Dental implants have become a widely accepted solution for replacing missing teeth. Despite their high success rates, postoperative discomfort such as pain, swelling and foreign body sensation is commonly experienced by patients. However, the prediction of such outcomes based on patient characteristics remains underexplored. Develop and validate risk models for patient-reported postoperative symptoms after dental implant surgery. A total of 506 patients who underwent dental implant surgery between January 2024 and December 2024 were included. Postoperative symptoms were assessed using Numerical Rating Scales (NRS) ranging from 0 to 10. Multivariable ordinal logistic regression models were developed to predict the severity of swelling, pain and foreign body sensation based on clinical and demographic factors. Among 506 patients, swelling occurred in 65.6% (47.0% mild; 18.6% moderate-severe), pain in 55.6% (51.4% mild; 4.2% moderate-severe) and foreign-body sensation in 63.1% (53.0% mild; 10.1% moderate-severe). Increased swelling was independently associated with female sex, hypertension, multiple surgical sites, membrane use and 4.8-mm diameter implants. Pain was associated with multiple sites and bone substitute use. Foreign-body sensation decreased with age and increased with multiple sites. Postoperative discomfort is common after dental implant surgery, with significant variability in severity. Identifying key predictors of symptoms can help tailor preoperative counselling and postoperative interventions to improve patient outcomes and satisfaction.

Background & Objectives: Periodontal disease (PD) is a common oral disease that affects the supporting structures of the teeth and is a leading cause of tooth loss worldwide. This study aimed to estimate the prevalence of PD among 9th-grade teachers in the northern West Bank and examine its association with key behavioral and socioeconomic factors. Methods: A cross-sectional study was conducted among 920 teachers selected through proportional stratified random sampling from governmental and private schools. Periodontal health was assessed using the WHO Community Periodontal Index for Treatment Needs (CPITN), and oral hygiene status was measured with the Simplified Oral Hygiene Index (S-OHI). A structured questionnaire was administered to collect data on socioeconomic status, oral hygiene practices, dietary habits, and smoking behaviours. Data was analysed using descriptive statistics, bivariate and multivariate logistic regression. Results: Only 11.8% of participants exhibited completely healthy gingiva, with the mean condition ranging between calculus and shallow pockets. Oral hygiene practices were the strongest predictors of periodontal outcomes: frequent tooth brushing (Adjusted Odds Ratio: AOR = 0.015), morning brushing (AOR = 0.015), and regular toothbrush replacement (AOR = 2.514) were protective. Higher red meat intake was negatively associated with periodontal health (AOR = 0.032), while frequent nut consumption was protective (AOR = 0.227). The number of cigarettes smoked per week was positively associated with PD (AOR = 1.085). Conclusions: PD is highly prevalent among Palestinian adults, with significant behavioural and lifestyle-related determinants. Targeted oral health interventions are urgently needed to improve adults’ oral health.

Sex differences in the association between tooth loss and socioeconomic status: the 8020 Promotion Foundation Study of Japanese Dental Patients.

ObjectiveTo estimate the prevalence of edentulism and functional dentition (FD) in Brazil and assess the magnitude of inequalities among older adults, according to education in 2003, 2010, and 2023.MethodsThis study used repeated cross‐sectional data from individuals aged 65–74 years who participated in the national oral health surveys (SB Brasil) conducted in 2003, 2010, and 2023. Edentulism was defined as the loss of all permanent teeth, and FD as the presence of 21 or more teeth. Educational level was categorized as: 0 (no schooling), 1–4, 5–8, 9–11, and ≥ 12 years of study. Absolute and relative inequalities in edentulism and FD were assessed using the slope index of inequality (SII) and the relative index of inequality (RII) based on education. Generalized linear models (GLMs) were applied with a logarithmic link function to estimate RII and an identity link function to estimate SII, adjusting for sex and age. The concentration index (CI) was calculated as twice the area between the concentration curve and the line of equality. All analyses accounted for the complex sampling design and sample weights.ResultsThe study included 5347 individuals in 2003, 7619 in 2010, and 9745 in 2023. The prevalence of edentulism was 53.33% in 2003 and 53.38% in 2010. In 2023, the prevalence significantly declined to 36.47%. FD prevalence was significantly higher in 2023 (23.94%) compared with 2003 (9.89%) and 2010 (11.45%). A worse oral health status was observed among individuals with lower educational levels. Indicators of absolute and relative inequality showed a significant increase in disparities, confirmed by the CI.ConclusionThere was an increase in inequalities in edentulism and FD, indicating that the reduction in tooth loss was greater among socioeconomically advantaged groups.

Introduction: chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, and owing to its increasing global prevalence, poses a serious public health challenge. Patients with CKD frequently experience protein-energy wasting, frailty, sarcopenia, and cachexia, necessitating complex dietary restrictions, including protein, salt, and potassium limitation. Although a nutrition support team (NST) can improve nutritional status in hospitalised patients, additional interventions such as swallowing evaluation, oral care, and medication adjustments are crucial for effective outcomes. CKD is also strongly correlated with periodontal disease and diabetes: tooth loss and oral frailty exacerbate low nutritional intake, especially in older individuals. Objectives: to examine whether NST intervention combined with dental care would enhance nutritional and oral parameters in hospitalised patients referred for dental treatment. Methods: twenty-seven patients were assigned to either an NST-intervention (n = 10) or non-NST (n = 17) groups. We assessed serum albumin, C-reactive protein (CRP), body mass index (BMI), Subjective Global Assessment scores, remaining teeth, periodontal pocket depth, and bleeding on probing. Results: over a 1-month period, both groups showed significant decline in body weight and BMI, whereas albumin, CRP, and periodontal indices did not substantially change. The NST group demonstrated a higher proportion (50 %) of improved carbohydrate intake than the non-NST group (11 %), but this difference was not statistically significant. Reduced appetite was correlated with meal reduction, decreased body weight and meal reduction, and swallowing difficulties. Conclusions: short-term periodontal or NST interventions are insufficient for achieving significant improvements in CKD-associated malnutrition or periodontal status; therefore, more specialised interventions are needed.

ABSTRACTBackgroundThe articular eminence is essential for the proper functioning of the temporomandibular joint (TMJ), guiding the movement of the mandibular condyle along its posterior slope. Changes in the inclination of the articular eminence (AEI) can occur as a result of tooth loss or aging. The objective of this study was to investigate the association between the AEI and the Eichner Index.Materials and MethodsThe study analyzed 162 cone beam computed tomography (CBCT) images from patients with TMJ dysfunction. These images were categorized into three groups (A, B, and C) according to the Eichner Index. The posterior surface of the AEI was measured using the top‐roof line method. An ANOVA test was conducted to assess the relationship between the Eichner Index and AEI.ResultsA statistically significant relationship has been found between the AEI and the Eichner Index (p = 0.005). Class C had a significantly lower inclination than Classes A and B.ConclusionThis study revealed that tooth loss impacts the AEI, with patients who have more missing teeth exhibiting a significantly flatter AEI. To prevent morphological changes and potential future issues in the TMJ, it is essential to ensure proper dental care and maintain occlusal support for these patients.

The purpose of this study is to develop a deep learning model that can identify the maxillary sinus, posterior superior alveolar artery(PSAA), and alveolar ridge, and evaluate its diagnostic performance. Based on this, relevant parameters for preoperative design of maxillary sinus elevation can be measured to achieve intelligent preoperative design for maxillary posterior tooth implantation surgery. A total of 2400 CBCT slices from patients with maxillary posterior tooth loss was selected as the initial dataset. Anatomical structure annotation and enhanced YOLOv11 architecture were used for model training to achieve segmentation of maxillary sinus, PSAA, and alveolar ridge. Intersection over union (IoU), average precision (AP), average recall (AR) and the Euclidean distance were used to evaluate the accuracy of structure segmentation. On the basis of the segmentation of the three important anatomical structures mentioned above, five anatomical parameters (A1-A5) related to maxillary posterior tooth implantation were set, and their errors were statistically analyzed. The median IoU for maxillary sinus segmentation was 0.945 (IQR: 0.934-0.951, 95%CI: 0.935-0.941), while the median IoU for PSAA segmentation was 0.991 (IQR: 0.982-1.000, 95%CI: 0.948-0.974). The model achieved an average precision of 0.902 ± 0.023 and a recall of 0.937 ± 0.024 for PSAA segmentation. For alveolar crest localization, the mean Euclidean distance errors between predicted and ground-truth landmarks were 0.50 ± 0.31mm and 0.38 ± 0.24mm for the two key points, respectively. 95% of AI prediction errors for A1-A4 were within 1mm, while 95% of AI prediction errors for A5 were within 10 mm2. The enhanced YOLOv11 framework reliably and autonomously identifies critical anatomical structures for maxillary sinus elevation including the maxillary sinus, PSAA, and maxillary alveolar crest in CBCT images. This model enables the acquisition of reliable clinical parameters, demonstrating its potential for future intelligent assisted preoperative evaluation and design of maxillary posterior dental implant surgery.

Ultra-processed foods (UPFs) have become a major component of modern diets and have been linked to adverse health outcomes. However, evidence regarding their association with dental health in adults remains limited. This cross-sectional study analyzed baseline data from 3947 adults (35–75 years old, 57.8% females), enrolled in the Bandare-Kong Non-Communicable Disease (BKNCD) cohort. Dietary intake was assessed using a validated food frequency questionnaire, and UPFs consumption was classified according to the NOVA system. Dental health was evaluated through clinical examinations measuring the number of teeth, missing teeth, decayed teeth, and filled teeth. Structural equation modeling (SEM) was employed to assess the relationships, incorporating age and gender as a potential mediating variables. UPFs intake across tertiles was 14.2, 28.9, and 49.2% of total intake. Age and gender partially mediated the associations between UPFs consumption and dental health. Higher UPFs intake (NOVA T3 vs. T1) was linked to more decayed teeth in females 35–50 years (β = 0.521) and to fewer total teeth (β = − 0.976), more missing teeth (β = 0.987), and more decayed teeth (β = 0.536) in females 50–75 years. Among males, higher UPFs intake was associated with more missing teeth in those 35–50 years (β = 0.387) and with fewer teeth (β = − 0.937), more missing teeth (β = 0.911), and more decayed teeth (β = 0.754) in older males. This study highlights significant associations between greater UPFs consumption and poorer dental health among Iranian adults. A longitudinal study is required.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-30049-7.

Hypertension constitutes a widespread public health concern. While epidemiological evidence has linked tooth loss with hypertension, the precise association between masticatory function operationally defined through functional tooth units (FTUs) and hypertension remains insufficiently elucidated. The aim to investigate the relationship between masticatory function and hypertension. This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. Hypertension status was ascertained through standardized questionnaires and triplicate blood pressure measurements. Masticatory function, defined as FTUs, was characterized by the presence of antagonistic natural or prosthetic tooth pairs in premolar and molar regions. To investigate the FTUs-hypertension association, we employed logistic regression models coupled with restricted cubic spline analyses. Subgroup stratification and mediation analysis were subsequently conducted to elucidate potential effect modifiers and biological mechanisms. Individuals with optimal masticatory function (10 ≤ FTUs ≤ 12) exhibited an 18% reduction in hypertension risk compared to those with compromised function (FTUs < 3), demonstrating an adjusted odds ratio of 0.82 (95% confidence interval: 0.72-0.92, P < .0001). Mediation analysis identified metabolic markers: glycated hemoglobin as a significant intermediary, accounting for 18.0% (95% confidence interval: 14.8-21.1) of the total effect. Subgroup analyses revealed significant effect modification by gender and age (P-interaction < .05). Restricted cubic spline modeling demonstrated a nonlinear association, with hypertension risk following an inverted U-shaped curve across FTU quintiles (P-nonlinearity < .001). Our findings suggest that higher FTUs may lower the risk of hypertension via the metabolic markers: glycated hemoglobin pathway.

Introduction: Oral health is a significant concern among older adults, negatively impacting quality of life due to conditions such as dental caries and tooth loss. Objective: To evaluate the effectiveness of an oral health educational intervention on the quality of life of older adults belonging to two community groups in the city of Coronel, Chile Methodology: A pre-experimental design with pretest and posttest was applied, using the OHIP-14 questionnaire with 18 participants over 65 years old, self-sufficient, and with at least one natural tooth. The intervention, based on the Health Belief Model, consisted of four 45-minute educational sessions developed through participatory methods, addressing topics such as oral diseases, prevention, psychosocial consequences, and healthy habits. Results:Significant improvements were observed in the psychosocial dimensions of the OHIP-14, particularly dissatisfaction with oral appearance (p &lt; 0.001), loss of self-confidence (p = 0.005), and embarrassment related to oral health problems (p = 0.016). Positive changes were also identified in social disability (p = 0.029) and handicap (p = 0.012). Although no significant differences were found in all dimensions or in the overall score, a favorable trend was observed toward a reduced perception of the negative impact of oral health on quality of life. Conclusion:The educational intervention proved to be an accessible and low-cost strategy with the potential to improve the perception of oral health, self-image, and social interaction among older adults.

Osteogenic and angiogenic gelatin-coated Whitlockite nanoparticles incorporated chitosan composite scaffold for alveolar bone regeneration.

Implant Failures: Part 1.

Ectodermal Dysplasia (ED) is a heterogeneous group of genetically determined disorders affecting two or more ectodermal derivatives, including skin, teeth, nails, hair, and sweat glands. Other structures, including the lips, ears, and eyes-also of ectodermal origin-may be involved. This report presents a 6-year-old Bahraini boy with ED who presented to the Paediatric Dental Clinic at the Dental and Maxillofacial Centre (DMFC), Royal Medical Services (RMS), with concerns regarding his appearance due to numerous missing teeth. Initial management focused on preventive care to preserve the existing dentition, followed by restorative procedures and comprehensive prosthetic rehabilitation. A multidisciplinary team approach was essential to establishing a practical treatment pathway.

Dental implants are frequently used to replace missing teeth, often satisfying aesthetic and functional expectations. Immediate implant placement with provisional prosthetic rehabilitation not only shortens treatment duration but also minimizes peri-implant tissue loss. The preservation of tissues around the implant and the achievement of an aesthetic appearance after tooth extraction have contributed to the growing popularity of this approach. Due to its complexity compared with delayed loading protocols, immediate placement should be performed by experienced clinicians. Provisional prostheses prepared on the same day are recommended when optimal conditions are achieved. For anterior implants, patients primarily seek the rapid restoration of lost aesthetic tissue. Immediate provisional prostheses fulfill patients' aesthetic expectations and support the shaping of soft tissue around the implant to resemble the emergence profile of the natural tooth.

Background. Periodontitis, the leading cause of tooth loss in adults, is a common inflammatory-dystrophic disorder. As periodontitis occurs due to inflammation in the marginal gingiva caused by harmful bacteria, effective pharmacological intervention is essential. Aim: to investigate changes in the concentra-tions of calcium and phosphorus in the blood serum and periodontal tissue homogenate of rats using the model of experimental periodontitis, and to focus on the effects of substances with antioxidant and anti-inflammatory properties. Materials and Methods. Various natural substances were used in the treatments. "Vitamin C," "Rutin," and "Ascorutin" were administered intragastrically, while "Salviae tincture" was applied locally. The experiment involved 90 adult white rats divided into nine groups, with ten animals in each group, and measurements of calcium and phosphorus levels were taken on the 1st, 8th, and 15th days. Results and Discussion. It was found that the combined use of the conventional medicines "Ascorutin" and "Salviae tincture" was the most effective option for restoring calcium and phosphorus levels in both blood serum and periodontal tissue homogenate in experimental animals (p&lt;0.05). The analyses of trends that characterize changes in calcium and phosphorus concentrations in blood serum and periodontal tissue homogenate demonstrate the synergistic effect of such a combination. The separate use of "Vitamin C," "Rutin," and "Sal-viae tincture" did not consistently lead to effective restoration of calcium and phosphorus levels in the blood serum and periodontal tissue homogenate. Regarding the effectiveness of treatment, "Ascorutin" occupied an average position. Conclusion and future perspectives. The combinative treatment with "Ascorutin" and "Salviae tincture" was the most effective approach for restoring the concentrations of calcium and phospho-rus in both blood serum and periodontal tissue homogenate in experimental rats. To broaden understanding of the effects of combining "Ascorutin" and "Salviae tincture" in treating experimental periodontitis, it is ad-vised to study how they influence enzyme activities, especially those involved in the body's antioxidant de-fense system.

Atrophic jaws are frequently seen in edentulous patients due to early tooth loss, leading to progressive alveolar bone resorption, bone fragility, and increased susceptibility to fractures, even with low-energy trauma. Surgical management of these fractures presents additional challenges, such as reduced bone density, fragment instability, reduced blood flow, and lack of natural occlusal support. With advances in implant-supported rehabilitation, new perspectives have emerged, but risks remain, especially in areas with severe resorption. Iatrogenic fractures can occur during implant placement due to reduced bone thickness. Fracture reduction and adaptation of reconstruction plates are also limited by atrophic anatomy, compromising the stability of osteosynthesis. This paper reports the case of a 55-year-old patient with an iatrogenic fracture in the atrophic mandible after an attempt at dental implant placement. The treatment involved 3-dimensional virtual planning, biomodel printing, and prior adaptation of a reconstruction plate. The use of digital planning contributed to greater predictability, precision, and reduced surgical time. During the postoperative period, the patient developed an infection in the fistula region, which was successfully treated with antimicrobial photodynamic therapy (aPDT) with methylene blue, demonstrating efficacy in controlling the infection and accelerating healing. It is concluded that the management of atrophic mandibles remains challenging, requiring therapeutic individualization, and the use of digital technology through virtual surgical planning and 3-dimensional prototyping has proven to be an important tool in mandibular fracture surgery, although limitations persist regarding the accuracy of condylar positioning in edentulous patients.

While associations between poor oral health and cognitive impairment are documented, research on how different oral health conditions relate to specific cognitive measures remains limited. Using data from 756 Baltimore Longitudinal Study of Aging 2005-2024 participants (mean age=72.0 years, 52.5% women, 24.2% Black), we investigated the association between the first oral health assessment and subsequent cognitive decline across domains in older adults aged 60+ who were free of cognitive impairment at baseline over an average of 7.7 follow-up. Cognitive function was assessed across language, executive function, attention, memory, and visuospatial ability domains, with domain-specific composite scores calculated using various cognitive tests. Oral health was evaluated for clinically-assessed tooth loss and dental plaque, alongside self-reported periodontal symptoms. Linear mixed-effect models were used to examine the longitudinal associations with cognitive decline, adjusted for socio-demographic and clinical characteristics. After covariate adjustment, more tooth loss was associated with greater declines across all cognitive domains, including language (β=-0.0017; 95% CI=-0.0025, -0.0008), executive function (β=-0.0011; 95% CI=-0.0019, -0.0002), attention (β=-0.0011; 95% CI=-0.0021, -0.0001), memory (β=-0.0018; 95% CI=-0.0030, -0.0005), and visuospatial ability (β=-0.0017; 95% CI=-0.0029, -0.0006). Dental plaque was associated with executive function (β=-0.0165; 95% CI=-0.0276, -0.0054) and memory (β=-0.0279; 95% CI=-0.0444, -0.0115) declines. Presence of periodontal symptoms was only associated with executive function decline (β=-0.0004; 95% CI=-0.0007, -0.0001). Tooth loss may indicate broader cognitive decline, while other oral health conditions, such as plaque and periodontal symptoms, particularly affect memory or executive function. Future studies are warranted to investigate underlying mechanisms.

Weak social relationships are associated with high rates of tooth loss in older adults. To explore the mechanisms connecting social relationships and tooth loss, we systematically assessed the current evidence for the association between social relationships and dental care utilisation in this population. We conducted a comprehensive literature search of five electronic databases for relevant studies published between 1966 and 2024. We included observational studies assessing the structural, functional and/or both combined components of social relationships as exposures and dental care utilisation as outcomes in adults aged 60+. The risk of bias was assessed using the Newcastle-Ottawa Scale. To assess whether weak social relationships are associated with low dental care utilisation, an average odds ratio (OR) and corresponding 95% confidence interval were generated using a meta-analysis. Eighteen studies were included in the review, and 12 (35,097 participants) in the meta-analysis. The average OR was 0.81 (0.69, 0.94), indicating a 19% lower probability of utilising dental care for those with weaker social relationships. This review suggests that weak social relationships are a significant factor associated with low dental care utilisation among older adults, highlighting a potential for public health interventions that address social isolation and loneliness. To guide future interventions, a better understanding of the specific components and time-dependency of this association is needed (PROSPERO [CRD42023417845]). The review protocol was registered with PROSPERO (CRD42023417845).

This review aims to cover the best practices for diagnosing, classifying, and managing these injuries according to current clinical guidelines, as well as examining recent studies on the topic. Dental trauma in young children is a common concern, especially as they go through stages of active play and development. Most of these accidents happen at home, usually from falls. Recent research has been exploring the environmental and personal risk factors that lead to these injuries. When primary teeth, which are closely linked to permanent teeth, get injured, it can cause a range of problems for both sets of teeth, now and in the future. Complications following primary tooth trauma may include pulp necrosis, root resorption, early tooth loss, and disturbances in the permanent successors, such as enamel hypoplasia, discoloration, and eruption abnormalities. The risk and severity of sequelae are influenced by the child’s age, type of injury, and number of affected teeth. Long-term follow-up until eruption of the permanent teeth is therefore essential. The complexity of these injuries, along with the difficulty of getting young children to cooperate and the high levels of anxiety in both kids and their parents, highlights the importance of healthcare professionals following accurate protocols for diagnosis, treatment, and follow-up. Sometimes, it is necessary to refer to a specialist. Effective management of TDIs in the primary dentition requires early diagnosis, adherence to evidence-based guidelines, and a child-centered, minimally invasive approach to reduce both immediate and future complications.

Furcation involvement complicates the management of periodontitis and increases the risk of tooth loss. Conventional methods of detection, such as probing and two-dimensional radiographs, are limited by operator variability and anatomical complexity. Deep learning has shown a potential to detect furcation involvement on radiographic images. The aim of this review was to systematically evaluate the diagnostic potentials of deep learning models in detecting furcation involvement on radiographic images. Systematic search was conducted in PubMed, EMBASE, CENTRAL, ClinicalTrials.gov and ProQuest for studies published from 2010 to September 2025. Two reviewers independently screened studies, extracted data, and assessed quality using QUADAS-2. Diagnostic metrics (sensitivity, specificity, F1-score, area under the curve (AUC)) were pooled using random-effects meta-analysis. Heterogeneity and publication bias were assessed via I2 statistics, meta-regression, and funnel plots. Eight studies, including 7814 radiographs of 12,373 molars (periapical, panoramic, cone-beam computed tomography), were analyzed. Deep learning models demonstrated high accuracy: sensitivity 0.93, specificity 0.94, diagnostic odds ratio (DOR) 187, AUC 0.97 with mandibular molars reflecting higher accuracy (sensitivity 0.96, specificity 0.97, DOR 631, AUC 0.99). Fagan plot analysis indicated strong clinical utility. Meta-regression showed no significant effect of dataset type, augmentation, or number of annotators. No publication bias was detected. Deep learning models show promising accuracy in detecting furcation involvement, particularly in mandibular molars, comparable to expert clinicians. Further refinement with larger, diverse datasets is needed to reduce false positives and enable safe clinical integration. Furcation involvement, a condition where the bone between the roots of a tooth is lost, makes managing gum disease more difficult and increases the risk of tooth loss. Clinical probing remains a reliable and essential method for detecting this condition, while dental X-rays can provide complementary information, particularly in complex cases. This study reviewed the use of deep learning, a type of artificial intelligence (AI), to detect furcation involvement on dental X-rays. Data from eight studies, including more than 7,800 dental radiographs of >12,000 molars, were analyzed and the results showed that deep learning models were highly accurate, performing similarly to expert dentists. Accuracy was slightly higher for lower jaw (mandibular) molars. The study suggests that these AI tools could help dentists detect furcation involvement more reliably. However, more research with larger and more diverse datasets is needed before these tools can be safely used in everyday dental practice.