Journal of Oral Research

The Paradox of Speed in Contemporary Endodontics: Techological Advances and the Overlooked Role of Irrigation time

Pablo Betancourt — 2026-05-07

Effect of Periodontal Treatment plus omega-3 in subjects with Periodontitis: A Randomized Controlled Clinical Trial

Mariely Navarrete — 2026-05-07

Aim: To evaluate the effect of systemic omega-3 fatty acid (Ω-3) supplementation as an adjunct to non-surgical periodontal therapy (NSPT) on the clinical and microbiological parameters of patients with periodontitis.
Material and Methods: Eighteen volunteers received NSPT combined with placebo or Ω-3 (2 g/day) for 90 days (n=10 control, n=8 intervention). Clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), O’Leary index (OI), Bleeding on Probing (BoP) and suppuration, were recorded at baseline, and at 1, 3, and 6 months post-therapy. Microbiological evaluation at baseline, 3, and 6 months assessed the presence of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum using conventional polymerase chain reaction.
Results: Fifteen patients completed the study (n=9 control, n=6 intervention). No significant differences were found in demographic, clinical, or microbiological variables between groups at baseline (p>0.05). Both groups showed clinical improvements over time; however, no significant intergroup differences were detected in PPD, CAL, PPD reduction, CAL gain, or the percentage of sites with BoP and biofilm (p>0.05). Similarly, no differences were observed in the mean or changes (Δ) of shallow (PPD 1–3 mm), intermediate (PPD 4–6 mm), or deep sites (PPD ≥7 mm) between groups at any post-NSPT evaluation. No significant intra- or intergroup differences in periodontal pathogens were observed at any post-therapy evaluation.
Conclusions: Within the limitations of this study, adjunctive systemic Ω-3 did not provide additional clinical or microbiological benefits compared to NSPT alone. Further studies with larger samples and longer follow-up are required to clarify its role in periodontal therapy.

Assessment on oral health knowledge, attitude, and practice and its association with sociodemographic factors in Jakarta population

Maria Amanda — 2026-05-07

Introduction: Oral health (OH) is vital to overall well-being, influencing essential functions such as chewing, speaking, and expressing emotions without discomfort. Despite its importance, OH problems remain a public health concern globally and in Indonesia, especially among youth. Jakarta, as the capital, reflects disparities in OH knowledge, attitude, and practices, shaped by demographic and socioeconomic factors.
Material and Methods: This cross-sectional study was conducted in 2025 using an online questionnaire targeting Jakarta residents aged 10 years and above. A total of 614 participants were recruited through random sampling. The questionnaire, adapted from a validated tool, assessed OH knowledge, attitudes, and practices. Data were analyzed using non-parametric tests and Spearman’s correlation, with p <0.05 considered statistically significant.
Results: The majority of participants demonstrated good knowledge (98.2%) and positive attitudes (95.3%), but only 75.9% practiced adequate oral hygiene. Significant associations were found between age group and both knowledge (p< 0.001) and practice (p = 0.018). Education level and location were also linked to knowledge (p= 0.030 and p= 0.021, respectively), while gender showed no significant associations.
Conclusions: While OH knowledge and attitudes are high among Jakarta residents, gaps in practice persist, particularly among younger age groups. Targeted interventions based on age, education, and regional disparities are essential to improve oral health behaviors. This study underscores the need for continuous, demographically tailored oral health promotion efforts to reduce preventable oral diseases in Jakarta.

Relationship between dental calcification stages and cervical vertebral maturation in Mexican individuals. A cross-sectional study

María Dolores Tatiana Orozco Alvarez — 2026-05-07

Introduction: This study used panoramic and lateral cephalometric radiographs to evaluate the relationship between dental calcification stages and cervical vertebral maturation in Mexican individuals.
Material and Methods: In this study, 201 patients aged 6 to 17 from Queretaro, Mexico, underwent lateral cephalometric radiographs and panoramic radiographs. Two trained and calibrated orthodontists and oral radiologists used Baccetti's method to assess cervical maturation stages and Demirjian's method to evaluate dental calcification stages. The correlation between the stages was assessed using Spearman's correlation coefficient. Additionally, the chi-square test was used to evaluate the association between the stages of both methods, using the teeth with the highest correlation values (p<0.05).
Results: The strongest correlation values were observed for the second molar (r=0.706), second premolar (r=0.661), and lower canine (r=0.653) (p<0.001). Among these teeth, the lower canine displayed the strongest association. There was a significant relationship between the CS3 vertebra stage and the G stage (42.9%), as well as between the CS4 stage and the H stage (48.2%) (p<0.001).
Conclusions: Based on the sample results, the stage of bone development can be identified by examining dental calcification using the lower canine on panoramic radiographs as a reference. This knowledge can help determine the stage of cervical calcification, which can help create an effective treatment plan.

The effect of aloe vera oil addition on the mechanical properties of soft denture liners: an in vitro study

Huda Jaafar Naser — 2026-05-07

Background: Soft denture liners are used to improve comfort and stress distribution in edentulous patients, yet their mechanical durability remains a major limitation. Natural additives such as Aloe vera oil have gained interest for their potential to enhance biological compatibility and modify the viscoelastic performance of these materials. Objective: This study aimed to investigate how incorporating different concentrations of Aloe vera oil affects the mechanical properties of a silicone-based soft liner.
Material and Methods: Silicone soft liner specimens containing the three Aloe vera oil concentrations (0.25%, 0.75%, and 1.25% by weight) and a control group (0%) were prepared according to ISO 10139-2 standards. Each group consisted of ten samples (n = 10). All specimens were stored in distilled water at 37 ± 1 °C for 24 h before testing. Mechanical tests were performed using a universal testing machine and analyzed by one-way and two-way ANOVA (α = 0.05).
Results: The addition of Aloe vera oil produced a concentration-dependent modification of the liner’s properties. Tear resistance and tensile energy absorption significantly increased up to 0.75% (6.42 ± 0.24 N/mm and 135.7 ± 4.8 J/m², respectively; p< 0.001) before slightly decreasing at 1.25%. Shore A hardness decreased gradually with increasing oil content, maintaining desirable softness at 0.75% after 30 days (48.6 ± 1.2). Dynamic mechanical analysis revealed that the 0.75% group exhibited the lowest storage modulus (2.91 MPa) and the highest damping factor (tan δ = 0.40), reflecting improved elasticity and energy dissipation.
Conclusion: Incorporating 0.75% Aloe vera oil into a silicone-based soft liner optimally enhanced its flexibility, resilience, and damping capacity without compromising dimensional stability.

Comparison of the Efficacy of 4-0 Polydioxanone and 4-0 Polyglactin 910 Suture Material in Mandibular 3rd Molar Surgery – A Split-Mouth Double-Blinded Randomized Controlled Study

Dharaneesh Sivakumar Kalaiselvi — 2026-05-07

Aim: The study was to compare the clinical efficacy of 4-0 polydioxanone and 4-0 polyglactin 910 suture materials on postoperative outcomes after mandibular third molar surgery.
Methods: This split-mouth prospective study included 100 patients (200 surgical sites) requiring bilateral mandibular third molar extraction. The patients were randomly segregated into 2 groups. Group I included 100 patients who were sutured with 4-0 Polydioxanone, and group II included 100 patients who were sutured with 4-0 Polyglactin 910. All the participants were assessed for pain, facial swelling, mouth opening, and wound healing on the 1st, 3rd, and 7th postoperative days.
Results: The mean wound closure time in group I was 2.40 minutes (p<0.05) and 4.16 minutes in group II. Pain, swelling, mouth opening and wound healing in group I (p<0.05) were statistically significant on all three postoperative days when compared to group II.
Conclusion: Polydioxanone sutures provide superior clinical outcomes compared to polyglactin 910 in mandibular third molar surgery, particularly in terms of pain, edema, oral function and early healing.

Clinical and radiographic evaluation of ameloblastoma features: a longitudinal observational study

Verônica Caroline Brito Reia — 2026-05-07

Objective: This study aimed to describe the radiographic features of ameloblastomas using panoramic radiography; evaluate the radiographic appearance over follow-up, associating with the performed treatment; and analyze the influences of age and lesion size on their progression.
Materials and Methods: Records of patients diagnosed with ameloblastoma. A pilot study with 10% of the sample was conducted for evaluator calibration using the Kappa test; the remaining imaging studies were evaluated using ImageJ® software. Statistical analysis was conducted using the Kruskal-Wallis test followed by the Dunn test.
Results: A total of 23 records were included in the study for data collection and analysis. Predominant radiographic characteristics included radiolucent lesions in the posterior region of the lower jaw 21 (91.30%), unilocular 17 (73.91%), with poorly defined borders 14 (60.86%), associated with retained or impacted teeth 13 (56.52%); common effects on adjacent structures included root resorption 14 (60.86%), tooth displacement 16 (69.56%), and expansion of the bony cortex 16 (69.56%). Resection was the treatment that showed complete lesion regression; age and lesion area did not influence the regression of lesion size after treatments.
Conclusion: Throughout follow-up appointments evaluation, resection treatment stood out as the most effective treatment option for ameloblastoma.

Two-year follow-up study of repairs using conventional resins and bulk-fill in proximal restorations. A double-blind randomized clinical trial

Patricio Vildósola Grez — 2026-05-07

Introduction: Currently, composite resins (CRs) are the material of choice for direct restorations, and in cases of partial deterioration, repair is often recommended, as it significantly increases their lifespan. Bulk-fill resins (BFRs), on the other hand, are restorative materials that can be applied in single increments, thereby simplifying the procedure and reducing clinical time. The objective of this study was to evaluate the two-year clinical performance of repairs of proximal posterior composite resin restorations performed using BFRs and conventional nanohybrid CRs.
Materials and Methods: Thirty-six volunteer patients from the clinic of the Faculty of Dentistry at the Universidad de Chile participated in this study. It had an experimental, controlled, randomized, double-blind clinical design, in which the experimental unit was the repair of proximal CR restorations. The groups evaluated were as follows: Group 1, repair with Tetric EvoCeram Bulk Fill® resin (TEVO); and Group 2, repair with Filtek Z350 XT® resin (Z350). Repairs were evaluated at baseline and at 24 months using the FDI World Dental Federation evaluation system (1: clinically excellent/very good, 2: clinically good, 3: clinically sufficient/satisfactory, 4: clinically unsatisfactory, 5: clinically poor) for the following clinical properties: marginal integrity (MI), surface texture (ST), marginal staining (MS), sensitivity (S), fracture and retention (RT), proximal and occlusal anatomy (AN), and caries (C).
Results: A total of 72 restorations were followed up. Excellent clinical performance was observed in the following parameters: MI: Z350 86.1% and TEVO 83.3%; ST: Z350 77.8% and TEVO 80.6%; MS: Z350 63.9% and TEVO 66.6%. For both fracture and retention (RT) and anatomy (AN), excellent performance was observed for Z350 (86.1%) and TEVO (88.8%). For sensitivity (S) and caries (C), both groups showed 100% excellent outcomes. No statistically significant differences were found between the two groups (p>0.05).
Conclusion: There were no statistically significant differences in two-year clinical performance between repairs of proximal posterior composite resin restorations performed using BFR and conventional composite resin.

Periodontitis and Rheumatoid Arthritis. A case-control study

Victoria Garcia — 2026-05-07

Background: Periodontitis and Rheumatoid Arthritis (RA) are immunoinflammatory diseases that share etiological mechanisms in their onset and development. Objective: To evaluate the bidirectional relationship between them.
Material and Methods: In 150 participants, sociodemographic variables, clinical attachment loss (CAL), probing depth (PD), bleeding on probing (BoP), rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were assessed. Additionally, arthritis activity was evaluated using the Disease Activity Score 28 and the Health Assessment Questionnaire. Initially, we analyzed the characteristics of the sample and associated different oral health. Finally, a logistic regression model was developed with rheumatoid arthritis status as the primary outcome.
Results: It was observed that patients with RA had a higher prevalence of periodontitis (p= 0.026), fewer present teeth (p<0.001), a higher number of sites with BoP (p=0.02), and more sites with PD = 4 mm and CAL ≥3 mm (p<0.001) compared to the group without RA. Additionally, when comparing patients with and without periodontitis, the periodontitis patients had a higher occurrence of RA than those without periodontitis (73.3% versus 26.7%, p=0.026). In the multivariate regression model, sites with PD = 4 mm and CAL ≥ 3 mm (OR 1.08, p<0.001), age (OR 1.07, p< 0.001), and CRP (OR 1.07, p=0.031) remained significant for the presence of RA.
Conclusions: Our results show worse oral health in patients with RA. It is also concluded that periodontal indicators negatively impact RA activity.

Assessment of oral health status and its association with oral hygiene practices and oral health-related quality of life among beedi factory workers in southern districts of tamil nadu: a cross-sectional study

A. Banu Jothi — 2026-05-31

Aim: This study aims to assess the oral health status, oral hygiene practices and Oral Health Related Quality of Life among Beedi workers in the southern districts of Tamil Nadu.
Material and Methods: A cross-sectional study was conducted among beedi factory workers in the southern districts of Tirunelveli, Theni, and Tenkasi. The total sample included was 1000. Workers aged 19-60 years who had worked for at least 2 years were included. A multistage simple random sampling method was used to recruit participants. The oral hygiene practices and behaviour of the workers were assessed using a self-structured 19-item questionnaire. The oral health assessment was done using the WHO Oral Health Assessment Form for Adults, 2013. Oral health-related quality of life (OHRQoL) was assessed using the Oral Health Impact Profile-14 (OHIP-14). Wilson and Cleary's conceptual model was used to analyse the integration of biological and physiological characteristics and the overall quality-of-life outcomes. Statistical analysis was conducted using SPSS version 26. P-value<0.05 was considered to be statistically significant.
Results: Among all participants, 73.9% were male, and the majority were aged 47-59 (38.6%). Gingival bleeding was significantly associated with the social disability (p= 0.006) and handicap (p= 0.026) domains of OHRQoL, while mild fluorosis was associated with psychological discomfort (p= 0.042) and higher total OHIP scores (p= 0.010). The SEM demonstrated poor model fit (SRMR = 0.137, RMSEA = 0.102, CFI = 0.829), and findings were interpreted as exploratory associations.
Conclusion: Gingival bleeding and mild fluorosis among beedi factory workers were significantly associated with the social disability and handicap domains of OHRQoL. The biological, functional, and symptomatic factors showed stronger relationships, although the overall fit indices were poor in the SEM analysis.

Surgical removal of mesiodens, a case series

José Eduardo Orellana-Centeno — 2026-05-07

Introduction: Dental anomalies are congenital malformations of the tissues of the tooth that can range from alterations in number, eruption, location, size and shape to structural abnormalities. Among the alterations in number we find the supernumerary tooth, defined as a tooth formed in excessive number.
Case Report: Two paediatric patients presented for consultation between June and August 2022 at the dentistry clinic of the Universidad de la Sierra Sur (UNSIS). On clinical and radiographic examination, the presence of a supernumerary tooth located in the palate between the upper central incisors (dental organ 11 and 21) was observed.
Results: The mesiodens type supernumerary teeth were extracted with a surgical technique using a surgical motor and with a favourable operative and postoperative outcome for the patient.
Conclusions: Among the supernumerary teeth, the most common is the mesiodens. Early detection, diagnosis and management is important in order to avoid abnormal development of the patient's dental occlusion and aesthetics.

Radiographic Enigma: a case report of clear cell odontogenic neoplasm in the anterior mandible diagnosed by Cone Beam Computed Tomography

Prarthana Sudeep — 2026-05-07

Introduction: Clear cell odontogenic carcinoma (CCOC) is a rare and aggressive odontogenic tumour, seldom involving the anterior mandible.
Case Report: This report presents an atypical case in a 38-year-old female, emphasizing the diagnostic challenges, the role of CBCT in detecting aggressive features, and the importance of considering CCOC in the differential diagnosis of anterior mandibular lesions. The patient presented with gingival swelling, and cone-beam computed tomography revealed a diffuse, irregular, expansile lesion with labial cortical perforation, thinning of the lingual cortex, and hyperdense foci. Periosteal bone formation was also noted anteriorly.
Results: These atypical features initially suggested alternative diagnoses, but histopathological evaluation confirmed CCOC.
This case reinforces the diagnostic challenges of CCOC and demonstrates the utility of radiographic evaluation for identifying aggressive features of rare mandibular tumours.

Mandibular reconstruction with iliac crest graft for recurrent ameloblastoma: a case report

Karol Romero — 2026-05-07

Background: Ameloblastoma is an odontogenic tumor characterized by slow but aggressive growth, which can lead to significant facial deformity and functional impairment.
Case Report: We present the case of a 47-year-old patient with a history of mandibular ameloblastoma treated with enucleation and curettage 20 years ago. The patient presented pain, paresthesia of the lower lip, and swelling in the mandibular region. Panoramic radiography and cone-beam computed tomography revealed a multilocular osteolytic lesion in the left hemimandible, suggesting tumor recurrence. An incisional biopsy confirmed the diagnosis of conventional ameloblastoma, plexiform variant. Due to the recurrent nature of the tumor, a radical approach was taken, consisting of block resection of the affected hemimandible followed by mandibular reconstruction using an autologous iliac crest graft. The surgery was meticulously planned using stereolithographic models, allowing precise adaptation of the graft. Postoperative follow-up showed positive results with complete healing and adequate functional recovery.
Conclusions: An accurate diagnosis is essential to determine the appropriate treatment for ameloblastoma, and thorough planning ensures a successful surgical outcome. The use of a free iliac crest graft offers several advantages, such as low morbidity at the donor site, availability of corticocancellous bone, and the ability to restore both function and aesthetics. Favorable results were achieved, significantly improving the patient's quality of life.

Orthodontic retreatment with clear aligners in a patient with open bite and severe root resorption: Case report

Eric Bustamante Olivares — 2026-05-31

Introduction: External apical root resorption (EARR) is a multifactorial orthodontic complication influenced by treatment duration, appliance type, and the magnitude of applied forces. Clear aligners have been shown to reduce the risk of EARR compared to fixed appliances by applying lighter and more controlled forces.
Case Report: This report describes retreatment with clear aligners in an adult patient with relapse of anterior open bite and severe EARR diagnosed through CBCT. The rate of tooth movement was reduced from 0.25 mm to 0.18 mm per aligner to preserve root integrity.
Conclusions: The controlled biomechanics of clear aligners, combined with an inter-disciplinary approach, enabled esthetic and functional outcomes in a patient with severe EARR, demonstrating that this therapy represents a safe option in complex retreatment scenarios.

Comparative evaluation of the efficacy of chemo-mechanical caries removal and atraumatic restorative treatment on pain reaction among children: A systematic review and quantitative synthesis

Subhashree Mohapatra — 2026-05-07

Aim: The aim of the systematic review and quantitative synthesis was to assess and compare the efficacy of chemo-mechanical caries removal (CMCR) and atraumatic restorative treatment (ART) on pain reaction among children.
Material and Methods: Scopus, PubMed, Cochrane, Science Direct, EBSCOhost, Lilacs, Web of Science, and Google Scholar were searched from the earliest available year till July 15, 2024. PICO Strategy: P: Children; I: Chemo-mechanical caries removal; C: Atraumatic restorative treatment; O: Pain reaction. The review comprised only randomised controlled trials and clinical studies. The risk of bias assessment and quality of evidence were assessed using the RoB-2 Tool and GRADE Tool, respectively.
Results: Five full-text publications that met the requirements for eligibility underwent additional processing for data extraction. The overall results of the review suggest that there is no difference in the effect of CMCR and ART on pain reaction among children with a 95% CI of OR: 0.12 [0.01, 1.68]; p=0.12. However, the pooled data suggested high heterogeneity (p<0.0001; I2=89%) among the studies.
Conclusions: The current review concludes that the effect of CMCR and ART on pain reaction among children is comparable. However, the certainty is low due to high heterogeneity among the included studies. Further studies with a combination of subjective and objective scales may help determine the true pain reaction and provide more conclusive evidence for pain reaction to CMCR and ART.

Effects of masseter muscle dry needling on temporomandibular myofascial pain: A scoping review

Rosario Bäumle — 2026-05-03

Purpose: Myofascial pain is a common temporomandibular disorder that negatively affects quality of life. This study aims to assess the current evidence on the clinical response of dry needling (DN) applied to the masseter muscle as a therapeutic option for managing temporomandibular myofascial pain.
Material and Methods: A systematic electronic search of the literature was performed in PubMed, SCOPUS and Web of Science databases using tailored search strategies for each database. Articles published within the last five years were included if they evaluated DN of the masseter muscle in adults with myofascial pain, compared to placebo or other interventions. Pain intensity was assessed using the Visual Analogue Scale (VAS). Methodological quality was evaluated with the Critical Appraisal Skills Programme Spanish (CASPe) checklist for randomized controlled trials. Risk of bias assessment was not performed due to heterogeneity in study designs.
Results: Six studies met the inclusion criteria (four randomized clinical trials, one prospective study, one with unspecified design) involving 243 patients aged 18-65 years. Myofascial pain diagnosis was based on RDC/TMD or DC/TMD criteria. DN produced clinically meaningful reductions in pan intensity, with improvements maintained up to six months in some studies. Functional outcomes such as mouth opening and lateral movements also improved. The comparative efficacy of DN versus other treatments (botulinum toxin- A, platelet-rich plana, anesthetic nerve blocks) remains inconclusive due to variability in protocols and follow-up.
Conclusions: Dry needling of the masseter muscle shows potential as a therapeutic option for temporomandibular myofascial pain, particularly in reduction and functional improvement. However, heterogeneity across studies and lack of standardized protocols limit definitive conclusions. Further high-quality, standardized research is warranted.

Pre-surgical nasoalveolar molding for complete unilateral cleft lip and palate. Scoping review

Macarena Garrido — 2026-06-17

Introduction: Cleft lip and palate is a frequent congenital malformation with a significant impact on facial function and aesthetics. Pre-surgical nasoalveolar molding (PNAM) emerged as an early orthopedic technique to correct them. Objectives: To describe the state of the art of nasoalveolar molding in a pre-surgical treatment of unilateral complete cleft lip and palate and its benefits.
Material and Methods: A systematic review was conducted in PubMed and Scopus, using the PICO strategy and PRISMA guidelines, focusing on studies published between 2020 and 2024 that evaluated PNAM in unilateral complete clefts, in English and Spanish, excluding single cases, incomplete, bilateral clefts, and syndromic patients. The mesh and boolean terms used were "cleft lip," "cleft palate," "molding" AND "nasoalveolar."
Results: Of a total of 695 studies, 8 articles were selected that met the inclusion criteria. Benefits of PNAM in correcting cleft lip and palate were observed, including: (1) improvements in nasal symmetry, (2) reduction of the alveolar cleft, and (3) alignment of the alveolar segments, based on the principle of neonatal plasticity. This treatment facilitates primary surgery and dental alignment, although with significant variability due to the lack of standardized protocols. Additionally, PNAM reduces the psychological and financial burden on families, improving the quality of life of the patients.
Conclusions: PNAM is a useful technique in the early orthopedic management of cleft lip and palate, offering aesthetic and functional benefits in the immediate, short, and long term. However, further clinical studies are needed to support its long-term effectiveness and to promote the standardization of protocols.

Mechanical, Physical And Optical Properties Comparison Between Direct Printed And Thermoformed Aligners - A Systematic Review

Najiya VP — 2026-05-07

Background: Clear aligners are a popular choice for orthodontic treatment due to their aesthetic appeal, comfort, and the ability to be easily taken on and off, unlike fixed appliances, which cannot be removed once treatment begins. Two common fabrication methods for aligners are direct 3D printing and thermoforming. This systematic review aims to compare the mechanical, physical, and optical properties of 3D-printed aligners (DPAs) and thermoformed aligners (TFAs) to provide evidence-based insights for clinicians and researchers.
Material and Methods: A comprehensive literature search was conducted in electronic data-bases, including PubMed, Scopus, Web of Science and Google Scholar, to identify studies evaluating and comparing DPAs and TFAs. Studies were selected based on predefined inclusion and exclusion criteria, focusing on outcomes such as load-deflection behavior, dimensional accuracy, tensile strength, force decay, thickness, and transparency. The quality of the included studies was assessed using the RoBDEMAT tool for in vitro studies and the ROBINS-I tool for in vivo studies. Data synthesis involved narrative and qualitative approaches to summarize the findings.
Results: A total of ten studies were included, comprising eight in vitro studies and two in vivo studies. The included studies exhibited moderate risk of bias due to insufficient reporting of randomization and operator blinding. DPAs demonstrated superior dimensional accuracy, thickness uniformity, and optical properties compared toTFAs. However, TFAs exhibited better force retention and consistent load. While the mechanical strength of DPAs was higher, TFAs showed greater stability in long-term force delivery.
Conclusions: DPAs provide superior precision and aesthetics, while TFAs offer better durability and sustained force retention, highlighting the need for case-specific aligner selection.

Effectiveness of magic-based (thaumaturgic) techniques in reducing dental anxiety among children across cognitive developmental stages: a systematic review and meta-analysis

Gauri Shingi — 2026-05-07

Background: Pediatric dental anxiety had remained a major barrier to care, with the need for brief non-pharmacologic strategies, especially during local anesthesia. Thaumaturgic techniques had been hypothesized to reduce procedure-proximal anxiety through attentional capture, positive affect, and expectancy modulation aligned with the cognitive developmental stages.
Material and Methods: Six databases were searched (inception to final run), reference lists and grey literature were screened, and authors were contacted for missing data. Two re-viewers independently screened, extracted data and applied Cochrane RoB 2.0. Continuous outcomes were synthesised with random-effects models using mean difference (MD) or standardized mean difference (SMD) with 95% Cis.
Results: Four randomized trials (k = 4; N = 690) met inclusion. Trick-specific syntheses showed that the thumb-and-light routine produced a pooled MD = −3.40 (95% CI −6.18 to −0.61; I² = 95.9%; τ² = 7.76; prediction interval −13.35 to 6.55), the magic coloring book yielded SMD = −2.65 (95% CI −4.02 to −1.29; I² = 81.5%; τ² = 0.80), and the item-prediction routine yielded SMD = −4.73 (95% CI −5.74 to −3.72). Qualitative synthesis showed stage-contingent benefits (visual salience favoured younger children; rule-/prediction-based routines favoured older cohorts), larger effects versus minimal/standard comparators than versus active audio-visual distraction, and greater impact when timed to the injection moment.
Conclusions: Thaumaturgic techniques were associated with clinically meaningful, procedure-proximal reductions in pediatric dental anxiety, with magnitude conditioned by cognitive stage, trick family, and comparator stringency.

Association of Periodontitis and Hepatocellular Carcinoma: a Systematic Exploratory Review

Valentina Gallardo — 2026-05-31

Introduction: Periodontitis is a highly prevalent oral disease characterized by chronic inflammation and microbial dysbiosis. Hepatocellular carcinoma (HCC) is the most common primary liver cancer worldwide. Emerging evidence suggests a potential association between these diseases; however, current evidence remains scarce and fragmented. Objective: To systematically map and synthesize the available human evidence regarding the association between periodontitis and HCC.
Materials and Methods: A scoping review was conducted following the Joanna Briggs Institute guidelines. Electronic searches were performed across PubMed, Scopus, Web of Science, Cochrane library, and OVID databases. Eligibility was restricted to primary human studies.
Results: six studies met the inclusion criteria. Epidemiological findings regarding initiation risk were inconsistent. Conversely, clinical and microbiological studies converged on a plausible association of periodontitis with HCC progression and severity. Overall, HCC patients exhibited reduced oral immunity and microbial diversity, with enrichment of specific pathogens such as Fusobacterium nucleatum, Porphyromonas gingivalis and Cyanobacteria. Furthermore, periodontitis was clinically associated with advanced HCC staging, and increased serum reactive oxygen metabolites, indicating synergistic oxidative burden.
Conclusions: While epidemiological evidence on periodontitis as a risk factor for HCC remains conflicting, growing clinical research supports periodontitis may contribute to HCC progression and severity. Further longitudinal and mechanistic research are needed to clarify this relationship, explore its underlying mechanisms, and determine its implications for cancer prevention and multidisciplinary care.

Expectations and satisfaction of patients who attend dental emergency clinics: a systematic review

Luay Thanoon Younis — 2026-05-07

Objectives: This systematic review was conducted to evaluate patients’ expectations upon visiting dental emergency clinics, the factors affecting patients’ expectations and satisfaction negatively or positively, and assess the level of these satisfactions.
Material and Methods: A systematic search was conducted in accordance with the PRISMA guidelines. Articles published between 2010 and 2024 that meet the inclusion and exclusion criteria were selected from PubMed, Scopus, Wiley, and Cochrane databases using the keywords such as patient expectation, dental emergency, patient satisfaction, and visiting dental emergency clinic. The Newcastle-Ottawa Scale and Quality Assessment by the Joanna Briggs Institute was used to assess the study quality.
Results: A total of 145 articles were found after searching the database; seven of these studies were included in the review, comprising five cross-sectional, one qualitative, and one prospective study. Key findings indicate patients value respectful and empathetic dentist-patient relationships, efficient administrative services, and high-quality, pain-free treatment. Shorter waiting times were strongly associated with higher satisfaction levels, while delays in doctor arrival and prolonged treatment processes led to dissatisfaction. Safety measures, organised facilities, and accessible care contributed to positive experiences. Overall, patient satisfaction was high across studies, ranging from 76% to 96%. However, gaps remain in addressing specific patient expectations, particularly regarding service accessibility and individualised care. Quality assessments revealed moderate risks of bias, particularly in confounding factors and study designs, which may affect the reliability of findings.
Conclusion: While overall satisfaction rates were high, gaps remain in meeting specific patient expectations, particularly regarding service accessibility and individualised care. Addressing these concerns by improving waiting time, enhancing communication, and improving service delivery may improve patient experiences. However, the moderate risk of bias in some studies suggests the need for more rigorous research to strengthen the evidence base.