Articles publicats en revistes (Odontoestomatologia)

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Salivary Characteristics and Other Risk Factors Associated with the Severity of Chemical and Mechanical Tooth Wear in At-Risk Groups: A Cross-Sectional Study.
(MDPI, 2025-10-14) Rius Bonet, Ona; Willaert Jiménez-Pajarero, Eva; Jiménez-Murcia, Susana; Diego Esteve, Guillem; Artero, Cristina; Sánchez Romero, Isabel; Baenas, Isabel; Peña Cala, Maria Carmen; Fernández Aranda, Fernando; Martínez Gomis, Jordi
L’objectiu de la recerca va ser explorar com els factors salivals influeixen en el desgast dental (TW) en persones amb malaltia per reflux gastroesofàgic (GERD), bruxisme del son (SB), trastorns de la conducta alimentària (ED) i ludopatia (GD), comparant-les amb un grup control sa. L’estudi, de disseny transversal, va incloure 147 adults dividits en aquests cinc grups. Es van recollir dades mèdiques, d’hàbits i d’estil de vida, i es va avaluar el desgast dental amb l’escala TWES 2.0, així com la força oclusal i les propietats de la saliva (pH, flux i capacitat tampó).Els resultats van mostrar que els grups amb GERD i ED presentaven el pH salival més baix i també el desgast químic i mecànic més elevat. El desgast químic i el mecànic estaven fortament correlacionats, i aquest últim augmentava amb l’edat. El pH salival i el grup de risc explicaven gairebé la meitat de la variabilitat del desgast químic, mentre que l’edat i la força de mossegada explicaven més de la meitat del desgast mecànic.En conclusió, el desgast químic està estretament relacionat amb el pH salival baix i amb pertànyer als grups de risc GERD o ED, mentre que el desgast mecànic depèn sobretot de l’edat i de la força de mossegada. Els autors recomanen estudis longitudinals futurs amb mostres més àmplies i metodologies estandarditzades per aprofundir en aquestes associacions.
PATIENT SATISFACTION AND FUNTIONAL OUTCOMES OF CAD/CAM VERSUS CONVENTIONAL DENTURES
(Seybold Publications, 2025-07-30) Torné Duran, Sergi
Digital realm prosthodontics has become an enormous area of development in one application of complete dentures. CAD/CAM technology has become a dominant alternative to conventional methods. This paper compares systematically different outcomes and patient satisfaction between those dentures produced by CAD/CAM and those of classical fabrication. In addressing the subject, there is a discussion of contemporary clinical trials, crossover studies, and meta-analyses on comfort, esthetics, masticatory efficiency, adaptation period, and long-term retention. According to the results, CAD/CAM denture offers greater precision compared with the one of conventional fabrication, and patient-reported satisfaction was also higher for CAD/CAM complete dentures about their oral health–related quality of life (OHRQoL). However, this new method is disadvantageous because of accessibility and cost-effectiveness. Here, the review further discusses why the results may differ between populations, digital methods (milled vs. 3D-printed comprehensive), and evaluation instruments. This discussion provides clues for decision-making; namely, when the patient-centered outcomes bear, the CAD/CAM denture provides a potential advantage over traditional dentures. Nonetheless, randomized controlled trials with standardized measures are still foremost to establish long-term effectiveness
Substantivity of mouth-rinse formulations containing cetylpyridinium chloride and O-cymen-5-ol: a randomized-crossover trial
(BioMed Central, 2022-12-27) Aguilera, Felipe-Rodrigo; Vinas, Miguel; Sierra, Josep M.; Vinuesa Aumedes, Teresa; Fernandez de Henestrosa, Antonio R.; Furmanczyk, Marta; Trullàs, Carles; Jourdan, Eric; López López, José, 1958-; Jorba Pedrosa, Marta
Background The efficacy of mouth-rinses strongly depends upon their substantivity. The use of natural and non-toxic products that avoid secondary effects is gaining interest in preventive dentistry. The purpose of this study was to evaluate the substantivity of two formulations of mouth-washing solutions based on cetylpyridinium (CPC) and O-cymen-5-ol. Methods This was a randomized, double-blind, crossover trial conducted at the Faculty of Medicine and Health Sciences of the University of Barcelona. Bacterial re-colonization was followed by live/dead (SYTOTM9 + propidium iodide) bacterial staining and measured by confocal laser scanning microscopy and fluorometry. Unstimulated saliva samples were collected from 16 healthy individuals at baseline saliva and then, at 15 min, 30 min and 1, 2, 3, and 4 h after the following mouth-rinses: (i) a single, 1-min mouth-rinse with 15 ml of placebo (negative control); (ii) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) ; (iii) a single, 1-min mouth-rinse with 15 ml of O-cymen-5-ol (0.09%); (iv) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) + O-cymen-5-ol (0.09%). Results Proportion of dead bacteria was significantly higher for all mouthrinses during the first 15 min compared to baseline (CPC = 48.0 ± 13.9; 95% CI 40.98–56.99; p < 0.001, O-cymen-5-ol = 79.8 ± 21.0; 95% CI 67.71–91.90; p < 0.05, CPC + O-cymen-5-ol = 49.4 ± 14; 95% CI 40.98–56.99; p < 0.001 by fluorometry and 54.8 ± 23.0; 95% CI 41.50–68.06; p < 0.001, 76.3 ± 17.1; 95% CI 66.36–86.14; p < 0.001, 47.4 ± 11.9; 95% CI 40.49–54.30; p < 0.001 by confocal laser scanning microscopy, respectively). Nevertheless, after 4 h, CPC + O-cymen-5-ol was the only one that obtained significant values as measured by the two quantification methods used (80.3 ± 22.8; 95% CI 67.15–93.50; p < 0.05 and 81.4 ± 13.8; 95% CI 73.45–89.43; p < 0.05). The combined use of CPC + O-cymen-5-ol increased the substantivity of the mouthrinse with respect to mouthrinses prepared with either of the two active products alone. Conclusion The synergistic interaction of CPC and O-cymen-5-ol prolongs their substantivity. The resulting formulation may be as effective as other antimicrobials, such as triclosan or chlorhexidine, but without their undesirable secondary effects. Thus, mouthrinsing products based on Combinations of CPC and O-cymen-5-ol may replace in the near future Triclosan and Chlorhexidine—based mouthrinses.
ADVANCEMENTS IN 3D PRINTING FOR DENTAL PROSTETICS :A REVIEW OF CURRENT TRENDS AND APPLICATIONS
(Seybold Publications, 2025-07-30) Torné Duran, Sergi
3D printing has sparked a major revolution in the field of dental prosthetics by offering never-before levels of customization, accuracy, and efficiency in production. As an extension of digital dentistry, 3D printing provides suitable fabrication of dental prostheses using additive manufacturing techniques such as stereolithography (SLA), selective laser sintering (SLS), or fused deposition modeling (FDM). These technologies have made things easier from the time of intraoral scanning and computer-aided design (CAD) to the actual production of working dental appliances. This review aims to bring forth the current trends, innovations in materials, and clinical applications of 3D printing in the field of prosthodontics. Using recent peer-reviewed literature, we weigh the benefits of 3D printing against those of traditional methods concerning turnaround time, patient comfort, and reproducibility. These are opposed by drawbacks such as fewer options for materials, the expense entailed in acquiring state-of-the-art equipment, and long-term clinical proof for some applications. From the primary overview emerges a rapid evolution in printable biomaterials, including biocompatible resins, polymers, and metal alloys; adoption of digital workflows in dental laboratories and clinics has also grown. Prominent trends seem to include integration with AI, hybrid printing methods, and the potential for smart prosthetic devices. In a clinical prosthodontic setting, 3D printing allows far-reaching implications for treatment that is more accessible, more accurate, and more patient specific. Thus, interdisciplinary research and regulatory standardization are necessary to maximize the potential in the long run.
Histological assessment of a novel de-epithelialization method for connective tissue grafts harvested from the palate. An experimental study in cadavers.
(Springer Verlag, 2024-05-28) Bara Gaseni, Natalia; Jorba García, Adrià; Alberdi Navarro, Javier; Barbosa de Figueiredo, Rui Pedro; Bara Casaus, Javier
Objectives: This study aims to compare the histological outcomes of three distinct de-epithelialization methods used in (connective tissue grafts) CTG harvested from the palate. Materials and methods: An experimental study using nine cadaver head specimens was carried out to compare 3 different de-epithelialization techniques for CTG. Eighteen samples were randomly allocated to three study groups: bone scraper, diamond bur and extraoral removal with a scalpel. The main outcome variable was the graft surface percentage without epithelium remains. Additionally, the time employed, and the graft thickness were also measured. Results: Sixteen CTGs were analyzed. The extraoral scalpel group presented a total surface area with no epithelium of 58.84% (22.68) and a mean de-epithelialization time of 3.7 min; the intraoral diamond bur group had 88.24% (41.3) of the surface with no epithelium and took 1.455 min, and the intraoral bone scraper showed 97.98% (5.99) of surface without epithelium and a mean time of 0.815 min (P < 0.05). Histological analysis showed significant differences between the bone scraper and the extraoral group (P = 0.009).Conclusion: The de-epithelialization technique with a bone scraper seems to be the most effective and fastest de-epithelialization technique for CTG. These findings need to be confirmed in future clinical studies with larger samples. Clinical relevance: The use of bone scrapers, could be a simple, effective and fast technique to de-epithelialize connective tissue grafts harvested from the palatal area for both novice and experienced surgeons.
Substantivity of mouth‑rinse formulations containing cetylpyridinium chloride and O‑cymen‑5‑ol: a randomized‑crossover trial
(BioMed Central, 2022-12) Aguilera, Felipe-Rodrigo; Viñas, Miquel; Sierra Ortigosa, Josep Maria; Vinuesa Aumedes, Teresa; Fernandez de Henestrosa, Antonio R.; Furmancyk, Marta; Trullás, Carles; Jourdan, Eric; Lopez-Lopez, José; Jorba, Marta
Background: The efficacy of mouth-rinses strongly depends upon their substantivity. The use of natural and nontoxic products that avoid secondary effects is gaining interest in preventive dentistry. The purpose of this study was to evaluate the substantivity of two formulations of mouth-washing solutions based on cetylpyridinium (CPC) and O-cymen-5-ol. Methods: This was a randomized, double-blind, crossover trial conducted at the Faculty of Medicine and Health Sciences of the University of Barcelona. Bacterial re-colonization was followed by live/dead (SYTOTM9 + propidium iodide) bacterial staining and measured by confocal laser scanning microscopy and fluorometry. Unstimulated saliva samples were collected from 16 healthy individuals at baseline saliva and then, at 15 min, 30 min and 1, 2, 3, and 4 h after the following mouth-rinses: (i) a single, 1-min mouth-rinse with 15 ml of placebo (negative control); (ii) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) ; (iii) a single, 1-min mouth-rinse with 15 ml of O-cymen-5-ol (0.09%); (iv) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) + O-cymen-5-ol (0.09%). Results: Proportion of dead bacteria was significantly higher for all mouthrinses during the first 15 min compared to baseline (CPC = 48.0 ± 13.9; 95% CI 40.98-56.99; p < 0.001, O-cymen-5-ol = 79.8 ± 21.0; 95% CI 67.71-91.90; p < 0.05, CPC + O-cymen-5-ol = 49.4 ± 14; 95% CI 40.98-56.99; p < 0.001 by fluorometry and 54.8 ± 23.0; 95% CI 41.50-68.06; p < 0.001, 76.3 ± 17.1; 95% CI 66.36-86.14; p < 0.001, 47.4 ± 11.9; 95% CI 40.49-54.30; p < 0.001 by confocal laser scanning microscopy, respectively). Nevertheless, after 4 h, CPC + O-cymen-5-ol was the only one that obtained significant values as measured by the two quantification methods used (80.3 ± 22.8; 95% CI 67.15-93.50; p < 0.05 and 81.4 ± 13.8; 95% CI 73.45-89.43; p < 0.05). The combined use of CPC + O-cymen-5-ol increased the substantivity of the mouthrinse with respect to mouthrinses prepared with either of the two active products alone. Conclusion: The synergistic interaction of CPC and O-cymen-5-ol prolongs their substantivity. The resulting formulation may be as effective as other antimicrobials, such as triclosan or chlorhexidine, but without their undesirable secondary effects. Thus, mouthrinsing products based on Combinations of CPC and O-cymen-5-ol may replace in the near future Triclosan and Chlorhexidine¿based mouthrinses.
Prevalence of dental attrition and its relationship with Sent dental erosion and salivary function in young adults
(Quintessence Publishing Group, 2023-01-01) Rius Bonet, Ona; Roca Obis, Paula; Zamora Olave, Carla; Willaert, Eva; Martínez Gomis, Jordi
Objectives: The aim of this study was to estimate the prevalence of dental attrition in a young adult population and to explore associated factors. Method and materials: Dental students aged 18 to 40 years old with a minimum of 24 natural teeth were invited to take part in this cross-sectional study. Their demographic information, medical history, perceived stress, frequency of dietary acid intake, and frequency of oral habits were obtained through several questionnaires. Assessment of each type of tooth wear (erosion, attrition, and abrasion) was performed according to the tooth wear evaluation system (TWES 1.0). All participants underwent salivary tests. Statistical analysis was performed by chi-squared or Mann–Whitney tests and logistic regression models. Results: In total, 178 participants (88 women and 90 men) with a median age of 22 years were included and of those 74.7% (95% confidence interval [CI], 68% to 81%) had dental attrition. Univariate analysis revealed pos- itive associations for male sex, age, body mass index, awake bruxism frequency, and erosive tooth wear with the presence of dental attrition. Multivariable logistic regression (Nagelkerke r2 = 0.31) indicated that dental attrition was associated with ero- sive tooth wear (adjusted odds ratio [aOR], 6.3; 95% CI, 2.8 to 14.2), body mass index (aOR, 1.3; 95% CI, 1.1–1.5), and age (aOR, 1.2; 95% CI 1.0 to 1.3). Conclusion: Dental attrition is present in most young adults of Catalonia. The associated factors were erosive tooth wear, body mass index, and age. Slight alterations of salivary parameters do not seem to predict dental attrition.
Immunological and tissue reactions to titanium particles generated by the mechanical decontamination of dental implants: In vitro and in vivo study
(Medicina Oral, S.L., 2025-10-17) Gil, J.; Fonseca, D.; Fernández-domínguez, M.; Fernández-domínguez, P.; Akagi-camacho, S.; Toledano-serrabona, J.; Vegas-bustamante, E.; Camps-font, O.; Sánchez-garcés, MÁ.; Aragoneses, Jm.
Background: Mechanical decontamination of biofilm, or implantoplasty, is a commonly employed technique for managing peri-implantitis. However, the inflammatory response and in vivo behavior of titanium (Ti) particles released during this procedure remain underexplored. This study aimed to evaluate the cytotoxic, inflammatory, and osteogenic effects of Ti particles released during implantoplasty, as well as their in vivo behavior Material and Methods: Titanium particles were generated by following a standardized protocol using drills on 150 commercially pure Ti implants. Cytotoxicity thresholds were determined using THP-1 macrophages and bone marrow-derived mesenchymal stem cells (BM-MSCs). These cells were subsequently cultured with Ti particle-conditioned medium, and inflammatory responses were analyzed using RT-qPCR for markers such as CCR7, TNF-alpha, IL-1 beta (pro-inflammatory), and CD206, TGF-beta, IL-10 (anti-inflammatory). Cytokine levels were quantified using ELISA. Osteogenic responses in BM-MSCs were assessed by analyzing Runx2, alkaline phosphatase (ALP), and osteocalcin (OC) expression, and ALP activity was measured colorimetrically. In vivo, Ti particles were introduced into mandibular defects in 20 Wistar rats, with histological analysis performed 20 days post-implantation Results: Ti particles elicited a pro-inflammatory response in macrophages, with increased expression of TNF-alpha and reduced expression of TGF-beta and CD206. Cytokine analysis confirmed elevated IL-1 beta and reduced IL-10 levels. No significant changes in ALP activity were observed. Conclusions: Titanium particles released during implantoplasty induce pro-inflammatory responses.
Validity and reliability of the Spanish version of the Dental Impact on Daily Living (Sp-DIDL) questionnaire in a Spanish population: a cross-sectional study.
(BioMed Central, 2026-01-08) Rosa Gay, María Cristina de la; Pérez-Borrego, Laura; Subirà Pifarré, Carles; Barbosa de Figueiredo, Rui Pedro; Valmaseda Castellón, Eduardo; Sánchez Torres, Alba
BACKGROUND: Oral health has an impact on the patient's quality of life. This study aimed to translate, culturally adapt, and comprehensively validate the Dental Impact on Daily Living (DIDL) index for use among Spanish-speaking adults, encompassing the assessment of its reliability and construct validity. A secondary aim was to correlate the Sp-DIDL with demographic data, caries, periodontal attachment loss, and the use of prosthesis.METHODS: The original DIDL was translated and adapted into Spanish following international guidelines. A pilot test was done with 20 patients to assess comprehension and validity. Psychometric properties were evaluated in a cross-sectional study using a convenience sample of 125 adults (mean age 49.3 years) recruited from the Dental Hospital of the University of Barcelona. Internal consistency was analysed with Cronbach's alpha. Intraclass Correlation Coefficient (ICC) was used to assess the test-retest reliability of the clinical measures (DMF index and periodontal attachment loss). Confirmatory Factor Analysis (CFA) and Known-Groups Validity were used to evaluate construct validity. The associations with demographic data, the Decayed-Missing-Filled (DMF) index, periodontal loss, and the use of prosthesis were assessed using one-way ANOVA, Student t-tests, Pearson's correlation, and multiple linear regression analysis.RESULTS: The final version of the Sp-DIDL was approved after testing on 20 patients (Cronbach's α = 0.919). In the validation stage, all Cronbach α values were > 0.90, indicating excellent internal consistency. The 5 factors had an explained variance over 0.40 (0.51 to 0.78). The mean DIDL score was - 1.08 (standard deviation (SD) = 1.82). Overall, the Sp-DIDL score showed a negative correlation with age (r = -0.535, p < 0.001) but was not associated with gender (p = 0.235). Patients with elementary studies or less had lower Sp-DIDL scores (p < 0.05). DMF was negatively correlated with Sp-DIDL (r = -0.318; p < 0.001). Patients with dental prostheses had lower Sp-DIDL scores (p < 0.05). The multiple lineal regression model only included age as a predictor of Sp-DIDL score (B = -0.049; p < 0.001).CONCLUSIONS: The DIDL questionnaire was validated in a Spanish population. This Spanish version of the DIDL proved valid and reliable for measuring the impact of oral health on patient quality of life. The Sp-DIDL was negatively correlated with age: the older the patient, the greater the impact of oral health status upon quality of life.
La osteorradionecrosis de los huesos maxilares. Protocolo de prevención y tratamiento
(Ediciones Especializadas Europeas, 2000) Montero Briceño, Mauricio; Delgado Molina, Esther; Berini Aytés, Leonardo; Gay Escoda, Cosme
Las radiaciones ionizantes utilizadas en el tratamiento de los tumores de cabeza y cuello pueden favorecer la aparición de complicaciones bucales con una frecuencia y gravedad variables. Aunque la osteorradionecrosis (ORN) es la complicación menos frecuente también es la más grave.
Tratamiento odontológico del paciente infectado por el VIH
(Ediciones Especializadas Europeas, 2001) Gallego Medina, I; Delgado Sureda, Eulàlia; Berini Aytés, Leonardo; Gay Escoda, Cosme
El tratamiento odontológico de los pacientes infectados por el virus de la inmunodeficiencia humana (VIH), en general no se diferencia de culaquier otro paciente, exceptuando el riesgo de contagio propio de dicha infección.
Consideraciones previas al tratamiento odontológico del paciente infectado por el VIH
(Ediciones Especializadas Europeas, 2001) Gallego Medina, I; Delgado Sureda, Eulàlia; Berini Aytés, Leonardo; Gay Escoda, Cosme
La infección por el virus de la inmunodeficiemcia humana (VIH) se caracteriza principalmente por una depresión de la respuesta inmonológica del hospedador. Los recientes avances en el conocimiento de la enfermedad y los nuevos tratamientos framacológicos han dado lugar a que la patologia asociada a la infección por el VIH pueda ser considerada actualment de carácter crónico.
Manejo odontológico del paciente drogodependiente
(Ediciones Especializadas Europeas, 2001) Díaz Ortiz, María Luisa; Delgado Sureda, Eulàlia; Berini Aytés, Leonardo; Gay Escoda, Cosme
El abuso de drogas es un problema común de la sociedad actual. Sus consumidores pueden padecer enfermedades que el odontológico debe conocer para prevenir, evitar y tratar posibles complicaciones durante le tratamiento bucodental.
Drill irrigation during in vitro drilling with three static computer-assisted implant surgery systems.
(Medicina Oral SL, 2026-01-24) Moya Martínez, Tania; Jorba García, Adrià; Lobos-Grimaldi, Sebastián; Valdés-Berritzbeitia, Iván; Bara Casaus, Javier; Barbosa de Figueiredo, Rui Pedro; Valmaseda Castellón, Eduardo
BACKGROUND: Static computer-assisted implant surgery (sCAIS) allows for accurate implant placement. However, the currently available systems usually block drill irrigation, increasing the risk of overheating and tissue damage. The present in vitro study evaluates the volume of irrigation solution that passes through the guide sleeve during implant drilling with different sCAIS systems.MATERIAL AND METHODS: The volume of irrigation solution that passed through a designed guide sleeve was measured on a 5ml syringe. The following sCAIS systems and groups were evaluated: a sleeve-in-sleeve with drill handle system (Straumann® sCAIS system); an integrated sleeve-in-drill system (RealGuide™ Z3D sCAIS system), and an integrated sleeve-in-drill system with irrigation channels (Adin® sCAIS system). The control group had neither drill handle nor sleeve-in-drill. The first pilot drill from each system was used, and drilling was performed for 10 seconds. The experiment was repeated 10 times for each group, and a blinded investigator measured the amount of irrigation solution in ml/s. A descriptive and bivariate analysis was performed.RESULTS: The median volume of irrigant collected over 10 seconds was: sleeve-in-sleeve group, 0.35 (IQR: 0.04) ml/s; sleeve-in-drill group, 0.07 (IQR: 0.04) ml/s; sleeve-in-drill system with channels group, 0.46 (IQR: 0.12) ml/s; and control group, 0.54 (IQR: 0.02) ml/s. The differences between groups were statistically significant (p=0.0001), except for the Adin sCAIS® system, which was not different from the control group (p=0.085).CONCLUSIONS: Within the limitations of the study, the volume of irrigation seems to be influenced by the design and sCAIS system used. Although all guides impeded irrigation, the Adin® sCAIS system facilitated irrigation the most.
Dynamic Computer-Assisted Surgery in Oral Surgery: A Systematic Review.
(MDPI, 2026-01-21) Requena Gatell, Ariadna; Moya Martínez, Tania; Sánchez Torres, Alba; Valmaseda Castellón, Eduardo; Barbosa de Figueiredo, Rui Pedro; Delgado Molina, Esther
Background/Objectives: Dynamic computer-assisted surgery (dCAS) has emerged as a promising tool, particularly in implantology, enabling real-time procedural adjustments through 3D image-based tracking. However, their application in other areas of oral surgery remains limited. This systematic review aims to evaluate the advantages, limitations, clinical implications, and complications associated with the use of dCAS in oral surgery (excluding implants or miniscrew insertion) beyond implant placement, in comparison to conventional freehand (FH) techniques. Methods: A systematic review was conducted in accordance with the PRISMA guidelines. A focused PICO question was developed, and a comprehensive literature search was performed in PubMed, Scopus, and the Cochrane Library between February and March 2025, and supplemented by manual screening. The risk of bias of the included studies was evaluated using the Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials (RCTs) and the ROBINS-I tool for non-randomized controlled trials (NRCTs). Data were summarized in tables and analyzed through qualitative synthesis. Results: Ten studies evaluating dCAS in several oral surgical procedures, including complex tooth extractions and endodontic surgery, were included. A substantial improvement was observed in accuracy of endodontic procedures. Operator experience was a key factor in surgical outcomes. Regarding postoperative complications, no significant differences were observed, although the trend indicated an equal or lower risk in comparison with conventional FH techniques. Conclusions: dCAS may significantly improve accuracy and efficiency in endodontic surgery and reduce operative time in complex mandibular third molar (M3M) extractions. The complication rate is comparable to that of conventional FH techniques. However, current evidence remains limited, heterogeneous, and mainly experimental. Further studies are recommended to validate the benefits of dCAS in clinical settings.
The Clinical Impact of the Combination of CBCT andPeriapical Radiographs on Endodontic Diagnosis andTreatment Planning—A Retrospective Cohort Study
(John Wiley & Sons, 2026-02) Soldado Cañadas, Piedad; Muñoz Garduño, C.; Sanz-Serrano, Diana; Sánchez Torres, Alba; Mercadé Bellido, Montserrat
Aim To determine whether the combined use of periapical radiography (PR) and cone beam computed tomography (CBCT) improves agreement among three endodontic experts compared with using either diagnostic tool alone. Methodology Sixty clinical records with CBCT scans were selected from cases performed by postgraduate and master's students in endodontics at the University of Barcelona Dental Hospital. Three endodontic experts independently evaluated each case using a standardised questionnaire. Initially, they assessed the PR images. After 4 months, they reassessed the cases using CBCT. One year later, they reviewed both PR and CBCT together. Agreement levels were analysed for pulpal and periradicular diagnoses, treatment recommendations and aetiological assessments. Results Inter-observer agreement improved across the study phases, peaking in phase 3—particularly for treatment recommendations. In this final phase, where both PR and CBCT were evaluated together, the agreement rate for pulpal diagnosis was 73.33%, with substantial reliability (κ = 0.67). Periradicular diagnosis showed a 40.00% agreement rate, with moderate inter-observer concordance (κ = 0.44). The lowest agreement was observed in the aetiology category (28.33%), with moderate concordance (κ = 0.50). Agreement on treatment recommendations reached 43.33% (κ = 0.51) and was the only category to show statistically significant differences between phases (p = 0.01). No significant differences were found for pulpal diagnosis (p = 0.39), periradicular diagnosis (p = 0.19) or aetiology (p = 0.36). Intra-observer agreement varied among experts, with some showing lower consistency in their responses when evaluating PR, CBCT and the combination of both, highlighting the influence of imaging modality on clinical decision-making. Conclusions The combination of PR and CBCT improved inter-observer agreement across all categories compared to the use of a single imaging modality. However, this improvement reached statistical significance only for treatment recommendations. These findings suggest that, whereas combining PR and CBCT may support more consistent therapeutic decision-making, its impact on diagnostic agreement may vary depending on the specific diagnostic domain.
Sex-specific reference values for the crown heights of permanent anterior teeth and canines for assessing tooth wear
(Taylor & Francis, 2023-01-31) Roca Obis, Paula; Rius Bonet, Ona; Zamora Olave, Carla; Willaert Jiménez-Pajarero, Eva; Martínez Gomis, Jordi
Objective: We propose sex-specific reference values for the clinical crown height of anterior teeth and canines. Material and methods: In this cross-sectional study, 1426 teeth were analysed from 169 undergraduate and postgraduate dental students (83 women and 86 men, median age 22 years). Teeth with worn or totally restored incisal edges, or gingival inflammation were excluded. Age, gender and body height were recorded and the degree of tooth wear was scored according to the quantification module of the Tooth Wear Evaluation System. The clinical crown heights of all anterior teeth and canines were measured from the gingival margin to the incisal edge with a digital calliper. Reference values for tooth groups were obtained at the percentiles 10, and expressed by sex if there was a significant difference between men and women. Results: Mean crown heights were bigger in men than in women for each tooth group (p = .028). Clinical crown heights showed sexual dimorphism at the 10th percentiles for all tooth groups except for mandibular anterior teeth. Conclusions: For assessing tooth wear, the sex-specific reference values for the clinical crown height of young adults Caucasoids range from 7.5 mm to 9.0 mm in women and from 7.5 mm to 9.5 in men.
Diagnostic accuracy of clinical signs to detect erosive tooth wear in its early phase
(John Wiley & Sons, 2024-01-08) Rius Bonet, Ona; Roca Obis, Paula; Zamora Olave, Carla; Willaert Jiménez-Pajarero, Eva; Martínez Gomis, Jordi
Background: Agreement exists about most of the clinical features of erosive tooth wear, though no evidence supports their validity in diagnosing the condition. Objective: This study aimed to determine the accuracy of clinical signs for diagnosing erosive tooth wear in a young adult general population. Methods: We conducted a cross-sectional study of dental students. In the first session, two examiners independently determined the presence of erosive tooth wear based on glazed enamel surfaces, morphological changes on non-occlusal surfaces, flattening of convex areas, or any type of concavity. In the second session, one examiner recorded the presence of clinical signs according to the Tooth Wear Evaluation System. The diagnostic accuracy of each clinical sign, both alone and combined, was assessed by calculating their sensitivity and specificity for detecting erosive tooth wear and performing multivariate logistic regression models. Results: Of the 147 participants (78 women and 69 men; median age, 22 years) we included, 76.2% had erosive tooth wear. The single clinical signs with greatest balance between the sensitivity and specificity were 'convex areas flatten' (63% and 71%, respectively) and 'dull surface' (47% and 89%, respectively). Multivariate logistic regression revealed that 'preservation of the enamel cuff' (odds ratio, 22) and the combination of 'smooth silky shining, silky glazed appearance, and dull surface' (odds ratio, 68) had the best predictive values. Conclusions: The most accurate clinical signs for detecting early erosive tooth wear were dull surface, flattened convex areas and preservation of the enamel cuff.
Do implant-supported fixed partial prostheses improve masticatory performance in patients with unilateral posterior missing teeth?
(John Wiley & Sons, 2019-05-11) Khoury-Ribas, Laura; Ayuso Montero, Raúl; Willaert Jiménez-Pajarero, Eva; Peraire Ardèvol, Maria; Martínez Gomis, Jordi
Objectives: The purpose of this study was to determine the improvement in masticatory performance and satisfaction with chewing ability in partially edentulous patients after treatment with an implant-supported fixed partial prosthesis (ISFPP). Material and methods: This prospective study included 30 patients (mean age 59 years; 17 women) with unilateral posterior missing teeth treated with one-, two- or three-unit ISFPPs and 10 healthy individuals (mean age 36 years; 8 women) with complete natural dentition to establish the normal levels of mastication. Three variables were determined at baseline and at 3-months' follow-up in all participants: masticatory performance according to the median particle size (MPS) during freestyle mastication and unilateral mastication on each side, and satisfaction with chewing ability using a visual analog scale. Paired samples t test and Kruskal-Wallis test were used for intra-group and inter-group comparisons. Results: The MPS following freestyle mastication decreased significantly at 3 months in both groups. Significant reductions of 21%, 30%, and 42% in the MPS were obtained from unilateral mastication on the treated side after treatment with 1, 2, or 3 restorative units, respectively. Three months after ISFPP, satisfaction with chewing ability improved by 40% in the treatment group. Conclusions: Freestyle masticatory performance may improve slightly within three months of treatment with an ISFPP and may be similar to that of subjects with complete natural dentition. Patients may obtain a 21%-38% improvement in unilateral mastication on the treated side and a 26%-54% improvement in satisfaction with chewing ability.
Changes in masticatory laterality three months after treatment with unilateral implant-supported fixed partial prosthesis
(John Wiley & Sons, 2020-01-01) Khoury-Ribas, Laura; Ayuso Montero, Raúl; Willaert Jiménez-Pajarero, Eva; Peraire Ardèvol, Maria; Martínez Gomis, Jordi
Objective: This study assessed changes in masticatory laterality in patients with unilateral posterior missing teeth three months after treatment with an implant-supported fixed partial prosthesis (ISFPP). Methods: Thirty patients with unilateral posterior missing teeth participated in this prospective study. They were treated with one-, two- or three-unit ISFPPs. The control group comprised 10 healthy individuals with complete natural dentition. Each participant performed masticatory assays at baseline and at 3-month follow-up, chewing pieces of silicon inside a latex bag. Masticatory laterality was determined using three different methods: assessment of the first chewing cycle, of all cycles, and application of a visual analogue scale. Data were compared using the Kruskal-Wallis or the Mann-Whitney U test as appropriate. Results: Three months after treatment, a significant change in the asymmetry index towards the treated side and a significant reduction in the Unilateral Chewing Index were observed in the ISFPP group. No significant differences in masticatory laterality between groups were detected at three-month follow-up, regardless of the method assessed. Conclusion: Treatment with ISFPPs alters the masticatory laterality, moving it to the treated side and increasing the degree of bilateral chewing in patients with unilateral posterior missing teeth.

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