Miguel Ramón Pecci Lloret

Background/Objectives: The biologically oriented preparation technique (BOPT) is a vertical tooth preparation approach that eliminates a conventional finish line and positions the prosthetic margin within the gingival sulcus, aiming to promote peri-restorative soft tissue adaptation through controlled gingival remodeling. This article describes a clinical case report of a hybrid impression protocol combined with a digital workflow intended to address some of the main clinical limitations of BOPT, particularly the recording of deep subgingival margins and the transfer of the emergence profile from the provisional to the definitive restoration. Methods: The proposed technique combined a conventional silicone impression to obtain a complete reading of the gingival sulcus with intraoral digital scanning, complemented by extraoral scanning of the provisional restoration to reproduce its subgingival morphology within the definitive prosthetic workflow. Results: Within the limitations of a single clinical case with short-term follow-up, this hybrid approach showed a satisfactory esthetic outcome and favorable short-term peri-coronal soft tissue behavior. Conclusions: This hybrid workflow may represent a feasible clinical option for transferring the cervical contour and emergence profile to the definitive prosthesis in anterior BOPT restorations.

Traditionally, checklists or evaluation templates have been utilized to assess psychological and health-related issues in fields like psychology and pediatrics. Currently, their use has expanded, particularly in medical research and healthcare evaluation. This study aims to develop and validate checklists for standardized patient use in the subject " Special Care Health Needs patients" within the Dentistry Degree program, ensuring international applicability whenever clinical simulation is employed. Six different scenarios were developed for student evaluation. Along with each scenario, a script was also created for the simulated participant or the instructor voicing the simulator. An evaluation template was designed for each clinical scenario. Once the scenarios and checklists were designed, 11 experts in the field of Special Care Health Needs Patients from six different universities were provided with a file for each simulation scenario, which they had to complete. The data collected from the validation of the evaluation templates by the expert panel were sent to the Statistical Support Section (SAE) of the University of Murcia. Data analysis was performed using R version 4.0.3. The level of agreement among experts regarding the importance and scoring of items in six clinical evaluation templates was analyzed. Most results were statistically significant (p < 0.05), except for the physical examination dimension in several templates, likely due to the low number of items. Overall, high concordance was observed across competency dimensions, particularly in communication. The positive statistical outcomes observed in our implementation of these checklists highlight their potential not only to assess students' clinical behavior with consistency but also to inform and refine educational strategies. The adoption of a standardized, rigorous approach to checklist development-such as the one applied in this study-may contribute significantly to the advancement of performance evaluation in healthcare education, promoting both learner competency and patient-centered care.

Clinical simulation is a teaching-learning methodology that shows positive results in clinical learning, emphasizing the importance of active learning due to its proximity to real-life professional settings. The aim of this study is to assess the effectiveness of clinical simulation as a learning tool in the course of Special Needs Dentistry and Geriatric Dentistry Courses at one Dental School in Spain. A total of six different scenarios were performed. Evaluation of the students was carried out using assessment checklist, the data were collected item by item, recording the evaluation provided (Yes/No) by the three evaluators in the initial simulation (PRE) and six months later (POST). Data analysis was performed using R version 4.0.3 and Bartlett’s test and one-way ANOVA were used. At the re-evaluation six months later, all participants achieved a significantly higher score on the checklist assessment. In all scenarios, there was adequate concordance among evaluators, with no statistically significant differences. High-fidelity clinical simulation helps improve students’ clinical performance over time, particularly their ability to apply theoretical knowledge in practice.The average scores obtained by students were higher in the final phase (six months later) compared to the initial phase.

Background: Depression is a mental disorder characterized by a combination of somatic and cognitive disturbances, in which a predominantly sad or irritable mood significantly interferes with the patient’s functioning. This condition can affect individuals of all ages and socioeconomic backgrounds. Currently, various studies are exploring a possible association between oral dysbiosis and depression—an increasingly relevant topic, as confirmation of such a relationship could position the oral microbiota as a potential etiological or diagnostic factor for depression, given its accessibility and ease of analysis. Aim: To present a qualitative synthesis of studies addressing how oral dysbiosis influences the onset of depression, as well as the importance of controlling this alteration of the oral microbiota to aid in the prevention of the disease. Materials and Methods: The PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) outline the procedures to be followed for conducting this systematic review. The article search was carried out on 22 May 2025, across the PubMed, Scopus, Scielo, and The Cochrane Library databases, using terms related to “depression” and “oral dysbiosis”. Studies published within the last 10 years that addressed the potential association between oral dysbiosis, and depression were included. Furthermore, the quality of the studies was assessed using various tools depending on their design: the Newcastle–Ottawa Scale (NOS) was applied to case-control and cohort studies; the Joanna Briggs Institute (JBI) critical appraisal checklist was used for cross-sectional studies; and experimental studies were evaluated using SYRCLE’s Risk of Bias Tool. Results: A total of eleven studies were included in this systematic review. The findings suggest the presence of alterations in the oral microbiota of patients with depression, particularly in terms of composition, structure, and diversity. A reduction in alpha diversity—an indicator of local microbial balance—was observed, along with an increase in beta diversity, indicating greater inter-individual variability, which may be associated with inflammatory processes or immunological dysfunctions. Some studies reported differing results, which may be attributable to methodological variability regarding study design, or the populations sampled. Conclusions: This systematic review suggests that the oral microbiome could be considered a diagnostic biomarker and therapeutic target for depression, as the analyzed studies demonstrate a significant association between oral microbiome dysbiosis and this mental disorder. However, the methodological heterogeneity among the studies highlights the need for further research to confirm this potential relationship.

Background/Objectives: Diabetes mellitus is defined as a group of metabolic diseases characterized by chronically elevated blood glucose levels. This condition influences the course of orthodontic treatment, as it affects various clinical aspects of the patient that must be taken into consideration prior to initiation. Therefore, achieving adequate control and management of diabetic patients undergoing orthodontic therapy is essential. This article presents a qualitative synthesis of studies addressing how diabetes affects orthodontic treatments, emphasizing the importance of understanding the necessary considerations prior to initiating treatment and how to manage potential complications. Methods: This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A database search was performed on 5 May 2025, in PubMed, Scopus, Scielo, and The Cochrane Library, using terms related to “diabetes mellitus” and “orthodontic treatments”. Studies meeting the search criteria were included, particularly those that were published in the past ten years and reported on the influence of diabetes on orthodontic treatment. The quality of the case–control studies was assessed using the Newcastle–Ottawa Scale (NOS); for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used; and for experimental studies, the SYRCLE’s Risk of Bias Tool was applied. Results: Fourteen studies ultimately met the inclusion criteria. The evidence showed that diabetes increases gingival bleeding due to elevated levels of advanced glycation end-products (AGEs) and pro-inflammatory cytokines; reduces the efficiency of tooth movement; increases root resorption and affects bone remodeling; and compromises both periodontal and pulpal responses, thereby hindering tissue regeneration. It was also observed that the use of insulin or antidiabetic agents such as metformin may partially mitigate these adverse effects. Conclusions: This systematic review reveals a clear relationship between diabetes and various clinical aspects that influence the progression of orthodontic treatments. Nonetheless, further studies are needed to better understand the impact of this systemic condition on dental treatment outcomes.

Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by diverse clinical manifestations, including the potential involvement of the oral cavity. Oral symptoms in MS patients may arise both as direct consequences of the disease and as side effects of pharmacological treatments. These manifestations, such as xerostomia, periodontal disease, and dental sensitivity, can significantly affect quality of life and may be underrecognized in clinical practice. Aim: To systematically assess the presence and relevance of oral manifestations in patients with MS, and to identify correlations between these symptoms and clinical parameters such as MS phenotype, disease duration, and disability level. Materials and Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A database search was conducted in PubMed and Scopus on 17 March 2025, using terms related to “multiple sclerosis” and “oral manifestations”. Inclusion criteria were limited to observational studies published in the last ten years, focusing on oral symptoms in MS patients. Furthermore, the quality of the studies was assessed following the Newcastle–Ottawa Scale (NOS) for cohort and case–control studies, and the JBI Critical Appraisal checklist for analytical cross-sectional studies. Results: Ten studies met the inclusion criteria. The most frequently reported oral manifestations were hyposalivation, gingival inflammation, increased DMFT and plaque indices, dental sensitivity, and oral pain. Several studies found statistically significant associations between oral dryness and MS phenotype (p < 0.05), and between periodontal health and degree of disability (p < 0.05). However, heterogeneity in methodology and lack of longitudinal studies were noted as limitations. Conclusions: This review highlights a clear relationship between MS and several oral health disturbances, particularly xerostomia and periodontal disease. The findings underscore the need for multidisciplinary care approaches and further studies with standardized protocols to better understand oral-systemic interactions in MS.

Background: Unilateral mastication (UM), defined as the habitual use of one side of the mouth for chewing, has been linked to various craniofacial asymmetries and systemic effects. This study aims to explore the relationship between UM and nasal airway asymmetry, investigating whether a habitual chewing side correlates with a narrowed nostril. These findings provide a preliminary understanding of how chewing practices might impact craniofacial anatomy and respiratory health. Methods: A pilot study involving 24 adults aged 18 and older was conducted. Inclusion criteria excluded individuals with prior orthodontic treatment or edentulism. The habitual chewing side was determined through self-report and direct observation of chewing gum activity. Nostril dimensions were assessed using ImageJ^® 1.54 software by blinded observers. Statistical analysis, including Fisher’s exact test and Kruskal-Wallis test, was performed using R version 4.4.1 to examine associations between the chewing side and nasal asymmetry. Results: Half of the participants (50%) preferred the right side for chewing. A significant association was found between the chewing side and the smaller nostril (p < 0.001). Participants with a smaller right nostril consistently preferred chewing on the right side, with a large effect size (ϕ = 0.845). No significant differences in age were observed across nostril groups (p = 0.47). Conclusions: This study reveals a strong association between unilateral mastication and nasal airway asymmetry, highlighting the potential role of chewing habits in influencing craniofacial development. These findings emphasize the need for further longitudinal studies to explore the systemic and aesthetic implications of habitual chewing patterns.

Background: Unilateral mastication (UM), defined as the habitual use of one side of the mouth for chewing, has been linked to various craniofacial asymmetries and systemic effects. This study aims to explore the relationship between UM and nasal airway asymmetry, investigating whether a habitual chewing side correlates with a narrowed nasal window. These findings provide a preliminary understanding of how chewing practices might impact craniofacial anatomy and respiratory health. Methods: A pilot study involving 24 adults aged 18 and older was conducted. Inclusion criteria excluded individuals with prior orthodontic treatment or edentulism. The habitual chewing side was determined through self-report and direct observation of chewing gum activity. Nasal window dimensions were assessed using ImageJ® software by blinded observers. Statistical analysis, including Fisher’s exact test and Kruskal-Wallis test, was performed using R version 4.4.1 to examine associations between the chewing side and nasal asymmetry. Results: Half of the participants (50%) preferred the right side for chewing. A significant association was found between the chewing side and the smaller nasal window (p < 0.001). Participants with a smaller right nasal window consistently preferred chewing on the right side, with a large effect size (ϕ = 0.845). No significant differences in age were observed across nasal window groups (p = 0.47). Conclusions: This study reveals a strong association between unilateral mastication and nasal airway asymmetry, highlighting the potential role of chewing habits in influencing craniofacial development. These findings emphasize the need for further longitudinal studies to explore the systemic and aesthetic implications of habitual chewing patterns.

Background/Objectives: The rising use of antidepressants is linked to oral health risks, including xerostomia, caries, and periodontal disease. Recognizing these risks is essential for improving patient care. To systematically review oral manifestations in patients undergoing antidepressant treatment. Methods: This review follows the PRISMA guidelines and includes observational studies published in the last 21 years. A PICO-based question was developed to select relevant studies, which were assessed for quality using a modified STROBE checklist. Results: A total of 11 studies were analyzed, revealing a consistent association between antidepressant use and the increased risk of xerostomia, caries, and periodontal disease. Additional findings included taste dysfunction and oral bleeding complications. Among the antidepressants, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) were most commonly associated with xerostomia and caries. However, no significant impact was observed on the chemical composition of saliva or on hemostasis in invasive dental procedures. Conclusions: Antidepressant use may lead to significant oral health issues, notably xerostomia and caries. Further studies are recommended to clarify the influence of specific antidepressants and confounding factors, such as treatment duration, dosage, and hygiene habits, on oral health outcomes.