Dentin hypersensitivity is characterized by a short, sharp pain arising from exposed dentin in response to external stimuli, as explained by the hydrodynamic theory. Although oxalate-based mouthrinses can reduce sensitivity by occluding dentinal tubules, their effectiveness may be limited due to brief contact time and rapid clearance by saliva. To develop and evaluate a novel potassium oxalate-incorporated carboxymethyl chitosan strip and compare its dentinal tubule occlusion, intratubular penetration and biocompatibility with a commercially available potassium oxalate mouthwash (Vantej) using an in vitro model. A polymeric strip containing 1.6% potassium oxalate was fabricated using a carboxymethyl chitosan matrix. The strip was characterized using physicochemical properties including pH, viscosity, and thickness. Structural and morphological analyses were performed using Fourier Transform Infrared Spectroscopy and Scanning Electron Microscopy. Dentinal tubule occlusion and crystal deposition patterns were evaluated through SEM imaging. Cytocompatibility was assessed using a cell viability assay to determine the biocompatibility of the developed strip. The fabricated strip demonstrated favourable physicochemical characteristics and successful incorporation of potassium oxalate. SEM analysis revealed dense and homogeneous crystal deposition on dentin surfaces treated with the strip. No statistically significant difference in occlusion scores was detected between the developed strip and the commercially available potassium oxalate mouthwash. Cell viability of exceeded 70%, indicating that the strip was non-toxic and biocompatible. The potassium oxalate-incorporated carboxymethyl chitosan strip exhibited favourable dentinal tubule occlusion, intratubular penetration and biocompatibility compared with the conventional mouthwash. The novel bioadhesive system may enhance the retention of desensitizing agents at dentin surfaces and provides a basis for further preclinical and clinical investigation for the management of dentin hypersensitivity.
Chinmay D. Bhat, Vandana Sadananda, Gowrish S. Bhat
Thermal changes generated during routine dental procedures have traditionally been evaluated only in relation to acute pulpal injury and irreversible temperature thresholds. A growing body of experimental evidence suggests that repeated low-grade heat exposure may produce cumulative sub-clinical biological changes within the dentine–pulp complex, a phenomenon we here group under the working term “thermal micro-insults” (TMI). To map the available literature on sub-threshold, sub-lethal and sub-ablative thermal exposure of the dentine–pulp complex during routine restorative and endodontic procedures, and to identify concepts, mechanisms, evidence gaps and clinically relevant thermal parameters. A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed/MEDLINE, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were searched from January 1965 to May 2026 using combined keywords covering thermal injury, intrapulpal temperature, dentine–pulp complex, heat-shock response and the specific dental procedures under consideration. In vitro , ex vivo , in vivo animal and human studies, and prior narrative or systematic reviews were eligible. Two reviewers independently screened records; disagreements were resolved by discussion. Heat generated during cavity preparation, finishing/polishing, photopolymerisation, ultrasonic instrumentation and laser use can transiently raise intrapulpal temperature. Even when the classical 5.5 °C Zach and Cohen threshold is not exceeded, repeated sub-threshold exposures have been associated in in vitro and animal studies with heat-shock-protein expression (HSP25, HSP27, HSP70), altered mitochondrial function and reactive-oxygen-species generation, up-regulation of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α), activation of thermosensitive TRPV1/TRPA1 channels, and long-term changes such as reparative dentine deposition, focal fibrosis and calcification. Current evidence is dominated by in vitro work using extracted teeth without pulpal microcirculation; clinical validation and standardised sub-threshold thermal-dose descriptors are lacking. TMI should be viewed as a plausible but still developing hypothesis rather than an established clinical entity. Recognising cumulative low-grade heat exposure as a potentially modifiable biological factor may complement existing minimally invasive restorative and endodontic principles, guide the design of low-heat instrumentation and cooling strategies, and inform future in vivo research.
Mowat–Wilson syndrome (MWS) is a rare genetic disorder characterized by intellectual disability, distinctive craniofacial features, behavioral impairments, and congenital anomalies. Although oral and craniofacial abnormalities are frequently reported, their impact on oral health-related quality of life (OHRQoL) has not been investigated. This study aimed to evaluate OHRQoL in children with MWS and compare it with peers with autism spectrum disorder (ASD) and neurotypical controls. Secondary analyses explored caregiver functional limitations and dental care characteristics. A cross-sectional questionnaire-based study was conducted involving caregivers of children aged 6–18 years with MWS ( n = 19), ASD ( n = 19), and neurotypical controls ( n = 38). OHRQoL was assessed using the short-form Parental-Caregiver Perception Questionnaire ( P -CPQ) and Family Impact Scale (FIS). Additional questions explored socioeconomic characteristics, dental care setting and attendance, and parental perceptions of oral health. Group comparisons were performed using non-parametric and parametric tests, with significance set at p < 0.05. Children with MWS showed significantly higher total P-CPQ scores than neurotypical controls (37.11 ± 8.65 vs. 26.23 ± 5.05; p < 0.001), indicating poorer OHRQoL. The greatest impairments were observed in the functional limitation domain, particularly regarding chewing difficulties, mouth breathing, slower eating, and sleep disturbances (all p < 0.001). Halitosis and food impaction on the palate were also significantly more frequent in the MWS group. Parents of children with MWS reported a greater impact of oral conditions on wellbeing than both ASD and neurotypical groups ( p < 0.05). Although OHRQoL impairment was comparable between MWS and ASD participants, ASD was associated with greater family burden, reflected by higher FIS scores (16.42 ± 7.09 vs. 21.58 ± 4.85; p = 0.016). Both MWS and ASD groups exhibited higher combined P-CPQ + FIS scores than neurotypical controls ( p < 0.01). Both MWS and ASD were associated with poorer OHRQoL than neurotypical status, although distinct patterns of impairment emerged. MWS was primarily characterized by functional oral limitations and a greater impact of oral conditions on wellbeing, whereas ASD was associated with greater psychosocial and family burden. These findings support the existence of a syndrome-specific profile of caregiver-perceived unmet oral health needs and functional limitations in children with complex healthcare conditions and emphasize the importance of individualized, multidisciplinary dental care strategies.
Arjun KV, Anmol Sharma, Azhar Mohammed, M. S. Ravi, Sunidhi Kamboj, Naveen Pulikkottil Sunny
Maxillary canine retraction following premolar extraction is a time-consuming phase of orthodontic treatment. Various adjunctive methods, including platelet concentrates, corticotomy, and piezocision, have been proposed to accelerate tooth movement; however, their relative effectiveness and safety remain unclear. To evaluate the effectiveness and safety of platelet concentrates, corticotomy, and piezocision as adjuncts to maxillary canine retraction after premolar extraction. PubMed/MEDLINE, Scopus, and Cochrane CENTRAL were searched from inception to April 30, 2026. Randomized controlled trials comparing platelet-rich plasma, injectable platelet-rich fibrin, leukocyte and platelet-rich fibrin, corticotomy, or piezocision with conventional maxillary canine retraction were included. Study selection, data extraction, and risk-of-bias assessment using RoB 2 were performed independently. Findings were synthesized narratively. Twenty-five randomized studies were included. Corticotomy and piezocision generally increased canine retraction during the early postoperative period, although the effect decreased over time in several trials. Platelet concentrates produced inconsistent findings, ranging from no significant effect to small or temporary increases in movement. Evidence that these interventions shortened the complete duration of canine retraction was limited. Anchorage loss and periodontal outcomes were generally similar between groups, while findings for tipping, root resorption, pain, and adverse effects varied. Four studies had a low risk of bias, 21 raised some concerns. Corticotomy and piezocision may increase rate of early maxillary canine retraction, while the effects of platelet concentrates are less consistent. Current evidence does not establish a reliable reduction in total retraction duration or support a clear ranking of the interventions. Better standardized randomized trials are required. identifier CRD420261287411.
