Artículos (Estomatología)

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Current practices and perceived effectiveness of alternative behavioral management techniques for pediatric dental anxiety: a cross-sectional survey of dentists in Spain
(Frontiers Media, S. A., 2026-03-25) del Toro Alcántara, Daniela; Arenas-González, Marcela; Formoso Veloso, Ángel Luis; Caleza Jiménez, Carolina; Barra Soto, María José; Biedma Perea, María; Ribas Pérez, David; Estomatología; CTS353: Estomatología Infantil y Ortodoncia; CTS1166: Ortodoncia y Ortopedia Dentofacial
Objectives: Fear of the dentist and associated anxiety in pediatric patients can negatively impact dental care and oral health. Traditional behavioral management techniques, such as physical restraint or sedation, are increasingly debated and rejected. The main objective of this study was to analyze the level of knowledge, use, and perceived effectiveness of alternative behavioral management techniques among practicing dentists in Spain. Materials and methods: A cross-sectional study was conducted with 144 dental practitioners from Seville, Spain, predominantly female (77.8%) and aged 25–35 years (44.4%). Participants represented various specialties, with general dentistry being the most common (51.4%). Data were collected regarding the frequency of use, knowledge, and perceived effectiveness of behavioral management techniques for pediatric patients. Results: Across all specialties, the most frequently reported behavioral management technique was tell-show-do, particularly among general dentists, orthodontists, and pediatric dentists. Endodontists primarily favored positive reinforcement, whereas oral surgeons/implantologists reported higher use of pharmacological management. Use of physical restraint was minimal and limited to pediatric dentistry. Conclusions: The study highlights the need to enhance training in emotional management and alternative behavioral management techniques to prevent future trauma and reduce the likelihood that children will avoid dental care due to anxiety. Additionally, adapting the clinical environment to be more child-friendly is important to support effective behavioral management. Clinical relevance: Improving dentists' knowledge and use of alternative behavioral management strategies can reduce pediatric dental anxiety, improve patient cooperation, and promote long-term oral health by encouraging regular dental visits.
Resin-modified calcium silicate-based materials versus conventional formulations in primary teeth: a systematic review and meta-analysis of clinical and radiographic outcomes of vital pulp therapy procedures in pediatric dentistry
(MDPI, 2026-03-17) Cabrera Fernández, Alberto; Dominguez-Dominguez, Laura; Pérez Pérez, Antonio; Santos, João Miguel Marques dos; Díaz-Cuenca, Aránzazu; Sánchez Margalet, Víctor; Sequeira, Diana B.; Segura Egea, Juan José; Martín González, Jenifer; Estomatología; Bioquímica Médica y Biología Molecular e Inmunología; CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; CTS151: Bioquímica Medica
Vital pulp therapy comprises a group of procedures whose use in the primary dentition is increasingly supported in pediatric dentistry. The clinical management of pediatric patients requires biomaterials that provide precision, ease of handling, and reduced chairside time; in this context, resin-modified calcium silicate-based materials (RM-CSCs) have been introduced as an alternative to conventional calcium silicate formulations. This systematic review and meta-analysis aimed to evaluate the clinical effectiveness of RM-CSCs compared with non-resin calcium silicate-based materials in vital pulp therapy performed in primary teeth. A systematic search was conducted in MEDLINE, Scopus, Embase, and Web of Science in accordance with PRISMA guidelines. Randomized clinical trials were included, the risk of bias was assessed using the RoB 2 tool, and the certainty of evidence was evaluated using the GRADE approach. Of the 605 records initially identified, nine randomized clinical trials were ultimately included, all of which evaluated TheraCal LC as the RM-CSC. Meta-analyses were performed for vital pulp therapy overall and for procedure-specific subanalyses, including indirect pulp capping and pulpotomy. None of the meta-analyses demonstrated statistically significant differences between RM-CSCs and non-resin calcium silicate-based materials in terms of clinical or radiographic success. Therefore, the available evidence supports the use of TheraCal LC as an effective option for indirect pulp capping in primary teeth; however, its use in pulpotomy should be interpreted with caution until further randomized clinical trials become available.
Revascularization of immature permanent teeth with apical periodontitis
(John Wiley & Sons Ltd., 2014-04) Moreno-Hidalgo, M. C.; Caleza Jiménez, Carolina; Mendoza Mendoza, María Asunción; Iglesias Linares, Alejandro; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
The aim of this minireview was to identify and review the scientiﬁc evidence regarding regenerative endodontic protocols claiming to revascularize permanent immature teeth with apical periodontitis. The literature was identiﬁed using the PubMed/MEDLINE, Scopus, Scirus, EMBASE and Cochrane databases up to February 2013. Studies were selected independently by two different researchers (kappa index: 0.88), based on established inclusion/exclusion criteria. The methodological quality of the reviewed papers was classiﬁed as high, medium or low (HQ, MQ, LQ). The search strategy identiﬁed 285 titles. Nine studies, both human and animal based, were selected after application of the criteria (LQ:5; MQ:4). In most of these studies (seven of nine), the revascularization protocol included a triple antibiotic combination as canal disinfectant for a period of 1–4 weeks after blood clot formation (LQ:5; MQ:4), although there is no clear consensus about the treatment protocol. Two studies reported tooth discoloration after the revascularization process (LQ:2), and only three (LQ:1; MQ:2) reported a success rate of 54.9% in dogs and 73.6% and 80% in humans, respectively. Revascularization of immature permanent teeth with apical periodontitis is possible and preferable to apexiﬁcation. Nevertheless, there is a widespread lack of randomized clinical trials and blinded measures. In addition, the small sample sizes that are common in these studies as well as the generally low quality of the analysed publications require the results to be viewed with caution. There is a high risk of bias, with a low quality of available information, for developing clinical guidelines for regenerative endodontic protocols; rigorous randomized clinical trials are therefore needed.
Childhood obesity and delayed gratification behavior: a systematic review of experimental studies
(Mosby-Elsevier, 2017-02) Caleza Jiménez, Carolina; Yáñez Vico, Rosa María; Mendoza Mendoza, María Asunción; Iglesias-Linares, Alejandro; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
Objective: To evaluate the extent of the association between instant gratification behavior and childhood obesity. Study design: PubMed, Scopus, EMBASE, EBSCOhost, and Cochrane databases were searched for the terms delayed gratification, children, and obesity. Studies were eligible if they included a sample of at least 100 children who were made to choose between an immediate reward and a larger one later, with the authors comparing the response in different populations and observing some relationship with obesity. A specifically designed data extraction form was used, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodologic quality of the included studies was assessed with the methodologic index for nonrandomized studies. Results: Nine articles were included after we applied the inclusion and exclusion criteria. Almost all studies conducted the test in populations of preschool children and offered food and/or nonfood rewards. The studies found a clear relationship between an inability to defer gratification and overweight and obesity. The quality assessment of the publications was ranked high in 5 studies and medium in 4. Conclusions: Children with the inability to delay gratification are more likely to be overweight or obese. Observation of such trends is useful in its implications for reeducation programs. Although the methodologic quality of the eligible studies was acceptable, additional experimental controlled studies are required to associate these behaviors with other aspects.
In vitro comparative analysis of two resonance frequency measurement devices: osstell implant stability coefficient and Penguin resonance frequency analysis
(Wiley, 2019-11-12) Herrero-Climent, Mariano; Falcão, Artur; López-Jarana, Paula; Díaz-Castro, Carmen M.; Ríos Carrasco, Blanca; Ríos-Santos, J.V.; Estomatología
Adequate implant stability is an essential requirement. The introduction of the Penguin resonance frequency analysis raises some questions regarding its reliability, reproducibility, and repeatability as well as how it compares to the older Osstell device. Purpose: To assess the newer Penguin implant stability coefficient (ISQ) device (vs the Osstell device). Materials and methods: A total of 120 implants were used, divided into four groups (A, B, C, and D) (according to design) and placed in fresh bovine bone. Consecutive measurements were made with both devices (Penguin/Osstell) with their respective transducers. Then, the ISQ values were measured with the Penguin device using the Osstell transducer, and vice-versa. Results: The mean insertion torque (N/cm) values for the implants were as follows: Group A = 24.7 ± 9.4; Group B = 25.6 ± 9.7; Group C = 28.7 ± 7.9; Group D = 19.1 ± 5.5. The mean ISQ values for the entire sample were as follows: Penguin 67.7 ± 6.1 and Osstell 68.5 ± 9.6. The ISQ value measured with the Penguin device using a SmartPeg transducer was 67.0 ± 8.0, and that for the Osstell device using a MultiPeg transducer was 68.3 ± 7.5. The intraclass correlation coefficient (ICC) was calculated for the ISQ values obtained from both devices and was >0.90 for all transducers. When the ICC transducers were interchanged, the values were <0.77. Conclusions: Both ISQ devices allow for reliable and repeatable measurement of implant stability; however, the use of each device-specific transducer is recommended.
Survival Evaluation of Restorations in Pulpotomized Primary Teeth with MTA or Biodentine®: A Systematic Review
(MDPI, 2025-08-05) Biedma Perea, María; Moscoso Sánchez, María; Barra Soto, María José; Arenas-González, Marcela; Ribas Pérez, David; Caleza Jiménez, Carolina; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
Objective: Due to the increasing esthetic demand among pediatric patients and different restorative materials, we focused on analyzing which of the options of restorations may provide superior clinical outcomes. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed and Cochrane databases. Results: Five articles met all inclusion criteria from an initial pool of 359 articles identified in the initial search. Greater bond strength was observed when pulpotomized teeth were restored with Biodentine® and resin composites compared to resin-modified glass ionomer cements (RMGICs). When comparing pulpotomies in primary teeth with MTA and Biodentine®, the fracture resistance values were higher in the pulpotomized teeth with Biodentine® than with MTA. Additionally, following a narrative synthesis in MTA-treated teeth, a higher risk of failure was observed using RMGICs or composite instead of stainless-steel crowns (SCCs) as the final restorative material. Conclusions: Variables such as the type of final restoration can affect the survival of primary teeth after pulpotomy reconstruction. Regardless of the pulp material, survival with SSCs is higher, but resin composites appear to be a viable restorative material after Biodentine® application.
Impact of delayed gratification on oral health and caries status in the primary dentition
(Elsevier, 2017-07-12) Caleza Jiménez, Carolina; Yáñez Vico, Rosa María; Mendoza Mendoza, María Asunción; Palma, Juan Carlos; Iglesias Linares, Alejandro; Estomatología; Instituto de Salud Carlos III; European Union (UE); CTS353: Estomatología Infantil y Ortodoncia
Objective: The ability to delay gratification (ATDG) is naturally linked to key regulatory psychological traits involved in self-discipline/regulation. The aim of this study was to ascertain the normalized impact of ATDG as an early predictor of oral health, on the primary dentition. Methods: 404 subjects [202 children (4–6 years old) and 202 mothers] were enrolled in a case-control study. Systematic data collection included: i) extraoral diagnostic parameters; ii) intraoral health status; iii) behavioral aspects; iv) baseline socio-demographic data. The ICC, the paired Student’s t-test and kappa statistic were used to evaluate intra-observer reliability. Distributions were explored with the chi-squared test [Odds ratio;95%CI;p < 0.05]. Conditional logistic regression was used to evaluate associations between all clinical diagnostic data and ATDG. Results: Overweight/obese children and those diagnosed with ADHD are more prone to lack ATDG (p < 0.001). Higher deft values were observed in children who lacked ATDG, who were also strongly associated with higher sugar consumption and more impulsive personalities (p < 0.001;OR:.107/0.031;95%CI:036–0.316/0.008–0.115). By contrast, children with responsible personality traits were associated with this skill (p < 0.028;OR:3.33;95%CI:1.1–9.7) and obtained the lowest deft (p < 0.306;OR:0.539;95%CI:0.165–0.176) and gingival index values (p < 0.001;OR:10.44;95%CI:2.6–40.9), which are clear indicators of better current and future oral health. Conclusions: These data provide insights into a novel predictor for identifying individuals at a higher risk of dental caries in early childhood.
Regenerative Endodontic Treatment in Permanent Incisors: Two Case Reports with 6 Years of Follow-Up
(MDPI, 2026) Biedma Perea, María; Arenas-González, Marcela; Barra Soto, María José; Caleza Jiménez, Carolina; Ribas Pérez, David; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
Background: Regenerative endodontic treatment (RET) has emerged as a biologically based alternative to traditional apexification for managing immature permanent teeth with pulp necrosis. By promoting tissue ingrowth and continued root development, RET aims not only to eliminate infection but also to reinforce structurally compromised roots. Although its clinical use has expanded, evidence regarding the long-term predictability and durability of RET remains limited, as most published studies provide only short- or mid-term follow-up. Case presentation: This report describes two pediatric cases involving regenerative procedures performed on three immature permanent maxillary incisors, each followed for more than six years. The first case involved a 7-year-old girl who developed pulp necrosis in a maxillary lateral incisor after acute dental trauma. Management followed a regenerative protocol using triple antibiotic paste (ciprofloxacin, metronidazole, and minocycline) as intracanal medication and mineral trioxide aggregate as the coronal barrier. The second case concerned an 8-year-old girl presenting with chronic infection and sinus tracts affecting both maxillary central incisors. These teeth were treated using a regenerative approach with calcium hydroxide as the intracanal medicament and Biodentine as the sealing material. Clinical, radiographic, and cone beam computed tomography evaluations demonstrated complete symptom resolution and periapical healing but incomplete progressive apical closure. All treated teeth developed a calcified apical barrier, and outcomes remained stable throughout the extended follow-up period. Conclusions: While inherently limited by the nature of case reports, these findings support RET as a reliable and durable therapeutic option for necrotic immature permanent teeth, including cases in which conventional apexification has not been successful.
Factores asociados a la alteración de erupción dental en niños: un estudio observacional
(Asociacion Latinoamericana de Odontopediatria, 2024-10-03) Sandra Gallardo Prado; Arenas-González, Marcela; Irene Coll Campayo; Aragoneses Lamas, Juan Manuel; Caleza Jiménez, Carolina; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
Introducción: La patología eruptiva puede alterar la cronología de la erupción encontrándonos con erupción precoz y tardía. Estas patologías de erupción pueden asociarse a factores locales o sistémicos. Objetivos: Identificar las alteraciones en la cronología de erupción y los factores asociados, analizando los diferentes grupos dentarios. Material y métodos: Los datos fueron recogidos de 218 pacientes entre 6 y 14 años vistos en la facultad de Odontología de la Universidad de Sevilla desde 2019 hasta 2024. Se evaluaron historias clínicas, ortopantomografías de manera digital y los datos fueron analizados estadísticamente. Resultados: No se encontró asociación significativa entre las alteraciones de la erupción con los grupos de edad ni sexo. En cuanto al tipo de dentición, se encontró asociación estadísticamente significativa con la dentición mixta segunda fase y la alteración en la cronología de erupción (p<0,05). En los incisivos y caninos, la alteración en la cronología de erupción más frecuente fue el retraso eruptivo, principalmente por falta de espacio y erupción ectópica respectivamente. Los premolares presentan una mayor alteración en la cronología de la erupción (34%), predominando en los primeros el adelanto por pérdida prematura del temporal y en los segundos el retraso por pérdida de espacio. Conclusiones: El 41% de la muestra presentó alteración en la cronología de erupción (adelanto o retraso) reflejando la importancia que supone un correcto diagnóstico. Es necesaria la adecuada exploración clínica y radiológica de la patología eruptiva debido a la importancia que supone su diagnóstico temprano y adecuado tratamiento en odontopediatría.
Eficacia de la expansión rápida palatina como tratamiento de la apnea obstructiva del sueño en niños y adolescentes. Una revisión bibliográfica
(Aran Ediciones, 2026-01-22) Cynthia Maldonado-Domínguez; Arenas-González, Marcela; Ribas Pérez, David; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
La presente revisión bibliográfica pretende evaluar la eficacia de la expansión palatina en el tratamiento del Síndrome de Apnea Obstructiva del Sueño (SAOS) en niños y adolescentes. Se realizó una búsqueda en las bases de datos PubMed, Scopus y The Cochrane Library. Después de considerar los criterios de inclusión y exclusión, fueron extraídos los datos más relevantes de seis artículos; los cuales consistieron en estudios clínicos donde fue utilizado como tratamiento principal la expansión rápida palatina (RME). Los resultados indican que la RME reduce significativamente el índice apnea-hipopnea (IAH), con mejoras más notables en casos leves y moderados, especialmente cuando el tratamiento se aplica de forma temprana. Es posible concluir que la expansión rápida palatina es eficaz en el tratamiento multidisciplinar del SAOS con compresión maxilar; pero no de forma aislada.
Association between diabetes and the outcome of root canal treatment in adults: An umbrella review
(Wiley, 2019-11-13) Nagendrababu, Venkateshbabu; Segura Egea, Juan José; Fouad, A.F.; Pulikkotil, S.J.; Dummer, P.M.H.; Estomatología; CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
Background: Diabetes mellitus is the most common metabolic disorder among dental patients. The association between diabetes and the outcome of root canal treatment is unclear. Aim: To conduct an umbrella review to determine whether there is an association between diabetes and the outcome of root canal treatment. Data source: The protocol of the review was developed and registered in the PROSPERO database (ID number: 141684). Four electronic databases (PubMed, EBSCHOhost, Cochrane and Scopus databases) were used to perform a literature search until July 2019. Study eligibility criteria, participants, and interventions: Systematic reviews with or without meta-analyses published in English assessing any outcomes of root canal treatment comparing diabetic and nondiabetic patients were included. Two reviewers were involved independently in study selection, data extraction and appraising the reviews that were included. Disagreements were resolved with the help of a third reviewer. Study appraisal and synthesis methods: The quality of the reviews was assessed using the AMSTAR tool (A measurement tool to assess systematic reviews), with 11 items. Each AMSTAR item was given a score of 1 if the criterion was met, or 0 if the criterion was not met or the information was unclear. Results: Four systematic reviews were included. The AMSTAR score for the reviews ranged from 5-7, out of a maximum score of 11 and all the systematic reviews were classified as “medium” quality. Limitations: Only two systematic reviews included a meta-analysis. Only systematic reviews published in English were included. Conclusions and implications of key findings: Diabetes mellitus is associated with the outcome of root canal treatment and can be considered as a preoperative prognostic factor. Declaration of interest: No funding was received to support this umbrella review. The authors declare no conflict of interest.
Clinical and Radiographic Outcomes of Vital Pulp Therapy Using Resin-Modified Versus Conventional Calcium Silicate-Based Materials: A Systematic Review and Meta-Analysis
(MDPI, 2026-01-07) Cabrera Fernández, Alberto; Domínguez-Domínguez, Laura; Pérez Pérez, Antonio; Santos, João Miguel Marques; Díaz-Cuenca, Aránzazu; Torres-Lagares, Daniel; Sequeira, Diana B.; Segura Egea, Juan José; Martín González, Jenifer; Estomatología; Bioquímica Médica y Biología Molecular e Inmunología; Instituto de Biomedicina de Sevilla (IBIS); CTS151: Bioquímica Medica; CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; CTS523: Innovación y Desarrollo en Técnicas y Fundamentos de Cirugía Bucal y Craneofacial
Vital pulp therapy (VPT) is increasingly recognised as a biologically driven alternative to root canal treatment in teeth with deep caries and a vital pulp diagnosis. Resin-modified calcium silicate-based materials (RM-CSMs) were introduced to combine the bioactivity of traditional cements with improved handling and immediate light-curing, but their biological performance remains debated. Objectives: This systematic review and meta-analysis aimed to evaluate the clinical and radiographic outcomes of VPT performed with RM-CSMs compared with conventional non-resin-modified calcium silicate-based materials (NRM-CSMs) Methods: PRISMA Guidelines were followed to carry out this systematic review. Electronic databases (Medline, Embase, Scopus, and Web of Science) were searched up to October 2025 for randomised clinical trials evaluating indirect pulp capping, direct pulp capping, or pulpotomy. Nine trials met the inclusion criteria. Meta-analyses were performed for TheraCal LC, the only RM-CSM with sufficient clinical evidence. The risk of bias was assessed using the RoB 2 Tool. The certainty of evidence was assessed using GRADE. Results: Pooled results showed no significant differences in overall clinical–radiographic success between RM-CSMs and NRM-CSMs at 90 or 180 days. At 360 days, a trend favouring NRM-CSMs emerged, though not statistically significant. Dentine bridge formation at 360 days was significantly lower with TheraCal LC. Conclusions: Current RM-CSMs demonstrate comparable short-term success to conventional materials but still present biological limitations, particularly regarding long-term reparative outcomes. NRM-CSMs remain the preferred option when maximal bioactivity and predictable dentinogenesis are required.
Over-prescription of antibiotics for pulpitis: a systematic review and meta-analysis of cross-sectional surveys
(MDPI, 2025-12-20) Delgado-Giugni, Vanessa; León-López, María; Crespo Gallardo, Isabel; Sauco Márquez, Juan José; Montero-Miralles, Paloma; Martín González, Jenifer; Cabanillas Balsera, Daniel; Segura Egea, Juan José; Estomatología; CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
Background: Pulpitis requires operative dental treatment, and antibiotics are not indicated. Nevertheless, inappropriate antibiotic prescribing persists worldwide. This systematic review and meta-analysis evaluated the prevalence of antibiotic prescription for pulpitis among dentists. Methods: A systematic search of MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest (2015–2025) was performed according to PRISMA guidelines. Observational studies reporting the proportion of dentists prescribing systemic antibiotics for pulpitis were included. Random-effects meta-analyses estimated pooled prevalence for all clinicians, general dental practitioners (GDPs), and endodontists (ENs). Risk of bias was assessed using a modified Newcastle–Ottawa Scale, and certainty of evidence was rated with GRADE. Results: Twelve cross-sectional studies met the inclusion criteria, including 3189 dentists. The overall pooled prevalence of antibiotic prescribing for pulpitis was 19.2% (95% CI: 10.4–32.6%), with very high heterogeneity (I2 = 98%). GDPs exhibited significantly higher prescribing rates (26.9%, 95% CI: 14.9–43.5%; I2 = 98%) compared with ENs (5.1%, 95% CI: 1.2–19.2%; I2 = 92%). Sensitivity analysis excluding two high-prevalence studies reduced the pooled estimate to 13.3% (95% CI: 8.0–21.3%) but heterogeneity remained substantial (I2 = 95%). Most studies showed moderate-to-high risk of bias, and the certainty of evidence was graded as very low due to inconsistency, indirectness, imprecision, and potential publication bias. Conclusions: Approximately one in five dentists prescribe antibiotics for pulpitis, despite strong guideline recommendations against their use. However, certainty of evidence was very low. Marked variability across regions and clinical profiles highlights persistent gaps in diagnostic accuracy, access to emergency dental care, and antibiotic stewardship. Targeted education, improved urgent care pathways, and strengthened antimicrobial stewardship programs are needed to reduce unnecessary antibiotic use in pulpitis.
Immediate loading of implants placed immediately in fresh sockets: a 10-year single-arm prospective case series follow-up
(MDPI, 2025-12-13) Velasco-Ortega, Eugenio; Ortiz García, Iván; Monsalve Guil, Loreto; López-López, José; Núñez Márquez, Enrique; Matos-Garrido, Nuno; Rondón Romero, José Luis; Jiménez Guerra, Álvaro; Moreno Muñoz, Jesús; Estomatología; CTS618: Investigación y Clínica en Implantología Oral
Background. Implant dentistry is an important treatment option for patients requiring prosthetic rehabilitation after tooth loss. This study reports the evaluation of immediately loaded, immediately placed implants in fresh extraction sockets. Methods. Fifty-two partially edentulous patients (27 females and 25 males with mean age of 53.6 years), were treated with 112 Galimplant® implants placed immediately into fresh sockets for prosthodontic rehabilitation. All implants were loaded immediately. Clinical and radiographic parameters related to both the implants and the prosthodontic restorations were followed for 10 years. Results. Nine patients (17.3%) had a history of periodontitis, 26.9% were smokers, and 21.1% presented with chronic systemic conditions. The outcomes demonstrated an implant survival and success rate of 97.1%, indicating that immediately placed implants with immediate loading can achieve and maintain successful osseointegration. Three implants were lost during the healing period. The mean marginal bone loss was 1.09 ± 0.75 mm. Mucositis affected 21.4% of implants, and peri-implantitis was observed in 11.6% of implants. Fourteen implants (7.1%) were associated with technical complications, including screw loosening and ceramic chipping. Conclusions. The clinical findings of this study indicate favorable long-term outcomes for immediately loaded implants placed in fresh extraction sockets. Both implants and prosthetic restorations demonstrated a success rate of over 92.9% during the observation period.
Are they eosinophil extracellular traps?
(Frontiers media SA, 2025-12-17) Chacón, Pedro; López-Postigo, Adrián; Monteseirín, Javier; Ribas Pérez, David; Vega-Rioja, Antonio; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
This perspective critically evaluates the reliance on eosinophil cationic protein (ECP) as a marker for eosinophils in identifying extracellular traps (ETs) in asthma research, as exemplified in the study by Lu et al. While traditionally associated with eosinophilic activity, ECP is also produced by neutrophils, monocytes, and other myeloid cells, undermining its specificity. This limitation risks misattributing ET origin, leading to incorrect pathophysiological interpretations and misdirected therapeutic strategies. In allergic asthma, our findings demonstrate that sensitized neutrophils—rather than eosinophils—form ECP-positive ETs in response to relevant antigens, challenging conclusions that ECP+/cit-H3+ structures necessarily represent eosinophil extracellular traps (EETs). We advocate for the use of more specific eosinophil markers, such as eosinophil peroxidase (EPO) or major basic protein (MBP), in combination with neutrophil-specific markers, alongside rigorous methodological controls and clinically relevant human models. Accurate identification of ET cellular origins is essential for understanding asthma’s heterogeneous inflammatory mechanisms and for guiding the development of targeted, phenotype-specific therapies.
Dental health as a determinant of operational readiness in military populations: evidence from Ceuta (Spain)
(Lippincott williams & wilkins; Ovid Technologies (Wolters Kluwer Health), 2025) Bel-Blesa, Alejandro; Hernández-Donadeu, Marta; Flores-Fraile, Javier; Gómez Salgado, Juan; El Khoury Moreno, Luis; Torrejón-Martínez, Julio; Ribas Pérez, David; Castaño Seiquer, Antonio Luis; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
The Spanish Armed Forces require optimal oral health to ensure operability during international missions. In a cross-sectional study with a sample of 691 military personnel, 17.66% were classified as temporarily unfit (NAT), predominantly among enlisted ranks (21.7%). Employment status and smoking showed significant associations with NAT (P < .000), while gender, age, and alcohol consumption were not significant factors. The decayed, missing filled teeth index, particularly its decayed component, was strongly related to NAT (P = .000). Periodontal disease presence and the need for multiple dental treatments significantly increased NAT prevalence (P < .000). Use of dental floss correlated with higher fitness, whereas mouthwash use was associated with increased NAT (P < .05). These findings highlight the importance of prevention and risk factor control to maintain oral fitness and ensure military personnel effectiveness during deployments.
Evaluation of an oral health program for children in San Francisco de Macorís, Dominican Republic (2019–2024)
(Frontiers Media SA, 2025-12-09) Ribas Pérez, David; Muñoz-Viveros, Carlos; Formoso Veloso, Ángel Luis; Carrillo-Sánchez, Francisco Jesús; Castaño Seiquer, Antonio Luis; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
Introduction: Oral diseases remain a public health concern in the Dominican Republic, with epidemiological data indicating greater severity compared to other countries with similar geo-economic profiles. Numerous organizations, both governmental and private, have been involved in addressing this issue. Various nonprofit organizations have implemented oral health initiatives in the form of programs aimed at mitigating this situation. However, these projects often lack validation through studies assessing their impact on oral health outcomes. Objective: The objective of this study is to describe the oral health status of a pediatric population and its association with perceived quality of life, while also evaluating the impact of a specific oral health program conducted in the city of San Francisco de Macorís. The evaluation aims to identify areas for improvement in the program’s design and implementation. Methods: The oral health program was assessed over the period 2019–2024. Oral health status was measured using a World Health Organization (WHO)- based survey, and oral health-related quality of life was assessed with the culturally adapted Spanish version of the COHIP-19SF questionnaire. The impact of the program was analyzed using various health and quality-of- life indicators. Results: At baseline in 2019, 94 children from three regions in the Dominican Republic were assessed. Over five years, the restoration index improved substantially from 31.4% to 86.2%, indicating better access to dental care. Quality of life, measured using the COHIP-SF19, also improved. Significant gains were seen in functional well-being, oral health, and self-image domains, while socio-emotional well-being remained unchanged. Overall, the total COHIP-SF19 score dropped by 4 points, reflecting a meaningful improvement in oral health-related quality of life. Conclusion: The intervention significantly reduced primary tooth decay, improved treatment access, and enhanced children’s oral health-related quality of life. These results support the value of sustained oral health programs in vulnerable communities.
The topography of titanium in dental implants: Key to osseointegration and bactericidal capacity
(Mdpi Ag, 2025-07-17) Romero, Marta; Romero-Ruiz, Manuel María; Ríos-Santos, J.V.; Ríos Carrasco, Blanca; Herrero-Climent, Mariano; Brizuela-Velasco, Aritza; Martínez-López, Jordi; Gil, Javier; Estomatología; Gobierno de España; Ministerio de Economia, Industria y Competitividad (MINECO). España
The following five factors established by Albrektsson for osseointegration of dental implants are well known: dental implant material, design, surface, surgical technique, bone quality, and mechanical conditions [...].
Stereo-Photogrammetry for Impression of Full-Arch Fixed Dental Prosthesis—An Update of the Reviews
(MDPI, 2024) Ribeiro, Paulo; Díaz Castro, Carmen María; Ríos Carrasco, Blanca; Ríos-Santos, J.V.; Herrero Climent, Mariano; Estomatología
Photogrammetry (PG) appeared as an alternative for multiple implant impressions. Stereo-photogrammetry is a more sophisticated alternative to PG, which estimates the 3D coordinates of the points of an object, making the process quicker and more precise. A search in PubMed MEDLINE, PMC, and Google Scholar was conducted to find systematic reviews published in the last 10 years. The PICdental® camera (IDITEC NORTH WEST, SL; Torrelodones, Spain) is a stereocamera that records implant positions in the mouth by means of photogrammetry with the objective of registering and obtaining a viable, reliable, and direct digital impression of the positions of the multiple implants. The use of photogrammetry via PiCdental® camera as an alternative to digital impression for multiple implants is an easy and trustworthy technique that permits an adequate fit without prosthetic complications.
Correlation between Implant Surface Roughness and Implant Stability: A Systematic Review
(MDPI, 2024) Romero-Serrano, Marta; Romero Ruiz, Manuel María; Herrero Climent, Mariano; Ríos Carrasco, Blanca; Gil Mur, Javier; Estomatología; Ministerio de Ciencia y Tecnología (MCYT). España
The aim of this study was to find in the literature data on the relationship between implant surface roughness and implant stability achieved, from the time of placement to three months afterward, to help us to know what type of surface roughness is more favorable to guarantee implant stability and osseointegration. A systematic review was conducted in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-analysis) statement, and the protocol was registered on the Open Science Framework. The specific inclusion and exclusion criteria were selected using the PICOS framework. The databases Medline (PubMed), Scopus, the Web of Science and The Cochrane Library were searched up to October 2023. The selection of studies and data extraction were conducted by two independent reviewers. The review included a total of 11 studies. A total of 1331 dental implant placements were identified. Two of the eleven selected studies were on humans in vivo, eight were on animals in vivo, and one was on animals in vitro. A statistically significant correlation between surface roughness and implant stability as measured by resonance frequency analysis (RFA) was not identified in ten of the eleven selected studies. It appears that there is no correlation between primary stability and the degree of implant roughness. However, there appears to be a correlation between the roughness of the implant and the degree of osseointegration, as indicated by bone-implant contact values. This correlation is more closely related to secondary stability. The great methodological variability makes it difficult to compare data and draw conclusions, so it would be desirable to agree on a common methodology to help draw appropriate conclusions from published studies.

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