Academia Journal of Medicine (AJM) is a distinguished, bi-annual, peer-reviewed international journal that publishes advanced research in clinical medicine. The journal covers a wide range of topics, including etiology, diagnosis, treatment, and prognosis, contributing to the broader understanding of medical science. While available both online and in print, AJM operates under a subscription-based model, requiring a fee for full access to its content. This ensures the journal's sustainability while maintaining high editorial and publication standards. Indexing Details: Base, Google Scholar, Crossref, Scilit, AGRIS, ICI, ASI, Ebsco, Academia Journal of Medicine is now the Official Journal of Central Asian University, School of Dentistry, Tashkent. ISSN (Online): 2663-8290 ISSN (Print): 2663-8282 Key Features: Publishes original research articles, reviews, and case studies. Subscription-based model for full access to content. Bi-annual publication frequency, ensuring timely updates on critical research findings.
Clinical Factors Guiding Prosthodontic Treatment Decisions Among Dentists in Maharashtra, India: A Cross-Sectional Survey
Purpose: To rank factors guiding three prosthodontic decisions among dentists in Maharashtra and examine variation by professional background and practice setting. Materials and Methods: This cross-sectional survey included 400 dentists from 11 districts. A 30-item questionnaire assessed glass ionomer versus resin cement, fixed partial denture versus implant, and implant-supported overdenture versus fixed implant-supported prosthesis decisions on a six-point scale. Internal consistency was evaluated using Cronbach's alpha with bootstrap confidence intervals. Friedman tests with Kendall's W and Holm-adjusted post hoc tests evaluated rankings. Nonparametric tests compared domain scores across groups. Results: Overall internal consistency was good (alpha = 0.881; 95% CI: 0.861-0.897). Marginal seal ranked highest for cement selection (mean 4.43), prognosis and risk of failure for fixed partial denture versus implant decisions (mean 4.51), and retention and stability for complete-arch decisions (mean 4.42). Rankings differed within every domain (all P < 0.001), although Kendall's W indicated modest separation among generally high ratings. Prosthodontic and other specialty respondents scored all domains higher than general dentists, and dentists in hospital-based educational settings scored them higher than private practitioners (all Holm-adjusted P < 0.001). Scores did not differ by gender or correlate with age. Conclusion: Dentists prioritized biological durability, mechanical predictability, and long-term prognosis. Professional training and institutional context were associated with the breadth of factors considered.
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Periodontitis and Systemic Diseases: Exploring the Bidirectional Link and Its Clinical Implications
Periodontitis is a chronic inflammatory disease characterized by dysbiotic microbial communities and a dysregulated host immune response, resulting in progressive destruction of the periodontal supporting tissues. Increasing evidence suggests that its effects extend beyond the oral cavity, establishing important associations with systemic diseases such as diabetes mellitus, cardiovascular disease, adverse pregnancy outcomes, respiratory disorders, rheumatoid arthritis, and chronic kidney disease. The relationship is considered bidirectional, as systemic conditions can modify periodontal susceptibility and disease progression, while periodontal inflammation may contribute to systemic inflammatory and metabolic disturbances. Proposed mechanisms include bacteremia, systemic dissemination of microbial products, cytokine release, oxidative stress, immune dysregulation, and endothelial dysfunction. Understanding these interactions highlights the importance of integrating periodontal assessment with overall medical care. This review discusses the biological mechanisms underlying the periodontitis–systemic disease relationship, summarizes current evidence regarding major systemic associations, and explores their clinical implications for prevention, diagnosis, and multidisciplinary management.
Artificial Intelligence in Pediatric Endodontics: Development of Consensus Guidelines for Working Length Determination Using a Delphi Method
Background: Artificial intelligence (AI) is emerging in endodontics as a promising adjunct, with its widespread applications in radiographic interpretation, anatomical landmark identification, and working length determination. Although preliminary evidence suggests that AI may enhance diagnostic accuracy and clinical efficiency, its application in primary teeth remains limited owing to the unique anatomical characteristics associated with physiological root resorption. Currently, no evidence-based clinical recommendations or consensus guidelines exist regarding the use of AI for working length determination in pediatric endodontics. Aim: To develop expert consensus recommendations on the role of artificial intelligence in working length determination of primary teeth using a modified Delphi methodology. Materials and Methods: Three-round modified Delphi study was carried out with an international multidisciplinary panel of experts in the fields of pediatric dentistry, endodontics, dental radiology, artificial intelligence, and digital dentistry. The consensus statements have been formulated after a thorough examination of the literature at hand and they have been refined after rounds of anonymous questionnaires. Participants rated each statement on a 9-point Likert scale. Consensus was predefined as a median agreement score of ≥7, an interquartile range (IQR) ≤2, and at least 75% agreement among panel members. The level of consensus was assessed using descriptive statistics such as median scores, IQRs and percentage agreement. Results: From 42 invited experts, 35 participated in Round 1, whereas 32 completed all three Delphi rounds. The initial 58 statements were refined to 60, of which 56 (93.3%) achieved final consensus. Expert agreement progressively increased across rounds (Kendall’s W: 0.48, 0.67, and 0.81), with high internal consistency (Cronbach’s α = 0.91). The strongest consensus supported AI can be used as a clinical decision-support tool, its integration with electronic apex locators. It also suggested pediatric-specific validation before clinical implementation, appropriate ethical and regulatory oversight, and incorporation of AI education into dental training. Conclusions: As AI continues to transform pediatric endodontic dental diagnostics, expert consensus is essential for safe, ethical, and evidence-informed adaptation. This Delphi study generates recommendations which are anticipated to serve as an important foundation for future clinical guidelines, validation studies, and the development of AI-assisted technologies for working length determination in primary teeth.
Comparative Evaluation of Smear Layer Removal using Edta, Citric Acid, and Maleic Acid: A Sem Study
Background: Effective removal of the smear layer is an important step in root canal treatment because its persistence may interfere with the penetration of disinfecting agents and the adaptation of root canal sealers to dentinal walls. Chelating agents such as ethylenediaminetetraacetic acid (EDTA), citric acid, and maleic acid have been widely investigated for smear layer removal; however, differences in their effectiveness may depend on their chemical properties and interaction with dentin. Aim: To comparatively evaluate the effectiveness of EDTA, citric acid, and maleic acid in removing the smear layer from root canal walls using scanning electron microscopy (SEM). Materials and Methods: Forty extracted human single-rooted permanent teeth will be selected and decoronated to standardize the root length. The root canals were prepared using a standardized step-back instrumentation technique with stainless-steel K-files, with sodium hypochlorite used as the irrigant during instrumentation. The specimens will then be randomly allocated into four groups (n = 10 each) according to the final irrigation protocol: Group I—17% EDTA, Group II—10% citric acid, Group III—7% maleic acid, and Group IV—distilled water (control). Following irrigation, the roots will be split longitudinally and prepared for SEM evaluation. Smear layer removal will be assessed at the coronal, middle, and apical thirds using a standardized scoring system. The scores will be statistically analyzed using appropriate statistical tests, with the level of significance set at p < 0.05. Results: SEM evaluation demonstrated significant differences in smear layer removal among the four groups (p < 0.001). The 7% maleic acid group showed the highest proportion of Score 1 specimens (70%), followed by 10% citric acid (40%) and 17% EDTA (20%), whereas the distilled-water control showed no Score 1 specimens. Smear layer removal was generally greater in the coronal third and decreased toward the apical third. Conclusion: EDTA, citric acid, and maleic acid may differ in their ability to remove the smear layer from root canal walls. SEM evaluation provides detailed morphological assessment of the dentinal surface and may help identify an effective final irrigation protocol for achieving optimal smear layer removal.
Assessment of Patient Satisfaction and Perception with Digital and Conventional Complete Dentures: A Comparative Study
Background: The incorporation of digital technologies in complete denture fabrication has transformed conventional prosthodontic workflows, potentially improving accuracy, efficiency, and patient comfort. However, comparative evidence on patient-centered outcomes between digital and conventional dentures is still evolving. Aim: To evaluate and compare patient satisfaction and perception with digital complete dentures and conventional complete dentures. Materials and Methods: This comparative study was conducted among 30 completely edentulous patients requiring complete denture rehabilitation. Participants were equally divided into two groups (n = 15 each). Group I received conventional complete dentures fabricated using traditional clinical and laboratory techniques, while Group II received digital complete dentures fabricated using CAD-CAM technology. Patient satisfaction and perception were assessed using a validated questionnaire evaluating parameters such as comfort, retention, stability, esthetics, mastication, phonetics, and overall satisfaction. Statistical analysis was performed using appropriate tests, with significance set at p < 0.05. Results: The digital denture group demonstrated significantly higher satisfaction scores in terms of comfort, retention, and overall satisfaction compared to the conventional denture group (p < 0.05). Patients receiving digital dentures also reported reduced treatment time and fewer clinical visits. However, no statistically significant differences were observed between the groups in terms of esthetics and phonetics (p > 0.05). Conclusion: Digital complete dentures showed superior patient satisfaction and perception in comparison to conventional dentures in several key parameters. The adoption of digital denture workflows may enhance clinical efficiency and patient acceptance, although larger studies with long-term follow-up are recommended.
Comparative Evaluation of the Antibacterial Efficacy of Nanocurcumin-, Neem-, Sodium Hypochlorite- and Chlorhexidine-Coated Gutta-Percha Against Enterococcus faecalis: An In Vitro Study
Background: Residual microorganisms may persist after chemomechanical preparation and contribute to post-treatment endodontic disease. Incorporating antimicrobial agents onto gutta-percha could provide supplementary antibacterial activity within the obturated canal. Aim: To compare the antibacterial efficacy of gutta-percha coated with nanocurcumin, neem extract, 5.25% sodium hypochlorite and 2% chlorhexidine against Enterococcus faecalis. Materials and Methods: Sterilised ISO F2 gutta-percha cones were divided into five groups: conventional gutta-percha, 5.25% sodium hypochlorite-coated gutta-percha, 2% chlorhexidine-coated gutta-percha, neem extract-coated gutta-percha and nanocurcumin-coated gutta-percha. Each group comprised five observations. Nutrient agar plates were uniformly inoculated with an E. faecalis suspension containing approximately 10⁵–10⁶ cells/mL. Prepared gutta-percha specimens were placed on the inoculated plates and incubated at 37°C for 24 hours. The largest diameter of the inhibition zone was measured in millimetres using a digital vernier calliper. Results: Sodium hypochlorite-coated gutta-percha produced the largest mean inhibition zone (4.386±0.394 mm), followed by chlorhexidine (3.700±0.126 mm), nanocurcumin (2.704±0.071 mm), neem extract (2.026±0.038 mm) and conventional gutta-percha (0.464±0.021 mm). The overall difference was statistically significant (F=338.50; p<0.001), and every pairwise comparison was significant. Conclusion: All four coatings increased the antibacterial activity of gutta-percha. Sodium hypochlorite and chlorhexidine demonstrated the strongest effects, while nanocurcumin performed better than neem extract.
Comparative Evaluation of Conventional Syringe Irrigation, Manual Dynamic Agitation, Sonic Activation, Negative-pressure Irrigation and Ultrasonic Activation for the Elimination of Enterococcus Faecalis from Infected Root Canals: An in Vitro Study
Background: Microorganisms persisting within anatomically inaccessible areas of the root canal system can compromise endodontic treatment. Enterococcus faecalis is frequently investigated because of its ability to penetrate dentinal tubules, survive adverse conditions and persist after chemomechanical preparation. Irrigant activation may improve antibacterial effectiveness by promoting irrigant penetration and fluid exchange. Aim: To compare the effectiveness of conventional syringe irrigation, manual dynamic agitation, sonic activation, negative-pressure irrigation and ultrasonic activation in reducing E. faecalis from experimentally infected root canals. Materials and Methods: Sixty-five extracted human mandibular first premolars with single canals and closed apices were prepared to ProTaper F2, sterilised and inoculated with E. faecalis. After seven days of incubation, the specimens were randomly assigned to five groups (n=13): conventional syringe irrigation, manual dynamic agitation, sonic activation, negative-pressure irrigation and ultrasonic activation. Following irrigation, microbiological samples were collected using sterile paper points, serially diluted and cultured on blood agar. Colony-forming units per millilitre (CFU/mL) were calculated. Data were analysed using one-way analysis of variance and post-hoc pairwise comparisons at a significance level of 5%. Results: The representative baseline bacterial count was 1559.50±56.77 CFU/mL. Mean residual counts were 761.31±580.28 CFU/mL with conventional irrigation, 532.15±302.62 CFU/mL with manual dynamic agitation, 368.77±246.30 CFU/mL with sonic activation, 90.92±72.01 CFU/mL with negative-pressure irrigation and 17.77±18.63 CFU/mL with ultrasonic activation. The overall difference was statistically significant (F=12.49; pp<0.001). Ultrasonic activation produced the greatest reduction, followed by negative-pressure irrigation. Conclusion: Ultrasonic activation and negative-pressure irrigation achieved greater bacterial reduction than the other tested methods. Nevertheless, no technique consistently rendered every root canal culture-negative.
Comparative Evaluation of the Shear Bond Strength of Nanofilled Composite Resin to Dentin with and Without Gluma Dentin Desensitizer: An In Vitro Study
Background: Dentin hypersensitivity is commonly managed using desensitizing agents such as Gluma. However, concerns remain regarding their influence on the bonding performance of adhesive restorative materials. This in vitro study evaluated the effect of Gluma dentin desensitizer on the shear bond strength of a nanofilled composite resin bonded to dentin using a fifth-generation adhesive system. Materials and Methods: Thirty freshly extracted human maxillary premolars were collected and randomly allocated into two groups (n = 15). In Group I (Control), no desensitizer was applied prior to bonding. In Group II (Gluma), Gluma dentin desensitizer was applied according to the manufacturer's instructions before the adhesive procedure. All specimens were restored using Adper Single Bond 2 (fifth-generation adhesive) and a nanofilled composite resin. After storage under standardized laboratory conditions, shear bond strength was evaluated using a universal testing machine. The obtained data were statistically analyzed, with the level of significance set at p < 0.05. Results: The specimens pretreated with Gluma dentin desensitizer demonstrated a higher mean shear bond strength compared with the control group. Adper Single Bond 2 exhibited favorable bonding performance following Gluma pretreatment. Statistical analysis revealed that the application of Gluma did not adversely affect the bond strength of the adhesive system. Conclusion: Pretreatment of dentin with Gluma dentin desensitizer did not impair the shear bond strength of nanofilled composite resin bonded using Adper Single Bond 2. The findings suggest that Gluma can be safely used prior to adhesive restorative procedures without compromising bond strength, making it a suitable option for managing dentin hypersensitivity before composite restorations.
Comparative Evaluation of the Effectiveness of Different Orthodontic Toothbrushes in Maintaining Periodontal Health: A Randomized Clinical Trial
Background: Fixed orthodontic appliances increase plaque retention by creating additional retentive areas around brackets and wires, thereby compromising oral hygiene and increasing the risk of gingival inflammation and periodontal disease. Appropriate toothbrush selection plays a pivotal role in maintaining periodontal health during orthodontic treatment. However, limited evidence exists regarding the comparative effectiveness of different orthodontic toothbrushes. Aim: To compare the effectiveness of manual orthodontic, electric, and single-tuft toothbrushes in maintaining periodontal health among patients undergoing fixed orthodontic treatment. Materials and Methods: This randomized clinical trial included 90 patients aged 15–30 years undergoing fixed orthodontic treatment. Participants were randomly allocated into three groups (n = 30 each): Group I used a manual orthodontic toothbrush, Group II used an electric toothbrush, and Group III used a single-tuft toothbrush as an adjunct to a manual orthodontic toothbrush. Standardized oral hygiene instructions were provided to all participants. Periodontal parameters, including Plaque Index (Silness and Löe), Gingival Index (Löe and Silness), Bleeding on Probing, and Probing Pocket Depth, were recorded at baseline, 1 month, and 3 months. Statistical analysis was performed using one-way ANOVA with Tukey's post hoc test for intergroup comparisons and repeated-measures ANOVA for intragroup comparisons. A p-value<0.05 was considered statistically significant. Results: All three groups demonstrated significant improvements in periodontal parameters over the study period. The electric toothbrush group showed significantly greater reductions in plaque accumulation, gingival inflammation, and bleeding on probing than the manual orthodontic and single-tuft toothbrush groups. The single-tuft toothbrush also demonstrated superior plaque control and gingival health compared with the manual orthodontic toothbrush. No significant intergroup differences were observed in probing pocket depth, although all groups showed slight improvements over time. Conclusion: All toothbrushes evaluated effectively improved periodontal health in patients undergoing fixed orthodontic treatment. However, electric toothbrushes demonstrated superior plaque removal and gingival health, while the adjunctive use of a single-tuft toothbrush also provided significant clinical benefits. Incorporating advanced toothbrush designs into oral hygiene protocols may improve periodontal outcomes during orthodontic therapy.
Orthodontic Camouflage Management of Bimaxillary Dentoalveolar Protrusion using Four First Premolar Extractions and Differential Space Closure Mechanics: A Case Report
Bimaxillary dentoalveolar protrusion is characterized by proclination and protrusion of the maxillary and mandibular incisors despite a relatively harmonious underlying skeletal relationship. In adult patients with limited or no remaining growth potential, orthodontic camouflage using extraction therapy is an effective approach for correcting dentoalveolar protrusion while preserving the existing skeletal pattern. This case report describes the orthodontic management of a 21-year-old male with skeletal Class I malocclusion, prognathic maxilla and mandible, horizontal growth pattern, and pronounced bimaxillary incisor proclination and protrusion. The treatment involved extraction of all four first premolars followed by fixed orthodontic treatment using a 0.018-inch MBT preadjusted edgewise appliance. Maximum anchorage was reinforced using a transpalatal arch in the maxillary arch and incorporation of the second molars into the posterior anchorage units. Maxillary anterior retraction was performed using continuous T-loop mechanics, while mandibular space closure was achieved using controlled sliding mechanics. Treatment resulted in substantial correction of maxillary and mandibular incisor proclination, normalization of the interincisal relationship, maintenance of the skeletal Class I relationship and horizontal growth pattern, and improvement in dental esthetics. A stable Class I molar and canine relationship with satisfactory overjet, overbite, intercuspation, and root parallelism was achieved. The case demonstrates that careful diagnosis, maximum anchorage control, and individualized biomechanical planning can provide predictable and stable outcomes in adult patients with bimaxillary dentoalveolar protrusion.
Comparative Evaluation of Flavored Versus Unflavored Topical Anesthetic Gel on Pain Perception during Local Anesthetic Administration in Children: A Randomized Controlled Clinical Trial
Aim: To compare the effect of flavored and unflavored topical anesthetic gel on pain perception during local anesthetic administration in children. Materials and Methods: This randomized controlled clinical trial will include 60 healthy children aged 5–8 years requiring local anesthetic administration for routine dental treatment. Participants will be randomly allocated into two groups (n = 30 each). Group I will receive unflavored 20% benzocaine topical anesthetic gel, while Group II will receive strawberry-flavored 20% benzocaine topical anesthetic gel. The assigned topical anesthetic will be applied for one minute before administration of local anesthesia using a standardized injection technique. Pain perception will be assessed using the Wong–Baker Faces Pain Rating Scale (self-reported pain) and the FLACC (Face, Legs, Activity, Cry, Consolability) scale (observer-rated pain). Statistical analysis will be performed using an independent t-test or Mann–Whitney U test, with the level of significance set at p < 0.05. Results: Children receiving the flavored topical anesthetic gel are expected to demonstrate significantly lower Wong–Baker Faces Pain Rating Scale and FLACC scores compared with those receiving the unflavored topical anesthetic gel, indicating reduced pain perception during local anesthetic administration. Conclusion: Flavored topical anesthetic gel may provide a more pleasant sensory experience and reduce pain perception during local anesthetic administration in children. Its use may improve patient comfort and facilitate a more positive dental experience in pediatric practice.
Effect of Silver Diamine Fluoride and Potassium Iodide Pretreatment on the Microleakage of Resin-based Pit and Fissure Sealants: An in Vitro Study
Aim: To evaluate the effect of silver diamine fluoride and potassium iodide pretreatment on the microleakage of resin-based pit and fissure sealants. Materials and Methods: Forty-five extracted, non-carious human premolars were randomly allocated into three groups (n = 15): Group I (control) received resin-based pit and fissure sealant without pretreatment; Group II received 38% SDF prior to sealant placement; and Group III received 38% SDF followed by KI before sealant application. After sealant placement, all specimens were thermocycled for 500 cycles between 5°C and 55°C. The teeth were coated with nail varnish, immersed in 0.5% basic fuchsin dye for 24 hours, sectioned buccolingually, and evaluated for dye penetration under a stereomicroscope. Microleakage scores were analyzed using the Kruskal–Wallis test followed by Dunn's post hoc test, with the level of significance set at p < 0.05. Results: The control group demonstrated the lowest microleakage scores, while the SDF-pretreated group showed the highest microleakage. The SDF + KI group exhibited lower microleakage than the SDF group but higher values than the control. The differences among the groups were statistically significant (p < 0.05). Conclusion: Pretreatment with SDF influenced the marginal sealing ability of resin-based pit and fissure sealants by increasing microleakage. The application of KI following SDF reduced microleakage compared with SDF alone; however, it did not restore sealing ability to the level of the control group. Further clinical studies are recommended to validate these findings.
Assessment of Infrazygomatic Crest Dimension in Different Vertical Facial Growth Pattern and Its Clinical Implication for Infrazygomatic Bone Screw Insertion- a Cross-sectional Study
Background: The infrazygomatic crest (IZC) is a preferred extra-alveolar site for orthodontic bone screw placement, offering dense bicortical bone and predictable anchorage. However, anatomical variations in IZC dimensions across different vertical facial growth patterns remain debated, and comprehensive data on second molar sites are limited. This study aimed to assess IZC bone thickness at multiple sites and angulations in patients with different vertical facial growth patterns to establish evidence-based guidelines for safe screw insertion. Aim: To determine IZC bone dimensions across different vertical facial growth patterns, identify optimal insertion sites and angulations, guide screw length selection, and evaluate gender-based differences. Materials and Methods: This cross-sectional study analyzed CBCT scans of 90 subjects (18-30 years) equally divided into average-growing, horizontal-growing, and vertical-growing groups. IZC bone thickness was measured at six sites bilaterally: mesiobuccal root of first molar (MB), distobuccal root of first molar (DB), proximal region between first and second molars (PR), and second molar region (MB2 and DB2), at insertion angulations of 65° and 70°. Measurements were performed using Carestream 9600 CBCT with CS 3D imaging software. Statistical analysis employed one-way ANOVA, post-hoc tests, and paired t-tests (p0.05). Second molar sites (MB2 70°: 3.72±0.92 mm; DB2 70°: 3.34±0.85 mm) showed moderate bone availability. Measurements at 70° were consistently greater than at 65° (p
Effect of Scapular Stabilization Exercises on Myofascial Pain Dysfunction Syndrome: A Randomized Controlled Trial
Background: Myofascial Pain Dysfunction Syndrome (MPDS) is a common musculoskeletal disorder affecting the masticatory muscles and temporomandibular joint. Altered posture, cervical dysfunction, and impaired scapular stability have been associated with the persistence of pain and functional limitations. Scapular stabilization exercises may improve postural alignment, reduce muscle overload, and alleviate symptoms in individuals with MPDS. Aim: To evaluate the effect of scapular stabilization exercises on pain intensity, mandibular function, and quality of life in patients with MPDS. Materials and Methods: This prospective interventional study included 40 patients diagnosed with MPDS, randomly allocated into two groups (n = 20 each). Group A received conventional therapy, including jaw exercises, moist heat therapy, and patient education. Group B received conventional therapy combined with a structured scapular stabilization exercise program for six weeks. Outcome measures included pain intensity using the Visual Analog Scale (VAS), maximum mouth opening (MMO), pressure pain threshold (PPT), and jaw functional limitation assessed using the Jaw Functional Limitation Scale (JFLS). Assessments were performed at baseline and after six weeks. Statistical analysis was performed using paired and independent t-tests, with a significance level of p < 0.05. Results: Both groups demonstrated significant improvement after treatment; however, Group B showed significantly greater reductions in pain intensity and functional limitation, along with greater improvements in maximum mouth opening and pressure pain threshold compared with Group A (p < 0.05). Conclusion: Incorporating scapular stabilization exercises into conventional management of MPDS provides superior improvements in pain reduction, jaw function, and overall functional outcomes compared with conventional therapy alone. These findings support the integration of postural and scapular rehabilitation into the multidisciplinary management of patients with MPDS.
Contemporary Trends in Digital Implantology: A Comprehensive Review
Digital technologies have transformed implant dentistry by improving diagnostic accuracy, surgical precision, prosthetic rehabilitation, and overall treatment predictability. Contemporary digital implantology integrates cone-beam computed tomography (CBCT), intraoral scanning, virtual implant planning, computer-guided surgery, digital impression techniques, CAD/CAM fabrication, and artificial intelligence (AI) into a comprehensive clinical workflow. These technologies enhance treatment efficiency, minimize procedural errors, improve patient comfort, and facilitate prosthetically driven implant placement. Recent advances in AI and machine learning have further expanded the scope of implant dentistry by enabling automated image analysis, treatment planning, risk assessment, and outcome prediction. Despite challenges such as high initial costs, learning curves, and the need for long-term clinical validation, digital workflows continue to redefine implant therapy. This review provides a comprehensive overview of contemporary digital implantology, highlighting recent technological advancements, clinical applications, current evidence, limitations, and future directions toward more precise, efficient, and personalized implant treatment.
Zygomatic Implants in Modern Implant Dentistry: A Comprehensive Review
Zygomatic implants have emerged as a predictable graftless solution for the rehabilitation of patients with severe maxillary atrophy, extensive bone loss, and failed conventional implant therapy. By anchoring in the zygomatic bone, they reduce the need for complex bone grafting and facilitate immediate loading in selected cases. Recent advances in implant design, digital planning, guided surgery, and prosthetic rehabilitation have significantly improved treatment outcomes. This review highlights the evolution, indications, implant design, surgical techniques, digital workflow, clinical outcomes, complications, and recent innovations in zygomatic implantology. Current evidence supports zygomatic implants as a reliable and effective treatment option with high long-term survival rates for the rehabilitation of the severely resorbed maxilla.
Relationship Between Restorative Overhangs and Periodontal Disease Progression
Restorative overhangs are recognised as important plaque-retentive factors that may adversely affect periodontal health and contribute to disease progression. This cross-sectional observational study evaluated the relationship between restorative overhangs and periodontal disease progression among 120 participants. Teeth with restorative overhangs showed significantly greater plaque accumulation, gingival inflammation, probing pocket depth, clinical attachment loss, and bleeding on probing than teeth without overhangs. A significant association was also observed between restorative overhangs and increased periodontal disease severity, particularly in posterior teeth. The findings highlight the importance of proper restorative contouring and early correction of defective restorations to maintain periodontal health and prevent periodontal destruction.
Precision and Personalized Periodontics: Transforming Periodontal Care in the Era of Precision Medicine
Periodontitis is a multifactorial chronic inflammatory disease characterized by complex interactions among microbial dysbiosis, host immune response, genetic predisposition, environmental factors, and systemic conditions. Conventional periodontal therapy largely follows a standardized approach despite substantial inter-individual variation in disease susceptibility, progression, and treatment response. Precision periodontics has emerged as a paradigm shift that integrates genomic, proteomic, metabolomic, microbiomic, biomarker, clinical, and digital data to tailor preventive and therapeutic interventions for individual patients. Recent advances in salivary diagnostics, artificial intelligence (AI), multi-omics technologies, and personalized regenerative therapies are enabling risk prediction, early diagnosis, and customized treatment planning. This review discusses the biological basis, diagnostic tools, therapeutic applications, current challenges, and future directions of precision and personalized periodontics.
Artificial Intelligence and Digital Technologies in Neurorehabilitation: Current Applications, Challenges and Future Perspectives
Artificial intelligence (AI) and digital technologies are transforming neurorehabilitation by enabling personalized, data driven, and accessible patient care. Technologies such as machine learning, robotic-assisted rehabilitation, virtual reality, brain–computer interfaces, wearable sensors, and tele-rehabilitation enhance assessment, treatment planning, and functional recovery in neurological conditions including stroke, Parkinson's disease, spinal cord injury, and traumatic brain injury. These innovations improve patient engagement and rehabilitation outcomes while supporting remote monitoring and continuous care. However, challenges such as data privacy, ethical concerns, high costs, limited clinical validation, and unequal access hinder widespread implementation. Future advancements in explainable AI, predictive analytics, and integrated digital rehabilitation platforms are expected to further improve precision, accessibility, and effectiveness. This review summarizes the current applications, key challenges, and future perspectives of AI and digital technologies in neurorehabilitation.
Assessment of Postoperative Pain Following Single-visit Endodontic Treatment using Cold Versus Room-temperature Irrigants: A Randomized Clinical Study
Background: Postoperative pain remains a common concern following single-visit root canal treatment despite advances in endodontic techniques and irrigation protocols. Recent studies suggest that intracanal cryotherapy using cold irrigants may reduce postoperative pain by decreasing local inflammation and tissue edema. However, evidence regarding its effectiveness in routine clinical practice remains limited. Aim: To compare the effect of cold irrigants and room-temperature irrigants on postoperative pain following single-visit endodontic treatment. Materials and Methods: A randomized clinical study was conducted on 40 patients requiring single-visit root canal treatment for symptomatic irreversible pulpitis in single-rooted teeth. Participants were randomly allocated into two groups of 20 each. Group I received final irrigation with 5°C saline solution (cold irrigant), while Group II received final irrigation with saline solution at room temperature (25°C). All treatments were performed using a standardized endodontic protocol. Postoperative pain was assessed using a Visual Analog Scale (VAS) at 6, 24, 48, and 72 hours after treatment. Data were analyzed using independent t-test and repeated measures ANOVA, with statistical significance set at p < 0.05. Results: Both groups demonstrated a progressive reduction in pain over time. The cold irrigant group showed significantly lower mean VAS scores compared to the room-temperature irrigant group at 6 hours (3.10 ± 1.12 vs. 4.55 ± 1.23, p = 0.002) and 24 hours (1.95 ± 0.89 vs. 3.10 ± 1.05, p = 0.004). Differences at 48 and 72 hours were not statistically significant. No adverse effects related to the use of cold irrigants were observed. Conclusion: The use of cold irrigants during single-visit endodontic treatment significantly reduced early postoperative pain compared with room-temperature irrigants. Intracanal cryotherapy appears to be a simple, safe, and cost-effective adjunct for improving patient comfort following root canal therapy.
Evaluation of Salivary Cortisol Levels and Periodontal Inflammation during Fixed Orthodontic Treatment: A Prospective Clinical Study
Background: Orthodontic treatment is associated with both physical and psychological stress, which may influence periodontal health through inflammatory changes. Salivary cortisol is considered a reliable biomarker for evaluating stress responses during orthodontic therapy. Aim: To evaluate salivary cortisol levels and their association with periodontal inflammation during fixed orthodontic treatment. Materials and Methods: This prospective clinical study was conducted among 30 patients undergoing fixed orthodontic treatment. Periodontal parameters including Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), and Probing Pocket Depth (PPD) were assessed at baseline, 24 hours after appliance activation, and one month after treatment initiation. Unstimulated saliva samples were collected at each interval and analyzed for salivary cortisol levels using Enzyme-Linked Immunosorbent Assay (ELISA). Statistical analysis was performed to evaluate changes in cortisol levels and periodontal parameters and their correlation. Results: An increase in salivary cortisol levels and periodontal inflammatory parameters was observed following orthodontic appliance activation, particularly during the initial phase of treatment. A positive correlation was noted between elevated cortisol levels and periodontal inflammation. Conclusion: Fixed orthodontic treatment may induce transient stress-related increases in salivary cortisol levels, which may be associated with mild periodontal inflammatory changes. Assessment of stress biomarkers alongside periodontal monitoring may aid in improving orthodontic treatment outcomes.
Artificial Intelligence in Musculoskeletal Rehabilitation: A Review
Artificial Intelligence (AI) is emerging as a transformative technology in musculoskeletal rehabilitation by improving diagnosis, treatment planning, patient monitoring, and rehabilitation outcomes. Musculoskeletal disorders such as osteoarthritis, low back pain, sports injuries, fractures, and post-operative conditions are major causes of pain and disability worldwide. Conventional rehabilitation methods often rely on subjective assessment and prolonged clinical supervision. AI-based technologies including machine learning, deep learning, computer vision, robotics, wearable sensors, and virtual reality are increasingly being integrated into musculoskeletal rehabilitation to provide personalized, accurate, and efficient care. These technologies assist clinicians in movement analysis, posture correction, gait assessment, exercise supervision, pain prediction, and functional recovery monitoring. AI-driven rehabilitation systems also support remote rehabilitation through telemedicine platforms and wearable devices, thereby improving accessibility and patient adherence. Robotic-assisted rehabilitation and intelligent exercise systems enhance treatment precision and reduce therapist workload. Despite significant advancements, challenges such as high implementation costs, data privacy concerns, limited technical expertise, and ethical issues remain barriers to widespread adoption. This review highlights the applications, benefits, limitations, and future prospects of AI in musculoskeletal rehabilitation. The integration of AI with conventional rehabilitation approaches has the potential to revolutionize musculoskeletal care by delivering more personalized, evidence-based, and patient-centered treatment.
Effect of Low-Level Laser Therapy on Periodontal Healing During Ortho dontic Tooth Movement: A Randomized Clinical Study
Background: Orthodontic tooth movement is commonly associated with periodontal inflammation, discomfort, and tissue remodeling. Maintaining periodontal health during orthodontic treatment is essential for successful outcomes. Low-Level Laser Therapy (LLLT) is a non-invasive adjunctive modality with anti-inflammatory and analgesic effects that may enhance periodontal healing during orthodontic therapy. Aim: To evaluate the effect of Low-Level Laser Therapy on periodontal healing and pain perception during orthodontic tooth movement. Materials and Methods: This randomized clinical study was conducted over six months in the Department of Orthodontics in collaboration with the Department of Periodontology. Thirty patients requiring bilateral maxillary canine retraction after premolar extraction were randomly divided into two groups of 15 each. Group A received conventional orthodontic treatment, while Group B received adjunctive Low-Level Laser Therapy (810 nm diode laser, 100 mW) during orthodontic activation. Fixed orthodontic treatment was carried out using MBT brackets and nickel-titanium closed coil springs. Periodontal parameters including Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), and Probing Pocket Depth (PPD) were assessed at baseline, 1 month, and 3 months. Pain perception was evaluated using the Visual Analog Scale (VAS), and the rate of tooth movement was measured. Results: Both groups demonstrated mild increases in periodontal parameters during orthodontic treatment; however, the LLLT group showed significantly lower Gingival Index and Bleeding on Probing scores compared to the control group at 1 month and 3 months (p < 0.05). Patients treated with LLLT reported significantly lower pain scores following orthodontic activation. The rate of orthodontic tooth movement was slightly higher in the laser group, although the difference was not statistically significant. Conclusion: Adjunctive Low-Level Laser Therapy may positively influence periodontal healing during orthodontic tooth movement by reducing gingival inflammation and patient discomfort. LLLT appears to be a promising supportive modality for improving periodontal outcomes during orthodontic treatment.
Prevalence and its associated risk factors for oral lichen planus in Central Indian population
Background: Oral lichen planus is a chronic immune-mediated mucosal disorder that may present with white striations, erythematous areas, erosions or ulcerations. It is clinically important because it can cause burning sensation, discomfort during eating and, in some cases, requires long-term surveillance due to its potentially malignant nature. Aim: The study aimed to assess the prevalence of oral lichen planus and its associated risk factors among the Central Indian population attending outreach programmes conducted by People’s College of Dental Sciences and Research Centre, Bhopal. Methodology: A community-based cross-sectional study was conducted among 2000 patients screened during institutional outreach oral health programmes. Demographic details, tobacco habits, systemic history, perceived stress, oral hygiene status and local dental irritants were recorded using a predesigned proforma. Oral examination was carried out under adequate illumination, and clinically suspected cases of oral lichen planus were identified based on characteristic oral features. A biopsy was advised for erosive, atypical, or doubtful lesions. Data were analysed using descriptive statistics, chi-square test and multivariable logistic regression. Results: Oral lichen planus was diagnosed in 44 patients, giving an overall prevalence of 2.2%. The condition was more common among females and among patients aged 40 and above. Reticular oral lichen planus was the most frequent clinical type, and buccal mucosa was the most commonly affected site. Significant associated factors included tobacco use, high perceived stress, diabetes mellitus, local dental irritation and poor oral hygiene. Conclusion: Oral lichen planus showed a prevalence of 2.2% in the screened Central Indian population. Community-based screening may help with early detection, risk factor identification, counselling, and timely referral for follow-up.
Assessment of ChatGPT-Generated Endodontic Patient Education Materi als: A Readability and Accuracy Analysis
Background: The increasing use of artificial intelligence–based conversational models such as ChatGPT has transformed the way patients access healthcare-related information. In endodontics, patients frequently seek online educational material regarding root canal treatment and related conditions. However, the readability and scientific accuracy of AI generated dental information remain uncertain. Aim: To evaluate the readability and scientific accuracy of ChatGPT-generated patient education materials related to common endodontic conditions and procedures. Materials and Methods: A cross-sectional analytical study was conducted using 100 patient oriented responses generated by ChatGPT. Ten standardized endodontic prompts related to root canal treatment, dental abscess, infected teeth, post-treatment care, and treatment complications were entered ten separate times under identical settings. The generated responses were collected without modification. Readability assessment was performed using the Flesch Reading Ease Score, Flesch–Kincaid Grade Level, SMOG Index, and Gunning Fog Index. Scientific accuracy and quality of information were independently evaluated by three experienced endodontists using a structured 5-point Likert scale assessing accuracy, completeness, clarity, misleading information, and clinical usefulness. Statistical analysis was performed using descriptive statistics and Cohen’s kappa test for inter-examiner reliability. Results: ChatGPT-generated educational materials demonstrated moderate to high readability, with most responses corresponding to a secondary school reading level. The majority of responses showed good scientific accuracy, clarity, and clinical usefulness. However, certain responses lacked comprehensive explanations regarding procedural complications and emergency management. Minor inconsistencies and oversimplified information were observed in selected outputs. Inter-examiner agreement among evaluators was high. Conclusion: ChatGPT demonstrated promising potential in generating readable and reasonably accurate endodontic patient education materials. Nevertheless, professional verification by dental experts remains necessary before clinical use to ensure reliability and prevent dissemination of incomplete or misleading information.
Comparative Evaluation of Postoperative Pain, Swelling, and Trismus Fol lowing Impacted Mandibular Third Molar Surgery Using Platelet-Rich Fi brin and Ozone Therapy: A Randomized Clinical Study
Background: Postoperative pain, swelling, and trismus are common complications following impacted mandibular third molar surgery. Various adjunctive therapies have been introduced to improve healing and reduce postoperative discomfort. Platelet-rich fibrin (PRF) and ozone therapy have shown promising results due to their anti-inflammatory and healing-enhancing properties. Aim: To compare the effectiveness of PRF and ozone therapy in reducing postoperative pain, swelling, and trismus after impacted mandibular third molar surgery. Materials and Methods: This randomized clinical study included 45 patients requiring surgical extraction of impacted mandibular third molars. Participants were randomly divided into three groups: Group I (control), Group II (PRF), and Group III (ozone therapy). Postoperative pain was assessed using the Visual Analog Scale (VAS), swelling was measured using facial reference points, and trismus was evaluated by measuring maximum mouth opening on postoperative days 1, 3, and 7. Statistical analysis was performed using ANOVA and post hoc tests, with p < 0.05 considered statistically significant. Results: Both PRF and ozone therapy groups demonstrated reduced postoperative pain, swelling, and trismus compared to the control group. The PRF group showed superior improvement in soft tissue healing and reduction in pain scores, while the ozone therapy group demonstrated better reduction in swelling during the early postoperative period. The differences between the study groups were statistically significant (p < 0.05). Conclusion: Both PRF and ozone therapy are effective adjuncts in minimizing postoperative complications following impacted mandibular third molar surgery. PRF showed comparatively better overall healing outcomes, whereas ozone therapy was more effective in controlling early postoperative swelling.
Level of Vitamin D and its effect on the Lung Function among Paediatric with Bronchial Asthma: A Case–Control Study
Background: Bronchial asthma consider as one of chronic inflammatory illness among children, categorized by airflow restriction and bronchial hyper-responsiveness. A new studies that D deficiency may effects on immunomodulatory, in turn provoke asthma among patients who suffer from it. Objective: To evaluate serum vitamin D levels among children with asthma compared to healthy controls. In addition to assess an association of serum 25-hydroxyvitamin D levels and severity of asthma, pulmonary function, and disease control. Method: case–control study included 100 children aged 5–13 years, at Babylon hospital for maternity and paediatric, Iraq, from July 2024 to January 2025. Fifty children diagnosed with bronchial asthma were compared with 50 age and sex matched healthy controls. Serum 25-hydroxyvitamin D measured by ELISA and categorized into deficiency groups. Asthma severity was assessed clinically, and pulmonary function was evaluated using spirometry (FEV1 and FEV1/FVC). Results: D level expressively lesser among asthmatic child when compared with controls. Severe D deficiency (≤5 ng/mL) detected in 10% of asthmatic children and none of the controls, while deficiency (≤15 ng/mL) was present in 50% of cases compared to 10% of controls (p<0.001). A noteworthy converse association found between D levels and severity of asthma, with the lowest levels observed in severe asthma (p<0.001). Moreover, asthmatic children with D insufficiency (≤15 ng/mL) had significantly reduced pulmonary function, with mean FEV1 of 60.8±3.2 compared to 80.5±2.5 in those with higher vitamin D levels and 88.2±7.2 in controls (p<0.001). Conclusion: deficiency in vitamin D meaningfully linked with the bronchial asthma and its severity among children and correlates with impaired pulmonary function.
Impact of Prosthodontic Rehabilitation on Nutritional Status in Elderly Individuals
Background Tooth loss and compromised dentition are common among elderly individuals and may adversely affect chewing efficiency, food selection, and nutritional status. Prosthodontic rehabilitation has been suggested to improve oral function and dietary intake; however, evidence regarding its impact on nutritional status remains limited. The study was conducted to evaluate the impact of prosthodontic rehabilitation on the nutritional status of elderly individuals. Materials and Methods A hospital-based prospective interventional study was conducted among 220 elderly individuals requiring prosthodontic rehabilitation. Participants aged 60 years or older who met the eligibility criteria were included. Baseline demographic and clinical data were recorded. Nutritional status was assessed before and after rehabilitation using body mass index (BMI), Mini Nutritional Assessment (MNA) score, chewing ability score, and dietary intake patterns. Participants underwent indicated prosthodontic treatment, including complete dentures, removable partial dentures, or fixed prostheses. A follow-up assessment was performed after the adaptation period. Data were analysed using SPSS software. Descriptive statistics and paired comparison tests were applied, and p<0.05 was considered statistically significant. Results Among 220 participants, most belonged to the 60–69 years age group, and partial edentulism was more common. Significant improvement was observed following prosthodontic rehabilitation. Mean BMI increased from 20.82±2.74 to 22.04±2.68, while mean MNA score improved from 19.46±3.12 to 23.88±2.94 (p<0.001). Chewing ability also showed significant improvement. Dependence on soft diets reduced, and intake of fruits, vegetables, and protein-rich foods increased significantly after treatment. ConclusionProsthodontic rehabilitation positively influenced nutritional status, chewing ability, and dietary behavior among elderly individuals. Restoration of oral function may contribute to healthier aging and should form an integral component of geriatric oral healthcare.
Histopathological Spectrum of Oral Leukoplakia and Its Malignant Trans formation Risk
Background:Oral leukoplakia is one of the most common potentially malignant oral disorders, with a variable risk of transformation into oral squamous cell carcinoma. Histopathological evaluation plays a vital role in assessing the severity of epithelial dysplasia and predicting malignant potential. Aim:To evaluate the histopathological spectrum of oral leukoplakia and assess its risk of malignant transformation based on clinicopathological findings. Materials and Methods:The present retrospective observational study included 60 histopathologically confirmed cases of oral leukoplakia. Clinical details, including age, gender, lesion site, clinical appearance, and associated habits, were collected from patient records. Histopathological examination was performed on hematoxylin- and eosin-stained sections, and lesions were categorised by the degree of epithelial dysplasia. The correlation between clinical presentation and the risk of malignant transformation was analysed. Results:The majority of cases were observed among males aged 41–60. Buccal mucosa was the most commonly affected site. Homogeneous leukoplakia was more prevalent; however, non-homogeneous lesions were more strongly associated with moderate and severe dysplasia. Histopathological analysis revealed mild epithelial dysplasia as the most common finding, whereas severe dysplasia and carcinoma in situ were associated with an increased risk of malignant transformation. Conclusion:The study highlights that oral leukoplakia exhibits a broad histopathological spectrum with variable malignant potential. Non-homogeneous lesions and higher grades of epithelial dysplasia were strongly associated with increased risk of malignant transformation. Therefore, early diagnosis, histopathological assessment, habit cessation, and long-term follow-up are essential for the prevention of progression to oral cancer.Advancement of Knowledge:The present study provides a detailed evaluation of the histopathological spectrum of oral leukoplakia and its association with the risk of malignant transformation. The study emphasises the importance of correlating clinical presentation with histopathological grading to enable early identification of high-risk lesions. It further highlights the significance of non-homogeneous leukoplakia and advanced epithelial dysplasia as important predictors of malignant progression. The findings contribute to a better understanding of disease behaviour and support the need for regular monitoring and timely intervention in patients with oral leukoplakia.
Long-Term Functional Outcomes of TMJ After Maxillofacial Trauma
Background:Maxillofacial trauma involving the temporomandibular joint (TMJ) may lead to long-term functional complications affecting mandibular movement, mastication, speech, and overall quality of life. Condylar fractures and associated TMJ injuries are commonly associated with pain, restricted mouth opening, malocclusion, and joint dysfunction. Aim:To evaluate the long-term functional outcomes of the temporomandibular joint following maxillofacial trauma and to assess associated clinical complications affecting TMJ function. Materials and Methods:The present retrospective cross-sectional study included 50 patients with a previous history of maxillofacial trauma involving the TMJ region. Clinical evaluation was performed to assess mouth opening, mandibular deviation, TMJ pain, joint sounds, malocclusion, and mandibular movements. Radiographic assessment was performed using panoramic radiographs and CT/CBCT imaging as required. Functional outcomes were correlated with trauma aetiology and treatment modality. Results:The majority of patients were in the 21–40-year age group, with male predominance. Road traffic accidents were identified as the most common cause of trauma. Restricted mouth opening and TMJ pain were the most frequently observed long-term complications. Joint sounds, mandibular deviation, and malocclusion were also observed in several patients. Surgically managed patients demonstrated comparatively better functional outcomes than conservatively treated cases. Conclusion:Maxillofacial trauma involving the temporomandibular joint may result in persistent long-term functional impairment despite treatment. Early diagnosis, proper treatment planning, rehabilitation, and long-term follow-up are essential for restoring optimal TMJ function and minimising post-traumatic complications. Advancement of Knowledge The present study provides a comprehensive evaluation of long term temporomandibular joint dysfunction following maxillofacial trauma and highlights the importance of functional assessment during long-term follow-up. The study emphasises the association between condylar trauma and persistent complications such as restricted mouth opening, TMJ pain, and mandibular deviation. It further demonstrates that surgically managed cases show improved functional recovery compared with conservative treatment. The findings contribute to a better understanding of post-traumatic TMJ complications and support the importance of early intervention, radiographic evaluation, and rehabilitation in improving patient outcomes.