Clinical, Cosmetic and Investigational Dentistry最新文献

{"title":"Cross-Cultural Analysis of Smile Characteristics, Perception, and Satisfaction Among Latvian and Uzbek Young Adults: A Comparative Study.","authors":"Nozima Razakova, Dace Priede, Surayyo Artykova","doi":"10.2147/CCIDE.S558771","DOIUrl":"10.2147/CCIDE.S558771","url":null,"abstract":"<p><strong>Introduction: </strong>Dental esthetics play a significant role in perceived facial attractiveness. This study aimed to assess and compare smile characteristics, smile perception and satisfaction with smile appearance among young adult populations in Latvia (Northern Europe) and Uzbekistan (Central Asia).</p><p><strong>Methods: </strong>A total of 200 participants (100 Latvian and 100 Uzbek), aged 20-35 years, were divided into two groups. In the first group, photographs of the smiles of 50 Latvian and 50 Uzbek participants were analyzed for smile characteristics (smile type, smile symmetry, number of teeth displayed in a smile, position of maxillary incisor edge relative to the lower lip, smile arc, dental midline). In the second group, a self-administered questionnaire was distributed electronically to 50 respondents from each country to evaluate smile perception and satisfaction with smile appearance. The Wilcoxon-Mann-Whitney test, Spearman test, and Pearson Chi-Square test were used for statistical analyses.</p><p><strong>Results: </strong>Statistically significant differences were found between Latvian and Uzbek participants in smile type (p = 0.009) and the number of teeth displayed in a smile (p = 0.05). Satisfaction with smile appearance was significantly higher among Uzbek participants compared to Latvians (p = 0.004). The average smile line and parallel smile arc were the most preferred designs in both countries.</p><p><strong>Conclusion: </strong>Differences in smile characteristics and satisfaction with smile appearance exist between Latvian and Uzbek populations, while smile perception is largely similar. These findings highlight the influence of cultural backgrounds on self-perception of the smile and emphasize the importance of culturally informed dental treatment planning.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"641-650"},"PeriodicalIF":1.8,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12730141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Performance of One-Piece Molar Endocrowns Fabricated from Different Ceramic Materials: A 36-Month Retrospective Clinical Study.","authors":"Emad Ahmed Kamli, Fadwa Saeed Alasmari, Youssef A Algarni, Abdulelah Sameer Sindi, Abdulaziz Mohammed Zailai, Razan Abu Alqasem Bosly, Maha Nasser Al Lebdan, Mushyirah Yahya Sabyei, Salha Hussein Alwadei, Abdulsalam Ahmed Alamir, Ahmad Abdulrahim Al Aqil, Moahmmed M Al Moaleem","doi":"10.2147/CCIDE.S572017","DOIUrl":"10.2147/CCIDE.S572017","url":null,"abstract":"<p><strong>Background: </strong>This retrospective observational clinical study designed to assess the clinical performance and outcomes of cemented one-piece molar endocrowns (ECs) using the United States Public Health Service (USPHS) criteria at various time intervals. Additionally, patient satisfaction for cemented ECs was measured using the Visual Analog Scale (VAS).</p><p><strong>Methods: </strong>Clinical data were collected from 29 participants (mean age 26.34 ± 6.99 years) who received ECs at a specialist dental center. Twenty-four ECs were constructed from lithium disilicate glass-ceramic (LDGC) and five from multilayered zirconia. All patients were analyzed at each follow-up (baseline, 6, 12, 24, and 36 months). Clinical performance was evaluated using modified USPHS criteria, and patient satisfaction was measured with a VAS. Statistical analyses included ANOVA and McNemar tests, with significance set at p ≤ 0.05.</p><p><strong>Results: </strong>After 36 months most LDGC restorations retained \"Alpha\" (clinically excellent) scores for marginal adaptation, color match, anatomical form, restoration integrity and retention; zirconia restorations showed a mix of Alpha and Bravo scores. Significant differences between the materials were found for color at baseline (p=0.001) and at 36 months (p=0.018) and for retention at 36 months (p=0.001). Overall patient satisfaction by VAS remained high across groups.</p><p><strong>Conclusion: </strong>Despite the limitations of a small zirconia sample, LDGC ECs showed better color matching and retention than zirconia. Zirconia is still a viable option where strength is essential. Material selection should consider esthetic demands and occlusal load. Long-term studies with larger cohorts are needed for validation.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"595-608"},"PeriodicalIF":1.8,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural Strategies for Dental Hard-Tissue Remineralization: A Scoping Review of Galla Chinensis and Its Dual Anticaries Action.","authors":"Laura Monica Rusu, Marioara Moldovan, Anca Labunet, Adriana Objelean, Alexandrina Muntean, Sorina Sava","doi":"10.2147/CCIDE.S572471","DOIUrl":"10.2147/CCIDE.S572471","url":null,"abstract":"<p><p>Dental caries remains a global public health challenge, traditionally managed through fluoride-based strategies that enhance enamel remineralization and inhibit demineralization. However, concerns regarding fluoride resistance, fluorosis, and the growing demand for minimally invasive alternatives have stimulated interest in bioactive, plant-derived compounds. Galla chinensis extract (GCE), rich in polyphenols and tannins, has emerged as a promising candidate with dual effects on hard tissue repair and microbial control. This scoping review aimed to assess the evidence on Galla chinensis extract (GCE) as a non-fluoride agent for enhancing enamel and dental hard tissue remineralization and preventing dental caries. A structured search of available literature was conducted, focusing on experimental, in vitro, in vivo, and clinical studies evaluating GCE's biological properties, mechanisms of action, and translational potential in dentistry. Our findings indicate that GCE consistently promotes mineral deposition and enhances enamel surface microhardness, effectively inhibiting demineralization processes. In addition, GCE exhibits strong antimicrobial activity against cariogenic biofilms, particularly <i>Streptococcus mutans</i>, highlighting its potential to reduce caries risk by modulating the oral microbiome. Preliminary clinical studies show favorable outcomes, although the available evidence is limited in scale and duration. Collectively, these results demonstrate a dual action of GCE: supporting enamel repair while concurrently suppressing cariogenic activity. This suggests that GCE may serve as a promising adjunct or alternative to conventional fluoride-based strategies within minimally invasive dentistry. However, further well-designed clinical trials are necessary to confirm its efficacy, safety, and long-term benefits in caries management.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"609-622"},"PeriodicalIF":1.8,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness, Attitude, and Knowledge Regarding Periodontal Disease Among Pregnant Women in Kunduz, Afghanistan.","authors":"Farhat Homayoun, Mustafa Jan Hamayoun, Sossan Hamrah, Tamkin Hamayoun, Ali Maisam Eshraqi, Firoozeh Alipour, Mohammad Hassan Hamrah","doi":"10.2147/CCIDE.S559172","DOIUrl":"10.2147/CCIDE.S559172","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy can make women more vulnerable to oral health problems due to hormonal fluctuations. Periodontal disease, a chronic inflammatory condition that affects the gums and supporting tissues, has been linked to serious complications such as preterm birth and low birth weight. Despite the established connection between oral and general health, especially during pregnancy, many women, particularly in developing countries like Afghanistan, are not adequately informed about these risks.</p><p><strong>Objective: </strong>The aim of this study was to explore the awareness, knowledge, and attitudes regarding periodontal disease among pregnant women in Kunduz, Afghanistan.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was carried out among 200 pregnant women attending antenatal clinics in Kunduz. Participants completed a structured questionnaire designed to assess their demographic characteristics and their understanding and perceptions of periodontal disease. The data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Among the respondents, 63.0% were aged 22-34 years, and 39.0% were in their third trimester. Nearly half (49.5%) reported poor general health. Educational levels were low, with 64.0% being illiterate. Awareness of periodontal disease and its impact on pregnancy outcomes was generally poor, with only 40.5% agreeing that pregnancy increases gingival inflammation risk and 45.0% recognizing a link between dental health and pregnancy. Many participants held misconceptions, such as avoiding dental care during pregnancy due to safety concerns.</p><p><strong>Conclusion: </strong>There is a critical need for targeted oral health education during pregnancy in Kunduz. Incorporating oral health education into antenatal care services may help bridge the current knowledge gap and reduce the risk of preventable complications.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"587-593"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of the Periodontal Pathogen <i>Selenomonas noxia</i> and Salivary Visfatin Level in Overweight and Obese Individuals with Periodontitis.","authors":"Jannah Aqeel Jasim, Ghasaq Asim Abdul-Wahab","doi":"10.2147/CCIDE.S560611","DOIUrl":"10.2147/CCIDE.S560611","url":null,"abstract":"<p><strong>Background: </strong>Periodontal diseases are prevalent and can be worsened by conditions such as obesity. Understanding obesity impact on periodontal health is essential for developing effective management strategies. Hence, the aim of the present study was to assess the prevalence of <i>Selenomonas noxia</i> and pro-inflammatory visfatin marker for periodontitis in overweight/obese and non-obese population and correlate them with periodontal status.</p><p><strong>Materials and methods: </strong>Eighty-five participants aged from (30-50) years were divided into three groups: healthy controls (n=25), normal-weight periodontitis patients (n=30), and overweight/obese periodontitis patients (n=30). Unstimulated saliva was analyzed for visfatin level using ELISA, and subgingival plaque was examined for <i>S. noxia</i> prevalence using qPCR. Data were analyzed using Kruskal-Wallis, Spearman correlation, and ROC curves.</p><p><strong>Results: </strong>Overweight/obese periodontitis patients had significantly higher salivary visfatin level (111.1 ± 277.4 ng/mL) compared with normal-weight periodontitis (28.2 ± 20.6 ng/mL) and controls (19.3 ± 4.6 ng/mL) (P<0.001). Similarly, <i>S. noxia</i> was more prevalent in overweight/obese individuals with periodontitis (155052.5±647,130.3) compared to persons with periodontitis and periodontal health (P<0.001). Strong positive correlation encountered between bacteria and visfatin level in both patient groups (P<0.001) and with BMI in the overweight/ obese group (P=0.001). ROC analysis showed excellent diagnostic accuracy for <i>S. noxia</i> in overweight/obese patients with periodontitis (AUC=0.86) and strong performance for visfatin (AUC=0.83).</p><p><strong>Conclusion: </strong>Obesity might play a devastating role in the pathogenesis of periodontitis through the increased salivary visfatin level and <i>S. noxia</i> prevalence. This indicates that they may serve as potential markers for periodontal inflammation in the obese population.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"575-586"},"PeriodicalIF":1.8,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12701660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of the X Platform (Formerly Twitter) by Saudi Dental Societies: A Content and Engagement Analysis.","authors":"Khalifa S Al-Khalifa, Daneah Alibrahim, Hind Alharbi, Basmah Omar Alakloby, Danah Salah Albuhmdouh, Shahad T Alameer, Areeb Alotaibi, Haneen A Alzayer, Israa Saleh Alkhalifah, Hussain Alibrahim","doi":"10.2147/CCIDE.S564387","DOIUrl":"10.2147/CCIDE.S564387","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the patterns and use of \"X\" as a social media platform for Saudi dental societies and to assess their engagement strategies in light of national digital transformation goals.</p><p><strong>Methods: </strong>This cross-sectional, observational study analyzed publicly available data from the official X (formerly Twitter) accounts of Saudi dental societies (n=8) from July 2023 to June 2024. Data were collected using the Twitter API v2 via the Tweepy library in Python. Thematic analysis was performed, classifying posts into main themes like. Continuing education, research, and community outreach. Posts were also categorized by their originality (original, repost, or quote), language, and content nature (text, media, or both). To ensure reliability, two trained investigators coded the posts, and weighted Kappa statistics confirmed strong inter-rater and intra-rater agreement. Data analysis was performed using IBM SPSS Statistics, including descriptive statistics, ANOVA, and multiple linear regression to identify factors associated with engagement.</p><p><strong>Results: </strong>A total of 2649 posts were analyzed. The Saudi Dental Society (SDS) was the most active, producing 1257 posts (47.45%). Posts primarily focused on continuing education (70.4%), with news and announcements being the most frequent content types. The vast majority of posts were original (94.1%) and media-enriched (86.1%). The mean total engagement per post was 9.67. Research-related posts achieved the highest total engagement (22 ± 24.04), despite their very low frequency (0.1%).</p><p><strong>Conclusion: </strong>Saudi dental societies primarily use the X platform for continuing education content, while posts focused on research, advocacy, and community outreach generate higher engagement. Analyzing these content and engagement patterns is important to guide strategic communication that enhances professional visibility, audience interaction, and public health outreach. These findings are also aligned with the Saudi Vision 2030 objectives promoting digital transformation and innovation in healthcare communication.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"563-573"},"PeriodicalIF":1.8,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude and Practices of Primary School Teachers Towards Oral Health in Mchinji District, Malawi.","authors":"George Kafera, Ruth Kalimbira, Jeremy Bagg, Peter Cosmo Chimimba, James Maurice Mchenga, Akim Nelson Bwanali, Adriano Focus Lubanga","doi":"10.2147/CCIDE.S562531","DOIUrl":"10.2147/CCIDE.S562531","url":null,"abstract":"<p><strong>Background: </strong>Oral health is an essential component of overall well-being, yet it remains a neglected public health area in many low- and middle-income countries. Teachers play a vital role in shaping students' oral health behaviours, making their knowledge and practices crucial for school-based oral health promotion. This study assessed the knowledge, attitudes, and practices (KAP) regarding oral health among primary school teachers in Mchinji District, Malawi, to evaluate their readiness to support oral health education.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 316 primary school teachers using a structured questionnaire. Descriptive statistics summarized demographic and KAP variables, while chi-square tests and Cramér's V measured associations between demographic characteristics and oral health knowledge and practices.</p><p><strong>Results: </strong>Among participants, 60.0% were male, 61.4% were aged 30-45 years, and 61.9% had more than 10 years of teaching experience. While 63.6% demonstrated average oral health knowledge and 29.4% showed good knowledge, awareness of preventive dental procedures such as dental scaling (26.7%) and flossing (14.2%) was low. Most teachers (82.2%) exhibited average oral hygiene practices, and only 10.2% had good practice scores. Although positive attitudes were widespread, with over 90% recognizing the importance of oral health and regular dental visits, only 26.4% had received oral health training, and 68.5% identified limited knowledge as a barrier to teaching oral health. Age was significantly associated with knowledge level (p = 0.007, Cramér's V = 0.152), while gender and teaching experience were not.</p><p><strong>Conclusion: </strong>Primary school teachers in Mchinji District hold positive attitudes toward oral health but display knowledge and practice gaps. Strengthening teacher training through structured oral health capacity-building programs could enhance school-based health education and inform policies that integrate oral health into Malawi's primary school curriculum.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"549-561"},"PeriodicalIF":1.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12662778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maxillary Anterior Teeth Dimensions: A Biometric Analysis in a Kuwaiti Population.","authors":"Ahmad Alsahli, Mohammad Qali, Jagan Kumar Baskaradoss, Dana AlOuda, Mubarak Alsaeed","doi":"10.2147/CCIDE.S551820","DOIUrl":"10.2147/CCIDE.S551820","url":null,"abstract":"<p><strong>Purpose: </strong>Maxillary anterior tooth dimensions are critical in esthetic and restorative dentistry, yet data remain limited for some populations. Existing reference values may not apply universally, and sex-related differences are underreported. This study examined the clinical crown width (w), length (l), and width/length ratio (w/l) of maxillary central incisors, lateral incisors, and canines in a Kuwaiti adult population, and evaluated the sex-related differences.</p><p><strong>Patients and methods: </strong>Maxillary 3D resin models were obtained from 126 healthy adults. Mesiodistal width (w) and clinical crown length (l) were measured with a digital caliper (0.01 mm). The w/l ratio was calculated, and reproducibility was tested on 24 models. Sex differences were assessed with independent sample <i>t</i>-tests.</p><p><strong>Results: </strong>Of the participants, 84 (66.6%) were female and 42 (33.4%) were male, with a mean age of 29.8 years. Mean (± SD, range) crown widths were 8.83 ± 0.65 (7.5-9.8) mm, 6.83 ± 0.52 (6.0-7.8) mm, and 7.76 ± 0.58 (6.8-8.7) mm for central, lateral, and canine teeth, respectively. Corresponding lengths were 9.83 ± 0.72 (8.2-11.2) mm, 8.00 ± 0.60 (7.0-9.2) mm, and 9.14 ± 0.68 (8.0-10.4) mm. The corresponding w/l ratios were 91% (centrals), 86% (laterals), and 86% (canines). Statistically significant sex differences were observed in crown length (p < 0.001) and w/l ratio (p < 0.001) for all three tooth types, with males exhibiting longer crowns and females showing higher w/l ratios.</p><p><strong>Conclusion: </strong>Width/length ratios were higher in females across all maxillary anterior teeth, whereas crown length of all anterior teeth and canine width were greater in males, showing the greatest sexual dimorphism. Ethnicity and sex significantly influence maxillary anterior tooth dimensions, highlighting the need for population- and sex-specific reference values to guide esthetic and restorative treatment.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"539-548"},"PeriodicalIF":1.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival and Success Rate of Restoration Post Endodontic Treatment.","authors":"Ayu Trisna Hayati, Diani Prisinda, Alodia Luna Latifa Nugroho","doi":"10.2147/CCIDE.S555608","DOIUrl":"10.2147/CCIDE.S555608","url":null,"abstract":"<p><strong>Introduction: </strong>Dental restoration following endodontic treatment aims to restore tooth function, aesthetics, and strength compromised by caries or trauma. Loss of tooth structure post-treatment can reduce strength by up to 60%, increasing fracture risk. Restoration choice depends on remaining tooth structure, coronal sealing, retention, and occlusal factors. Direct restorations suit minimal damage, while indirect options like crowns or endocrowns address significant structural loss.</p><p><strong>Objective: </strong>To evaluate the durability and success of post-endodontic restorations through a scoping review focused on remaining tooth structure, restoration techniques, materials, and post use.</p><p><strong>Methods: </strong>A scoping review was conducted using PubMed, ScienceDirect, and Scopus, following PRISMA-ScR guidelines. Included studies were randomized controlled trials, cross-sectional studies, and case-control studies published in English within the last five years. In vitro studies, non-randomized clinical trials, and literature reviews were excluded.</p><p><strong>Results: </strong>From 353 articles, 14 met inclusion criteria. The studies found that indirect restorations exhibited higher success rates (63% to 91.61%) than direct restorations (43.2% to 86.7%). This finding attributed to the inherent advantages of indirect approach. Indirect restorations demonstrated higher 3-year survival rates (82.7 to 99.1%) than direct restorations (75 to 97.6%). Among these, full-coverage crowns were superior, due to their enhanced fracture resistance, ferrule effect, and stress distribution while direct resin composites suffice when adequate tooth structure remains. Direct restorations are recommended for endodontically treated teeth that still have two or more intact coronal walls, as their prognosis and success rates are quite good for both anterior and posterior teeth. Glass-fiber posts reduce root fracture risk compared to metal posts; however, outcomes depend on post design and occlusal load.</p><p><strong>Conclusion: </strong>The long-term success of post-endodontic restorations depends on multiple factors, with remaining tooth structure being paramount. Evidence shows a clear hierarchy: indirect restorations, particularly full-coverage crowns (FCCs), demonstrate superior success and survival rates due to their fracture resistance and effective stress distribution. Direct composites are only viable with substantial remaining tooth structure (≥2 intact walls). Glass-fiber posts are preferred over metal posts to reduce fracture risk. Ultimately, a ferrule-effect-based, tailored approach that matches biomechanical demands to clinical conditions is essential for optimal outcomes.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"525-537"},"PeriodicalIF":1.8,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12607662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Equity in Oral Health: Thailand's 15-Year System-Level Initiative for People with Disabilities (2011 to 2025).","authors":"Nithimar Sermsuti-Anuwat, Yaowapa Chantaraboot","doi":"10.2147/CCIDE.S565977","DOIUrl":"10.2147/CCIDE.S565977","url":null,"abstract":"<p><strong>Background: </strong>People with disabilities experience disproportionate oral health burdens worldwide. In Thailand, despite universal health coverage (UHC), persistent barriers-including transportation, caregiver availability, distance, and costs-limit access to care. Since 2011, government and partners have pursued multilevel actions to improve equity for this population, yet no comprehensive synthesis of their evolution has been reported.</p><p><strong>Objective: </strong>To describe the context and content of Thailand's 2011 to 2025 initiative for people with disabilities, summarize what was implemented across policy, workforce, curriculum, services, and governance, and identify observed results, limitations, and next steps for sustainability.</p><p><strong>Methods: </strong>A national secondary synthesis aligned with SQUIRE 2.0 analyzed policy documents, program reports, and training materials (2011 to 2025) using document and thematic analyses with contribution analysis and triangulation. Eligibility required relevance to disability-inclusive oral health in Thailand; units were policies, curricula, service models, and financing/monitoring, and engagement mechanisms were extracted as reported; no human data were used, and ethics approval was not required.</p><p><strong>Results: </strong>The initiative advanced through four overlapping phases: Phase 1 (2011 to 2014) comprised Thai Health Promotion Foundation (ThaiHealth) funded pilot projects to increase access, followed by increasingly explicit government policy in Phase 2 (curriculum integration and professional development, 2015 to 2017), Phase 3 (network expansion and digital knowledge sharing, 2017 to 2020), and Phase 4 (institutionalization and policy integration, 2021 to 2025). Actions were associated with expansion of dental service sites from 11 to 30 across 12 provinces, integration of special care dentistry into multiple dental curricula, establishment of specialty boards, and adoption of national strategic frameworks. Persistent barriers included workforce shortages, transportation difficulties, and gaps in national oral health data.</p><p><strong>Conclusion: </strong>Thailand's phased, system-level strategy demonstrates how policy integration, curriculum reform, and network development can accelerate equity in oral health care for people with disabilities. Priorities for sustainability include a nationwide disability-focused oral health survey, rural workforce pipelines, integration of special care dentistry into UHC benefits, and expanded use of digital platforms. Lessons may inform similar reforms in other middle-income settings.</p>","PeriodicalId":10445,"journal":{"name":"Clinical, Cosmetic and Investigational Dentistry","volume":"17 ","pages":"515-523"},"PeriodicalIF":1.8,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}