Jian Yu

The appropriate management of traumatic dental injuries (TDIs) in immature permanent teeth is critical for predicting prognosis and preserving injured teeth. However, providing accurate treatment is always challenging for dental students due to their limited knowledge of TDIs. This study aimed to assess TDIs in immature permanent teeth in terms of knowledge, attitudes, and clinical practice among Chinese dental undergraduates and residents. Dental undergraduates (in 3rd -, 4th -, and 5th -years) and residents (in 1st -, 2nd -, and 3rd -years) at the School of Stomatology, Wuhan University (763 in total, from May to June 2024), were distributed with a structured electronic questionnaire containing 22 items. The obtained data was statistically analyzed via the Chi-square (χ2) test (p < 0.05) using SPSS. Participants from various academic levels completed 502 questionnaires, with a response rate of 65.79%. Approximately half of the participants (58.6%) were familiar with TDIs, chiefly through traditional classroom learning (90.0%). Participants had limited knowledge on correct emergency treatment for TDIs, including tooth replantation timing (51.6%), fixation method (43.8%), and time (25.5%), with 3rd -year undergraduates reporting the lowest percentage (10.2%) (p < 0.05). Most participants agreed that vital pulp preservation (95.0%) and additional examination (91.0%) are essential for TDI management. Besides, only 29.9% of participants had ever treated a clinical TDI case independently. The majority of participants expressed a strong desire to gain comprehensive knowledge of TDIs (90.0%) and additional training (96.4%). Dental students at the undergraduate and postgraduate levels lacked sufficient knowledge and practice with TDIs but had a positive attitude toward TDI management. Thus, it would be enormously beneficial for dental students to gain a better understanding of TDIs through improved dental education, including multiple teaching methodologies and more clinical practice. Not applicable.

Editorial on the Research Topic Advanced biomaterials for hard tissue repair and regeneration Bone and tooth are typical hard tissues in vertebrates. Due to hierarchical structural characteristics and excellent mechanical properties, hard tissues play important roles for human body, such as health protection, movement support, and food mastication. Once hard tissue defect occurs, our living quality will be seriously affected. In general, hard tissues lack the ability of self-repair, except for the regeneration ability of bone for small-scale defects. As a result, the past few decades have witnessed great progress in the field of biomaterials for hard tissue repair. Actually, both bone and tooth are masterpieces of biomineralization in nature, the repair and regeneration of hard tissues should be performed in a biomimetic way. Therefore, this Research Topic provides a comprehensive overview of the current state of the art regarding advanced biomaterials used to repair or regenerate damaged hard tissues, as well as to highlight the most promising advanced strategies other than suggest the future direction in the field. In the present Research Topic, 154 authors from all over the world decided to publish their outstanding and promising results.

Background: Early childhood caries (ECC) causes severe, widespread oral health issues in children. Dental undergraduates and residents are expected to have a solid understanding of ECC for children’s oral health promotion. This study aimed to evaluate the knowledge, attitude, and clinical practice on ECC among dental undergraduates and residents in China. Methods: A 23-item electronic questionnaire was distributed to 598 dental undergraduates (4th- and 5th-year undergraduates) and residents (1st-, 2nd-, and 3rd-year residents) at the School of Stomatology, Wuhan University, China (in April–May 2023). SPSS Statistics was used to analyze the data using the Chi-square test at a significance level of 0.05. Results: A total of 422 questionnaires were completed by participants (recovery rate: 70.6%) from various academic levels. Around 77.3% of participants had heard of ECC (mainly from textbooks), and only 27.5% considered themselves familiar with it. Residents (79.8%) had higher risk awareness of ECC on children’s overall health than undergraduates (58.3%) (p < 0.05), but only 54.0% of participants correctly defined ECC. Most participants had a positive understanding of ECC’s pathogenic factors and preventive measures, including feeding patterns (71.6%), fluoride application (93.4%), and teeth cleaning (93.1%). Furthermore, only 50.2% of participants encountered ECC cases in clinic. Conclusions: Despite having a suboptimal level of ECC-related knowledge and practice, dental undergraduates and residents in China demonstrated a more positive attitude towards its etiology-based prevention. Strengthening ECC education, guidance, and practice may enable them to gain a better understanding of ECC learning, which would benefit children’s oral health.

Titanium alloys have gained popularity in implant dentistry for the restoration of missing teeth and related hard tissues because of their biocompatibility and enhanced strength. However, titanium corrosion and infection caused by microbial biofilms remains a significant clinical challenge leading to implant failure. This study aimed to evaluate the effectiveness of antibiofilm peptides 1018 and DJK-5 on the corrosion resistance of titanium in the presence of Streptococcus mutans. Commercially pure titanium disks were prepared and used to form biofilms. The disks were randomly assigned to different treatment groups (exposed to S. mutans supplied with sucrose) including a positive control with untreated biofilms, peptides 1018 or DJK-5 at concentrations of 5 μg/mL or 10 μg/mL, and a negative control with no S. mutans. Dynamic biofilm growth and pH variation of all disks were measured after one or two treatment periods of 48 h. After incubation, the dead bacterial proportion, surface morphology, and electrochemical behaviors of the disks were determined. The results showed that peptides 1018 and DJK-5 exhibited significantly higher dead bacterial proportions than the positive control group in a concentration dependent manner (p < 0.01), as well as far less defects in microstructure. DJK-5 at 10 μg/mL killed 84.82% of biofilms and inhibited biofilm growth, preventing acidification due to S. mutans and maintaining a neutral pH. Potential polarization and electrochemical impedance spectroscopy data revealed that both peptides significantly reduced the corrosion and passive currents on titanium compared to titanium surfaces with untreated biofilms, and increased the resistance of the passive film (p < 0.05), with 10 μg/mL of DJK-5 achieving the greatest effect. These findings demonstrated that antibiofilm peptides are effective in promoting corrosion resistance of titanium against S. mutans, suggesting a promising strategy to enhance the stability of dental implants by endowing them with antibiofilm and anticorrosion properties.

One of the primary causes for the failure of glass ionomer cement (GIC) is secondary caries. To enhance the anti-microbial performance of GIC without affecting its mechanical properties, chlorhexidine (CHX) was encapsulated in expanded-pore mesoporous silica nanoparticles (pMSN) to synthesize CHX@pMSN. CHX@pMSN was added at three mass fractions (1%, 5%, and 10% (w/w)) to GIC powder as the experimental groups. Pure GIC was set as the control group. The mechanical and anti-biofilm properties of GIC from each group were tested. The results demonstrated that CHX was successfully encapsulated on/into pMSN, and the encapsulating efficiency of CHX was 44.62% in CHX@pMSN. The anti-biofilm ability was significantly enhanced in all experimental groups (p < 0.001) compared with that in the control group. CHX was continuously released, and anti-biofilm ability was maintained up to 30 days. In addition, the mechanical properties (compressive strength, surface hardness, elastic modulus, water sorption, and solubility) of 1% (w/w) group were maintained compared with those in the control group (p > 0.05). In conclusion, adding 1% (w/w) CHX@pMSN to GIC led to conspicuous anti-biofilm ability and had no adverse effect on the mechanical properties of this restorative material. This study proposes a new strategy for preventing secondary caries by using CHX@pMSN-modified GIC.