Background: The purpose of this in vitro study was to compare the accuracy of implant placement in model surgeries according to the design of the drills (straight drills or step drills) used to finalize the implant bed during pilot-guided static computer-assisted implant surgery (sCAIS). Methods: Model surgeries were carried out on resin models randomly assigned to three study groups. Virtual planning software (coDiagnostiX 10.6, Dental Wings, Montreal, Canada) was used to plan the implant positions. In Groups 1 and 2, pilot-guided sCAIS was performed. Straight drills were used in Group 1, and step drills were used in Group 2 to finalize the implant beds. In Group 3, fully guided sCAIS was performed using a universal fully guided kit (RealGUIDE Full Surgical Kit 3DIEMME, RealGUIDE, Cantù, Como, Italy). A total of 90 dental implants (Callus Pro, Callus Implant Solutions GmbH, Nuremberg, Germany) were placed (six implants per model, five models per study group). The primary outcome variables (angular deviation, coronal global deviation, and apical global deviation) were calculated for all implants based on the comparison of the preoperative surgical plan with the postoperative scans. Results: Group 2 (coronal global deviation, 0.78 ± 0.29 mm; apical global deviation, 1.02 ± 0.56 mm) showed significantly lower values of both global deviation variables than Group 1 (coronal global deviation, 0.95 ± 0.20 mm; apical global deviation, 1.42 ± 0.49 mm). However, there was no significant difference in angular deviation between Groups 1 and 2 (7.56 ± 2.92° and 6.44 ± 2.84°). Group 3 produced significantly lower values of all three primary outcome variables (angular deviation, 2.36 ± 0.90°; coronal global deviation, 0.59 ± 0.28 mm; apical global deviation, 0.90 ± 0.29 mm) than Group 1 and significantly lower angular deviation and coronal global deviation values than Group 2. Conclusions: The design of the drills used to finalize implant osteotomies during pilot-guided sCAIS influences dental implant placement accuracy. Using step drills instead of straight drills for final osteotomies decreases deviation from the surgical plan. The fully guided approach performed better than the pilot-guided sCAIS.

Background: Navigated endodontics is a cutting-edge technology becoming increasingly more accessible for dental practitioners. Therefore, it is necessary to clarify the ideal technical parameters of this procedure to prevent collateral damage of the surrounding tissues. There is a limited number of studies available in published scientific literature referencing the possible collateral thermal damage due to high-speed rotary instruments used in guided endodontic drilling. The aim of our study was to investigate the different drilling parameters and their effect upon the temperature elevations measured on the outer surface of teeth during guided endodontic drilling. Methods: In our in vitro study, 72 teeth with presumably narrow root canals were prepared using a guided endodontic approach through a 3D-printed guide. Teeth were randomly allocated into six different test groups consisting of 12 teeth each, of which, four parameters affecting temperature change were investigated: (a) access cavity preparation prior to endodontic drilling, (b) drill speed, (c) cooling, and (d) cooling fluid temperature. Temperature changes were recorded using a contact thermocouple electrode connected to a digital thermometer. Results: The highest temperature elevations (14.62 °C ± 0.60 at 800 rpm and 13.76 °C ± 1.24 at 1000 rpm) were recorded in the groups in which drilling was performed without prior access cavity preparation nor without a significant difference between the different drill speeds (p = 0.243). Access cavity preparation significantly decreased temperature elevations (p < 0.01) while drilling at 800 rpm (8.90 °C ± 0.50) produced significantly less heating of the root surface (p < 0.05) than drilling at 1000 rpm (10.09 °C ± 1.32). Cooling significantly decreased (p < 0.01) temperature elevations at a drill speed of 1000 rpm, and cooling liquid temperatures of 4–6 °C proved significantly (p < 0.01) more beneficial in decreasing temperature elevations (1.60 °C ± 1.17) than when compared with room temperature (21 °C) liquids (4.01 °C ± 0.22). Conclusions: Based on the results of our study, guided endodontic drilling at drill speeds not exceeding 1000 rpm following access cavity preparation, with constant cooling using a fluid cooler than room temperature, provides the best results in avoiding collateral thermal damage during navigated endodontic drilling of root canals.

Background: Soft tissue stability around dental implant abutments is critical for maintaining a functional peri-implant seal. Yellow anodization is used to improve the aesthetic and surface characteristics of titanium abutments, yet its epithelial effects under more physiologically relevant 3D conditions remain insufficiently explored. Objective: To develop a 3D bioprinted in vitro peri-implant mucosa model and to compare epithelial cell responses on yellow anodized versus turned titanium abutment surfaces. Methods: Commercial Grade 5 (Ti6Al4V) titanium abutments were anodized and compared with turned controls. A collagen-based 3D bioprinted “collar-like” construct incorporating YD-38 epithelial cells was fabricated using a custom holder system to simulate peri-implant mucosal contact. Samples were cultured for 14 and 21 days. Cell distribution and morphology were assessed by optical microscopy and HE staining, while cytoskeletal organization was evaluated by TRITC-phalloidin/Hoechst staining and confocal microscopy. Quantitative fluorescence analysis was performed at 21 days. Results: Both surfaces supported epithelial coverage in the 3D environment. Anodized specimens showed more pronounced actin cytoskeletal organization and the presence of actin-rich, filamentous cellular extensions compared with turned controls. Quantitative image analysis demonstrated significantly higher TRITC-phalloidin signal intensity at 21 days on anodized samples (p < 0.001). Conclusions: Within the limitations of a 3D epithelial in vitro model using YD-38 cells, yellow anodization was associated with enhanced epithelial cytoskeletal organization compared with turned titanium. The presented 3D bioprinted platform may serve as a practical in vitro tool for screening abutment surface modifications relevant to peri-implant soft tissue integration.

Background: Shift-working emergency medical services (EMS) personnel face structural barriers to preventive oral care, yet national workforce data remain scarce. Objective: To estimate prevalence of oral symptoms, behaviours, dental attendance, and psychosocial OHRQoL impacts among Hungarian National Ambulance Service (OMSZ) staff; assess associations with occupational enablers/barriers; and evaluate acceptability of employer-supported screening. Methods: Nationwide cross-sectional anonymous online survey (13 Sep 2024–17 Apr 2025; n = 1,061; 73% men, 74% 24-hour shifts). Logistic regression examined a priori outcomes (ORs, 95% CI), adjusted for age/sex/attendance; STROBE-compliant. Results: Among 1,061 respondents, 74% reported 24-hour shifts as their primary duty pattern. Over half reported current or recent dental/oral problems (54.9%), and 20% had not attended a dental check-up within the previous two years. Off duty, 33% brushed twice daily, whereas during duty about two-thirds reported regular brushing. Workplace hygiene kits were reported by 40% of respondents and were more common among 24-hour shift workers. In regression analyses, kit availability was strongly associated with daily or more frequent on-duty brushing among 24-hour staff (85% vs. 21%). Daily brushing was associated with lower odds of toothache, non-use of interdental cleaning with higher odds of hiding teeth, and rare on-duty brushing with higher odds of halitosis. Psychosocial impacts were similar across roles, and 88–90% were willing to undergo workplace screening. Conclusions: Shift-constrained EMS staff face substantial, preventable oral health burdens amenable to occupational solutions. Enabling on-duty hygiene and supporting routine care are key priorities. High screening readiness supports integrating teledentistry. Consistent gaps across roles underscore the need for further longitudinal and interventional studies.

Soft tissue calcifications on dental panoramic radiographs (PR) may reflect systemic vascular disease. Given the increased cardiovascular and cerebrovascular risk in diabetes, this study compared their prevalence in patients with diabetes and baseline-comparable nondiabetic controls and explored associations in the combined sample. This retrospective case-control study included 56 adults with diabetes and 56 nondiabetic controls, frequency-matched by age (±5 years) and sex. Four calibrated examiners independently evaluated PRs with consensus adjudication. Outcomes were soft tissue calcification, carotid-region calcification, and stylohyoid ligament complex calcification/ossification. Crude prevalence was calculated for each group and the total sample, and multivariable logistic regression adjusted for age, sex, diabetes status, smoking, alcohol use, renal disease, and rheumatic disease. A total of 112 participants were analysed (56 with diabetes mellitus and 56 controls), with comparable baseline characteristics between groups. In the total sample, the crude prevalence of any soft tissue calcification was 42.0%, carotid-region calcification 27.7%, and stylohyoid ligament complex calcification/ossification 35.7%. In adjusted models across the combined sample, age was independently associated with higher odds of any soft tissue calcification (per 10-year increase: aOR 1.68, 95% CI 1.23-2.29; P = 0.001) and carotid-region calcification (aOR 1.52, 95% CI 1.08-2.14; P = .016). Male sex was associated with lower odds of any soft tissue calcification (aOR 0.40, 95% CI 0.16-0.99; P = .047). Diabetes status was not independently associated with the outcomes in the fully adjusted models. Panoramic soft tissue calcifications were common. Although diabetes was not an independent predictor, frequent detection of suspected carotid-region calcifications supports structured reporting and opportunistic vascular risk assessment on routine PR, especially in older patients. Opportunistic identification of carotid-region calcifications on routine PR may support early cardiovascular risk assessment, particularly in patients with diabetes and older adults.