Wiley-Online-Library: Australian Dental Journal: Table of Contents

Odontogenic Orbital Abscess in Paediatric Patients: Diagnosis and Surgical Management of Three Cases

Naseem Maalouf, Imad Abu El‐Naaj, Shareef Araidy — Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Background

Paediatric orbital abscesses represent true emergencies requiring immediate recognition and multidisciplinary management to prevent permanent vision loss and life-threatening complications.

Methods

We present three paediatric cases of orbital abscess (ages two, six, and eight years) presenting to emergency departments. Cases were analysed for emergency presentation patterns, imaging findings, and treatment outcomes.

Results

All patients presented with periorbital swelling and fever, and all three cases originated from odontogenic infections. Emergency CT imaging was crucial for diagnosis. Multidisciplinary management involving emergency medicine, ENT, and maxillofacial surgery achieved excellent outcomes with no visual or neurological complications.

Conclusions

Emergency physicians must maintain high clinical suspicion for orbital abscess in children with periorbital swelling and fever. Immediate CT imaging, broad-spectrum antibiotics, and emergency surgical interventions can prevent catastrophic complications.

Oral‐Onset Langerhans Cell Histiocytosis in a Noncompliant Adult: A Cautionary Case of Multisystem Progression

Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder that may initially present with oral manifestations, posing diagnostic challenges, especially in adults. We report a rare case of a 27-year-old male who initially presented with painful ulcerative palatal lesions and advanced periodontal symptoms. Despite early biopsy-confirmed LCH diagnosis and haematology referral, the patient's noncompliance led to delayed treatment, resulting in progression from localised oral involvement to multisystem disease, including mandibular, iliac, and vertebral bone lesions. Treatment ultimately required systemic chemotherapy after repeated biopsies and positron emission tomography/computed tomography imaging confirmed disease dissemination. Dental extractions and soft tissue excision were performed to manage oral symptoms. This case highlights the critical role of dental professionals in early LCH detection and underscores the impact of delayed intervention. Interdisciplinary collaboration and patient compliance are essential to prevent disease progression and improve outcomes in LCH with oral involvement.

Misquoting of Scientific Literature

Ivan Darby — Tue, 26 May 2026 19:04:57 -0700

Australian Dental Journal, Volume 71, Issue 2, Page 99-100, June 2026.

Issue Information

Tue, 26 May 2026 19:04:57 -0700

Australian Dental Journal, Volume 71, Issue 2, Page 97-98, June 2026.

Chronic Traumatic Dental Occlusion: Its Impact on Temporomandibular Joint and Systemic Health, and Clinical Management Strategies

Furkan Akkılıç, Hacer Balkaya — Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Purpose

Traumatic dental occlusion (TDO) is a multifactorial and dynamic clinical condition that extends beyond localised tooth wear and has been reported to be associated with alterations in temporomandibular joint biomechanics, neuromuscular function and overall masticatory system performance. While acute dental trauma often receives greater clinical attention, chronic occlusal trauma may remain underrecognised in routine practice, despite its potential to influence mandibular movement patterns, modify joint loading and contribute to patient-reported functional complaints.

Basic Procedures

This narrative review synthesises current concepts from the literature regarding the proposed etiologic factors, functional implications and long-term clinical consequences of traumatic dental occlusion. Particular emphasis is placed on the adaptive nature of the masticatory system and the variability of individual responses to occlusal disturbances. Contemporary digital diagnostic tools, occlusal analysis technologies and CAD/CAM-assisted restorative workflows are discussed as adjunctive modalities that may support clinical assessment and treatment planning rather than as definitive solutions.

Main Findings

The review outlines commonly applied clinical approaches used in the management of TDO-related structural and occlusal changes, including tooth wear and variations in occlusal vertical dimension, with reference to provisional strategies, indirect restorations and minimally invasive interventions.

Principal Conclusions

By providing an expert narrative synthesis and acknowledging ongoing controversies within occlusion and temporomandibular disorder research, this review aims to enhance clinician awareness, support cautious and patient-centred decision-making and encourage further research to clarify the clinical relevance of traumatic dental occlusion within contemporary dental practice.

The Safety and Effectiveness of the Hydraulic Pressure Sinus Floor Elevation Technique: A Systematic Review

Jared Hughes, Ajay Sharma, Lavanya Ajay Sharma — Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Aim

This project aims to systematically review and synthesise the data found in the literature regarding the survival of implants, complications, and gain in bone height using the hydraulic pressure technique to elevate the maxillary sinus floor.

Methods

A comprehensive literature search was conducted using databases including PubMed, Scopus, Embase, and Cochrane, covering studies from 2005 to July 2024. A total of 24 studies were included, comprising randomised control trials, cohort studies, and case series. The main outcomes evaluated were implant survival, complication rates, and endo-sinus bone gain.

Results

The review included 3053 implants placed in 2290 Sinuses of 2231 patients. The patients' ages ranged from 23 to 84, with a mean of 51.6 years. The included studies reported a pooled implant survival rate of 98.40% over follow-up periods ranging from 6 months to 8 years. The rate of sinus membrane perforation was relatively low (2.05%), and other complications, such as hematoma, sinusitis, nasal discharge, or oedema, occurred in 0.49% of cases. The average endo-sinus bone gain achieved using this technique was 6.72 mm.

Conclusion

The hydraulic pressure technique for sinus floor elevation is one of the many proposed solutions to provide predictable, safe, and efficient sinus floor elevation. The results from this review provide some cause for optimism, with high survival rates, low complication rates, and adequate gain in bone height. There is still a need for further long-term, high-quality research by independent third parties to confirm the effectiveness and safety of this technique.

Clinical Relevance

There is limited information available for the hydraulic pressure technique for sinus floor elevation. It has only been briefly mentioned in a limited number of literary reviews, none of which quantify the available data. This study presents the first systematic review of the hydraulic pressure technique, synthesising the available data and suggesting that the hydraulic pressure technique demonstrates high success and safety.

Prospero

This review is registered in PROSPERO under ID: 1070614.

Effect of Probiotic Supplementation on Cariogenic Streptococcus mutans Levels: A Systematic Review and Network Meta‐Analysis

Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Objective

To systematically evaluate and quantitatively compare, through pairwise and network meta-analysis, the effectiveness of probiotic supplementation in reducing cariogenic Streptococcus mutans levels in human subjects.

Methods

A comprehensive search was conducted in PubMed, Scopus, Embase, Web of Science and Cochrane Library up to October 2025. Randomised controlled trials assessing probiotic or synbiotic formulations with quantitative S. mutans outcomes were included. Data expressed as mean ± standard deviation were synthesised under a random-effects model using a frequentist network meta-analysis (netmeta, R). Effect sizes were reported as mean differences (MD, 95% CI). To strengthen analytical validity, all outputs were cross-validated through triangulation using the MetaInsight platform, confirming consistency between independent computational environments. Risk of bias was assessed with RoB 2, and evidence certainty was appraised via CINeMA.

Results

Twenty trials fulfilled inclusion criteria. Most interventions showed a short-term reduction in S. mutans counts, but differences versus placebo were small and not statistically significant across intervals. Forest-plot synthesis and triangulated results indicated that effects were transient and strain-dependent. SUCRA rankings suggested a high percentage of success, but those findings are only probabilistic, not conclusive superiority. Overall evidence certainty was low to moderate.

Conclusions

Probiotic supplementation exhibited a limited, time-dependent capacity to modulate S. mutans levels without a consistent advantage over placebo. Current findings support its role as a safe adjunctive rather than as a standalone preventive strategy.

Clinical Significance

Within the available evidence, probiotics should be regarded as experimental adjuncts rather than as replacements for conventional caries-prevention measures. Any observed microbiological benefits were modest, transient and strain-specific, without consistent translation into clinical outcomes. Their recommendation should remain cautious until larger, long-term randomised trials confirm durable effects.

Trial Registration

PROSPERO registration number: CRD420251180536

Trauma‐Informed Care Practice for Dental Practitioners: A Scoping Review

Kristy S. Choi, Woosung Sohn, Delyse Leadbeatter — Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Background

Trauma-informed care (TIC) is a patient care framework that recognises the widespread impact of trauma. While the likelihood of dental practitioners encountering patients with trauma is significant, there is limited guidance on TIC in dental care, highlighting the need for a clearer understanding. This scoping review was conducted to synthesise the literature to date concerning TIC practice for dental practitioners.

Methods

A search across six electronic databases and a manual search were conducted to find literatures from January 1992 to September 2025 that met inclusion criteria following the Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Of 176 identified papers, 27 papers informed this review.

Results

Identified TIC practices were categorised and synthesised according to ‘the four R's’ of TIC, such as safety and trust and other additional recurring TIC themes. This scoping review synthesised key concepts of TIC with the aim of informing clinical practice for dental practitioners.

Conclusion

The review highlights core TIC themes in the literature and identifies priorities for future research. As trauma is pervasive and often undisclosed, TIC practice by dental practitioners is recommended as a universal precaution approach in all patient care.

The Letter to Editor Regarding ‘Photogrammetry in Implant Dentistry’

Jiayi Chen — Tue, 26 May 2026 19:04:57 -0700

Australian Dental Journal, Volume 71, Issue 2, Page 213-213, June 2026.

Oral Health‐Related Quality of Life of Western Australian Refugee Children With Childhood Caries

Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Objectives

Dental caries remains the most common chronic childhood condition and in Australia persists as a leading cause of potentially preventable hospitalisation. Despite various public health initiatives and improvements in oral health among the wider community, significant disparities exist among refugee families due to the unique challenges they face. Beyond the effects on a tooth level, dental caries profoundly influences a child's oral health-related quality of life (OHRQoL) which encompasses the physical, psychological and social impacts oral health has on daily life, an area that is often overlooked. This study explores the OHRQoL of Western Australian refugee children who experience childhood caries.

Methods

This nested study was conducted within a larger randomised controlled trial (ACTRN12616000456459) investigating caries arrest in newly resettled refugee children. Participants were recruited from the tertiary paediatric Refugee Health Service (RHS), where demographic information, clinical dental examination findings and OHRQoL data were collected using the Early Childhood Oral Health Impact Scale (ECOHIS). Non-parametric methods were employed to assess differences in total and domain-specific ECOHIS scores across stratification groups, including caries burden, caries depth, age and geographical region.

Results

A total of 223 children were included with a mean age of 4.6 years. Approximately, 65% of the children had high caries burden (> 5 affected teeth), and 160 out of 223 (72%) had frank dentine lesions. The mean (SD) total ECOHIS score was 6.52 (6.68). Parental distress had the highest mean score among the ECOHIS domains (1.79), while the symptoms domain score was unexpectedly low (0.96), despite participants experiencing severe and extensive caries.

Conclusion

Refugee children experience a high burden of caries, yet reported symptoms were low, suggesting under recognition of oral pain. Conversely, high parental distress scores reveal the significant psychological impact on families. These findings highlight the need for early, culturally appropriate dental care within a family-centred model of care.

Association of Migration Status of Parents With Their Satisfaction With Oral Care Provision for Their Children in Australia—Insights From a National Study

Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Background

Globally, the number of migrants with limited language proficiency and low health literacy has been steadily increasing. In Australia, while most state governments have recognised these individuals as a priority population and provide free or subsidised access to oral healthcare services, their satisfaction levels regarding the received dental care remain uncertain. Studies suggest that patients with communication barriers often report greater dissatisfaction and anxiety in healthcare settings, with cultural insensitivity further worsening their experience. Therefore, feedback on oral healthcare services is crucial for improving service delivery and care quality.

Objective and Methods

This study aims to compare and assess the satisfaction of migrant and Australian-born parents with the oral healthcare received by their children in Australia. Data from the 2012–2014 National Child Oral Health Survey (NCOHS) was utilised, which involved a cross-sectional survey of 24,664 representative school children aged 5–14 years and their parents in Australia. This study used the Child Oral Care Performance Assessment Scale (COPAS), which was originally developed to collect parental observation and assessment of dental care received by their child. In the present study, the COPAS was used as a proxy measure for gauging the parents' satisfaction. Data were analysed using the complex samples' general linear model regression analyses to confirm the association between the factors.

Results

In general, the satisfaction scores were significantly lower in migrants than non-migrant parents regarding the oral healthcare provided to their children in efficient, responsive, accessible and capable domains of COPAS. The overall satisfaction score, across all domains, revealed that migrant parents had lower satisfaction levels than non-migrants (B = −1.64; 95% CI, −3.11 to −0.17). Parental language and income were also linked to satisfaction levels, with migrant parents from countries where English is not the primary language having notably lower scores than migrant parents from countries where English is the primary language (B = −4.16; 95% CI, −5.98 to −2.34). Among the other factors studied, parents in lower-income (B = −7.55; 95% CI, −9.14 to −5.95) and middle-income (B = −4.31; 95% CI, −5.45 to −3.17) groups were less satisfied with oral healthcare compared to higher-income parents. Single-adult households also reported lower satisfaction (B = −5.01; 95% CI, −9.67 to −0.35). On the other hand, having fewer children was associated with higher parental satisfaction.

Conclusions

Notable differences in satisfaction levels with oral healthcare of their children were observed between migrant and non-migrant parents. These findings help guide policymakers in developing public health measures to improve satisfaction among migrant parents.

Root Canal Treatment for Older Adults: New Zealand Dentists’ Experiences and Approach to Practice

Lara Friedlander, Payman Hamadani, Nicholas Chandler, Ben Daniel — Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Background

This study investigated the experiences and approach to practice of New Zealand (NZ) general dental practitioners (GDP) providing root canal treatment (RCT) for older adults.

Methods

A national online survey collected data from GDPs managing older adults including their approaches to pulpal diagnosis and RCT techniques. Questions also explored informed consent, specialist referrals, confidence, treatment outcomes and engagement with continuing education. Data were analysed descriptively and bivariate analysis of categorical variables used Chi-square and Fisher's exact tests.

Results

A total of 382 GDPs participated (response rate 23.6%). RCT for older adults was common, and most dentists felt confident and incorporated contemporary techniques, although they were less comfortable managing polypharmacy or complex medical conditions. Verbal consent was usual. Almost three-quarters had updated their endodontic knowledge and skills within the previous 2 years through continuing professional development. Around two-thirds found diagnosis challenging; however, RCT was viewed as successful. Females were less confident, and a proportion did not treat molars.

Conclusion

Older adults commonly require RCT, and enhancing GDPs’ knowledge and skills to manage patients with a range of medical conditions is important. Written consent is advised for RCT when patient or tooth factors are complex, or where patients’ capacity may be impaired.

Exploring Clinical Decision‐Making in Static Computer‐Assisted Guided Implant Placement: A Survey of Clinicians in Australia and New Zealand

Mathew Amen, Jake Ball, Jing Sun, Anthony Dawson — Tue, 26 May 2026 19:04:57 -0700

ABSTRACT

Background

Static computer-assisted guided implant placement (sCAIP) has been shown to enhance accuracy and predictability; however, little is known about the multifactorial decision-making processes impacting use among clinicians.

Methods

An exploratory cross-sectional electronic survey was distributed to implant practitioners across Australia and New Zealand, including general dentists and specialists (periodontists, prosthodontists, oral surgeons, and oral and maxillofacial surgeons) involved in implant placement. Items covered demographics, training profiles, clinical experience, utilisation patterns, and attitudes towards sCAIP, with free-text reflections. Quantitative data were analysed using descriptive statistics, factor analysis, and t-tests; qualitative data underwent thematic analysis.

Results

Thirty-three respondents completed the survey, with 90.9% reporting current use of sCAIP. Sixteen respondents (48.5%) were classified as analytical decision-makers and 17 (51.5%) as intuitive. Factor analysis identified seven components that explained 84.2% of the variance in decision-making, including surgical complexity and soft tissue conditions, case timing, aesthetic site sensitivity, cost, anatomical risk, training exposure, and clinical experience. Internal consistency across items was high (Cronbach's alpha, α = 0.95). Analytical decision-makers placed significantly more weight on anatomical risk and bone quality compared to intuitive decision-makers (p = 0.038, d = 0.93). Intuitive decision-makers reported higher levels of training exposure (p = 0.04, d = 0.80). Thematic analysis revealed three key influences on sCAIP use: clinician capability, surgical planning and risk mitigation, and restorative outcomes. In addition, several barriers were identified including financial cost, workflow integration, and attitudinal factors.

Conclusion

Clinicians with an analytical decision-making style placed greater emphasis on anatomical risk and were more likely to adopt sCAIP in complex or high-risk cases. Because intuitive clinicians reported higher training exposure, education alone did not explain these patterns, indicating that cognitive style and risk appraisal are central determinants of sCAIP adoption.

Trauma‐Informed Care Practice for Dental Practitioners: A Scoping Review

Kristy S. Choi, Woosung Sohn, Delyse Leadbeatter — Tue, 26 May 2026 19:04:57 -0700

Australian Dental Journal, Volume 71, Issue 2, Page 214-214, June 2026.

Perspectives of Oral Health Practitioners Working in Rural New South Wales: Culture, Wellbeing and Workforce Sustainability

Lisa Hai My Do, Jessica Biles, Bradley Christian, Woosung Sohn — Sun, 24 May 2026 09:28:45 -0700

ABSTRACT

Background

While limited research has explored the experiences of this workforce, oral health practitioners in rural areas face distinct cultural and personal challenges that influence workforce sustainability and delivery of care. This study aims to understand the cultural and personal experiences of oral health practitioners working in rural New South Wales and identify factors influencing their cultural capabilities, personal wellbeing and workforce sustainability.

Methods

A cross-sectional survey was conducted among oral health practitioners across three rural Local Health Districts in New South Wales. The survey included items on sociodemographic characteristics, cultural capabilities and awareness, and personal experiences. Data was analysed using descriptive statistics and subgroup comparisons made based on profession (dentists vs. other oral health practitioners) and years of experience (less or more than 10 years).

Results

Nineteen participants completed the survey, primarily dentists and oral health therapists, with few dental therapists. Most reported initial cultural awareness training; however, less than half reported ongoing training. Most participants reported personal growth associated with their role. Dentists reported greater access to support systems and training opportunities than other oral health practitioners.

Conclusion

There is need for continuous cultural capability training and equitable support systems to strengthen rural oral health workforce sustainability. Despite small participant numbers, this study provides valuable insight into practitioner experiences and identifies opportunities for a culturally safe and wellbeing-focused workforce in rural NSW.

Surface Physical and Mechanical Properties of Short Fibre Reinforced Composite Resins in Direct Restorative Dentistry: A Systematic Review

Murray Macpherson, Michael Liddell, Touraj Nejatian — Mon, 11 May 2026 22:40:47 -0700

ABSTRACT

Background

Short Fibre Reinforced Composite resins may be used to restore odontogenic tissues and have enhanced physical and mechanical properties compared with conventional resins. However, their surface characteristics remain a concern, and this has limited their use as direct dental restorative materials.

Methods

Five published and three grey literature electronic databases were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results

This systematic review identified and assessed studies that examined surface hardness, surface roughness, surface wear, water solubility, water sorption, and surface energy of SFRC resins. Most studies were in vitro (n = 30), and only two clinical trials were identified. Minimal grey literature was found, all originating from manufacturers. The evidence from these studies suggests that matrix composition and fibre characteristics influence surface properties, consistent with findings reported for conventional particle filled composite resins.

Conclusions

The physical and mechanical surface properties of SFRC resins used as direct dental restorative materials appear appropriate and stable in the oral environment; however, long-term clinical studies are needed to confirm this.

Marginal and Internal Fit, Surface Roughness and Fracture Resistance of Hybrid Dental Crown Materials Fabricated With Milling and 3D‐Printing Systems: An In Vitro Study

Abdullah M. Al‐Rifai, Ahed Al‐Wahadni, Abedelmalek Tabanjah — Thu, 07 May 2026 03:13:08 -0700

ABSTRACT

Background

This study evaluated the marginal and internal fit, surface roughness and fracture resistance of three hybrid crown materials fabricated using milling and 3D-printing.

Methods

A maxillary premolar typodont tooth was prepared and scanned to produce 30 cobalt-chromium dies through selective laser melting 3D printing. Thirty crowns were fabricated from two milled materials (Vita Enamic; Cerasmart) and one printed material (Irix Max) (n = 10). Marginal and internal fit were assessed using a three-dimensional superimposition technique, while surface roughness was measured with an optical profilometer. After cementation, specimens underwent thermocycling for 3600 cycles, followed by 720,000 mechanical loading cycles. Fracture resistance was tested using a universal testing machine and failure modes were recorded. Statistical analysis was performed using one-way ANOVA test.

Results

No statistically significant differences were observed in marginal fit among the groups. Cerasmart showed significantly higher internal gaps but smoother surfaces than Vita Enamic and Irix Max. Vita Enamic exhibited significantly greater fracture resistance compared to Cerasmart. All failures were catastrophic.

Conclusion

All crowns exhibited comparable marginal fit. Cerasmart demonstrated smoother surfaces but inferior internal adaptation and fracture strength, whereas Vita Enamic provided superior mechanical performance.

The Australian and New Zealand Dental Implant Registry: Regulatory Requirements and Registry Development

S. Soukoulis, S. Davis, A. Goss — Sun, 05 Apr 2026 23:59:59 -0700

ABSTRACT

Background

The Therapeutic Goods Administration is responsible for the Regulation of manufacture and supply of all medical devices including dental implants. Medically, the patient is given a ‘Patient Implant Card’ (PIC). It is recommended to monitor the performance of devices in an implant registry.

Methods

The TGA Regulations were reviewed. The detailed methodology to establish a National Dental Implant Registry is presented and initial analysis performed.

Results

The placement of dental implants in Australia is not as regulated as other comparable medical devices. Currently the Registry has 43 clinics with 44 participating dental practitioners. The DIR has recorded dental implant related information from 4842 patients with 9429 devices (Australian and New Zealand data). Patients were usually over 60 years of age, more female and more implants were placed in the maxilla. The Australian replacement rate of dental implants was 1.83% and 1.42% for prostheses.

Conclusions

Improving the regulatory framework by introducing the issuing of Patient implant cards (PICs) so the specific device information type is transferable and retained long term and establishment of long-term independent monitoring in a Dental Implant Registry, crucial in identifying problems with the aim of improving outcomes for patients and dental professionals should be considered.

Patterns of Surgical Prophylaxis Prescribing for Dentoalveolar Procedures in Australian Hospitals: 2016–2022

Sat, 07 Mar 2026 02:14:44 -0800

ABSTRACT

Background

Antimicrobials are an adjunctive therapy in clinical dentistry. In dentoalveolar surgery, antimicrobials are not routinely required for surgical prophylaxis. This retrospective analysis of the Australian Surgical National Antimicrobial Prescribing Survey (Surgical NAPS) dataset aimed to evaluate the guideline compliance and appropriateness of antimicrobial prescribing for dentoalveolar procedures in Australian hospitals.

Methodology

Deidentified Surgical NAPS data for dentoalveolar procedures (tooth extractions and implant placements) between 2016 and 2022 were extracted. Procedures outside the scope of a general dentist were excluded. Prescribed antimicrobials for surgical prophylaxis, including procedural prophylaxis doses and post-procedural prescriptions, were assessed for guideline compliance and appropriateness according to the Surgical NAPS algorithm.

Results

1345 surgical episodes with dental procedures were included. This comprised 1077 procedural prophylaxis doses and 555 post-procedural prescriptions. Of the post-procedural prescriptions, 478 (86%) were for prophylaxis. Guideline compliance was demonstrated in 35.3% of procedural doses and 14.6% of post-procedural prescriptions. Rates of appropriateness were 33.5% for procedural doses and 12.6% for post-procedural prescriptions. Most procedural doses and post-procedural prescriptions were deemed inappropriate as they were not required (72.5% and 93.0%, respectively).

Conclusions

Suboptimal guideline compliance and appropriateness of antibiotic prescribing for dentoalveolar surgery reinforces the need for antimicrobial stewardship interventions.