BMC Oral Health最新文献

{"title":"Oral and perioral changes in professional morsing players: a descriptive exploratory pilot study.","authors":"Simrita Sri K Jagthap, K G Sruthi, Deepikha Krishnaraj, Anita Murali, Yoka T, Sasmitha C, Suganya P, Charumathi Dhanushkodi","doi":"10.1186/s12903-026-09415-y","DOIUrl":"10.1186/s12903-026-09415-y","url":null,"abstract":"<p><strong>Background: </strong>The morsing, a traditional South Indian jaw harp, is played by holding two metal forks against the anterior teeth. Prolonged playing of mouth-contact musical instruments may be accompanied by structural and functional changes in the oral and perioral regions. The effects of morsing playing on oral health have not been well studied, despite its cultural significance.</p><p><strong>Aim: </strong>The purpose of this study was to assess oral and paraoral alterations, such as tooth wear and temporomandibular joint (TMJ) symptoms, among professional morsing players.</p><p><strong>Methods: </strong>This exploratory study was conducted over three months among 62 professional morsing players in Tamil Nadu with at least three years of active practice, recruited through purposive and snowball sampling. Clinical examinations assessed occlusion, TMJ function, facial muscle activity, oral mucosa, anterior tooth wear (Smith and Knight Tooth Wear Index), oral hygiene (Oral Hygiene Index - Simplified), dental caries (Decay Missing Filled teeth) and periodontal health (Community Periodontal Index). Data were analysed using descriptive statistics and simple bivariate tests. Significance was set at p < 0.05.</p><p><strong>Results: </strong>Moderate-to-severe anterior tooth wear was present in 58.1% of players. Facial muscle fatigue was present in 72.6% of the morsing players. The mean DMFT was 2.45 ± 0.80, and mild-to-moderate periodontal involvement (mean CPI 1.63 ± 0.66). Age and years of playing were strongly correlated with each other (ρ = 0.74) and with tooth wear score (ρ = 0.78 and 0.74, respectively).</p><p><strong>Conclusion: </strong>Professional morsing players showed a high prevalence of anterior tooth wear and facial muscle fatigue, together with appreciable TMJ symptoms, that tended to be more common in older and longer-practising players.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cuspal displacement, marginal adaptation, and nanoleakage in maxillary premolars restored with a novel auto-cured bulk-fill composite versus a light-cured bulk-fill composite: an in-vitro study.","authors":"Khaled Wagih Al-Saudi, Mohamed Ahmed Basha, Aalaa Mohamed Nabil Amin, Dina Yehia Rehab, Shaymaa Mohamed Nagi, Khaled Beshr, Diaaeldin Farag","doi":"10.1186/s12903-026-09875-2","DOIUrl":"10.1186/s12903-026-09875-2","url":null,"abstract":"<p><strong>Background: </strong>STELA is a newly introduced auto-cured bulk-fill composite proposed as an alternative to amalgam. It does not require light activation and provides an unlimited depth of cure, in addition to acceptable esthetic and mechanical properties.</p><p><strong>Objectives: </strong>To evaluate cuspal displacement, marginal adaptation, and nanoleakage in mesio-occluso-distal (MOD) Class II preparations of maxillary premolars restored with an auto-cured bulk-fill composite compared with a light-cured bulk-fill composite.</p><p><strong>Materials and methods: </strong>Sixty maxillary human premolars extracted for orthodontic purposes were randomly assigned to two groups (n = 30) according to the bulk-fill composite used. Standardized MOD Class II preparations were made and restored using either Group 1: STELA Capsule (SDI, Australia) or Group 2: Tetric N-Ceram Bulk Fill (Ivoclar Vivadent, Liechtenstein). Each group was subdivided into three subgroups (n = 10) based on the test performed. In Subgroup 1, cuspal displacement was recorded after post-cavity preparation and at (5 min, 24 h) post-restoration using a digital microscope. The remaining restored specimens underwent thermocycling and mechanical loading. Subsequently, marginal adaptation (Subgroup 2) was examined using scanning electron microscopy. Nanoleakage (Subgroup 3) was evaluated using silver nitrate tracing. Statistical analysis was performed using the independent-samples t-test and Fisher's exact test (P ≤ 0.05).</p><p><strong>Results: </strong>STELA Capsule demonstrated significantly lower cuspal displacement at both 5 min and 24 h post-restoration compared with Tetric N-Ceram Bulk Fill (P < 0.001). Following thermocycling and mechanical loading, STELA Capsule also exhibited better marginal adaptation (P = 0.033) and reduced nanoleakage (P < 0.001) compared with the Tetric N-Ceram Bulk Fill.</p><p><strong>Conclusions: </strong>The STELA composite with its dedicated primer showed favorable laboratory outcomes compared with Tetric N-Ceram Bulk Fill used with Tetric N-Bond. This restorative protocol can serve as a viable clinical alternative to light-cured bulk-fill composites, particularly for restoring MOD Class II preparations in maxillary premolars.</p><p><strong>Clinical relevance: </strong>The novel auto-cured bulk-fill composite with its dedicated primer demonstrated excellent performance in reinforcing weakened premolars. It exhibited superior results in reducing cuspal displacement, improving marginal adaptation, and minimizing nanoleakage compared to a light-cured bulk-fill composite, indicating its potential for clinical use.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of β-tricalcium phosphate grafting on implant stability and peri-implant radiodensity following immediate implant placement in sites with jumping gaps exceeding 2 mm: a randomized controlled trial.","authors":"Alaa A Salem, Mohamed S Hammed, Ahmed M ElRawdy, Hesham ElHawary","doi":"10.1186/s12903-026-09810-5","DOIUrl":"10.1186/s12903-026-09810-5","url":null,"abstract":"<p><strong>Background: </strong>Whether grafting peri-implant jumping gaps exceeding 2 mm during immediate implant placement improves outcomes remains uncertain. This trial evaluated the effect of β-tricalcium phosphate (β-TCP) grafting on implant stability and peri-implant radiodensity in such sites.</p><p><strong>Methods: </strong>In this prospective, parallel-group randomized controlled trial, 16 patients (8 per group) receiving 39 immediate maxillary anterior/premolar implants at sites with a jumping gap exceeding 2 mm were randomized 1:1 to no grafting (control) or injectable β-TCP (test); the patient was the unit of analysis. The pre-specified primary comparison was implant stability quotient (ISQ) at 6 months. Peri-implant radiodensity was monitored on standardized periapical radiographs (grayscale value) at baseline, 3, and 6 months, and quantified by cone-beam CT (CBCT) at 6 months only (ALARA principle); CBCT values are relative, arbitrary gray-value radiodensity, not true Hounsfield units. Between-group differences were analyzed with independent-samples t tests, within-group changes with repeated-measures ANOVA, and group×time interactions with mixed-design ANOVA (α = 0.05).</p><p><strong>Results: </strong>No statistically significant between-group differences were detected in baseline age or jumping-gap width. No significant between-group difference in ISQ was detected at any time point, and the ISQ group×time interaction was not significant (p = 0.49); ISQ increased significantly over time in both groups. Periapical grayscale value increased significantly faster in the test group on unadjusted analysis (group×time interaction, p = 0.009), but this was no longer significant after adjusting for a small baseline difference (ANCOVA, p = 0.39). On 6-month CBCT, radiodensity was significantly higher in the test group (1224.0 ± 237.0) than control (931.9 ± 100.4 arbitrary units; mean difference 292.1; 95% CI 87.7 to 496.5; p = 0.010), a secondary outcome not included in the a priori sample-size calculation.</p><p><strong>Conclusions: </strong>β-TCP grafting of jumping gaps exceeding 2 mm did not significantly affect ISQ or baseline-adjusted periapical grayscale value. The test group showed significantly higher 6-month CBCT-derived radiodensity, but this was not prospectively powered and may partly reflect residual graft material, so it should be interpreted cautiously. Larger, adequately powered equivalence trials are needed before conclusions about grafting necessity can be drawn.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT07709676. Registered 2026-07-12. Retrospectively registered.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dentin conditioners on biomarker release and microhardness of radicular dentin: an in vitro study.","authors":"Maii Youssef Elmesellawy, Mona Abdel Rehim Wahby, Ahmed Hussein Abuelezz","doi":"10.1186/s12903-026-09318-y","DOIUrl":"10.1186/s12903-026-09318-y","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated the effects of various radicular dentin conditioning agents, maleic acid, citric acid, phosphoric acid, and EDTA, on dentin-derived biomarker release and radicular dentin microhardness for regenerative endodontic applications.</p><p><strong>Materials and methods: </strong>Sixty single-rooted teeth were processed into dentin cylinders and discs and randomly assigned to five groups (n = 12): 7% maleic acid, 10% citric acid, 37% phosphoric acid, 17% EDTA, and phosphate-buffered saline (PBS) as a negative control. Growth factor release (TGF-β, VEGF, BMP-2) was quantified using ELISA after 24 h incubation. Microhardness changes were evaluated in corresponding dentin cylinders sectioned longitudinally.</p><p><strong>Results: </strong>Maleic acid produced the highest release of TGF-β, VEGF, and BMP-2 (p < 0.001), followed by EDTA, citric acid, and phosphoric acid in a biomarker-dependent hierarchy. Microhardness was significantly affected by the conditioning agent (p = 0.004), with EDTA and maleic acid reducing dentin hardness compared with the control, while citric acid and phosphoric acid showed no significant effect. No significant differences were observed among root thirds (p = 0.169).</p><p><strong>Conclusion: </strong>Dentin conditioning in regenerative endodontics involves a trade-off between biological activation and preservation of structural integrity. Stronger conditioning agents enhance growth factor release but may compromise dentin hardness. Among the tested agents, citric acid demonstrated the most balanced performance, combining effective biomarker release with minimal effects on dentin microhardness. In contrast, phosphoric acid preserved dentin structure but showed limited biological activity, making it less suitable when regenerative signaling is the primary objective.</p><p><strong>Clinical relevance: </strong>The selection of dentin conditioning agents should not be based solely on their biological signaling potential, as it directly influences the mechanical properties of radicular dentin and may impact regenerative outcomes.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Algorithm-based approach to the management of rhino-maxillary mucormycosis: part II of a two-part study.","authors":"Samir Ali Elborolosy, Ghada Amin Khalifa, Kamal Ebeid, Hamada Mahran, Mohammed Nahed Attia Mohammed, Mohamed Yehia Abdelfattah, Mohamed Mostafa Elshamaa","doi":"10.1186/s12903-026-09052-5","DOIUrl":"10.1186/s12903-026-09052-5","url":null,"abstract":"<p><strong>Background: </strong>Rhino-maxillary mucormycosis (RMM) is an aggressive, life-threatening fungal infection associated with substantial morbidity and mortality. While early diagnosis is universally advocated, robust quantitative evidence delineating how defined diagnostic delays influence objective clinical outcomes remains scarce. This study aimed to quantify the relationship between diagnostic timing and treatment outcomes in RMM and to develop a protocol-driven multidisciplinary algorithm to standardize management.</p><p><strong>Methods: </strong>This retrospective case series analyzed patients diagnosed and treated for RMM at the Otolaryngology and Oral and Maxillofacial Surgery clinics of Beni-Suef University between November 2019 and December 2021. Data extraction and statistical analysis were conducted from June 2022 to January 2024. Diagnostic timing was categorized as early (4-7 days), late (8-10 days), or delayed (> 10 days). Primary outcomes included disease prognosis (regression, stabilization, progression, or death) and resolution pattern (favorable or unfavorable). Associations were evaluated using chi-square tests and Cramer's V, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>Thirty patients were included (mean age 56.53 ± 11.52 years; 60% male). Early diagnosis occurred in 40% of cases, late in 26.67%, and delayed in 33.33%. The overall survival rate was 83.33%. At final follow-up, disease regression was observed in 60% of patients, stabilization in 16.67%, and progression in 6.67%. A statistically significant association was identified between diagnostic timing and disease regression across follow-up intervals, most pronounced at the third postoperative month (χ² = 17.47, Cramer's V = 0.56, p = 0.008). Diagnostic timing was also significantly associated with a favorable resolution pattern at the third month (χ² = 15.77, Cramer's V = 0.75, p = 0.0004). This association was not statistically significant at six months (p = 0.87).</p><p><strong>Conclusion: </strong>Diagnostic timing demonstrates a significant association with clinical outcomes in RMM. Earlier diagnosis correlates with higher rates of regression and favorable resolution patterns. Adoption of a structured diagnostic and management algorithm may facilitate early triage and coordinated multidisciplinary intervention, contributing to improved outcome standardization in oral and maxillofacial practice. Prospective validation in larger cohorts is warranted.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiographic outcomes of second molars with external root resorption following impacted third molar removal: a retrospective CBCT-based cohort study.","authors":"Baocheng Yao, Shiyu Qiu, Chengyi Wang, Qiao Ling, Ning Ma","doi":"10.1186/s12903-026-09857-4","DOIUrl":"https://doi.org/10.1186/s12903-026-09857-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the clinical and radiographic outcomes of second molars (M2s) affected by external root resorption (ERR) following impacted third molar (M3) removal, and to assess the influence of adjunctive guided bone regeneration (GBR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study included patients presenting with ERR of M2s associated with impacted M3s who underwent M3 extraction with or without concurrent GBR. Cone-beam computed tomography (CBCT) was used to assess ERR progression and distal alveolar bone levels before surgery and at least 6 months postoperatively. Pulp sensibility was also evaluated. Changes in distal bone height were compared between groups. Generalized estimating equations (GEE) were used to evaluate the association between treatment modality and bone gain while adjusting for baseline defect severity and potential confounders. Interaction analysis was performed to assess whether the effect of GBR varied according to baseline defect severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The Wilcoxon signed-rank test revealed no significant pre- to post-treatment change in root length among teeth with root length alteration (Z = 0.110, 95% CI - 0.185 to 0.380, P = 0.457), nor in the vertical dimension of the defect among teeth without root length alteration (Z = 0.033, 95% CI - 0.248 to 0.283, P = 0.785), supporting the radiographic stability of the resorptive defect following M3 removal. Regarding pulpal status, excluding one tooth that had undergone preoperative root canal treatment, all remaining teeth (64/64, 100%) maintained positive pulp sensibility at the final follow-up, as assessed by cold testing. The between-group difference was 2.03 mm (Hodges-Lehmann estimate, 95% CI, 0.56-3.82 mm), with significantly greater bone gain in the GBR group (6.32 ± 2.67 mm) compared with the Extraction-Only group (4.08 ± 3.50 mm), P = 0.007. After adjustment for baseline defect severity and other covariates, treatment modality remained a significant predictor of distal bone gain in the GEE model with exchangeable correlation structure (QIC = 1123.229), with GBR associated with greater bone gain compared with extraction alone (β = 2.244, 95% CI, 0.612-3.875, P = 0.007). To assess the robustness of this estimate to potential unmeasured confounding, the E-value was calculated: the E-value for the point estimate was 3.25, while the E-value for the lower bound of the 95% CI was 1.68. The interaction term between treatment modality and baseline distal bone height was not statistically significant (β = 0.008, 95% CI (-0.229, 0.245), P = 0.945), suggesting that the effect of GBR on distal bone gain did not vary significantly across the range of baseline defect severities observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Among M2s with available follow-up, no radiographic progression of ERR was detected following M3 removal. The findings do not support routine prophylactic root canal treatment in asymptomatic M2s ","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the efficacy of AngelAligner A6 mandibular advancer and Twin Block in the treatment of class II malocclusion in growing patients: a prospective clinical study.","authors":"Giacomo Scuzzo, Giuseppe Scuzzo, Elena Calzadilla-Suárez, Mario Alvarado-Lorenzo, Laura Criado-Pérez, Adrián Curto, Alfonso Alvarado-Lorenzo","doi":"10.1186/s12903-026-09565-z","DOIUrl":"10.1186/s12903-026-09565-z","url":null,"abstract":"<p><strong>Background: </strong>Although the twin block is the most commonly used appliance for the treatment of Class II malocclusion, the clear aligner industry has developed systems with integrated mandibular advancement. The purpose of this study was to evaluate and compare the effects of Twin block appliances, standard AngelAligner clear aligners and AngelAligner A6 mandibular advancement clear aligners as early orthodontic interventions for patients who develop Class II division 1 malocclusion.</p><p><strong>Methods: </strong>The study sample comprised 60 patients with a mean age of 12.4 ± 1.3 years, who were divided into three homogeneous groups of 20 patients each and received different treatments: Twin Block (GTB), AngelAligner aligners (GAA) and AngelAligner A6 for mandibular advancement (GA6). Clinical and radiographic assessments were performed at baseline (T0), immediately prior to appliance placement, and repeated after the completion of treatment objectives (T1).</p><p><strong>Results: </strong>Class II malocclusion was corrected with all three appliances. The GA6 and GTB groups showed similar mandibular advancement, with an increase in the SNB angle of 2.1° and 2.3° respectively, and correction to Class I in 85-90% of cases, outperforming the GAA group, which showed an increase in the SNB angle of 1.2° and correction to Class I in 70% of cases. The duration of treatment was shorter in the GA6 group (15.2 months).</p><p><strong>Conclusion: </strong>These findings suggest that the AngelAligner A6 MA and Twin Block are superior for skeletal correction, whereas the standard AngelAligner is effective for milder cases with aesthetic priorities.</p><p><strong>Clinical trial number: </strong>ClinicalTrials.gov, NCT07591025. Registered 6 May 2026. Retrospectively registered.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improbable healing in endodontics: a case series of favorable outcomes despite adverse prognostic conditions.","authors":"Ricardo Machado","doi":"10.1186/s12903-026-09903-1","DOIUrl":"10.1186/s12903-026-09903-1","url":null,"abstract":"<p><strong>Background: </strong>Endodontic prognosis is based on clinical and radiographic factors that estimate the likelihood of treatment success. Because periapical healing reflects complex interactions among microbial, host, anatomical, and treatment-related factors, individual outcomes may occasionally differ from conventional prognostic expectations. This paper aimed to describe and critically analyze favorable outcomes in teeth presenting conditions traditionally associated with reduced probabilities of treatment success.</p><p><strong>Case presentation: </strong>Three clinical cases were described in accordance with the Preferred Reporting Items for Case Reports in Endodontics (PRICE) 2020 guidelines. The cases presented adverse prognostic conditions, including substantial root resorption, inability to achieve apical patency or complete canal instrumentation, overextension of root filling material, absence of a definitive coronal restoration, and lack of recommended periodontal treatment. Despite these conditions, the teeth remained functional and asymptomatic and demonstrated favorable radiographic outcomes during longitudinal follow-up.</p><p><strong>Conclusions: </strong>These cases illustrate that unfavorable prognostic conditions do not invariably result in treatment failure. The reported outcomes neither diminish the importance of established prognostic factors nor validate the treatment limitations encountered. Rather, they emphasize that prognosis is probabilistic and that unusual favorable outcomes should be interpreted cautiously as individual observations.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative in vitro evaluation of sonic, passive ultrasonic, and Er: YAG laser-activated irrigation on Enterococcus faecalis reduction and smear layer/debris removal in root canals.","authors":"Rehab Ali Farag, Abd El Rahman O El Mekkawi, Khaled Beshr, Mohamed Sayed, Mohammad Rayyan","doi":"10.1186/s12903-026-09514-w","DOIUrl":"10.1186/s12903-026-09514-w","url":null,"abstract":"<p><strong>Background: </strong>Persistent intraradicular infection remains a major cause of endodontic treatment failure because conventional syringe irrigation may not adequately reach the apical third, dentinal tubules, and canal irregularities. The aim of this in vitro study was to compare the antimicrobial efficacy and smear layer/debris removal ability of sonic activation, passive ultrasonic irrigation, and Er: YAG laser-activated irrigation using photon-induced photoacoustic streaming (PIPS), relative to conventional syringe irrigation, in prepared root canals infected with a mono-species Enterococcus faecalis biofilm.</p><p><strong>Methods: </strong>Sixty extracted single-rooted mandibular second premolars were prepared, sterilized, inoculated with E. faecalis, and randomly allocated to conventional syringe irrigation, sonic activation, passive ultrasonic irrigation, or Er: YAG/PIPS activation (n = 15). All groups received 2.5% sodium hypochlorite. Post-irrigation bacterial load was quantified as log10 CFU/mL, and smear layer/debris removal in the apical, middle, and coronal thirds was assessed by scanning electron microscopy using a five-point score. CFU values were analysed by one-way ANOVA with Tukey's post hoc test, and SEM scores by the Kruskal-Wallis test with Dunn's multiple-comparison test. Inter-examiner agreement was assessed using Cohen's kappa. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Bacterial load differed significantly among groups (F(3, 56) = 85.11, p < 0.001). Mean log10 CFU/mL values were 6.41 ± 0.30 for conventional irrigation, 5.37 ± 0.26 for sonic activation, 4.12 ± 0.24 for passive ultrasonic irrigation, and 4.28 ± 0.27 for Er: YAG/PIPS activation. Passive ultrasonic and Er: YAG/PIPS activation produced significantly lower bacterial loads than sonic activation and conventional irrigation, with no significant difference between the ultrasonic and laser groups (p = 0.452). SEM scores also differed significantly (H = 38.9, p < 0.001). Overall median scores were 4.5 (IQR 4-5), 3 (IQR 3-4), and 2 (IQR 2-3) for conventional, sonic, and both ultrasonic and laser activation, respectively.</p><p><strong>Conclusions: </strong>All tested activation methods improved root canal disinfection and smear layer/debris removal compared with conventional syringe irrigation. Passive ultrasonic irrigation and Er: YAG/PIPS activation were more effective than sonic activation and showed comparable performance. These methods may be useful adjuncts to sodium hypochlorite irrigation, although clinical studies are needed to confirm their clinical effectiveness.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Root canal morphometric indices of anterior teeth and their association with chronological age: a retrospective CBCT study in an Iranian population.","authors":"Nazanin Zargar, Arefeh Shamsi, Yaser Safi, Alireza Akbarzadeh Baghban, Asal Fetrati, Payam Paymanpour","doi":"10.1186/s12903-026-09866-3","DOIUrl":"10.1186/s12903-026-09866-3","url":null,"abstract":"<p><strong>Background: </strong>This study examined the associations between root canal morphometric indices of anterior teeth and chronological age and evaluated their apparent model fit for age association analysis in an Iranian population using cone-beam computed tomography (CBCT).</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, 1,200 intact anterior teeth from 100 patients were analyzed using CBCT images. Although each patient contributed 12 anterior teeth, regression analyses were performed separately for each tooth type. Participants were evenly distributed across five predefined age strata (15-24, 25-34, 35-44, 45-54, and ≥ 55 years), while age was treated as a continuous variable in all analyses. Measurements included length ratio (LR), buccolingual and mesiodistal width ratios (WR), and canal shape ratio (CSR), obtained using OnDemand3D™ software. Multiple linear regression was used to assess age associations and construct exploratory age‑estimation models, while logistic regression was used for exploratory sex‑prediction analyses.</p><p><strong>Results: </strong>The sample comprised 69% females and 31% males, with a mean age of 39.65 ± 14.58 years. Several morphometric indices showed tooth‑ and level‑specific associations with age. Buccolingual WR at the cementoenamel junction (CEJ) demonstrated the most frequent association. CSR showed significant negative associations with age in maxillary and mandibular central incisors and mandibular lateral incisors. LR showed only limited association with age. Sex demonstrated limited and inconsistent relationships. The maxillary right central incisor showed the strongest apparent model fit (R² = 0.465), with buccolingual WR at the CEJ as the most influential morphometric index across models.</p><p><strong>Conclusion: </strong>Root canal morphometric indices exhibit tooth-specific associations with chronological age in this population. Central incisors and mandibular lateral incisors demonstrated the most consistent age-related associations, and buccolingual WR at the CEJ showed the most frequent association with age. Tooth‑specific variability in model fit suggests that morphometric behavior, rather than methodological factors, drives the strength of age‑related associations. These findings represent exploratory age‑estimation patterns.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}