Vivek Padmanabhan

Background: Parenting style may influence children’s oral health behaviours and responses to dental care, but its joint relationship with dental anxiety and caries has rarely been examined. This study assessed these associations and whether dental anxiety mediated the association between parenting style and caries experience. Methods: In this cross-sectional study, 143 children aged 6–12 years attending a university pediatric dental clinic in the United Arab Emirates were assessed using a 30-item adaptation of the Parenting Styles and Dimensions Questionnaire, the Modified Dental Anxiety Scale, and the DMFT/dmft index. Mediation was tested in a single bootstrapped model containing all three parenting dimensions, age, and sex. Results: Parenting was classified as authoritative (n = 127), authoritarian (n = 4), or permissive (n = 12). Parenting style was associated with dental anxiety (p = 0.016) and caries experience (p < 0.001), and anxiety correlated with caries experience (ρ = 0.314, p < 0.001). Dental anxiety accounted for approximately 39% of the association between the authoritative dimension and caries experience (ACME = −0.260, p = 0.006), and this indirect effect remained significant in children aged 9–12 years. For the permissive dimension, only the direct effect was significant (p < 0.001). Conclusions: These exploratory findings, obtained with markedly imbalanced parenting-style groups, require confirmation in larger, more balanced, longitudinal samples.

Periodontal and peri-implant diseases cause progressive tissue destruction that may lead to tooth and implant loss. Conventional clinical and radiographic assessments document accumulated tissue damage but provide limited information on current biological activity or healing. This narrative review synthesizes the literature published between 2015 and 2025, identified through searches of PubMed/MEDLINE, Scopus, and Web of Science, on salivary biomarkers in periodontal and peri-implant diseases, with emphasis on diagnostic performance, changes after therapy, and clinical translation. Salivary inflammatory mediators and tissue- and bone-remodeling markers—including interleukin (IL)-1β, IL-6, IL-8, IL-17, tumor necrosis factor-α, matrix metalloproteinase (MMP)-8, MMP-9, calprotectin, and the RANKL/osteoprotegerin axis—are consistently associated with periodontal and peri-implant disease. Multimarker panels generally outperform single biomarkers, with some studies reporting areas under the curve above 0.90 for periodontitis detection; however, most evidence derives from cross-sectional diagnostic studies, and prospective prognostic data remain limited. We propose the “salivary healing signature” as a conceptual framework—not a validated test—in which serial multimarker measurements could complement clinical assessment for disease detection, risk stratification, and treatment monitoring. Standardized sampling and analytical protocols, control of confounders, defined thresholds, and prospective validation in diverse populations are required before clinical implementation.

Incident and adverse-event reporting is an important component of patient safety and provides opportunities for risk reduction and organizational learning. In undergraduate dental education programmes, students deliver patient care as they develop clinical competence; however, the extent to which incident reporting is taught, practiced, and integrated into clinical education or the dental curriculum remains unclear. This scoping review mapped the available evidence on the reporting of incidents and adverse events in undergraduate dental education. The review was undertaken in accordance with the framework of Arksey and O’Malley, JBI guidance, and PRISMA-ScR. Scopus, PubMed, Web of Science, and Google Scholar were searched for English-language studies published from 2015 to 2026 that addressed incident or adverse-event reporting in undergraduate dental education programmes, and data were collated and synthesized descriptively and thematically. Thirteen studies met the inclusion criteria. Students’ knowledge, confidence, and preparedness for incident reporting varied widely, and reporting was more often taught within general patient-safety education than as a distinct subject. Underreporting was common, particularly for incidents perceived as minor. Recurring barriers included fear of adverse consequences, limited support within the clinical hierarchy, and uncertainty about how to report. Few studies described any formal assessment of reporting competence, whereas studies in which adverse events were reviewed and fed back to students pointed to clear educational value. Undergraduate dental education addresses incident and adverse-event reporting inconsistently; clear reporting pathways, supportive supervision, constructive feedback, and a non-punitive clinical environment may strengthen reporting competence and patient-safety learning.

Background: Uterine Sensitization-Associated Gene-1 (USAG-1), also known as SOSTDC1, is a bifunctional antagonist of bone morphogenetic protein (BMP) and Wnt signalling—two pathways that are central not only to tooth development but to the entire repertoire of periodontal tissue biology. Current periodontal regenerative therapy relies on exogenous BMP delivery and barrier membranes, approaches with significant limitations in predictability and tissue specificity. The recent entry of anti-USAG-1 antibody therapy into early-phase human clinical trials, with congenital tooth agenesis as the lead indication, raises the question of whether targeted USAG-1 inhibition could be repurposed for periodontal regeneration. Purpose: This perspective examines the biological rationale for USAG-1 as a target in periodontal regeneration, maps the plausible mechanisms through which its inhibition could restore cementum, periodontal ligament (PDL), and alveolar bone, and outlines the conditions and research agenda under which such an approach could be clinically developed. Conclusions: USAG-1 transcripts have been reported in adult gingival tissues, and USAG-1 antagonises BMP and Wnt signals that are implicated in cementogenesis, PDL fibre formation, and alveolar bone homeostasis. Its inhibition is proposed as a biologically plausible, hypothesis-generating strategy for amplifying endogenous regenerative signalling in the periodontium, which might differ from, and could potentially complement, existing regenerative protocols; neither possibility has yet been tested. Realising this potential will require localised delivery strategies, validated biomarker endpoints, and controlled trials embedded in the framework of the EFP S3 stepwise treatment algorithm. Direct experimental evidence that USAG-1 inhibition promotes periodontal regeneration is currently lacking; the case advanced here is inferential and hypothesis-generating, not a demonstrated therapeutic effect.

Self-adhesive resin composites (SARCs) are gaining popularity due to their simplified clinical steps. The objectives of the study were to evaluate the bonding performance, mass stability and mechanical properties of three SARC materials and to compare them with those of two conventional RC materials using a universal adhesive system (UAS). Materials and Methods: A total of 80 bovine enamel blocks with 5 mm × 5 mm dimensions were prepared and embedded in acrylic molds. The surface of the enamel was polished using 600-grit carbide to create the smear layer. After acid etching, 2 mm × 2 mm cylinder-shaped restorations were made either with one of the three SARCs or with two types of RCs using UASs. Shear bond strength tests were performed after 24 h of water incubation and after 1 year of artificial aging. The mass stability of the hexagonal-shaped SARC and conventional RC was evaluated using water sorption and solubility tests. Then the mechanical properties of the bonded composites were tested, including Vickers hardness, elastic modulus and creep, after 24 h of water incubation and after 1 year of artificial aging. Results: Both the material types and aging showed a significant effect on the bonding performance, mass stability and mechanical properties of SARCs and conventional RCs (p < 0.05). The shear bond strength of SARCs was comparable to that of a conventional RC + UAS. Conventional RCs showed lower water sorption and solubility compared to SARCs. The Vickers hardness, elastic modulus and creep properties of some SARCs were inferior compared to conventional RCs both at 24 h and at 1 year. Conclusions: The bonding performance of SARCs can substitute the conventional RC+ UAS; however, its inferior mass stability and mechanical properties limit its use in routine dental restorative procedures.

Background. Radiographic bone loss is a primary determinant of periodontitis stage. Intraoral radiographs (periapical and bitewing) are the standard projections for assessing interproximal bone levels, yet their interpretation is subjective and poorly reproducible, and previous syntheses have pooled intraoral with panoramic imaging. Objectives. To appraise and synthesise studies developing or validating deep learning (DL) models for detecting, quantifying, staging or classifying alveolar bone loss on intraoral radiographs. Methods. Seven databases and six supplementary sources were searched from 1 January 2015 to 12 June 2026 (PROSPERO CRD420261455818, registered retrospectively). Two reviewers screened, extracted and appraised in duplicate using QUADAS-2 with AI-specific signalling questions, CLAIM and APPRAISE-AI; certainty was rated by GRADE. Heterogeneity precluded pooling; synthesis was narrative. Results. Sixteen publications reporting 15 independent datasets (2018–2026) were included (11 periapical, two bitewing, three mixed; 39–21,819 radiographs). The architectures employed comprised classification, segmentation, object-detection, keypoint-localisation and transformer-based models. Accuracy for binary detection ranged from 0.73 to 0.97, Dice coefficients reached ≥0.91, and intraclass correlation with expert measurement was 0.75–0.85. Performance fell for multiclass staging, posterior sites and furcations. Only two studies used an external test set; none was prospective; risk of bias was mostly high or unclear. Conclusions. Performance lies within the range observed for calibrated readers, but the evidence is dominated by small, single-centre, retrospective datasets with annotation-based reference standards and almost no external validation; certainty is very low. Deep learning is best regarded as a clinician-supervised adjunct for screening, triage and quality assurance rather than an autonomous diagnostic device.

Background: Universal-shade resin composites (USRCs) have gained popularity for their simplified shade-matching and reduced chairside time. However, their long-term performance under oral environmental stresses remains uncertain. This study aimed to compare the mechanical and esthetic properties of five commercially available single-shade resin composites and one conventional micro-hybrid resin composite (MHRC) after simulated aging. Methods: A total of 18 disc-shaped specimens (10 mm circular × 3 mm thick) were prepared from five USRCs (Omnichroma, Zenchroma, A-Uno, TRANSCEND, and Ecosite One) and one MHRC (Clearfil AP-X). The polymerized specimen disk was polished using 2500 grit SIC paper. The mechanical properties, Vickers microhardness (HV), elastic modulus (EM) and creep (CR), and the esthetic properties, color and gloss, were measured after 24 h water storage and after 1-year stimulated aging. The data was analyzed using SPSS 27.0 software. A significance level of α = 0.05 was used for all statistical analyses. Results: Both the aging and types of material showed a significant effect on the mechanical and esthetic properties of the tested resin composite materials. The MHRC showed a significantly higher HV and EM compared to the USRC (p < 0.05). The MHRC showed significantly lower CR compared to USRC (p < 0.05). The color retention of USRCs was comparable to the MHRC (p > 0.05) and some USRCs showed superior gloss values compared with MHRC (p < 0.05). The solubility of USREs were comparable to MHRC (p > 0.05) except A-Uno which showed significantly higher solubility compared to MHRC (p < 0.05). Conclusions: Within the limitations of this in vitro study, it concludes that the USRC possesses inferior mechanical properties compared with the convention MHRC. Thus, their use should be limited when strong and durable mechanical properties are required under heavy occlusal stress. The use of USRCs could be beneficial for achieving a highly esthetic outcome of the restoration that does not includes the area that comes under heavy occlusal stress.

Systemic antibiotics are among the most widely prescribed therapeutic agents worldwide, and their effects on host–microbe equilibrium extend well beyond the infection for which they are intended. Periodontitis is conventionally framed as a biofilm-initiated, host-mediated inflammatory disease, although recent work has shifted this framework toward microbial homeostasis as a regulator of periodontal stability. We hypothesize that antibiotics are not direct etiologic agents of periodontitis but instead act as risk-modifying factors that lower the threshold at which plaque-mediated inflammation progresses to destructive disease. We propose that this effect may operate through several mechanisms: broad-spectrum or repeated exposure could deplete protective commensals and narrow microbial diversity, creating ecological space for opportunistic and pathogenic taxa; antibiotics may also alter host neutrophil function, cytokine profiles, and antimicrobial peptide regulation and may interfere with the osteoblastic and osteoclastic dynamics governing alveolar bone remodelling; and antibiotic-induced gut dysbiosis may propagate systemic inflammatory signals that further modulate periodontal susceptibility. To evaluate this hypothesis, we synthesize the available clinical, epidemiological, and experimental data across four converging axes—oral microbial ecology, immune regulation, alveolar bone remodelling, and the gut–oral axis—and identify the predictions the hypothesis generates and the evidence gaps it exposes. We emphasize that no clinical study has yet demonstrated a causal link between antibiotic exposure and periodontitis; the framework advanced here is therefore intended to inform antimicrobial stewardship in dentistry and to define a research agenda for determining whether antibiotic exposure constitutes a clinically meaningful modifier of periodontal disease susceptibility.

Periodontal disease is a chronic inflammatory condition driven by polymicrobial biofilms whose interaction with the host immune response drives the destruction of tooth-supporting tissues. Within these communities, bacterial cell–cell communication—particularly quorum sensing (QS)—coordinates virulence factor expression, biofilm maturation, and interspecies behaviour, allowing pathogens to mount population-dependent attacks on the host. Disrupting these signals has therefore drawn growing attention as an anti-virulence strategy for biofilm-associated oral infection. Quorum quenching (QQ)—the inhibition or disruption of QS pathways—prevents bacteria from coordinating these virulence-related activities. The candidate inhibitors investigated to date fall into three broad classes: conventional antibiotics used at sub-inhibitory concentrations, plant-derived natural compounds, and synthetic molecules designed to interfere with signal synthesis, signal reception, or signal transduction. In experimental work on periodontal pathogens, agents from each class reduce biofilm formation, suppress virulence factor production, and disrupt microbial communication within polymicrobial biofilms. Clinical translation, however, lags behind the laboratory evidence. Most data still come from in vitro systems and animal models, and the ecological complexity of the oral biofilm makes therapeutic targeting difficult: signals that drive virulence in pathogens also support cooperation among commensals. Toxicity profiles, pharmacokinetics, and well-powered clinical trials are needed before quorum-quenching agents can be considered for routine periodontal care. Even with these caveats, targeting bacterial communication offers a different therapeutic logic from conventional antimicrobials: attenuating virulence rather than killing cells, and so exerting weaker selective pressure for resistance. Further dissection of QS networks in oral biofilms—and the rational design of quenching agents that act on pathogenic rather than commensal signalling—may yield useful adjuncts to current periodontal therapy.