BMC Oral Health最新文献

{"title":"Conditioned medium from the inflammatory microenvironment of human dental pulp stem cells regulated functional pulp regeneration.","authors":"Qian Zhang, Hengwei Zhang, Linting Wei, Bin Yang, Xiaofan Bai, Jianping Ruan, Ning Dong","doi":"10.1186/s12903-026-08563-5","DOIUrl":"https://doi.org/10.1186/s12903-026-08563-5","url":null,"abstract":"<p><strong>Objective: </strong>This study explored the effects of inflammatory microenvironment on stem cells from the apical papilla (SCAP) for cell homing strategy-based pulp regeneration.</p><p><strong>Methods: </strong>Dental pulp stem cells (DPSCs) were treated with lipopolysaccharide (LPS) for 48 h, creating a conditioned medium (LPS-CM). The influence of LPS-CM on SCAP proliferation, migration, odontogenic and neurogenic differentiation, pro-angiogenetic effects, cell apoptosis and senescence were assessed. Following construction of the ectopic pulp regeneration model, treated dentin matrix (TDM) specimens were harvested after a 2-month implantation period and subjected to histological examination to assess changes in the regenerated tissues.</p><p><strong>Results: </strong>We found that a moderate inflammatory microenvironment (LPS-5 CM) significantly enhanced SCAP proliferation, migration, odontogenic differentiation, and the formation of neuron-like cells. In contrast, a high-inflammatory microenvironment (LPS-10 CM) exerted inhibitory effects on these processes and concurrently induced cellular apoptosis and senescence. All LPS-CM groups promoted angiogenesis in vitro. Critically, only the LPS-5 CM group successfully facilitated the regeneration of well-vascularized pulp-like tissue in vivo.</p><p><strong>Conclusions: </strong>Inflammatory microenvironment performed a dual role in pulp regeneration. A moderate inflammatory stimulus enhances the regenerative functions of SCAP, while excessive inflammation is detrimental. This underscores the importance of inflammatory signals for successful cell homing-based pulp regeneration.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-based diagnostic evaluation of GPT-4o for crown-fracture detection on maxillary periapical radiographs: effects of prompt detail and customization.","authors":"Enes Mustafa Aşar, Büşra Muslu Dinç, Zeynep Şeyda Yavşan","doi":"10.1186/s12903-026-08528-8","DOIUrl":"https://doi.org/10.1186/s12903-026-08528-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background/aim: &lt;/strong&gt;Artificial intelligence (AI) and large language models (LLMs) are rapidly entering dental imaging workflows. We conducted a diagnostic evaluation of GPT-4o for crown-fracture detection on periapical radiographs and examined how prompt detail and customization (prompt-based; no fine-tuning) affect performance in a positives-only dataset.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this single-center, retrospective study, 90 different anonymized maxillary periapical radiographs with at least one crown fracture were evaluated by standard GPT-4o (GPT-4o) and customized GPT-4o (CGPT-4o). Both variants were accessed via a commercial interface (no API parameter control). Customization was achieved via a custom GPT with task instructions and in-context examples; no model parameter fine-tuning was performed. Two different prompts were used: a detailed prompt (DP) and a short prompt (SP). The performance of four different test groups (GPT-4o + DP, GPT-4o + SP, CGPT-4o + DP, CGPT-4o + SP) in detecting crown fractures from periapical radiographs was evaluated. Each group evaluated 90 radiographs in 5 independent runs, yielding a total of 1800 responses. Outputs were scored on an ordinal rubric (0 = incorrect, 1 = partially correct, 2 = correct) by three pediatric dentists. The reference standard was the blinded, independent assessment of these experts with consensus. A proportional-odds mixed model assessed the main and interaction effects of Model and Prompt on the odds of higher ordinal correctness, with random intercepts for radiograph (and runs) and adjustment for fracture grade (G1-G3).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The analysis revealed that both the main and interaction effects of models and prompts were statistically significant. Specifically, CGPT-4o generated higher odds of ordinal correctness than GPT-4o, and detailed prompts were associated with higher odds of ordinal correctness compared to short prompts. There was a significant Model×Prompt interaction, indicating that correctness depended on the specific model-prompt pairing. Among the four combinations, GPT-4o, with short prompts, exhibited the lowest odds of correctness, whereas no statistically significant differences were observed among the remaining three combinations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The crown fracture detection performance of GPT-4o was significantly affected by prompt design and customization. Especially for short prompts, customization improved detection performance considerably, and using detailed prompts with the standard GPT-4o improved ordinal correctness. The findings demonstrate the critical importance of task-oriented configuration and prompt engineering in the clinical application of AI-based language models in dental traumatology. The dataset comprised only positive cases from a single center and was limited to the maxillary anterior region. Accordingly, we used an ordinal (0-1-2) localization outcome; specificity and ROC-AUC c","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of dental anxiety in adults attending tertiary care dental centres in Karachi, Pakistan.","authors":"Ammarah Muhammad Nauman, Yousra Altaf, Sidra Mohiuddin, Maryam Panhwar, Aahad Rasul, Umaiya Altaf","doi":"10.1186/s12903-026-08561-7","DOIUrl":"https://doi.org/10.1186/s12903-026-08561-7","url":null,"abstract":"<p><strong>Background: </strong>Dental anxiety is a multifactorial condition that negatively affects oral health behaviours, yet evidence on modifiable determinants in developing settings remains limited. This study assessed associations between dental anxiety and sociodemographic, dental attendance, environmental, experiential, and patient-dentist interaction factors among adults in Karachi, Pakistan.</p><p><strong>Methodology: </strong>A multi-centre cross-sectional study included 400 adults aged ≥ 18 years. Participants completed a structured questionnaire covering sociodemographics, dental attendance, prior dental experiences, environmental triggers, and patient-dentist interactions. Dental anxiety was measured using the Corah Dental Anxiety Scale (DAS). Data were analysed using SPSS v27. Mann-Whitney U and Kruskal-Wallis tests were used for group comparisons, and hierarchical multiple linear regression was performed to identify independent predictors (p < 0.05).</p><p><strong>Results: </strong>Most participants reported low anxiety (81.8%), with a mean DAS score of 8.57 ± 3.39. Higher anxiety was significantly associated with females (U = 15790, p = 0.009) and longer time since last dental visit (H = 11.19, p = 0.011). The regression model was significant (F(28,371) = 10.02, p < 0.001), explaining 43.1% of variance (R² = 0.431; adjusted R² = 0.388). Significant predictors of increased anxiety included clinic environment anxiety (B = 1.48, p < 0.001), exposure to others' expressions of pain (B = 1.54, p < 0.001), drill sound (B = 1.35, p < 0.001), and drill smell (B = 0.73, p = 0.021), while clear explanations (B = - 1.83, p = 0.001) and involvement in decision-making (B = - 1.00, p = 0.031) reduced DAS scores.</p><p><strong>Conclusion: </strong>Dental anxiety in this population was more strongly associated with modifiable environmental and communication-related factors than with sociodemographic characteristics. Improvements in patient-centred communication and clinical environments may help reduce anxiety and enhance care experiences; however, causal inferences cannot be drawn from the cross-sectional design.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel plate design versus two conventional miniplates for treatment of mandibular angle fractures (a pilot randomized controlled clinical trial).","authors":"Peter N El-Masry, Nevein S Mohamed, Mohamed E Saber","doi":"10.1186/s12903-026-08474-5","DOIUrl":"https://doi.org/10.1186/s12903-026-08474-5","url":null,"abstract":"<p><strong>Background: </strong>Among facial skeletal injuries, mandibular fractures are highly prevalent, second after nasal bone fractures. Consequently, a lot of research has focused on treatment modalities for these fractures, to ensure faster healing & rigid fixation. One of these modalities is the application of the Sagittal Split plate at the mandibular angle. The objective of this study is to compare the clinical and radiographic outcomes of the use of a novel Sagittal Split Osteotomy Plate (SSOP) design versus conventional two-miniplate fixation in the treatment of mandibular angle fractures, and to assess the biomechanical stability of the new design.</p><p><strong>Materials and methods: </strong>In this pilot randomized controlled trial, 16 patients with mandibular angle fractures were randomly assigned (1:1 allocation ratio) using computer-generated block randomization into two groups. Group A (8) patients were treated using the new plate modified from Sagittal Split plate, and Group B (8) patients were treated using two conventional miniplates. Mechanical test bench was performed to measure plate strength & mechanical stability of the new plate design. Clinical evaluations were performed at 24 h, one, four, six and twelve weeks postoperative to assess operating time, pain, occlusion, wound healing & interincisal mouth opening. In addition, radiographic assessments were conducted immediately postoperatively and at three months to evaluate the mean bone density at the fracture site.</p><p><strong>Result: </strong>The study group showed reduced operating time. No statistically significant differences between the groups regarding occlusion, wound healing, postoperative pain and interincisal mouth opening. A statistically significant difference was observed regarding mean bone density of the study group after 3 months. The mean displacement of the mechanical test was 1.46 mm under 60 N of the new plate.</p><p><strong>Conclusion: </strong>Within the limitations of this pilot study, the novel SSOP demonstrated reduced operative time and comparable short-term clinical outcomes to conventional double-miniplate fixation. Radiographically, higher bone density was observed at three months, and the prototype demonstrated acceptable baseline biomechanical outcomes during pre-clinical testing. While the SSOP represents a potential fixation alternative, larger longitudinal studies remain necessary to evaluate long-term clinical outcomes and to directly compare this prototype biomechanically against other established plates used for mandibular angle fractures.</p><p><strong>Trial registration: </strong>This clinical trial was prospectively submitted for registration to ClinicalTrials.gov prior to the enrollment of the first participant (identifier NCT07103590; official public posting August 5, 2025).</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of concentrated growth factors on early soft tissue healing and postoperative recovery after mesioangular impacted lower third-molar extraction: a randomised split-mouth clinical trial.","authors":"Moatasem Alshtawi, Gamil Al-Madhagy, Khaldoun Darwich","doi":"10.1186/s12903-026-08550-w","DOIUrl":"https://doi.org/10.1186/s12903-026-08550-w","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this randomised, split-mouth clinical trial study is to investigate the effect of concentrated growth factors (CGF) on the healing of soft tissues and postoperative sequelae following the extraction of mesioangular impacted lower third molars in a split-mouth design.</p><p><strong>Materials and methods: </strong>Twenty-five patients, systematically healthy, aged between 18 and 35, were subjected to bilateral lower third molar extraction (Class II, division B) at the oral surgery clinics in Damascus University, Syria, from October 2023 to July 2025. CGF was applied to one extraction site (test), and the opposite side served as a control (no treatment). Randomization was achieved through sealed envelopes, and the patients, outcome assessor, and data analyst were blinded. The main outcome was soft tissue healing, which was assessed by the Landry healing score at the 7th postoperative day. Secondary outcomes investigated were pain, which was assessed by the Visual Analog Scale throughout the 7th postoperative days, facial swelling, evaluated by the tape method at baseline, day 3, and day 7, and trismus by measuring the inter-incisal distance at baseline, third, and seventh postoperative days. Bonferroni correction was applied for repeated postoperative comparisons.</p><p><strong>Results: </strong>At postoperative day 7, the CGF-treated sides exhibited superior healing compared with control sides (p = 0.008). Lower pain scores were observed in the test group during the first four postoperative days (unadjusted p < 0.05); however, these differences did not remain statistically significant after Bonferroni correction. (p > 0.05). Facial swelling was significantly lower in the CGF group on day 3 (p = 0.011) but not at day 7 (p = 0.247). No significant differences were found for trismus at any time-point (p = 0.260 & 0.615).</p><p><strong>Conclusion: </strong>The application of CGF to extraction sockets following surgical removal of mesioangular impacted mandibular third molars was associated with improved early soft tissue healing and reduced facial swelling at day 3. Although lower early postoperative pain scores were observed, these differences did not persist after multiplicity adjustment. No significant effects were observed for trismus or at later time points. CGF may represent a promising adjunctive local approach to support early postoperative recovery, particularly for enhancing soft tissue healing. Further research with larger samples and extended follow-up is recommended.</p><p><strong>Clinical trial registration: </strong>Thailand Clinical Trial Registry (TCTR). Registration number (ID: TCTR20251102008). Registered on 02/11/2025 (retrospective registration). URL: (https://www.thaiclinicaltrials.org/show/TCTR20251102008).</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative photobiomodulation-enhanced T-PRF in posterior mandibular fractures: a randomized pilot study.","authors":"Amr Hassaan Elyamany, Mona S Oraby, Marwa G Noureldin","doi":"10.1186/s12903-026-08455-8","DOIUrl":"https://doi.org/10.1186/s12903-026-08455-8","url":null,"abstract":"<p><strong>Background: </strong>Mandibular body fractures are common maxillofacial injuries, often resulting from road traffic accidents. Optimal management seeks anatomical reduction and stable fixation. Recent advances highlight the adjunctive use of low-level laser therapy (LLLT) and Titanium-Prepared Platelet-Rich Fibrin (T-PRF) to enhance bone healing. LLLT stimulates osteogenesis and angiogenesis, while T-PRF provides sustained growth factor release. This pilot study examines the synergistic potential of LLLT and T-PRF in improving bone regeneration and clinical outcomes in mandibular body fracture repair.</p><p><strong>Patients and methods: </strong>Open reduction and internal fixation (ORIF) of posterior mandibular fractures was performed using titanium plates and screws. Patients were divided into two groups: the control group received T-PRF placement at the fracture site, while the study group received T-PRF followed by postoperative LLLT sessions. Using Computerized Tomography, bone mineral density was evaluated at three months postoperatively. Clinical parameters, including pain, wound healing, maximum mouth opening, and edema, were monitored postoperatively to evaluate recovery dynamics.</p><p><strong>Results: </strong>Twelve patients (14 fracture lines) were treated with ORIF and divided equally into two groups. All patients achieved satisfactory anatomical reduction and stable occlusion. The study group demonstrated significantly higher bone density at 12 weeks and experienced significantly greater pain reduction during the first and second weeks postoperatively (p < 0.05) compared to controls. Both groups showed similar results in mouth opening, wound healing, and edema resolution, with no significant intergroup differences in these parameters.</p><p><strong>Conclusion: </strong>The adjunctive application of LLLT with T-PRF significantly enhanced osseous regeneration in the study group, yielding higher bone density at 12 weeks and greater pain reduction compared to T-PRF alone. However, both groups demonstrated equivalent improvements in clinical outcomes - including edema resolution, maximum mouth opening, and wound healing - with no significant intergroup differences.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypomelanotic melanoma of the mandibular gingiva: a case report and literature review.","authors":"Shuying Liu, Yumeng Yang, Liyi Jiang","doi":"10.1186/s12903-026-08460-x","DOIUrl":"https://doi.org/10.1186/s12903-026-08460-x","url":null,"abstract":"<p><strong>Background: </strong>Oral mucosal melanoma (OMM) is a rare and aggressive malignancy that exhibits distinct clinical and pathological characteristics compared to cutaneous melanomas. The hypomelanotic subtype of OMM is even rarer, with clinical signs and symptoms often being nonspecific, complicating the diagnostic process and contributing to a poor prognosis. Due to its rarity and the frequent delays in diagnosis, case reports are an invaluable source of information regarding this condition. A 78-year-old male presented with a painless mass on the left mandibular gingiva, which was initially misidentified as an inflammatory gingival lesion. After ineffective anti-inflammatory treatment, further investigation led to a confirmed diagnosis of hypomelanotic melanoma through histopathological and immunohistochemical examination.</p><p><strong>Conclusion: </strong>Early biopsy plays a critical role in establishing a definitive diagnosis for OMM. Histology combined with immunohistochemistry is the gold standard for diagnosing of hypomelanotic OMM.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water sorption and bond strength of graphene oxide-added universal adhesives.","authors":"Muhittin Ugurlu, Fatmanur Sari","doi":"10.1186/s12903-026-08360-0","DOIUrl":"https://doi.org/10.1186/s12903-026-08360-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of adding graphene oxide (GO) to HEMA-containing and HEMA-free universal adhesives on water sorption/solubility and bonding effectiveness to dentin.</p><p><strong>Materials and methods: </strong>GO was incorporated into universal adhesives (Scotchbond Universal and G-Premio Bond) at three weight percentages (0.5, 1, and 3%) and characterized by SEM. Clearfil SE Bond was used as the reference adhesive. Disk-shaped specimens were prepared to evaluate water sorption and solubility (n = 10). Microspecimens were prepared from ninety extracted human third molar. The µTBS of half of the specimens was tested after 24 h, and the remaining specimens were aged for 6 months. Failure mode was analyzed using a stereomicroscope. Statistical analyses were performed with one-way ANOVA, Duncan, and paired t-tests (p = 0.05).</p><p><strong>Results: </strong>Adding 3% GO increased water sorption of the adhesives (p < 0.05). Clearfil SE Bond exhibited the lowest water sorption and solubility (p < 0.05). 1% GO significantly increased the immediate µTBS of the adhesives, whereas 3% resulted in a significant decrease (p < 0.05). 0.5 and 1% GO significantly increased the aged µTBS of Scotchbond Universal, while only 1% improved the aged µTBS of G-Premio Bond (p < 0.05). 3% GO reduced the aged µTBS of the adhesives (p < 0.05). The highest immediate and aged µTBS were recorded for Clearfil SE Bond (p < 0.05).</p><p><strong>Conclusions: </strong>The bonding performance of universal adhesives improved with 0.5% and 1% GO additions, whereas 3% GO had a detrimental effect on both bond strength and water sorption.</p><p><strong>Clinical significance: </strong>Adding GO to adhesives may improve the long-term durability of bonded restorations.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of implant position on clinical outcomes of two implant overdentures: a 3-year randomized clinical trial.","authors":"Mohammed Hussein Raafat, Khloud Ezzat Mourad, Moustafa Abdou Elsyad","doi":"10.1186/s12903-026-08441-0","DOIUrl":"https://doi.org/10.1186/s12903-026-08441-0","url":null,"abstract":"<p><strong>Background: </strong>Reviewing the literature, the optimal implant position for 2-implant retained mandibular overdentures, which would be associated with improved peri-implant tissues, higher retention values, and better patient satisfaction, remains uncertain. The study was designed to assess the effect of the implant position of two implant-retained mandibular overdentures on clinical outcomes (peri-implant soft tissue health, bone loss, retention, and patient satisfaction).</p><p><strong>Materials and methods: </strong>Ninety edentulous patients with unsatisfactory retention of their mandibular conventional dentures were included in this study and received 2-implant mandibular overdentures with Locator attachments. The patients were randomly divided into three groups based on the positions of the implants. Group LA (implants in lateral incisor positions), Group CA (implants in the canine positions), and Group PM (implants in the premolar positions). Changes in the peri-implant soft tissue health (plaque, gingival scores, and probing depth) and the retention values of overdentures were evaluated at prosthesis insertion (T0), 6 months (T6), and 12 months (T12) after insertion. The peri-implant marginal bone loss changes were evaluated one year (T12), 2 years (T24), and three years after insertion (T36). A visual analog scale (VAS) assessed patient satisfaction for conventional dentures (CD), LA, CA, and PM at T6.</p><p><strong>Results: </strong>At T6 and T12, the highest plaque and gingival scores were noted with the PM, followed by LA, and the lowest scores were observed with CA. For all observations, the highest pocket depth was noted with PM, followed by CA, and the lowest pocket depth was noted with LA. CA and PM showed significantly higher bone loss compared to LA. The highest retention forces were exhibited by PM, followed by CA, and the lowest retention values were noted with LA. Regarding retention, stability, occlusion of the mandibular prosthesis, and ease of chewing, the PM group had the greatest patient satisfaction, then CA and LA. The lowest satisfaction scores were noted with CD.</p><p><strong>Conclusions: </strong>In selecting the implant position for two-implant mandibular overdentures, it is crucial to balance several key clinical outcomes. The chosen location for the implants should effectively prioritize bone preservation, the health of peri-implant soft tissues, retention, and overall patient satisfaction. Positioning the implants near the lateral incisors is advantageous for minimizing bone loss, while placement near the canines supports optimal soft tissue health. Conversely, positioning them near the premolars maximizes retention and enhances patient satisfaction.</p><p><strong>Clinical trial registry number: </strong>(NCT06166316) (12/13/2023).</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of 0.5M mannitol as an adjuvant to lidocaine and epinephrine for intra-oral nerve blocks - a split-mouth, randomized controlled trial.","authors":"Radhika Singh, Anupam Singh, Mehul Saha, Adarsh Kudva, Srikanth Gadicherla, Kalyana C Pentapati, A Chitra, Dharnappa Poojary, Sreea Roy","doi":"10.1186/s12903-026-08468-3","DOIUrl":"https://doi.org/10.1186/s12903-026-08468-3","url":null,"abstract":"<p><strong>Background: </strong>In dentistry operations, addition 0.5 M mannitol to lidocaine-epinephrine improves anesthesia efficacy. However, its effect on hemodynamic parameters and post-operative outcomes have not been evaluated. This study aimed to compare the efficacy, hemodynamic parameters, and post-operative outcomes of 2% lidocaine and 1:200,000 epinephrine, with or without 0.5 M mannitol, in intra-oral nerve blocks.</p><p><strong>Materials and methods: </strong>This prospective, randomized, controlled, triple-blind, split-mouth study included 25 patients who required intra-oral block for elective extraction of lower erupted teeth. The Test side (n = 25) received lidocaine-epinephrine-mannitol, while the Control side (n = 25) received lidocaine-epinephrine. The primary outcome measures were evaluated were onset and duration of anesthesia. The secondary outcome measures were pain (assessed with visual analogue scale [VAS] on day 0-3, and 7); hemodynamic parameters (including heart rate, systolic blood pressure [SBP], diastolic blood pressure [DBP], and oxygen saturation, assessed pre-, intra-, and post-operatively); and post-operative complications (swelling and trismus assessed on day 7).</p><p><strong>Results: </strong>The Test side had a significantly early onset of action (p = 0.006) and delayed return of sensation (p = 0.001). On day 0, VAS score was significantly lower in the Test side (p = 0.017), with no difference at other intervals (p > 0.05). Post-operatively, mouth opening was significantly greater on the test side (p = 0.023), with no difference in post-operative swelling (p = 0.317). The control side had a significantly higher intra- (p = 0.018) and post-operative (p = 0.006) heart rate, with comparable SBP, DBP, and oxygen saturation.</p><p><strong>Conclusion: </strong>Lidocaine-epinephrine-mannitol formulation showed improved anesthetic efficacy, reduced pain on the day of procedure, stable hemodynamic parameters, and increased post-operative mouth opening.</p><p><strong>Trial registration: </strong>CTRI/2022/10/046921 [Registered on: 31/10/2022].</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}