Platelet-rich fibrin (PRF), a second-generation platelet concentrate, accelerates soft and hard tissue regeneration. Chorion membrane, of fetal origin, has wound-modulating properties. This study aimed to evaluate and compare the clinical outcomes of PRF and chorion membrane in treating isolated Miller's class I or II gingival recession defects. Fifty recession defects in 50 patients were randomly treated with a coronally advanced flap (CAF) and PRF membrane (site A, n = 25) or CAF with chorion membrane (site B, n = 25). Clinical parameters recorded at baseline, 1, 3, and 6months included recession depth (RD), recession width (RW), clinical attachment level (CAL), width of keratinized gingiva (WKG), plaque index (PI), gingival index (GI), and gingival biotype. Statistical analysis compared outcomes across follow-up intervals. At 6months, both groups demonstrated significant improvements in RD, RW, CAL, WKG, PI, and GI compared with baseline. Mean percentage root coverage was 86.76 ± 13.76 in the PRF group and 82.89 ± 15.65 in the chorion group, with no statistically significant difference between them. Sites with an initial thin biotype showed conversion to thick biotype in both groups. Both PRF and chorion membrane demonstrated predictable effectiveness for managing isolated recession defects, with comparable outcomes. Longitudinal studies are needed to confirm these findings. TRIAL REGISTRATION: (Clinical trial number- NCT07308405).

Relevance. Investigation of the effects of systemic interventions on the mineralization of dental hard tissues represents a promising direction in preventive pediatric dentistry. In contrast to topical remineralizing agents, whose effectiveness has been demonstrated in numerous clinical studies, the role of systemic preventive approaches, including dietary supplementation, in reducing dental caries in children remains insufficiently studied and requires further clinical validation. Objective. To evaluate the clinical and diagnostic effectiveness of the dietary supplement Cigapan in improving the condition of dental hard tissues and periodontal tissues in children. Materials and methods. The study included 60 children aged 8–17 years (mean age, 12 years). Participants were stratified into two groups according to caries experience: Group 1 (n = 30), children with low to moderate caries experience (DMFT < 4.5), and Group 2 (n = 30), children with high to very high caries experience (DMFT > 4.5). Dental status assessment involved evaluation of permanent teeth using the Simplified Oral Hygiene Index (OHI-S), the DMFT index, the enamel acid resistance test (TER test), and the International Caries Detection and Assessment System (ICDAS II). The degree of demineralization of initial enamel lesions in permanent teeth was measured by laser fluorescence using the DIAGNOdent Pen 2190 (Germany). Periodontal tissue status was assessed using the Papillary–Marginal–Attached (PMA) index and the Sulcus Bleeding Index (SBI). To evaluate the comparative effectiveness of the preventive intervention incorporating Cigapan, changes in dental and periodontal tissue parameters were monitored in both groups over a three-month follow-up period. Results. The results demonstrated a statistically significant reduction in the extent of focal enamel demineralization and in the severity of demineralization of initial enamel lesions in both study groups (p < 0.05). In children with DMFT < 4.5 (Group 1), complete resolution of initial enamel lesions classified as ICDAS II code 1 was observed. The prevalence of ICDAS II code 2 lesions decreased by 78.6%. Laser fluorescence measurements indicated a 67.6% increase in mineralization within affected enamel sites (p < 0.05), confirming the effectiveness of the intervention. In children with high caries activity (Group 2), a statistically significant reduction in ICDAS II code 1 lesions was also recorded, with a decrease of 76.9% (p < 0.05). According to DIAGNOdent Pen 2190 measurements, mineralization levels in demineralized enamel areas increased by 72.4% compared with baseline values (p < 0.05). A reduction in ICDAS II code 2 lesions was likewise observed (26%), accompanied by a 53.9% increase in enamel mineralization as assessed by laser fluorescence; all observed differences were statistically significant (p < 0.05). Conclusion. Incorporation of the dietary supplement Cigapan as part of systemic preventive therapy within a comprehensive prevention program led to improvements in oral hygiene and gingival health in children, reduced enamel permeability, increased acid resistance of permanent teeth, a decreased prevalence of early carious lesions, and enhanced mineralization in areas of enamel demineralization.

ABSTRACT In periodontal therapy, successful regeneration of osseous defects necessitates biomaterials capable of overcoming challenges such as infection, inflammation, and impaired intrinsic osteogenic capacity within the complex oral environment. Herein, we introduce a biointerface membrane engineered to precisely manipulate cellular activities and coordinate healing events at the soft–hard tissue interface. The membrane fabricated through mixed and co‐axial electrospinning techniques comprises two distinct layers: an antibacterial (Ab) layer (near gingival) laden with controlled‐release chlorhexidine‐conjugated nanogels (nGel‐CHX), and an osteoinductive (OI) layer (near defect) incorporating nanoneedle‐shaped magnesium (Mg) oxychloride ceramic colloids (MOC NN). Upon implantation, ingrowth barrier to pathogenic bacteria and rapidly growing soft tissues is retained at the gingival–Ab layer interface. Concurrently, a pro‐healing osteoimmune niche is established at the OI layer–defect interface, promoting in situ osteogenesis and new bone ingrowth. In a rat periodontal defect model, the biointerface membrane presents remarkably optimized regenerative performance compared to the clinically utilized Bio‐Gide membrane. Histological, immunohistochemical, immunofluorescence, and micro‐CT analysis reveal the enhanced macrophage M2 polarization, notably elevated osteogenic activity, and accelerated formation of new bone with functional periodontal ligament structure. Collectively, these findings render this biointerface membrane as a promising candidate for effective periodontal defect repair in clinical applications.

Background/Objectives: Geometric morphometric analysis (GMA) is a statistical method that captures and quantifies shape variation. This study aimed to assess hard and soft tissue shape variations and changes following orthodontic treatment in Class III skeletal malocclusion using GMA. Methods: A retrospective study was conducted on 84 lateral cephalometric radiographs (pre-treatment and near-end treatment) of Class III patients aged 16–40 years (ANB < 2°). Thirty-five landmarks were digitized in Cartesian coordinates using MorphoJ software for shape analysis. Results: The sample included 62% females and 38% males, with a mean age of 24.7 ± 5.2 years. Vertical dimension variations (hypodivergent to hyperdivergent) contributed most to shape changes PC1 (23.35%), followed by anteroposterior variations PC2 (13.51%). Gender significantly influenced hard and soft tissue variation with 30.91%SS (F = 56.99, p < 0.0001). Males had significantly larger and longer ramus, body of the mandible, alveolar height, LAFH, TAFH and upper lip length. (PD: 0.026, p < 0.05). Significant shape changes were seen in the mandible (PD = 0.018, p < 0.05). SNB increased by 0.41° (from 81.73° ± 3.67°), and ANB improved by 0.46° but remained Class III (−0.33° ± 1.82°). Lower anterior facial height increased by 1.78 mm (p < 0.05). The lower incisors retroclined significantly (from 92° ± 8.56° to 87° ± 6.96°, p < 0.05), while the interincisal angle increased by 5.9°. Upper incisors remained procline (118° ± 11°, p > 0.05). Upper lip length increased by 0.4 mm (p < 0.05). Conclusions: Vertical and anteroposterior shape variations are notable within Class III malocclusion. Post-treatment changes in both hard and soft tissues indicate that orthodontic camouflage can enhance facial esthetics and skeletal balance. GMA provides objective quantification and visualization of these treatment-related craniofacial changes.

To evaluate the shaping ability, debris removal efficiency and morphological alterations induced by the SAF Infinitum system during progressive instrumentation of flat-shaped root canals of mandibular incisors. Twelve extracted mandibular incisors with flat-shaped canals were selected using micro-CT and instrumented with 1.5-mm Self-Adjusting File (SAF) Infinitum instruments under continuous NaOCl-HEDP irrigation for 2, 4 and 6 min. Micro-CT scans were performed before and after each step to evaluate changes in canal volume, surface area, debris removal, unprepared canal walls and dentine thickness. Following the preparation procedures, all instruments were examined under a microscope for defects.Data were analysed using GLM for repeated measures and the Related-Samples Friedman test (α = 0.05). Root canal preparation with the SAF Infinitum significantly increased canal volume and surface area (p = 0.000), while progressively reducing unprepared canal wall areas and hard tissue debris (p = 0.000). Unprepared surfaces decreased by 77.8% and debris volume by 77.2% from 2 to 6 min, with improved cleaning efficiency over time. Dentine thickness also declined significantly (p < 0.001), particularly on the lingual surface at the pericervical area and the mesial surface at midroot. Buccolingual walls consistently remained above 1.0 mm, whereas only two mesiodistal cross-sections at the midroot level exhibited dentine thickness below 0.5 mm. After 6 min, all instruments showed structural deformations, and one specimen exhibited a minor intracanal fragment. This is the first study to evaluate the progressive, time-dependent effects of the SAF Infinitum system in challenging flat-shaped root canals. The system exhibited a time-dependent shaping effect, with most morphological changes occurring within the first 2 min, followed by continued, although more gradual, improvements up to 6 min. Cleaning efficacy increased steadily over time, while remaining dentine thickness generally stayed above critical safety thresholds. All instruments showed structural deformations after 6-min preparation.

To combine quantitative measures of gingival thickness (GT), keratinized tissue width (KTW), and alveolar buccal bone thickness (ABT) for developing a novel classification of periodontal phenotype through a clustering analysis, using two digital images. This cross-sectional study comprised 180 subjects with a total of 1080 maxillary anterior teeth. GT and ABT were assessed utilizing superimposed Cone Beam Computed Tomography (CBCT) and intraoral scan data, while KTW was obtained from intraoral images employing a correction factor. Hierarchical cluster analysis (HCA) was conducted to discern phenotypic categories. Cutoff values for GT, KTW, and ABT were derived from cluster boundaries to provide a clinically applicable scoring system. Cluster analysis identified four statistically significant phenotypic groupings (p < 0.001). Only 48.9% of instances accounted for conventional "thin" or "thick" phenotypes, while 51.1% exhibited mixed characteristics. Cutoff values were established as GT = 0.85mm, KTW = 3.0mm, and ABT = 1.0mm. Based on these cutoffs, a scoring system (0-3) was developed to classify individuals as fully thin, majority-thin (gingival thin/ bone thick)" and "majority-thick (gingival thick/ bone thin), or fully thick. This system demonstrated good internal consistency, with moderate to high coefficients of determination (R²) across parameters. This study presents a comprehensive, data-driven classification of periodontal phenotype using quantitative evaluations of GT, KTW, and ABT, providing an innovative viewpoint on phenotype-based diagnostics. The proposed system offers a clinically relevant framework for phenotype-based diagnostics, risk evaluation, and individualized treatment planning. By combining soft (GT, KTW) and hard (ABT) tissue parameters with 3D imaging and clustering analysis, this classification provides clinicians with a practical and quantitative tool for assessing periodontal phenotype, thereby supporting accurate diagnosis and evidence-based decision-making across multiple dental disciplines.

Dentin, the main component of dental hard tissues, is produced by differentiated odontoblasts. How odontoblast differentiation is regulated remains understudied. Here, we screen that the expression of membrane-associated RING finger protein 2 (March2) is the highest among all March family members, with an increasing trend during odontoblast differentiation. In mouse incisors and molars, MARCH2 is moderately expressed in the undifferentiated dental papilla cells and strongly expressed in the odontoblasts. Knockdown and overexpression experiments demonstrate that MARCH2 inhibits odontoblastic differentiation of mouse dental papilla cells (mDPCs). Additionally, both March2 deficient mice and mice with odontoblast specific knockdown of March2 exhibit the phenotype of increased dentin thickness, accelerated dentin deposition as well as elevated expression levels of odontoblast markers compared with control littermates. Therefore, MARCH2 plays an inhibitory role in odontoblast differentiation. Mechanistically, MARCH2 interacts with protein tyrosine phosphatase receptor delta (PTPRD) and facilitates its K27-linked polyubiquitination and subsequent degradation, which is dependent on the ligase activity of MARCH2. The presence of MARCH2 promotes the translocation of PTPRD from the cell membrane to the lysosome, thereby enhancing its degradation via the lysosomal pathway. Further experiments show that knockdown of endogenous Ptprd impairs odontoblastic differentiation of mDPCs. Ptprd and March2 double knockdown in mDPCs apparently reversed the enhanced odontoblastic differentiation by knockdown of March2 alone, indicating that MARCH2 inhibits odontoblastic differentiation by promoting PTPRD degradation. This study unveils a novel mechanism where an E3 ubiquitin ligase regulates odontoblast differentiation through post-translational modification of a membrane protein, highlighting a promising direction for future exploration.

The aim of this novel study was to assess the effects of e-PRF (Extended PRF) along with xenograft and xenograft alone around the immediate implant in the aesthetic zone of stage III and stage IV periodontitis. The present study included Sixteen patients undergoing immediate dental implant placement in the anterior aesthetic region. Eight sites in each group were randomly assigned to either Group-I (e-PRF and xenograft around the immediate implant) or the Group-II (xenograft alone). The primary objective was the volumetric bone analysis, and the secondary objectives were to assess the wound healing index (WHI), probing depth, and Tissue biotype. Patients were evaluated at baseline, 3 months, 6 months, and 9 months for assessing WHI, probing depth, and Tissue biotype and at baseline, 9 months for volumetric bone analysis through CBCT. Group 1 showed significant improvement in pocket probing depth, tissue biotype, and bone volume compared to Group 2 which showed minimal changes in probing depth, tissue biotype, and bone volume. The combination of e-PRF and xenograft around immediate implants in the aesthetic zone showed favourable outcomes in preserving hard and soft tissues, enhancing bone volume, and promoting wound healing. Hence e-PRF appears to be a valuable promising adjunct in immediate implant placement.

The purpose of this prospective 12-year long-term follow-up of a randomized clinical trial was to evaluate clinical and radiographic outcomes of two implants placed using either an immediate loading (IL) or delayed loading (DL) protocol to support a non-splinted, locator-retained mandibular overdenture. Twelve eligible patients were enrolled, with six in the IL group and six in the DL group. Clinical and standardized radiographic examinations were conducted to assess implant survival, and peri-implant hard and soft tissue health. Patient-reported outcomes (PROs) were collected, and the incidence and nature of prosthetic complications documented. The data for 5-year follow up of the RCT is reported in a previous publication. No statistically significant difference in radiographic bone levels (∆RBL) was observed between IL and DL groups during the 5-12 year or 0-12-year intervals. One implant was lost in the DL group between the 5-12-year period, resulting in a cumulative implant survival rate (CSR) of 96% for DL and 100% for IL at 12 years. At the 12-year follow-up, no significant differences were observed between IL and DL groups with respect to clinical outcomes such as probing depths (PPD), plaque score (PS), keratinized tissue width (KTW) and apical migration of the free gingival margin (GM). PROs related to patient comfort and satisfaction were similar in IL and DL groups. Major prosthetic complications occurred in 50% of patients, while 92% experienced at least one minor prosthetic issue. A temporal trend of increase in radiographic bone loss, decrease in KTW, and increase in GM from baseline to 12 years was noted in both IL and DL groups. Both immediate and delayed loading protocols demonstrated comparable long-term patient comfort, patient satisfaction, clinical and radiographic performance when applied to two non-splinted, locator-retained implants supporting a mandibular overdenture. Within the limitations of the present investigation, immediate loading may represent a reliable and potentially favorable treatment approach for mandibular overdentures in appropriately selected cases. Significant prosthetic complications were noted in both groups, which highlights the importance of regular recall and prosthetic maintenance for long-term success.

The abrasiveness of toothpastes is one of the key para­meters that determine their clinical efficacy and safety. The relative dentin abrasivity (RDA) is used in world dentistry to quantitatively assess the intensity of the abrasive effect of toothpastes on dentin. The article summarizes data on the upper safety threshold of RDA, modern methods for its measurement, international standards (ISO 11609, ADA acceptance program), the chemical nature of abrasive components, as well as the results of experimental and clinical studies on the relationship between abrasiveness and clea­ning efficacy. The features of the influence of low and high abrasiveness on tooth cleaning, the role of oral cavity condition and eating habits in the formation of tooth wear, as well as the relationship between the risk of abrasive wear and the harm of poor oral hygiene are considered. Separately, modern abrasive systems (silicate, carbonate, phosphate, polymer, bicarbonate, biomineral and high-hardness oxide) and the classification of abrasives by mechanism of action are analyzed. Examples of the main active complexes included in toothpastes with different RDA ranges are given, and practical recommendations for their rational use from the standpoint of evidence-based dentistry are formulated.

Oral and maxillofacial diseases are often accompanied by tissue defects and damages, which are difficult to repair and affect patients both physically and psychologically as well as daily life. Recent 5 years studies have proved that stem cell-derived exosomes possess a broad clinical application in regenerative dentistry by promoting hard and soft tissue regeneration, angiogenesis, nerve repair, and wound healing, inhibiting inflammation and apoptosis, and modulating immune responses. The purpose of this review is to sum up the current state of research on stem cell-derived exosomes in periodontal regeneration and to discuss the current challenges and future directions. This review article was conducted using electronic databases such as PubMed and Web of Science. The search included studies published up until January 1, 2025. Stem cell-derived exosomes are a kind of membrane vesicles that encapsulate proteins, RNAs, and other substances, which are one of the important strategies for tissue regeneration and repair. Stem cell-derived exosomes play an important role in the field of periodontal regeneration, including dental pulp, periodontium, jawbone, temporomandibular joint, maxillofacial soft tissue, and nerve. Mechanistically, stem cell-derived exosomes alleviate oral and maxillofacial diseases by promoting tissue regeneration, osteogenesis, odontogenesis, angiogenesis, axonal regeneration, and suppressing inflammation. Stem cell-derived exosomes may serve as a potential therapeutic strategy for oral and maxillofacial diseases.

Advancements in three-dimensional (3D) printing have introduced innovative tools for medical and dental education. In dental surgery, 3D-printed simulation models offer valuable presurgical training. This review explores the scope, study types, key findings, limitations, and future research needs to enhance their application in dental education. A comprehensive literature search was conducted across seven major health and education databases for studies published up to June 2025. A structured search strategy was developed using a combination of MeSH terms and keywords related to dental and oral surgical procedures, educational interventions, and 3D printing. Two reviewers independently screened and evaluated the retrieved articles. Studies were included if they investigated the use of 3D-printed models as hands-on simulation tools for intraoral surgery education. Only peer-reviewed articles published in English were considered. A total of 3686 studies were identified, 34 of which met the inclusion criteria after screening. These studies, largely published within the past decade, evaluated the use of 3D-printed models as training tools across five core areas of intraoral surgery, with the greatest focus on minor oral surgery (32%) and maxillofacial related procedures: orthognathic procedures (26%), followed by cleft palate surgery (15%), implant surgery (15%), and periodontal interventions (12%). Various printers and materials were employed, with an emphasis on model fabrication and evaluation through trainee feedback. The models were widely accepted by trainees, who reported improved technical skills, increased confidence, and reduced procedure time. However, challenges remain, particularly the need for advanced soft tissue-replicating material to enhance anatomical realism. 3D-printed models are effective tools for pre-operative planning and hands-on training in oral surgery. Future research should focus on developing cost-efficient printing technologies and advanced materials to better replicate hard and soft tissues in these models. Furthermore, well-designed studies are needed to support changes to implementation into current curricula and enhance the delivery of surgical education.

Nanostructural evolution during carious and demineralisation process of human dentine using small angle X-ray scattering tensor tomography.

Three-dimensionally printed, noninvasive restorations in the treatment of localized tooth wear using the Dahl approach: A preliminary clinical trial.

Diopside/sodium-substituted hydroxyapatite composite for hard tissue engineering: Preparation, characterisation, in vitro biomineralisation, mechanical stability, degradation behaviour and biological assessment

Collagen-polyurethane-maltodextrin hydrogels as bioactive scaffolds for soft and hard tissue regeneration, immunomodulation, and drug delivery.

TiTaMo medium entropy alloys with synergistic biomechanical properties for long term implantation.

Fused filament fabrication manufactured biological scaffolds: An investigation of mechanical properties by using the Taguchi method and machine learning techniques.

Changes in residual limb volume and shape pose significant challenges in achieving and maintaining an accurate and comfortable fit for prosthetic socket. While numerous techniques for measuring residual limb volume have been proposed, their clinical application remains limited by insufficient resolution and the inability to perform in-socket measurements. To address this issue, this study develops a novel method for predicting residual limb soft tissue deformation to guide prosthetic socket design. A three-dimensional (3D) finite element (FE) model of the human thigh was developed to simulate the soft tissue deformation during daily activities, driven by muscle contraction to replicate natural biomechanics. The model included hard tissue and muscle components, with the muscle modeled as a structure of evenly distributed, contractile fibers that generate movement. Parameters controlling fiber contraction were iteratively adjusted to best match the calculated tissue deformation and that observed in physical muscle models. The optimized FE model significantly improved the accuracy of predicting dynamic soft tissue deformation, with average errors of 0.83% and 1.86% for tissue expansion and contraction regions, respectively. For various gait patterns, the average differences in equivalent volume and cross-sectional area changes were also less than 0.83% and 1.86%, respectively. The model demonstrated consistent prediction accuracy across different gait data. The fiber-driven soft tissue model developed offers a valuable tool for pre-design simulations of prosthetic sockets and orthoses. It is equally applicable to other wearable devices that interface with the skin, providing a robust framework for improving device design and functionality.

Digital fabrication of obturators with immediate optimized facial support for extensive maxillectomy using the existing maxillary contour.