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Aim of the StudyThe aim of this in vitro study was to evaluate the effect of the resin infiltration technique and remineralization of induced enamel caries with fluoride solution on the color masking of white spot lesions and surface roughness. Materials and MethodsA total of 45 sound teeth were used in this study. All the teeth were sectioned along the long axes into two halves, lingual and buccal to get 90 specimens. All specimens were immersed in a demineralized solution for 7 days. The specimens were divided randomly into three equal groups (n = 30) according to the type of treatment; Group 1 (n = 30) was treated with fluoride varnish (Clinpro); Group 2 (n = 30) was treated by resin infiltration (Icon); and Group 3 (n = 30) was used as a control group with no treatment. The color and surface roughness were measured three times at baseline (T1), directly after induction of artificial white spot lesions (WSLs) (T2), and directly after application of the treatment options (T3). The colors were measured using a portable reflective spectrophotometer and the 3D surface roughness was measured using a Light Sectioning Vision System. Data were collected and statistically analyzed using T test and Mann–Whitney U test. The ResultsSurface roughness was almost equal in the study groups with no statistically significant differences reported. Icon showed slightly higher color scores than that of ClinPro. ConclusionsThe Icon produced favorable esthetic results compared to the fluoride therapy while no significant differences were reported regarding the surface roughness.

Background: Apexification is a procedure that promotes apical closure by forming mineralized tissue in the apex region of a nonvital young permanent tooth. Calcium silicate-based cement like Mineral trioxide aggregate (MTA) and Biodentine are commonly employed as apical barriers to facilitate this process. Microleakage, defined as the leakage along the junction between the canal wall and filling material, is a crucial aspect to assess in MTA and Biodentine applications as apical barriers, as it directly impacts the prevention of bacterial seepage and maintenance of structural integrity. The current study aims to assess the microleakage of MTA and Biodentine when used as apical barriers in simulated young permanent teeth. Methods: From a total of 128 extracted teeth, 114 were selected for the study and randomly allocated into three groups: G1 (MTA), G2 (Biodentine), and G3 (Control), with 38 teeth per group. After excluding 5 teeth from each group due to issues such as canal calcification, breakage during sectioning, and procedural errors, 33 teeth were analyzed to ensure equal distribution. To simulate young permanent teeth, samples were instrumented using a person-reamer with a diameter of 1.7 mm. A 4 mm thick apical plug of MTA and Biodentine was placed in G1 and G2, respectively, while G3 was the control group. Apical microleakage in all experimental groups was assessed using a dye penetration method. Specimens were longitudinally sectioned and examined under a stereomicroscope with graded eyepiece. Results: The Kruskal-Wallis test revealed variations in mean apical microleakage among the groups: G1 recorded 0.67, G2–0.16, and G3–1.62, with G2 showing the lowest value and G3 group exhibiting the highest. Conclusions: Biodentine was found to excel in its ability to create a secure seal and function effectively as an apical barrier in simulated young permanent teeth. These results underscore its potential as a highly efficient material for dental applications, particularly in scenarios requiring reliable sealing and barrier formation in the root canal system of developing permanent teeth. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this in vitro study was to evaluate the effects of different preparation designs on the mean colour change (ΔE*), marginal adaptation, fracture resistance, and fracture types of maxillary and mandibular premolar endocrowns (ECs). Methodology: A total of 40 extracted maxillary and mandibular premolars were treated endodontically, and each type was subdivided according to the remaining axial height (remaining walls on all surfaces; 2–4 mm) and 2 mm inside the pulp chamber. Specimens were immersed in coffee for 14 days, ΔE* was determined, marginal adaptation was observed, fracture forces test was conducted, and the samples were examined visually at 10× magnification to evaluate failure type and identify fracture origin. The data were entered and analyzed using Statistical Package for Social Sciences, and significance between and within groups was evaluated through ANOVA. The p-value ≤ 0.05 was considered statistically significant. Results: The ΔE* values of the maxillary premolar with 2 mm axial height were the highest (6.8 ± 0.89 units), whereas the lowest value was observed in the mandibular premolar with 4 mm axial height (2.9 ± 0.53 units). Significant differences (p < 0.05) in teeth and design were observed. The marginal adaptation of the mandibular premolar with 4 mm axial height was the highest (30.20 ± 1.53 μm), whereas the lowest marginal adaptation was observed in the maxillary premolar with 2 mm axial height (14.38 ± 0.99 μm), and the difference was statistically significant (p < 0.05). The maximum fracture force was observed in maxillary premolars with 2 mm axial height (2248.15 ± 134.74 N), and no statistically significant difference (p = 0.07) was observed between maxillary and mandibular premolars at 4 mm axial height. Conclusion: The recorded ΔE* values of the ECs were within clinically acceptable values or slightly higher, and the marginal adaption values were within acceptable and recommended clinical values in µm. EC preparation with 2 mm axial height in both arches recorded the highest fracture forces. Type III (split fracture) failure was recorded as the highest in the maxillary and mandibular premolar ECs with different axial wall heights. [ABSTRACT FROM AUTHOR]

Background and Aim: Dental caries is largely preventable, yet an important global health issue. Numerous systematic reviews have summarized the efficacy of artificial intelligence (AI) models for the diagnosis and detection of dental caries. Therefore, this umbrella review aimed to synthesize the results of systematic reviews on the application and effectiveness of AI models in diagnosing and detecting dental caries. Methods: MEDLINE/PubMed, IEEE Explore, Embase, and Cochrane Database of Systematic Reviews were searched to retrieve studies. Two authors independently screened the articles based on eligibility criteria and then, appraised the included articles. The findings are summarized in tabulation form and discussed using the narrative method. Result: A total of 1249 entries were identified out of which 7 were finally included. The most often employed AI algorithms were the multilayer perceptron, support vector machine (SVM), and neural networks. The algorithms were built to perform the segmentation, classification, caries detection, diagnosis, and caries prediction from several sources, including periapical radiographs, panoramic radiographs, smartphone images, bitewing radiographs, near‐infrared light transillumination images, and so forth. Convoluted neural networks (CNN) demonstrated high sensitivity, specificity, and area under the curve in the caries detection, segmentation, and classification tests. Notably, AI in conjunction with periapical and panoramic radiography images yielded better accuracy in detecting and diagnosing dental caries. Conclusion: AI models, especially convolutional neural network (CNN)‐based models, have an enormous amount of potential for accurate, objective dental caries diagnosis and detection. However, ethical considerations and cautious adoption remain critical to its successful integration into routine practice. [ABSTRACT FROM AUTHOR]

Background: Understanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation. Method: This cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761–70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05. Results: The distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females. Conclusion: This study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars. [ABSTRACT FROM AUTHOR]

Iron nanoparticles comprise a significant class of inorganic nanoparticles, which discover applications in various zones by prudence of their few exciting properties. This study achieved the green synthesis of iron oxide nanoparticles (IONPs) by black cumin seed (Nigella sativa) extract, which acts as a reducing and capping agent. The iron nanoparticles and black cumin extract were synthesized in three different concentrations: (01:01, 02:04,01:04). UV-visible spectroscopy, XRD, FTIR, and AFM characterized the synthesized iron oxide nanoparticles. UV-visible spectra show the maximum absorbance peak of 01:01 concentration at 380 nm. The other concentrations, such as 02:04, peaked at 400 nm and 01:04 at 680 nm, confirming the formation of iron oxide nanoparticles. AFM analysis reveals the spherical shape of iron oxide nanoparticles. The XRD spectra reveal the (fcc) cubic crystal structure of the iron oxide nanoparticles. The FTIR analysis's peaks at 457.13, 455.20, and 457.13 cm-1 depict the characteristic iron nanoparticle synthesis. The black cumin extract-mediated iron oxide nanoparticles show substantial antibacterial, antifungal, antioxidant and anti-inflammatory activity in a dose-dependent manner. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to assess the influence of combining different forms of fiber-reinforced composites (FRC) on the mechanical behavior and bond strength of compromised endodontically treated teeth (ETT). Materials and methods: Eighty extracted human premolar teeth were randomly divided into five experimental groups according to the type of intra-radicular restoration and the canal preparation design which was either non-flared (Group 1), flared (Groups 2–5), closed-apex (Groups 1,3,5) or open-apex (Groups 2,4). Standard prefabricated fiber posts were used as intra-radicular restoration for Groups 1–3 while Groups 4–5 were restored with anatomically customized relined fiber posts. After composite core fabrication, all samples were sent for an artificial aging process. Fracture resistance and push-out bond strength tests were then carried out through a universal testing machine followed by mode of failure analysis via a stereomicroscope and scanning electron microscope. Results: Pairwise Log-Rank comparisons revealed that the survival rate of Group 2 and Group 3 was significantly lower than all other groups after artificial aging. The highest fracture resistance value (1796 N) was recorded in Group 5 and was significantly higher than that of the other groups (p < 0.05), while Group 2 exhibited the lowest fracture resistance (758 N), which was significantly lower compared to the other groups. Group 5 and Group 4 demonstrated a significantly higher push-out bond strength, at all root thirds, than Group 3, Group 2, and Group 1 (p < 0.05). The most frequently observed failure mode in the tested groups occurred between the resin cement and radicular dentin. Conclusion: The use of short fiber-reinforced composite (SFRC) to reline the prefabricated FRC post has been proven to have superior fracture resistance with favorable failure patterns and increased push-out bond strength values compared to standard prefabricated FRC posts. [ABSTRACT FROM AUTHOR]

Due to the low cost, natural origin, higher safety margins, and little to negligible adverse effects of herbal medications, the use of plants and plant derivatives in medicine is becoming increasingly widespread. Terminalia chebula is among the most significant medicinal plants in ayurvedic, siddha, unani, and homeopathic remedies. It is ranked first in Ayurvedic material medicine. T. chebula has been shown to have established effects against various bacterial and fungal infections, including dental caries pathogens. In recent years, there has been a rise in interest in dentistry and medicine related to Enterococcus faecalis. The research aimed to assess the antibacterial effectiveness of different concentrations of T. chebula ethanolic fruit extract (10%, 40%, and 100%) in opposition to E. faecalis and compare it with 2% chlorhexidine. For the study, T. chebula ethanolic fruit extracts were obtained and prepared with Group I: −10% concentration, Group II: −40% concentration, Group III: −100% concentration, and Group IV: −2% chlorhexidine. Colonies of E. faecalis were cultivated in brain heart infusion (BHI) broth at 37°C and were inoculated in 16 BHI agar plates. Then, on the petri dishes, four wells were created (8 mm diameter) using a metal borer. The Agar well diffusion method was used to examine the antibacterial activity, and the zones of inhibition around the wells were noted. The obtained data were statistically analyzed using one‐way ANOVA and post‐hoc tests. The result shows that as the concentration increases, there is an increase in the efficacy of the antibacterial property of the extract before it reaches the saturation point. The decreasing order of antibacterial was chlorhexidine >100% T. chebula >40% T. chebula >10% T. chebula. The production of contemporary pharmaceuticals from T. chebula was addressed, as the global scenario is currently evolving toward using nontoxic plant products with traditional medicinal benefits. [ABSTRACT FROM AUTHOR]

Introduction: Oral hygiene is paramount for maintaining optimal oral and physical health, especially among children who are particularly susceptible to dental caries and issues due to dietary habits and inadequate hygiene practices. This study aimed to evaluate the awareness and knowledge of oral health among public school children, analyse their oral hygiene habits, educate parents on the importance of oral health for their children, and implement an oral hygiene educational program in Al-Kharj City, Saudi Arabia. Methods: Four public elementary schools were selected for the study, with a sample size of 200 school-going children participating. A structured questionnaire was used to assess awareness and knowledge of oral health among the participants. SPSS software version 26 was used for data analysis. Multiple regression analysis and correlation tests was employed to explore the relationships between the different variables measured in the study. Results: The findings revealed a significant lack of awareness regarding oral health among school children. Oral hygiene habits were found to be inadequate in many participants. Overall, the findings highlight the need for targeted interventions aimed at promoting regular dental visits, addressing dental fear, and fostering positive oral hygiene practices among school-going children to improve oral health outcomes in the studied population. Conclusion: The study highlighted a critical gap in oral health awareness among school children, underscoring the need for targeted interventions. While the oral hygiene educational program has been implemented and future data will shed light on its effectiveness, preliminary observations suggest that such programs could potentially improve oral health outcomes and overall engagement among students. [ABSTRACT FROM AUTHOR]

Background: Oral submucous fibrosis (OSMF) is a chronic, potentially malignant disorder characterized by progressive fibrosis of the oral mucosa, leading to restricted mouth opening and discomfort. This study investigates the efficacy and safety of astaxanthin, a potent antioxidant and anti-inflammatory carotenoid, in the comprehensive management of OSMF., Methods: A randomized, double-blind, placebo-controlled trial was conducted with 68 eligible participants diagnosed with OSMF. Participants were randomly assigned to the experimental group (astaxanthin capsules, 5 mg twice daily) or the control group (placebo capsules) for 12 weeks. Primary outcomes included changes in mouth opening and burning sensation assessed by Visual Analog Scale (VAS). Adverse events were monitored to evaluate safety., Results: The experimental group demonstrated a statistically significant improvement in mouth opening compared to the control group over the 12-week intervention (p < 0.001). Additionally, the experimental group reported a significant reduction in burning sensation, as indicated by VAS scores (p < 0.001). Adverse events were generally mild and comparable between groups., Conclusion: This study suggests that astaxanthin may have a positive impact on mouth opening and burning sensation in individuals with OSMF. The safety profile observed supports the feasibility of astaxanthin as a potential therapeutic adjunct in OSMF management. Further research with larger sample sizes and extended follow-up periods is warranted to validate these findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Perumal et al.)