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Background: The dreaded sensation of pain in the dental chair has a significant impact on children's behavior. This study aimed to compare and contrast the perception of pain and patient behavior between the use of INJEX and the conventional syringe needle technique during pulpotomy among children. Methods: A randomized clinical trial was designed and conducted among pediatric dentistry patients aged 6–12 years old. Fifty-eight children were divided into two groups, conventional syringe needle and INJEX, using simple randomization method applying the sequentially numbered, opaque, sealed envelope method of allocation concealment. Anesthesia was administered to the groups as local infiltration by a single operator following routine behavior guidance techniques. After 3 min, pulpotomy was performed using the standard protocol. The Face, Legs, Activity, Cry, Consolability (FLACC) scale and Wong–Baker FACES Pain Rating Scale (WBS) were used to assess the intensity of pain, while the Frankl behavior rating scale (FBRS) was used to assess the children's behavior. Results: During anesthesia, most of the participants in the INJEX group (median = 3) had higher FBRS scores compared with the conventional syringe needle group (median = 2), and the difference was very highly significant (p-value < 0.001). Analyzing the FLACC scores during local anesthesia administration revealed a high statistical significance (p-value < 0.01) across the two groups. A very high statistically significant difference (p-values < 0.001) with higher WBS scores for pain intensity was seen in the group using conventional syringe needles. Conclusions: INJEX administration significantly reduced the intensity of pain experienced by the children and helped maintain a positive attitude among them during pulpotomy. It provided a positive and comfortable experience for both the child and the practitioner. Therefore, it can serve as an excellent alternative to conventional needle anesthesia. [ABSTRACT FROM AUTHOR]

Aim: This study compares the microhardness, water sorption and solubility of nano-zirconia-reinforced biodentin groups to commercially available biodentine. Materials and Methods: Samples were prepared by adding different percentages of nano zirconia to biodentin. Four groups were categorized as follows: group 1 used Biodentin as the control group, group 2 used 10% nano zirconia and 90% Biodentine, group 3 used 20% nano zirconia and 80% Biodentine, and group 4 used 30% nano zirconia and 70% Biodentine. A Vickers microhardness tester was used to measure the microhardness of the groups according to ISO 4049/2000. The water sorption and solubility of the divided groups were assessed using disk-shaped molds. The second weight was measured on an electronic weight machine after two weeks, and values were recorded. FTIR analysis was performed. Vickers microhardness, water sorption and solubility were analyzed using a one-way ANOVA, and for multiple comparisons, a post hoc Tukey's HSD test with a significance level of p < 0.05 was performed. Group 3 had the highest mean microhardness measurement among all groups. The microhardness values for all groups in descending order are as follows: group 3, group 2, group 1 and group 4 (p = 0.008). Group 2 showed the lowest mean of water sorption compared among all groups. Group 2 has the lowest mean of water sorption, followed by group 3, group 1 and group 4 (p = 0.002). Group 4 showed the highest water sorption among all groups. Group 4 exhibited the highest solubility mean among all groups. Group 1 had the lowest mean of solubility, followed by group 2, group 3 and group 4 (p = 0.000). The FTIR spectra of different types of biodentin showed the absorbance peaks of the precipitates of each modified biodentin. The absorbance peaks fell between 474.63 cm−1 and 3438.33 cm−1. Conclusion: Biodentin is a competitive biomimetic material, but it lacks hardness and has more solubility. Thus, adding nano zirconia improved microhardness and reduced water sorption. The solubility of 20% nano zirconia added to biodentin was almost close to biodentin but with no significance. The 20% nano-zirconia-modified biodentin showed overall better properties compared to biodentin. The 20% nano-zirconia-modified biodentin can be used in deep cavities as a single restorative material instead of multi-layered restorations to increase longevity without microleakage and failure of restoration. [ABSTRACT FROM AUTHOR]

This study analyzes the evidence of the marginal discrepancy and internal adaptation of copings fabricated using three types of resin patterns with subtractive (milling) and additive technology (3D printing), as it is not widely reported. Working casts (n = 15) were scanned and patterns were completed using computer-aided designing (CAD). Resin patterns were fabricated using the designed data and divided into three groups according to the method of fabrication of patterns: subtractive technology–CAD milled polymethyl methacrylate resin (Group-PMMA), additive technology [digital light processing (DLP) technique]–acrylonitrile–butadiene–styrene (ABS) patterns (Group-ABS), and polylactic acid (PLA) patterns (Group-PLA). Resin patterns were casted with Cobalt–Chromium (Co–Cr) alloy (lost wax technique). Internal and marginal gaps of the metal copings were analyzed with the replica technique under optical microscope. The Kruskal–Wallis test was used to compare values among the groups, and post hoc multiple tests confirmed the specific differences within the groups. The median marginal gap was least for CAD milled resin patterns, followed by PLA printed resin patterns and ABS printed resin patterns. There were significant differences between Group-PMMA and Group-PLA and Group-ABS (p = 0.0001). There was no significant difference between Group-PLA and Group-ABS (p = 0.899). The median internal gap was least for metal copings fabricated from Group-PLA, followed by Group-ABS and Group-PMMA. The differences were not statistically significant (p = 0.638) for the internal gap. Full metal Co–Cr copings fabricated from the milled PMMA group had a better marginal fit, followed by the PLA and ABS printed groups. Copings fabricated with the PLA printed group had the best internal fit, though the values were statistically insignificant between the groups. [ABSTRACT FROM AUTHOR]

The essential factor in determining the preservation of restoration is the marginal seal. Restoring cervical lesions with a resin composite has always been a challenge. Composite resins with various viscosities and different bonding systems are being researched to reduce the microleakage. Confocal laser scanning microscopy (CLSM) is the latest non-destructive technique for visualizing the microleakage. Objectives: To evaluate and compare the microleakage of Universal Flo composite resin (G-aenial) using etch and rinse adhesive system ER-2 steps (Adper Single Bond 2), self-etch adhesive system SE-1 step (G-Bond), and self-adhesive flowable composite resin (Constic) in Class V cavities using a confocal laser scanning microscope. Materials and Method: Class V cavities were prepared on 27 caries-free human extracted premolar teeth on the buccal and lingual surfaces with standardized dimensions of 2 mm height, width 4 mm, and a depth of 2 mm. After the cavity preparation, all teeth were randomly divided into three groups, namely Group-I: G-aenial Universal Flo with Single Bond 2 (n = 9 teeth); Group-II: G- aenial Universal Flo with G-Bond (n = 9 teeth), and Group-III: Constic (n = 9 teeth). The prepared and restored specimens were then subjected to thermocycling for 500 cycles in a water bath at 5 °C and 55 °C with a dwelling time of 30 s. The specimens were placed in 0.6% aqueous rhodamine dye for 48 h. Sectioning was carried out bucco-lingually and specimens were evaluated for microleakage under a confocal laser scanning microscope. Results: There was a significant difference (p = 0.009) in microleakage when comparing total etch and rinse, specifically between Adper Single Bond 2 ER-2 steps (fifth generation) and self-adhesive flowable composite resin, which is Constic. There was more microleakage in the self-etch bonding agent, particularly G-Bond, SE-1 step (seventh generation), when compared to ER-2 steps (fifth generation bonding agent); however, the results were not statistically significant (p = 0.468). The self-adhesive flowable composite resin showed more microleakage than SE-1 step and ER-2 steps. Conclusions: None of the adhesive systems tested were free from microleakage. However, less microleakage was observed in the total etch and rinse, especially Adper Single Bond 2 (ER-2 steps), than the self-etch adhesive system SE-1 step and self-adhesive flowable composite resin. Clinical significance: Constant research and technological advancements are taking place in dentin adhesives to improve the marginal seal. This has led to the evolution of total acid-etching dentin bonding agents termed as etch and rinse (ER)-2 steps (fifth generation dentin bonding agents) and self-etching (SE) 2 steps, and SE-1 step dentin bonding agents termed as the sixth and seventh generation bonding agents, respectively. [ABSTRACT FROM AUTHOR]

Dental pulp treatment is the least intrusive procedure currently available for preserving the vitality of the pulp. Several studies are underway to improve the bioactivity of pulp capping materials. Tideglusib isa potent anti-inflammatory, antioxidant, and a regenerative drug developed against Alzheimer's disease and has been shown to be effective in the treatment of dental cavities. However, its bioactive properties encapsulated within the nanoparticles as a component of pulp capping material are largely unknown. In this study, tideglusib-loaded bioactive glass nanoparticles were synthesized (tideglusib-BgNPs) and mixed at various concentrations into the calcium silicate cement to testits physiomechanical and bioactivitiescompared with biodentine (control). The calcium silicate cement with 10wgt% tideglusib-BgNPs showed comparable physiomechanical properties to that of biodentine. Additionally, the assessment of cytotoxicity and bioactivity (cell proliferation, wound healing, and cell migration assays) showed increased bioactivity in terms of better wound healing, increased proliferation, and better migration of human dental pulp stem cells than biodentine. These findings suggest new opportunities to use tideglusib-BgNPs in pulp therapy. [ABSTRACT FROM AUTHOR]

BACKGROUND This computer-aided design and computer-aided manufacturing (CAD/CAM) study aimed to evaluate the effects of thermocycling on deep margin elevation relocation of subgingival cavity outlines in 80 molar teeth using advanced lithium disilicate ceramic. MATERIAL AND METHODS Eighty mandibular molar teeth were prepared for deep margin elevation below the cementoenamel junction. The following types of restorations were subsequently applied to each group: glass ionomer filling, bulk-fill flowable resin composite, bioactive resin composite, and nanohybrid resin composite. Full-coverage crowns with standardized preparation and a shoulder finish line were prepared to receive CAD/CAM-milled advanced lithium disilicate crowns. Samples were examined at 6 equidistant points via digital microscope on each proximal surface at the restoration-tooth and crown-restoration interfaces before and after thermocycling for 15 000 cycles. Data were analyzed using one-way analysis of variance, at a level of significance of 0.05. RESULTS The vertical marginal gap was significantly higher after aging and was the highest for glass ionomer filling, 9.091 (±1.147) and 9.936 (±6.376) µm, followed by nanohybrid resin composite, 3.59 (±1.03) and 3.87 (±0.97) µm, bioactive resin composite, 3.17 (±0.81) and 2.59 (±0.21) µm, and bulk-fill flowable resin composite, 1.89 (±0.60) and 2.42 (±0.64) µm, at the cervical and apical interfaces, respectively. CONCLUSIONS Thermocycling significantly changed the marginal adaptation of all restorative materials. Highest values for marginal adaptation were recorded in the glass ionomer filling group, followed by nanohybrid composite and bioactive resin groups, whereas lowest values were recorded among the bulk-fill flowable resin composite group at cervical and apical interfaces.

Background: Artificial intelligence (AI) has made significant contributions to the development of medicines and vaccines. In addition, AI can analyze large amounts of COVID-19 test data, including the number of positive cases, to forecast the trajectory of the pandemic., Aim: This study aimed to assess the knowledge, perception, and awareness of the general population in Saudi Arabia regarding AI and its application in combating COVID-19., Methods: A cross-sectional research design was employed, and online surveys were distributed via email and social media platforms. Purposeful sampling was used to select participants who met the inclusion criteria. The reliability and validity of the survey instrument were also assessed., Results: The majority of respondents (34.6%) fell within the age range of 30 to 39 years. The sample predominantly consisted of female participants. Approximately 59% of respondents reported using at least one AI tool or application on a daily basis. Furthermore, the majority of respondents agreed that digital medical services, mentioned in a previous question, could be beneficial in reducing unnecessary interactions between patients and healthcare providers., Conclusion: The COVID-19 pandemic has demonstrated the transformative potential of AI in pandemic response. AI has played a crucial role in various aspects of combating COVID-19, including patient diagnosis, treatment development, and vaccine creation. However, challenges and limitations exist in terms of data accessibility, bias, and privacy when utilizing AI. These issues need to be addressed to ensure the ethical and responsible use of AI in the fight against COVID-19 and future pandemics., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Haleem et al.)

Aim: The aim of this study is to evaluate and compare the impact strength of conventional acrylic resin, high-impact acrylic resin, high-impact acrylic resin reinforced with silver nanoparticles, and high-impact acrylic resin reinforced with a zirconium oxide powder., Materials and Methods: A total of 60 samples were prepared of dimensions 60 mm length × 7 mm width × 4 mm thickness to test impact strength. Machined stainless steel dies of the same dimension were used to form molds for the fabrication of these samples. Of 60 samples, 15 samples were prepared each from conventional acrylic resin (Group A1), high-impact acrylic resin (Group A2), acrylic resin reinforced with silver nanoparticles (Group A3), and acrylic resin reinforced with zirconium oxide powder (Group A4). Izod-Charpy pendulum impact testing machine was used., Results: The impact strength of group A1 was in the range of 2.83-3.30 kJ/m 2 ( M = 3.12 kJ/m 2 , SD = 0.16), group A2 was in range of 5.10-5.78 kJ/m 2 ( M = 5.51 kJ/m 2 , SD = 0.18), group A3 was in range 3.18-3.56 kJ/m 2 ( M = 3.37 kJ/m 2 , SD = 0.11), and group A4 was in range 7.18-7.78 kJ/m 2 ( M = 7.5 kJ/m 2 , SD = 0.18). Statistical analysis using one-way ANOVA and t -test revealed significant differences ( p < 0.001)., Conclusion: High-impact acrylic resin reinforced with zirconium oxide powder has the highest impact strength., Clinical Significance: This research sheds light on the usefulness of novel filler materials in clinical prosthodontics.

Objective: Dentin hypersensitivity (DH) is characterized by a short, sharp pain in response to a thermal or tactile stimulus. The application of desensitizing agents such as GLUMA and laser is a non-invasive and safe approach to decrease sensitivity. The evidence for the efficacy of GLUMA desensitizer compared to laser desensitization in patients with DH was evaluated for 6 months., Design: In March 2022, an electronic search of PubMed, Scopus, and Web of Science databases was conducted. Articles published in English that compared GLUMA and laser in the treatment of DH with a follow-up of 6 months or more were included. Randomized, non-randomized controlled trials, and clinical trials were included. Risk of bias assessment tools developed by the Cochrane collaboration ROB 2 and ROBINS-I were used to assess the quality of studies. The GRADE assessment method was used to assess the certainty of evidence., Results: About 36 studies were identified in the search results. After applying the predefined eligibility criteria, eight studies with 205 participants and 894 sites were included in this review. Of the eight studies, four were judged to be at high risk of bias, three had some concerns, and one had a serious risk of bias. The certainty of the evidence was graded as low., Conclusion: Based on limited evidence, GLUMA and laser appear to be equally effective in providing relief from DH. GLUMA showed an immediate effect and provided pain relief. Over the course of a week, laser showed long-term stable results. GLUMA is effective in providing immediate relief.