Background/Objectives: This study evaluated the effectiveness of Cotinus coggygria (Smoke Tree) Flower Water mouthwash in reducing halitosis and improving oral hygiene parameters among adolescents undergoing fixed orthodontic treatment. Methods: A double-blind, randomized, placebo-controlled, parallel-group clinical trial was conducted with 30 individuals undergoing treatment with fixed orthodontic appliances. Participants were allocated (1:1) into two groups: Group A received the Cotinus coggygria mouthwash, while Group B received the placebo mouthwash. Hydrogen sulfide (H2S) concentration in breath, measured by the OralChromaTM II device, was the primary outcome. Secondary outcomes included dimethyl sulfide [(CH3)2S] and methyl mercaptan (CH3SH) levels, assessed with the same device, and oral hygiene status evaluated using the Modified Silness & Löe Plaque (PI-M) as well as the Silness & Löe Gingival (GI) indices. Normality of the data distribution was assessed using the Shapiro–Wilk test. Statistical analyses were conducted using the Mann–Whitney U test and Student’s t-test. Results: A statistically significant reduction in H2S levels was observed in the C. coggygria group compared to placebo (p = 0.014). Median H2S levels decreased from 147.00 ppb at baseline (T0) to 35.00 ppb at follow-up (T1) after 2 weeks. A statistically significant reduction in total VSC levels was also observed in the C. coggygria group compared to placebo (p < 0.001). Median total VSC levels decreased from 254.00 ppb at baseline (T0) to 105.00 ppb at follow-up (T1) after 2 weeks. No significant differences were found between groups for the other volatile sulfur compounds. A Significant improvements were noted in periodontal parameters in favor of the C. coggygria group. The Gingival Index decreased from 2.0 to 1.3 (p < 0.001; 95% CI: −0.7 to −0.2), and the Plaque Index (PI-M) decreased from 1.6 to 1.0 (p = 0.001; 95% CI: −0.7 to −0.3). Conclusions: Cotinus coggygria mouthwash appeared to be an effective adjunct for managing halitosis and improving oral hygiene parameters in adolescents undergoing fixed orthodontic treatment. No adverse effects were reported.

Objectives: The impact of dental and oral health conditions on the oral health state and oral health-related quality of life (OHRQL) in geriatric in-hospital (GIH) patients requires clarification. For this reason, this exploratory and hypothesis-generating study aimed to examine the associations between intra-oral risk factors (IRFs), masticatory functions (MFs), and treatment satisfaction (TS) in this context. Methods: This retrospective cohort study enrolled a total of 81 patients requiring immediate prosthetic treatment (IPT) by consultant dentists at Sana Hospital, Coburg, Germany. The evaluation focused on oral and dental state and MFs such as a modified DMFT and Eichner Index (EI), as well as on IRFs such as inflammation, mucogingival junction insufficiency (MGJI), severe bone crest atrophy (SBCA), and oral pain. The outcomes were measured after IPT using MF improvement (MFI) as the primary outcome and TS as the secondary outcome. Results: The outcomes (p < 0.05) were evaluated using objective measures such as the calculations of the EI, the EI modifications and the modified DMFT index. The results were associated, respectively, with the different IRFs and with specific SBCA. A total of 85% of GIH patients suffered from severe bone crest atrophy (SBCA), which showed a significant association with MF measured using EI after IPT (p = 0.001). MFI after IPT was associated with the EI before IPT (p < 0.000). The achieved MFI was finally associated with the untreated sample (all patients, p < 0.000) and with the presence or absence of the following IRFs at baseline: inflammation (p < 0.003), absence of oral pain (p < 0.000), presence of SBCA (p < 0.000), and absence of MFI (p < 0.000). A total of 78% of GIH patients confirmed treatment satisfaction (TS) after IPT, which was significantly and strongly associated with SBCA (p < 0.003). Conclusions: Oral health was primarily impaired by SBCA and can be measured by the analysis of EI and DMFT associations, which provided MFI and TS as outcomes for OHRQL.

Background/Objectives: Down syndrome (DS) is characterised by a marked susceptibility to early-onset severe periodontitis, suggesting an intrinsic host predisposition. Interleukin-1 (IL-1) gene variants may influence inflammatory burden, yet DS-specific evidence is limited. Methods: Nineteen Caucasian adults with DS underwent a comprehensive periodontal examination and received a periodontal diagnosis according to the AAP/EFP 2018 classification. Buccal swabs were genotyped by real-time PCR for IL1A −889, IL1B +3954 and IL1RN +2018; the composite IL1A/B genotype was also evaluated. Results: All participants presented advanced, generalized periodontitis (Stage III/IV: 37%/63%; Grade B/C: 32%/68%). Variant alleles were detected in 63% for IL1A, 53% for IL1B and 37% for IL1RN, and the composite IL-1A/B genotype in 47%. Variant carriage showed associations with higher Clinical Attachment Loss (IL1A p = 0.03; IL1B p = 0.002; composite p = 0.012) and Bleeding on Probing (IL1A p = 0.02; IL1RN p = 0.05; composite p = 0.04). The composite genotype was associated with Stage IV (p = 0.027) and Grade C (p = 0.005), and tooth loss was greater among variant carriers for all polymorphisms (p = 0.01). Conclusions: In this DS cohort with advanced periodontitis, IL-1 variants (particularly the composite IL1A/B genotype) were frequently observed and were associated with greater periodontal severity and tooth loss.

Background: The relationship between facial aesthetic procedures and changes in the stomatognathic system has attracted increasing interest, motivating investigations into their functional and structural impacts. This longitudinal observational study analyzed molar bite force and orofacial tissue pressure in adults who underwent hyaluronic acid injections in the mandibular angle. Methods: Ten adults (eight women and two men; mean age 34.3 ± 11.2 years) with normal occlusion and no temporomandibular disorders were included. The MD Codes guided injection points of 2 mL of hyaluronic acid in the mandibular angle. Maximum right and left molar bite force was measured using a digital dynamometer, and tongue, lip, and cheek pressures were measured with a Pro-Fono Biofeedback device. Assessments occurred before and at 15, 30, and 60 days. Repeated measures ANOVA with Bonferroni correction was applied (p < 0.05), and effect sizes and 95% confidence intervals were calculated. Results: No statistically significant differences were observed in maximum molar bite force throughout the follow-up period. Regarding orofacial pressures, a significant main effect of time was observed for tongue pressure (p = 0.03); however, the effect size was moderate-to-large, and values showed considerable variability across participants. Lip and cheek pressures remained stable over time. Conclusions: Hyaluronic acid injection in the mandibular angle did not show clinically detectable changes in maximum molar bite force, suggesting short-term preservation of masticatory function within the 60-day follow-up period. These findings are limited to short-term observations and specific sample characteristics. The observed variation in tongue pressure may reflect adaptive functional adjustments, although variability across participants was considerable.

Background/Objectives: Prosthodontic restoration design plays a key role in the long-term success of implant-supported treatments and in maintaining peri-implant tissue health. Inadequate emergence angles and profiles can compromise tissue stability and negatively influence clinical outcomes. Generative design, as an algorithm-driven optimization approach, requires the definition of key parameters in advance to guide the process and determine the final shape of the hybrid implant abutment. Methods: A detailed literature review of the PubMed and Scopus databases was performed to find appropriate studies published up to 1 December 2025. Studies that investigated the emergence angle and emergence profile of implant-supported restorations were included. Seventeen studies fulfilled criteria and were included in the final analysis. Results: While the optimal emergence angle is still debatable, the literature suggests that an angle less than 30° may be beneficial. However, a concave emergence profile of implant-supported restoration has a significant role in improving stability and maintaining peri-implant health. Conclusions: Careful characterization and evaluation of the included parameters provide useful insights for generative design workflows, enabling the creation of implant abutment designs that maintain a balance between mechanical performance and biological compatibility.

Despite advances in dental materials and digital color registration systems, esthetic matching remains a clinical challenge for both dental students and experienced professionals. A comprehensive narrative review was conducted through bibliographic searches in PubMed, Scopus, Web of Science, and PsycINFO databases from January 2015 to January 2026. The evidence was synthesized using a four-dimensional analytical framework encompassing technological, cognitive-psychological, educational, and clinical-contextual factors. Quantitative synthesis revealed substantial variability in shade matching success rates, with intraoral scanners demonstrating pass rates ranging from 31.3% to 78.2% across devices, while spectrophotometers achieved superior repeatability (ICC > 0.9) but faced interpretive barriers. Cognitive load theory explains the performance deterioration, with novices being particularly susceptible to retinal fatigue and metamerism under non-standardized lighting conditions. The proposed paradigm shift involves redefining shade selection from a purely technical task to a cognitive skill that requires deliberate perceptual calibration, structured educational protocols, and hybrid digital visual workflows. To improve esthetic predictability, educational programs need to integrate longitudinal training in color science with objective feedback mechanisms. Clinical workflows should adopt hybrid calibration-centric protocols that position technology as a verification tool, rather than a replacement for clinical judgment. Understanding the multidimensional nature of shade matching difficulty enables the development of evidence-based educational protocols and clinical workflows, ultimately improving esthetic outcomes.

Background/Objectives: Accurate assessment of periodontal parameters such as bleeding on probing (BoP) and tooth mobility is essential for diagnosis and treatment planning. In contrast to metric measures, these findings represent more subjective clinical parameters, potentially increasing examiner-related variability, particularly among less experienced examiners. This study evaluated agreement patterns between student recordings and educator verification recordings and assessed the influence of educational level and anatomical factors. Methods: BoP and tooth mobility data recorded by undergraduate dental students (ICC1, ICC4, state examination) and verified by licensed dental educators were retrospectively analyzed, comprising 6504 BoP sites and 1084 mobility recordings. Agreement and directional disagreement (under-/over-rating) were analyzed. Statistical analyses evaluated the effects of training stage, anatomical site, and periodontal severity. Associations with probing depth deviations and patient age were also examined. Results: Overall agreement was high for both parameters (BoP: 86%; mobility: 91%). Nevertheless, statistically significant differences were observed across educational levels (global Chi2 tests p < 0.001). ICC1 students predominantly underestimated findings, whereas ICC4 students more frequently overestimated them; results stabilized in the state examination. Anatomical location significantly influenced disagreement patterns, with anterior and distal sites showing higher variability. BoP deviations were significantly associated with probing depth inaccuracies (r = 0.6; p < 0.001) and patient age (r = 0.187; p < 0.05). Conclusions: Within the limitations of this retrospective study, student recording accuracy for subjective periodontal parameters appears to be influenced by training stage and anatomical site. These findings may highlight the importance of structured calibration and targeted training strategies to improve diagnostic reliability in undergraduate periodontal education.

Background: Emphysema is a rare complication of dental procedures. The highest incidence has been associated with the use of air turbine handpieces. If not recognized and treated promptly, this complication can lead to serious outcomes. Methods: We present a case of a 43-year-old man who developed deep cervicofacial and subcutaneous emphysema of the face, neck and chest along with the specific voice change due to nose blowing shortly after alveolectomy of the lower right third molar. Results: The patient was hospitalized, conservatively treated, monitored and treated with intravenous antibiotic therapy. After two weeks he made a full recovery. Conclusions: It is essential to recognize and adequately manage emphysema, and to inform patients postoperatively not to blow their nose after third molar alveolectomy to prevent this rare but potentially serious complication. To our knowledge, this is the first reported case of voice alteration caused by nasopharyngeal emphysema following third molar alveolectomy.

Background/Objectives: Although many studies have examined the determinants and management of dental anxiety (DA), its broader placement as a potential bottleneck along oral-systemic health pathways, from the determinants of DA to consequences through dental avoidance, oral outcomes, psychosocial impacts, and possible systemic health outcomes, has not been mapped across the review literature. This review aimed to conceptually map how existing DA reviews are distributed across this pathway, whether this broad framing changed across 5-year periods, and how systemic health outcomes were framed. Methods: We conducted a conceptual mapping review of DA-focused review articles published between 2005 and 2025. PubMed and Scopus were searched for English-language narrative, systematic, scoping and umbrella reviews and meta-analyses addressing the determinants or consequences of DA. One reviewer screened records, extracted review characteristics, and classified each review into predefined domains using binary framed/not framed coding rules. A structured AI-assisted prompt was used only to support full-text evaluation across domains; all final coding decisions were made by the reviewer. Results: The search identified 851 records; after removing 426 duplicates, 425 unique records were screened, and 39 reviews met the inclusion criteria. Framing concentrated on environmental and psychological determinants and on the pathway from DA to avoidance and poor oral health, whereas broader consequences, including shame, OHRQoL, and systemic health outcomes, were less consistently framed. Across 5-year periods, the broad pattern of framing remained relatively stable. Systemic health outcomes were framed in only a minority of reviews. Conclusions: Future research should test hypothesized pathways from DA to broader health consequences using clearly specified bridge mechanisms and appropriate temporal designs.

Background: Accurate digital impressions are crucial for the long-term success of implant-supported prostheses, with scan bodies playing a pivotal role in transferring the implant position into the virtual model. Recent work has focused on PEEK (polyether-etherketone) scan bodies because their optical behavior may facilitate intraoral scanning; however, the breadth and quality of supporting evidence remain unclear. Methods: This scoping review followed PRISMA-ScR reporting guidelines and was registered in the Open Science Framework (OSF; Registration DOI 10.17605/OSF.IO/CU3V8). Pub-Med/MEDLINE, Embase, and Scopus were searched through September 2025. Eligible designs included in vitro studies, randomized trials, observational studies, and technical reports evaluating PEEK scan bodies in implant dentistry. Screening and data extraction were performed in duplicate, and findings were synthesized descriptively. Results: The search identified 227 records, and after screening, 31 studies met the inclusion criteria. Most studies were in vitro, with limited clinical evidence, and only one prospective clinical study was identified. Outcomes commonly addressed trueness, precision, scan time, and handling. Comparators varied (e.g., titanium, resin; splinted vs. unsplinted), and the results on accuracy were heterogeneous, with deviations typically within clinically acceptable limits (<100 µm). Conclusions: PEEK scan bodies are applicable for digital implant impressions. Clinical data are sparse, though, and methods vary. Controlled clinical studies are necessary to confirm the accuracy, reliability, and indications of this approach compared to titanium ISBs.