Childhood cancer survivors face significant long-term oral health challenges following antineoplastic treatment. The primary aim of this study was to examine the effect of time elapsed since completion of antineoplastic treatment on oral health parameters - caries experience, salivary function, and dental developmental anomalies - in childhood ALL survivors. Secondary objectives included comparing oral health parameters between survivors and healthy sibling controls and identifying independent predictors of caries outcomes. This cross-sectional study included 38 ALL survivors (aged 5-18 years) and 20 healthy sibling controls. Dental caries was assessed using the International Caries Detection and Assessment System (ICDAS II) and DMFT/dft indices. Salivary flow rate (SFR) and pH were measured using standardized protocols. Dental developmental anomalies were assessed by combined clinical and panoramic radiographic examination. Comparisons were performed using the Mann-Whitney U test, the Kruskal-Wallis test, and the chi-square test, with multivariable linear regression used to identify independent predictors of caries outcomes. Early survivors demonstrated significantly higher mean ICDAS scores (median 1.38 vs. 0.60; p = 0.007) and elevated DMFT/dft indices (median 12.0 vs. 7.0; p = 0.002), together with significantly lower SFR (median 0.28 vs. 0.40 mL/min; p = 0.017), compared with late survivors. Dental developmental anomalies were significantly more prevalent in survivors (84.2%) than controls (10%; p < 0.001); microdontia was most common (37.7%), followed by root malformation (24.5%) and taurodontism (15.1%). Multivariable regression identified age and time since treatment completion as independent predictors of ICDAS scores (adjusted R² = 0.285, p = 0.014), while time since treatment completion independently predicted DMFT/dft scores (B = - 4.522, p = 0.003). Dental developmental anomalies were highly prevalent among childhood ALL survivors and, being a direct consequence of treatment, were independent of the time elapsed since its completion. In contrast, salivary flow rate and caries experience were poorer among survivors examined within 24-36 months of treatment completion than among those examined later, indicating gradual recovery of salivary function over time. Closer preventive dental monitoring during the first years after treatment, supported by sustained oncology-dental collaboration, is therefore recommended.
Recurrent aphthous stomatitis (RAS) is one of the most common inflammatory ulcerative disorders that impact the oral mucosa. The etiology of aphthous ulcers is complex and multifaceted; however, emotional stress is considered one of the primary risk factors contributing to their development in younger populations. This study aimed to determine the prevalence of RAS among a sample of dental students, its correlation with their stress levels, and to identify possible risk factors linked to these oral ulcers. This cross-sectional study involved 4th level dental students at King Salman International University using a standardized questionnaire evaluating medical and dental histories, personal habits, as well as oral hygiene practices including tooth brushing frequency and clinically relevant data regarding oral diseases, particularly RAS, alongside the 10- item Perceived Stress Scale. One hundred twenty-eight out of 150 students participated, 68.8% experienced RAS with females exhibiting a significantly lower likelihood of developing aphthous ulcers compared to males (OR = 0.233, p = 0.015). Daily toothbrushing was unexpectedly associated with a markedly increased risk (OR = 9.634, p < 0.001), suggesting a potential underlying mechanism warranting further investigation. Additionally, a family history of recurrent ulcers emerged as the strongest predictor (OR = 34.394, p < 0.001), highlighting a possible genetic predisposition. While poor oral hygiene demonstrated a high odds ratio (OR = 11.224), the association was not statistically significant (p = 0.059), possibly due to wide variability in the data. Similarly, high and moderate stress levels exhibited elevated odds ratios (OR = 8.716 and OR = 6.519, respectively), but their associations did not show statistical significance (p = 0.056 and p = 0.061). This research underscored a notable prevalence of RAS among dental students. It also identified familial history of aphthous stomatitis, presence of other dental issues, and regular daily toothbrushing as the three primary risk factors for aphthous lesions. Stress levels did not show a significant association with RAS lesions among dental students. Given that RAS is a multifactorial condition, further investigation into additional intervening factors is warranted.
This study analyzed the publication characteristics, citation patterns, and research trends of the Turkish Journal of Orthodontics (TJO) since its Web of Science (WoS) indexing in 2017. A retrospective bibliometric analysis was conducted using data from the WoS Core Collection (2018-24) on April, 2025. Network analysis was performed using CiteSpace 6.3.R1 and VOSviewer 1.6.18. Descriptive statistics were used to analyze publication trends, authorship patterns, geographical distribution, and citation performance. A total of 244 publications were analyzed, comprising 192 (78.7%) original articles, 27 (11.1%) reviews, eight (3.3%) systematic reviews, and 17 (7.0%) case reports. The journal achieved an h-index of 15, with 1408 total citations and an average of 5.77 citations per article. Türkiye contributed the most publications (58.2%), followed by India (16.8%), the USA (6.6%), and Iran (5.3%). International collaboration involved 39 countries, and the most-cited article received 32 citations. The gender distribution of authorship was closely balanced: 52.2% female and 47.8% male. 94.7% of publications were multi-authored, with an average of 3.5 authors per article. Keyword analysis revealed thematic clusters dominated by clear aligners, malocclusion, cone-beam computed tomography, and dental materials. TJO shows consistent growth in publication volume, expansion of international collaboration, and increases in citation impact since WoS indexing. The journal successfully captures emerging trends in clear aligners and rapid maxillary expansion while maintaining coverage of fundamental orthodontic topics. A strategic editorial evolution toward systematic reviews indicates a commitment to evidencebased practice. This bibliometric overview offers a data-driven foundation for future editorial decision-making and monitoring the journal's evolving role within orthodontic research.
This review examines the evolution, current structure and reform trajectories of dental education in Kazakhstan in relation to international standards, the Bologna Process and contemporary competency-based approaches. A literature search was conducted in PubMed, Scopus, Google Scholar and CyberLeninka, complemented by governmental and institutional documents covering the Soviet period to 2025. The review was guided by the SANRA framework. English- and Russian-language sources were included. Grey literature and policy reports were analysed due to the limited availability of peer-reviewed evidence. Kazakhstan has made important progress in structurally aligning dental education with international standards through Bologna-compatible curricula, accreditation mechanisms, competency-based educational standards and emerging simulation-based learning. However, evidence of consistent outcome-level implementation remains limited. Key challenges include uneven clinical and simulation infrastructure, faculty shortages, limited English proficiency, variable implementation of competency-based curricula, and insufficient standardization of modern assessment methods such as OSCE and workplace-based assessment. Recent initiatives focus on alignment with ADEE and WFME standards, curriculum modernization, clinical training reform and quality assurance. Kazakhstan's dental education system is transitioning from structural reform toward competency-based modernization, but its educational effectiveness remains unevenly documented. Strengthening clinical training, standardized assessment, faculty development, evidence-based teaching and policy stability is essential for improving graduate preparedness and international comparability.
Dental prostheses not only restore oral function but may also impact systemic health outcomes. This scoping review sought to synthesize evidence on the association between dental prostheses, hypertension, and physical function, including frailty, in adults with established cardiovascular disease (CVD) or elevated cardiovascular risk. This review was conducted following the PRISMA-ScR guidelines and Joanna Briggs Institute methodology. Literature searches were performed in PubMed and Google Scholar up to November 10, 2024. Eligible studies were observational investigations involving adults with established CVD or elevated cardiovascular risk who used dental prostheses. An exploratory quantitative approach was used to summarize the direction and patterns of association. Seven studies met the inclusion criteria: 5 assessed hypertension and 2 examined physical function. Exploratory pooled analysis based on unadjusted data indicated that individuals with dental prostheses had a lower odds of hypertension (odds ratio = 0.69; 95% confidence interval, 0.52-0.91), although substantial heterogeneity (I² = 95%) and the use of unadjusted estimates imply a high risk of residual confounding. Limited evidence suggests that dental prosthesis use may help preserve mobility and mitigate frailty in patients with CVD; however, differences in frailty definitions and limited adjustment for confounding factors reduce comparability and indicate that these findings should be interpreted as exploratory and hypothesis-generating. Current evidence suggests that dental prosthesis use may offer benefits beyond oral rehabilitation, potentially linked to better hypertension-related outcomes and physical function in adults with CVD or elevated cardiovascular risk, but certainty is limited by the small number of studies and methodological heterogeneity. These exploratory, hypothesis-generating findings highlight the need for well-designed longitudinal studies to clarify potential associations and underlying mechanisms. Beyond restoring oral function, prosthodontic rehabilitation may have broader systemic implications, contributing to better cardiovascular-related outcomes in aging populations.
Bruxism is a common condition that can lead to serious dental and implant-related complications. This cross-sectional study aimed to assess the presence and type of bruxism in patients seeking dental implant treatment and to evaluate their awareness of the condition. By increasing awareness and identifying bruxism before implant placement, the study seeks to reduce the risk of future implant and prosthetic complications. One hundred fifty systemically healthy patients aged 18-65 who presented for implant treatment were enrolled in the study. Bruxism was assessed through both clinical examination and self-reported questionnaires, in accordance with the 2025 international consensus on bruxism. Clinical evaluation included both intraoral and extraoral examinations to identify bruxism-related signs. Self-reported data were collected using the Bruxism Questionnaire to identify possible awake and sleep bruxism. Instrumentally-based methods were not applied in this study. The Fonseca Anamnestic Index (FAI) was applied to screen for temporomandibular disorder-related symptoms, and the Perceived Stress Scale-14 (PSS-14) was used to evaluate psychoemotional status. In addition, patients completed a bruxism awareness questionnaire before surgery. Among the 150 participants, 31.3% were clinically diagnosed with bruxism, while 26% reported experiencing sleep, awake, or both types of bruxism according to the self-reported questionnaire. Bruxism was significantly associated only with age (p = 0.042), but not with gender, education, or TMD severity. Awareness levels did not significantly differ by education, except for the association between bruxism and tooth loss (p = 0.014). Perceived stress scores and oral complaints showed no significant relationship with either bruxism diagnosis or type (p ≥ 0.05). Clinically based bruxism-related signs were frequently observed among patients seeking implant treatment, although awareness and self-recognition of bruxism appeared limited. Routine screening and increased awareness may help reduce potential stomatognathic system overload and implant- or prosthodontic-related complications.Trial registration number: NCT07088887, 2025-07-11 'Retrospectively registered'.
In this in vitro study, a CAD-based test workflow was established to evaluate the dimensional accuracy of conventional dental impression materials under standardized laboratory conditions. Ninety double-mix impressions were made from a rigid metal reference arch with four reference spheres using three elastomeric materials: vinyl polysiloxane (VPS), polyether (PE), and vinyl siloxanether (VSE). Guided impressions and freehand impressions were performed with both stock and custom trays. Impressions were cast in type IV dental stone, digitized with a laboratory scanner, and analyzed by comparing four linear inter-sphere distances with the reference model. Non-parametric statistics were applied. VPS and PE showed significantly lower global deviations than VSE, while VPS and PE did not differ significantly from each other. No significant differences were found between guided and freehand impressions when using stock trays. In the freehand-only comparison, stock and custom trays did not differ significantly; a borderline difference in the full cohort should be interpreted cautiously because of the partially crossed design. All measured deviations remained below the 1.5% linear-change threshold specified in DIN EN ISO 4823. This is the German adoption of a European and international standard for dentistry, specifically elastomeric impression materials. Within the limitations of this in vitro stone-cast workflow and linear-distance analysis, material selection had the strongest effect on global dimensional accuracy.
Primary Hyperoxaluria Type 1 (PH1) is a rare metabolic disorder characterized by systemic oxalate deposition, which may influence bone metabolism through mechanisms such as oxalate accumulation in alveolar bone, renal osteodystrophy, and the long‑term effects of immunosuppressive therapy following transplantation. In the present case, conventional prosthetic options were unsuitable due to external root resorption and the poor prognosis of the remaining dentition. This report describes implant‑supported oral rehabilitation in a medically complex patient with PH1 and a history of combined liver-kidney transplantation and multiple systemic comorbidities. Dental implant therapy was selected following comprehensive clinical and radiographic assessment. At six months, resonance frequency analysis demonstrated secondary stability with ISQ values of 75 (right) and 74 (left). Clinical and radiographic evaluation at 14 months showed stable peri‑implant conditions without detectable complications. This case suggests that implant therapy may be feasible in selected patients with PH1 when thorough risk assessment, individualized planning, and close postoperative monitoring are ensured. However, the findings are limited by the single‑case design and relatively short follow‑up period, and should be interpreted as hypothesis‑generating rather than conclusive evidence regarding long‑term implant outcomes in this population.
To evaluate the short-term effects of professional scaling and polishing on nine oral health and dental aesthetic outcomes in current smokers and never smokers. A total of 371 participants from the SMILE Study Cohort (305 smokers and 66 never smokers) were assessed at baseline (V0) and 14 days after scaling and polishing (V1). Outcomes included Modified Gingival Index (MGI), quantitative light-induced fluorescence parameters (ΔR30, reflecting the percentage of tooth surface covered by mature plaque, and ΔR120, reflecting the percentage covered by thicker deposits including calculus), MacPherson-modified Lobene Stain Index (MLSI) for buccal and lingual surfaces, Whitening Index for Dentistry (WID), Simple Oral Hygiene score (SOH), oral health-related quality of life (OHRQoL), and general health perception (EQ-VAS). Linear mixed model analysis was used for between-group comparisons of V0-V1 changes. At baseline, smokers exhibited significantly worse values across all objective indices. Following intervention, significant improvements were observed in MGI, MLSI, ΔR30, ΔR120, and SOH in both groups (p<0.0001). MGI improved by a median of -0.5 units in smokers (IQR: -0.8/-0.2) and -0.08 units in never smokers (IQR: -0.3/-0.02); the magnitude of improvement was significantly greater in smokers (p<0.0001). Similarly, greater reductions in buccal MLSI (p<0.0001), lingual MLSI (p<0.0001), and ΔR120 (p=0.010) were observed in smokers compared to never smokers. WID showed no significant changes in either group. OHRQoL improved slightly without between-group differences; EQ-VAS did not change significantly. Professional scaling and polishing produced consistent short-term improvements in objective oral health indicators in both smokers and never smokers, with greater gains among smokers reflecting their higher baseline burden. Regular professional mechanical plaque removal is clinically beneficial for smokers, producing measurable short-term improvements in gingival and aesthetic parameters even in the presence of ongoing tobacco exposure, although smoking cessation remains essential for long-term oral health.
Spain combines one of Europe's highest dentist densities with limited public oral health coverage and marked regional variation in publicly funded provision. This study quantified total, salaried public and privately accredited dental workforce capacity across Spain and assessed implications for public oral health system planning and equity. A cross-sectional national workforce analysis was conducted across the 17 Autonomous Communities and the Autonomous Cities of Ceuta and Melilla. Data were obtained through formal transparency requests to all administrations, supplemented by official professional registration data, population statistics and Ministry of Health records. Indicators included total and salaried public dentists per 100,000 inhabitants, population load per public dentist, the public/total ratio and a Structural Dependence Index (SDI) quantifying reliance on accredited private providers. In 2024-2025, Spain registered 42,860 active dentists (84.68/100,000) but only 1685 salaried public dentists (mean territorial density: 3.36/100,000; mean territorial load: 31,590 inhabitants per public dentist). The public/total ratio ranged from 2.0% in Madrid to 7.6% in Castilla-La Mancha. A further 6810 privately accredited providers participated in publicly funded programmes across 11 mixed-model regions, yielding an effective public-system workforce of 8495 professionals (17.21/100,000). Among territories with reported individual accredited-provider counts, SDI ranged from 0% in direct public-provision regions to 95.4% in País Vasco; ten of eleven mixed-model regions recorded SDI values above 80%. Spain does not face a shortage of dentists, but a structural imbalance between abundant private professional supply and limited, unevenly distributed public-system capacity. High aggregate dentist density is a poor proxy for public oral health system capacity. Workforce planning standards and stronger monitoring systems are needed to translate expanded publicly funded oral health coverage into effective and equitable access.
Dental pulp stem cell (DPSC) has gained attention as a cell-free therapeutic approach to enhance bone regeneration. However, the degradation of exosomal biomaterials limits their application, which may be overcome by using an injectable chitosan hydrogel crosslinker (ICHC) as a natural polymeric carrier. ICHC was prepared and loaded with exosomes derived from DPSCs. Cytotoxicity, calcium deposition, nanoparticle tracking analysis (NTA), and transmission electron microscopy (TEM) were conducted to assess biocompatibility, mineralization capacity, and structural characteristics. The cell viability of ICHCs, exosome 5 ng/mL, and exosome-loaded ICHC 0.6% ranged from 95% to 132%. NTA analysis revealed particle sizes of 147.5 nm for exosomes and 377.5 nm for exosome-loaded ICHC, with concentrations of 4.6 × 106 and 1.4 × 107 particles/mL, respectively. TEM further validated effective encapsulation, revealing electron-dense particles dispersed throughout the ICHC hydrogel matrix. The combination of exosome-loaded ICHC achieved 100% viability in osteoblast cells and promoted more elongated cell morphology compared to the control, suggesting a safe and effective cell-free material for bone regeneration therapy.
Esophagectomy is one of the highest risk surgical procedures and complications are common. While patient safety remains the primary focus, the impact on healthcare staff-the so-called 'second victims'-is often overlooked. Evidence suggests that a large proportion of surgeons experience emotional, professional, and social consequences following adverse outcomes. Our aims were to explore the effect of complications on personal and professional wellbeing and to identify systems and support required to help surgeons. An online survey, containing questions on surgeon demographics, the impact of surgical complications on personal and professional wellbeing, and current support systems available, was distributed globally to practicing esophageal cancer surgeons. A total of 100 responses were analysed from 30 countries. The median number of esophagectomies performed was 18 (IQR 0-90; n = 100)/annually. The complications with the most significant impact included patient mortality, gastric conduit necrosis and tracheobronchial injury. About 73% of surgeons reported changes in personal relationships and 66% experienced workplace pressures. Support was mainly obtained from colleagues (67%) or family (30%), however, 29% sought no support. 55% felt they received adequate support. About 58% felt under-supported by their particular institution. Complications after esophagectomy significantly affect surgeons' emotional wellbeing and clinical practice. While peer support was valued, many felt under-supported institutionally. These findings highlight the need for structured support systems to protect surgeon wellbeing and maintain safe surgical standards.
National oral health research strategies (NOHRSs) are increasingly recognized as critical mechanisms for aligning oral health research with public health needs, strengthening health systems, and advancing the World Health Organization's (WHO's) vision of "oral health for all." They are also pivotal for accelerating global progress toward Strategic Objective 6 of the WHO Global Oral Health Action Plan 2023-2030, which calls for the development of public health-oriented national research agendas. While global momentum for NOHRS development is growing, countries remain at markedly different stages of readiness and implementation. To support coordinated international progress, a satellite workshop was convened at the International Association for Dental, Oral, and Craniofacial Research (IADR) General Session and Pan European (PER) Congress in Barcelona, Spain, in June 2025. The workshop brought together invited participants, policymakers, and researchers representing diverse geographic, economic, and governance contexts. Drawing on a preworkshop survey, invited workshop presentations, and structured breakout discussions, this article synthesizes key insights and lessons learned.
Randomized controlled trial (RCT) represent a type of study design wherein research subjects are randomly allocated to different groups to receive various interventions, allowing for the comparison of result differences and minimizing bias to the greatest extent possible. They are the primary source of evidence in evidence-based dentistry. Recently, an international team of dental experts has published the Preferred Reporting Items for Randomized Trials in Endodontics (PRIRATE) 2020 checklist, a set of guidelines aimed at enhancing the quality of design and reporting of RCTs contextualized to dentistry. We provide a detailed interpretation of the key items of the PRIRATE checklist, supplemented with specific examples, to promote the reporting of RCTs in China. 随机对照试验（RCT）是一种将研究对象随机分组，不同组实施不同的干预，以对照结果差异的试验，能够最大程度地避免偏倚，循证口腔医学证据常来源于此。近期，多位口腔医学专家组成的国际团队发表了口腔医学随机对照试验推荐报告项目（PRIRATE）清单2020，为口腔医学领域的RCT提供指导，提高试验设计与报告的质量。本文将结合具体实例对清单的关键条目进行详细解读，以期为国内口腔医学RCT报告提供参考。.
Cancer remains the second leading cause of death in the United States (U.S.), with increasing incidence among younger adults. Sepsis, a life-threatening organ dysfunction caused by infection, frequently complicates cancer due to disease-related and treatment-induced immunosuppression. Understanding cancer-sepsis mortality trends is essential for identifying high-risk populations and improving prevention and clinical management strategies. We analyzed U.S. mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database to identify deaths among adults aged ≥ 25 years in which both cancer (International Classification of Diseases, Tenth Revision C00-D48) and sepsis (International Classification of Diseases, Tenth Revision A41) were listed on the same death certificate, representing concomitant cancer-sepsis mortality. Age-adjusted mortality rates per 100,000 population were calculated and temporal trends were assessed using Joinpoint regression. Statistical significance was set at P < .05. From 1999 to 2023, a total of 20,108,555 U.S. adults aged 25+ died from cancer complicated by sepsis. From 1999 to 2023, the average annual percentage change (AAPC) decreased by 1.09% (95% confidence interval, -1.33--0.84%). Rates fell from 417.6 per 100,000 in 1999 to 322.0 in 2023, showing a steady decline until 2018 (annual percent change [APC]: -1.32%), a brief rise from 2018 to 2021 (APC: 2.17%), and a significant drop from 2021 to 2023 (APC: -3.65%). Mortality was highest in men (AAPC: -1.33%) and Black or African American individuals (AAPC: -1.68%), as well as in nonmetropolitan areas (AAPC: -0.60%) and the Southern U.S. (AAPC: -1.02%). Most age groups experienced significant declines, particularly middle-aged adults, while the youngest (25-34) and oldest (85+) age groups showed minimal long-term change. All racial and ethnic groups showed improvement, although American Indian or Alaska Native trends remained largely flat until a notable decline (APC: -8.26% from 2021 to 2023). Most deaths occurred in hospitals (38%) or at home (35%), with fewer in nursing homes, hospices, or other settings. Concomitant cancer-sepsis mortality declined overall in the U.S. from 1999 to 2023, but substantial disparities persist by sex, race/ethnicity, geography, and urbanization, reflecting inequities in access to oncology care, critical care, and timely sepsis management.
Despite their vulnerability to radiation-induced damage, the maxilla and dentition are not routinely contoured in head and neck (HN) radiotherapy (RT), preventing accurate dose assessment and establishment of dose-effect relationships. This literature review aimed to: (1) identify published dentofacial contouring approaches, (2) synthesise current methods, and (3) where feasible, compare practices in paediatric and adult RT. MEDLINE and Embase were searched for studies that contoured the maxilla, mandible, or teeth in HN RT. Reference lists were manually screened. Thirty-one (2003-2025) papers met inclusion criteria. Manual contouring predominated (77.4%), with substantial heterogeneity across all structures. Only seven studies (22.6%) contoured the maxilla. Tooth contouring varied from individual segmentation to variable groupings. Eight studies (25.8%) reported dental professional involvement. Dentofacial contouring lacks standardisation and predominantly relies on manual techniques. This variability impedes dose assessment and cross-study comparisons. Standardised international guidelines for the contouring of the maxilla, mandible and teeth are necessary to ensure uniformity and enable comparability between studies.
Fluoride (F¯) is a global geogenic contaminant in groundwater, occurring at elevated concentrations across almost every continent. While optimal fluoride intake benefits dental health, levels exceeding the WHO safe limit (1.5 mg L-1) can cause dental fluorosis and even severe skeletal fluorosis, with drinking water being the primary exposure pathway. Understanding the global occurrence and geochemistry of fluoride in groundwater is essential for minimizing associated health risks. Therefore, this study reviews the incidence, distribution, mobilization mechanisms of fluoride in groundwater, and identifies the key knowledge gaps related to fluoride contamination worldwide. The study presents a large-scale synthesis of contaminated aquifers, cost-effective defluoridation methods, socio-economic challenges, and strategies for safe drinking water supply. This was done by adopting the PRISMA 2020 systematic review framework with review period between 1953 and 2025. Findings confirm that fluoride contamination is prevalent in Asia, Africa, the Middle East, Europe, and the Americas, driven mainly by fluorine-bearing minerals in aquifers. Key factors intensifying the contamination includes hydrogeochemical conditions such as high pH, Na-HCO3 water types, and low calcium (Ca2+) concentrations. Identified hotspot are the East African Rift Valley, Indo-Gangetic plains, northern China, and volcanic or geothermal regions in Mexico and Türkiye, with localized anomalies observed in Estonia, Poland, and Australia. Anthropogenic inputs contribute in some localized areas, although their impact is minimal. The fluoride levels are particularly high in arid and semi-arid regions, where evaporation and prolonged water-rock interaction accelerate fluoride mobilization. Despite decades of research, monitoring gaps persist, and mitigation remains challenging, especially for rural communities who are entirely dependent on untreated groundwater. This study recommends prioritizing efforts on scalable, cost-effective solutions to provide fluoride-safe water, particularly in areas where populations are largely vulnerable.
The effect of different postpolymerization units on the mechanical reliability and degree of conversion (DC) of 3-dimensional (3D) printed interim resins remains unclear, particularly when third-party units are used instead of manufacturer-recommended devices. The purpose of this in vitro study was to evaluate the effects of 5 different postpolymerization units on the mechanical properties and DC of 5 commercially available 3D printed interim resins. Five commercially available 3D printed dental resins were printed and postpolymerized using 5 different postpolymerization units (LC-3D Print Box, Tera Harz Cure, OneJet Cure+, ODS Cure Box, and ARUM UV Curing Machine). A total of 500 specimens were fabricated, including 250 bar-shaped specimens for flexural testing and 250 disk-shaped specimens for DC analysis. Statistical analysis included Kruskal-Wallis tests with Mann-Whitney U post hoc comparisons (Bonferroni correction) (α=.05). Reliability of mechanical performance was evaluated using Weibull analysis to calculate the Weibull modulus (m) and characteristic strength/modulus (σ₀) with 95% confidence intervals (CI). All resins exceeded the International Organization for Standardization (ISO) 10477 standard minimum flexural strength requirement (≥50 MPa). Flexural strength and modulus differed significantly depending on the resin-postpolymerization unit combination. The ODS Cure Box and Tera Harz Cure generally yielded higher flexural performance, whereas OneJet Cure+ produced the lowest values across materials. DC varied widely across polymerization conditions and showed no significant association with flexural strength or flexural modulus (P>.05). Mechanical properties varied across resin-postpolymerization unit combinations, with certain third-party units showing flexural performance comparable with that of manufacturer-recommended systems. Although the DC differed among polymerization conditions, the surface DC measured in this study did not show a significant association with flexural strength or modulus.
Periodontal disease, a major oral disease, includes various inflammatory diseases that affect the tooth support structure (gums, alveolar bone, and periodontal ligament) and can lead to tooth loss and promote systemic inflammation, affecting more than 1 billion people worldwide. This study aimed to investigate the relationship between self-efficacy, psychological state, oral health behaviours, and oral health-related quality of life (OHRQoL) in patients with periodontal disease. Convenience sampling was implemented to recruit participants diagnosed with periodontal disease. Data on demographic characteristics, tooth brushing frequency, and self-reported oral health status were collected using a structured questionnaire. Participants were assessed using the General Self-Efficacy Scale, 9-item Patient Health Questionnaire, Modified Dental Anxiety Scale, and Oral Health Impact Profile (OHIP-14). Finally, structural equation modelling (SEM) was used to identify associations. Of the 366 participants included in the study, 77.6% reported brushing their teeth at least twice daily, and 53.4% reported using dental floss at least once daily. The mean OHRQoL score (OHIP-14) was 24.7. The SEM showed a good fit. Depression was negatively correlated with self-efficacy (β = -0.235, P < .001), while self-efficacy was positively correlated with oral health behaviours (β = 0.176, P < .001). Furthermore, oral health status, socioeconomic status, depression, and anxiety were significant predictors of OHRQoL. Self-efficacy played an important role in establishing good oral health behaviours. Future interventions should prioritize enhancing self-efficacy and paying more attention to psychological factors (such as depression) to effectively promote oral health behaviours.
Background and aim Flexible removable dentures are increasingly used in partial prosthetic rehabilitation because of their aesthetic appeal and mechanical flexibility. However, their limitations should be considered carefully, and their use should be restricted to selected clinical situations. This study aimed to assess the clinical practices and perceptions of Moroccan private-sector dentists in the Rabat-Salé-Kénitra region regarding the indications, advantages, disadvantages, and clinical use of flexible removable dentures, as well as the association between their use and participants' demographic and professional characteristics. Materials and methods This cross-sectional study used an anonymous online questionnaire developed in Google Forms (Google LLC, Mountain View, CA, USA) and administered between November 2023 and February 2024 to licensed private-sector dentists practicing in the Rabat-Salé-Kénitra region. Qualitative variables were expressed as counts and percentages (n (%)). Associations between the use of flexible removable dentures and participants' demographic and professional characteristics were analyzed using the chi-square test or Fisher's exact test. A p-value < 0.05 was considered statistically significant. Results A total of 101 private-sector dentists participated in the study. Flexible removable dentures were used in clinical practice by 86 (85.1%) participants, and 82 (98.8%) clinicians used them mainly for partial edentulism. 48 (55.2%) practitioners considered flexible dentures suitable as definitive prostheses. In cases of extensive partial edentulism, 61 (62.2%) participants preferred metal-based removable partial dentures combined with acrylic resin. Valplast (Valplast International Corp., Westbury, NY, USA) was the most commonly used material by 56 (67.5%) participants, and 68 (71.6%) practitioners reported favorable satisfaction with flexible dentures. Conclusions Flexible removable dentures appear to be widely used among Moroccan private-sector dentists, particularly for the management of partial edentulism and aesthetically demanding situations. However, their use remains less favored in extensive edentulous cases. These findings highlight the need for greater emphasis in undergraduate and continuing dental education regarding the indications, limitations, and appropriate clinical application of flexible removable dentures.