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 Our journal consider unpublished and original manuscripts in ENGLISH with a prominent focus on critical and innovative data, promoting major clinical, academic and scientific research, based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
ODOVTOS - Int. J. Dent. Sc. endorses CC BY-NC-SA This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements: BY: credit must be given to the creator. NC: Only noncommercial uses of the work are permitted. SA: Adaptations must be shared under the same terms.
Genetic Association Between RFC1 Gene Polymorphism (rs1051266) and Non-Syndromic Cleft Lip and Palate in the South Indian Population: A Case Control Study
To identify whether an association exists between RFC1 gene polymorphism (rs1051266) and the development of non-syndromic cleft lip and palate. Twenty-five patients with non-syndromic cleft lip and palate (NSCL/P) with ages ranging from 1 year to 17 years belonging to both genders (Group 1) and twenty-five patients without cleft lip and palate malformations as controls (Group 2) were included in the study. Genomic DNA was obtained from whole blood drawn from the patients. The region around the RFC1 gene polymorphism was amplified with sequence-specific primers using polymerase chain reaction (PCR). RFLP technique was used to identify the genotype of the patients. The genotype and allele frequency distributions in both groups were determined. Statistical analysis was done with the Chi-square test. In both groups, the frequency of the GA genotype was greater compared to the GG genotype and AA genotype. There was no statistically significant deviation from Hardy Weinberg Equilibrium with a P value of <0.247 and <0.815 in the case and control groups, respectively. The frequency distribution of the dominant genotype GG had an odd ratio of 0.3506 (0.0791-1.5544) and a P value of 0.1678 and the recessive genotype AA had an odd ratio of1.5556 (0.4187-5.7795) and a P value of 0.5094. The distribution of G allele and A allele between the two group had an odd ratio of 0.6169 (0.2798-1.3597)and a P value of 0.2309. Classification of the genotypes based on genetic models such as dominant, recessive, or additive did not present any significant association between the polymorphism marker and NSCL/P. There was no significant association between RFC1 gene polymorphism (rs1051266) and NSCL/P in the South Indian population.
RFC1 gene; Polymorphism; NSCL/P; rs1051266.
Copyright (c) 2025 A. Sumathi Felicita, Ritya Mary Jibu, Vijayashree Priyadharshini Jayaseelan. 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
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
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
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
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
In Vitro Analysis of Marginal Sealing Using Light Curing Techniques on Aged and Unaged Composite Resins
To evaluate the marginal sealing of resin composite restorations subjected to various light-curing protocols, both with and without artificial aging through thermocycling. A comparative, longitudinal in vitro experimental study was performed with 120 bovine teeth distributed across 8 groups. The teeth were treated with different light intensities (650-1200 mW/cm², 800 mW/cm², 1200 mW/cm², 2500-2800 mW/cm²) along with different curing times (15", 20", 10", 3"), as described in the ISO 11405-2015 standard. Thermocycling comprised of 10,000 cycles to replicate one year of intraoral conditions, and microleakage was measured with dye penetration and the Khera and Chan scale (0-3). The majority of samples (41.7%) displayed dye penetration in the middle third of the interface (grade 2). Significant differences were detected among samples with and without thermocycling in the specific groups (p=0.027 and p=0.013), confirming a possible effect of artificial aging. For the highest light intensities (2500-2800 mW/cm²), no significant differences were present (p=0.527), indicating a possible lower effect of thermocycling at these intensities. The results demonstrate that marginal sealing varies by curing protocols and aging processes. Thermocycling affected microleakage with moderate light intensity, while higher intensities and shorter curing times had a reduced effect. These results point to the need for optimizing the curing protocols to provide better long-term durability for the restoration. Further work should examine other variables that may alter marginal sealing.
Marginal sealing; Light curing; Thermocycling.
Copyright (c) 2025 Julia Medina, Lucia Quispe-Tasayco, Hector Orellana-Arauco, Willy Muñoz, Fran Espinoza-Carhuancho, Frank Mayta-Tovalino. 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
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
Use of Thyroid Shield in Cone-Beam Computed Tomography: A Literature Review
The aim of this literature review was to analyze the evidence and international recommendations on the use of thyroid shield (TS) in cone-beam computed tomography (CBCT) examinations. The search was conducted in three electronic databases (PubMed, Scopus, and Web of Science) in English from 2010 to date. This search included articles that provided recommendations or benefits of TS use in CBCT, as well as those that discouraged its use. A complementary search was conducted by reviewing guidelines, recommendations, or articles from international organizations and globally recognized journals, published on their official websites. Of the 23 articles reviewed, 19 indicate that using TS in CBCT reduces radiation doses in patients or recommend its use in these examinations, as it provides a benefit to the patient. However, some note specific cases where its use is not advised. On the other hand, two articles, from the British Institute of Radiology and the UK Health Security Agency, do not recommend the use of TS in CBCT examinations, except in specific cases. Finally, two articles, both from the American Dental Association, oppose TS use in all maxillofacial radiographic examinations, including CBCT. Although there is no consensus among the reviewed articles regarding recommendations or benefits of TS use in CBCT examinations, most articles indicate that it reduces ionizing radiation doses or recommend its use. However, in some cases, TS use may interfere with image quality, making deciding whether to use TS in CBCT examinations challenging for the operator.
Radiation protection; Cone-beam computed tomography; Guideline; Radiation, Ionizing; Thyroid gland; Radiography, Dental; Radiation dosage.
Copyright (c) 2025 Andrea Carrasco M, Lucía Barba R., Alejandro Hidalgo R. 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
Fibro-Osseous Lesion Associated with Central Giant Cell Granuloma: A Rare Hybrid Lesion of the Anterior Mandible
Hybrid lesions have been reported in literature as lesions consisting of a combination of characteristics from different pathologies. In this article we document a case where a collision tumor of central giant cell granuloma and juvenile trabecular ossifying fibroma co-existed in the mandible. Only a few cases of similar conditions were documented in literature. An 18-year-old female presented with an unusually painful swelling in the symphysis and parasymphysis region bilaterally. Although the two-dimensional imaging suggested an enlarged cystic lesion, the CBCT revealed a well-defined multi-locular hypodense lesion with hyperdense foci, buccal cortical expansion, and lingual cortical perforation suggesting a more aggressive pathology. Curettage, peripheral ostectomy and apicectomy to the associated teeth were the treatment modalities performed. Six months postoperatively, tooth mobility had resolved, and trabecular bone formation was evident in the parasymphysis region. The co-existence of central giant cell granuloma and juvenile trabecular ossifying fibroma is to be considered on observing the clinical and radiographic pictures of both in the same case.
Giant cell granuloma; Juvenile ossifying fibroma; Ossifying fibroma; Fibro-osseous lesion; Hybrid tumor; Collision tumor.
Copyright (c) 2025 Esraa Ahmed Eid, Mona Mahmoud Abo El Fotouh, Hossam El-Dien Hany, Basma Abdelrahman Ahmed, Mariam Magdy Mostafa, Iman Mohamed Helmy. 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
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
Effectiveness of Injectable Platelet Rich Fibrin, Oxygen Releasing Gel and Hyaluronic Acid Gel as Local Drug Delivery Agents in the Treatment of Chronic Periodontitis: A Clinico-Microbiologic Study
This study clinically and microbiologically evaluated the efficacy of liquid i-PRF, oxygen-releasing gel, and hyaluronic acid (HA) gel as local drug delivery (LDD) agents adjunctive to scaling and root planing (SRP) for treating periodontal pockets. A split-mouth randomized controlled trial involved 12 patients with 80 periodontal pockets (3-6 mm depth). Pockets were randomly assigned to four groups: Control (SRP alone), Experimental Group I (i-PRF + SRP), Group II (oxygen-releasing gel + SRP), and Group III (HA gel + SRP). Plaque samples were analyzed for spirochetes using dark-field microscopy at baseline, 1- and 3-months post-treatment. Other primary outcome assessed were Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), and Gingival Recession (GR)—were measured using a UNC-15 probe. The statistical tests used were the Bonferroni test for intragroup comparison, the paired t test, the repeated measure analysis of variance test (ANOVA), and the unpaired t test for intergroup comparison between different groups. Intragroup analysis showed significant improvements in PI, GI, PPD, CAL, and GR across all groups (p<0.05). Intergroup comparisons revealed no significant differences. Microbiologically, i-PRF significantly reduced spirochetes (p<0.05), while oxygen-releasing gel showed superior clinical outcomes (p<0.05). All LDD agents have shown significant therapeutic potential. Oxygen-releasing gel excelled clinically, while i-PRF was microbiologically superior, indicating its therapeutic potential for periodontal pocket treatment.
Dental scaling; Hyaluronic acid; Periodontal pocket; Periodontitis, Platelet-rich fibrin; Root planning.
Copyright (c) 2026 Mansi Bansal, Manish Khatri, Deepali Mathur, Pratiksha Tripathi, Nisha Parveen, Nutan Tyagi. https://creativecommons.org/licenses/by-nc-sa/4.0
Dental Care Delivery in a Social Assistance Center in Mexico: A 14-Month Case Series of Children and Adolescents in Foster Care
All children and adolescents have the right to receive a series of special protection and assistance measures from their respective countries. States must protect them from all forms of maltreatment, harm, neglect, or abuse. In cases that arise, the priorities must be the restoration of rights and residential care that provides comprehensive services including health. The paper reports a descriptive and retrospective study for a 14-month period conducted as a case series of 54 children and adolescents who received dental care in a Social Assistance Center in Mexico, where they were temporarily housed. Based on the initial clinical evaluations, it was identified that 100% of them had at least one untreated cavitated caries lesion, and 64.8% had apparently not received previous dental care. A total of 418 dental procedures were performed and 19 patients were discharged with completed treatment plans. There is a need to seek more collaborative approaches and to make positive contributions to improve the oral health of the pediatric population in situations of vulnerability and Foster Care.
Adolescents; Dental care; Foster children; Oral health; Social service.
Copyright (c) 2026 Guillermina Preciado-Meza, Jaasiel Ramírez-Rangel, Hiram Daniel López-Santacruz. https://creativecommons.org/licenses/by-nc-sa/4.0
Annualization of Fifth-Year Clinical Training in Dentistry: A Curricular Experience at the University of Costa Rica
The aim of this study was to determine the academic impact of converting fifth-year clinical courses at the Faculty of Dentistry of the University of Costa Rica from a semester-based to an annual format by comparing approval, failure, and academic delay outcomes between the two curricular models. An observational retrospective study with longitudinal follow-up was conducted using institutional academic records of 670 students from entry years 2007-2020, with follow-up through December 2024. Student records were analyzed considering variables such as gender, age, admission note, clinic approval rates, and academic delay. Approval rates between curricular formats were compared using chi-square tests and multivariate logistic regression models (OR, 95% CI). Academic delay was analyzed descriptively by clinical discipline and curricular format. Of the students included, 322 completed clinical courses under the semester-based system and 348 under the annual system. Statistically significant differences favoring the annual format were observed in Endodontics (79% vs. 64.3%; p<0.001) and Periodontics (91.4% vs. 83.5%; p=0.002), whereas Restorative Dentistry showed higher approval rates under the semester-based model (83.5% vs. 75.9%; p=0.014). No significant differences were found in Diagnosis, Oral Surgery and Exodontia, or Pediatric Dentistry and Orthodontics. Although a greater absolute number of students repeated courses under the semester-based format, failure in the annual format was associated with a longer mandatory academic delay (12 months vs. 6 months). The academic impact of annualization was heterogeneous across clinical disciplines, highlighting the importance of evaluating curricular reforms using objective indicators before consolidating permanent structural changes in dental clinical education.
Dental education; Curriculum; Clinical clerkship; Educational measurement; Curriculum reform; Longitudinal studies.
Copyright (c) 2026 Natalia Gutiérrez-Marín, Marco Godínez-Chinchilla, Adrián Gómez-Fernández. https://creativecommons.org/licenses/by-nc-sa/4.0
Color Stability and Surface Roughness of Esthetic Resin Composites Following Simulated Toothbrushing with Whitening Toothpastes
This in vitro study aimed to evaluate the effects of two whitening toothpastes with different mechanisms and one non-whitening, low-abrasivity toothpaste on the color stability and surface roughness of three anterior esthetic resin composites after coffee staining. Ninety disc-shaped specimens (2 mm × 6 mm) were prepared from three resin composites: Filtek Ultimate, Estelite Sigma Quick, and Neo Spectra ST Effects (n=30 each). After polishing, specimens were stored in distilled water for 24 hours at 37°C. For staining, the specimens were fully immersed in a freshly prepared coffee solution (3.6 g/300 ml) at room temperature for six consecutive days. The solution was renewed every 24 hours to ensure a constant concentration of chromogens, simulating six months of clinical coffee consumption. Color and surface roughness were measured at baseline and after staining. Each composite group was then divided into three subgroups (n=10) and brushed in a simulator with one of three toothpastes—Sensodyne Promine, Opalescence Whitening, or R.O.C.S. Sensation Whitening—for a total of 30 minutes at a 200 g load. Final measurements were taken, and color change (∆E00) and surface roughness change (∆Ra) were calculated. Data were analyzed using ANOVA and Tukey HSD (p<0.05). Composite type significantly influenced color change after staining (p<0.05), with Estelite Sigma Quick showing the highest ∆E00 values. Toothpaste type also significantly affected color change (p<0.05), with Opalescence Whitening producing greater whitening in certain composite groups. All experimental groups exhibited ∆E00 values above the clinical acceptability threshold (∆E00> 1.8). Surface roughness increased significantly within some groups after brushing, but there were no significant intergroup differences between toothpaste types (p>0.05).
Coffee staining; Color stability; Resin composites; Surface roughness; Whitening toothpaste; Toothbrushing.
Copyright (c) 2026 Ecehan Kaplan, Ayşe Dündar, Çağatay Barutçugil. https://creativecommons.org/licenses/by-nc-sa/4.0
Artificial Intelligence in Endodontic Diagnosis and Treatment: A Bibliometric and Science-Mapping Analysis
This study aimed to map global research trends, intellectual structure, and emerging themes in artificial intelligence (AI) applications for endodontic diagnosis and treatment using bibliometric and science-mapping approaches. A comprehensive search of the Web of Science Core Collection was performed on July 20, 2025, without time restrictions. Records were independently screened by two reviewers according to predefined inclusion and exclusion criteria. Bibliometric data were analyzed using Microsoft Excel, RStudio (bibliometrix package), VOSviewer, and CiteSpace. Indicators assessed included annual scientific production, citation impact, leading journals and countries, collaboration networks, keyword co-occurrence, co-citation clusters, and citation bursts. Of the 121 records identified, 72 articles met the inclusion criteria. Scientific production increased markedly after 2022, with more than half of the publications appearing during 2024-2025. The Journal of Dentistry and the Journal of Endodontics demonstrated the highest citation impact. China, the United States, Germany, India, and Turkey were the most productive countries, with China leading in total citations. Four principal thematic clusters were identified, including review-based evidence synthesis, methodological workflows, convolutional neural network–based imaging applications, and future research perspectives. Citation burst analysis revealed emerging interest in segmentation techniques, cone-beam computed tomography–based diagnosis, and deep learning applications. Research on AI applications in endodontics has expanded rapidly, with a strong focus on imaging-driven diagnostic and clinical applications. Future research should emphasize multicenter validation, standardized methodological frameworks, and ethical integration into clinical practice.
Artificial intelligence; Bibliometrics; Cone-Beam computed tomography; Deep learning; Endodontic.
Copyright (c) 2026 María Mihaela Iuga, Tatiana Ramírez-Mora, Fernando Mauricio Espada Salgado. https://creativecommons.org/licenses/by-nc-sa/4.0
Management of Post-Extraction Orthodontic Relapse Using Miniplate Anchorage: A Case Report
Orthodontic relapse, particularly after extraction-based treatment and compromised anchorage control situation, remains a clinical as well as esthetic challenge. This case report presents the successful re-treatment of a 24-year-old female patient with a relapsed malocclusion, proclined incisors, molar crossbites, and lip protrusion, following prior fixed orthodontic therapy with extraction of four premolars. Miniplate-assisted maxillary arch distalization was employed to accomplish en-masse retraction, correct molar relationship, and improve facial profile. The use of temporaray skeletal anchorage device such as miniplates imparted steady, compliance-free mechanics, ensuing enhanced dental occlusion and soft tissue harmony. Here we highlight the effectiveness of miniplate-based mechanics in complex retreatment circumstances where traditional anchorage generally proves to be inefficient.
Distalization; Orthodontic re-treatment; Miniplates; Relapse;Temporary anchorage device.
Copyright (c) 2026 A. T. Prakash, Nikunj Maniyar, Amarnath P. Upasi. https://creativecommons.org/licenses/by-nc-sa/4.0
Altered Catecholamine Metabolism in Atypical Facial Pain: Quantitative and Predictive Insights from Salivary COMT Expression
Atypical Facial Pain (AFP) is a chronic orofacial pain disorder marked by persistent, idiopathic facial pain significantly affecting the mental health and quality of life. Identifying objective biomarkers remains challenging. Catechol-O-methyltransferase (COMT), a key enzyme in catecholamine metabolism, modulates pain and stress responses; its reduced activity has been linked to chronic pain. This study assessed salivary COMT levels in AFP patients and explored its diagnostic utility through statistical and machine-learning approaches. A comparative cross-sectional study was conducted with 20 AFP patients and 20 age- and sex-matched healthy controls. Unstimulated saliva samples (8:00-10:00 AM) were analyzed using a Human COMT ELISA kit (KRISHGEN Biosystems). Group differences were tested with an independent samples t-test, and effect size, confidence intervals, and power were calculated. Diagnostic performance was evaluated using ROC and logistic regression, with leave-one-out cross-validation (LOOCV) for model validation. AFP patients showed significantly lower salivary COMT (14.20±3.15 ng/mL) than controls (20.08±2.39 ng/mL; t(18)=3.03, p=0.0073). The mean difference (7.03 ng/mL; 95% CI: 2.07-11.49) yielded a large effect size (Cohen’s d=1.35) and power of 0.82. ROC analysis produced an AUC=0.86 with 90% sensitivity and specificity at 17.7 ng/mL. Logistic regression confirmed COMT as a significant AFP predictor (β= –1.19, p<0.05). LOOCV achieved 75% accuracy, 0.86 precision, 0.60 recall, and AUC=0.82. Salivary COMT levels are markedly reduced in AFP, reflecting altered catecholamine metabolism and pain modulation. Both statistical and machine-learning analyses confirmed excellent discriminative accuracy, supporting COMT as a promising non-invasive, accessible biomarker for AFP screening and diagnosis.
Pain; Biomarker; Mental health; COMT; Saliva.
Copyright (c) 2026 Sarthak Juneja, Suganya Panneer Selvam, Ramya Suresh, Ramya Ramadoss, Sandhya Sundar. https://creativecommons.org/licenses/by-nc-sa/4.0
Titanium Scanbody Repeated Use for Complete-Arch Implant Impression: An In Vitro Accuracy Analysis
The aim of the study was to assess the effect of titanium scanbody (Ti ISB) repeated use on the accuracy of complete-arch implant impression in vitro. A mandibular resin model with four conical connection implant analogues was digitized using an extraoral scanner to achieve a reference file. Thirty-eight test files were obtained with an intraoral scanner (IOS) and superimposed to the reference file. Screw-retained sand-blasted Ti ISB were screwed and unscrewed between each test scan. Implant positions (n=152) were analyzed through linear (∆X, ∆Y and ∆Z- axis) and angular deviations (∆ANGLE). Three-dimensional (3D) deviation was calculated as Euclidean distance (∆EUC) from the linear deviations. Effect of implant position was also calculated. A significative reduction of ∆EUC over time (p=0.001, b=-0.00099) was noticed, with position 4.5 as the least accurate with a significant difference compared to 3.2. Considering ∆ANGLE a significant reduction was noticed over time (p=0.041, b=-0.0031), with position 4.5 as the least accurate with a significant difference compared to 3.2 and 4.2. Conclusions: Ti ISBs repeated use didn’t show a significant negative effect on complete-arch IOS implant impression accuracy both in terms of angular and 3D deviation. Implant position showed a significant effect on accuracy with posterior tilted identified as most critical positions.
Scanbody; Repeated use; Wear; Complete-arch; Accuracy; Intraoral scanner.
Copyright (c) 2026 Lorenzo Arcuri, Ilaria Cammarota, Alessio Rosa, Alessandro Pozzi, Luca Testarelli, Massimo Galli. https://creativecommons.org/licenses/by-nc-sa/4.0
Supracrestal Tissue Attachment (Biologic Width) in Clinical Practice: A Narrative Review
The supracrestal tissue attachment, historically referred to as the biologic width, represents a dentogingival unit fundamental for periodontal health and restorative predictability. This narrative review evaluates both conventional and technology-assisted strategies for its preservation. Searches were conducted in PubMed/MEDLINE, Scopus, and Web of Science. Eligible studies encompassed systematic and narrative reviews, consensus statements, clinical trials, comparative studies, and case series. The evidence was critically appraised using the Oxford Centre for Evidence-Based Medicine (OCEBM) framework and synthesized thematically into comparative and recommendation tables. Conventional techniques (gingivectomy, access flaps, osteotomy, and osteoplasty) remain reliable when guided by biologic and prosthetic principles. Laser-assisted procedures enhance soft tissue management through improved precision, effective hemostasis, and reduced morbidity. Digitally guided workflows that integrate CBCT, intraoral scanning, and CAD/CAM technology enable precise mapping and reproducibility, particularly in esthetically demanding cases. Optimal management requires individualized planning that integrates conventional, laser-assisted, and digital approaches within an evidence-based framework, ensuring periodontal stability, restorative longevity, and harmonious esthetic outcomes in clinical practice.
Periodontium; Gingiva; Gingival diseases; Periodontal surgery; Dental technology.
Copyright (c) 2026 César-Augusto Padilla-Avalos, Consuelo Marroquín-Soto, Gianella Sedano Huaman, Paula Ximena Gómez Restrepo, Rocío Alvarez Medina, Claudio Peña-Soto. https://creativecommons.org/licenses/by-nc-sa/4.0
Initial Structural Validity and Internal Consistency of the MKAB-OH-S Scale for Oral Health in Andean Schoolchildren
This study aimed to provide initial psychometric evidence of structural validity and internal consistency of the Measurement of Knowledge, Attitudes, and Behaviors Regarding Oral Health in Schoolchildren Scale (MKAB-OH-S), developed in Spanish for Andean bilingual schoolchildren. Following a pilot test with 30 students, the scale was administered to 227 schoolchildren aged 8 to 12 years. Content validity indices indicated high expert agreement, with item-level I-CVI values ranging from 0.89 to 1.00 and Aiken’s V confidence intervals between 0.80 and 1.00. At the scale level, the average I-CVI was 0.9925 and Aiken’s V was 0.966 (95% CI: 0.915-1.00). Exploratory and confirmatory factor analyses supported the unidimensional structure of each scale dimensión, with satisfactory model fit indices. Internal consistency was acceptable to excellent across dimensions, with Cronbach’s alpha coefficients of 0.65 for knowledge, 0.91 for attitudes, and 0.73 for behaviors, alongside consistent McDonald’s omega and AVE values. The attitudes dimension demonstrated the strongest psychometric performance, followed by behaviors and knowledge. Overall, the results provide initial evidence supporting the structural coherence and internal consistency of the MKAB-OH-S scale for use in similar bilingual school settings. Further studies in broader and more diverse populations are recommended to strengthen evidence of stability and generalizability.
Bilingualism; Cultural characteristics; Dental caries; Health knowledge; Attitudes; Practice; Oral health; Rural population; Students.
Copyright (c) 2026 Vilma Mamani-Cori, Evelyn L. Tintaya-Quispe, Marco A. Quispe-Apaza, José M. Aguilar-Huanca, Franz A. Jamachi-Ccama, Betsy Quispe-Quispe, Yessica Quilca-Soto. https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of Preheating and Glycerin Barrier on Surface Characteristics of Composite Resins
This study aimed to assess the influence of preheating, glycerin barrier application, and polishing protocols on the surface roughness of microhybrid and submicron-filled composite resins. Eighty extracted human third molars were prepared with standardized Class I cavities and restored using Enamel Plus HRi (microhybrid) or Estelite Sigma Quick (submicron-filled). Specimens were divided into preheated (55 °C) and non-preheated groups, and further allocated to four subgroups: (1) polishing only, (2) polishing + glycerin, (3) glycerin only, and (4) control. All restorations were light-cured with an LED unit. Surface morphology was analyzed by scanning electron microscopy (SEM), and Ra values were determined. Data were analyzed using one-way ANOVA and Tukey’s post hoc test (p<0.05). SEM showed that glycerin-shielded specimens were cleaner, with reduced OIL-related debris. Preheating consistently yielded smoother, less porous surfaces across protocols. Polishing significantly reduced Ra in all groups, with the lowest values for “polishing + glycerin” (0.83±0.01 µm in preheated Enamel Plus HRi; 1.09±0.02 µm in non-preheated Estelite Sigma Quick). Glycerin without polishing improved polymerization but did not significantly reduce Ra. Controls exhibited the highest roughness (up to 5.20±0.61 µm). Overall, the combination of preheating, glycerin barrier application, and polishing produced the smoothest composite surfaces. Glycerin improved surface chemistry by reducing OIL, while polishing was essential for levelling filler protrusions and irregularities.
Resin composite; Preheating; Glycerin barrier; Oxygen-inhibited layer; Surface roughness; Polishing.
Copyright (c) 2026 Zurab Khabadze, Oleg Mordanov, Vini Mehta. https://creativecommons.org/licenses/by-nc-sa/4.0
Oxidative Stress Markers Analysis in Sites with Healthy Conditions and with Periodontal and Peri-Implant Diseases
To evaluate the gingival crevicular fluid (GCF) and the peri- implant crevicular fluid (PICF) concentration of oxidative stress markers, such as malondialdehyde (MDA) and superoxide dismutase (SOD) in healthy sites and in those affected by periodontitis (PER) and peri-implantitis (PIM). Sites in periodontal (PH) and peri-implant (PIH) healthy conditions and sites with PER and PIM were investigated in 120 subjects. Clinical parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bleeding on probing (BOP) were recorded. Levels of MDA and SOD in GCF and PICF were determined using commercially available enzyme-linked immunosorbent assay (ELISA) kits and statistically correlated with PI, GI PPD and BOP. No statistically significant differences (p>0.05) in level of MDA and SOD were found in PH vs. PIH sites with. Compared to PH sites, PER sites presented a higher level of MDA and SOD, but the difference was not statistically significant (p>0.05). Statistically significant higher concentrations of MDA (p=0.009) and SOD (p= 0.004) were found in PIM sites compared to PIH. Moreover, PIM sites showed also statistically higher levels of MDA (p=0.012) and SOD (p=0.013) than PER sites. MDA and SOD concentrations were found positively correlated with PD and BOP. The measured oxidative stress markers were statistically higher in diseased peri-implant sites than in diseased periodontal sites.
Perimplantitis; Periodontitis; Oxidative stress markers.
Copyright (c) 2026 Renzo Guarnieri, Rodolfo Reda, Alessio Zanza, Chiara Bramucci, Luca Testarelli, Dario Di Nardo. https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Aloe vera Gel on Osteoclast and Osteoblast Activity and Receptor Activator of Nuclear Factor Kappa-B Ligand Expression During Bone Remodeling Following Orthodontic Temporary Anchorage Device Placement: An In Vivo Study
The biomedical use of Aloe vera continues to expand, including in orthodontics where its role in bone remodeling is of particular interest. This study aimed to evaluate the effect of Aloe vera gel on osteoclast, osteoblast, and RANKL expression following Temporary Anchorage Device (TAD) placement. Thirty male New Zealand White rabbits were randomly assigned to control and treatment groups. TADs were placed in the maxillary buccal region, and the treatment group received 50% Aloe vera gel topically. Each rabbit in the treatment group received 0.5 g of 50% Aloe vera gel topically around the TAD site twice daily. Histological analysis and ELISA were conducted on days 3, 7, and 14. The results showed a significant increase in osteoblast counts on days 7 and 14 (p<0.05). Osteoclast counts remained elevated on day 3 but were significantly lower than the control group (p < 0.05), followed by a further decrease on day 14. RANKL expression increased moderately over time (R²=0.517). Regression analysis demonstrated a time-dependent effect of Aloe vera on osteoblasts (R²=0.834) and osteoclasts (R²=0.928). These findings suggest that Aloe vera gel supports bone remodeling by relatively suppressing osteoclast activity, enhancing osteoblast response, and modulating RANKL expression proportionally, making it a promising adjunct for improving TAD stability in clinical orthodontics.
Aloe vera; Bone remodeling; Osteoblasts; Osteoclasts; RANKL; Temporary Anchorage Device (TAD).
Copyright (c) 2026 Pepi Riyani Siregar, Baharuddin M. Ranggang, Nasyrah Hidayati, Eddy Heriyanto Habar, Eka Erwansyah, Ardiansyah S. Pawinru, Zilal Islamy Paramma. https://creativecommons.org/licenses/by-nc-sa/4.0
Human Papillomavirus Detection in Crevicular Fluid and Risk Stratification in Refractory Periodontitis: A Multicenter Cross-Sectional Study
Refractory periodontitis affects treatment success rates and may be associated with viral reservoirs in periodontal pockets. Human papillomavirus (HPV) causes direct cytopathic effects on periodontal tissues and may contribute to treatment failure. This study aimed to detect HPV in crevicular fluid and develop a risk stratification tool for patients with refractory periodontitis. A cross-sectional multicenter study was conducted involving 80 patients with refractory periodontitis from two Colombian universities. HPV detection was performed using conventional and real-time duplex PCR in crevicular fluid samples. Sociodemographic and clinical variables were analyzed. Multivariate logistic regression and ROC curve analysis were used to develop and validate a risk prediction score. HPV prevalence was 15% (12/80 patients), with high-risk genotypes identified in 4 cases (33% of HPV-positive). Multivariate analysis revealed oral sex practice as the strongest independent predictor (OR=18.9; 95%CI: 4.2-85.3, p<0.001), followed by female sex (OR=2.8; 95%CI: 0.6-13.1) and age >50 years (OR=4.2; 95%CI: 0.5-35.7). The developed risk score showed excellent discriminative capacity (AUC-ROC=0.85; 95%CI: 0.74-0.96) with 75% sensitivity and 82% specificity at optimal cutoff. HPV detection in crevicular fluid using our validated risk stratification tool may identify patients with refractory periodontitis requiring modified therapeutic approaches. The risk score provides a practical clinical tool for HPV screening in periodontal practice.
Periodontitis; Human papillomavirus; Polymerase chain reaction; Gingival crevicular fluid; Risk assessment; Oral health.
Copyright (c) 2026 Martha Rebolledo Cobos, Alejandra Herrera-Herrera, Jaime Plazas Román, Luisa Barriga Periñan, Martha Carmona Lorduy. https://creativecommons.org/licenses/by-nc-sa/4.0