2026-03-30
Paula Boo-Gordillo, Maria Fernanda García-Morales, Laura Marqués-Martinez, Carla Borrell-García, Clara Guinot-Barona, Juan Ignacio Aura-Tormos, Esther García-Miralles
BackgroundInterdental spacing in the primary dentition is a key physiological feature that facilitates proper eruption and alignment of permanent teeth. While genetic factors play a central role, environmental influences such as early feeding practices may also affect jaw development and spacing, although quantitative evidence is limited.ObjectiveTo analyze the relationship between early feeding practices—including breastfeeding, formula feeding, bottle and pacifier use, and timing of complementary feeding—and interdental spacing in the primary dentition.MethodsA descriptive cross-sectional study was conducted with 52 children aged 3–5 years. Digital intraoral scans were obtained using an iTero Element 2® scanner, and 18 interdental spaces per child were digitally measured using Orthocad® software. Parents completed structured questionnaires detailing their children's feeding history. Data were analyzed using descriptive statistics and comparative tests.ResultsThe largest mean interdental spaces were observed in the primate areas, specifically between the left lateral incisor and canine in the maxilla (0.756 mm) and between the left canine and first molar in the mandible (0.356 mm). No statistically significant associations were found between feeding variables and interdental distances (p > 0.05). However, a consistent trend toward larger interdental spaces was observed in children with prolonged breastfeeding compared to those with shorter or no breastfeeding, in line with proposed physiological mechanisms.ConclusionEarly feeding practices were not significantly associated with interdental spacing in the primary dentition. Nevertheless, the observed trends suggest that prolonged breastfeeding may positively influence interdental spacing, highlighting the need for larger and longitudinal studies to further investigate the role of environmental factors in dental arch development.
DOI: 10.3389/fdmed.2026.17162332026-03-30
Claudio Sotomayor Julio, Alfredo Torres
Immediate implant placement (IIP) in sites with infection and buccal bone wall deficiency remains a clinical challenge. This case report introduces the “ROLL BMP” technique, a flapless regenerative approach combining absorbable collagen sponge (ACS), biphasic calcium phosphate (BCP), and recombinant human Bone Morphogenetic Protein-2 (rhBMP2) to achieve simultaneous buccal bone reconstruction and soft-tissue preservation in type 2 post-extraction sockets. A healthy 56-year-old female presented with a root fracture and chronic infection at tooth 2.1. After atraumatic extraction and debridement, a 3.5 × 12 mm INNO sub implant (Cowellmedi,Busan, South Korea) was immediately placed. The biomaterial roll was created by layering BCP granules onto hydrated ACS, rolling it, and inserting it between the implant and soft tissue, followed by a 0.1 mL (1.5 mg/mL) rhBMP-2 injection (CowellBMP, Busan, South Korea). No flaps or membranes were required. Follow-ups at months (M) 3, 5, 12, 18, 24, and 36 demonstrated excellent peri-implant soft-tissue stability (Pink Esthetic Score 13 out of 14 at M36) and progressive trabecular bone maturation, accompanied by buccal cortical reconstruction on CBCT. In silico bioinformatic analysis identified BMP2, RUNX2, SPP1, and BGLAP as key osteogenic hub genes underlying bone repair and osseointegration, supporting the biological rationale for this approach. In conclusion, the “ROLL BMP” technique enables predictable, flapless IIP in compromised sockets while preserving both hard and soft tissues.
DOI: 10.3389/fdmed.2026.17501332026-03-26
Radhika Vasudev, Tony Mathew, Nireeksha
BackgroundThe long-term success of root canal treatment depends on the formation of an effective three-dimensional seal, which is strongly influenced by the ability of endodontic sealers to penetrate dentinal tubules and adapt closely to the root canal walls. Sodium hypochlorite (NaOCl), the most commonly used endodontic irrigant, produces oxidative alterations in dentin, including collagen degradation, reduced surface wettability, and residual free radical formation, which collectively compromise sealer penetration and interfacial integrity. The use of antioxidant agents has been used as a strategy to reverse these adverse effects and restore dentin surface properties.ObjectiveThis systematic review aimed to assess the influence of various antioxidant agents on dentinal tubular penetration and interfacial adaptation of root canal sealers following NaOCl irrigation.MethodsA comprehensive electronic search of PubMed, Scopus, Web of Science, and Google Scholar was performed up to November 2025. In vitro studies evaluating NaOCl-treated dentin followed by antioxidant application and reporting sealer penetration or adaptation outcomes using confocal laser scanning microscopy (CLSM) or scanning electron microscopy (SEM) were included. Methodological quality and risk of bias were evaluated using a modified QUIN assessment tool.ResultsFrom 216 initially identified records, four studies fulfilled the eligibility criteria. The antioxidants investigated included ascorbic acid, tannic acid, gallic acid, ellagic acid, sodium thiosulfate, and glutathione. All antioxidant-treated groups demonstrated greater dentinal tubular penetration and increased interfacial adaptation compared with NaOCl-only controls. Polyphenolic antioxidants, particularly gallic acid and ellagic acid, produced the greatest enhancement in penetration depth. Sodium thiosulfate significantly reduced interfacial gaps and voids, while glutathione improved sealer penetration in both resin-based and bioceramic sealers and was associated with increased bond strength.ConclusionThe available in vitro evidence indicates that antioxidant agents effectively mitigate NaOCl-induced oxidative changes in dentin, leading to improved sealer penetration and adaptation. Incorporating antioxidants as a final irrigant step may enhance obturation quality and potentially improve sealer peneteration; however, well-designed clinical studies are required to confirm these findings.Systematic Review Registrationhttps://doi.org/10.17605/OSF.IO/PBRQA.
DOI: 10.3389/fdmed.2026.17668262026-03-26
Sanabel O. Barakat, Nebras I. AlHawamdeh, Rama Marar
Blood concentrates, such as platelet rich plasma and platelet rich fibrin, have been proposed to speed up tissue healing and regeneration in many dental fields. This was based on the fact that upon platelet activation, α-granules, which are reservoirs for many growth factors, fuse with the plasma membrane and release their cargo. The released growth factors exhibit chemotactic and mitogenic properties that promote and modulate cellular functions involved in tissue healing, cell proliferation, and tissue regeneration. Platelet rich fibrin (PRF) products were introduced as a grafting biomaterial to be used in surgical periodontics, because of their regenerative qualities. PRF variants are totally autogenous, easy to prepare, fast, economic and most importantly, they do not involve a donor site, therefore PRF was suggested as a connective tissue graft (CTG) substitute, to avoid complications relating to the second surgical site to harvest the CTG. It is important to highlight that the quality and the content of the PRF matrix depends largely on the preparation conditions of the patients’ blood sample. Based on the centrifugation speed of the extracted blood, different PRF matrices can be produced, such as Leukocyte- platelet rich fibrin (L-PRF), Advanced platelet rich fibrin (A-PRF) and Advanced platelet rich fibrin plus (A-PRF+), in addition to the injectable form of platelet rich fibrin (i-PRF) and lyophilised PRF (Ly-PRF). All these variants are currently used in different dental and periodontal procedures. This article aims to provide an overview of different PRF preparations and their applications in periodontal surgery.
DOI: 10.3389/fdmed.2026.18101752026-03-18
Luca Levrini, Stefano Saran, Emanuela Imbesi, Irene Vanini, Veronica Russo, Valeria Rimoldi, Andrea Carganico, Nicola Giannotta, Martina Perugini
IntroductionMaxillary transverse deficiency (MTD) is a common craniofacial condition associated with posterior crossbite, dental crowding, and compromised respiratory function. This study aimed to evaluate whether the Invisalign Palatal Expander (IPE) can induce midpalatal suture opening and occlusal changes, and to compare these outcomes with those obtained using conventional rapid palatal expansion (RPE).Materials and methodsThirty subjects (14 females, 16 males; aged 6–18 years) with mixed dentition were enrolled and divided into two groups: 15 treated with IPE and 15 with RPE. Radiographic images and digital dental models were analyzed before (T0) and after treatment (T1) to assess skeletal and occlusal changes, including midpalatal suture opening and transverse arch dimensions. Molar tipping and palatal depth were also measured. Patient-reported side effects during the first month of treatment were evaluated using a questionnaire addressing bulkiness, tongue impression, dysphonia, dysphagia, and gag reflex, scored on a 1–5 scale. Inclusion criteria comprised mixed dentition, erupted first molars, deciduous fourth/fifth teeth or erupting premolars, and complete diagnostic records. Exclusion criteria included previous orthodontic treatment, craniofacial anomalies, extraction therapy, allergies, hereditary angioedema, or active caries.ResultsNo significant differences were found between groups in the number of activations, radiographic outcomes, or theoretical expansion, indicating comparable skeletal effects. Midpalatal suture opening was achieved in all patients. Baseline occlusal conditions were similar between groups. After normalization for the number of activations, statistically significant differences were observed for arch depth, canine gingival width, canine dental width, and arch perimeter, all of which were greater in the RPE group (p < 0.05). No significant differences were found in intermolar angle or palatal depth changes. Questionnaire analysis revealed no significant differences in reported side effects between groups.ConclusionsThe Invisalign Palatal Expander effectively produced transverse maxillary expansion with midpalatal suture opening, yielding skeletal and occlusal outcomes comparable to those of the Hyrax expander. Although the amount of expansion was slightly lower, the IPE demonstrated more controlled and predictable results, supporting its use as a valid alternative in mixed dentition and as a step toward fully digital orthodontic protocols.
DOI: 10.3389/fdmed.2026.17570942026-03-11
Emi Shimizu, Maiko Suzuki, Motoki Okamoto, Hayato Ohshima
DOI: 10.3389/fdmed.2026.1814550