged 18-36 years; 210 (65.0%) were female and 113 (35.0%) male. Regarding sexual activity, 37.8% had become sexually active at or before age 18, 33.7% thereafter, and 28.5% remained sexually inactive. Over 90% of students were aware that HPV causes cervical cancer, while 63.5% recognized its role in head and neck cancer and 79.5% its association with oral cancer. Overall, 57.6% had been vaccinated against HPV, and 90.4% were willing to receive the vaccine. Awareness that HPV causes cervical cancer increased recognition of its association with head and neck (OR=6.86, p<0.01; adjOR=5.12, p=0.02) and oral (OR=12.36, p<0.01; adjOR=15.15, p<0.01) cancers. However, willingness to receive the HPV vaccine did not translate into knowledge of HPV’s role in head and neck (OR=0.16, p<0.01; adjOR=0.15, p=0.04) or oral (OR=0.11, p=0.01; adjOR=0.05, p=0.03) cancer. Raising knowledge of HPV’s role in head and neck and oral cancers offers an opportunity to boost vaccination uptake and prevent HPV- related disease.
Human papillomavirus viruses; Knowledge; Students, medical; Students, health occupations.
Copyright (c) 2025 Cynthia M. Urias-Barreras, José G. Rendón-Maldonado, Denisse A. Camacho-Peinado, Arturo M. Padilla Hermosillo, Juan J. Villalobos-Rodelo, Alberto Rodríguez-Archilla. https://creativecommons.org/licenses/by-nc-sa/4.0
Bond Strength of Bulk-Fill Resin Repairs: Impact of Surface and Adhesive Protocols
Although repair is a conservative approach that preserves healthy tooth structure, there is still no consensus on the most effective surface treatment and adhesive protocol for repairing aged bulk-fill composite resin restorations. The objective of the study was to evaluate the effect of diamond bur roughening and aluminum oxide (Al2O3) sandblasting as surface treatments combined with different adhesive protocols on the repair bond strength (BS) of aged bulk-fill composite resin.150 Filtek™ One resin discs were thermocycled (5,000 cycles of 5°/55°C) and divided into three surface treatment groups (n=50): no treatment (NT), roughening with diamond bur (B), and sandblasting with Al2O3 (Al). Each group was further subdivided according to five adhesive protocols (n=10): no adhesive (NA), Adper Single Bond 2 (SB), Single Bond Universal (SBU), Silane + Adper Single Bond 2 (S+SB), and Silane (S). Three Bulk Fill resin cylinders were fabricated for each specimen to simulate repair, followed by micro-shear bond strength testing and fracture pattern analysis after 24-hour storage in deionized water. Two-way ANOVA and Tukey's test (α=0.05) were applied. When B or Al was applied, only NA showed inferior results. No statistical differences were found between B/SB, B/SBU, B/S+SB, and B/S, as well as between Al/SB, Al/SBU, Al/S+SB, and Al/S. Al/SBU showed higher bond strength than B/SBU. The most frequent fracture patterns for B and Al were cohesive and mixed, while for NT, it was adhesive. Surface treatment with B or Al, combined with an adhesive protocol, improved bond strength. Surface treatment is crucial for bulk-fill composite resin repair, enhancing bond strength with adhesive systems, with or without silane. A universal adhesive containing silane is as effective as adhesive-silane combinations, offering superior bond strength on Al2O3 blast-treated surfaces.
Bulk fill; Resin; Composite; Surface treatment; Silane; Repair.
Copyright (c) 2026 Samuel Eleutério Paiva Sousa, Fiorella Elizabeth Arévalo Tarrillo, Maria Paula Novaes Camargo Manna, Sandra Ribeiro de Barros da Cunha, Maria Ângela Pita Sobral. https://creativecommons.org/licenses/by-nc-sa/4.0
Analysis of Exosomal Biomarkers in Oral Fluids of Periodontal Patients
Exosomes, small extracellular vesicles enriched with markers such as CD63, play essential roles in cell communication and inflammatory regulation. In periodontal disease, salivary and gingival crevicular fluid (GCF) exosomes may act as carriers of inflammatory mediators like interleukin-1 beta (IL-1β), a key factor in periodontal tissue destruction. Evaluating these exosomal biomarkers may support non-invasive assessment of periodontal disease activity. A total of 20 subjects were enrolled and categorized into two groups: 10 periodontally healthy individuals and 10 with chronic periodontitis. Saliva and GCF samples were collected and processed for extracellular vesicle (EV) isolation using ultracentrifugation. The size distribution of exosomes was assessed using Dynamic Light Scattering (DLS). Western blotting was performed to detect the exosomal marker CD63, and IL-1β expression was quantified via RT-PCR. Correlation analyses between exosome sizes in saliva and GCF were conducted. Salivary exosome size was significantly larger in the periodontitis group (419.21±181.95 nm) than in the healthy controls (285.24±76.95 nm; p<0.001). GCF exosome size showed no significant difference between the groups. Salivary IL-1β expression, measured by 2^(–∆∆Ct), was significantly higher in the periodontitis group (5.22±2.42) compared to healthy controls (1.11±0.53; p=0.017). A strong positive correlation (r=0.967, p<0.001) was found between salivary and GCF exosome sizes in the periodontitis group. Western blot confirmed CD63-positive exosomes in all samples, with stronger bands observed in the disease group. Exosomalprofiling of saliva, particularly IL-1β expression and CD63 detection, presents a promising, non-invasive approach for diagnosing and monitoring periodontitis. These findings highlight the potential of salivary exosomes as surrogate indicators of periodontal inflammation and emphasize the need for further research to improve diagnostic accuracy. Results should be interpreted cautiously due to the pilot nature and small sample size.
Periodontitis; Exosomes; Biomarkers; Interleukin-1beta; Saliva; Gingival crevicular fluid.
Copyright (c) 2025 Mohammed Rathan Sharfudeen, Shivakumar Baskaran, Swarna Alamelu, Karthick Baskar. https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of Relationship Between β-Catenin and Extracellular Matrix on Progression of Oral Epithelial Dysplasia to Oral Squamous Cell Carcinoma
This study aimed to explore roles of β-catenin, collagen&elastic fibers in progression of Oral Epithelial Dysplasia (OED) to oral squamous cell carcinoma (OSCC). Sixty paraffin wax blocks of oral mucosa were divided into: control (Group I), mild OED (Group II), severe OED (Group III), well differentiated SCC (Group IV), moderately differentiated SCC (Group V), poorly differentiated SCC (Group VI). The sections underwent staining using hematoxylin and eosin, histochemical stains and β-catenin immunostaining. Group I revealed normal gingival tissue. Group II showed some basal and prickle cells with pleomorphic nuclei. Group III illustrated poorly demarcated cell membrane. Group IV showed keratinized epithelial islands. Group V was devoid of keratin pearls. Group VI showed dispersed epithelial cells. β-catenin-immunoreactivity was; strong membranous in Group I, moderate membranous, cytoplasmic and nuclear in Groups II&III, moderate nuclear and cytoplasmic in Group IV but strong in Groups V&VI. Collagen fibers were closely packed in Groups I&II, loosely packed in Groups III&IV, dispersed in Groups V&VI. Elastic fibers in Group I were apparently few & thin, abundant in Group II, numerous in Group III, short in Groups IV&V and thick in Group VI. β-catenin and elastic fibers were upregulated meanwhile collagen formation was downregulated towards progression from mild OED to poorly differentiated SCC.
β-Catenin; Elastic fibers; Collagen; Oral epithelial dysplasia; Oral squamous cell carcinoma.
Copyright (c) 2025 Seham Ahmed Abdel Ghani, Amany A. Rabea. 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
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
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
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
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
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
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
Influence of Communication Channels on Patient Choices in Dental Services: A Market Study
The dental business is complex and multifactorial, requiring strategic market positioning and the adoption of innovative health technologies. This study analyzes the dental services market, focusing on the range of services sought and the communication channels patients use to select a clinic. A survey of 124 patients revealed that 45% trust information from their general dentist, while 24% rely on the Internet. A significant portion (63%) sought highly complex treatments. Findings suggest a need for a marketing strategy enhancing social media presence, digitalizing processes, and upskilling the medical team to meet high-demand complex treatments.
Marketing of health services; Digital technology; Health communication; Market research; Dental practice management; Doctor-patient relations; Patient web portals.
Copyright (c) 2025 Iliyan Kostov, Mirela Georgieva. https://creativecommons.org/licenses/by-nc-sa/4.0
Changes in Buccolingual Inclination of the Posterior Maxillary Teeth with Forces Applied from the Mini-Implants in the Sagittal and Vertical Direction-A non-Randomized Clinical Study
To compare the changes in the buccolingual inclination of the posterior teeth when forces are applied from mini-implants placed on the buccal side of the maxillary posterior teeth in both sagittal and vertical directions. Sixteen young patients requiring distal movement of the maxillary teeth with mini-implants and ten patients requiring intrusion of the posterior teeth with mini-implants were included in group 1(G1) and group 2(G2), respectively. In G1,200 grams of sagittal forces were applied bilaterally using NiTi coil springs from mini-implants placed between the maxillary second premolar and first permanent molar to attachments on a 0.018"X0.025" stainless steel wire in the anterior region. In G2,200 grams of vertical forces were applied bilaterally through an elastic thread from the mini-implants onto a 0.019"X0.025" stainless steel archwire. CBCT scans were taken before and towards the end of distalisation/intrusion. Paired t-tests and Independent t-tests were performed. There was statistically significant buccal tipping of the maxillary second premolar in G2 (p-value of .008) accompanied by mild buccal tipping in G1. However, not statistically significant, mild buccal tipping of the maxillary second molar was observed in both groups. The maxillary first molar though not statistically significant demonstrated lingual tipping in G1 while no changes in buccolingual inclination were noted in G2. There was a clinically significant buccal tipping of maxillary second molar and second premolar in G1 and G2, lingual tipping of the maxillary first molar in G1. Significant changes were observed in the buccolingual inclination of the maxillary second premolars and second molars when forces were applied in the sagittal and vertical direction in the buccal direction. Lingual tipping of the maxillary first molar was noted in the sagittal direction.
Distal movement; Intrusion; Posterior teeth; Mini-implants; Buccolingual inclination; Forces.
Copyright (c) 2025 A. Sumathi Felicita, T.N. Uma Maheswari. https://creativecommons.org/licenses/by-nc-sa/4.0
Regional Disparities in the Prevalence and Severity of Early Childhood Caries Among Preschoolers Living in Poverty in Costa Rica
Early childhood dental caries remains a major public health concern, especially among populations affected by socioeconomic and geographic disparities. In Costa Rica, persistent regional inequalities may influence the burden and severity of this condition. To analyze regional disparities in the prevalence and severity of dental caries among Costa Rican preschool children living in poverty. A secondary analysis was conducted using data from a descriptive, cross-sectional study carried out in 2013. The national sample included 803 children under 81 months of age enrolled in government-run centers for early childhood care and nutrition (CEN-CINAI). Clinical assessments were performed using the ICDAS system. Descriptive statistics and regional comparison tests were applied. The national caries prevalence in Costa Rica was 84.81%. Significant regional differences in severity were observed, with higher averages of affected teeth and surfaces in the Chorotega and Brunca regions. While incipient lesions (ICDAS 1-2) were most frequent, a substantial burden of moderate and severe lesions (ICDAS 3-6) was also detected, particularly in rural areas with greater structural vulnerability and limited access to oral health services.The high prevalence of dental caries and the documented regional inequalities highlight the need to strengthen prevention, early diagnosis, and timely treatment. Integrating a territorial approach into oral health policy-through early detection, preventive interventions, caregiver education, and mobile dental services-may help reduce disparities and improve pediatric oral health outcomes.
Dental caries; Oral health; Preschool children; Health inequities; Regional disparities; Costa Rica; Poverty.
Copyright (c) 2025 Adrián Gómez-Fernández, Katherine Molina-Chaves, Sylvia Gudiño-Fernández. https://creativecommons.org/licenses/by-nc-sa/4.0
Impact of Three Cementation Materials on the Fracture Strength of All-Ceramic CAD/CAM Overlay Restorations
To compare and assess the fracture strength of indirect overlay restorations bonded using various bonding techniques: sonically activated composite materials, preheated composite materials, and adhesive resin cement. The restorations were fabricated utilizing two distinct categories of all-ceramic CAD/CAM materials: reinforced resin composite blocks and lithium disilicate blocks. Depending on the CAD/CAM block type utilized for constructing the indirect overlay restorations, two main groups of 24 teeth each were created from the 48 human maxillary first premolar teeth that were ready for restorations. Group A consisted of indirect overlays made of lithium disilicate (IPS e.max CAD) blocks, whereas Group B used reinforced resin blocks (BRILLIANT Crios) for indirect overlays. subsequently according to the type of cement utilized in cementation. After the prepared teeth were scanned using the CEREC Omnicam digital intraoral scanner, indirect overlay restorations were designed utilizing CEREC Premium programme (version 4.4.4), and additional milling was carried out using the CEREC MC XL milling device. A computer-controlled universal testing machine (LARYEE, China) was then used to apply compressive axial loads to all cemented indirect overlay restorations at a crosshead speed of 0.5 mm/min till occurrence of fracture. A Student's t-test, LSD test, and one-way ANOVA test were utilized to analyze the data at a significance level of 0.05. This in vitro investigation revealed the greatest fracture strength mean value in the indirect overlays cemented with resin cement compared to other types of cement, regardless of the CAD/CAM block type. Depending on the findings of this research, regardless of the cement type, the mean fracture strength values of the indirect overlays made from both CAD/CAM blocks exceed the maximum biting force in the premolar area, indicating that both block types may be utilized clinically as overlay restorations in the premolar area.
Fracture strength; Resin cement; Lithium disilicate; CAD/CAM; Brilliant Crios; CAD/CAM.
Copyright (c) 2025 Zaidoon Hasan Mohammed, Manhal A. Majeed. https://creativecommons.org/licenses/by-nc-sa/4.0
Application of Ergonomic Principles in Clinical Practice: An Observational Study Among Dental Students
The objective of the present study was to assess the application of ergonomics among undergraduate dental students at the University Dental Hospital Sharjah. The study also intended to compare application of ergonomic principles among fourth and fifth year dental students, and predict the risk of musculo-skeletal disorders for each group based on the RULA (Rapid Upper Limb Assessment) method. Eighty-four participants of this observational study were evaluated for ergonomic risk factors by obtaining data in the form of static photographs of dental students in their fourth and fifth years at UDHS. These images were then analyzed by the observers to determine musculo-skeletal risk using the Rapid Upper Limb Assessment (RULA) worksheet. The dependent variables were the risk scores obtained from the RULA worksheet, which evaluated the risk of WMS and/or WMSD for the dental students. Conversely, the students' work postures, movement repetition, static muscle work, and associated loads, were considered the independent variables. The Mann-Whitney U test was used to compare the statistical significance between both year groups. The overall final RULA scores showed that fourth year dental students had a higher mean ranking (score =1980.5) than fifth year dental students (score=1589.5), which was statistically significant (P=0.009), thereby placing them at a higher risk of developing musculo-skeletal diseases due to their ergonomics. The overall RULA scores of both groups portrayed that the 4th year participants were in the medium-risk category of developing WMSDs as a result of their working postures, whereas the 5th year participants were in the low-risk category.
Ergonomics; Dental students; Clinical training; Education.
Copyright (c) 2025 Rafiq Maged, Noor Al Khayat, Rayaheen Kilidar, Helia Sadeghi, Manal Awad, Shishir Shetty. https://creativecommons.org/licenses/by-nc-sa/4.0
Quality of Life, Oral Health and Dental Caries in Military Personnel from Arequipa, Peru
The objective of this research was to determine oral health-related quality of life and its relationship with the incidence of dental caries, oral hygiene, and gingival health in a military population in the city of Arequipa, Peru. The study was cross-sectional and included 234 Peruvian military personnel. Oral quality of life was assessed using the Oral Health Impact Profile (OHIP-14Sp) questionnaire. Clinical condition was determined using the DMFT (cavities), OHI-S (simplified oral hygiene), and the Löe and Silness reduced gingival index (GI-r). The median OHIP-14Sp score was 19 (RI: 12-27), with physical pain being the most affected dimension (mean: 4.1±1.7). A significant association was found between the OHIP-14Sp and the OHI-S (p=0.011) and OHI-r (p<0.001) indices. In the case of the DMFT index, no statistically significant association was found with the overall OHIP-14Sp score (p=0.152); however, a trend was observed in which higher DMFT values corresponded to higher OHIP-14Sp scores, suggesting a possible clinically unperceived impact in this population. In conclusion, there is a significant relationship between oral health-related quality of life and levels of oral hygiene and gingival inflammation. Although no statistically significant association was found between DMFT and perceived quality of life, the observed trend suggests that caries experience could influence oral well-being at more advanced stages. Implementing oral health prevention and promotion strategies that address both hygiene and early caries diagnosis in institutional settings is recommended.
Quality of life; Oral health; OHIP-14Sp; CPOD; Oral hygiene; Military personnel.
Copyright (c) 2025 Rosa Y. Cruces Crisóstomo, Carmen Rosa García-Rupaya. https://creativecommons.org/licenses/by-nc-sa/4.0
Comparative Effects of Prize Distraction and Conversation Distraction Behavioral Control Methods on Dental Pain and Anxiety of 3-7-Year-Old Children: A Clinical Trial
Management of pediatric patients’ dental pain and anxiety is a challenge. This study aimed to compare the effects of prize distraction (PD) and conversation distraction (CD) on dental pain and anxiety of 3-7-year-old children. This cross-over split-mouth randomized clinical trial was conducted on 64 systemically healthy children between 3-7 years with bilateral primary maxillary first molars requiring pulpotomy. The patients were randomly assigned to two groups. In the first group, PD was used in the first session for treatment of one randomly selected quadrant while CD was used in the second session for treatment of the other quadrant. This order was reverse in the second group. The pain and anxiety of patients were evaluated at the onset of each treatment session and during anesthetic injection by measuring their pulse rate (PR) as a physiological parameter, and using the Sound-Eyes-Motor (SEM) and the Wong-Baker Faces Pain Rating (WBFPR) scale. Data were analyzed by STATA 16 (alpha=0.05). Local anesthetic injection significantly increased the PR in both groups (P<0.05); however, this increase was significantly smaller in the PD group (P<0.001). Also, the WBFPR scale (P<0.002) and SEM (P<0.001) scores were significantly lower in the PD group than CD. Local anesthetic injection significantly increased dental anxiety of children in both groups despite the distraction methods. PD was significantly more effective than CD for reduction of dental pain and anxiety in 3-7-year-old children.
Pain; Dental anxiety; Dental care for children; Awards and prizes; Reinforcement, Psychology.
Copyright (c) 2025 Maryam Rahmati, Hamid Sarlak, Amir Almasi-Hashiani. https://creativecommons.org/licenses/by-nc-sa/4.0
Conservative Approaches to Managing Medication-Related Osteonecrosis of the Jaw (MRONJ): A Narrative Review
Medication-Related Osteonecrosis of the Jaw (MRONJ) is a severe complication associated with the use of bone-modifying agents, such as Zoledronic Acid and Denosumab, in cancer patients. It poses significant challenges in prevention, diagnosis, and treatment, highlighting the urgent need for effective and evidence-based management strategies to optimize patient outcomes. Conservative approaches have gained attention as viable alternatives to surgical intervention, particularly in early-stage MRONJ. These strategies include antimicrobial therapy, pain management, local wound care, and adjunctive therapies such as low-level laser therapy and photodynamic therapy. Hyperbaric oxygen therapy has also been investigated; however, current literature doesn’t provide strong evidence to support its routine use. Additionally, several inflammatory and bone turnover markers, including CTX, P1NP and RANKL in addition to regulatory cytokines like OPG have been studied for their potential to reflect disease progression and treatment response. While non-surgical management has shown promising results in symptom control and healing, the lack of standardized treatment protocols remains a limitation. Further research is needed to refine conservative treatment guidelines to explore reliable biomarkers and innovative therapeutic strategies to improve clinical outcomes and quality of life for affected patients.
Osteonecrosis; Zoledronic acid; Denosumab; Cancer patients; Conservative treatment; Patient care; Bone turnover.
Copyright (c) 2025 Amany Hany Mohamed Kamel, Fatma AlKindi, Rawan Alharrasi, Nadiya AlKindi. https://creativecommons.org/licenses/by-nc-sa/4.0
Assessment of Serum Ferritin Levels and Periodontal Indices in Patients with Chronic Periodontitis Post/Pre Radiation Treatment of Head and Neck Cancer
Acute phase protein (APP) positivity is exhibited by ferritin in the presence of inflammation and chronic infections, such as periodontal disease. This study aims to investigate serum ferritin levels compared between post- and pre-radiation of periodontal disease with head and neck cancer PD+HNC. A total of 100 individuals in the present study were enrolled, comprising 50 patient’s periodontal disease (PD) with head and neck cancer who underwent radiotherapy post-six months (post-RT HNC) and 50 PD patients (pre-RT HNC). Probing pocket depth (PPD), clinical attachment level (CAL), gingival bleeding index (GBI), plaque index (PI), oral pH, and hyposalivation were noted. Serum ferritin levels were measured using an electrochemiluminescence immunoassay (eCLIA). A significantly higher percentage of ferritin levels was found in patients post-RT PD+HNC (301.90 ng/ml) contrasted to pre-RT PD+HNC (82.71 ng/ml) subjects. Serum ferritin levels were shown to be significantly positively correlated with CAL, PPD, PI, and GBI in subjects with chronic periodontitis. Receiver operating characteristic results of ferritin (area under the curve (AUC) =0.806 for post-RT PD+HNC, AUC=0.454 for pre-RT PD+HNC). It may be suggested that elevated serum ferritin levels in patients with post-RT PD+HNC have the potential to be evaluated as biomarkers for inflammation during periodontal tissue breakdown via radiation treatment.
Head and neck cancer; Periodontal disease; Ferritin; Radiotherapy.
Copyright (c) 2025 Ahmed A. Al-Kubaisi, Abdulrahman Khalid Mssdf, Sameer A. Awad, Khalid H. Ibrahim, Mahmood Yaseen Mukhlif, Ekram R. Aldelaimi. https://creativecommons.org/licenses/by-nc-sa/4.0
Radiolucent Lesions Associated with Stainless Steel Mini-Implants During Routine Examination with Cone Beam Computed Tomography-An Observational Study
The aim of this study was to determine the prevalence of radiolucent lesions around mini-implants used for orthodontic anchorage due routine evaluation with cone beam computed tomography. Twenty two mini-implants were examined prior to and after orthodontic treatment in young adults requiring absolute anchorage. All mini-implants were placed in the maxillary arch between the second premolar and first permanent molar. CBCT taken immediately after mini-implant placement (T1) and towards the end of treatment (T2) were checked for the presence of radiolucency around the mini-implants. A radiolucent lesion was recorded when it was present in any one of the planes, either the tangential or cross-sectional view of the panoramic window or the coronal or sagittal view of the multiplanar window. The presence/absence of radiolucency was checked individually at T1 and T2 and also compared between T1 and T2. Descriptive statistics with frequency distribution and percentage was done. 31.82% of mini-implants showed a small radiolucency at its tip at T1 and T2. 13.64% of mini-implants showed a linear radiolucency along the length of the mini-implant at T1 and T2. Two mini-implants had periapical lesion at the time of mini-implant at T1 which exaggerated and increased in size at T2 while two mini-implants had a tiny periapical lesion at T1 which resolved at T2. Three mini-implants had radiolucent lesions around the tip of the mini-implant at T1 which changed to a linear radiolucency along the length of the mini-implant at T2 and vice versa. 45.45% of all the mini-implants evaluated showed the presence of radiolucency around it at T1 and 50% of all the mini-implants evaluated showed radiolucency at T2.