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Original Research Article
ABSTRACT
Periapical endodontic surgery involves surgical techniques to: remove a persistent periapical lesion, clean the apex of the tooth, and facilitate access to the apical end of the root canal, which will then be retrograde filled. Intraoperative antimicrobials are important in these procedures because they prevent and treat sepsis in the area. The EPX® Biomolecule contains chitosan fortified with silver and copper nanoparticles; it is non-toxic, biocompatible, and antiseptic. The safety and antimicrobial pharmacodynamics of this medication were evaluated in periapical surgery. An experimental study—a Phase I clinical trial—was conducted on a sample of 36 patients with a clinical and radiographic diagnosis of chronic periapical disease requiring surgical treatment, who were treated at the Mexicali School of Dentistry, Autonomous University of Baja California, Mexico, from January 2022 to December 2025. All were healthy patients who underwent periapical surgery with topical application of the EPX® Biomolecule, in the form of a surgical gel, with the patients’ consent and under the multidisciplinary care of specialists in Oral and Maxillofacial Surgery and Endodontics. All patients had a favorable outcome, with signs and symptoms within normal parameters. Radiographic follow-up was favorable, with most patients showing signs of bone regeneration and no recurrent septic complications. No adverse reactions to the EPX® Biomolecule as an intraoperative gel were reported; doses were standardized in proportion to the size of the periapical lesion, and surgical wound healing was excellent in all patients, whether the procedure was simple or combined with bone grafting.
Review Article
Smart Restorative Materials in Dentistry: From Passive Restorations to Self-Healing, Ion-Releasing, and Stimuli-Responsive Systems
Ebtsam Ben Zeglam, Alasifa Arshad, Dellal Hadjadj, Sowmya Yelagandula, Arun Kumar Boppa, Unseba, Ridhi Bhola, Sandeep Singh
EAS J Dent Oral Med; 2026, 8(5): 171-179
https://doi.org/10.36349/easjdom.2026.v08i05.004
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ABSTRACT
Conventional restorative materials primarily aim to replace lost tooth structure but remain susceptible to polymerization shrinkage, microcracking, wear, marginal degradation, and secondary caries. The development of smart restorative materials represents a shift toward materials capable of actively interacting with and responding to the oral environment. These materials include self-healing systems, ion-releasing and bioactive materials, and stimuli-responsive systems that respond to changes in pH, mechanical stress, temperature, or other environmental conditions. Emerging evidence suggests potential applications in resin composites, dental adhesives, remineralization, pulp protection, and prevention of secondary caries. However, limitations related to mechanical performance, long-term durability, biocompatibility, manufacturing complexity, and limited clinical evidence continue to restrict their widespread clinical use. This review discusses the current principles, applications, evidence, challenges, and future perspectives of smart restorative materials and their potential to transform conventional restorations into more adaptive and biologically interactive restorative systems.
ABSTRACT
Aim & Background: Postoperative pain is a multifactorial phenomenon, influenced by patient-related factors, tooth characteristics, and procedural aspects. This systematic review aims to identify and analyze the factors influencing the occurrence of postoperative pain following conventionnal endodontic treatments. Materials and Methods: The protocol was developed according to the guidelines established by the PRISMA statement. An electronic search was conducted in two databases, MEDLINE via PubMed and Web of Science, using the Boolean operator "AND" with the following MeSH terms: "root canal therapy" and "postoperative pain", as well as keywords including "root canal preparation", "endodontics," and "apical debris extrusion". A standardized data extraction grid was developed, and Risk of bias was assessed through the Cochrane Risk of Bias 2.0 tool. The review protocol was registered on PROSPERO (CRD420251027137). Results: Of the 72 initial articles, 11 clinical trials were included. The selected studies investigated various procedural variables, such as shaping kinematics, irrigation dynamics, and obturation technique. Postoperative pain was assessed using the Visual Analog Scale (VAS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and OHIP-14. Ten studies were rated as having a low risk of bias, and one showed moderate risk. Conclusion: Postoperative pain after root canal treatment is a multifactorial phenomenon influenced by various procedural parameters. Although some techniques, such as continuous rotation shaping, negative pressure irrigation, and adjunctive use of photodynamic therapy, appear to be associated with lower pain levels, the current evidence does not support a definitive superiority of one protocol over another. Further high-quality clinical trials are needed to standardize pain assessment and clarify the most effective strategies for minimizing postoperative discomfort. Clinical Significance: Postoperative endodontic pain is a multifacto
Original Research Article
ABSTRACT
Periodontal surgery is widely used in dentistry to treat periodontal conditions and restore oral health. Biomolecules have been incorporated into periodontal procedures to promote healing and tissue regeneration. The EPX® Biomolecule is a nanostructure composed of chitosan, graphene, thymol, and metals, including colloidal silver nanoparticles, with potential regenerative, healing, and antiseptic properties. This study aimed to evaluate the quality of soft tissue healing following periodontal surgery assisted by EPX® Biomolecule in its pharmaceutical form as a surgical gel. An experimental Phase I clinical trial was conducted in 45 patients undergoing periodontal surgery at the University Polyclinic of the Mexicali School of Dentistry, Autonomous University of Baja California, Mexico, from February 2024 to May 2025. Following informed consent, EPX® Biomolecule surgical gel was applied intraoperatively. Healing was assessed using the Early Wound Healing Score (EHS) at 7, 14, and 28 days and compared with a control group of 45 patients treated with 0.12% chlorhexidine and selected based on procedural similarity. All patients demonstrated favorable postoperative soft tissue healing. At 7 days, the EPX® Biomolecule group showed significantly better re-epithelialization, inflammation, and overall EHS outcomes than the control group; at 14 days, a significant difference remained only for re-epithelialization, while no significant differences were observed at 28 days. No adverse reactions associated with the topical intraoperative application of EPX® Biomolecule were observed.
Original Research Article
ABSTRACT
Background: Oral cancer (OC) is a major global health concern, with squamous cell carcinoma accounting for more than 90% of cases. Major risk factors include tobacco and alcohol consumption, while other factors such as human papillomavirus (HPV) infection and prolonged sun exposure may also contribute. This study aimed to assess oral cancer awareness among the general population. Materials and Methods: A cross-sectional, questionnaire-based study was conducted among 474 participants. A structured questionnaire collected demographic information and assessed awareness using 14 knowledge-based items covering risk factors, warning signs, disease progression and early detection, and prevention. Awareness was categorized as low (0–6), moderate (7–10), or high (11–14). Data were analyzed using SPSS version 26.0. Chi-square and independent-samples t-tests were used, with statistical significance set at p<0.05. Ethical approval was obtained from the Institutional Review Board of the Ministry of Health in the Tabuk Region (TU-077/026/400). Results: Overall oral cancer awareness was generally high, with nearly three-quarters of participants classified as having high awareness. Knowledge was particularly strong regarding tobacco-related risks, early detection, and preventive measures. However, lower awareness was observed for alcohol consumption (72.9%), HPV infection (53.5%), and prolonged sun exposure as a risk factor for lip cancer (42.9%). Knowledge gaps were also identified regarding red or white oral lesions. Previous familiarity with oral cancer was significantly associated with greater knowledge, whereas age and gender were not significantly associated with overall awareness. Conclusion: Participants demonstrated generally high oral cancer awareness. Continued community education should emphasize less-recognized risk factors, warning signs, prevention, and the importance of early detection.
ABSTRACT
Management of anterior tooth fractures has progressively shifted toward minimally invasive strategies that preserve sound dental tissues while achieving optimal esthetic outcomes. When traumatic injuries are associated with enamel defects and gingival pigmentation, successful rehabilitation requires a comprehensive multidisciplinary approach addressing both dental and soft-tissue esthetics. A 22-year-old woman presented with esthetic concerns following trauma to the maxillary anterior region. Clinical examination revealed an uncomplicated enamel–dentin fracture of the maxillary right central incisor (tooth 11), enamel hypomineralization affecting both central incisors, and physiological gingival hyperpigmentation. A staged multidisciplinary treatment protocol was implemented. The fractured tooth was initially restored with a direct composite resin as a provisional restoration. Enamel microabrasion was subsequently performed to eliminate superficial hypomineralization defects and improve color uniformity. Gingival depigmentation using a rotary diamond bur was then carried out to optimize the appearance of the gingival tissues before definitive restoration. Finally, a lithium disilicate partial ceramic veneer was fabricated using a digital workflow and adhesively bonded following conventional hydrofluoric acid etching, silanization, and adhesive cementation protocols. The sequential therapeutic approach resulted in excellent integration of the restoration with the adjacent dentition and surrounding gingival tissues while preserving maximum sound enamel. The patient expressed high satisfaction with the esthetic outcome, which included improved tooth morphology, color harmony, and gingival appearance. This case illustrates that combining enamel microabrasion, gingival depigmentation, and adhesive rehabilitation with a lithium disilicate partial ceramic veneer provides a conservative and predictable treatment option for complex anterior esthetic rehabilitation. Careful t
Original Research Article
ABSTRACT
This article explores the convergence between orthodontics and bioengineering, highlighting key advances in the use of biomaterials and technologies that are transforming orthodontic treatment. This review focuses on the innovative use of thermoplastic polyurethane (TPU) in invisible aligners highlighting its exceptional mechanical properties and addresses current challenges by proposing solutions focused on patient comfort, oral hygiene and preventing microbial proliferation. Regarding the latter, the contribution of nanotechnology is mentioned through the use of functionalized nanoparticles on the surface of the aligners, which could reduce the probability of oral bacterial infections. It also mentions how orthodontic archwires could be improved in anticipation of a future where orthodontics becomes more personalized and efficient. Undoubtedly, bioengineering and odontology are driving innovations together that will improve patients' quality of life.