Irina Nica

Background/Objectives: Patient non-attendance disrupts dental scheduling and may leave reserved appointment time unused when missed slots cannot be reassigned. Most no-show prediction studies focus on discrimination or the number of missed appointments identified, without considering appointment duration, probability calibration, temporal robustness, or limited intervention capacity. This study developed and evaluated a calibrated, duration-weighted framework for operational prioritization of dental appointments. Methods: A retrospective secondary analysis was conducted using 196,018 appointments recorded in 2019 at a dental clinic in Riyadh, Saudi Arabia. L2-regularized logistic regression was used as the primary model, with CatBoost as a secondary nonlinear comparator. Model development, probability calibration, and testing were performed in separate chronological periods. Performance was assessed using ROC-AUC, average precision, Brier score, calibration measures, rolling-origin temporal validation, dentist-level transportability analysis, and sensitivity analyses. Four prioritization strategies were compared at intervention budgets from 5% to 30%: random, probability-only, duration-only, and calibrated probability multiplied by scheduled duration. Results: In the independent November–December test set, the calibrated logistic model achieved a ROC-AUC of 0.6886 (95% CI: 0.6827–0.6941), average precision of 0.6087, and Brier score of 0.2238. At the prespecified 10% intervention budget, probability-only targeting captured 15.88% of scheduled no-show minutes, duration-only targeting captured 18.49%, and duration-weighted targeting captured 23.04%. Duration-weighted targeting exceeded probability-only targeting by 7.16 percentage points (95% CI: 6.47–7.79) and duration-only targeting by 4.54 percentage points (95% CI: 4.00–5.39). The advantage persisted across rolling-origin validation and sensitivity analyses. Conclusions: Combining calibrated no-show probability with scheduled appointment duration identified more scheduled time associated with non-attendance than either probability or duration alone under the same intervention budget. The framework demonstrated a retrospective ranking advantage for identifying scheduled minutes associated with non-attendance but did not establish recoverable clinical capacity, reductions in missed appointments, or improvements in clinical efficiency. Independent external validation and prospective intervention studies are required before routine clinical implementation.

Background/Objectives: Caries adjacent to restorations or sealants (CARS) is among the most frequent biological causes of composite restoration failure, resulting from the interplay between the patient’s cariogenic risk and restoration-related factors such as marginal adaptation. The study aimed to investigate whether cariogenic risk modifies the effect of marginal adaptation on the occurrence of caries adjacent to posterior composite restorations (CARS), using risk-stratified univariate analysis and a clustering-adjusted approach, to identify associated clinical, socio-demographic, and local risk factors. Methods: This retrospective cross-sectional study evaluated 453 posterior direct composite resin restorations (Class I, Class II) in 88 patients at the Faculty of Dental Medicine, “Grigore T. Popa” University, Iași, Romania. CARS and marginal adaptation were assessed using FDI Criteria. Patients were classified as high or low cariogenic risk using a multifactorial institutional protocol. Univariate analysis and Generalized Estimating Equations (GEE) accounting for within-patient clustering were performed. Results: CARS prevalence was 27.9% in high cariogenic risk patients versus 3.15% in low cariogenic risk patients. Univariate analysis identified high cariogenic risk (OR = 11.904), deficient marginal adaptation (OR = 25.929–69.475), restoration age of 3–5 years (OR = 3.045), and Class II configuration (OR = 2.597) as significant risk factors. GEE analysis, adjusted for clustering of restorations within patients, confirmed high cariogenic risk (OR = 12.597) and deficient marginal adaptation (OR = 121.320) as independent correlates of CARS. A significant interaction between the two (p < 0.001) showed that marginal adaptation remained the dominant local risk factor in low cariogenic risk patients, while its association with CARS was largely attenuated in high-risk patients. Conclusions: GEE analysis confirmed high cariogenic risk and deficient marginal adaptation as independent correlates of CARS, with marginal adaptation acting as the dominant local risk factor only in low-risk patients.

Background: Salivary gland dysfunction is a central manifestation of Sjögren’s syndrome, but the relationship between quantitative salivary impairment and salivary microcrystallization remains insufficiently defined. This study aimed to assess unstimulated and stimulated whole salivary flow and salivary pH in patients with primary and secondary Sjögren’s syndrome and to explore salivary microcrystallization indices as complementary descriptive markers of salivary physicochemical patterns. Materials and Methods: This cross-sectional observational study included 126 patients diagnosed with primary or secondary Sjögren’s syndrome. Unstimulated whole salivary flow, stimulated whole salivary flow, and salivary pH were assessed under standardized conditions. Salivary dysfunction severity was classified according to predefined functional salivary parameters. Salivary microcrystallization was evaluated microscopically on dried saliva samples and expressed using the IMK-RFR and IMK-RFS indices. Differences between disease subtypes and associations between salivary parameters, microcrystallization indices, and dysfunction severity were analyzed. Results: The mean unstimulated salivary flow rate was 0.272 ± 0.246 mL/min, while the mean stimulated salivary flow rate was 1.04 ± 0.50 mL/min. In unadjusted analyses, patients with primary Sjögren’s syndrome showed lower unstimulated and stimulated salivary flow rates than patients with secondary Sjögren’s syndrome. Both salivary flow parameters were inversely associated with salivary dysfunction severity. In an exploratory internal consistency ROC analysis, unstimulated salivary flow showed good internal agreement with grade ≥ 3 salivary dysfunction, while stimulated salivary flow showed very high internal agreement. Salivary pH showed limited internal consistency with dysfunction severity. Firth penalized logistic regression indicated that stimulated whole salivary flow remained associated with grade ≥ 3 salivary dysfunction after adjustment for unstimulated salivary flow. IMK values described salivary microcrystallization patterns within the Sjögren’s syndrome cohort; however, they were not robustly correlated with salivary flow, pH, or dysfunction severity. Conclusions: Salivary flow assessment remains a simple, non-invasive, and clinically relevant method for evaluating glandular dysfunction in Sjögren’s syndrome. In this cohort, primary Sjögren’s syndrome was associated with lower salivary flow rates, but these unadjusted findings should be interpreted as descriptive. Salivary microcrystallization provided exploratory information on qualitative salivary patterns, but its clinical value remains limited and requires methodological standardization and validation in larger prospective studies.

Background/Objectives: High-viscosity glass hybrid restorative systems (GHRS) were developed to improve the mechanical limitations of conventional glass ionomer cements while preserving their bioactive properties. This scoping review aimed to map and synthesize the currently available evidence regarding the clinical performance of high-viscosity glass hybrid restorative systems in posterior teeth. Methods: A literature search was conducted in PubMed/MEDLINE, Web of Science and Google Scholar using MeSH terms and free-text keywords related to glass hybrid restorative systems and posterior restorations. After screening and eligibility assessment, 39 studies were included in the review. Results: The reviewed studies indicated that GHRS exhibited better wear resistance, higher fracture resistance, improved surface durability, and superior marginal integrity compared with conventional high-viscosity glass ionomer cements. Equia Forte HT (GC Corporation, Tokyo, Japan), combined with nano-filled resin coatings, was the most frequently investigated system and showed favorable short- and medium-term clinical performance in small-to-moderate posterior restorations. Discussion: Glass-hybrid restorative systems have demonstrated considerable potential in minimally invasive dentistry, atraumatic restorative treatment, and pediatric restorative applications, particularly in patients with increased caries susceptibility. Their sustained fluoride release, chemical adhesion to dental tissues, and improved moisture tolerance may contribute to favorable clinical outcomes in challenging operative conditions. Conclusions: Within the limitations of the available evidence, high-viscosity glass-hybrid restorative systems may represent a promising restorative option for selected posterior restorations. Nevertheless, the available evidence remains heterogeneous, and further high-quality long-term randomized controlled trials are required to confirm their clinical performance and indications.

Background/Objectives: In vitro simulation of dental wear is essential for preclinical evaluation of dental materials, but available devices differ widely in operating principles and simulated oral conditions. This scoping review mapped devices used to reproduce dental wear and oral aging and classified them according to the dominant wear mechanism. Methods: Searches were conducted in PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase, and Google Scholar for records published between 1985 and 2026. Eligible sources reported an identifiable in vitro device or setup, a dental material or hard-tissue substrate, and extractable device-level data on operating principles, parameters, environment, antagonist, or outcomes. Results: Sixty-eight reports were retained and consolidated into 19 devices or device families. The systems included two-body chewing simulators, three-body wear machines, robotic or multiaxial masticatory platforms, tribometers, toothbrushing abrasion devices, erosion and pH-cycling systems, tribocorrosion setups, and multifunctional oral aging simulators. Device development showed a transition from mainly mechanical wear testing toward integrated platforms combining load, sliding, thermocycling, saliva or electrolyte exposure, pH control, chemical challenge, biofilm-related conditions, and electrochemical monitoring. Reporting remained heterogeneous, particularly for load, cycle number, frequency, sliding distance, antagonist material, medium, temperature, pH, and outcome measurement. Conclusions: Device selection should be based on the dominant wear mechanism, material type, and research objective. More complete source-level reporting is needed to improve reproducibility and comparability.

Introduction: The goal of this study was to evaluate the influence of combined artificial aging protocols on the surface roughness and Vickers microhardness of bulk-fill resin composites, compared with a nanofilled composite used as a reference. Materials and Methods: A total of 120 cylindrical specimens were prepared from three bulk-fill composites (Tetric EvoCeram Bulk Fill, Filtek One Bulk Fill, Venus Bulk Fill) and one nanofilled composite (Filtek Supreme Ultra). Specimens were allocated into three aging conditions: mechanical wear (A), mechanical wear combined with pH-cycling (B), and mechanical wear combined with thermocycling (C). Surface roughness (Ra) and Vickers microhardness (VHN) were evaluated at two time points (T1: 120,000 cycles; T2: 240,000 cycles). Non-parametric statistical tests were applied (α = 0.05). Results: Aging protocols significantly influenced both Ra and VHN (p < 0.05). Overall, higher surface roughness and lower Vickers microhardness values were observed after cumulative aging, with material-dependent variations between T1 and T2. The greatest post-aging differences were observed under combined mechanical wear and pH-cycling (subgroup B), whereas mechanical wear alone showed the lowest changes. Filtek One Bulk Fill and Filtek Supreme Ultra showed more favorable post-aging Ra and VHN values, whereas Venus Bulk Fill showed less favorable post-aging surface properties. No significant correlation was found between Ra and VHN (rho = −0.009; p = 0.958). Conclusions: Combined aging conditions significantly affected the surface roughness and Vickers microhardness of resin composites, with the greatest post-aging differences observed under acidic challenges. Bulk-fill materials exhibit variable resistance depending on composition, emphasizing the importance of material selection for long-term clinical performance. Clinical relevance: Composite restorations exposed to combined mechanical and acidic challenges may show altered surface roughness and microhardness, highlighting the need for materials with enhanced resistance in high-risk oral environments.

The management of adult patients requiring multidisciplinary dental care presents unique challenges, particularly when addressing the interrelationship between orthodontics, periodontics, and restorative dentistry. In many cases, the successful resolution of complex dental issues necessitates a coordinated approach that integrates these specialties. Orthodontic therapy plays a critical role in aligning teeth and correcting malocclusions, while periodontal treatment focuses on the prevention and management of periodontal diseases. Restorative dentistry, which includes procedures to restore tooth structure and function, is essential for achieving long-term dental health and aesthetic outcomes. The main motivation for referring adults to the orthodontist is the desire to improve dental and smile aesthetics, missing teeth due caries, periodontal disease or trauma and subsequently functional impairment. Pre-restorative orthodontics is necessary for the most favourable distribution of teeth, with good root parallelism to optimise future restorative treatment, correction of occlusal plane for incisal guidance, improvement or correction of mucogingival and osseous defects, and for obtaining a more favourable crown-to-root ratio for long-term maintainability of periodontally compromised teeth. Clinical examples will be used to illustrate the different indications for adult orthodontic-restorative treatment and the necessity for close collaboration of a well-orchestrated interdisciplinary team.

A unitary model of drug release dynamics is proposed, assuming that the polymer–drug system can be assimilated into a multifractal mathematical object. Then, we made a description of drug release dynamics that implies, via Scale Relativity Theory, the functionality of continuous and undifferentiable curves (fractal or multifractal curves), possibly leading to holographic-like behaviors. At such a conjuncture, the Schrödinger and Madelung multifractal scenarios become compatible: in the Schrödinger multifractal scenario, various modes of drug release can be “mimicked” (via period doubling, damped oscillations, modulated and “chaotic” regimes), while the Madelung multifractal scenario involves multifractal diffusion laws (Fickian and non-Fickian diffusions). In conclusion, we propose a unitary model for describing release dynamics in polymer–drug systems. In the model proposed, the polymer–drug dynamics can be described by employing the Scale Relativity Theory in the monofractal case or also in the multifractal one.

Aims of study. The aims of study were as follows: assessment of esthetic, functional and biological FDI indices of posterior composite restorations; assessment of decisions for non-intervention vs. repair/replacement of the posterior composite restorations. Materials and method. The retrospective study was performed on a study group of 69 patients (mean age: 25.31± 4,45 yrs; gender: 36 males, 33 females) that were treated for various dental pathologies in Odontology-Periodontology, Fixed Restorations of Clinical Learning Base of Faculty of Dental Medicine, U.M.F. Grigore T.Popa Iași (Romania) with a total number of 309 posterior composite restorations (class I and II Black) aged 3-5 yrs. The composite restorations were clinically evaluated using visual-tactile method. The evaluations were carried out during the recall session by an independent examiner, according to the FDI criteria (esthetic, functional, biological). The frequency of non-intervention versus repair/replacement decision was assessed globally and related to the parameters of the study group (gender, cariogenic risk, cavity design, arch/dental group location). Statistical analysis was performed in SPSS 29.0. Quantitative variables were characterized by descriptive statistics (means and standard deviations). Results. In the study group, 38,8% of all composite resin restorations required repair or replacement (FDI scores 4-5). The decisions of repair/replacement related to the assessed variables were as follows: 22,4% (Class I) vs 54,2% (Class II); 30,6% (males) vs 31% (females); 42,9% (high cariogenic risk) vs 20,4% (low cariogenic risk); 29,7% (Mx location) vs 31,5% (Md location); 41,4% (premolars) vs 49,5% (molars). Conclusions. 31% of posterior composite restorations aged 3-5 years require repair or replacement. Surface condition and margin discoloration are most frequent esthetic scores related to decisions of repair or replacement. Significantly higher percentages of Class II composite restorations (versus Class I) and molars restorations (versus premolars) were associated to requires repair or replacement. The most frequent biological score related to replacement decisions is the presence of secondary caries, mostly in Class II restorations.