Background: Surgical excision of salivary gland (SG) tumors frequently results in glandular tissue loss and long-term functional impairment. Human dental pulp stem cells (hDPSCs) and their derived Exosomes (hDPSCs-Exos) have emerged as promising regenerative strategies. Therefore, the present study aimed to compare the regenerative capacity of hDPSCs versus their Exos on surgically induced defects in rats' submandibular SGs.
Methods: Seventy-two male Sprague Dawley rats were randomly assigned to four groups (n=18). Group I (negative control): no surgical intervention. The remaining rats underwent a circular defect preparation on the right submandibular SG, then the dissected areas were injected circumferentially with different treatments according to group assignment. Group II (positive control): 1ml phosphate buffered saline (PBS). Group III (hDPSCs group): 1×105 hDPSCs suspended in 1ml PBS, and group IV (hDPSCs-Exos): hDPSCs-Exos (20µg/ml) suspended in 1 ml PBS. Six rats from each group were euthanized at 3, 7, and 14 days postoperatively. Histological evaluation, immunohistochemical analysis (IHC) of Collagen-I (COL-I), and quantitative real time polymerase chain reaction (qRT-PCR) for aquaporin-5 (Aqua-5) gene expression were performed, followed by relevant statistical analyses.
Results: The positive control group showed marked acinar disorganization and fibrosis. The hDPSCs-treated group demonstrated partial regeneration, whereas the exosome-treated group showed near-normal architecture by day 14. Statistical analysis showed significant differences between groups as COL-I expression decreased significantly over time, with the lowest levels in the exosome group indicating tissue regeneration without fibrosis. Aqua-5 expression increased significantly, showing superior molecular restoration in the exosome group approaching negative control baselines by day 14 that raises hope toward functional recovery followed by hDPSCs and finally positive control groups.
Conclusions: Both hDPSCs and their exosomes promote regeneration of surgically injured submandibular glands. The exosomes-treated group demonstrated superior structural and molecular recovery approaching normal architecture, supporting their potentiality as a safer and effective cell-free regenerative therapy.
Background: Peri-implant diseases are among the most clinically significant biological complications of implant therapy, yet the relative contribution of patient- and implant-related factors to their development remains incompletely understood. This retrospective study examined the associations between demographic, clinical, and implant-related variables and peri-implant disease status in a large clinical cohort.
Methods: A total of 199 patients with 968 dental implants placed between January 2015 and January 2023 were evaluated. Variables recorded included demographic characteristics, systemic conditions, smoking status, oral hygiene habits, implant-related parameters, clinical indices (plaque index, gingival index, probing depth, attached gingiva width, and gingival thickness), and radiographic marginal bone loss. Peri-implant disease status - classified as peri-implant health, peri-implant mucositis, or peri-implantitis according to the 2017 World Workshop criteria - was the primary outcome. Multivariable generalized estimating equations (GEE) models were applied to account for the clustering of multiple implants per patient.
Results: Of the 968 implants, 713 (73.6%) were classified as peri-implant health, 173 (17.9%) as peri-implant mucositis, and 82 (8.5%) as peri-implantitis. In multivariable GEE analysis, smoking ≥ 10 cigarettes/day (OR = 2.55, 95% CI: 1.07-6.10 for mucositis; OR = 4.40, 95% CI: 1.60-12.08 for peri-implantitis), inadequate tooth brushing (OR = 4.65, 95% CI: 1.99-10.86; OR = 5.90, 95% CI: 2.21-15.77), and thin gingival phenotype (OR = 4.22, 95% CI: 2.09-8.51; OR = 15.64, 95% CI: 6.08-40.23) were independently associated with both conditions. Longer implant functional duration was additionally associated with peri-implantitis (OR = 1.57, 95% CI: 1.30-1.90; p < 0.001).
Conclusion: Within the limitations of this retrospective study, smoking, inadequate oral hygiene, thin gingival phenotype, and longer implant functional duration were independently associated with peri-implant diseases. These findings suggest that peri-implant soft tissue assessment and patient-level risk assessment should be integral components of long-term implant maintenance protocols.
Background: Virtual surgical planning (VSP) and custom-made plates (patient-specific implants, PSIs) are increasingly used in mandibular fracture repair, but quantitative data on plan-execution fidelity remain limited. Plan-execution fidelity refers to the geometric agreement between the virtually planned and postoperative mandibular morphology after image registration. The aim of this pilot study was to quantify plan-execution fidelity and to describe patient-reported recovery in a fully digital, custom-plate workflow for non-comminuted mandibular fractures, while generating hypotheses about plate design.
Methods: Six patients with non-comminuted mandibular body or parasymphyseal fractures underwent open reduction and internal fixation (ORIF) using a fully digital workflow. Plan-execution fidelity (the primary feasibility outcome) was assessed as the mean absolute error (MAE) of 10 predefined measurements after iterative closest point (ICP) registration on the contralateral ramus and condyle (condylar metrics excluded a priori). Measurements were performed by three blinded observers. The Oral Health Impact Profile-14 (OHIP-14) was recorded preoperatively and at 1, 4, and 12 weeks. Analyses are purely descriptive; no inferential statistics are reported.
Results: In this six-patient cohort, the primary (patient-level) MAE ranged from 0.25 to 0.81 mm (mean 0.48 mm, SD 0.21 mm). At the level of individual measurements (60 readings from the same six patients), the MAE was 0.45 mm. OHIP-14 total scores improved from 48.2 (SD 5.6) preoperatively to 5.2 (SD 4.1) at 12 weeks. Plate design, indication, and chronological order were structurally confounded; therefore, no comparative interpretation is possible.
Conclusions: In this pilot cohort, a fully digital workflow using custom-made plates was associated with submillimetre plan-execution deviation (mean 0.48 mm) within the registration framework used. The workflow was technically feasible and showed close correspondence between the virtual plan and postoperative morphology, although this geometric agreement should not be interpreted as independent anatomical accuracy. These preliminary findings provide a basis for future controlled studies aimed at validating clinical relevance, workflow efficiency, and cost-effectiveness in larger patient cohorts.
Trial registration: ClinicalTrials.gov NCT07499726; registered 24 March 2026 (2026-03-24), retrospectively, after initiation of recruitment.
Objective: Three-dimensional (3D) printing technologies are increasingly used in the fabrication of space maintainers in pediatric dentistry. However, studies on improving the properties of space maintainer materials produced by digital methods remain limited. The aim of this study was to evaluate the potential of a 3D printing resin modified with glass ionomer cement powders as a new-generation composite space maintainer material for pediatric dentistry in terms of mechanical properties. This study addresses the question of whether a 3D printing resin modified with glass ionomer cement powders can serve as a new-generation space maintainer material with favorable mechanical properties.
Materials and methods: Two different glass ionomer cement powders as fluoride sources were added to a 3D printing resin at different concentrations, and four experimental groups were formed. Unmodified resin was used as the control group, while acrylic was used as the clinical reference group. Mechanical properties of the composite space maintainers were assessed using three-point bending and tensile tests.
Results: Groups with lower filler levels generally exhibited a more balanced mechanical performance. In the tensile analysis, filler type had a significant effect on maximum stress (p = 0.0135), while filler level had a significant effect on maximum stress (p < 0.0001), maximum strain (p = 0.0191), and elastic modulus (p < 0.0001). Low-level filler groups showed mechanical behavior closer to that of the acrylic reference material.
Conclusion: The addition of glass ionomer powder altered the mechanical behavior depending on the filler ratio. Low filler levels provided better preservation of mechanical properties. Although these materials show potential as new-generation space maintainers in pediatric dentistry, further in vitro and in vivo studies are required to confirm their clinical applicability.
Background: Dental radiographs are a primary modality for human identification in disaster victim identification, when fingerprint and visual recognition are not feasible. As antemortem (AM) databases grow, exhaustive AM-postmortem (PM) comparisons by expert visual inspection scale poorly to large reference databases. An automated method that pre-screens an AM database into a ranked shortlist of candidates for expert verification would address this bottleneck.
Methods: The framework integrates a Detection Transformer (DETR) with a Circle Loss objective. DETR detects individual teeth and outputs 256-dimensional embeddings from the detection queries. Circle Loss then optimizes these embeddings to minimize same-individual pair distances and maximize different-individual pair distances. Evaluated on 1,029 individuals with paired AM-PM DPRs, identification performance was assessed by deriving the retrieval indices including Rank-K accuracy, mean average precision (mAP), and normalized discounted cumulative gain (nDCG). This detection-based approach was benchmarked against representative convolutional neural network (CNN)-based detectors, including Faster Region-based CNN (Faster R-CNN), RetinaNet, and You Only Look Once (YOLOv9), as well as image-level representations that bypass tooth localization.
Results: The framework achieved 65.4% Rank-1 and 87.4% Rank-10 accuracy, 72.8% mAP, and 75.3% nDCG, consistently outperforming CNN-based detection architectures. Detection-based structural representations improved Rank-1 accuracy by 44.4% over image-level counterparts, with embeddings capturing fine-grained anatomical details such as root curvature and arch configuration.
Conclusions: The proposed detection-based metric learning framework provides a practical pre-screening tool that compresses exhaustive AM-PM database comparisons into a ranked shortlist of candidates for forensic expert verification. The system is intended to operate upstream of expert verification rather than to replace in disaster victim identification and missing person investigations.
Background: Burning Mouth Syndrome (BMS) is a chronic orofacial pain disorder characterized by a burning or dyesthetic sensation in the oral mucosa in the absence of identifiable clinical or laboratory abnormalities, predominantly observed in postmenopausal women. Despite its prevalence, the underlying causes remain poorly understood. This systematic review aims to synthesize current evidence on factors associated with BMS to inform future research and clinical management.
Methods: A comprehensive literature search was conducted across PubMed, Web of Science, and Embase databases to identify relevant studies published between January 2000 and June 2025. After removing 108 duplicates from an initial pool of 688 records, 22 studies met the inclusion criteria. Eligible designs included cross-sectional, case-control, cohort, and descriptive studies involving individuals diagnosed with BMS. Methodological quality was assessed using the Newcastle-Ottawa Scale.
Results: BMS was consistently associated with female sex, menopause, hypothyroidism, chronic medication use, and sociodemographic factors such as older age, marital status, unemployment, and lower educational attainment. Some studies found no significant correlations between BMS and salivary biomarkers such as protein, opiorphin, Candida species, or diabetes, while the role of progesterone remains inconsistent across studies. Additional contributing factors included chronic pelvic pain, heightened pain sensitivity, depression, anxiety, stressful life events, poor sleep quality, diminished quality of life, and oral health issues such as denture use, xerostomia, periodontitis, dental procedures, and parafunctional habits. Lifestyle factors particularly smoking, alcohol consumption, and intake of acidic, spicy, or strong-flavored foods were reported to exacerbate BMS symptoms.
Conclusion: The findings highlight the multifactorial nature of BMS and identify vulnerable populations at increased risk. While numerous associations have been documented, no single etiological factor can be definitively implicated, underscoring the complexity of BMS pathogenesis and the need for interdisciplinary approaches in diagnosis and management.
Purpose: This in vitro study evaluated the effects of occlusal thickness and thermocycling on the fracture resistance and color stability of monolithic CAD/CAM crown materials.
Materials and methods: Standardized full-coverage crowns were fabricated from four CAD/CAM materials: resin nano-ceramic (CM), extra-translucent zirconia (VXT), translucent zirconia (VT), and zirconia-reinforced lithium silicate (VS). Two occlusal thicknesses (1.0 mm and 1.5 mm) were designed. Specimens from each material-thickness combination were divided into non-aged and thermocycled subgroups (n = 10 each). The thermocycled subgroups were subjected to 10,000 cycles between 5 °C and 55 °C. Fracture resistance was measured using a universal testing machine. Color measurements (L*, a*, b*) were obtained using a spectrophotometer before and after thermocycling, and color differences (ΔE₀₀) were calculated. Data were analyzed using two-way and three-way ANOVA with post hoc Tukey tests (α = 0.05).
Results: Material type (P < .001; ηp² = 0.52) and occlusal thickness (P = .003; ηp² = 0.11) had significant effects on fracture resistance. Increasing occlusal thickness resulted in higher fracture resistance values across all tested materials. VXT demonstrated the highest fracture resistance, whereas VS exhibited the lowest values. Thermocycling did not have a significant main effect on fracture resistance (P = .178; ηp² = 0.02). Color differences (ΔE₀₀) varied significantly among materials (P < .05); however, all values remained below the clinically acceptable threshold.
Conclusions: Occlusal thickness and material type significantly influence the mechanical performance of monolithic CAD/CAM crowns. Although thermocycling had a limited effect on fracture resistance, all materials maintained clinically acceptable color stability. These findings support the use of reduced-thickness restorations with appropriate material selection.
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