Frontiers in dental medicine最新文献

{"title":"Peri-implantitis: a systemic burden for our patients.","authors":"Emilio A Cafferata, Frank Schwarz","doi":"10.3389/fdmed.2026.1774378","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1774378","url":null,"abstract":"<p><p>Peri-implantitis-an increasingly prevalent chronic inflammatory disease-has been linked not only to peri-implant bone destruction and implant failure, but also to systemic inflammation and chronic inflammatory diseases. Accumulating evidence suggest that peri-implant inflammation can contribute to a sustained systemic low-grade inflammatory state characterized by elevated inflammatory mediators, like interleukin (IL)-6 and C reactive protein, episodic bacteremia, and metabolic alterations. This persistent inflammatory burden has been associated with distal organ dysfunction, including cardiovascular and renal complications, and neuroinflammatory processes implicated in cognitive decline and neurodegeneration. In parallel, implant-supported rehabilitation and long-term maintenance has been linked to surrogate markers of cognitive resilience, whereas treatment of peri-implant diseases aimed at reducing local inflammation may, at the same, be associated with the improvement of systemic inflammatory markers. This concise review synthesizes mechanistic and clinical evidence that peri-implantitis is not only an oral disease but also a systemic health modifier, highlights current knowledge gaps, and outlines priorities for research and clinical practice.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1774378"},"PeriodicalIF":1.8,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500769","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":"Performance of artificial intelligence models designed as adjuncts for determining working length and apical landmark assessment in endodontic procedures: a systematic review.","authors":"Sanjeev B Khanagar, Majed Alharthi, Adel Asery, Muhammad Alalweet, Abdullah Aldobiyan, Meshal Alhayf, Ahmed Binobaid","doi":"10.3389/fdmed.2026.1783828","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1783828","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The success of endodontic procedure depends on the precise determination of the working length (WL), which is measured from a coronal reference point to the apical constriction of the root canal. Accurate WL measurement ensures thorough debridement, effective disinfection, and optimal obturation, thereby preventing complications such as postoperative pain, over instrumentation, and persistent infection. Given the emerging use of artificial intelligence (AI)-based computational models in endodontics, this systematic review aimed to evaluate the performance of AI models developed to assist in determining WL length and identifying related apical landmarks in endodontic procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search of PubMed, Scopus, Embase, Cochrane Library, Web of Science, and Google Scholar was conducted from January 1, 2000, to July 31, 2025. Eligible studies included those evaluating machine learning or neural network-based models for WL assessment. Methodological quality was appraised using QUADAS-2, with explicit differentiation between risk of bias (internal validity) and applicability (external validity). The certainty of evidence was assessed using the GRADE approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Six studies met the eligibility criteria. Substantial heterogeneity was observed in algorithm types (e.g., artificial neural networks, ensemble machine learning models), input modalities (radiographic vs. impedance-based), reference standards, and validation strategies. Most studies relied on retrospective or &lt;i&gt;in vitro&lt;/i&gt; datasets with internal validation only; no study reported prospective, real-world external validation. The QUADAS-2 assessment identified concerns related to patient selection and applicability, particularly in studies using extracted teeth or experimental datasets. According to GRADE, the overall certainty of the evidence was low. Reported performance metrics varied, with sensitivity ranging from 0.85-1.00, specificity from 0.50-1.00, and accuracy from 0.70-0.95. However, comparisons across studies were limited by inconsistent outcome definitions, the absence of standardized clinical error thresholds (e.g., ±0.5 mm), and infrequent reporting of confidence intervals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;AI-based models show preliminary and investigational potential as adjunctive tools for WL determination. However, the current evidence is limited by methodological heterogeneity, reliance on non-clinical datasets, and a lack of external validation. None of the included studies provide high-certainty evidence from prospective, real-world clinical trials. Therefore, AI systems should currently be considered adjunctive and experimental rather than clinically established. Future research should prioritize prospective, multicenter clinical validation, standardized outcome definitions, and transparent reporting to enhance generalizability and clinical applicability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;S","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1783828"},"PeriodicalIF":1.8,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500811","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 transformative interprofessional model for geriatric oral health care - A proposed working model.","authors":"Ashwini Tumkur Shivakumar, Sowmya Srinivas, Sowmya Halasabalu Kalgeri, M Kishor, Shilpa Avarebeel","doi":"10.3389/fdmed.2026.1757007","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1757007","url":null,"abstract":"<p><strong>Background/rationale: </strong>The rapid global expansion of the geriatric population has intensified the burden of chronic diseases, functional decline, and healthcare utilization. Oral health, despite its well-established links with systemic health, nutrition, cognition, and quality of life, remains marginalized within conventional geriatric care models. Fragmented health systems and discipline-specific silos have perpetuated inequities in oral healthcare access for older adults.</p><p><strong>Objective: </strong>This Perspective article proposes a transformative interprofessional working model designed to integrate oral healthcare into comprehensive geriatric services, thereby addressing oral health disparities and promoting holistic, person-centred care for the ageing population.</p><p><strong>Model description: </strong>The proposed model brings together dentists, geriatricians, psychiatrists, nutritionists, clinical pharmacists, and occupational therapists within a cohesive care unit. It emphasizes structured interprofessional collaboration, clearly defined roles, and shared care pathways. In addition to clinical integration, the model prioritizes education and capacity-building for caregivers, healthcare workers, and students. Key components include geriatric-friendly clinic design, community and caregiver education modules, home-based oral healthcare, tele-dentistry, and the use of portable dental units to improve access for functionally dependent older adults.</p><p><strong>Expected outcomes: </strong>The model demonstrates feasibility in real-world settings, with anticipated outcomes including improved patient satisfaction, earlier identification of oral-systemic risks, reduced unnecessary medical referrals, enhanced continuity of care, and better oral and general health-related quality of life among older adults.</p><p><strong>Implications: </strong>By reframing oral health as an integral component of healthy ageing, this interprofessional model offers a scalable and adaptable framework for academic institutions, policymakers, and healthcare systems. Its adoption could significantly reduce oral health disparities and contribute to sustainable, preventive, and integrated geriatric care globally.</p><p><strong>Rationale for the proposed interprofessional model: </strong>Older adults commonly present with multimorbidity, polypharmacy, and functional limitations that directly influence oral health, yet dental care remains largely disconnected from geriatric services. This fragmentation leads to delayed diagnosis, reactive treatment, and preventable declines in quality of life. An interprofessional model integrating dental and geriatric care enables early risk identification, coordinated prevention, and continuity of care. By addressing shared biological, functional, and social determinants, this approach repositions oral health as an essential component of holistic, person-centred healthy ageing.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1757007"},"PeriodicalIF":1.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500816","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":"Structured reporting of dental panoramic images in a hospital-based radiology setting: a comparative study.","authors":"Moritz Ludwig Schnitzer, Gloria Biechele, Emilia Schober, Felix L Herr, Christian Dascalescu, Maurice Heimer, Ricarda Ebner, Victoria Fusch, Sebastian Marschner, Stefanie Corradini, Florian Georg Ortner, Matthias Frank Frölich, Fabian Baier, Tobias Graf, Johannes Rübenthaler, Thomas Geyer","doi":"10.3389/fdmed.2026.1769864","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1769864","url":null,"abstract":"<p><strong>Background: </strong>Despite radiological advancements, free-text reporting remains common. Structured reporting (SR) improves completeness, clarity, communication, efficiency, and information extraction while benefiting education and research. Its success depends on well-designed, modality-specific templates.</p><p><strong>Methods: </strong>This study aimed to compare SRs and narrative reports (NRs) for dental panoramic images in a hospital-based radiology department with respect to completeness, clarity, ease of information extraction, and clinical utility.Fifty dental panoramic images were randomly selected from the clinical archive of a tertiary-care hospital radiology department. NRs by radiologists were compared with SRs retrospectively created by a board-certified dentist using a decision-tree template (Smart Radiology platform). A questionnaire, developed with two additional dentists, assessed completeness, clarity, ease of information extraction, and clinical utility.</p><p><strong>Results: </strong>SRs outperformed NRs in all areas. Clinical questions were answered in 100% of SRs vs. 42% of NRs (<i>p</i> < 0.05). SRs enabled clinical decision-making in 100% of cases vs. 29% for NRs (<i>p</i> < 0.05). Key features were omitted in 3% of SRs but in 96% of NRs (<i>p</i> < 0.05). Information extraction was rated \"easy/fast\" in 100% of SRs vs. 52% of NRs (<i>p</i> < 0.05). Evaluators showed greater trust in SRs (Likert score: 5.97 vs. 4.27, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>SR significantly enhances report quality, clinical decision-making, and communication in dental panoramic imaging.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1769864"},"PeriodicalIF":1.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500824","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: Coping with antimicrobial resistance in the context of dental medicine.","authors":"Lucinda J Bessa, Simonetta D'Ercole, Ricardo Alves","doi":"10.3389/fdmed.2026.1807351","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1807351","url":null,"abstract":"","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1807351"},"PeriodicalIF":1.8,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488657","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":"Antimicrobial mechanism of <i>Phyllanthus niruri</i> L. against oral pathogens: a scanning and transmission electron microscopy study.","authors":"Vanishree H Shivakumar, Anand S Tegginamani, Raghavendra M Shetty, Annapurny Venkiteswaran, Nurhayati Mohamad Zain, Nurul 'Izzah Mohd Sarmin, Zolkapli Eshak, Eddy Hasrul Hassan","doi":"10.3389/fdmed.2026.1696836","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1696836","url":null,"abstract":"<p><strong>Introduction: </strong>Endodontic infection in primary teeth is a multimicrobial disease involving a rich combination of bacterial species. The secondary metabolites from the medicinal plant <i>Phyllanthus niruri</i> L. have antimicrobial properties. This <i>in vitro</i> research evaluated the antimicrobial activity of <i>P. niruri</i> and its mode of action against <i>Enterococcus faecalis</i>, <i>Porphyromonas gingivalis</i>, and <i>Treponema denticola</i>.</p><p><strong>Methodology: </strong>The antimicrobial activities of an ethanolic extract of <i>P. niruri</i> and a triple antibiotic paste (TAP) as a positive control were evaluated using the disc diffusion method, and their minimum inhibitory concentration (MIC) and minimum bacterial concentration were determined. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to observe the cellular damage induced by the extract. A one-way ANOVA followed by Tukey's <i>post hoc</i> test was used to compare the mean zone of inhibition for all three microbes. The level of significance was set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>The herbal extract of <i>P. niruri</i> had the highest inhibitory effects against <i>T. denticola</i> (16.06 ± 3.13), followed by <i>P. gingivalis</i> (14.54 ± 2.28 mm), and <i>E. faecalis</i> (10.10 ± 0.71 mm). However, it was less than the TAP (<i>p</i> < 0.001). <i>P. niruri</i> exhibited bacteriostatic potential with its MIC against all microbes. Furthermore, SEM and TEM found severe membrane deformation and extensive cytoplasmic leakage in <i>T. denticola</i> and <i>P. gingivalis</i> compared to <i>E. faecalis</i>.</p><p><strong>Conclusion: </strong>Based on the study results, a 250 mg/mL concentration of <i>P. niruri</i> could be beneficial as a potential medicament for reducing root canal pathogens.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1696836"},"PeriodicalIF":1.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476198","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":"Exploring anatomical variations of mandibular premolars and their clinical management: a case series.","authors":"Bridhi Jalan, Srishti Grover, Janina Loren DSouza, Annapoorna Shenoy, Nisha Gawade","doi":"10.3389/fdmed.2026.1769755","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1769755","url":null,"abstract":"<p><p>Anatomical variations in root canals pose significant challenges and may affect the course of treatment. Mandibular premolars usually have a single canal with single root. However, this case series highlights three mandibular premolars with distinct canal configurations. The first case involved a mandibular second premolar with Sert and Bayirli Type IX anatomy, characterised by one canal trifurcating into three different canals at the apex. In the second case, the Vertucci Type V configuration is in the mandibular second premolar. In the third case, a mandibular first premolar showed a Vertucci Type IV configuration, which remained distinct throughout its course. Cone-beam computed tomography (CBCT) is a reliable diagnostic tool for identifying these intricate canal morphologies. The use of magnification ensured through biomechanical preparation and obturation, which contributes to the success of endodontic therapy.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1769755"},"PeriodicalIF":1.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470406","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":"Developing an AI-powered tool for radiographic feedback on working length determination in pre-clinical endodontic training.","authors":"Sanaa Aljamani, Iman AlMomani, Walid El-Shafai, Mousa Al-Akhras, AbdulAziz AlHaddad, Rawan Abu Zaghlan","doi":"10.3389/fdmed.2026.1730454","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1730454","url":null,"abstract":"<p><strong>Background: </strong>Establishing an accurate working length is a critical step in root canal treatment and directly influences clinical success. As artificial intelligence increasingly integrates into medical education, applying it to enhance endodontic training has become increasingly important.</p><p><strong>Aims: </strong>This study aimed to develop a machine learning-based tool that provides prompt, personalized, constructive feedback on radiographic working length determination in a pre-clinical setting and to evaluate its usability among dental students.</p><p><strong>Methods: </strong>A newly labeled dataset of 3,000 radiographic images was created and categorized into optimal, over-extended, and under-extended working lengths. This dataset was balanced and split into 80%, 10%, and 10% for training, validation, and testing, respectively. Twenty-two convolutional neural network models were developed, trained, and evaluated using five diagnostic metrics (accuracy, F1-score, precision, recall, and testing time). The best-performing model was integrated into a web-based platform and piloted with 30 pre-clinical dental students who provided usability feedback via a Likert-scale questionnaire. The study hypothesized that students would rate the tool as usable and educationally supportive.</p><p><strong>Results: </strong>The custom-developed deep CNN achieved 97%-99% accuracy, 95%-98% F1-score, 94%-99% precision, and a recall rate of 96%-98%, with an average testing time of 0.54 s. Students rated the proposed system positively across clarity, ease of use, and learning support, with median usability scores of 5.0 across all items and interquartile ranges of 4-5 to 5-5.</p><p><strong>Conclusion: </strong>The AI-powered feedback system demonstrated high accuracy with strong user acceptance. By delivering instant, constructive feedback on working length determination, it supports effective learning and skill refinement in endodontic education. It is also beneficial in classrooms with large student populations. Future work will expand the dataset and integrate additional stages of root canal training into a unified AI-based educational platform.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1730454"},"PeriodicalIF":1.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470434","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 different surface treatments on the bond strength of zirconia to resin cement. An <i>in vitro</i> study.","authors":"Aya El Feghaly, Elie Nasr, Monika Lukomska-Szymanska, Ewa Zmysłowska-Polakowska, Georges Najjar, Ryan Harouni, Rim Bourgi, Louis Hardan","doi":"10.3389/fdmed.2026.1778379","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1778379","url":null,"abstract":"<p><strong>Introduction: </strong>Achieving a durable and stable bond between zirconium dioxide (zirconia) and resin cement remains a significant clinical challenge. This study aimed to investigate the effects of two novel zirconia surface treatments on the shear bond strength (SBS) between zirconia and resin cement following thermocycling.</p><p><strong>Methods: </strong>Seventy-five CAD/CAM zirconia specimens (8 × 10 × 8 mm) were fabricated and randomly assigned to five groups (<i>n</i> = 15): control (no treatment); air particle abrasion (APA); Zircos-E etching; APA+Zircos-E; Biomic LiSi Connect. All specimens were bonded using a zirconia primer, adhesive system, and dual-cure resin cement, except for Biomic LiSi Connect, which did not receive the zirconia primer treatment. Subsequently, all specimens underwent thermo-cycling. SBS was measured, and failure modes were classified. Statistical analysis revealed significant differences in SBS among the groups (<i>p</i> < 0.001).</p><p><strong>Results and discussion: </strong>Zircos-E etching, APA+Zircos-E and Biomic LiSi Connect exhibited significantly higher bond strength than the control, with Biomic LiSi Connect demonstrating the highest mean SBS (<i>p</i> < 0.001). Failure mode analysis showed no statistically significant differences among groups. Both Zircos-E and Biomic LiSi Connect significantly enhanced the bond strength.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1778379"},"PeriodicalIF":1.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470423","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":"Fracture strength of roots restored with relined and milled glass fiber posts.","authors":"Pedro Henrique Soares Aguiar, Kusai Baroudi, Tarun Walia, Vivek Padmanabhan, Fillipe Mendes Silva, Ellen Christine Rodrigues de Abreu, Milton Edson Miranda, Rafael Pino Vitti, William Cunha Brandt","doi":"10.3389/fdmed.2026.1711272","DOIUrl":"https://doi.org/10.3389/fdmed.2026.1711272","url":null,"abstract":"<p><strong>Objectives: </strong>Computer-aided design/computer-aided manufacturing (CAD/CAM)-milled glass fiber posts offer notable advantages. However, their performance compared to that of prefabricated, composite-reinforced glass fiber posts is controversial. This study aimed to evaluate the fracture strength and fracture patterns of canine roots restored with relined glass fiber posts and CAD/CAM-milled glass fiber posts.</p><p><strong>Materials and methods: </strong>In total, 20 decoronated canine roots underwent endodontic treatment (<i>n</i> = 10). In the relined group (control), prefabricated glass fiber posts (Reforpost Angelus #1, Angelus, Brazil) were relined with a resin composite (Z350, 3M ESPE, USA). In the milled group, the root canal was modeled using a post (Pinjet, Angelus) and red acrylic resin (Pattern Bright Kit, Kota Ind., Brazil). The acrylic resin patterns were scanned and milled from a glass fiber block (Fiber CAD Post & Core, Angelus). A dual-cure self-adhesive resin luting agent (RelyX™ U200, 3M ESPE) was used for post cementation in both groups. The specimens were subjected to compressive loading, applied at a 45° angle to the long axis of the tooth using a universal testing machine with 200 kgf of compressive force at a crosshead speed of 1 mm/min, until failure. The failure mode was classified as catastrophic (fracture extended to the middle and/or apical third) or repairable (glass fiber post and/or coronal core or limited to the cervical region). A statistical analysis was performed using an independent samples <i>t</i>-test (<i>α </i>= 0.05).</p><p><strong>Results: </strong>A statistically significant difference was observed in the mean fracture strength, with higher values for the milled group (<i>p</i> = 0.004). Furthermore, the milled group had fewer catastrophic failures.</p><p><strong>Conclusions: </strong>The CAD/CAM-milled glass fiber posts exhibited greater fracture strength and a reduced incidence of catastrophic fractures.</p>","PeriodicalId":73077,"journal":{"name":"Frontiers in dental medicine","volume":"7 ","pages":"1711272"},"PeriodicalIF":1.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470380","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}