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 Our journal consider unpublished and original manuscripts in ENGLISH with a prominent focus on critical and innovative data, promoting major clinical, academic and scientific research, based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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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.
Effect of Cetrimide with Bioceramic or Calcium Hydroxide Intracanal Medication
This study evaluated the pH, solubility, and intratubular decontamination of bioceramic intracanal medications Bio-C® Temp (BCT), a calcium hydroxide-based paste Calen® (CAL), and their associations with 1% Cetrimide (CTR): BCT, CAL, BCT/CTR, CAL/CTR. Polyethylene tubes filled with the medications were used for pH measurement at intervals of 1, 3, 7, 14, and 21 days. Solubility was evaluated after 14 days of immersion in distilled water at 37°C. Bovine dentin tubules contaminated with Enterococcus faecalis were used to assess intratubular decontamination using confocal laser scanning microscopy and Live/Dead BacLight Bacterial dye three days after exposure to the medications and a Control Group using Polyethylene glycol 400. Statistical analysis was performed using ANOVA and Tukey tests (p<0.05). CAL/CTR exhibited the highest pH after 1 day (p<0.05). CAL had the highest pH values at 14 and 21 days (p<0.05). BCT showed the lowest pH values at 3 days, and BCT/CTR at 7 and 21 days (p<0.05). The association of CTR did not affect the solubility of the medications (p > 0.05). CAL demonstrated superior intratubular decontamination (p<0.05), while CAL/CTR, BCT, and BCT/CTR showed similar results (p>0.05). The association of 1% cetrimide did not increase the intratubular decontamination of Bio-C® Temp and decreased the antibacterial activity of Calen®. The calcium hydroxide medication in a viscous vehicle exhibited higher alkaline potential, solubility, and intratubular decontamination.
Calcium hydroxide; Dental materials; Endodontics; Enterococcus faecalis; Root canal therapy; Silicates.
Copyright (c) 2025 Larissa Braz Pontes, Camila Soares Lopes, Jéssica Arielli Pradelli, Mário Tanomaru-Filho, Juliane Maria Guerreiro-Tanomaru. https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of Colonization and Biofilm Formation of E. faecalis over G-MTA, W-MTA and Biodentine. In vitro study
Apicectomy is a procedure indicated for the treatment of non-healing apical periodontitis after non-surgical Root Canal Treatment or certain clinical conditions; the procedure consists in the elimination of the last 3 mm of the RCS and creation of an apical preparation to finally seal it with a root-end filling material, like bioceramics. It has been reported that bioceramic materials (Gray-MTA, White-MTA and Biodentine) have adequate antibacterial properties. The aim of the study is to evaluate the colonization capacity and biofilm formation of E. faecalis over the surface of bioceramic materials In vitro. 180 dentin disks were employed and distributed in 3 experimental groups (G-MTA+E. faecalis, W-MTA E. faecalis and Biodentine+E. faecalis) and 3 control groups (G-MTA, W-MTA and Biodentine), the surface area covered by biofilm and microorganisms were evaluated by SEM. All samples of experimental groups showed a rough and irregular surface due to microorganism colonization and biofilm formation. G-MTA group showed better antimicrobial properties than W-MTA and Biodentine. The complete elimination and removal of damaged and contaminated periapical tissues during the surgical treatment is critical for long-term success.
Apicectomy, Root-End Filling Material, Biodentine, Gray-MTA, White-MTA.
Copyright (c) 2025 Alejandra Ruiz-Flores, Ana Maria González-Amaro, Norma Verónica Zavala-Alonso, Francisco Javier Gutiérrez-Cantú, Jairo Mariel-Cárdenas, Ricardo Oliva-Rodríguez, Abraham I. Muñoz-Ruiz. https://creativecommons.org/licenses/by-nc-sa/4.0
Cleaning Protocols for Bioceramic & Epoxy Resin Endodontic Sealers: Adhesion and Residue Removal
This study evaluated the effect of different chemo-mechanical cleaning protocols on the residual presence of epoxy resin-based and bioceramic endodontic sealers, as well as the bond strength of a universal adhesive system for cementing fiber posts to intraradicular dentin. A total of 160 bovine incisors were prepared using the ProTaper system and filled with either an epoxy resin-based sealer (Vioseal) or a bioceramic sealer (BioRoot RCS). Four cleaning protocols were tested: ethanol (ET), amyl acetate (AA), acetone (AC), and an experimental solution (EX) combining amyl acetate, ethanol, and acetone. Residual sealer was analyzed via scanning electron microscopy, and bond strength was assessed through push-out tests. Fracture patterns were examined under a stereomicroscope, and data were analyzed using ANOVA and Kruskal-Wallis tests (α=5%). For epoxy resin-based sealers, AA and AC resulted in greater dentinal tubule opening than ET and EX (p<0.05), with AC leaving the least residue. Conversely, ET and EX showed higher residual presence. For bioceramic sealers, ET and EX achieved the greatest tubule opening (p<0.05). Bond strength was highest with ET in the apical third (epoxy sealer) and in the cervical third (bioceramic sealer) (p<0.05). Ethanol and the experimental solution effectively removed bioceramic sealer residues while preserving bond strength. Although epoxy resin-based sealers left more residue, all tested protocols provided satisfactory adhesion.
Intraradicular dentin; Bioceramic cement; Epoxy resin cement; Bond strength; Cleaning protocols.
Copyright (c) 2025 Jaime Barcena-Taco, Ivana D. Mamani-Colque, Eliam C. Zúñiga-Mayhua, Wilfredo G. Escalante-Otárola, Milton C. Kuga, Gabriela M. Castro-Núñez. https://creativecommons.org/licenses/by-nc-sa/4.0
An Update on Bulk-Fill Restorative Materials. Myths, Facts and Guidelines for Predictable Clinical Application
Bulk-fill materials were developed to facilitate direct restorative procedures, mainly for deep and wide posterior cavities by allowing the placement of increments up to 4-5 mm thick. However, misinformation about the limitations on the technique used to place and polymerize these materials may impair achieving the topmost performance, because the mechanical properties may not be optimal at the deeper regions of the increment. Because the clinical performance of some materials varies according to the cavity depth, polymerization mechanism, chemical composition, this paper presents a general review of the materials available in the market, as a guide for the clinician, to help with the decision-making process and improve the predictability of the restorations made with bulk-fill materials.
Composite resins; Dental materials; Operative dentistry; Light curing.
Copyright (c) 2025 Marcelo Giannini, Alejandra Brenes Alvarado, Jorge Soto-Montero. https://creativecommons.org/licenses/by-nc-sa/4.0
Nanoleakage in Dentistry: 30 Years Later
Copyright (c) 2025 José Luis Álvarez-Vásquez, Nicholas G. Fischer. https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Simulation Technologies in Advancing Dental Radiology Education
Copyright (c) 2025 Elka Kostova, Stanislava Mavrodinova, Yanita Chernogorova. https://creativecommons.org/licenses/by-nc-sa/4.0
Florid Cemento-Osseous Dysplasia of the Mandible: A Case Report with Magnetic Resonance Imaging Findings and Conservative Management
Florid cemento-osseous dysplasia (FCOD) is a benign fibro-osseous lesion that often affects multiple regions of the mandible and maxilla and is usually detected incidentally. Although it is frequently asymptomatic clinically, complications such as pain and infection may develop in some cases. This case report presents in detail a case of FCOD identified in a 51-year-old female patient who presented with pain in the left mandibular region. Panoramic radiographs taken at different times and magnetic resonance imaging (MRI) findings were used in the diagnostic process, and a definitive diagnosis was made based on clinical and radiological data. The patient was managed conservatively without the need for any invasive intervention. This case highlights the role of comprehensive imaging modalities in the differential diagnosis of florid cemento-osseous dysplasia and underscores the importance of conservative management strategies.
Florid cemento-osseous dysplasia; Fibro-osseous lesions; Magnetic resonance imaging.
Copyright (c) 2025 Mustafa Kaan Samur, Melisa Öçbe. https://creativecommons.org/licenses/by-nc-sa/4.0
Knowledge and Compliance with the Infection Control Protocol in Dentistry at a Costa Rican University
Biosafety is essential for reducing exposure to infections and preventing contamination in dental practices. This study aimed to assess the knowledge level and compliance with the infection control protocol at a dental school within a university in Costa Rica. An online survey was distributed to all students, faculty, and support staff working in the university’s dental clinics between May and June 2022. The questionnaire included items on sociodemographic characteristics, training and mechanisms of information dissemination, access to personal protective equipment (PPE), perceptions of protocol adherence, sharps injuries, and vaccination practices. Descriptive statistics and chi-square tests were used to analyze the data. A total of 232 individuals participated; the majority were women (71%). Clinical students represented 35% of respondents, followed by faculty (30%), preclinical students (25%), and support staff (10%). While 98% reported being familiar with the protocol and 79% had received training, the proportion of trained faculty was notably lower (55%). Faculty also reported lower adherence to PPE use and biomedical waste management procedures. Preclinical students reported limited access to handwashing stations and related supplies. Only 66% of participants reported performing proper hand hygiene, and 70% cleaned electronic equipment appropriately. Vaccination rates for hepatitis B and COVID-19 were high, but antibody testing frequency was low. Despite widespread awareness of infection control protocols, adherence varies across groups. Faculty and preclinical students exhibit greater challenges in compliance. Strengthening training efforts and improving access to essential biosafety resources are critical to enhancing protocol implementation and ensuring safer clinical environments.
Biosafety; Dental clinics; Communicable disease control; Education; Occupational health.
Copyright (c) 2025 Carmen Dittel-Jiménez, Andrea López-Soto, Yadira V. Boza-Oreamuno. https://creativecommons.org/licenses/by-nc-sa/4.0
Influence of Printing Orientation on the Mechanical, Surface, and Polymerization Properties of Two 3D-Printed Dental Resins
This study aimed to evaluate the effect of printing orientation on the accuracy, flexural strength, surface roughness, and degree of conversion of two methacrylate-based resins commonly used in dental 3D printing. Rectangular specimens (64×10×3.3 mm) were designed according to ISO 20795-1:2013 standards and printed using an Asiga Max UV printer at three orientations (0°, 45°, and 90°) with two commercial resins: VeriGuide OS and VeriModel OS (Whip Mix). Dimensional accuracy was measured using a digital caliper, surface roughness by profilometry, and flexural strength through a three-point bending test. The degree of conversion (DC) was assessed using Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR). Data were analyzed with one-way ANOVA and Tukey’s post hoc test (α=0.05). Printing orientation significantly influenced several properties of the tested resins (p≤0.05). Specimens printed at a 45° angle showed the highest dimensional accuracy in length, width, and thickness. Flexural strength increased as the printing orientation became more vertical, with significant differences between 0° and 90° for both resins. Surface roughness was highest at 45°, while smoother surfaces were observed at 0°. The mean DC values were approximately 40% for all groups, with statistically significant differences observed only for the VeriGuide resin, where specimens printed at 0° achieved higher conversion compared to 45° and 90° orientations. Specimens printed at 45° demonstrated superior dimensional accuracy and higher surface roughness, while vertical orientations enhanced flexural strength. None of the resins achieved complete polymerization.
3D printing; Printing orientation; Dental resins; Flexural strength; Surface roughness; Degree of conversion.
Copyright (c) 2025 Tatiana Vargas Koudriavtsev, Marcela Hernández Jiménez, Esteban Avendaño Soto. https://creativecommons.org/licenses/by-nc-sa/4.0