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Background: The esthetic proportion gauge developed by Chu is using a 78% recurring esthetic dental (RED) proportion and it is based on evaluating the size and proportion of frontal teeth chairside.

Background: The most common dental materials are resin composite direct restorative materials and dentin adhesives, which are marketed with different techniques, application recommendations, and compositions, making it difficult to choose the most suitable material and method for different cases.

Introduction: In our modern society, burnout syndrome develops over a long period of time because of constant stress and increased emotional pressure. Dentistry is known as one of the most stressful professions. The aim of this study was to determine the incidence of burnout syndrome among dentists in Mureș County, Romania, and to assess the determining factors associated with burnout. Material and methods: We conducted an online survey regarding burn-out syndrome among dentists. Results: The most frequent complaint among respondents was the loss of personal accomplishment, followed by emotional exhaustion and depersonalization. Higher levels of emotional exhaustion and depersonalization were seen in non-married, male dentists between 51–60 years, who worked more than 8 hours a day without an assistant. Conclusions: Based on the presented data, the risk factors for burnout syndrome should be brought to the attention of dentists and various preventive programs should be implemented.

The scientific literature is increasingly focused on peri-implant mucositis and peri-implantitis, which are biological outcomes of dental implant treatment. Background/Objectives: The present study aimed to evaluate the two most critical complications of dental implantation, peri-implant mucositis and peri-implantitis, through the prism of different influencing factors. Methods: We followed 40 patients, with a total number of 92 dental implants, divided into three age groups: under 35 years, between 35 and 55 years, and older than 55 years. Patients were also divided into groups according to the time since implant placement: 1–3 years, 4–7 years, and more than 7 years. The patients were examined, and periodontal pocket depth, peri-implant pocket depth, Löe–Silness gingival index, mucosal thickness, and keratinized mucosal width were recorded; bone resorption was measured on radiographs using a 2D image analysis method; and a questionnaire was also conducted. Results: Bone resorption was highest in the 35–55 age group (3.09 ± 0.04 mm) and for implants placed 4–7 years ago (3.39 ± 0.12 mm). Females had a mean bone resorption of 3.4 ± 0.15 mm and males of 2.45 ± 0.07 mm. Statistically, there was a significant difference only in the Löe–Silness index: the 35–55 age group had the highest values (p = 0.04). Conclusions: There were no statistically significant differences between the time since implant placement and the degree of bone resorption, nor between sexes. Peri-implant inflammation may occur at any age, regardless of the lifetime of the implants. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the effect of different light curing modes on the polymerization shrinkage of a bulk-fill composite and to evaluate the impact of two layering techniques on the cuspal deflection. Methods: Nine different light curing modes were tested on bulk-fill composite samples in aluminum MOD cavities. Intensity, duration, and illumination distance were the factors that changed during the different curing modes. The digital image correlation method was used to visually represent the displacement of carbon particles on the materials' surface caused by shrinkage along both the horizontal and vertical axes. For simulating cuspal deflection, a separate protocol was used, with a bulk and horizontal layering technique. Results: The results showed that the largest horizontal displacements were present in the soft start group (6.00 ± 0.82 µm) and in the X-tra power group (5.67 ± 1.21 µm). The smallest horizontal displacements were detected in normal curing modes (4.00 ± 1.58 µm; 4.00 ± 2.68 µm). The largest vertical displacements, at the bottom layer, were present in the normal curing mode group with a 20 s curing time (5.22 ± 1.56 µm), while the smallest vertical displacements were shown in the X-tra power group (2.89 ± 0.60 µm). The observed particle displacements showing the shrinkage of the composite were correlated with the curing mode. The bulk-fill group showed less cuspal deflection than the horizontal layering group did, but the difference was not statistically significant (p = 0.575). Conclusions: Within the limitations of this in vitro study, it can be concluded that lower intensities of curing lights (1200 mW/cm2) may perform better from the point of view of material shrinkage than high and extreme light intensities do. The pulse delay mode might be recommended in the case of bulk-fill materials. The number of layers did not significantly affect the cuspal deflection in the case of the studied composite. [ABSTRACT FROM AUTHOR]

Background: Allergy is one of the most widespread diseases in this century. Allergy-causing materials used in dentistry are most frequently metals, such as nickel, cobalt, palladium, and amalgam, certain components of dental composites, denture resin materials, and even certain mouthwash components. The aim of this study was to assess dentists’ experience regarding allergies occurring in their practice among patients and among dental team members.

Background: Measurement-based studies are prone to measurement errors, which occur at the same operator or between different operators during repeated measurements of the same sample.

Background: Epidemiological studies have reported an increasing prevalence of tooth wear, and general dental practitioners see a greater number of patients seeking treatment with worn dentition. Improper oral hygiene, unhealthy habits, occupational hazards, and potentially erosive processed foods seem to play a major role in the non-carious loss of dental hard tissue. The aim of this study is to assess the factors and cofactors that may play a major role in the genesis of dental attrition, dental abrasion, and, especially, dental erosion.

Background: The need for the whitening effects of toothpastes became primary for most users. Changes in the surface roughness of restoration materials after tooth brushing are inevitable, and the abrasion is known to increase the possibility of dental plaque accumulation. Aim of the study: To evaluate in vitro surface roughness changes of different dental restorative materials after tooth brushing simulation. Material and methods: Fifty specimens of two composite materials (Evicrol, Super-Cor), two glass ionomer materials (Glassfill, Kavitan Cem) and a silicate cement (Fritex) were prepared according to the manufacturer’s instructions. Each group of specimens was divided in three subgroups for tooth brushing simulation: using two different types of toothpaste and without toothpaste. Before and after 153 hours of tooth brushing simulation with a custom-made device, the surface roughness was measured with a surface roughness tester. Statistical analysis was performed after collecting the data. Results: All materials exhibited changes in surface roughness after the use of both toothpastes. The self-curing composite showed the less change and glass ionomer materials showed the greatest changes in surface roughness. Conclusions: The surface changes of dental materials depended on their composition and the cleaning procedure. Although self-curing composite was the most resistant to surface changes, its surface roughness values were high. Light-curing composite presented the lowest surface roughness values, even after brushing with toothpastes. The “medium” labeled toothbrush caused significant changes without toothpaste on the surface of light-curing composite, glass ionomer and silicate cement materials.

Background and aims. Sustainability is the sensitive and responsible way of using the natural resources, its goal being to prevent their depletion and preserving the ecological balance. An essential requirement to achieve this is to practice environmentally conscious behavior. The main objective of the present study was to carry out a survey among dentists about the importance of sustainability, feasibility of an environmentally friendly dental practice and the steps in favor of it. Methods. An online survey with 6 question groups, including a total of 50 questions, was performed. The survey was available online for dentists on different platforms. In total 98 responses were recorded during September - November 2020. Results. Out of the responding dentists, 74.49% liked the idea of an environmentally friendly dental practice and 98.97% would take some steps toward environmental awareness in their practice. A statistically significant (p<0.05) difference between those who prefer an environmentally conscious practice and those who had not yet thought about it was only in the questions related to environmentally conscious lifestyle in their household, the use of environmentally friendly cleaning products, the creation of a 'green wall' and selective waste collection in their practice. Conclusions. Most of the respondents were open to the idea of forming an environmentally conscious dental practice and they would act to achieve it. In order to reach this, it is necessary to provide dentists with feasible solutions for better practice. Some of the guidance issues, which would be easy to implement, are listed at the end of the present study. We intend to provide a guidance regarding sustainable dental practice. [ABSTRACT FROM AUTHOR]

(1) Background: Hypodontia has a multifactorial aetiology, in which genetic factors are a major component. Associated with this congenital absence, the formed teeth may show differences in size and shape, which may vary with the specific genetic variants and with the location of the missing teeth. The aims of the present study were to investigate a specific variant of MSX1, derive morphometric tooth measurements in a sample of patients with isolated maxillary lateral incisor agenesis and matched controls, and model the findings. (2) Methods: Genotyping of the MSX1 rs8670 genetic variant and morphometric measurements with a 2D image analysis method were performed for 26 hypodontia patients and 26 matched controls. (3) Results: The risk of upper lateral incisor agenesis was 6.9 times higher when the T allele was present. The morphometric parameters showed significant differences between hypodontia patients and controls and between the unilateral and bilateral agenesis cases. The most affected crown dimension in the hypodontia patients was the bucco-lingual dimension. In crown shape there was significant variation the Carabelli trait in upper first molars. (4) Conclusions: The MSX1 rs8670 variant was associated with variations in morphological outcomes. The new findings for compensatory interactions between the maxillary incisors indicate that epigenetic and environmental factors interact with this genetic variant. A single-level directional complex interactive network model incorporates the variations seen in this study. [ABSTRACT FROM AUTHOR]

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Currently available direct restoration materials have been developed to have improved optical properties to interact with light in the same manner as the natural tooth. The objective of this study was to investigate the fluorescence of different enamel resin composites. In the present study, nine brands of enamel composites were tested in vitro, some of which are cited by manufacturers as having color adjustment potential. Fluorescence spectra of the composite specimens and the human natural enamel were measured with a fluorescence spectrophotometer immediately after preparation and after 6 months. Qualitative data of the specimens were also collected. Statistical analyses were conducted by Kruskal–Wallis and Mann–Whitney U nonparametric tests (p < 0.05). Almost all tested resin composites presented a significant decrease in the fluorescence values after a period of 6 months. There was no significant decrease in fluorescence in the case of Harmonize™ resin composite samples, which presented the lowest initial fluorescence values. The highest value in the reduction of the initial fluorescence intensity after 6 months (22.95%) was observed for the Charisma® specimens. Composites with a color adjustment did not perform significantly better than other composites in terms of reduction in fluorescence intensity. [ABSTRACT FROM AUTHOR]

Background: The use of various clear Vacuum Formed Retainers (VFR) is widespread, but there are no comprehensive guidelines on how patients should clean their retainers for optimal aging and plaque removal. Direct comparisons between methods and materials have not been performed. Objective: We examined the change in surface roughness of polypropylene (PP) and thermoplastic polyurethane (TPU) materials undergoing various cleaning protocols. Material and methods: We conducted a study among individuals who wear vacuumformed retainers, to understand their cleaning habits. After summarizing responses, we created 4 cleaning groups: toothbrushes only, two different types of toothpaste with toothbrushes, and electric toothbrush with toothpaste. We chose to compare the cleaning protocols used by patients under in vitro conditions to eliminate changes caused by human factors. Samples of retainer materials: Copyplast C and Erkoloc-pro were vacuum-molded onto type IV dental stone models. A self-designed and self-fabricated toothbrush simulator was used for 30 days of brushing, 30s each day. Surface roughness (Ra) of the inner surface was measured using a Mitutoyo SJ-310 profilometer. Statistical analysis included ANOVA and t-tests. Results : The initial surface roughness between TPU and PP samples was not significantly different (p=0.199). Use of the Colgate Soft toothbrush alone had a significantly different effect (p=0.02) on the TPU and PP samples, with the TPU material showing a significant change in surface roughness (p=0.008). In addition, the Curaprox Soft toothbrush with Colgate Max White Optic toothpaste significantly altered the surface of the TPU samples (p=0.04). Interestingly, the Colgate Max White Optic toothpaste visibly discolored the TPU samples. The Colgate Soft and Medium toothbrushes combined with Elmex Caries Protection toothpaste significantly abraded the surface of the PP samples, with the TPU material being significantly more wear-resistant to the same protocol. Notably, using the Oral-B Pro3 Cross Action electric toothbrush with Colgate Max White Optic toothpaste showed a significant difference between the TPU and PP samples. Conclusions: Our results showed that different cleaning procedures affected TPU and PP retainer materials differently. TPU samples generally showed a decrease in surface roughness after most cleaning procedures, while PP samples showed an increase in surface roughness. Curaprox Super Soft and Soft toothbrushes with Elmex Caries Protection toothpaste are recommended for optimal cleaning, as they produce less wear than Colgate toothbrushes. Medium and electric toothbrushes and whitening toothpaste should be used with caution. These findings underscore the importance of cleaning method selection to maintain VFR material integrity and hygiene, thereby improving patient satisfaction. [ABSTRACT FROM AUTHOR]

The etiology of hypodontia is complex, in which both genetic and environmental factors can be related. The main objective of our study was to contribute to elucidating the genetic background of nonsyndromic hypodontia (NSH). In this order, we selected 97 NSH subjects (70 females and 27 males) from patients referred to orthodontic treatment, and we matched to each NSH subject a control by age and sex. DNA was obtained from epithelial cells from the oral mucosa. Genotyping of the PAX9 (rs4904155 and rs61754301), MSX1 (rs8670 and rs12532), and AXIN2 (rs2240308) SNPs was performed by using TaqMan SNP Genotyping Assays on a real-time PCR system. Single-nucleotide polymorphisms (SNPs) were studied for the whole NSH group and for frontal and lateral agenesis NSH subjects separately. Our results showed that the variant genotype (p=0.0008, OR = 2.9, 95% CI = 1.58–5.3) and variant T allele (p=0.0002, OR = 2.65, 95% CI = 1.6–4.39) of the MSX1 rs8670 SNP increased the risk of hypodontia in the studied population when the whole NSH group was compared with controls. The variant genotype of the MSX1 rs8670 SNP was the most frequent in frontal agenesis; meanwhile in the lateral agenesis NSH group, the AXIN2 rs2240308 SNP showed a higher frequency of the variant genotype, with a trend towards statistical significance. In conclusion, the results of the present study showed that the variant genotype and variant T allele of the MSX1 rs8670 SNP increased the risk of hypodontia in the studied population. The presence of the variant A allele of AXIN2 rs2240308 is associated with frontal agenesis but not with lateral agenesis. [ABSTRACT FROM AUTHOR]

Objective The associations seen clinically between variations in tooth number, size and shape reflect the repetitive genetic interactions occurring between the epithelium and mesenchyme during the initiation and morphogenetic stages of the Complex Adaptive System that is dental development. The aim of this study was to investigate the clinical relationship further by comparing multiple crown parameters, including cusp numbers, between patients with mild hypodontia and controls in a Romanian sample. Design Digital images of dental casts of the permanent dentition from 28 patients with mild hypodontia and 28 controls were used. Measurements from the vestibular and occlusal surfaces were performed using a 2D image analysis method and cusps, including the Carabelli trait, were counted. Two-way analysis of variance was performed. Results The dimensions of the mild hypodontia group had smaller values than the controls, with many measurements being significantly different (significance values varied from p = 0.049 to p = 0.001 ). The most affected regions were the upper and lower anterior region in both sexes. Mesio-distal, bucco-lingual and occlusal area and perimeter dimensions were affected. Females from the hypodontia group had significantly less tricuspidated lower premolars when compared with the control group. Carabelli cusps were present in the hypodontia group less frequently, the difference being highly significant ( p = 0.0002 ) in women. Conclusions The hypodontia patients presented with reduced crown dimensions and shape compared with controls. This is the first published study to demonstrate smaller cusp numbers in patients with hypodontia than in controls. The findings are compatible with a model of dental development as a Complex Adaptive System incorporating associations between tooth number, size and shape. [ABSTRACT FROM AUTHOR]

Objectives. The role was studied of multiple single nucleotide polymorphisms in tooth agenesis in the Hungarian population using a complex approach. Methods. Eight SNPs, PAX9 -912 C/T, PAX9 -1031 A/G, MSX1 3755 A/G, FGFR1 T/C rs881301, IRF6 T/C rs764093, AXIN2-8150 A/G, AXIN2-8434 A/G and AXIN2-30224 C/T, were studied in 192 hypodontia and 17 oligodontia cases and in 260 healthy volunteers. Case-control analysis was performed to test both allelic and genotypic associations as well as associations at the level of haplotypes. Multivariate exploratory Bayesian network-based multi-level analysis of relevance (BN-BMLA) as well as logistic regression analysis were performed. Results. Conventional statistics showed that PAX9 SNP -912 C/T and the MSX1 SNP changed the incidence of hypodontia, although after Bonferroni correction for multiple hypothesis testing, the effects were only borderline tendencies. Using a statistical analysis better suited for handling multiple hypotheses, the BN-BMLA, PAX9 SNPs clearly showed a synergistic effect. This was confirmed by other multivariate analyses and it remained significant after corrections for multiple hypothesis testing ( p < 0.0025). The PAX9-1031-A- PAX9-912-T haplotype was the most relevant combination causing hypodontia. Interaction was weaker between PAX9 and MSX1, while other SNPs had no joint effect on hypodontia. Conclusion. This complex analysis shows the important role of PAX9 and MSX1 SNPs and of their interactions in tooth agenesis, while IRF6, FGFR1 and AXIN2 SNPs had no detectable role in the Hungarian population. These results also reveal that risk factors in hypodontia need to be identified in various populations, since there is considerable variability among them. [ABSTRACT FROM AUTHOR]

Background: Identification of the characteristics of tooth agenesis is an important component in the understanding of the ethiology of this common developmental dental anomaly. The aim of the present study was to determine the prevalence and the characteristics of tooth agenesis among patients from Tîrgu Mureş. Material and method: The present study is retrospective and descriptive, based on the evaluation of the patient's dental records from 2004 to 2012 belonging to a pediatric dental office from Tîrgu Mureş. Orthopantomograms and anamnestic data of 947 children and young adults (365 male and 582 female) were analyzed. Results: The prevalence of tooth agenesis, excluding third molars, was 7.39%. The difference between the genders was statistically not significant (p = 0.09). The most frequently missing teeth were the upper second incisors, followed by the lower second premolars. The difference between the distribution of agenesis in the upper and lower jaws was statistically significant (p <0.0001). The distribution of dental agenesis between the anterior region and the lateral region of the maxilla and the mandible showed significant differences (p <0.0001). Symmetrical distribution of tooth agenesis was found more frequently (54.54%) than assymetrical distribution. Conclusions: The maxillary anterior region and the mandibular lateral region were the most affected by dental agenesis in the permanent dentition of the studied population. The maxilla was more affected than the mandible and bilateral forms of agenesis were more frequently than unilateral forms. The more extreme forms of agenesis were found amongst female. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the intra-operator reliability of a 2D image analysis method for tooth dimension measurements. Methods: Occlusal and vestibular surfaces of teeth from ten study models were captured with a digital camera. Images were transferred on a computer and different tooth dimensions (mesio-distal, occluso-gingival, vestibulo-oral and perimeter) were measured using the Image Pro Insight software. Measurements were repeated after two weeks. Fleiss' coefficients of reliability were calculated. Results: A high degree of reliability has been established for every type of measurement: all coefficient values of reliability being not less than 0.95. Conclusions: The 2D image analyzing system is an adequate alternative for measuring tooth dimensions. All measurements were in the excellent category of reliability. The method allows precise and repeatable measurements, generating an image database as well, available for future studies. [ABSTRACT FROM AUTHOR]

The associations seen clinically between variations in tooth number, size and shape reflect the repetitive genetic interactions occurring between the epithelium and mesenchyme during the initiation and morphogenetic stages of dental development. The aim of this study was to investigate this relationship further by comparing multiple crown parameters, including cusp numbers, between patients with mild hypodontia and controls. Digital images of dental casts of the permanent dentition from 28 Romanian subjects with mild hypodontia and 28 controls were used. Measurements of the vestibular and occlusal surfaces were performed using a 2D image analysis method. Seven dimensions were measured (mesio-distal, occluso-gingival, bucco-lingual, vestibular perimeter, vestibular area, occlusal perimeter and occlusal area) and cusps on premolars and first molars were counted. Multivariate analysis of variance was performed using SPSS V17 software. The results showed teeth in the hypodontia group were smaller than those of controls, with many measurements being significantly different (significance values varied from p=0.048 to p=0.0001). Lower first incisors and upper first premolar teeth presented the most reduced dimensions. Mesio-distal, bucco-lingual and occlusal area and perimeter dimensions were the most affected. Upper first molars presented the Carabelli trait in significantly less subjects in the hypodontia group than in controls. This variation was accompanied by a difference in tooth height. Lower premolars showed reduced cusp numbers in hypodontia subjects, accompanied by variation in tooth width or depth. In conclusion, this study demonstrated differences in multiple parameters of crown size and shape in patients with mild hypodontia compared to controls. The degree of these differences varied between different tooth types and dimensions. [ABSTRACT FROM AUTHOR]

Background: Bisphenol A (BPA) is a synthetic organic compound used as a monomer in the production of polycarbonates, epoxy resin and methacrylate. In dentistry, it can be released during the photopolymerization of dental materials. It is toxic at a certain level and it can influence or produce changes in hormonal activity, asthma, diabetes, obesity, behavior changes, cancer, infertility and genital malformations. Objective: The objective of this review is to assess data regarding the release of BPA from dental materials and its level in the human body as reported in the scientific literature. Material and methods: A review of the scientific literature was performed by searching PubMed database articles, based on the PRISMA guideline for systematic reviews. The key words used to search were "Bisphenol A resin composite toxicity", "Bisphenol A urine dental", "Bisphenol A toxicity dental", "Bisphenol A dental materials HPLC". The newest articles have been selected, between 2019 and 2023. Results : The database issued 98 articles. After the first selection we had 25 articles, after the second selection 16 relevant articles were included in the present review. The extracted datas were the materials and methods, the analysed period and the obtained results. Studies that analysed BPA through high-performance liquid chromatography (HPLC) were included. BPA levels were measured from saliva and associated with the use of dental composites and dental sealants. The amount of BPA increased after polymerisation from an average of 2 ng/ml to 35,5 ng/ml in 1 hour and it kept increasing with time. We found no relevant data in the literature regarding levels of BPA in the urine and blood. The studies conducted on specimens of dual cured resin cements did not detect BPA. On the contrary, the ones made on dental composites and compomers concluded that the amount of BPA increases in the first hour after application. The released BPA level depends on the photopolymerization method and it can be decreased by finishing and polishing. The amount of BPA released from dental composites has an average of 2- 35,5 ng/ml. The problem that occurs is that the tolerable daily dose is 0,2 ng/kg of body. Conclusions: Based on the included studies, the amount of BPA released from dental composites depends on different factors and it has an average value bigger than the tolerable daily dose. The release is very high and it can cause changes in the body. BPA can be absorbed in the oral or gastrointestinal mucosa, which can produce systemic toxic effects. [ABSTRACT FROM AUTHOR]