Evidence-based dentistry最新文献

{"title":"Does adding a mandibular mentoplate improve long-term Class III treatment?","authors":"A Selva Arockiam","doi":"10.1038/s41432-026-01275-3","DOIUrl":"https://doi.org/10.1038/s41432-026-01275-3","url":null,"abstract":"<p><strong>A commentary on: </strong>Meyns J, Meewis J, Dons F, Schreurs A, Aerts J, Shujaat S, Politis C, Jacobs R. Long-term comparison of maxillary protraction with hybrid hyrax-facemask vs. hybrid hyrax-mentoplate protocols using Alt-RAMEC: a 5-year randomised controlled trial. Eur J Orthod. 2025;47(2):cjaf011. https://doi.org/10.1093/ejo/cjaf011 .</p><p><strong>Design: </strong>Single-centre two-arm parallel randomised controlled trial with 1:1 allocation and 5-year follow-up.</p><p><strong>Case selection: </strong>Twenty-eight children in the mixed dentition with skeletal Class III malocclusion were recruited. Eligible patients had an anterior crossbite or edge-to-edge incisor relationship and a Class III molar relationship. Children with craniofacial syndromes, previous orthodontic or surgical treatment, marked skeletal asymmetry or functional Class III malocclusion were excluded. Participants were allocated to hybrid Hyrax plus facemask therapy or hybrid Hyrax plus mandibular mentoplate therapy. Both groups received Alt-RAMEC.</p><p><strong>Data analysis: </strong>Low-dose computed tomography was performed at baseline, 1 year and 5 years. Virtual lateral cephalograms were used to assess Wits appraisal as the primary outcome with skeletal and dentoalveolar variables as secondary outcomes. Between-group comparisons used unpaired two-sided t tests. Outcome assessment and statistical analysis were blinded. Measurement reliability was assessed using intraclass correlation coefficients.</p><p><strong>Results: </strong>Twenty-four of 28 randomised participants contributed data at 5 years. Wits appraisal improved by 4.42 mm with facemask treatment and 2.86 mm with mentoplate treatment at 1 year. At 5 years the corresponding improvements from baseline were 3.33 mm and 1.50 mm. Between-group differences were not statistically significant. Long-term vertical skeletal measures and incisor inclination were also comparable. Minor hook fracture and mucosal irritation occurred without treatment discontinuation.</p><p><strong>Conclusions: </strong>Adding a mandibular mentoplate did not demonstrate superior long-term skeletal correction over hybrid Hyrax plus facemask treatment in this small trial. The findings support selective rather than routine use of the more invasive approach. They do not establish equivalence between the protocols.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do different topical fluoride applications affect salivary and plaque fluoride levels for young children with dental caries?","authors":"Laura Timms, Zoe Marshman","doi":"10.1038/s41432-026-01277-1","DOIUrl":"https://doi.org/10.1038/s41432-026-01277-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;A commentary on: &lt;/strong&gt;Asavalertpalakorn C, Jirarattanasopha V, Nakornchai S, Horsophonphong S. Plaque and salivary fluoride levels in preschoolers following applications of silver diamine fluoride, sodium fluoride varnish, and their combination: a randomized clinical trial. Int J Paediatr Dent. 2026;36:81-9. https://doi.org/10.1111/ipd.70030 .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A three-arm randomised controlled trial compared the salivary and plaque fluoride levels for young children, following application of different fluoride prevention and treatment procedures (silver diamine fluoride, sodium fluoride varnish and silver diamine fluoride and sodium fluoride varnish together), in child development centres in Thailand.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case selection: &lt;/strong&gt;Children aged 3-6 were selected who had at least one carious tooth reaching dentine in the primary dentition. Included children were considered healthy and co-operative. Children who had received professional fluoride application within the last three months were excluded, or those with a known allergy to any component. Twenty children were randomised to each group. Group 1 received silver diamine fluoride application (1 drop) to dentinal carious lesions; group 2 received sodium fluoride varnish application (0.25 ml) to all erupted primary teeth; group 3 received both the silver diamine fluoride and sodium fluoride varnish interventions. Fluoride applications were not applied to pulpally involved teeth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data analysis: &lt;/strong&gt;Plaque and saliva samples were collected at baseline (prior to fluoride application), at 5, 30 and 60 minutes, and at 24 and 48 hours. Kruskal-Wallis and Friedman tests were used to compare the 3 groups at the various time points. A Bonferroni correction was applied to account for the multiple comparisons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 60 children were randomised, data were analysed for 50 children's salivary samples and 49 children's plaque samples. The mean age was 3.7 months, with children having a mean of 7.6 decayed, missing or filled teeth. At the shorter-term (5, 30 and 60 minute) time points, the salivary fluoride levels were significantly higher in the sodium fluoride varnish alone and silver diamine fluoride with sodium fluoride varnish groups than in the silver diamine fluoride alone group. There was no difference in the silver diamine fluoride with sodium fluoride varnish and sodium fluoride varnish alone groups for both salivary and plaque fluoride levels. Considering fluoride levels in plaque, the sodium fluoride varnish group had significantly higher levels at 5 and 60 minutes than the silver diamine fluoride group and the silver diamine fluoride with sodium fluoride varnish group was significantly higher at 30 and 60 minutes in comparison to silver diamine fluoride alone. At 60 minutes, the silver diamine fluoride and sodium fluoride varnish groups had returned to baseline; this was at 24 hours for the silver diamine f","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the current evidence sufficient to establish the most effective treatment for dental fluorosis?","authors":"Ifeoluwa Babatunde, Seyyedeh Mahsa Sheikholeslamian","doi":"10.1038/s41432-026-01276-2","DOIUrl":"https://doi.org/10.1038/s41432-026-01276-2","url":null,"abstract":"<p><strong>A commentary on: </strong>Chaple Gil AM, Pereda Vázquez L, Santiesteban Velázquez M, Menéndez JJ. Minimally invasive treatments for dental fluorosis: a network meta-analysis of aesthetic masking efficacy. J Esthet Restor Dent. 2026;38(7):1323-1337.</p><p><strong>Design: </strong>A systematic review and network meta-analysis evaluated the comparative aesthetic masking efficacy of minimally invasive treatments for dental fluorosis, including microabrasion, bleaching, resin infiltration, and remineralization strategies. The authors searched PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library. It is stated that the review was conducted according to PRISMA-NMA guidelines.</p><p><strong>Study selection: </strong>Randomized clinical trials with at least two parallel-group or split-mouth treatment arms were included. Eligible studies enroled patients with dental fluorosis diagnosed clinically using Dean's Index, the Thylstrup-Fejerskov Index (TFI), or the Tooth Surface Index of Fluorosis (TSIF), and reported aesthetic outcomes using continuous colorimetric measures, such as ΔE or CIE Lab* values, at short- or mid-term follow-up. Studies were excluded if they reported only subjective or ordinal aesthetic outcomes (e.g., TSIF categories, shade-guide scores, or visual analogue scale ratings) or evaluated restorative or prosthodontic treatments.</p><p><strong>Data analysis: </strong>Mean differences (MDs) in change scores with corresponding standard errors were pooled using a random-effects model. Network geometry, consistency, heterogeneity, and influence diagnostics were assessed to evaluate model fit and robustness. Results were presented using network forest plots, league tables, and treatment ranking plots (SUCRA/P-scores). Separate network meta-analyses were conducted for immediate post-treatment, 3-month, and 6-month follow-up periods. Risk of bias and certainty of evidence were assessed using the RoB 2 tool and CINeMA.</p><p><strong>Results: </strong>Across the seven included trials, the greatest improvement in aesthetic outcomes was observed with the combination of microabrasion and in-office bleaching. Among the standalone interventions, resin infiltration demonstrated the most consistent and clinically meaningful benefit. The overall risk of bias assessment indicated that most studies were judged as having some concerns. Assessment of incoherence using the CINeMA framework indicated a generally coherent evidence network.</p><p><strong>Conclusions: </strong>The highest aesthetic masking efficacy was observed with sequential multimodal approaches that combined surface modification, bleaching, and resin-based refractive adjustment in fluorosis lesions after 3- and 6-month follow-up.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary parameters in individuals undergoing orthodontic treatment with clear aligners: a scoping review.","authors":"Jéssica Tavares do Nascimento de Sousa, Beatriz Tebalde Albuquerque de Souza, Lívia Araujo Alves, Tamara Kerber Tedesco, Michele Baffi Diniz","doi":"10.1038/s41432-026-01274-4","DOIUrl":"https://doi.org/10.1038/s41432-026-01274-4","url":null,"abstract":"<p><strong>Aims: </strong>This scoping review aimed to map the salivary parameters investigated in children, adolescents, young adults, and adults undergoing orthodontic treatment with clear aligners, describe saliva collection and analytical assessment methods, and identify methodological gaps in the literature.</p><p><strong>Methods: </strong>The review was reported according to PRISMA-ScR and had its protocol registered in the Open Science Framework. Searches were conducted in MEDLINE/PubMed, Scopus, Web of Science, and ProQuest, without restrictions on year or language. The initial search was performed on June 12, 2024, and updated on September 9, 2025. Two independent reviewers screened records in Rayyan, assessed full texts, and extracted data using a standardized form. Eligible studies were primary clinical investigations assessing salivary parameters in individuals undergoing clear aligner therapy. Data were synthesized descriptively, without a formal risk-of-bias appraisal.</p><p><strong>Results: </strong>From 3225 records, 1917 references were screened, 28 full texts were assessed, and 22 studies from 11 countries were included. The included reports comprised 880 participants across all groups (494 clear aligner and 386 comparator participants), although potential overlap between reports cannot be excluded. Most studies were prospective observational investigations, and pediatric participants were underrepresented. Invisalign™ was the most frequently investigated aligner system, although several studies used other thermoformed appliances or did not specify the brand. The included studies varied substantially in follow-up schedules, pre-sampling instructions, saliva type, collection procedures, sample processing, storage conditions, and analytical platforms. Salivary outcomes were mapped into four domains: microbiological parameters, biochemical and immunological markers, physicochemical properties, and material-related chemical eluents. Microbiological outcomes were the most frequently mapped domain, followed by inflammatory, oxidative stress, hormonal, enzymatic, physicochemical, BPA, monomer, and metabolite-related outcomes.</p><p><strong>Conclusion: </strong>This scoping review provides a descriptive map of salivary parameters investigated during clear aligner therapy and the methods used for their collection and assessment. Methodological variability limits comparability across studies. Future research should prioritize standardized saliva collection, processing, storage, analytical reporting, age-stratified sampling, and transparent reporting of aligner materials and clinical context.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronally advanced flap with platelet-rich fibrin or amniotic membrane for the treatment of gingival recession: a systematic review and meta-analysis with trial sequential analysis.","authors":"Malik Alkabazi, Asmaa Abou-Bakr, Adriano Piattelli, Gustavo Vicentis Oliveira Fernandes, Fatma E A Hassanein","doi":"10.1038/s41432-026-01270-8","DOIUrl":"https://doi.org/10.1038/s41432-026-01270-8","url":null,"abstract":"<p><strong>Objectives: </strong>Platelet-rich fibrin (PRF) and Amniotic membrane (AM) have become viable substitute biomaterials to improve coronally advanced flap (CAF) outcomes. The aim of this study was to evaluate the effectiveness of CAF + PRF versus CAF + AM in treating Miller's Class I/II gingival recession (GR).</p><p><strong>Methods: </strong>A comprehensive search of six electronic databases was carried out in accordance with PRISMA guidelines. percentage of root coverage (PRC), keratinized gingiva width (KGW), gain gingival thickness (GT), recession depth (RD) reduction, and recession width (RW) reduction were the primary outcomes. clinical attachment level (CAL), plaque index (PI), and probing depth (PD) were secondary outcomes. Random-effects models were used to pool mean differences (MDs) with 95% confidence intervals, and trial sequential analysis (TSA) was performed to examine evidence sufficiency and required information size (RIS).</p><p><strong>Results: </strong>The qualitative and quantitative synthesis comprised six randomized controlled trials (RCTs) from 2017 to 2025. At 3- and 6-month follow-ups, a meta-analysis showed no statistically significant differences between CAF + PRF and CAF + AM for PRC, CAL, RD, RW, PD, or PI. At three months, there was a statistically significant difference in KGW gain favoring AM (MD = -0.16 mm, 95% CI: -0.27 to -0.06, p = 0.0028). TSA for KGW at 3 months showed that the accumulated evidence has reached the RIS and crossed the trial sequential monitoring boundary for benefit.</p><p><strong>Conclusion: </strong>Within the limitations of a small number of short-term randomized trials, outcome-level risk-of-bias concerns, and potential unit-of-analysis issues, current evidence suggests that CAF combined with PRF or AM yields comparable clinical outcomes for the treatment of gingival recession. Although a statistically significant advantage in KGW was observed for AM at 3 months, this difference is unlikely to be clinically meaningful and was not sustained over time.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontal disease and risk of dementia: a systematic review and meta-analysis.","authors":"V D'Souza, A Bhagirath, I Verma, J Johnson, Y Wang, R Shenoy","doi":"10.1038/s41432-026-01271-7","DOIUrl":"https://doi.org/10.1038/s41432-026-01271-7","url":null,"abstract":"<p><strong>Background: </strong>Periodontal disease is a biofilm-associated, host-mediated inflammatory disease characterized by inflammation and destruction of the tooth-supporting tissues. An association between periodontal disease and adverse cognitive outcomes, including dementia, has been proposed; however, findings across studies remain inconsistent.</p><p><strong>Objective: </strong>To systematically synthesize and examine the temporal association between periodontal disease and subsequent cognitive impairment and incident dementia.</p><p><strong>Methods: </strong>Six large databases were searched for studies published from January 2000 to June 2025. Eligible studies employed longitudinal or prospective designs in which periodontal disease was assessed prior to cognitive outcomes. Data extraction and methodological quality assessment were performed independently by multiple reviewers. Adjusted hazard ratios (HRs) for incident all-cause dementia were pooled using random-effects meta-analysis where appropriate.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria and were included in the synthesis. Most studies reported a positive association between periodontal disease and adverse cognitive outcomes. Four studies were included in the meta-analysis, which demonstrated a modest but statistically significant association between periodontal disease and incident all-cause dementia (pooled HR ≈ 1.12; 95% confidence interval, 1.01-1.24).</p><p><strong>Conclusions: </strong>Longitudinal evidence suggests that periodontal disease is associated with an increased risk of incident dementia and cognitive decline. Although evidence across studies supports periodontal disease as a potentially relevant exposure associated with adverse cognitive outcomes, causality cannot be inferred.</p><p><strong>Discussion: </strong>Overall, the findings indicate an association between periodontal disease and adverse cognitive outcomes across longitudinal studies that is consistent with proposed biological mechanisms linking periodontal disease and cognitive impairment. However, heterogeneity in periodontal disease definitions, cognitive outcome measures, and variations in confounding adjustment across studies limited interpretation of the observed associations. Residual confounding and potential reverse causation cannot be fully excluded, underscoring the need for well-designed prospective and interventional studies.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commentary on AI-based Prediction Models in Periodontitis Progression.","authors":"Fahad Umer, Ayesha Nooruddin, Aamna Khalid","doi":"10.1038/s41432-026-01272-6","DOIUrl":"https://doi.org/10.1038/s41432-026-01272-6","url":null,"abstract":"<p><strong>A commentary on: </strong>Furquim CP, Caruth L, Chandrasekaran G, et al. \"Developing Predictive Models for Periodontitis Progression Using Artificial Intelligence: A Longitudinal Cohort Study\" Journal of Clinical Periodontology, 2025;52:1478-1490 https://doi.org/10.1111/jcpe.14194 .</p><p><strong>Study design: </strong>A prospective multi-center cohort study utilized data from previous work that evaluated periodontitis progression over a 12-month follow-up. Baseline demographic, clinical, and immunological variables were used to develop predictive models employing Logistic Regression (LR), Multi-Layer Perceptron (MLP), and Probabilistic Graphical Modelling (PGM) approaches.</p><p><strong>Case selection: </strong>A total of 415 participants aged 25 years or older with at least 20 natural teeth were initially enrolled as part of the original study. Smokers, diabetic patients, pregnant or lactating women, individuals who had recently received periodontal therapy, antibiotics, or chronic anti-inflammatory medications, and those with incomplete data were excluded. Only participants who completed the 12-month follow-up and all bi-monthly assessments were included in the final analysis. Consequently, 273 participants remained, comprising 72 healthy/gingivitis individuals, 24 with Stage II periodontitis, and 177 with Stage III periodontitis.</p><p><strong>Data analysis: </strong>Model performance was assessed using accuracy, Area Under the Receiver Operating Characteristic curve (AUROC), Area Under the Precision Recall Curve (AUPRC), sensitivity, specificity, and Brier scores. Feature importance and model interpretability were evaluated using SHAP (Shapley Additive Explanations) analysis.</p><p><strong>Results: </strong>PGM approach demonstrated the strongest overall performance. The best-performing model incorporated clinical variables, salivary IL-1β, age, and sex. LR showed moderate discrimination but poor classification balance, while the MLP demonstrated limited clinical usefulness. Among all predictors, the number of periodontal pockets ≥5 mm emerged as the most influential clinical feature, while IL-1β was the most important biological marker.</p><p><strong>Conclusions: </strong>This study provides encouraging evidence that Machine Learning (ML) approaches can improve the prediction of periodontitis progression. It also suggests the value of integrating biological markers with conventional clinical assessment.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Third‑molar extraction: do antibiotics really prevent postoperative infection?","authors":"Sérgio Araújo Andrade, Mariana Ferreira Reis, Ana Cristina Nogueira Rodrigues Pestana, Bodil Lund","doi":"10.1038/s41432-026-01266-4","DOIUrl":"https://doi.org/10.1038/s41432-026-01266-4","url":null,"abstract":"<p><strong>A commentary on: </strong>Raiesian S, Ahmadiyeh ADP, Rad MM. A systematic review on prior/postoperative antibiotic therapy efficiency in reducing surgical complications after third molar extraction surgery. J Maxillofac Oral Surg. 2025;24(5):1427-1433 https://doi.org/10.1007/s12663-024-02355-6 .</p><p><strong>Design: </strong>Systematic review conducted in accordance with PRISMA recommendations, aimed at evaluating the efficacy of prophylactic antibiotic therapy in reducing postoperative complications following third molar extraction.</p><p><strong>Case selection: </strong>Randomised clinical trials and prospective and retrospective studies published between 2000 and 2021 were included, involving patients undergoing surgical removal of third molars. Selected studies evaluated different antibiotic protocols administered pre- and postoperatively.</p><p><strong>Data analysis: </strong>Eighteen English-language studies were selected from PubMed, Scopus, Web of Science, and Google Scholar databases.</p><p><strong>Results: </strong>No statistically significant differences were observed between patients undergoing prophylactic antibiotic therapy and control groups regarding main clinical outcomes, including postoperative pain and swelling in simple third molar extractions. Findings also highlight growing concern regarding microbial resistance, adverse drug effects, and costs associated with the indiscriminate use of antibiotics.</p><p><strong>Conclusions: </strong>Routine antibiotic administration, both pre- and postoperatively in third molar surgery, demonstrated no relevant clinical benefit in systemically healthy patients.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More therapy is not necessarily better: patient education and self-management perform similarly to other conservative interventions for temporomandibular disorders.","authors":"Jens Christoph Türp","doi":"10.1038/s41432-026-01273-5","DOIUrl":"https://doi.org/10.1038/s41432-026-01273-5","url":null,"abstract":"<p><strong>A commentary on: </strong>Ferland G, Vincent R, Desmeules F, Cormier AA, Huon M, Pitance L. Patient Education and Self-Management in Adults With Temporomandibular Disorders: Results From a Systematic Review With Meta-Analysis. J Oral Rehabil. 2026;53:1394-1408. https://doi.org/10.1111/joor.70187 .</p><p><strong>Design: </strong>Systematic review and meta-analysis of randomized controlled trials evaluating patient education and self-management interventions for adults with temporomandibular disorders (TMDs).</p><p><strong>Case selection: </strong>MEDLINE, PubMed, Embase, Cochrane CENTRAL, CINAHL, and PsycINFO were searched from inception to March 2025. Eligible randomized controlled trials included adults diagnosed with TMD according to RDC/TMD or DC/TMD criteria and evaluated patient education and/or self-management interventions, either alone or in combination with another conservative therapy. Forty-seven trials involving 3238 participants were included.</p><p><strong>Data analysis: </strong>Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane Risk of Bias tool. Random-effects meta-analyses were performed using standardized mean differences (SMDs) for pain, mandibular function, and health-related quality of life (HRQoL). Certainty of evidence was assessed using the GRADE approach.</p><p><strong>Results: </strong>Other conservative interventions demonstrated greater short-term pain reduction than education/self-management alone (SMD 0.79; 95% CI 0.27 to 1.32) and greater short-term improvement in HRQoL (SMD 0.61; 95% CI 0.20 to 1.01). However, no significant differences were observed for medium-term pain or mandibular function. Adding education/self-management to other conservative interventions did not improve short-term pain outcomes. Similarly, combining education/self-management with oral appliances, manual therapy, exercise, or electrotherapy was not consistently superior to education/self-management alone in reducing medium- and long-term pain or functional limitation. Most included trials exhibited substantial methodological limitations and considerable clinical heterogeneity.</p><p><strong>Conclusions: </strong>Education and self-management appear to provide clinical outcomes comparable to those of many other conservative treatments for TMDs, particularly beyond the short term. While some interventions may offer greater short-term pain relief or HRQoL improvement, the evidence does not support consistent additional benefit from combining education/self-management with other conservative therapies.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic surgery vs dynamic navigation: does greater accuracy make the difference in implant dentistry?","authors":"Paolo Nava, Andrea Laureti, Hamoun Sabri","doi":"10.1038/s41432-026-01267-3","DOIUrl":"https://doi.org/10.1038/s41432-026-01267-3","url":null,"abstract":"<p><strong>A commentary on: </strong>Wei H, Shu Z, Tian M, Ge Y, Li D. The Accuracy of Autonomous Robotic Surgery vs. Dynamic Navigation in Implant Placement: An Open-Label, Double-Arm, Randomized Controlled Clinical Trial. Clin Oral Implants Res. 2025;36:1486 -97 DESIGN: Double-arm, randomized controlled clinical trial comparing the accuracy and early clinical outcomes of autonomous robotic surgery and dynamic navigation for single-tooth implant placement. Both systems used the same optical tracking technology, allowing a more standardized comparison between the two computer-assisted surgical approaches.</p><p><strong>Case selection: </strong>Forty healthy adult patients requiring single implant-supported restoration were included and randomly allocated to either the autonomous robotic surgery group or the dynamic navigation group. Eligible patients presented with adequate soft tissue dimensions, sufficient bone volume, good oral hygiene, and no limitation in mouth opening. Patients with systemic contraindications to implant surgery, conditions or treatments affecting osseointegration, pregnancy or nursing status, recent head and neck radiotherapy, or inability to comply with follow-up were excluded.</p><p><strong>Data analysis: </strong>Implant placement accuracy was assessed by superimposing preoperative and postoperative CBCT scans. The primary outcomes were coronal, apical, and angular deviations between planned and actual implant positions. Secondary outcomes included surgical time, postoperative pain, edema, complications, and early implant success. Between-group comparisons were performed using parametric or non-parametric tests according to data distribution, with additional regression analysis to adjust for baseline variables.</p><p><strong>Results: </strong>Autonomous robotic surgery showed significantly lower angular deviation than dynamic navigation. No statistically significant differences were observed for coronal or apical deviations. Robotic procedures required significantly longer surgical time than dynamic navigation. Postoperative pain, edema, complications, and early implant success were comparable between groups, with all implants meeting success criteria after 3 months of healing.</p><p><strong>Conclusions: </strong>Autonomous robotic surgery may provide superior angular accuracy compared with dynamic navigation when both systems use the same optical tracking technology. However, this advantage was not accompanied by significant improvements in linear accuracy or early clinical outcomes, and robotic surgery required longer operative time. These findings support the potential of autonomous robotic systems for precise implant placement, while emphasizing the need for larger clinical trials, longer follow-up, and evaluation in more complex scenarios before broad clinical superiority can be established.</p>","PeriodicalId":12234,"journal":{"name":"Evidence-based dentistry","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}