Abstract: Dental restorations play a vital role in restoring teeth affected by caries, with stress distribution being a key factor in their durability. Finite element analysis is numerical method which commonly applied in dentistry to calculate and predict stress distribution. The study aimed to calculate and evaluate the von Mises stress distribution in Class V restorations of a mandibular first premolar using three different materials under varying occlusal loads. The 3D model of the mandibular first premolar was used in this study. Computer-aided design (version 4.0 SR8, USA), MIMICS®, 3-MATIC® software (3-Matic Medical 13.0, Materialise NV, Belgium) were used for preparation of the 3D model. ANSYS 16.0 (2020) program was to calculate and evaluate the distance and stress distribution four different applied forces ranging from 100N to 250N. To simulate and replicate the impact of tooth contact during a lateral excursive movement, the applied forces were positioned inside the buccal cusp tip (0.4 mm, right angles).Activa™ BioActive-Restorative (BIO) showed improved stress distribution, its stress concentrations remained higher than the two tested restorative materials. Among the restorative materials tested, Cention40 dental composite exhibited the lowest stress concentrations, especially at 100N (28.02 MPa). Stress distribution was similar across all materials, with no significant differences between them (p = 0.202). This suggests that all materials performed similarly in terms of stress distribution. There were statistically significant differences between loads in term of stress (p = 0.004). Stress values increased significantly with higher occlusal loads for all groups (p < 0.05).All the restorative materials exhibited comparable stress distribution patterns. Load intensity is the dominant factor influencing stress distribution in Class V restorations.

Abstract: Diagnostic imaging is fundamental in dentistry for disease detection, treatment planning, and outcome assessment. Traditional radiographic methods, such as periapical and panoramic radiographs, along with cone-beam computed tomography (CBCT), utilize ionizing radiation and primarily focus on visualizing bony structures. Magnetic resonance imaging (MRI) is emerging as a non-ionizing alternative that offers superior soft tissue contrast. However, conventional MRI faces challenges in visualizing mineralized tissues due to rapid signal decay from short transverse relaxation times (T2). Recent advancements exploring short T2 sequences, including Ultrashort Echo Time (UTE), Zero Echo Time (ZTE), and Sweep Imaging with Fourier Transformation (SWIFT), allow direct visualization of dental hard tissues. UTE captures signals from short T2 tissues using rapid pulse sequences, while ZTE employs encoding gradients before radiofrequency pulses to reduce signal loss. SWIFT enables near-simultaneous excitation and acquisition, improving ultrashort T2 detection. Additionally, customized intraoral and extraoral surface coils enhance image resolution and signal-to-noise ratio (SNR), increasing MRI's relevance in dentistry. Research highlights the potential of these short T2 sequences for early caries detection, pulp vitality assessment, and diagnosing jaw osseous pathology. While high-field MRI (3T–7T) improves resolution, it also increases susceptibility artifacts, whereas low-field systems with specialized coils and short sequences offer promising alternatives. Despite obstacles such as cost and hardware constraints, ongoing studies refine protocols to enhance clinical applicability. Incorporating MRI in dentistry promises a safer, more comprehensive imaging methodology, potentially transforming diagnostics. This review emphasizes three types of short T2 sequences that have potential applications in the maxillofacial region.

Abstract: Background/Objectives: Obstructive salivary gland disorders—primarily sialolithiasis and ductal stenosis—remain a significant source of morbidity, often requiring surgical intervention. Sialendoscopy has emerged as a minimally invasive, gland-preserving technique for both diagnosis and treatment. This retrospective study aimed to evaluate diagnostic and interventional sialendoscopy outcomes in a Romanian patient cohort and to identify gland-specific considerations in the management of salivary gland obstruction; Methods: A total of 89 patients with confirmed obstructive salivary gland disease (parotid or submandibular) were included. All underwent clinical evaluation, imaging (ultrasound, CBCT, CT, MRI), and sialendoscopic treatment between 2021 and 2025 in two centers. Data on demographics, imaging, calculus size, procedural technique, anesthesia, and complications were collected and analyzed using descriptive and inferential statistics; Results: The submandibular gland was more frequently involved (70.8%), with larger calculi compared to the parotid (mean 7.57 mm vs. 5.07 mm; P = 0.004). Minimally invasive techniques were predominantly used: sialolithotomy and intracorporeal lithotripsy were each performed in 32.6% of cases. Submandibulectomy was required in only 5.6% of patients. Most procedures (93.3%) were conducted under local anesthesia. Complication rates were low and primarily minor and self-limiting; Conclusions: Sialendoscopy is a safe and effective gland-preserving approach in managing obstructive salivary gland disorders. Gland-specific anatomy influences diagnostic pathways and therapeutic choices. These findings support broader adoption of sialendoscopy in routine practice and highlight the need for tailored management protocols based on gland involvement and stone characteristics.

Abstract: Background and Objectives: Dental anxiety is a common barrier to pediatric oral care. Non-pharmacological relaxation techniques like Jacobson’s Progressive Muscle Relaxation (JPMR) and Breathing Control (BC) may help reduce psychological and physiological stress. This study assessed the utility of JPMR and BC in reducing dental anxiety and physiological arousal in children and adolescents. Materials and Methods: In this observational study, 189 participants aged 8–17 undergoing non-invasive dental procedures were assigned to JPMR (n = 63), BC (n = 63), or control (n = 63) groups. Dental anxiety was measured with the Romanian-validated IDAF-4C⁺, and physiological stress via blood pressure and heart rate. Pre- and post-intervention data were analyzed using paired t-tests, ANOVA, and cluster analysis. Results: JPMR led to the highest reductions in IDAF-4C⁺ scores (Δ = −1.23, p < 0.001, d = 1.12) and systolic blood pressure (Δ = −9.4 mmHg, p < 0.01). BC showed moderate anxiety reduction (Δ = −0.64, p < 0.05, d = 0.61) with minor physiological changes. The control group showed no significant change. Cluster analysis revealed three response patterns: (1) high anxiety–strong responders (n = 58), mainly benefiting from JPMR; (2) moderate anxiety–partial responders (n = 74); and (3) low anxiety–non-responders (n = 57). Younger age and female gender were linked to better JPMR response. Conclusions: JPMR is an effective and practical method for reducing dental anxiety and physiological stress in pediatric dental care.

Abstract: Rehabilitation of severely resorbed anterior alveolar ridges presents considerable challenges due to compromised esthetics and insufficient bone volume. Conventional implant placement often necessitates extensive bone augmentation procedures, increasing patient morbidity, treatment duration, and overall complexity. Therefore, basal cortical implants have been developed to use basal cortical bone anchorage, offering enhanced initial stability and reducing the need for additional bone grafting. The ARi® Implant System, a novel basal cortical implant, combines a uniquely optimized thread design with a nanostructured, calcium-incorporated XPEED® surface treatment to promote early osteoblastic activity, rapid bone-to-implant integration, and improved biomechanical stability. This report describes two clinical cases involving patients with significant anterior alveolar ridge defects. The ARi® Implant System was used with vascularized interpositional periosteal (VIP) flap techniques, synthetic bone grafting, and collagen membrane coverage to optimize ridge augmentation and soft tissue stability. Both patients showed successful outcomes with stable osseointegration, minimal marginal bone loss, and excellent esthetic integration at 2-year follow-ups. The treatment approach reduced surgical complexity and healing time while enhancing patient satisfaction. The ARi® Implant System demonstrates promising clinical efficacy in anterior ridge augmentation, providing stable, esthetically pleasing outcomes without extensive bone grafting. Further biomechanical and long-term studies are necessary to confirm these findings.

Abstract: Background: This study aims to investigate ESM-1 (endocan) levels in periodontitis patients before and after nonsurgical periodontal treatment by analyzing the relationship between VEGF-A and TNF-α in gingival crevicular fluid (GCF). Methods: This study included 26 periodontally healthy people in the control group (Group 1) and 27 patients with Stage III-Grade B periodontitis (Group 2). Demographic and periodontal variables were assessed. GCF samples were collected from every subject both before and six weeks following non-surgical periodontal therapy (NSPT). Using an enzyme-linked immunosorbent test, biomarker levels were determined. Results: Periodontitis patients showed higher ESM-1 levels than controls, though not significantly (p > 0.005). ESM-1 levels decreased significantly after treatment (p = 0.001). VEGF-A levels did not differ significantly between periodontitis patients and controls (p > 0.005) and decreased following treatment without statistical significance (p > 0.005). TNF-α levels were significantly higher in periodontitis patients than controls (p = 0.000) and decreased significantly after treatment (p = 0.000). A significant correlation found between TNF-α and both PPD and iCAL in the control group (p < 0.05). In the periodontitis group, VEGF levels showed a significant correlation with GI (p < 0.05). Significant correlations were identified between ESM-1 and VEGF-A, ESM-1 and TNF-α, as well as VEGF-A and TNF-α in both the control group and the following treatment (p < 0.05). Conclusions: ESM-1 and TNF-a levels decreased with non-surgical periodontal treatment in GCF. Within the limits of the study, ESM-1 levels in periodontal tissues indi-cate that they may be indicator of periodontal disease prognosis.

Abstract: The aim is to present the 'Awake Bruxism Identification Tool (ABIT)' for children and adolescents. This tool was created at the Postgraduate Program of the Faculdade de Odontologia de Piracicaba at the Universidade Estadual de Campinas (FOP/UNICAMP) as part of a preliminary study, which was tested on 10 families from June to August 2023 at the Dental Specialties Center (CEO-Piracicaba-SP). The analysis consisted of Report 1 (R1), Report 2 (R2), Self-report (AR), Clinical Assessment (CA), and Ecological Momentary Assessment (EMA). R1, R2, and SR include questions about the perception of AB on a 5-point Likert scale, along with the recording of perception through analogical and playful EMA. Meanwhile, CA identifies intraoral and extraoral characteristics. Combining these items helps determine whether the child falls within the 'AB spectrum'. The tool was evaluated for comprehensibility, applicability and reliability, showing satisfactory results, with a reported completion time of between 5 and 10 minutes. The frequency of AB was 4 children in the “Possible AB Spectrum” and 3 children in the “Possible AB Spectrum corroborated by EMA”, with “teeth clenching” being the most frequently observed event. Adjustments to the instrument were made based on participant feedback, and the reproducibility of the ABIT seems adequate for the planned expanded study, which aims to contribute to the clinical investigation.

Abstract: The aim of this study was to investigate the effect of base material, restorative material and finish line on marginal and internal fit and fracture strength (FS) of endocrowns (N = 64). The restorative materials were ceramic and hybrid ceramic, the preparations were ferrule and modified butt joint (BJ) with two grooves, and the bases were with and without fiber ribbon. Marginal and internal fit were assessed using the triple scan. Statistical analyses were performed using three-way ANOVA. The absolute marginal discrepancy (AMD), marginal discrepancy and overall fit values obtained for ceramic were 127 µm, 108 µm and 120 µm, whereas those obtained for hybrid ceramic were 139 µm, 116 µm and 130 µm, respectively (p &lt; 0.05). The overall FS obtained for ceramic was 662 N, whereas that for hybrid ceramic was 903 N (p &lt; 0.001). When the material was evaluated regardless of preparation and base, ceramic and hybrid ceramic exceeded the selected clinical acceptability threshold for AMD, but did not exceed it for other parameters. Hybrid ceramic restorations with ferrules and fiber bases tended to provide the highest FS, whereas ceramic restorations with modified BJs and without fiber bases tended to provide the lowest FS.

Abstract: There are many clinical reasons for tooth extraction due to caries, periodontal disease, trauma, infection or the need to gain space due to orthodontic treatment. This study aimed to radiographically evaluate the preservation of the dental alveolus using platelet-rich fibrin. A total of 17 alveoli without PRF and 19 alveoli with PRF were analyzed, with an initial cephalocaudal height of 10.5 mm in both groups. The dimensional changes of the crest were evaluated using cone beam computed tomography (CBCT) images acquired 30 and 120 days post-extraction. In the cephalocaudal height at 120 days, a difference of 0.99 mm was identified in the alveolar height of both groups. The group with PRF had a greater height reaching an average of 10.30 mm, regarding to the depth measured at 1 mm, 3 mm and 5 mm, no significant differences were identified between both groups at 30 and 120 days, however, it is highlighted that those alveoli with PRF presented a lower bone loss in depth (1,3,5 mm) of 8.06mm, 8.45mm and 9.04mm. PRF filling effectivily preserves the dimensions of the alveolar crest in height, depth and bone tissue quality following extraction.

Abstract: Interim fixed dental prostheses (FDPs) play a crucial role in maintaining oral stability during the construction of final FDPs. Traditionally, interim FDPs were fabricated chairside using conventional methods. However, advancements in digital dentistry have introduced computer-aided manufacturing (CAM) techniques, including milling from prefabricated blanks and three-dimensional (3D) printing using light-sensitive resins, as common production methods. The aim of this review was to accumulate data on various fabrication techniques for interim FDPs, the materials used in their production, and the impact of each technique on the key factors influencing the success of interim FDPs.

Abstract: Background: Longitudinal studies that investigate the effects of the betterment of comorbid diseases on oral potentially malignant lesions are not yet available. Thereby, the aim of the current study is to examine the effects of comorbid disease betterment on oral potentially malignant lesions’ healing both in OLP and OL patients. Methods: The data of 197 consecutive patients (144 females and 53 males, age ± SD: 55.19±12.37 years, with ranges: 23-91 years), with oral lesions considered OLP and OL were processed and evaluated. Frequency of comorbid diseases and the presence of HPV (here subtypes were not evaluated) in the lesions in OLP, OL patient groups were evaluated and compared to the results of controls (n=139). Any risk model for OLP and OL lesions were established. High risk model for erosive-atrophic OLP and non-homogenous OL were also described. The influence of the betterment of comorbid diseases were also evaluated. Lesions were scored at the first and at the last visit (full recovery=0, improvement=1, no improvement=2). Results: One-hundred and ninety-seven patients (144 OLP +53 OL) were followed up for the average of 47.66 months (min-max: 1-203 months, SD: 54.19). Based on the established models HPV infection, iron deficiency, diabetes, and thyroid function disorders seem to behave as risk factors for OLP and also may affect OL formation. The betterment of comorbid diseases can cause significant improvement of OLP and OL lesions. Conclusion: By meticulous follow up of comorbid diseases the betterment of OLP and OL lesions can be achieved.

Abstract: It is well established that dental adhesive material are an important factor to achieve adequate adhesion results. However, it is not the only factor that contributes to the final bond strength. Improper operatory field isolation and contamination play an im-portant role in the final adhesion outcome. Background/Objectives: This article aims to give a clinical perspective with evidence-based arguments to find the best possible protocol for an enhanced adhesive protocol. Including why and how to make a rubber dam isolation, how to clean and prepare the dental substrate, and what the gold standard protocols for total-etch and self-etch techniques are. Conclusions: A well-established clinical protocol involving not only the adhesion material selection but also how to create a proper operative site free of contaminants and how to properly clean and prepare the dental substrate is paramount for achieving the best results in dental adhesion. Despite the development of simplified adhesive systems that offer acceptable bond strength results, the gold standard techniques continue to deliver superior and predictable out-comes. Great adhesion results do not depend only on the adhesive material itself but on a synergistic approach involving operative site isolation, substrate cleaning and treat-ment, and protocol fidelity. When these elements are correctly applied, they significantly enhance the reliability of dental adhesion for both direct and indirect restorations, con-tributing to improved restorative longevity.

Abstract: In this study, we proposed the successful conservative treatment of a Unicystic mural Ameloblastoma associated with an impacted tooth. Mural ameloblastoma is a subtype of Unicystic Ameloblastoma characterized by the expansion or infiltration of tumor nodules into the fibrous wall of the cyst. Our conservative approach preserved the integrity of the inferior alveolar nerve as well as mandibular functionality and resulted in a good aesthetic outcome. The conservative treatment consisted of an initial marsupialization followed by the enucleation of the lesion and restoration of the defective side with xenograft bone material.

Abstract: This study explores the application of advanced artificial intelligence (AI) models—DeepSeek, Grok 3, and ChatGPT—in orthodontics through a virtual simulation framework. Twenty virtual patients with malocclusions (Class I, II, III) were simulated over 28 days to evaluate AI-driven diagnosis, treatment planning, and patient education. DeepSeek achieved a 15% reduction in diagnostic errors compared to manual assessments, leveraging structured reasoning for cephalometric analysis. Grok 3 improved treatment plan accuracy by 20%, utilizing real-time biomechanical feedback to adjust tooth movement. ChatGPT enhanced patient comprehension by 25%, delivering natural language explanations of treatment processes. The virtual platform ensured precise control over variables like tooth movement rates and compliance, overcoming ethical and logistical barriers of traditional studies. Statistical analysis using t-tests (p &lt; 0.05) confirmed significant performance differences, with DeepSeek excelling in diagnostic precision, Grok 3 in adaptive planning, and ChatGPT in communication. These findings underscore AI’s potential to enhance orthodontic practice by improving accuracy, efficiency, and patient engagement. The complementary strengths of these models suggest a hybrid approach for future applications. As an open-access study, this work aligns with the Journal of Dental Sciences mission to advance clinical dentistry through innovative research, offering a scalable, cost-effective framework for orthodontic advancements.

Abstract: Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the widespread suspension of clinical practices worldwide, including dentistry. This study aims to evaluate the impact of these restrictions on oral health and dietary habits. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University Clinic (Lisbon Metropolitan Area), covering the period from June 2019 to June 2021. A total of 3,380 participants were included and categorized into two cohorts: pre- and post-COVID-19 restrictions. Data was collected through a structured questionnaire assessing oral health behaviors and dietary habits. Results: Out of 3,469 incoming patients, 3,380 met the inclusion criteria. Statistically significant post-lockdown changes were observed in body mass index, smoking status, oral hygiene behaviors, and specific dietary patterns such as tobacco and honey consumption, there was a decreased use of dental floss, mouthwash and altered tooth brushing frequency. Conclusions: COVID-19-related restrictions had an unequal impact on oral health and dietary behaviors in the studied population, highlighting the need for targeted public health strategies to mitigate the effects of such disruptions on vulnerable groups.

Abstract: Background: Plasma surface activation of dental implants has been proposed to enhance osseointegration by improving titanium surface chemistry. However, clinical data in humans remain limited. This randomized controlled trial aimed to assess the effect of vacuum plasma treatment on early implant stability in partially edentulous patients. Materials and Methods: In this single-blind, split-mouth randomized controlled trial, 24 patients requiring two contralateral implants were enrolled. Each patient received one plasma-treated implant and one untreated control implant. Vacuum plasma activation was performed immediately before insertion using a specific system (Plasma X Motion, MegaGen, Gyeongbuk, South Korea). Implant stability was assessed at placement and at 7, 14, 21, 28, 42, 60, and 90 days using resonance frequency analysis (Implant Stability Quotient, ISQ). Results: All 48 implants achieved successful osseointegration at 90 days, with no adverse events or complications. Mean insertion torque did not differ significantly between groups (p = 0.86). Both groups exhibited a typical initial reduction in stability, with the lowest ISQ values at 21 days. Plasma-treated implants showed a more favorable recovery pattern, with significantly higher ISQ values than controls at 60 and 90 days (p = 0.04 and p = 0.03, respectively). Nevertheless, the absolute difference in ISQ values between groups remained limited. Conclusion: Vacuum plasma activation of titanium implants may contribute to a more favorable early stability pattern, although both plasma-treated and untreated implants demonstrated predictable osseointegration outcomes. Further research with larger cohorts and longer follow-up is needed to fully assess the clinical significance of these findings.

Abstract: Background: Early Childhood Caries (ECC) is a common dental condition in children under six years, with Streptococcus mutans playing a key role in its development. The balance between demineralization and remineralization is essential for maintaining tooth integrity. Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) has anti-cariogenic properties and promotes remineralization. This study compares the effectiveness of CPP-ACP application versus Glass Ionomer Cement (GIC) restorations in reducing S. mutans in children with ECC.Materials and Methods: Eighty children were enrolled, with baseline S. mutans colony-forming units (CFU) assessed through stimulated saliva samples. Participants were randomly assigned to two groups: Group A received CPP-ACP application, and Group B underwent GIC restoration. Follow-up saliva samples were collected at 1 week, 1 month, and 3 months to reassess CFU counts. Results: No significant baseline difference in CFU counts was found between the groups (P = 0.7344). Post-treatment, the case group exhibited a significant reduction in CFU counts compared to the control group (P = 0.0002). Gender-based analysis revealed significantly lower CFU counts in both male and female participants in the case group at all time points (P < 0.05). These findings demonstrate the sustained efficacy of CPP-ACP with GIC restorations in reducing S. mutans. Conclusion: CPP-ACP application effectively reduces S. mutans levels in children with ECC, highlighting its potential as an adjunct to GIC restorations. Further studies with longer observation periods are needed to confirm these results.

Abstract: A common side effect of orthodontic treatment is pain that is typically managed with acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). However, the optimal NSAIDs choice for orthodontic pain relief, balancing efficacy and minimal impact on orthodontic tooth movement (OTM), remains unclear. This review investigates the relationship between OTM and orthodontic pain and explores how NSAIDs affect OTM based on a literature search of studies published between 2004 and 2024. Results suggest that ketorolac, nimesulide, and diclofenac may hinder OTM, while aspirin, ibuprofen, meloxicam, and celecoxib show varying effects. Tenoxicam, nabumetone, etoricoxib, and parecoxib appear to have no significant influence on OTM, with etoricoxib presenting as a potentially fa-vorable analgesic. The methodological limitations of the existing studies necessitate further rigorous clinical trials to validate the effects of NSAIDs on OTM in humans.

Abstract: This systematic review and network meta-analysis aimed to evaluate the bond strength of artificial caries-affected dentin (ACAD) of permanent human teeth with and without biomimetic remineralization (BR), assessed in in vitro studies. Following PRISMA guidelines, we conducted a systematic search until June 2023, identifying 82 eligible articles for full-text analysis. We assessed the study characteristics, methodological quality, and summary results. Bond strength was examined immediately and after artificial aging using three bond strength tests. We performed meta-regressions (using OpenBUGS software) to explore the relationship between the independent variable’s adhesive application technique (Etch-and-Rinse or Self-Etch) and ACAD protocol (chemical or biological) and the dependent variable bond strength. Additionally, we conducted random-effect NMAs (using CINEMA software) to compare the effect of multiple interventions per application technique and ACAD protocol simultaneously. Among the included studies that compared various BR strategies. Most studies (19 out of 22) presented a medium risk of bias. In some comparisons, meta-regression results revealed a significant association between bond strength at 24h and both the adhesive application technique and the ACAD protocol. Our findings indicate the potential of BR to enhance bond strength in human ACAD in in vitro settings .

Abstract: Kaposiform Hemangioendothelioma (KHE) is a rare, locally aggressive vascular tumor with histological similarities to Kaposi’s Sarcoma. It often presents in infancy or early childhood, rarely affecting adults. The most common sites include the skin, retroperitoneum, and less frequently, the head, neck, or mediastinum. KHE is seldom self-regressing, and distant metastases are rare, though 70% of cases may develop Kasabach-Merritt Syndrome (KMS), a severe coagulopathy marked by thrombocytopenia and high mortality due to hemorrhage. This report discusses a case of a 39-year-old woman referred for an exophytic lesion in the left retromolar region, with a diagnosis of Systemic Lupus Erythematosus. A biopsy confirmed KHE, and surgical resection was decided upon. Histological findings revealed characteristic features such as spindle cell clusters, numerous vascular fissure spaces, and eosinophilic cytoplasm. The patient underwent further surgical treatment due to the aggressive nature of KHE and the risk of KMS. This case highlights the importance of early diagnosis and appropriate surgical management for KHE to avoid complications.