Frontiers in dental medicine最新文献

{"title":"Oral microbiota and urinary system diseases: from mechanistic insights to clinical implications-a comprehensive review.","authors":"Haoling Chen, Yanan Chen, Yiwen Liu, Chuxiao Chen","doi":"10.3389/fdmed.2026.1803961","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1803961","url":null,"abstract":"<p><p>The human oral microbiome has attracted considerable attention due to its role in oral health and potential implications for systemic diseases. Oral microbes provide real-time insights into health and disease status, making them valuable for early disease risk stratification and treatment outcome prediction. Accumulating evidence indicates that oral microbiota contribute to the pathogenesis of urinary system diseases. Notably, in pediatric populations, the oral microbiome-shaped by age, feeding patterns, and immune maturation-may modulate susceptibility to renal-related systemic conditions; clinical observations specifically link untreated early childhood caries to an increased risk of Henoch-Schönlein purpura nephritis (HSPN). This review critically appraises the existing literature to clarify the nature and magnitude of the association between the oral microbiome and urinary system diseases, including chronic kidney disease, urolithiasis, benign prostatic hyperplasia, and urologic cancers, as well as pediatric HSPN. We also analyze the potential mechanisms through which the oral microbiota are involved in the pathogenesis and progression of these relevant diseases, and explore its potential implications for the prevention, diagnosis, and management of urinary system disorders.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1803961"},"PeriodicalIF":1.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846859","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":"Association between dentition defects and Alzheimer's disease risk: a systematic review and meta-analysis.","authors":"Qianxia Wang, Kaiyan Zhou, Miaomiao Zhang, Yao Dong, Mei Zhao","doi":"10.3389/fdmed.2026.1783171","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1783171","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's Disease (AD) is the most common neurodegenerative disorder among the elderly, with a steadily rising prevalence that poses a significant global public health challenge. Recently, dentition defects (DD), such as tooth loss, have gained attention as potential risk factors influencing neurocognitive health. However, the relationship between DD and AD remains inconclusive, necessitating a systematic analysis to clarify this association.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. We searched PubMed, Embase, Web of Science, and Cochrane Library databases to identify relevant studies published between 1996 and 2022. Eligible studies assessing the relationship between DD and AD were included. A random-effects model was applied to estimate the pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity and publication bias were also assessed.</p><p><strong>Results: </strong>Fourteen studies were included, with sample sizes ranging from 52 to 156,450 participants. The meta-analysis revealed a significant association between DD and an increased risk of AD (OR=1.38, 95% CI: 1.09-1.74, <i>P</i> < 0.05). Heterogeneity among the studies was substantial (I² = 97%), reflecting considerable variability in study designs, populations, and exposure definitions. Sensitivity analysis and publication bias assessments indicated the reliability of the results despite high heterogeneity. Mechanistic analyses suggested that DD may elevate AD risk through pathways such as chronic inflammation, nutritional deficiencies, alterations in the oral microbiome, and reduced cognitive reserve.</p><p><strong>Conclusions: </strong>DD are significantly associated with an increased risk of AD. Improving oral health may represent a modifiable factor warranting. However, further high-quality prospective studies are needed to validate these findings and explore the underlying mechanisms.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1783171"},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846875","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":"Decision-ready evidence for vital pulp therapy: a network meta-analysis of bioactive materials in mature permanent teeth.","authors":"Firas Elmsmari, Reem B Abdelsayed, Qamar Albasoumi, Tareq Aljafarawi, Swadheena Patro, Ajinkya M Pawar","doi":"10.3389/fdmed.2026.1780755","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1780755","url":null,"abstract":"<p><strong>Objectives: </strong>This network meta-analysis aimed to generate clinically credible, decision-ready evidence on the comparative effectiveness of bioactive materials used in vital pulp therapy (VPT) of mature permanent teeth with carious exposures, including symptomatic presentations.</p><p><strong>Materials and methods: </strong>Following PRISMA 2020 and PRISMA-NMA standards (PROSPERO: CRD420251074110), randomized controlled trials evaluating full pulpotomy (FP), partial pulpotomy (PP), direct pulp capping (DPC), and indirect pulp capping (IPC) were systematically identified across six databases. The primary outcome was composite success (clinical and radiographic) at 6, 12, 24, and 36 months. Arm-based Bayesian random-effects network meta-analyses and frequentist sensitivity models (REML-Hartung-Knapp) were performed. Certainty of evidence was graded using CINeMA.</p><p><strong>Results: </strong>The primary meta-analysis included a total of thirty-five RCTs with a total of 2906 teeth, of which a total of twenty-four RCTs involving mature/ permanent teeth were included. Success rates across all VPT types and time points of the 24 RCTs were generally comparable at >93%. Hydraulic calcium silicate materials (MTA & Biodentine) showed a greater likelihood of success than Ca(OH)2 in direct pulp caps and partial pulpotomy procedures. The difference was established with high-certainty evidence for the comparison of MTA vs. Ca(OH)2 and moderate-certainty evidence for the comparison of Biodentine vs. Ca(OH)2. In contrast, the comparisons of calcium silicate materials were frequently overlapped in their credible intervals with moderate certainty evidence; thus, no explicit difference was found between the calcium silicate materials (e.g., MTA & Biodentine). If adjunctive therapies (e.g., platelet-rich plasma & laser therapies) have a promising effect on success rates, they were supported with low-certainty evidence based on limited data and network sparsity. The meta-analysis met the requirement for network coherence (<i>p</i> > 0.10) and the amount of heterogeneity found was low (<i>τ</i> ² = 0.09).</p><p><strong>Conclusion: </strong>Vital pulp therapy in mature permanent teeth demonstrates consistently high success rates, particularly when using calcium silicate-based materials. These findings are supported by high-certainty evidence for comparisons with calcium hydroxide. However, differences among calcium silicate materials remain uncertain due to overlapping credible intervals and moderate certainty of evidence, while adjunctive therapies are supported by low-certainty evidence and should be interpreted cautiously.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251074110, PROSPERO CRD420251074110.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1780755"},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846941","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":"A longitudinal three-dimensional analysis of nasolabial morphology following primary cheiloplasty of unilateral cleft lip deformity.","authors":"Kei Yoshida, Kiyohide Ishihata, Motoko Tsuruda, Shinki Serizawa, Aiko Kurosaka, Namiko Kimura, Masahiro Tezuka, Toshiro Kibe, Tadashi Yamanishi, Hideto Saijo","doi":"10.3389/fdmed.2026.1783578","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1783578","url":null,"abstract":"<p><strong>Background: </strong>Primary cheiloplasty is the first definitive surgical intervention for infants with cleft lip and plays a central role in establishing the foundation of postoperative nasolabial morphology. Because the early configuration of the lip and nose can influence long-term facial harmony, achieving an anatomically favorable morphology at the time of initial surgery is an important clinical objective. At our institution, primary cheiloplasty is performed using the Cronin method in combination with nasal vestibular expansion (NVE), a technique designed to improve symmetry by simultaneously repositioning the soft tissues of both the lip and the nose. However, the extent and pattern of nasolabial morphological change during the early postoperative period and throughout the first year of growth remain insufficiently understood. This study therefore aims to longitudinally investigate postoperative changes in nasolabial morphology following primary cheiloplasty performed using the Cronin method with NVE.</p><p><strong>Methods: </strong>Twenty children with unilateral complete cleft lip were included in this study. Three-dimensional (3D) soft-tissue images were obtained using the Vectra H1® system at 1, 3, and 6 months and 1 year after surgery. An image analysis was performed using HBM-Rugle®, and symmetry was assessed by comparing the affected and non-affected sides. A reference plane was defined using the bilateral endocanthion points and the alar base point on the non-cleft side to ensure consistent spatial measurement of 3D coordinates.</p><p><strong>Results: </strong>The cleft-to-non-cleft side ratios of the alar base were 0.85-0.93 for the <i>X</i>-coordinate, 1.01-1.07 for the <i>Y</i>-coordinate, and 1.06-1.22 for the <i>Z</i>-coordinate across the four time points. Ratios for white-lip length were 0.86, 0.86, 0.84, and 1.02, whereas nasal-floor length ratios were 1.31, 1.38, 1.50, and 1.41. These trends indicated a slight deterioration in anteroposterior symmetry of the alar base and nasal floor over the first postoperative year, while white-lip length progressively improved and approached near-symmetry by 1 year.</p><p><strong>Conclusions: </strong>This longitudinal 3D analysis demonstrates region-specific postoperative changes within the nasolabial complex, suggesting that individual anatomical components exhibit distinct growth or relapse patterns. These findings may help refine surgical planning and early postoperative management aimed at optimizing nasolabial morphology following primary cheiloplasty with NVE.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1783578"},"PeriodicalIF":1.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824302","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":"Strengthening geriatric oral health care through interprofessional education: policy and practice implications.","authors":"Haziel Diana Jenifer, Vinita Boloor, Wasim Belim","doi":"10.3389/fdmed.2026.1784205","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1784205","url":null,"abstract":"<p><strong>Background: </strong>The global population is aging rapidly, and India is entering a phase of rapid demographic transition, similar to already super-aged societies like Japan and several European nations. As a result, older adults are increasingly retaining their natural dentition while living with multimorbidity, polypharmacy, cognitive decline, and functional impairment. However, dental education systems remain largely procedure-centric and disconnected from medicine and allied health. This misalignment has significant implications for patient safety, workforce readiness, and the sustainability of the health system.</p><p><strong>Objective: </strong>This Policy & Practice Review critically examines existing policies, accreditation standards, and educational practices governing geriatric oral health education, with a specific focus on India and global comparative perspectives. It evaluates interprofessional education (IPE) as a policy tool for curricular reform and assesses its implications for regulators, academic institutions, and health systems.</p><p><strong>Methods: </strong>A structured narrative policy review was conducted utilizing peer-reviewed literature from PubMed and Scopus, alongside official global and national repositories. Evidence was synthesized from World Health Organization (WHO) frameworks, international accreditation standards (e.g., CODA, ADEE, IPEC), and Indian national policies (NPHCE, Ayushman Bharat) from 2010 to 2025. Documents were evaluated based on their relevance to geriatric competencies, interprofessional education (IPE) models, and health system outcomes in India and selected comparator nations (Japan and Brazil).</p><p><strong>Findings: </strong>Across regions, a persistent \"geriatric gap\" in dental curricula is evident, characterized by insufficient exposure to frail older adults, inconsistent competency definitions, and limited integration with primary care and long-term care systems. Countries that have incorporated oral health within healthy aging and long-term care policies demonstrate stronger alignment between education and practice. Evidence suggests that IPE-based geriatric curricula enhance learner attitudes, diagnostic reasoning, and care coordination, leading to improved patient outcomes.</p><p><strong>Actionable recommendations: </strong>To address these challenges, it is crucial to mandate interprofessional geriatric competencies within accreditation standards, integrate oral health into national healthy aging policies (including India's National Programme for Health Care of the Elderly), and align reimbursement with preventive, team-based care.</p><p><strong>Conclusion: </strong>Geriatric oral health education must be prioritized as a policy and practice imperative. Coordinated reforms across education, regulation, and financing are essential to build an age-ready oral health workforce.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1784205"},"PeriodicalIF":1.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790949","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":"A rare maxillary lesion: a case report of developing complex odontoma in the left maxilla of a 5-year-old child.","authors":"Junji Xu, Lanqiu Lv, Yiduo Shao, Shanshan Guo","doi":"10.3389/fdmed.2026.1760785","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1760785","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to report the clinical diagnosis and management of a 5-year-old child with developing complex odontoma in the left maxilla, and to review the literature regarding its clinical features, imaging findings, and pathological characteristics, so as to provide clinical insights for early diagnosis and individualized treatment of pediatric maxillary developing complex odontoma.</p><p><strong>Materials and methods: </strong>A 5-year-old male presenting with a \"left maxillary mass\" was evaluated. Clinical examination assessed facial morphology and dental development. Panoramic radiography and cone-beam computed tomography (CBCT) were used to determine the lesion's location and imaging characteristics. The surgically resected specimen was sent to the Ningbo Clinical Pathological Diagnosis Center for gross and histopathological examination. Postoperative follow-up was conducted for 24 months to monitor wound healing, dental development, and potential recurrence. We implemented a proactive monitoring approach, which included regular follow-up visits every three months during the first year. During these visits, we assessed the growth and development of the surrounding teeth and evaluated the edentulous area for any signs of potential complications.</p><p><strong>Results: </strong>Clinical examination revealed a left maxillary mass without significant facial asymmetry, and the child was in the stage of dental development. Imaging confirmed an expansive lesion in the left maxilla. Pathological examination identified a 4.5 × 4 × 0.5 cm grayish-white to reddish, firm tissue, leading to a final diagnosis of developing complex odontoma. The lesion was completely removed via curettage. At the 24-month follow-up, no recurrence was observed, the surgical site had healed well, dental development was normal, and no complications such as secondary caries were noted.</p><p><strong>Conclusion: </strong>Pediatric maxillary developing complex odontoma often presents with subtle symptoms and atypical imaging features, leading to delayed diagnosis. Multimodal imaging combined with pathological examination enables accurate diagnosis. Complete excision via curettage, accompanied by long-term follow-up, effectively restores maxillary structure and function, supports normal dental development, and reduces recurrence risk, making it a viable treatment strategy for pediatric maxillary developing complex odontoma.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1760785"},"PeriodicalIF":1.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790766","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":"Calprotectin and aMMP-8 as biomarkers in gingival crevicular fluid in geriatric inpatients.","authors":"Alicia Maria Meyer-Hofmann, Gabriele Röhrig, Steffen Büttner, Sonja Henny Maria Derman, Anna Greta Barbe","doi":"10.3389/fdmed.2026.1790103","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1790103","url":null,"abstract":"<p><strong>Background: </strong>Accurate detection of periodontal inflammation and tissue degradation remains challenging in frail, hospitalized older adults with high periodontitis prevalences, where conventional diagnostics are often not feasible. Biochemical biomarkers such as Calprotectin (CP) and Active Matrix Metalloproteinase-8 (aMMP-8) in Gingival Crevicular Fluid (GCF) may offer low-barrier, bedside-compatible diagnostic alternatives for the future. While aMMP-8 is already well-studied and rather reflects collagen degradation, CP is supposed to indicate neutrophil-driven inflammation.</p><p><strong>Methods: </strong>In this cross-sectional study of 30 neurogeriatric inpatients (mean age 79 ± 6 years) with minimal systemic inflammation (CR<i>P</i> < 5 mg/dL), GCF samples were collected at bedside to assess aMMP-8 and CP levels and analyzed in addition to periodontal parameters [Probing Pocket Depth [PPD], Bleeding On Probing [BoP], Clinical Attachment Loss] and systemic status (blood values). Correlation and regression analyses were performed to explore associations between biomarkers and clinical indices. Correlation benchmarks were set as r = .10 weak, r = .30 moderate, r = .50 strong correlations.</p><p><strong>Results: </strong>CP and aMMP-8 showed a strong correlation (rs = .521), suggesting complementary diagnostic value. CP correlated moderately with BoP (rs = .365), mean PPD (rs = .455) and mean PPD at the sampling sites (rs = .478). aMMP-8 correlated moderately with BoP (rs = .329) and mean PDD (rs = .309). Both biomarkers were not associated with systemic variables. ANOVA revealed an effect of BoP on CP levels (<i>p</i> < .05). <i>post hoc</i> analysis showed higher CP higher in patients with BoP >30% compared to those with BoP >10%-30%. No group differences of aMMP-8 levels were observed across the BoP categories.</p><p><strong>Conclusion: </strong>Both biomarkers demonstrate a feasibility assessment for geriatric inpatients. In this population, CP reflects localized periodontal processes and inflammation. CP may in the future be particularly suited for inflammatory screening in care-dependent older adults. These findings contribute initial reference data and underscore the need for larger studies to validate biomarker-based diagnostics in broader geriatric populations.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1790103"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790896","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":"Editorial: Revolutionizing dentistry: the impact of AI and new algorithms on diagnostics, treatment, and patient engagement.","authors":"Gustavo Vicentis Oliveira Fernandes, Juliana Campos Hasse Fernandes","doi":"10.3389/fdmed.2026.1834761","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1834761","url":null,"abstract":"","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1834761"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790932","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":"Bioactive and Ion-releasing materials in minimum intervention dentistry: a clinical pathway from prevention to restorative treatment.","authors":"Hervé Tassery, Salvatore Sauro, Amel Slimani","doi":"10.3389/fdmed.2026.1739208","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1739208","url":null,"abstract":"<p><strong>Introduction: </strong>This paper examined the clinical applications of \"bioactive\" dental materials within a framework of minimum intervention dentistry, ranging from non-invasive to invasive procedures for managing carious lesions. Modern approaches to caries management emphasise personalised care, caries risk assessment, and lesion activity evaluation, combined with the strategic use of ion-releasing biomaterials (IRB). These materials, which can release ions such as calcium, phosphate, fluoride and other ions, may support dental remineralization, stabilize collagen, buffer pH, and deter bacterial growth, thus promoting long-term oral health.</p><p><strong>Discussion: </strong>The Bioactive Dental Concept finds a great ally with the new generation ABRAM (Advanced Bioactive Restorative Adhesive Material) and available materials; it is structured to guide clinicians to select bioactive options when clinically appropriate. Interventions are categorised as non-invasive (home care and professional applications), micro-invasive (sealants, resin infiltration, peptides), and invasive. Diagnostic tools like fluorescence and infrared imaging improve early detection, enabling minimally invasive, targeted treatments. Early lesions are sealed and remineralised; moderate ones need selective excavation and cavity conditioning. Extensive lesions require durable bioactive restorations, with new materials like \"alkasite\" and dual-cure bioactive composites. Integrating evidence-based dentistry (EBD) principles remains essential, though reliance on strict hierarchies of evidence may limit the adoption of innovative approaches. Practical clinical experience and biological acceptability must also inform decision-making.</p><p><strong>Conclusion: </strong>The article emphasises the need for a balanced approach that combines the rigor of EBD with clinical pragmatism. Even though no restorative material is yet biologically ideal, bioactive and ion-releasing materials significantly improve the management of carious lesions, supporting the aim of preserving natural tooth structures and promoting oral eubiosis.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1739208"},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790800","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":"Shear bond strength analysis of self-etch and total-etch adhesive systems on antioxidant-treated dentin in post-endodontic restoration.","authors":"Suvarna Kavya Harish, Shruthi H Attavar","doi":"10.3389/fdmed.2026.1809570","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1809570","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effect of antioxidant pretreatment on the shear bond strength and failure modes of total-etch and self-etch adhesive systems applied to sodium hypochlorite (NaOCl)-treated dentin.</p><p><strong>Materials and methods: </strong>Eighty extracted human premolars were prepared and irrigated with NaOCl. The specimens were allocated into two groups based on the adhesive strategy employed: total-etch and self-etch. Each group was further subdivided according to antioxidant pretreatment: control (no antioxidant), sodium ascorbate, alpha-tocopherol, and nanocurcumin. Composite resin was bonded, and shear bond strength was tested using a universal testing machine. Failure modes were evaluated microscopically. Data were analyzed using one-way ANOVA with <i>post-hoc</i> tests, two-way ANOVA to assess the effects of antioxidant type and adhesive system, and chi-square analysis for failure modes <i>(P</i> <i><</i> <i>0.05).</i></p><p><strong>Results: </strong>NaOCl-treated dentin without antioxidant pretreatment showed the lowest bond strength values in both adhesive systems. Sodium ascorbate and nanocurcumin significantly improved bond strength compared with control and alpha-tocopherol, with no significant difference between them. Self-etch adhesives demonstrated lower baseline bond strength but greater recovery following antioxidant pretreatment. Two-way ANOVA revealed significant effects of antioxidant type, adhesive system, and their interaction. Control groups predominantly exhibited adhesive failures, while antioxidant-treated groups showed increased mixed and cohesive failures.</p><p><strong>Conclusion: </strong>Antioxidant pretreatment effectively restores bonding to NaOCl-treated dentin. Sodium ascorbate and nanocurcumin demonstrated comparable efficacy, with greater benefit observed for self-etch adhesives.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1809570"},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790941","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}