BDJ Open最新文献

{"title":"Effectiveness of guided endodontic microsurgery using a trephine bur in critical anatomical regions: a randomized controlled clinical trial.","authors":"Rami Kaddoura, Thuraya Lazkani, Yasser Alsayed Tolibah","doi":"10.1038/s41405-026-00461-w","DOIUrl":"10.1038/s41405-026-00461-w","url":null,"abstract":"<p><strong>Aim: </strong>This randomized controlled clinical trial evaluated the effectiveness of guided endodontic microsurgery (GEMS) compared to conventional endodontic microsurgery (EMS) in critical anatomy regions.</p><p><strong>Materials and methods: </strong>Twenty-eight patients (ages 19-58 years) requiring endodontic microsurgery in critical anatomical regions were randomly allocated to guided surgery (n = 14) using 3D-printed surgical guides with trephine burs or conventional microsurgery (n = 14). Primary outcomes included surgical procedure time. Secondary outcomes were periapical lesion size measured by CBCT at 6, 12 months and success rate at 1-year follow-up and complications. statistical analysis employed independent t-tests and chi-square tests.</p><p><strong>Results: </strong>The guided group demonstrated significantly shorter surgical time (18.21 ± 3.45 min vs 26.07 ± 4.29 min) (independent t-test, p < 0.001). Complete lesion resolution at 1 year was achieved in 92.9% of guided cases, compared with 71.4% in conventional cases (chi-square, p = 0.139). No complications were observed.</p><p><strong>Conclusions: </strong>Guided endodontic microsurgery using a 3D-printed surgical guide with trephine burs significantly reduces surgical time. The technique demonstrates a clinically relevant trend toward improved healing outcomes, supporting its adoption for complex endodontic surgical cases.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05283252.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449743","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":"Evaluating the safety of large language models in healthcare and dentistry: adversarial testing approaches.","authors":"Fahad Umer, Muhammad Muthar Shaikh, Absar Ur Rahman","doi":"10.1038/s41405-026-00462-9","DOIUrl":"10.1038/s41405-026-00462-9","url":null,"abstract":"<p><strong>Introduction: </strong>The emergence of large language models (LLMs) provides new avenues for clinical support in healthcare and dentistry. However, these models often exhibit unpredictable behaviours when challenged by adversarial or misleading inputs. Recent data indicate that nearly 20% of LLM outputs contain safety risks or biases, necessitating rigorous evaluation prior to clinical use. This review examines AI red teaming, a systematic approach for identifying system vulnerabilities through simulated attacks. It details methodological approaches and outcome measures while proposing a structured framework to integrate these safety evaluations into the clinical AI lifecycle.</p><p><strong>Methods: </strong>This review focuses on prompt-based attacks, such as prompt injection and jailbreaking, which are highly relevant in medical settings. It evaluates various testing strategies, including manual expert reviews, automated \"attacker\" models, and hybrid human-in-the-loop systems. A lifecycle-based framework is introduced, utilizing the collaborative \"red-blue-purple\" teaming model. This approach spans pre-deployment testing, live deployment monitoring, and iterative review audits to ensure that clinical guardrails remain robust against evolving adversarial tactics.</p><p><strong>Conclusion: </strong>Safe implementation of LLMs in dentistry and healthcare requires continuous, iterative adversarial testing rather than static assessments. Success depends on standardized protocols, multidisciplinary collaboration between clinicians and AI researchers, and the development of domain-specific benchmarks. Bridging existing regulatory gaps through these structured frameworks is vital for ensuring LLMs are safe, reliable, and clinically fit for patient care.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413068","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":"Decoding bone grafting preferences: a cross-sectional survey of patient perspectives and influence of treatment cost.","authors":"Ahsan Khawaja, Zara Pervaiz, Nighat Naved, Fahad Umer","doi":"10.1038/s41405-026-00455-8","DOIUrl":"10.1038/s41405-026-00455-8","url":null,"abstract":"<p><p>This study aimed to evaluate patients' preferences for different bone graft materials and assess the influence of treatment cost on these preferences in the Pakistani population. A cross-sectional survey was conducted among adult patients across three tertiary-care hospitals in Karachi. A validated bilingual questionnaire assessed demographic characteristics, initial graft preferences, reasons for refusal, and changes in preference after introducing treatment cost. Descriptive statistics were reported and data were analyzed using chi-square test, and Bowker's test of symmetry. A total of 101 participants were included. Autologous grafts, particularly those derived from intraoral sites, were the most preferred type, while xenografts showed the highest refusal rates. Pain and discomfort were the primary concerns associated with autologous grafts, fear of disease transmission influenced allograft refusal, and religious considerations were the dominant factor for xenograft rejection. No statistically significant association was found between demographic variables and graft preference (p value > 0.05). Furthermore, introduction of treatment cost did not result in a significant preference shift (p value = 0.42). Cultural and safety-related perceptions significantly influenced decision-making. Although cost was acknowledged as an important factor, it did not significantly affect preferences, highlighting the need for culturally sensitive and patient-centered counseling.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406134","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":"Confidence of primary care dental practitioners in the assessment, referral and maintenance of dental implants: a cross-sectional survey in Yorkshire.","authors":"Jaymit Patel, Martin Ramsdale","doi":"10.1038/s41405-026-00456-7","DOIUrl":"10.1038/s41405-026-00456-7","url":null,"abstract":"<p><strong>Introduction: </strong>Dental implants are becoming more common in the UK, but the confidence of primary care practitioners in assessing, maintaining, and referring patients with implants is uncertain. Many implant patients struggle to access proper dental care. This study examined the confidence of general dental practitioners (GDPs) in the Yorkshire and Humber region regarding the management of implant patients within the NHS.</p><p><strong>Methods: </strong>An electronic survey was developed in collaboration with dental clinicians and approved by local dental networks. It included a five-point Likert scale assessing confidence in three clinical scenarios related to implants, alongside twelve yes/no questions about maintenance, referral pathways, and recognition of complications. Thirty-five GDPs completed the survey from January to March 2026.</p><p><strong>Results: </strong>A total of 35 dental practitioners completed the survey out of a potential 310. All respondents were working in primary care settings in Yorkshire and the Humber at the time of data collection. Respondents reported low confidence across all assessment scenarios, particularly for painful sites (mean 2.29) and those with bleeding (mean 2.37), with over 60% scoring 1 or 2 out of 5. The highest confidence was in oral hygiene instruction (62.9%), while confidence in procedural tasks was low, such as replacing Locator inserts (14.3%) and recognizing mechanical complications (e.g., abutment screw fracture at 20.6%). Only 28.6% were confident in appropriate NHS referrals.</p><p><strong>Conclusions: </strong>There is potential for a significant gap in the confidence of primary care dental practitioners in Yorkshire and the Humber regarding implant care. This requires broader exploration with a wider sample to characterise trends. Nonetheless our findings underscore the need for targeted education, clearer referral pathways, and structured maintenance protocols to enhance GDPs' ability to provide safe implant aftercare.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148398863","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":"Anthropometric status among infants with cleft lip and palate: a cross-sectional, single-center study in Indonesia.","authors":"Andi Setiawan Budihardja, Patriana Yossy","doi":"10.1038/s41405-026-00468-3","DOIUrl":"10.1038/s41405-026-00468-3","url":null,"abstract":"<p><strong>Objective: </strong>Infants with cleft lip and/or palate (CL/P) may experience feeding difficulties that place them at increased risk of growth faltering. However, data comparing anthropometric outcomes between infants with CL/P and non-cleft infants in Indonesia remain limited. This study aimed to compare anthropometric indicators of undernutrition between infants with CL/P and infants without craniofacial anomalies evaluated at the same hospital.</p><p><strong>Methods: </strong>This cross-sectional study included 174 infants aged <1 year (87 with CL/P and 87 without craniofacial anomalies). Anthropometric data were obtained from electronic medical records at a single cleft center and the paediatric department of the same hospital. Length-for-age z-scores (LAZ) and weight-for-length z-scores (WLZ) were calculated according to World Health Organization (WHO) Child Growth Standards. Stunting was defined as LAZ <-2 standard deviations (SD), and wasting as WLZ <-2 SD. Associations between CL/P and anthropometric status were analysed using χ² tests.</p><p><strong>Results: </strong>The mean age was 6.0 ± 3.9 months in the CL/P group and 5.6 ± 2.6 months in the comparison group. Infants with CL/P had a significantly higher prevalence of stunting than infants without craniofacial anomalies (52.9% vs. 5.7%; P < 0.001). No significant difference was observed in wasting between the groups (2.3% vs. 2.3%; P = 0.069). Anthropometric status was not associated with cleft type (P = 0.989).</p><p><strong>Discussion: </strong>Infants with CL/P demonstrated a substantially higher prevalence of stunting, an indicator of chronic growth restriction, whereas wasting, an indicator of acute undernutrition, did not differ between groups. These findings suggest that growth deficits in infants with CL/P may accumulate gradually over time rather than manifest primarily as acute nutritional deterioration.</p><p><strong>Conclusion: </strong>Infants with CL/P may be vulnerable to chronic growth restriction during early life. Strengthening early feeding assessment, nutritional surveillance, caregiver education, breastfeeding support, and multidisciplinary cleft care may help reduce growth faltering and improve outcomes.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388207","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":"Effects of anti-diabetic medications on the teeth, oral soft and hard tissues, saliva, and implants: a scoping review.","authors":"Arya Agarwal, Marwa Khalil, Aditi Chopra","doi":"10.1038/s41405-026-00431-2","DOIUrl":"10.1038/s41405-026-00431-2","url":null,"abstract":"<p><p>Diabetes mellitus (DM) is one of the world's most common non-communicable diseases. DM is a group of metabolic disorders in which blood glucose levels increase due to reduced insulin production or action, resulting in hyperglycemia. Various anti-diabetic medications, including insulin, metformin, glimepiride, glipizide, and thiazolidinedione, are used to control hyperglycemia in diabetic patients. These anti-diabetic medications have been shown to affect the gingiva, bone, fibroblast cells, pulpal tissues, dental stem cells, saliva, teeth, and oral microbiome. Metformin (a biguanide), insulin, and oral sulfonylureas (glipizide and glimepiride) have regenerative and host-modulating effects. Metformin and insulin can promote the growth of osteoblasts (bone-forming cells) and periodontal ligament fibroblasts and enhance the differentiation of mesenchymal stem cells to repair the lost periodontal tissues. Metformin is used in both systemic and local forms as a gel or scaffolds along with periodontal therapy (scaling and root planing) and surgical procedures to promote repair of periodontal tissues, alveolar bone defects, furcation defects, and osseointegration of dental implants. Although the effect of metformin on oral tissues is well established, the role of other anti-diabetic drugs on the oral and periodontal tissues is not comprehensively discussed. Thus, this review aims to discuss the positive and negative effects of various anti-diabetic medications on the oral cavity.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370125","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":"Launching BDJ Open's first Genetics Collection.","authors":"Manas Dave","doi":"10.1038/s41405-026-00439-8","DOIUrl":"10.1038/s41405-026-00439-8","url":null,"abstract":"","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340508","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":"Toothpastes containing potassium nitrate alone versus potassium nitrate combined with aluminum lactate in reducing dentin hypersensitivity: a randomized controlled trial.","authors":"Kohei Ishii, Taiki Suzuki, Chika Akabane, Gotaro Iizumi, Naho Suzuki, Yasushi Fukuda, Kenta Suzuki, Naoko Kawaguchi, Ruixue Zhu, Debao Li, Zhi Zhou, Deyu Hu","doi":"10.1038/s41405-026-00452-x","DOIUrl":"10.1038/s41405-026-00452-x","url":null,"abstract":"<p><strong>Objective: </strong>Dentin hypersensitivity (DH) is a common clinical condition characterized by transient, sharp pain arising from exposed dentinal tubules in response to external stimuli. The aim of this study was to evaluate and compare the efficacy of two toothpaste formulations: one containing 5% potassium nitrate alone and another combining 5% potassium nitrate with 2.18% aluminum lactate.</p><p><strong>Materials and methods: </strong>This was a parallel-group, randomized, double-blind, negative-control trial with 127 participants. Participants were randomly assigned to three groups (two test and one placebo). The Dentin Sensitivity Index (DSI) was assessed under tactile and air stimulation at baseline, immediately after brushing, and at 2 weeks, 4 weeks, 4 weeks plus 24 h, and 8 weeks.</p><p><strong>Results: </strong>Compared with baseline, both test groups showed statistically significant reductions in DSI for both tactile and air stimulation at all time points immediately after use. From 2 weeks onward, the DSI of both test groups was significantly lower than that of the placebo group at all evaluated time points. Furthermore, the toothpaste containing 5% potassium nitrate combined with 2.18% aluminum lactate exhibited a greater effect than the potassium nitrate alone at specific time points: 4 weeks for air stimulation, 4 weeks plus 24 h for tactile stimulation, and 8 weeks for both types of stimulation.</p><p><strong>Conclusions: </strong>Both toothpaste formulations-5% potassium nitrate alone and 5% potassium nitrate combined with 2.18% aluminum lactate-demonstrated significant efficacy in reducing dentin hypersensitivity, with the combination showing greater improvement at several time points.</p><p><strong>Clinical trial registration: </strong>Trial registration: ISRCTN80733222.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309816","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":"Efficacy and safety of essential-oil-containing mouthrinses for plaque and gingivitis control in people with diabetes: an examiner-blind, randomised controlled trial.","authors":"Kimberly Milleman, Mary Lynn Bosma, James A McGuire, Ruth Chen, Alicia DelSasso, Patricia Gorecki, Abbie Yoder, Jeffery Milleman","doi":"10.1038/s41405-026-00420-5","DOIUrl":"10.1038/s41405-026-00420-5","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the anti-plaque and anti-gingivitis efficacy and the safety of essential-oil-containing mouthrinses in people with diabetes, a group at high periodontal disease risk.</p><p><strong>Materials and methods: </strong>This Phase IV, examiner-blind trial randomised 154 adults with type 1 (n = 15) or type 2 (n = 139) diabetes to use alcohol-containing essential oil (ACEO), alcohol-free essential oil (AFEO), or negative control mouthrinses alongside twice-daily brushing for 12 weeks. Assessments included a plaque index (TPI), gingival index (MGI), bleeding index (EBI), participant survey and adverse event monitoring.</p><p><strong>Results: </strong>The essential-oil-containing mouthrinses (ACEO/AFEO) significantly reduced the primary endpoints of mean TPI (24.7%/13.2%) and mean MGI (37.2%/32.8%), versus the negative control, at Week 12 (p < 0.001). Both mouthrinses reduced EBI (68.7%/72.6%; p < 0.001), and participants reported better oral health experiences, versus negative control, at Week 12. Overall, 26.2% of participants were unaware of their elevated oral health risk due to diabetes, and 37.9% reported receiving no oral health guidance from healthcare providers. The mouthrinses showed good soft tissue tolerance.</p><p><strong>Conclusions: </strong>Essential-oil-containing mouthrinses significantly improved periodontal health in people with diabetes, when compared with a negative control rinse, and may serve as a valuable adjunct to mechanical oral hygiene in this population. The identified knowledge gap highlights the need for collaboration between primary, diabetes and dental practitioners to enhance patient outcomes through integrated care.</p>","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303387","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":"Digital education in preclinical prosthodontics: a critical review of recent evidence.","authors":"Nissaf Daouahi, Yosra Gassara","doi":"10.1038/s41405-026-00453-w","DOIUrl":"10.1038/s41405-026-00453-w","url":null,"abstract":"","PeriodicalId":36997,"journal":{"name":"BDJ Open","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284392","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}