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In-vitro mechanical performance of three CAD-CAM bar designs for implant-supported metal–resin hybrid prostheses: a preliminary pilot study
(Elsevier B.V., 2026-01-20) Arteaga-Losada, Lorena; Laura-Fernadez, Héctor; Puerta-Dominguez, María Alejandra; Ascaso Terrén, Carlos; Vives i Santa-Eulàlia, Eduard; Escuin-Henar, Tomás; Torné Duran, Sergi
Background: Implant-supported hybrid metal–resin prostheses are widely used to rehabilitate edentulous patients. However, fractures of the veneering resin and screw complications remain common mechanical failures. Advances in CAD-CAM design and laser sintering technology may improve the structural integrity of these restorations. Aims: To conduct a preliminary in-vitro evaluation of the fracture resistance of veneering resin in three CADCAM–designed bar configurations fabricated by laser sintering, describing their mechanical behavior and failure patterns under compressive stress. Methods: Three bar designs (inverted T, L-shaped, and Ackerman circular) were digitally created and manufactured in cobalt–chromium using laser sintering. Each bar was veneered with autopolymerizing acrylic resin and subjected to compressive loading up to 1000 N at a 30◦ angle, in accordance with ISO 14801. Simultaneously, acoustic emission analysis was performed to detect microcracks and structural failures. Results: No fractures of the veneering resin were observed. Mechanical failures occurred as deformation or fracture of prosthetic screws, beginning at 600 N. Acoustic emission detected early microcracks between 160 N and 400 N, and main fracture peaks between 627 N and 871 N. Among the three samples, the inverted T-shaped bar sustained the highest load before failure in this pilot test. Conclusion: In this pilot in-vitro study, the veneering resin showed high resistance under simulated masticatory loading. The combination of CAD-CAM design, laser-sintered fabrication, and retentive elements may enhance mechanical performance. Further studies with larger sample sizes and cyclic loading are warranted to validate these preliminary findings.
Integrating augmented reality in prosthodontics: the role of nursing in enhancing patient communication and collaborative treatment planning
(Hunan University, 2025-08-05) Torné Duran, Sergi
AR technology is now fast paced in modifying clinical dentistry, especially in prosthodontics, where it supports better visualization, patient education, and interdisciplinary treatment planning. Unfortunately, AR integration tends to be approached from either a purely technical or dental specialist perspective, thus neglecting the crucial role of nurses in patient communication and co-care. Therefore, the paper analyzes how nursing contributes to AR-supported prosthodontic care, aimed at enhancing patient understanding, emotional preparedness, and decision-making. It synthesizes state-of-the-art use of AR in dental surgery, diagnostics, and education, into a nursing communicative framework. The article focuses on nurses as communicative mediators between advanced technologies and patients, especially during patient preparation for extensive prosthodontic treatments. Through an interdisciplinary approach, this article identifies barriers to adoption and analyses case study applications, outlining strategies to improve cooperative workflows. This review aims to provide a future vision on applying immersive technology to patient-oriented prosthodontics, wherein nurses are assisted to become effective communicators and facilitators of digital care.
Age and risk of inferior alveolar nerve injury after removal of lower third molars close to the mandibular nerve
(Elsevier, 2026-06) Soler Capdevila, Judith; Camps Font, Octavi; Sanmartí Garcia, Gemma; Toledano Serrabona, Jorge; Gay Escoda, Cosme; Barbosa de Figueiredo, Rui Pedro; Valmaseda Castellón, Eduardo
Background: Extraction of lower third molars (3 Ms) carries a risk of inferior alveolar nerve (IAN) injury. Anatomical proximity is a well-known risk factor, although the effect of patient age remains insufficiently explored. Purpose: The study purpose was to measure the association between age and IAN injury among patients whose 3 Ms are close to the mandibular canal. Study Design, Setting, Sample: This case-control study included patients at increased risk for IAN injury due to close proximity of the lower 3 Ms to the mandibular canal, as assessed by preoperative cone-beam computed tomography. The exclusion criteria were poor preoperative CBCT, cysts or tumours related to the 3 Ms, intake of drugs related to osteonecrosis of the jaws, and previous radiotherapy. Exposure Variable: The exposure variable was age. Main Outcome Variable: The outcome variable was IAN neurosensory status. Cases were defined as IAN neurosensory deficit at 1 month after extraction. Covariates: The following covariates were analyzed: sex, body mass index, operated side, 3 Ms position (Pell and Gregory and Winter classifications), number and shape of the roots, IAN position (lingual, buccal, or apical), ostectomy, and tooth sectioning. Statistical Analysis: Univariate associations were explored with simple binary logistic regression, reporting crude odds ratios (ORS). The adjusted OR for age was calculated using multivariate binary logistic regression using Stata 14.2. Statistical significance was set at P < .05. Results: A total of 219 patients (60% female) were screened; the mean age was 28.2 ± 10.7 years. Thirty-seven subjects (16.89%) presented an IAN neurosensory deficit 1 month postextraction (cases). These cases were compared with 111 randomly selected subjects without IAN impairment from the initial cohort of 219 patients. The risk of IAN neurosensory deficit increased with age (adjusted OR per year = 1.06; 95% CI, 1.01 to 1.11; P = .008). Impaction depth (OR = 9.29; 95% CI, 2.44 to 35.39; P = .001) and lingual position of the IAN (OR = 3.09; 95% CI, 1.06 to 9.03; P = .039) were also associated with increased risk. Each additional year of age increased the adjusted OR of neurosensory deficit by 6%. Conclusions and Relevance: IAN neurosensory deficit occurred in 16.89% of subjects. Age was a statistically significant independent risk factor of IAN injury and should be considered in preoperative planning.
Emotional regulation, empathy and surgical performance in undergraduate dental students: A prospective cohort study
(Medicina Oral SL, 2026-07-01) Ballestero Pérez, Alba; Martínez Mayoral, Idana; Rosa Gay, María Cristina de la; García-García, Marta; Aguilera, Mari; Barbosa de Figueiredo, Rui Pedro; Valmaseda Castellón, Eduardo; Alba Sánchez-Torres
Background: Dental students experience high stress from academic and clinical demands, which may affect performance and well-being. Surgical procedures often increase patient anxiety, adding complexity for students. This study explored the relationship between perceived difficulty, emotional regulation, and empathy, and their impact on clinical outcomes and patient satisfaction. Material and Methods: A prospective cohort study included fourth-year dental students in the Clinical Oral Surgery and Implantology subject at the University of Barcelona Dental Hospital. Data collected comprised demographics, emotional regulation difficulties, and preoperative anxiety, using validated questionnaires. Procedure-related variables (perceived difficulty, operative time, complications) and patient data (anxiety, perceived empathy, satisfaction) were recorded. Results: Thirty-six students performed 108 extractions on 72 patients, with a mean operative time of 38.2±19.9 minutes. Emotional regulation difficulties were not associated with surgical difficulty, empathy, operative time, or complications. Interestingly, patient state anxiety was significantly related to higher difficulty on emotional regulation by the undergraduate. No significant correlation was found between patient anxiety and number of visits. Perceived empathy positively correlated to patient satisfaction. Conclusions: Empathy and emotional regulation are essential for enhancing patient experience and outcomes. Our findings suggest that students’ emotional regulation difficulties are related to situational anxiety during clinical encounters. These results support integrating interpersonal skills into dental education to improve clinical practice and patient-centered care.
Conditional Wave Function Theory: A Unified Treatment of Molecular Structure and Nonadiabatic Dynamics
(American Chemical Society, 2021-12-14) Albareda, Guillermo; Lively, Kevin; Sato, Shunsuke A.; Kelly, Aaron; Rubio, Àngel
We demonstrate that a conditional wave function theory enables a unified and efficient treatment of the equilibrium structure and nonadiabatic dynamics of correlated electron–ion systems. The conditional decomposition of the many-body wave function formally recasts the full interacting wave function of a closed system as a set of lower-dimensional (conditional) coupled “slices”. We formulate a variational wave function ansatz based on a set of conditional wave function slices and demonstrate its accuracy by determining the structural and time-dependent response properties of the hydrogen molecule. We then extend this approach to include time-dependent conditional wave functions and address paradigmatic nonequilibrium processes including strong-field molecular ionization, laser-driven proton transfer, and nuclear quantum effects induced by a conical intersection. This work paves the road for the application of conditional wave function theory in equilibrium and out-of-equilibrium ab initio molecular simulations of finite and extended systems.
Are arch width measurements from Invisalign arch width tables reliable?
(Springer Verlag, 2026-05-13) Rosa Gay, María Cristina de la; Valmaseda de la Rosa, Sofia; Hernández Mangas, Andrea; Camps Font, Octavi; Valmaseda Castellón, Eduardo; Barbosa de Figueiredo, Rui Pedro
Introduction: Despite being widely used for treatment planning, the accuracy of Invisalign arch width tables has not been independently assessed. The objective of this study was to assess whether the predicted and observed arch width changes calculated from Invisalign tables are consistent with measurements obtained from STL models. Methods: Thirty-five adults treated with Invisalign aligners were retrospectively selected. Arch width at the maxillary and mandibular canines, premolars, and first molars was measured on digital models (pretreatment, prediction and first-refinement) using Geomagic Control X. Predicted and observed expansions (difference between predicted or post-treatment and pretreatment arch widths), and their discrepancy, were compared with the corresponding values calculated from the ClinCheck arch width tables. Three references were selected: (1) the projection of the long axis of the tooth on the occlusal surface, (2) the buccal/mesiobuccal cusps, and (3) the most lingual point of the gingival margin. Normality was assessed with the Shapiro-Wilk test. Agreement was evaluated using Bland-Altman analysis with mixed-effects models to account for clustering of repeated measurements. Results: 840 arch widths were analyzed (35 patients, 4 tooth pairs, 2 jaws, and 3 time points). Non-normality of inter-method differences was observed in predicted expansion (gingival and occlusal references) and in discrepancy (cusp reference) (p < 0.05). Non-parametric Bland-Altman analysis showed high agreement between Geomagic and ClinCheck measurements for predicted expansion, observed expansion, and discrepancy, with bias values ranging from − 0.49 to 0.2 mm. Conclusions: ClinCheck arch width tables showed strong agreement with independent metrological assessment, particularly with occlusal reference points [bias: 0.00 mm; limits of agreement: −0.80 to 1.01 mm]. Clinical relevance: ClinCheck arch width tables have been validated with an independent metrological assessment (Geomagic Control X). Predicted expansion, observed expansion, and discrepancy derived from arch width tables agreed with independent measurements using virtual casts.
Cone Beam Computed Tomography (CBCT) Prevalence and Morphometry of Foramen Vesalius: A Systematic Review, Meta-Analysis, and Update of the Literature
(MDPI, 2026-03-01) Alshehri, Abdullah Hasan A.; Alsaeed, Anwar Abdullah; Al-Serhani, Hajer Saeed; Assiri, Hassan; Alqarni, Abdullah; Alassiri, Saeed; Alamri, Mohammad; Egido-Moreno, Sonia; Lopez-Lopez, José
Background: The foramen of Vesalius (FV; also known as the sphenoidal emissary foramen (SEF) or foramen venosum) is an inconstant skull-base foramen located near the foramen ovale. Its recognition may be relevant to percutaneous trigeminal procedures. Methods: This systematic review was registered in INPLASY (INOLASY2025100037; 11 October 2025) and conducted in accordance with PRISMA 2020. We searched PubMed, Scopus, and Web of Science from inception until December 2025 for English-language studies reporting the prevalence and/or morphometry of the foramen of Vesalius using cone-beam computed tomography (CBCT). Five reviewers screened and extracted data; prevalence studies were assessed for risk of bias using the Joanna Briggs Institute checklist. A random-effects meta-analysis of logit-transformed proportions was applied when ≥3 studies reported comparable prevalence outcomes. Results: Five retrospective CBCT studies (n = 1567) met the inclusion criteria. The prevalence of FV ranged from 28.1% (89/317; 95% CI 23.4–33.3) to 73.1% (190/260; 95% CI 67.4–78.1) throughout the cohorts. The total prevalence was 50.6% (95% CI 36.1–65.1), with significant variability (I2 = 96.8%) and a broad 95% prediction interval (19.5–81.3). The documented FV–FO distances were typically a few millimeters (about 2–5 mm), whereas the FV–foramen spinosum (FS) distances varied from approximately 11 to 14 mm, contingent upon the cohort and measuring technique employed. Conclusions: FV is frequently observable on CBCT when the skull base is within the field of view; nevertheless, current prevalence estimates lack precision because of the limited number of five retrospective investigations, which are inconsistent and clinic-based. Standardized definitions and reporting for CBCT, together with population-based cohorts, are crucial for improving clinically applicable prevalence and morphometric reference data.
From peri-implant mucositis to peri-implantitis: Incidence and risk indicators in a university dental hospital sample with up to 10 years of follow-up.
(Elsevier, 2026-01-25) Alahmari, Ahmad; Arsalan Askarizadeh, Amir; Barbosa de Figueiredo, Rui Pedro; García-García, Marta; Costa-Berenguer, Xavier; Sales Collado, Miquel; Valmaseda Castellón, Eduardo; Sánchez Torres, Alba
OBJECTIVES: To determine the proportion of patients with peri‑implant mucositis who develop peri‑implantitis over a 1- to 10-year follow-up period, and to identify the variables associated with this progression.MATERIALS AND METHODS: A retrospective cohort study was conducted including 97 patients with 204 dental implants diagnosed with peri‑implant mucositis. Clinical and radiographic examinations were performed, and compliance with supportive peri‑implant care (SPIC) was recorded. A multilevel multinomial logistic regression model was developed to identify the predictors of disease progression.RESULTS: After a mean follow-up of 49.8 months, 23.7% of patients initially diagnosed with peri‑implant mucositis became healthy, 57.7% showed no change and remained with peri‑implant mucositis, while 18.5% progressed to peri‑implantitis. A history of periodontitis significantly increased the odds of presenting peri‑implant disease at the last follow-up appointment (p < 0.001). Conversely, regular compliance with SPIC, prostheses with an adequate design, and single-unit restorations significantly reduced the risk of progression (p < 0.001).CONCLUSIONS: Almost one fifth of patients with dental implants with peri‑implant mucositis are likely to develop peri‑implantitis after a mean follow-up of 4 years. A history of periodontitis, irregular supportive peri‑implant care and inadequate prosthetic design increase the likelihood of bone loss and progression to peri‑implantitis.CLINICAL SIGNIFICANCE: This study emphasizes the importance of regular supportive peri‑implant care and appropriate prosthetic design to prevent progression from peri‑implant mucositis to peri‑implantitis, especially in patients with a history of periodontitis.
Laser-Based Photobiomodulation in Postoperative Tissue Healing in Oral and Maxillofacial Surgery: Systematic Review of RCTs
(MDPI, 2026-01-12) Niedzielska, Iwona; Dawiec, Grzegorz; Wiench, Rafal; Pihut, Malgorzata; Skaba, Dariusz; Arnabat Domínguez, Josep
Background: Postoperative bone healing can be impaired by systemic factors and surgical trauma, leading to delayed recovery. Photobiomodulation therapy (PBMT) has been proposed as a non-invasive method to enhance osteogenesis, but variability in protocols and outcomes limits its clinical use. Aim: To systematically review and synthesize evidence from randomized controlled trials (RCTs) evaluating PBMT’s effectiveness in promoting postoperative osteogenesis. Methods: A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted following the PRISMA 2020 guidelines. Only RCTs comparing PBMT with sham treatment or standard care were included. Data on laser parameters, surgical indications, and outcomes such as bone regeneration, healing time, and implant stability were extracted. The risk of bias of the included randomized studies was evaluated using the Cochrane Risk of Bias 2 (RoB version 2) tool. Results: Twelve RCTs were included. PBMT consistently improved early soft tissue healing and reduced postoperative inflammation and edema. Some studies showed accelerated bone maturation, especially in grafted sockets and distraction osteogenesis, while others reported no significant long-term effects on implant stability or chronic lesion healing. Heterogeneity in laser parameters limited comparability. Conclusions: PBMT is a safe adjunct that reliably enhances early postoperative healing and may promote bone remodeling in selected cases. Standardized protocols and larger, high-quality RCTs are needed to confirm long-term benefits and optimize treatment parameters.
Rescue Therapy With Quad Zygoma After Failure of Full-Arch Implant Rehabilitation: A Retrospective Study With a Mean Follow-Up of 8 Years
(John Wiley & Sons, 2026-01-02) Fan, Shengchi; Zhou, Wenjie; Al-Nawas, Bilal; Valmaseda Castellón, Eduardo; Davo, Ruben
OBJECTIVES: To evaluate the long-term clinical outcomes of quad zygomatic implants (ZIs) as a rescue therapy for patients with failed full-arch implant rehabilitation in the maxilla due to advanced peri-implantitis. MATERIAL AND METHODS: This was a retrospective cohort study of all patients treated with the Quad Zygoma Protocol. Primary outcomes included the ZI survival and success rates, and secondary outcomes, the prosthetic success rate and complications. RESULTS: The study population included 28 consecutive patients who received 112 ZIs between 2006 and 2024, with a mean follow-up of 8.2 ± 4.1 years. In 23 patients, a total of 113 failed conventional implants were removed, and 48 ZIs were immediately placed into the explantation sites. The ZI survival rate was 98.2%, with two ZIs requiring removal due to late complications. The implant success rate was 93.5%, and prosthetic success was achieved in 96.4% of cases. Sinusitis was diagnosed in 8 patients (28.5%) at a mean of 5.92 years postoperatively; all cases were successfully managed medically without implant loss. Soft tissue recession occurred in 9.8% of cases, while oroantral fistula and facial fistula were each observed in 0.9% of implants. CONCLUSIONS: The Quad Zygoma Protocol may represent a reliable and predictable option for the rescue of failed maxillary full-arch implant rehabilitations. Despite a relatively high prevalence of sinusitis, favorable long-term clinical outcomes were achieved with appropriate management.
Is accurate dental implant placement feasible using a novel dynamic computer-assisted surgery system without patient optical markers or registration? A preliminary retrospective cohort study
(Wiley, 2026-02-17) He, Gang; Liao, Hongbing; Sheng, Hong; Valmaseda Castellón, Eduardo; Barbosa de Figueiredo, Rui Pedro
Objectives: To evaluate the accuracy and surgery time of dental implant placement using a novel dynamic computer-assisted implant surgery (dCAIS) system that eliminates the need for patient registration and optical tracking markers. The secondary objective was to compare these outcomes with those obtained using a conventional dCAIS system. Materials and Methods: A preliminary retrospective cohort study was conducted involving 33 participants (33 implants). Eleven implants were placed using the novel dCAIS system that determines patient positioning based on anterior tooth anatomy (Prototype group), while 22 implants were placed using a conventional dCAIS system requiring standard registration and an optical tracking marker (Control group). Pre- and postoperative cone-beam computed tomography (CBCT) scans were superimposed to assess implant placement accuracy. Descriptive and bivariate analyses were performed to compare accuracy and surgery time between the two groups. Results: Mean angular deviations were similar between groups (p = 0.924): 1.95° (SD 1.38) in the prototype group and 2.38° (SD 2.30) in the control group. No significant differences were observed in platform global deviation (mean difference [MD]: −0.33 mm; 95% CI: −0.75 to 0.09), apex global deviation (MD: −0.43 mm; 95% CI: −0.94 to 0.08), or apex depth deviation (MD: 0.28 mm; 95% CI: −0.30 to 0.86). Surgical procedures were significantly faster in the prototype group (p = 0.002; MD: 3.0 min; 95% CI: 0.56–5.45). Conclusions: The findings of this preliminary study seem to suggest that the tested prototype dCAIS system may be feasible to accurately place implants without conventional registration or optical tracking, potentially reducing surgical time. However, these findings should be interpreted with caution due to the study limitations.
Relationship Between Anemia and Oral Lichen Planus: New Therapeutic Perspectives Based on Anemia Management—A Systematic Review and Meta-Analysis
(MDPI, 2026-01-11) Egido-Moreno, Sonia; Valls Roca-Umbert, Joan; Schemel-Suárez, Mayra; Vidal, August; Blanco, Albert; López-Olóriz, Jorge
Background/Objectives: Anemia is a multifactorial condition influenced by nutritional deficiencies, chronic diseases, and inflammatory processes. These factors not only contribute to anemia but may also exacerbate oral conditions such as Oral Lichen Planus (OLP) by impairing epithelial integrity and immune function. By synthesizing published studies, this review seeks to clarify whether anemia is associated with OLP and to highlight biological mechanisms common to both conditions that could be relevant for future therapeutic development. Methods: A comprehensive literature search was conducted across the selected electronic databases: Medline/Pubmed, Scopus, and Cochrane. Methodological quality and potential bias of the included studies were evaluated using the Newcastle–Ottawa Scale (NOS), while the overall certainty of the evidence was appraised according to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) framework. Forest plots were generated using the Cochrane RevMan software to evaluate and visually summarize the results of the included studies. Results: Application of the search strategy resulted in the identification of 549 articles; after applying exclusion and inclusion criteria, 11 papers were selected. The prevalence of anemia, iron deficiency, and folic acid deficiency was significantly increased in the study population (p < 0.05); whereas hemoglobin deficiency was observed exclusively in women with statistical significance (p < 0.00001), driven by a single large study. Conclusions: Patients with OLP show a higher prevalence of anemia and deficiencies in key hematologic micronutrients such as vitamin B12, folic acid, and iron. Routine laboratory evaluation is recommended to detect and manage these systemic alterations. In addition to corticosteroid therapy, micronutrient supplementation may serve as a useful complementary treatment approach.
From peri-implant mucositis to peri-implantitis: Incidence and risk indicators in a university dental hospital sample with up to 10 years of follow-up
(Elsevier, 2026-01-06) Alahmari, Ahmad; Arsalan Askarizadeh, Amir; Barbosa de Figueiredo, Rui Pedro; García-García, Marta; Costa-Berenguer, Xavier; Sales Collado, Miquel; Valmaseda Castellón, Eduardo; Sánchez Torres, Alba
Objectives: To determine the proportion of patients with peri‑implant mucositis who develop peri‑implantitis over a 1- to 10-year follow-up period, and to identify the variables associated with this progression. Materials and Methods: A retrospective cohort study was conducted including 97 patients with 204 dental implants diagnosed with peri‑implant mucositis. Clinical and radiographic examinations were performed, and compliance with supportive peri‑implant care (SPIC) was recorded. A multilevel multinomial logistic regression model was developed to identify the predictors of disease progression. Results: After a mean follow-up of 49.8 months, 23.7% of patients initially diagnosed with peri‑implant mucositis became healthy, 57.7% showed no change and remained with peri‑implant mucositis, while 18.5% progressed to peri‑implantitis. A history of periodontitis significantly increased the odds of presenting peri‑implant disease at the last follow-up appointment (p < 0.001). Conversely, regular compliance with SPIC, prostheses with an adequate design, and single-unit restorations significantly reduced the risk of progression (p < 0.001). Conclusions: Almost one fifth of patients with dental implants with peri‑implant mucositis are likely to develop peri‑implantitis after a mean follow-up of 4 years. A history of periodontitis, irregular supportive peri‑implant care and inadequate prosthetic design increase the likelihood of bone loss and progression to peri‑implantitis. Clinical Significance: This study emphasizes the importance of regular supportive peri‑implant care and appropriate prosthetic design to prevent progression from peri‑implant mucositis to peri‑implantitis, especially in patients with a history of periodontitis
Prediction of traction time for the alignment of impacted maxillary canines
(BioMed Central, 2026-01-20) Rosa Gay, María Cristina de la; Valmaseda Castellón, Eduardo; Barbosa de Figueiredo, Rui Pedro; Hernández Mangas, Andrea; Camps Font, Octavi
Background To identify which factors influence the traction time of impacted maxillary canines using a combined orthodontic-surgical approach and to create a multivariate model to predict canine traction time. Methods Patients undergoing traction of impacted maxillary canines by a single orthodontist were selected. Seventy patients (mean age±SD): 19.32±8.81) meeting the inclusion criteria were enrolled in the study. They had 89 impacted canines (69 palatally displaced and 20 in a buccal position). Variables that could be related to orthodontic treatment as a whole and to impaction and its treatment were recorded for each patient. The treatment predictors were explored by univariate Cox regression and multivariate generalized linear mixed models (GLMM). A multivariate analysis was performed using a mixed-effects parametric survival analysis (MMPSA) Weibull model to assess the contribution of each of the predictive variables and to create a multiple linear regression model to explain canine traction time. Results Cox regression showed significant association between traction time and age (p=0.013) and the number of failed appointments (p<0.001). An MMPSA Weibull model to build a predictive model based on the Akaike information criterion (AIC) showed that interceptive maxillary expansion significantly reduced traction time (p=0.002). In contrast, traction time increased with a wider angle of the impacted canine relative to the midline, with missed appointments, and with radiological overlap with lateral or central incisors. Conclusions The orthodontic treatment time to align impacted maxillary canines increases with radiological overlap with lateral and central incisors, a wider angle to the midline, the absence of interceptive maxillary expansion, and missed appointments.
Prevalence of Mandibular Third Molar Impaction, Associated Pathologies, and Correlation With Temporomandibular Joint Morphology in a Hospital-Based Spanish Cohort: A Panoramic Radiography Study
(Hindawi, 2026-12-01) Assiri, Hassan; Estrugo Devesa, Albert; Egido-Moreno, Sonia; Roselló Llabrés, Xavier; Hameed, Mohammed; Alqarni, Abdullah; López López, José, 1958-
Background Mandibular third molar is the most frequent impacted tooth in the oral cavity. Its presence can be associated with complications including the temporomandibular joint (TMJ) symptoms. Therefore, the present study aimed to assess the prevalence of impacted mandibular third molar (IMTM), associated pathologies, and its correlation with TMJ morphology in a hospital-based Spanish cohort. Methods We retrospectively reviewed existing orthopantomographs (OPGs) records, panoramic images of patients aged ≥18 with at least one IMTM who attended the Dental Hospital of the University of Barcelona (HOUB) between September 2021 and May 2023. The OPGs were assessed and interpreted by an experienced oral and maxillofacial radiologist for the type of impaction according to Winter’s classification system, associated pathologies, and shape of mandibular condyle. Results Out of 80 OPGs, 60% (95% confidence interval [CI]: 48.4%−70.7%) were females, and the majority 53.8% (95% CI: 42.3–64.9) were between 18 and 28 years of age. The prevalence rate of IMTM was 86.88%, with the left side commonly involved. On both sides, oval-shaped condyle and vertical IMTM were the most common, with dental caries and bone loss being the frequently observed pathologies. Sclerotic changes were depicted in 15% (95% CI: 8.2%−24.7%) of the cases on both sides of TMJ. On the other hand, no statistically significant associations were noticed between the pathologies and condyle shape (p > 0.05, Cramér’s V < 0.25). Vertical and mesioangular, followed by horizontally IMTMs, were the most prevalent types of impactions, indicating nonsignificant association with condylar shape (p > 0.05, Cramér’s V = 0.21–0.23). Conclusion In this hospital-based cohort, vertical IMTM and oval condylar morphology were predominant; however, condylar shape did not correlate with impaction type on panoramic radiographs. The findings are preliminary and require validation in sufficiently powered cone beam computed tomography (CBCT)-based studies with clinical TMJ assessment.
Patient-related factors that link chronic kidney disease and periodontitis: a scoping review
(Springer Verlag, 2024-12-09) Kaymaz, Kübra; Brunet i Llobet, Lluís; Rocha Eiroa, Maria Dolores; Ramírez Rámiz, Albert; Abdi Mahmoud, Muhiddin; Mashala, Elias Isaack; Miranda i Rius, Jaume
Several studies have proposed the existence of an association between periodontitis and chronic kidney disease (CKD) based on biological premises. There is growing evidence that chronic inflammation caused by periodontitis may contribute to the progression of CKD. The present study aimed to investigate studies that link CKD and periodontitis, including periodontitis proxies such as oral hygiene and tooth loss, and patient-related factors such as inflammatory response and genetic polymorphisms. An electronic search was conducted on the MEDLINE (Pubmed), Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science databases using an advanced search option up until August 2024. Thirty-two studies were included: 4 interventional, 16 cohort, and 12 case–control. Overall, the prevalence of periodontitis was significantly higher in patients with CKD: the diagnosis of periodontal disease was associated with an increase in the risk of incident CKD, and parameters of periodontal disease were negatively correlated with kidney function. Inside the field of periodontal medicine, the current evidence indicates a possible association between CKD and periodontitis and supports future longitudinal studies to investigate the two-way relationship between the diseases and their pathophysiology, and possibly to establish cause and effect.
New Middle Pleistocene hominin cranium from Gruta da Aroeira (Portugal).
(National Academy of Sciences, 2017) Villaescusa, Lucía; Souto, Pedro; Mauricio Ferré, Joan; Rodrigues, Filipa; Ferreira, A.; Godinho, P.; Trinkaus, E.; Zilhão, João, 1957-; Daura Luján, Joan; Sanz Borràs, Montserrat; Arsuaga, Juan Luis; Hoffmann, D.L.; Quam, Rolf M.; Ortega, María Cruz; Santos Ureta, Elena; Gómez, Sergio; Gómez Soler, Sandra; Rubio, Àngel
The Middle Pleistocene is a crucial time period for studying human evolution in Europe, because it marks the appearance of both fossil hominins ancestral to the later Neandertals and the Acheulean technology. Nevertheless, European sites containing well-dated human remains associated with an Acheulean toolkit remain scarce. The earliest European hominin crania associated with Acheulean handaxes are at the sites of Arago, Atapuerca Sima de los Huesos (SH), and Swanscombe, dating to 400–500 ka (Marine Isotope Stage 11–12). The Atapuerca (SH) fossils and the Swanscombe cranium belong to the Neandertal clade, whereas the Arago hominins have been attributed to an incipient stage of Neandertal evolution, to Homo heidelbergensis, or to a subspecies of Homo erectus. A recently discovered cranium (Aroeira 3) from the Gruta da Aroeira (Almonda karst system, Portugal) dating to 390–436 ka provides important evidence on the earliest European Acheulean-bearing hominins. This cranium is represented by most of the right half of a calvarium (with the exception of the missing occipital bone) and a fragmentary right maxilla preserving part of the nasal floor and two fragmentary molars. The combination of traits in the Aroeira 3 cranium augments the previously documented diversity in the European Middle Pleistocene fossil record.
Bruxism treatment outcomes: A systematic review and meta-analysis
(Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2025-12-05) Assiri, Hassan; Almuawi, Lama Fahad; Asiri, Batool Abdullah; Abumelha, Shatha Tareq; Alahmari, Raghad Musfer; Hameed, Mohammed; Egido-Moreno, Sonia; López López, José, 1958-
Background: This review aimed at addressing the treatment outcomes of bruxism. Methods: The systematic review protocol was registered in International Prospective Register of Systematic Reviews with protocol number (CRD42024597809). It was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search was performed to retrieve the relevant articles from PubMed, Web of Science, and Scopus databases. The inclusion criteria were predefined as original studies including randomized and non-randomized controlled trials, case series, studies published between October 2019, and October 2024 published in English. The retrieved studies suitable for analysis were subjected for data extraction and risk of bias assessment using the Joanna Brigg Institute checklists for the relevant design of the studies. Results: Finally, 22 studies were suitable for the data extraction and risk of bias assessment. Studies revealed that occlusal splints, both conventional and 3-dimensional-printed, have been widely studied for their ability to reduce nighttime muscle activity. These devices help distribute occlusal forces and alleviate symptoms, although their effectiveness varies depending on design and material. Botulinum toxin type A has been examined as a treatment option, particularly for reducing pain and muscle activity in patients with bruxism. Biofeedback devices have also been explored as a noninvasive alternative to control bruxism. Conclusion: Overall, there is no single treatment that is universally effective for all patients. A multidisciplinary approach combining different therapies may yield the best results. Further long-term studies with rigorous methodological control are essential to evaluate the durability of therapeutic effects and determine the most cost-effective interventions.
Comparative Performance of Haptic Virtual Simulation vs. Conventional Training in Class V Cavity Preparation: A Paired In Vitro Study
(MDPI, 2026-02-13) Basterra López, Aitor; Arroyo Bote, Sebastiana; López González, Ángel Arturo; Cuesta Román, Román; Obrador de Hevia, Joan; Riutord Sbert, Pedro
Background: Haptic virtual simulation (HVS) has emerged as a promising tool in dental education, yet evidence comparing its performance to conventional preclinical training remains limited. Establishing its effectiveness is essential to support its integration into competency-based curricula. Objective: The aim of this study was to compare Class V cavity preparations performed using conventional training on extracted teeth with those performed using a haptic virtual simulator, evaluating preparation time and cavity volume. Methods: Sixty-one extracted human molars were digitized using cone-beam computed tomography (CBCT) to generate corresponding virtual replicas. A calibrated operator prepared 122 standardized Class V cavities (61 real and 61 virtual). The simulator automatically recorded preparation time and cavity volume. For natural teeth, cavity volume was calculated by digital superimposition of pre- and post-operative STL models using Blender. Paired means were compared using Student’s t-test (α = 0.05). Results: Preparation time was significantly shorter when using HVS compared with the conventional method (p < 0.001). Virtual preparations resulted in slightly larger cavity volumes than real preparations, with a statistically significant yet clinically small difference (p = 0.047). Conclusions: Haptic virtual simulation enables more time-efficient Class V cavity preparation while producing cavity volumes comparable to those obtained through conventional training. These findings support the implementation of haptic simulators as a valid and effective complement for preclinical skill acquisition in operative dentistry.
Review of clinical practice guidelines on the diagnosis and treatment of third molars. Evaluation of adherence to AGREE II publication guideline
(Medicina Oral SL, 2026-01-01) Herráez-Tondo, Mª Gemma; Gay Escoda, Cosme; Toledano Serrabona, Jorge; Sánchez Garcés, Ma. Ángeles
Background: Clinical practice guidelines (CPG) are developed to summarize the available evidence for healthcare professionals and standardize decisions in the clinical setting. For them to be useful, they must be generated following systematic methods, have high scope and applicability, present information clearly, and be updated every five years. The main aim of this review was to evaluate the available CPGs on the diagnosis and treatment of third molars (3M) using the AGREE II instrument to assess their quality and strength of recommendations. Material and Methods: An electronic search was conducted using the PubMed (MEDLINE), Cochrane Library, and Scopus databases. Additionally, a manual search was performed by international health organizations and dental and surgical associations. The inclusion criterion was CPG published in the last 5 years on the diagnosis and treatment of 3M. The quality of the guidelines was analyzed using the AGREE II instrument. Results: 14 CPGs were identified; However, only seven met the inclusion criteria. The guidelines from the Spanish Society of Oral Surgery (SECIB) and the Malaysia Oral Health Programme (MOHP) were considered high-quality. In contrast, guidelines from the German Medical Association (DGMKG), French Society of Stomatology MaxilloFacial Surgery and Oral Surgery (SFSCMFCO) and Royal College of Surgeons of England (RCSE) were rated as moderate quality and recommended with modifications. The Finnish Medical and Dental Society (FMDS) and Dutch Association of Oral and Maxillofacial Surgeons (NVMKA) did not meet the minimum quality standards. Conclusions: The AGREE II analysis reveals a need for substantial improvement in third molar CPGs. Only two guidelines were rated as high-quality, with most being outdated or soon to be. Regular updates by guideline-developing organizations are essential to ensure accurate and relevant clinical recommendations.

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