Publications

Binocular integration and interocular suppression are fundamental processes underlying binocular vision, giving rise to stereopsis and binocular rivalry, respectively. To investigate how the visual system dynamically coordinates these processes to form a unified percept, we conducted four psychophysical experiments examining the temporal interactions between binocular rivalry and stereopsis. In Experiment 1a, binocular rivalry, especially with high-contrast stimuli, impaired subsequent stereopsis, significantly elevating average stereo detection thresholds from 60.5 to 111.8 arcsec. Experiment 1b revealed no effect on contrast detection, confirming that the suppression was specific to stereopsis rather than due to general attentional distraction. Experiment 2a revealed that preceding stereopsis rebalanced subsequent rivalry dynamics by reducing ocular dominance asymmetry and increasing mixed percepts, without affecting alternation rate. Experiment 2b further demonstrated that anti-correlated stereograms, which do not elicit stable stereopsis, exerted no effect on subsequent rivalry dynamics. These findings underscore a dynamic interplay between binocular integration and suppression in resolving perceptual ambiguity and achieving unified visual perception. Crucially, our results reinforce that stereopsis is not merely a passive consequence of binocular integration, but actively contributes to rebalancing ocular dominance, thus offering insights for interventions aimed at restoring binocular function.

Ultimately, human behavior needs to be understood in the context of natural everyday tasks. Over the last two decades, a number of observations of natural visually guided behavior have accumulated. These observations help define the functional demands placed on the visual system in a variety of tasks, but progress has been limited by the diversity of natural behavior and by the lack of unified theoretical structures to guide understanding of the underlying processes. In this article, we summarize some recent attempts that might provide a template for a more formal approach. This is possible because it has become clear that natural behavior has many regularities reflecting the underlying sensorimotor decisions. We first summarize these regularities and then show how simple visually guided behaviors can be well described by partially observable Markov decision processes. We give examples of how laboratory experiments can be designed to elicit the common elements of natural behavior and how such experiments afford control of the statistical structure of tasks, thereby allowing formal modeling. Finally, we suggest that a new exciting avenue using recently introduced inverse models may lead the way forward, as it recovers the intrinsic properties of human perception, cognition, and action, which are intertwined in natural behavior.

AIM: Xerostomia and hyposalivation represent a global health burden, affecting a considerable proportion of adults worldwide. This study explored the trends of the scientific production on xerostomia and hyposalivation in the dental literature using the Scopus database.

METHODOLOGY: Records related to the topic of xerostomia/hyposalivation, published since inception up to December 31, 2024, were searched on May 5, 2025 in Scopus, using the following search terms: "xerostomia," "hyposalivation," "dry mouth,"  "salivary hypofunction," "salivary dysfunction." The following categories were considered: Keywords, documents published on this topic; contributing authors, contributing countries, and contributing organizations; and authors, references, and sources cited. The bibliometric analyses were performed using the Biblioshiny app and VOS Viewer.

RESULTS: A total of 3,401 documents were published in 232 dental journals, representing 7% of the total publications in all fields and journals. Of these, 2,875 (84.5%) were original articles, and 526 (15.5%) were reviews. These documents were cited 1,00,949 times, with an average of 32.46 citations per document. There were 11,532 authors, the majority of whom were from the developed world. The top journal was "Oral Diseases," with 224 documents, followed by "Oral Oncology," with 177 documents. In terms of research impact, "Journal of Dental Research" ranked first with 56.09 citations per document, followed by "Oral Surgery, Oral Medicine, Oral Pathology" with 51.27. Epstein JB and Scully C were the most prolific authors with 37 and 34 articles each, respectively.

CONCLUSION: The present study reveals a notable shortage in impactful original research on xerostomia/hyposalivation and highlights selective citation from dental journals.

CLINICAL SIGNIFICANCE: Xerostomia and hyposalivation represent a symptom and a sign, respectively, of many oral and systemic diseases. Hence, assessment of the relevant scientific production may help highlighting whether the topic received what it deserves or a shortage is still there. How to cite this article: Halboub E. A Bibliometric Analysis of Dental Research on Xerostomia and Hyposalivation. J Contemp Dent Pract 2025;26(6):615-622.

AIM: This systematic review aims to assess the effectiveness of regenerative approaches in promoting periapical healing and restoring pulp vitality.

BACKGROUND: Periapical lesions of endodontic origin (LIPOE) are a common clinical issue that can compromise the prognosis of the affected tooth. While conventional treatment focuses on infection control and periapical healing, regenerative endodontics has emerged as a promising alternative.

RESULTS: The review protocol followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and was registered on PROSPERO (ID: CRD420251046339). A comprehensive electronic and manual search was conducted in three databases-MEDLINE via PubMed, Web of Science, and Cochrane-using keywords such as "periapical lesion," "regenerative endodontics," "platelet-rich fibrin," and "endodontic periapical lesion," focusing exclusively on randomized controlled trials (RCTs). Out of 135 initially retrieved articles, 10 RCTs met the inclusion criteria. Treatment outcomes were assessed through radiographic and clinical evaluations. Revascularization was the most commonly applied technique. The studies demonstrated a significant reduction in periapical lesion size, improved pulp vitality responses, and progressive tissue healing. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and all included studies were found to have a low risk of bias.

CONCLUSION: The selected studies highlight the effectiveness of regenerative endodontic techniques in the treatment of LIPOE. While the overall results are encouraging, complete pulp regeneration remains limited.

CLINICAL SIGNIFICANCE: This review provides evidence-based information on the effectiveness of regenerative endodontic procedures (REPs) for the treatment of periapical lesions. It underscores the potential of these techniques in promoting periapical healing and partial pulp tissue regeneration, making it a valuable resource for clinicians and researchers in the field of endodontics. How to cite this article: Kawthar BS, Fatma B, Hanen B, et al. Regenerative Endodontics in the Treatment of Periapical Lesions of Endodontic Origin: A Systematic Review of Randomized Controlled Trials. J Contemp Dent Pract 2025;26(6):623-631.

AIM: This study aimed to explore global research patterns, collaboration networks, and thematic evolution related to mouthwashes and cancer. Through a bibliometric analysis, the study aimed to identify the most influential authors, institutions, and sources, as well as to examine trends within this specific research domain from January 2019 to April 2025.

MATERIALS AND METHODS: The bibliometric analysis followed the RAMIBS framework. A systematic search was conducted in the Scopus database on April 8, 2025, using a comprehensive formula combining terms related to mouthwash and cancer. From the 357 initially identified records, 92 articles met the inclusion criteria and were analyzed. Data extraction encompassed information on publication type, citations, keywords, authorship, and collaboration. The SciVal and Bibliometrix tools were employed for data analysis, enabling advanced network visualization, thematic mapping, and impact evaluation.

RESULTS: The analysis revealed a 6.12% annual growth in scientific output, with 92 articles published in 76 sources. Collaboration was significant, involving 581 authors with an average of 7.02 co-authors per document and 11.96% international collaborations. The key contributors included Nagasaki University, Japan, and Saveetha Institute of Medical and Technical Sciences, India. Influential journals such as Supportive Care in Cancer and Journal of Evidence-based Dental Practice were identified. Thematic evolution revealed a shift from broader topics like "oral hygiene" to more specific areas such as "oral mucositis" and "cancer therapy."

CONCLUSION: Academic output has been steadily growing, there have been changing collaboration patterns within the field, and a small number of institutions and authors are responsible for the majority of work. There are prominent hubs of academia with several "leading" academic journals that, while still diverse in different regions, have huge impacts on productivity and citations across regions. The study, in addition, captures a clear thematic progression from generic oral hygiene topics to more clinical topics such as mucositis and cancer treatment.

CLINICAL SIGNIFICANCE: This study holds clear clinical significance by shedding light on global trends and key collaborations in the field of mouthwash and cancer research. Its findings can support the development of more evidence-based clinical guidelines, help optimize product use in oncology patients, and encourage preventive strategies against side effects like oral mucositis. By doing so, it contributes to improving the quality of oral care in cancer therapy settings and enhances overall patient well-being. How to cite this article: Espinoza-Carhuancho F, Huaman-De la Cruz M, Lozano-Castro F, et al. Global Patterns, Impact, and Networking in Mouthwash and Cancer: A Scientometric Analysis. J Contemp Dent Pract 2025;26(6):608-614.

AIM: This in vitro study aims to evaluate fracture strength and fractographic analysis of implant crown fabricated as monolithic cement-retained (MCV), monolithic screw retrievable-cement retained (MSV), and bilayer system monolithic (BSV), all bonded to Ti-base abutment.

MATERIALS AND METHODS: A total of 30 specimens were included, with sample size calculated based on an alpha level of 0.05 and statistical power of 80%. The specimens were equally distributed into three groups: control (MCV, n = 10) and test groups (MSV, n = 10, and BSV, n = 10). All specimens underwent thermal aging and were subjected to fracture strength testing. Data normality was assessed using the Shapiro-Wilk test. As the data were not normally distributed, group comparisons were analyzed using the Kruskal-Walli's test. Post-hoc pairwise comparisons (MCV vs MSV, MCV vs BSV, and MSV vs BSV) were performed using the Mann-Whitney U-test with Bonferroni correction. Fracture modes were further analyzed by scanning electron microscopy (SEM) and categorized based on the percentage of remaining crown material.

RESULTS: The MCV crowns demonstrated the highest fracture strength (2955.84 ± 310.93 N), followed by MSV (2846.11 ± 370.59 N) and BSV (1994.70 ± 95.44 N). Statistically significant differences in fracture strength were observed among the groups (p < 0.001). Post-hoc analysis showed that BSV had significantly lower fracture resistance than both MCV and MSV (p < 0.001), while no significant difference was found between MCV and MSV (p = 1.000). Regarding fracture mode, half of MCV specimens had >75% crown remaining, BSV exhibited 50-75% remaining, and MSV had <50% remaining. The SEM analysis revealed catastrophic fracture patterns for both MCV and MSV, whereas BSV exhibited complex failure patterns.

CONCLUSION: Implant crown design significantly impacts fracture resistance and failure modes. The MCV crowns exhibited superior strength, whereas BSV crowns, despite lower fracture strength, maintained intact zirconia abutment, offering repairability of the superstructure.

CLINICAL SIGNIFICANCE: Monolithic cemented crowns may be preferred in high-load areas for their superior strength, while bilayer designs with intact zirconia abutments offer retrievability and repair potential, making them suitable for lower-load regions. How to cite this article: Affendi NHK, Hakim AYA, Ahmad R, et al. The Effect of Crown Design on Fracture Strength and Mode of Implant-supported Molar Crown Bonded to Titanium-based Abutment. J Contemp Dent Pract 2025;26(6):565-672.

AIM: This retrospective study was designed to investigate the 12-month clinical performance of zirconia-lithium disilicate crowns among Yemenis using the modified United States Public Health Service (USPHS) criteria and patient satisfaction via the visual analog scale (VAS). Participants and methodology: This retrospective clinical study analyzed data from eight Yemeni patients who received a total of 103 single full-coverage crowns. All crowns had a zirconia core veneered with lithium disilicate. The crowns were fabricated using CAD/CAM technology and placed on anterior and posterior teeth in both the maxillary and mandibular arches. United States Public Health Service (USPHS) criteria were utilized to assess parameters such as marginal adaptation, color match, and retention. Meanwhile, VAS was used to measure patient satisfaction. Clinical evaluations were recorded at baseline (within one-week post-cementation), 3-, 9-, and 12-month post-cementation. Following data collection, the data were analyzed using the Statistical Package for Social Sciences with Chi-square and McNemar tests.

RESULTS: The survival and success rates were 100% and 97.1%, respectively. Significant degradation occurred in marginal adaptation (11.6% Bravo scores at 12 months) and color match (14.6% Bravo), particularly in posterior teeth and left-side restorations. Non-vital abutments had higher failure, with 2.9% Charlie/Delta scores. Patient satisfaction remained high, with mostly "very satisfied" scores. However, the marginal and color scores declined slightly. Moreover, khat chewing correlated with color changes but lacked statistical significance.

CONCLUSION: The findings of this study highlight that zirconia cores veneered with lithium demonstrated excellent retention and biological performance. However, they exhibited gradual degradation in marginal adaptation, restoration integrity, and color match.

CLINICAL SIGNIFICANCE: Clinicians are advised to weigh the esthetic and durable benefits of zirconia-lithium disilicate crowns against potential marginal degradation and discoloration in patients with high occlusal stress or social habits such as khat chewing. How to cite this article: Al-Hamzi MA, Al-Badani ITH, Al Kbous EHM, et al. Twelve-month Clinical Outcomes of Zirconia Cores Veneered with Lithium Disilicate Crowns: A Retrospective Study. J Contemp Dent Pract 2025;26(6):540-550.

AIM: This study aimed to assess oral hygiene practices, dental conditions, and access to dental care among children with autism spectrum disorder (ASD) in Tunisia.

MATERIALS AND METHODS: This descriptive cross-sectional study included 48 children diagnosed with ASD. Data were obtained through a structured questionnaire completed by caregivers and a clinical oral examination. The questionnaire comprised 25 items divided into three domains: (1) Knowledge (awareness of oral hygiene importance, fluoride use, recognition of dental caries, and regular dental checkups); (2) Attitude (motivation for oral care, caregiver perception of dental visits, and beliefs about prevention); (3) Practices (tooth brushing frequency, technique, use of toothpaste, dental attendance, and dietary habits). The clinical examination assessed oral hygiene status, presence of untreated caries, gingival condition, and parafunctional oral habits. Descriptive statistics were used to analyze the data.

RESULTS: Of the 48 children included in the study, 23% (n = 11) were classified at the severe end of the autism spectrum, while the remaining 77% (n = 37) presented with mild to moderate forms of ASD. Poor oral hygiene was observed in 46.6% (n = 14) of the children, untreated dental caries were present in 36.6% (n = 11), and 60% (n = 18) had never visited a dentist. Additionally, 33.3% (n = 10) of the children did not brush their teeth regularly. The presence of gingival inflammation and parafunctional habits was also noted but varied across severity levels of ASD.

CONCLUSION: The study reveals considerable challenges regarding oral hygiene behaviors, dental health status, and access to dental care among children with ASD in Tunisia. These findings underscore the necessity for targeted oral health education programs and enhanced caregiver involvement to improve oral health outcomes in this population.

CLINICAL SIGNIFICANCE: A better understanding of the specific oral health needs of children with ASD is essential for tailoring dental care protocols. Focused caregiver training and adapted dental approaches are recommended to promote improved oral hygiene practices and overall oral health in children with ASD. How to cite this article: Ben Hadj Khalfa A, Boukhris H, Ayari G, et al. Oral Health Challenges and Hygiene Practices in Children with Autism Spectrum Disorder: A Cross-sectional Study from Tunisia. J Contemp Dent Pract 2025;26(6):581-586.

PURPOSE: The lacrimal gland (LG) develops age-related alterations. This study investigated the lipid content of the accumulated secretions within the murine aged LG.

METHODS: C57BL/6J animals of different ages (3 months, 12 months, and 20-26 months) were used. Published data of bulk RNA sequencing of aged LGs were used to investigate lipid pathways. Exorbital LGs were excised for histology or PCR. Histologic sections were stained with standard histochemical stains or immunostained using anti-adiponectin, anti-perilipin 2 antibodies, and BODIPY dye. LG lipidomes were investigated using unbiased, untargeted high-resolution liquid chromatography/mass spectrometry (LC/MS), and the data were processed using unbiased, untargeted principal component and orthogonal projections to latent structure discriminant analyses.

RESULTS: Analyses of aged LGs revealed distinct changes in their state: immune infiltration without and with large dilated epithelial ducts. Sudan black and Oil Red O staining of cystic LG sections demonstrated lipid accumulation within the dilated epithelial ducts, accompanied by lymphocytic infiltration around dilated ductal structures. Bulk RNA sequencing of glands indicated upregulated transcription of genes associated with lipid metabolism, fatty acid synthesis, and lipid droplet formation. Adiponectin protein expression was restricted to ducts. Immunoreactivity to perilipin 2 and BODIPY was only observed in aged epithelial ducts. Moreover, lipidomic LC/MS analysis revealed a significant increase in the total lipid content in aged LGs compared to young LGs, with a pronounced accumulation in the neutral lipid fraction, particularly triglycerides.

CONCLUSIONS: The changes in LG lipidomes of aging mice indicate a considerable age-related shift in the specificity and efficacy of lipogenesis in LG.

We investigated how early human visual cortex processes color by analyzing individual variability in steady-state visual evoked potentials (SSVEPs). Sixteen participants viewed a flickering checkerboard that swept around the isoluminant hue circle at three chromatic contrasts. The current study analyzed the individual variability in the SSVEP data from the study to elucidate the hue-selective mechanisms in the early visual areas using a factor-analytic approach. The initial analyses of the correlations revealed that the responses to the nearby hues correlated highly, which is consistent with multiple overlapping color channels. Also, the correlational pattern showed consistent peaks and troughs at specific hue angles: 0° (+L-M), 30°, 120°, 180° (-L+M), 240°, and 300°. We further performed nonmetric multidimensional scaling, identifying four significant hue dimensions. Peaks and troughs of the dimension components were consistent with the hue angles revealed in the correlational pattern. Additional four hues also appeared in the last dimension: 90° (+S), 150°, 270° (-S), and 330°. The 10 (six plus four) hues suggested in these analyses may subserve the basis of early cortical color processing, including classical cone opponency and the mechanisms tuned to the intermediate hues.