Frontiers in dental medicine最新文献

{"title":"Evaluation of the effect of two biomimetic approaches on micro-tensile bond strength of one etch & rinse adhesive to dentin (An <i>in vitro</i> study).","authors":"Ahmad Diaa El Din Abou El Seoud, Essam Abdel Hafez Naguib, Eman Ali Abou Auf, Sara Hany Younis","doi":"10.3389/fdmed.2026.1791403","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1791403","url":null,"abstract":"<p><strong>Background: </strong>Hydrolytic and enzymatic degradation of the resin-dentin interface compromises the longevity of adhesive restorations. Biomimetic strategies for guided dentin remineralization, including self-assembling peptide P11-4 (Curodont Repair™) and the polymer-induced liquid precursor (PILP) process using poly-L-aspartic acid, have been proposed to stabilize the collagen matrix and enhance adhesive bond durability.</p><p><strong>Methods: </strong>Fifty-four extracted human molars were artificially demineralized and randomly assigned to three pretreatment groups (<i>n</i> = 18 each): control (no pretreatment), self-assembling peptide P11-4 (Curodont Repair™, Credentis AG) applied for 5 min, or polymer-induced liquid precursor (PILP) solution containing 100 μg/mL poly-L-aspartic acid applied for 1 h. Each group was subdivided according to storage time in artificial saliva (24 h, 3 days, or 14 days) (<i>n</i> = 6 teeth per subgroup). Specimens were restored using an etch-and-rinse adhesive system (Adper Single Bond 2, 3M ESPE) and resin composite. One micro-tensile beam (≈1 × 1 mm²) was prepared per tooth (experimental unit = tooth). Micro-tensile bond strength (µTBS) was measured using a universal testing machine equipped with a 500 N load cell at a cross-head speed of 0.5 mm/min. Data were analyzed using two-way ANOVA and Bonferroni <i>post hoc</i> tests (<i>α</i> = 0.05).</p><p><strong>Results: </strong>Two-way analysis of variance revealed significant effects of pretreatment, storage time, and their interaction on µTBS values (<i>p</i> < 0.001). At T0 and T1, specimens pretreated with P11-4 exhibited the highest mean µTBS values, which were significantly greater than those of the PILP group and comparable to or higher than the control group. At T2, the control group demonstrated significantly higher µTBS values, while both biomimetic pretreatment groups showed a significant reduction in bond strength. Failure mode analysis revealed predominantly mixed failures at T0 and T1 across all groups, whereas adhesive failures were more prevalent at T2 in the biomimetic groups; the control group exhibited mixed and cohesive-in-dentin failures.</p><p><strong>Conclusions: </strong>pretreatment with the self-assembling peptide P11-4 resulted in higher micro-tensile bond strength to demineralized dentin compared with the PILP approach at early storage periods. However, the durability of both biomimetic dentin remineralization strategies was time-dependent<b>.</b></p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1791403"},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790866","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":"Management of a complicated crown root fractured tooth via intentional replantation with 180° rotation: a 4-year case report.","authors":"Jianxin Wang, Yongliang Wang, Kaijie Lin, Rui Han, Lei Ma","doi":"10.3389/fdmed.2026.1791938","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1791938","url":null,"abstract":"<p><p>This case report describes the successful treatment and 4-year follow-up of a maxillary central incisor with a complicated crown-root fracture that had sustained two separate traumatic injuries during the transition from adolescence to adulthood. Following the initial trauma in adolescence, the tooth was treated with root canal therapy and reattachment of the fractured crown fragment. A second trauma in adulthood led to a complicated crown-root fracture whose margin extended subgingivally. The tooth was managed using intentional replantation with 180° rotation and subsequent restoration with an all-ceramic crown. After 4 years, clinical and radiographic examinations revealed a healthy outcome with no signs of root resorption or ankylosis.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1791938"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790935","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":"Case Report: Early treatment of anterior crossbite in young patients using clear aligners.","authors":"Aldo Giancotti, Paola Mozzicato, Martina Carillo, Franceco Pachì","doi":"10.3389/fdmed.2026.1761514","DOIUrl":"10.3389/fdmed.2026.1761514","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this paper is to describe the effects of an alternative treatment for anterior single-tooth crossbite in young patients with dental Class I and/or pseudo-Class III malocclusions. Indeed, anterior crossbite malocclusion of one or more teeth, without posterior crossbite association, is a relatively frequent condition in mixed dentition. This type of malocclusion is usually treated with either fixed or removable appliances. Currently, several clinical studies indicate the use of clear aligners as an effective option. Hence, clear appliances in early treatment could be a valid alternative to traditional removable and fixed orthodontic devices.</p><p><strong>Materials and methods: </strong>Eighteen growing patients with dental Class I and/or pseudo-Class III malocclusion, all presenting anterior crossbite, including 11 males and 7 females aged 8.3 to 9.9, had been treated with aligners between 2018 and 2021 in order to solve anterior cross bite of upper central incisors. Selected from the aforementioned sample, two pediatric cases - aged 9 - reporting anterior single-tooth crossbite malocclusion are further described in the Clinical Reports section.</p><p><strong>Results: </strong>In all treated patients, anterior crossbite was resolved within 12 months of treatment using clear aligners only, as exemplified by the two cases illustrated herein. By the end of clear aligner-based treatment, in all the 18 cases positive cephalometric and dental changes were observed, as well as normalized overjet and overbite and preservation of periodontal tissues.</p><p><strong>Conclusion: </strong>As confirmed by the results achieved, clear aligner treatment can be considered as a valid approach to rapidly correct anterior crossbite in growing patients, as long as a proper diagnostic procedure and optimal patient compliance level are ensured.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1761514"},"PeriodicalIF":1.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724758","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":"Effect of distal cantilever and anterior implant diameter on framework and cortical bone stress in a PEEK-based All-on-Four mandibular prosthesis.","authors":"Shobha Rodrigues, Sandipan Mukherjee, Reon David Sequeira, Krishna Kumar P, Nithesh Naik, Prashant Bajantri, Sowmya N, Shivani Shetty, Vathsala Patil","doi":"10.3389/fdmed.2026.1732749","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1732749","url":null,"abstract":"<p><strong>Background: </strong>Polyetheretherketone (PEEK) has been proposed as an alternative framework material for full-arch implant-supported prostheses due to its lower elastic modulus relative to metallic frameworks. However, quantitative data regarding the combined biomechanical influence of distal cantilever extension and anterior implant diameter in PEEK-based mandibular All-on-Four rehabilitations remain limited.</p><p><strong>Purpose: </strong>To quantify the effects of distal cantilever presence and anterior implant diameter (3.5 mm vs. 4.5 mm) on framework stress and peri-implant cortical bone response in a PEEK-based mandibular All-on-Four prosthesis using three-dimensional finite element analysis.</p><p><strong>Methods: </strong>Four implant configurations were modeled: Standard-NC (4.5 mm anterior, no cantilever), Mixed-NC (3.5/4.5 mm anterior, no cantilever), Standard-C (4.5 mm anterior, with cantilever), and Mixed-C (3.5/4.5 mm anterior, with cantilever). A 300 N static load was applied at premolar and molar positions under vertical (0°) and 30° oblique loading. Peak von Mises stress in the PEEK framework and crestal cortical bone, along with maximum principal cortical strain, were recorded.</p><p><strong>Results: </strong>Distal cantilever extension increased peak framework stress by up to 59% under premolar vertical loading (222.24 MPa vs. 139.60 MPa) and increased crestal cortical stress by approximately 49% (18.36 MPa vs. 12.31 MPa) compared with the non-cantilevered baseline configuration. Under molar vertical loading, maximum principal strain increased by approximately 105% in the Mixed-C model compared to the Standard-NC configuration (0.0080 vs. 0.0039). Reduction of anterior implant diameter increased cortical strain by approximately 28-31% in non-cantilevered models and further amplified strain when combined with cantilever extension. Peak framework stresses reached 222.24 MPa in localized regions.</p><p><strong>Conclusion: </strong>Distal cantilever extension was the primary determinant of biomechanical amplification in a PEEK-based mandibular All-on-Four prosthesis, while reduced anterior implant diameter exerted a secondary but additive effect. These findings highlight the mechanical sensitivity of low-modulus framework systems to cantilever geometry and implant diameter in full-arch rehabilitations.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1732749"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790863","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":"Immune suppression, HLA-risk and potential future immune based targets of oral leukoplakia progression.","authors":"Mehar Soni, Bryce DeSantis, Alessandro Villa, Malek Kamoun, James Gates","doi":"10.3389/fdmed.2026.1665195","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1665195","url":null,"abstract":"<p><strong>Background: </strong>Oral leukoplakia (OL) is the most common oral potentially malignant disorder and carries a non-trivial risk of malignant transformation. Biomarkers are sought to aid in identifying lesions with high risk for malignant transformation, yet none are currently validated. Recent success of immune based therapies in head and neck oncology highlights immune involvement in the progression of these diseases. The differential expression of classical and non-classical HLA molecules in oral leukoplakia are thought to contribute to their malignant transformation. To better evaluate the role HLA plays in oral pre-malignant lesions, a scoping review was performed.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with the PRISMA guidelines across PubMed, EMBASE, and Web of Science. 293 studies were reviewed from 1989 to 2025.</p><p><strong>Results: </strong>15 studies were screened by title, then 5 original research abstracts were included. Samples studied ranged from <i>n</i> = 16 to <i>n</i> = 100. It was found that leukoplakia lesions had higher expressions of HLA-E, HLA-G, CircHLA-C, and HLA-DR.</p><p><strong>Conclusion: </strong>The upregulation of non-classical HLA molecules, particularly HLA-G, HLA-E, and circHLA-C in oral leukoplakia, suggests an immunologic shift, potentially facilitating tumor immune evasion in oral leukoplakic lesions. HLA expression may serve as a potential biomarker for identifying pre-malignant oral lesions at increased risk of malignant transformation. Also, circHLA-C may provide a target for therapeutic intervention in high-risk oral premalignant lesions.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1665195"},"PeriodicalIF":1.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693502","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":"Immediate implant placement in infected sites using the \"Roll BMP\" technique: a 3-year case report with bioinformatic analysis.","authors":"Claudio Sotomayor Julio, Alfredo Torres","doi":"10.3389/fdmed.2026.1750133","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1750133","url":null,"abstract":"<p><p>Immediate implant placement (IIP) in sites with infection and buccal bone wall deficiency remains a clinical challenge. This case report introduces the \"ROLL BMP\" technique, a flapless regenerative approach combining absorbable collagen sponge (ACS), biphasic calcium phosphate (BCP), and recombinant human Bone Morphogenetic Protein-2 (rhBMP2) to achieve simultaneous buccal bone reconstruction and soft-tissue preservation in type 2 post-extraction sockets. A healthy 56-year-old female presented with a root fracture and chronic infection at tooth 2.1. After atraumatic extraction and debridement, a 3.5 × 12 mm INNO sub implant (Cowellmedi, Busan, South Korea) was immediately placed. The biomaterial roll was created by layering BCP granules onto hydrated ACS, rolling it, and inserting it between the implant and soft tissue, followed by a 0.1 mL (1.5 mg/mL) rhBMP-2 injection (CowellBMP, Busan, South Korea). No flaps or membranes were required. Follow-ups at months (M) 3, 5, 12, 18, 24, and 36 demonstrated excellent peri-implant soft-tissue stability (Pink Esthetic Score 13 out of 14 at M36) and progressive trabecular bone maturation, accompanied by buccal cortical reconstruction on CBCT. In silico bioinformatic analysis identified BMP2, RUNX2, SPP1, and BGLAP as key osteogenic hub genes underlying bone repair and osseointegration, supporting the biological rationale for this approach. In conclusion, the \"ROLL BMP\" technique enables predictable, flapless IIP in compromised sockets while preserving both hard and soft tissues.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1750133"},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693432","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":"Comprehensive evaluation of antibacterial activity, pH stability, and surface characterization of a mussel-inspired polymer for root perforation repair.","authors":"Lakshmi Nidhi Rao, Aditya Shetty, Veena Shetty, Heeresh Shetty","doi":"10.3389/fdmed.2026.1802925","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1802925","url":null,"abstract":"<p><p>Root perforation is a serious complication in endodontic therapy that can adversely affect treatment outcomes due to persistent microbial contamination and the limitations of currently available repair materials. Although mineral trioxide aggregate (MTA) is widely used, its handling characteristics, prolonged setting time, and variable antibacterial activity necessitate the development of alternative materials. This study evaluated a novel bio-inspired composite combining polydopamine, a mussel-derived adhesive polymer, with bioactive glass, designed to enhance antibacterial performance, surface characteristics, and pH behaviour relevant to root perforation repair. It was hypothesized that the experimental composite would exhibit improved antibacterial efficacy and a favourable surface nanoarchitecture compared with MTA, while maintaining physiologically relevant alkalinity. Antibacterial activity was assessed using agar diffusion against Porphyromonas endodontalis and Enterococcus faecalis, pH was measured at 24 h and 7 days, and surface characteristics were analysed using atomic force microscopy and field emission scanning electron microscopy. Antibacterial outcomes were compared using the Mann-Whitney <i>U</i> test, while pH values were analysed using independent <i>t</i>-tests. The experimental material demonstrated significantly greater antibacterial activity against Porphyromonas species (<i>P</i> < 0.05), with no significant difference against E. faecalis. A lower initial pH with gradual alkalinization and a smoother surface profile were observed. These findings suggest that the polydopamine-bioactive glass composite shows promise as an experimental material for root perforation repair, warranting further biological and translational investigation.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1802925"},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694139","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":"Breastfeeding and interdental spacing in primary dentition: a digital cross-sectional study.","authors":"Paula Boo-Gordillo, Maria Fernanda García-Morales, Laura Marqués-Martinez, Carla Borrell-García, Clara Guinot-Barona, Juan Ignacio Aura-Tormos, Esther García-Miralles","doi":"10.3389/fdmed.2026.1716233","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1716233","url":null,"abstract":"<p><strong>Background: </strong>Interdental spacing in the primary dentition is a key physiological feature that facilitates proper eruption and alignment of permanent teeth. While genetic factors play a central role, environmental influences such as early feeding practices may also affect jaw development and spacing, although quantitative evidence is limited.</p><p><strong>Objective: </strong>To analyze the relationship between early feeding practices-including breastfeeding, formula feeding, bottle and pacifier use, and timing of complementary feeding-and interdental spacing in the primary dentition.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted with 52 children aged 3-5 years. Digital intraoral scans were obtained using an iTero Element 2® scanner, and 18 interdental spaces per child were digitally measured using Orthocad® software. Parents completed structured questionnaires detailing their children's feeding history. Data were analyzed using descriptive statistics and comparative tests.</p><p><strong>Results: </strong>The largest mean interdental spaces were observed in the primate areas, specifically between the left lateral incisor and canine in the maxilla (0.756 mm) and between the left canine and first molar in the mandible (0.356 mm). No statistically significant associations were found between feeding variables and interdental distances (<i>p</i> > 0.05). However, a consistent trend toward larger interdental spaces was observed in children with prolonged breastfeeding compared to those with shorter or no breastfeeding, in line with proposed physiological mechanisms.</p><p><strong>Conclusion: </strong>Early feeding practices were not significantly associated with interdental spacing in the primary dentition. Nevertheless, the observed trends suggest that prolonged breastfeeding may positively influence interdental spacing, highlighting the need for larger and longitudinal studies to further investigate the role of environmental factors in dental arch development.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1716233"},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694071","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":"Effect of antioxidants on dentinal tubular penetration of root canal sealers in sodium hypochlorite treated root canal dentin: a systematic review.","authors":"Radhika Vasudev, Tony Mathew, Nireeksha","doi":"10.3389/fdmed.2026.1766826","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1766826","url":null,"abstract":"<p><strong>Background: </strong>The long-term success of root canal treatment depends on the formation of an effective three-dimensional seal, which is strongly influenced by the ability of endodontic sealers to penetrate dentinal tubules and adapt closely to the root canal walls. Sodium hypochlorite (NaOCl), the most commonly used endodontic irrigant, produces oxidative alterations in dentin, including collagen degradation, reduced surface wettability, and residual free radical formation, which collectively compromise sealer penetration and interfacial integrity. The use of antioxidant agents has been used as a strategy to reverse these adverse effects and restore dentin surface properties.</p><p><strong>Objective: </strong>This systematic review aimed to assess the influence of various antioxidant agents on dentinal tubular penetration and interfacial adaptation of root canal sealers following NaOCl irrigation.</p><p><strong>Methods: </strong>A comprehensive electronic search of PubMed, Scopus, Web of Science, and Google Scholar was performed up to November 2025. <i>In vitro</i> studies evaluating NaOCl-treated dentin followed by antioxidant application and reporting sealer penetration or adaptation outcomes using confocal laser scanning microscopy (CLSM) or scanning electron microscopy (SEM) were included. Methodological quality and risk of bias were evaluated using a modified QUIN assessment tool.</p><p><strong>Results: </strong>From 216 initially identified records, four studies fulfilled the eligibility criteria. The antioxidants investigated included ascorbic acid, tannic acid, gallic acid, ellagic acid, sodium thiosulfate, and glutathione. All antioxidant-treated groups demonstrated greater dentinal tubular penetration and increased interfacial adaptation compared with NaOCl-only controls. Polyphenolic antioxidants, particularly gallic acid and ellagic acid, produced the greatest enhancement in penetration depth. Sodium thiosulfate significantly reduced interfacial gaps and voids, while glutathione improved sealer penetration in both resin-based and bioceramic sealers and was associated with increased bond strength.</p><p><strong>Conclusion: </strong>The available <i>in vitro</i> evidence indicates that antioxidant agents effectively mitigate NaOCl-induced oxidative changes in dentin, leading to improved sealer penetration and adaptation. Incorporating antioxidants as a final irrigant step may enhance obturation quality and potentially improve sealer peneteration; however, well-designed clinical studies are required to confirm these findings.</p><p><strong>Systematic review registration: </strong>https://doi.org/10.17605/OSF.IO/PBRQA.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1766826"},"PeriodicalIF":1.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679083","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":"Resistance profiles of fastidious oral anaerobes and other periodontal species by multipoint inoculator: an <i>in vitro</i> study.","authors":"Alexandra Wolf, Alexander Indra, Florian Heger, Julia Reichl, Andreas Moritz, Apostolos Georgopoulos","doi":"10.3389/fdmed.2026.1753219","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1753219","url":null,"abstract":"<p><p>Periodontal disease is one of the most prevalent chronic infections worldwide. Associations with systemic conditions, including endocarditis, type 2 diabetes mellitus, cardiovascular disease, and tumor progression, have been extensively investigated in recent studies. Furthermore, it involves pathogens that are often anaerobic, biofilm-associated, and difficult to treat owing to inherent resistance mechanisms and the protective nature of biofilms. As dentists prescribe a substantial proportion of antibiotics and antibiotic resistance is increasing globally, innovative diagnostic methods are urgently needed to ensure effective and sustainable antibiotic stewardship. In this study, anaerobic stock isolates from 30 to 35 frozen samples per genera or species were subjected to minimum inhibitory concentration testing. A multipoint inoculator was used to seed agar plates containing serial antibiotic dilutions, allowing assessment of five commonly used antibiotics: amoxicillin, amoxicillin/clavulanic acid, imipenem, clarithromycin, and levofloxacin. This enabled simultaneous testing of multiple strains under strictly anaerobic conditions, reducing the handling time and material consumption. Among the tested oral pathogens, high resistance levels were observed for clarithromycin. Amoxicillin (±clavulanic acid) remains the most reliable first-line option, whereas levofloxacin may serve as an alternative for certain gram negative anaerobes, when standard treatment protocols are unsuccessful. Mixed-inoculum experiments further showed altered antibiotic responses under biofilm-like conditions. The multipoint inoculator enables reliable testing of oxygen-sensitive anaerobes, including mixed biofilms.</p><p><strong>Clinical relevance: </strong>The presented method enables dental practitioners and laboratories to obtain resistance data from subgingival pathogens, especially in low- and middle-income countries or remote regions where access to centralized microbiology laboratories is limited. This benefits the wider healthcare system by supporting sustainable antibiotic stewardship through reliable, cost-effective resistance testing and the patients by facilitating the selection of an effective targeted agent, particularly in complex cases where multiple empirical antibiotic therapies have failed.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1753219"},"PeriodicalIF":1.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679137","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}