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Background: White spot lesions are a widespread undesirable effect, especially prevalent during fixed orthodontic treatments. The study compared the in vitro enamel remineralization potential of undemineralized dentin matrix (UDD) versus chicken eggshell powder (CESP) for artificially induced enamel lesions. Methods: 100 caries-free and sound maxillary premolars were randomly divided into four groups each contain 25 teeth: Group I (Baseline): No treatment was done to the enamel surface. Group II (Negative control): The enamel surface of the teeth underwent demineralization using demineralizing solution to create artificial carious lesions then kept in artificial saliva. Group III (CESP treated): After demineralizing the tooth surface, the teeth have been suspended in the CESP remineralizing solution. Group IV (UDD treated): After enamel demineralization, the teeth were suspended in UDD remineralizing solution. The remineralization potential was assessed by Vickers microhardness testing, scanning electron microscopic examination (SEM), and energy dispersive X-ray (EDX). Results: The current study demonstrated an increase in the mean microhardness of CESP and UDD-treated groups; however, It was nearer to the baseline level in the UDD group. SEM imaging revealed greater enamel remineralization in the UDD group compared to the remaining groups. The UDD group disclosed complete coverage for the prismatic enamel compared to the CESP group, which revealed a partially remineralized enamel surface. Interestingly, the Ca/P ratio increased significantly in the CESP group compared to the negative control group. In contrast, a higher significant increase in the mean Ca/P ratios was recorded in the UDD group compared to the test groups. Conclusion: biomimetic UDD and CESP powder should be utilized to treat enamel early carious lesions. However, UDD demonstrated the most significant remineralization potential. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the tissue dissolving capacities of sodium and calcium hypochlorite [NaOCl and Ca(OCl)2] solutions applied without activation or with two irrigant activation methods. Materials and Methods: One hundred and eight dentin cavities were prepared. Preweighed tissue pieces were placed in these dentin cavities, and samples were divided into nine groups of twelve. In groups 1, 2, and 3, NaOCl was used with non-activation (NA), passive ultrasonic (PUA), and laser activation (LA). With the same techniques, Ca(OCl)2 was used in groups 4, 5, and 6, and distilled water was used in groups 7, 8, and 9. The weight loss of tissue samples was calculated and analyzed using Two-way ANOVA and Duncan tests. Results: Distilled water groups showed no tissue dissolution in any conditions. NaOCI and Ca(OCI)2 showed statistically similar dissolving effectiveness when used with the same technique. Activated groups dissolved significantly greater tissue than non-activated ones, the highest in LA. Conclusions: Ca(OCI)2 can be an alternative to NaOCl; for both, the first choice of activation may be the LA. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, 3D printing technology has revolutionized various fields, including dentistry. Provisional restorations play a crucial role in prosthetic rehabilitation, necessitating the evaluation of their bond strength with different provisional cement agents. Aims: This study is aimed at assessing the immediate and long‐term bond strength of 3D‐printed dental crowns using three provisional cement agents. Materials and Methods: Provisional crowns (N = 36) were manufactured using 3D modeling software and cemented in dentin analogues (G10 Nema resin). After the crowns' fabrication, they were randomly divided into three groups (n = 12) for cementation with Relyx Temp 3M ESPE, Provicol—VOCO, and Meron—VOCO. Tensile strength tests were conducted using a universal testing machine, with half of the specimens subjected to 2000 thermal cycles before testing. Finite element analysis was employed to assess tensile stress distribution. Results: Statistical analysis (two‐way ANOVA and Tukey's test at a 95% confidence level) revealed significant effects of cement type (p = 0.006) and thermal aging (p = 0.001) on bond strength. Glass ionomer cement exhibited the highest immediate resistance, while all types of cement were adversely affected by thermal aging, resulting in decreased bond strength. Conclusion: Thermal aging significantly alters the properties of 3D printing resin and affects the bond strength of provisional cement with 3D‐printed crowns. Despite the adverse effects of thermal aging, glass ionomer cement demonstrated the highest immediate resistance. Clinicians should carefully consider these findings when selecting provisional cements for 3D‐printed crowns. [ABSTRACT FROM AUTHOR]

Oral bacteria cause tooth caries and periodontal disease. Much research is being conducted to prevent both major oral diseases by rendering dental materials' antimicrobial potential. However, such antimicrobial materials are regarded as 'combination' products and face high hurdles for regulatory approval. We loaded inorganic montmorillonite with the antimicrobial agent cetylpyridinium chloride, referred to below as 'CPC-Mont'. CPC-Mont particles in a 1, 3 and 5 wt% concentration were added to the considered gold-standard self-etch adhesive Clearfil SE Bond 2 ('CSE2'; Kuraray Noritake) to render its antibacterial potential (CSE2 without CPC-Mont served as control). Besides measuring (immediate) bonding effectiveness and (aged) bond durability to dentin, the antibacterial activity against S. mutans and the polymerization-conversion rate was assessed. Immediate and aged bond strength was not affected by 1 and 3 wt% CPC-Mont addition, while 5 wt% CPC-Mont significantly lowered bond strength and bond durability. The higher the concentration of the antimicrobial material added, the stronger the antimicrobial activity. Polymerization conversion was not affected by the CPC-Mont addition in any of the three concentrations. Hence, adding 3 wt% CPC-Mont to the two-step self-etch adhesive rendered additional antimicrobial potential on top of its primary bonding function. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Immediate dentin sealing (IDS) was introduced to overcome the disadvantages of delayed dentin sealing like pollution of dentin tubules, microleakage, and bond strength destruction over time. The effect of IDS on the bond strength of indirect restorations is still debatable. Purpose: This study was conducted to determine the effect of IDS on the bond strength of ceramic restorations to dentin. Materials and Method: In this systematic review and meta-analysis, the study protocol was registered on the PROSPERO database under the registration number CRD420202014 27. MEDLINE (PubMed), Web of Science, Scopus, and ProQuest databases were searched until January 2021 and updated in January 2022. Worldcat.org and Opengrey.eu, ProQuest dissertation and thesis, and Google Scholar were searched to explore the grey literature. The in vitro studies evaluating the bond strength of ceramic restoration to dentin with and without IDS were included. Seven criteria were assessed to evaluate the risk of bias in the study. Statistical analyses were conducted using RevMan 5.3. The inverse variance method was used to determine the mean difference of micro-tensile bond strength (µTBS) and shear bond strength (SBS). Results: A total of 10 studies (20 datasets) were included in the meta-analysis. Regarding the µTBS analysis, IDS had a significantly higher bond strength than Delayed Dentin Sealing (DDS) (MD:1.16, 95%CI:0.28_2.03, I² =0%). However, no significant difference was found between them in the SBS analysis (MD:0.25, 95%CI: -0.56-1.06, I² =96%). All studies were categorized to have a moderate or high risk of bias. Conclusion: Most in vitro evidence showed favorable results for the effect of IDS on the bond strength and durability of indirect restorations. The adhesive system and the type of ceramic and its treatment before cementation are determining factors. Due to the heterogeneity of the outcomes and studies with a moderate/high risk of bias, the quality of the evidence was low. [ABSTRACT FROM AUTHOR]

Statement of the Problem: During endodontic therapy, irrigation solutions applied in the root canal may affect the physicochemical properties of the dentinal wall, thereby changing its microhardness. This may adversely affect the sealing ability and adhesion of dental materials. Therefore, many studies have focused on the search for an ideal root canal irrigant that has a minimal effect on dentinal microhardness. Purpose: This in vitro study was conducted to determine the changes in dentin microhardness after root canal irrigation with different endodontic irrigants. Materials and Method: Ninety-five freshly extracted maxillary central incisor teeth with straight single canals were selected. These teeth were sectioned transversely at the level of the cementoenamel junction. The working length of each tooth was determined, and canal space was prepared by the HyFlex CM rotary file system. During instrumentation, normal saline was used for irrigation. Then, teeth were split longitudinally into two segments. According to the irrigating solution employed, samples were divided into five groups (n=19): normal saline (Group A), 3% sodium hypochlorite (Group B), 2% chlorhexidine (Group C), 5% calcium hypochlorite (Group D), and 0.2% nanochitosan (Group E).3 mL of the corresponding irrigating solution was administered for total15 minutes in each prepared sample. The Vickers micro-hardness tester was then used to assess micro-hardness. The data was analyzed using one-way analysis of variance (ANOVA). Results: All tested irrigating solutions decreased the dentinal microhardness. Samples irrigated with 5% calcium hypochlorite demonstrated dentinal microhardness of 42.43± 1.62, which is the lowest among all the tested groups, followed by nano chitosan, sodium hypochlorite, and chlorhexidine. Samples treated with control group (saline) demonstrated the maximum microhardness of dentin in the present study. Conclusion: Within the limitations of this research, it can be concluded that the tested novel irrigating solutions, 5% calcium hypochlorite and 0.2% nanochitosan, were more detrimental to radicular dentin microhardness when compared with conventional endodontic irrigants. [ABSTRACT FROM AUTHOR]

Background: It is common to see patients who need orthodontic treatment but with insufficient alveolar bone volume. However, safe and effective tooth movement requires sufficient alveolar bone width and height. The aim of this study is to compare the bone augmentation efficacy of Autologous Partially Demineralized Dentin Matrix (APDDM) and Deproteinized Bovine Bone Mineral (DBBM) in orthodontic patients with insufficient bone by using a randomized controlled clinical trial approach. Materials and methods: Twenty-seven orthodontic patients involving 40 posterior teeth alveolar sites (n = 40) with insufficient alveolar bone volume were randomly divided into a control group (n = 20) and an experimental group (n = 20). The patients in the experimental group were treated with APDDM, and those in the control group were treated with DBBM. After surgery, the adjacent teeth are moved toward the bone grafting sites according to the orthodontic treatment plan. Patients completed a postoperative response questionnaire by the Visual Analogue Scale (VAS) score to indicate pain and swelling in the bone grafted area at the time of suture removal; and CBCT scans were conducted before surgery, 6 months and 2 years after surgery to assess changes in buccal and central alveolar heights, as well as widths at the alveolar ridge apex and 3 mm, 5 mm below the apex, respectively. The CBCT image sequences were imported into Mimics 21.0 software in DICOM format. The data of the patients in both groups were collected and analyzed by SPSS 25.0. Results: The VAS scores were significantly lower in the APDDM group than in the DBBM group (p < 0.05). Significant increases were observed in alveolar bone height and width at 6 months and 2 years postoperative (p < 0.05); At 2 years, the APDDM group exhibited a reduction in buccal crest height and in 3 mm, 5 mm width below alveolar ridge apex, relative to 6 months (p < 0.05), while the DBBM group showed a decrease only in the central height of the alveolar bone (p < 0.05). There was a significant bone augmentation increase found only 3 mm below the alveolar ridge apex in the APDDM group compared with the DBBM group among all 6 months group comparison (p < 0.05). At 2 years, the augmentation effects were similar across both groups (p > 0.05). Conclusion: Radiomics analysis indicates that APDDM serves as a viable bone augmentation material for orthodontic patients with insufficient alveolar bone volume, achieving comparable clinical efficacy to DBBM. Additionally, APDDM is associated with a milder postoperative response than DBBM. The registration number (TRN): ChiCTR2400084607. [ABSTRACT FROM AUTHOR]

Background: The purpose of this in vitro study was to compare and evaluate the stress distribution of maxillary first premolar residual crowns restored with post-core crowns, endocrowns and inlay crowns after deep margin elevation, to explore the fitting restoration for residual crowns using finite element analysis. Methods: A healthy complete right maxillary first premolar from a male adult was scanned by cone beam computed tomography (CBCT). The finite element model of the tooth was established by reverse engineering software such as Mimics, Geomagic and Hypermesh. On this basis, the residual crown model after deep margin elevation was made, and the experimental group models were divided into three groups, those restored with post core crowns, endocrowns and inlay crowns. Vertical and oblique static loads were applied to the experimental models to simulate the force on the tooth during mastication (the loading position was located in the central fossa of the occipital surface, and the load was 100 N) using Abaqus software. Results: The peak value and distribution of von Mises stress in each part of the experimental model were observed. After deep margin elevation, the peak dentin von Mises stresses were lower than the tensile strength of normal dentin in the post-core crown, endocrown, and inlay crown groups; the lowest stress results were found in the post-core crown group for the dentin, restoration, enamel, and deep margin elevation (DME) layers under vertical and oblique loading. In terms of stress distribution clouds, the peak stresses in the dentin tissue were located in the apical 1/3 of the root after postcore crown restorations for both loads, while stress concentrations were evident in the cervical and root areas after endocrown and inlay crown restorations; regardless of the load and restoration method, the corresponding stress concentration areas appeared at the junction of the DME and dentin tissue at the loading site of the restorations; Conclusions: Post-core crowns, endocrowns and inlay crowns can be used to restore residual crowns after deep margin elevation, and post-core crowns can better protect the residual tooth tissue. [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]

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Introduction: Peri-implantitis is a serious complication in dental implantology that, if left untreated, may lead to implant loss and systemic diseases. Effective regeneration of bone defects resulting from peri-implantitis is crucial to maintaining the functionality of dental implants. Purpose of the Study: The study aimed to compare the effectiveness of fine-particle dentin and Bio-Oss in the reconstruction of bone defects caused by peri-implantitis. Materials and Methods: The study included a comprehensive radiological assessment of changes in bone density over time. Bone density was assessed using Hounsfield Units (HUs) as a measure of bone attenuation, with radiological assessments performed at 8- and 12-week intervals during the healing process. The study included participants ranging in age from 30 to 65 years. Fifty-seven patients were divided into three groups: 22 patients received small-particle dentin, 15 received Bio-Oss, and 20 controls without bone substitute material. Results: The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine dentin group, 85% in the Bio-Oss group, and 70% in the control group. The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine-dentin group, 85% in the Bio-Oss group, and 70% in the control group. Conclusions: Both fine-particle dentin and Bio-Oss significantly improved bone density compared to the control group. Fine-particle dentin is suitable for immediate bone regeneration due to its rapid initial regeneration, while Bio-Oss provides long-term support, ideal for maintaining implant stability over a longer period of time. The results highlight the importance of selecting appropriate bone replacement materials depending on the clinical scenario to improve patient outcomes after dental implant placement. [ABSTRACT FROM AUTHOR]

Objective: This systematic review aims to evaluate the potential benefits and underlying mechanisms of combining SDF with light curing, based on available studies. Materials and methods: A systematic search of publications was conducted with the keywords "silver diamine fluoride" or "silver fluoride" and "dental light curing," "LED curing," "dental laser," and "dental polymerization" in 4 databases: PubMed, EBSCO, Scopus, and Google Scholar to identify English-language articles published up to March 2023. Duplicate publications were deleted. Two reviewers screened the titles and abstracts and excluded irrelevant publications. The full text of the remaining publications was retrieved. Studies investigating the effect of light-curing on SDF-treated carious lesions were included. Results: The 175 publications initially found included 5 laboratory studies investigating the effects of light curing on 38% SDF-treated dentine carious lesions, but no clinical study was found. Four of these studies were conducted on extracted primary teeth, and one was on extracted permanent teeth. SDF with light curing increased microhardness (n = 3, p <.05) showed a higher mineral density (n = 1, p <.041) and had more silver ion precipitation in infected dentine (n = 1, p <.016) compared to SDF without light curing. Moreover, no significant differences in the antibacterial activity were observed between SDF with light curing and SDF alone (n = 1, p >.05). Conclusion: Drawing from the limited number of laboratory studies, incorporating light curing subsequent to the SDF application yields potential favorable outcomes that include augmented microhardness, elevated mineral density, and heightened silver ion precipitation within infected dentine. Future clinical research is required to confirm or refute the benefit of light curing on SDF-treated carious lesions. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the effects of the titanium dioxide (TiO2) concentration and particle size in hydrogen peroxide (HP) on tooth bleaching effectiveness and enamel surface properties. Methods: TiO2 at different concentrations and particle sizes was incorporated into 40% HP gel to form an HP/TiO2 gel. The specimens were randomly divided into 8 groups: C1P20: HP + 1% TiO2 (20 nm); C3P20: HP + 3% TiO2 (20 nm); C5P20: HP + 5% TiO2 (20 nm); C1P100: HP + 1% TiO2 (100 nm); C3P100: HP + 3% TiO2 (100 nm); C5P100: HP + 5% TiO2 (100 nm); C0: HP with LED; and C0-woL: HP without LED. Bleaching was conducted over 2 sessions, each lasting 40 min with a 7-day interval. The color differences (ΔE00), whiteness index for dentistry (WID), surface microhardness, roughness, microstructure, and composition were assessed. Results: The concentration and particle size of TiO2 significantly affected ΔE00 and ΔWID values, with the C1P100 group showing the greatest ΔE00 values and C1P100, C3P100, and C5P100 groups showing the greatest ΔWID values (p < 0.05). No significant changes were observed in surface microhardness, roughness, microstructure or composition (p > 0.05). Conclusions: Incorporating 1% TiO2 with a particle size of 100 nm into HP constitutes an effective bleaching strategy to achieve desirable outcomes. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to assess how the application mode of a universal adhesive system affects the microshear bond strength (μSBS) of bulk‐fill and conventional composite resins to enamel and dentin in primary teeth. Methods: A total of 80 caries‐free primary second molars were randomly assigned to eight experimental groups (n = 10) based on the bonding substrate (enamel or dentin), the application mode of the universal adhesive system (etch and rinse [E&R], or self‐etch [SE]), and the type of composite resin used (bulk‐fill or conventional). After bonding the composite resin to enamel or dentin, the μSBS of the bonded composite resins was measured. Results: The mean μSBS value of bulk‐fill composite resin was significantly higher than that of conventional composite resin for both enamel and dentin substrates, regardless of the application mode (p < 0.001). An interaction effect between the bonding substrate and the application mode of the adhesive system was observed, indicating a significant relationship (p < 0.001). The highest μSBS values for primary teeth enamel were achieved using the E&R mode with bulk‐fill composite resin, while for dentin specimens, the SE mode with bulk‐fill composite resin yielded the highest μSBS values. The μSBS of the E&R group was significantly higher than that of the SE group for enamel specimens (p < 0.001), whereas the μSBS of the SE group was significantly higher than that of the E&R group for dentin specimens (p < 0.001). Conclusion: Bulk‐fill composite resin demonstrated higher μSBS in comparison to conventional composite resin. The universal adhesive system exhibited superior performance in the SE mode compared to the E&R mode on primary dentin. Pre‐etching the enamel before the application of the universal adhesive enhanced the μSBS to primary teeth enamel, highlighting the importance of selectively acid etching the enamel of primary teeth. [ABSTRACT FROM AUTHOR]

This study investigated the marginal adaptation of three recently introduced bioceramic root repair materials, EdgeBioCeramic RetroFill, Endocem MTA, and One-Fil PT, using VP-SEM analysis. Extracted single-rooted lower incisors were used to simulate retrograde fillings. The results showed no statistically significant differences in the marginal gap between the materials and the dentin walls. All three materials exhibited good dimensional stability, with gap sizes comparable to previously published research on similar materials. The mean GAP was 3.91 ± 2.56 for EdgeBioCeramic RetroFill, 4.32 ± 2.69 for Endocem MTA, and 4.50 ± 2.54 for One-Fil PT. This study employed VP-SEM, a valuable tool for analyzing bioceramic materials without altering their properties. The findings suggest the possibility of daily clinical use of these bioceramics by endodontists and general practitioners that could find applications in retrograde fillings and perforation repairs. However, further in vivo studies are needed to confirm long-term stability and assess the influence of sample preparation methods. [ABSTRACT FROM AUTHOR]

Background: Dental caries is the most common oral disease in the world. When treatable, the drilling method continues to be used. This technique has its disadvantages because it is invasive and nonspecific. Chemomechanical carious tissue removal agents (CCRAs) such as Carisolv™ or Papacarie® are non-invasive products that allow for the specific elimination of infected dentin. On the other hand, cariogenic bacteria are largely responsible for the initiation and development of lesions. Objectives: The aim is to analyze whether CCRAs have a relevant antimicrobial effect on cariogenic bacteria. Methods: A bibliographic search strategy was carried out in online databases using PRISMA 2020. The evaluation of the antibacterial efficacy of CCRAs was carried out through the analysis of the reduction in CFUs of cariogenic bacteria, and the presence of bacterial deposits, TVC, SVC and LVC by comparison with conventional drilling methods. Results: The results showed that the percentage of reduction in TVC, SVC and LVC for each agent is mostly high, but not significantly different from mechanical methods. The best results were found with CCRAs when compared to polymeric drills. The results also showed that there is a lack of methodological standardization. Conclusions: CCRAs have been shown to have a relevant antimicrobial effect on cariogenic bacteria; however, more studies need to be carried out using standardized methodologies. [ABSTRACT FROM AUTHOR]

Background: The global rise in the elderly population has increased the prevalence of root caries. Streptococcus mutans, Lactobacilli and Actinomyces are considered the primary pathogens of dental caries in culture-based studies. This study aimed to investigate bacterial profiles in coronal and root caries lesions and determine the association of specific bacterial genera at each site. Methods: Dentine samples from carious lesions were collected from 22 extracted teeth using an excavator. Microbial DNA was extracted from the samples using a protocol developed for this study. 16S rRNA gene amplicon sequencing was employed for microbial analysis. PCR amplification targeted the V3-V4 region of the bacterial 16S rRNA, and the amplicon sequencing used an Illumina MiSeq system (2 × 300 bp paired-end reads). Statistical analysis was performed by the Phyloseq and DESeq2 packages in R. Results: In coronal caries, Olsenella, Lactobacillus and Prevotella were the most prevalent genera, comprising approximately 70% of the microbiome community. In the root caries, however, although Olsenella, Prevotella and Lactobacillus remained the dominant genera, they accounted for only half of the microbiome community. This study identified significant differences in alpha diversity indices between the coronal and root caries. LEfSE analysis revealed several unique genera in each caries lesion. Conclusion: The microbiome of root caries lesions was richer and more complex than the coronal caries microbiota. The results suggest that lesion-related variations in the oral microflora may be detected in carious dentine. [ABSTRACT FROM AUTHOR]

This study evaluated the biocompatibility, bioactivity, porosity, and sealer/dentin interface of Sealer Plus BC (SP), Bio-C Sealer (BIOC), TotalFill BC Sealer (TF), and AH Plus (AHP). Dentin tubes filled with the sealers and empty tubes (control group) were implanted in the subcutaneous tissue of rats for different periods (n = 6 per group/period). Number of inflammatory cells (ICs), capsule thickness, von Kossa reaction, interleukin-6 (IL-6) and osteocalcin (OCN) were evaluated. Porosity and voids in the interface dentin/sealers were assessed by micro-computed tomography. The data were submitted to ANOVA/Tukey's tests (α = 0.05). Greater capsule thickness, ICs and IL-6 immunolabeling cells were observed in AHP. No significant difference in thickness of capsule, ICs, and IL-6- immunolabeling cells was detected between SP and TF, in all periods, and after 30 and 60 days between all groups. At 60 days all groups had reduction in capsule thickness, ICs and IL-6 immunolabeling cells. Von Kossa-positive and birefringent structures were observed in the capsules around the sealers. BIOC, SP, and TF exhibited OCN-immunolabeling cells. All sealers had porosity values below 5%, besides low and similar interface voids. BIOC, SP and TF are biocompatible, bioactive, and have low porosity and voids. The dentin-tube model used is an alternative for evaluating bioceramic materials. [ABSTRACT FROM AUTHOR]

Background: Recent studies have reported the inhomogeneity in the light emitted by dental light-curing units (LCUs). It is essential to understand how this uneven light distribution affects the physical properties of resin-based composites (RBCs) at various points across their surfaces. This study aimed to evaluate the effect of LCU beam's inhomogeneity on the microhardness of RBCs with different shades and thicknesses. Methods: Four body (A1B, A2B, A3B, and A4B), one dentin (A3D), and one enamel shade (A3E) of RBC (Filtek Z350 XT) were examined. The specimens were fabricated in four thicknesses (1, 2, 3, and 4 mm) and subjected to a 40-second light-curing. Vickers microhardness testing was performed at the center point, and 3 mm left and right from the center at the bottom surface of each sample. The LCU beam profile was characterized using a beam profiler, while irradiance after specimen passage was measured using a spectrometer. One-way analysis of variance (ANOVA) and Tukey's post-hoc tests were used to analyze the effects of shades and thicknesses on irradiance and microhardness, respectively. One-way repeated-measures ANOVA was used to compare the microhardness across different points. Pearson's correlation analysis examined the relationship between irradiance and microhardness. Results: The beam profile of LCU revealed inhomogeneous light distribution. Light irradiance was decreased with both the increase in thickness and darker shade of the specimens (p < 0.05). Microhardness was found to decline with an increase in sample thickness (p < 0.05), and was consistently higher at the center point compared to the periphery, particularly in thicker (3 and 4 mm) and darker shades (A3B, A4B, and A3D). A positive correlation was found between the irradiance and microhardness across all evaluated points (p < 0.05). Conclusions: Inhomogeneous light emission from LCU significantly influences the microhardness of RBC samples, depending on the thicknesses and shades. The findings underline the importance of considering LCU beam inhomogeneity in clinical settings to ensure optimal polymerization of RBC. [ABSTRACT FROM AUTHOR]

Background: The healing process after tooth removal involves bone remodelling which implies some loss of alveolar bone volume. Among materials proposed for minimising this remodelling and preserving the bone, autologous dental tissue is a promising option, but more data are needed. In this context, we evaluated size and density changes using cone beam computed tomography in autologous dental material (ADM)-preserved sockets compared to controls, and assessed biological responses by histological analysis. Methods: A split-mouth study was conducted including 22 patients, who underwent removal of ≥ 2 single-rooted teeth with intact sockets, assigning one socket to the experimental group which received ADM for alveolar preservation and another to the control group, which only underwent blood clot stabilisation. Cone beam computed tomography was performed postoperatively (week 0) and at weeks 8 and 16 to assess socket size and bone density. Histological analysis was carried out on trephine biopsies taken (Ø4 × 4.5 mm) from the experimental group. Results: Less horizontal shrinkage was observed in the ADM group, especially at week 16 considering the group-by-time interaction for the following variables: difference in height between the lingual and buccal alveolar crests (-1.00; p <.01; 95% CI: -0.28 – -1.73), and half-widths, measured as the distance from the long axis of the missing tooth to the buccal alveolar crest at 1 mm (-0.61; p <.01; 95% CI: -0.18 – -1.04) and at 3 mm (-0.56; p <.01; 95% CI: -0.15 – -0.97) below the crest, with mean decreases of 1.07 and 2.14 mm in height difference, 0.66 and 1.32 mm in half-width at 1 mm and 0.43 and 1.02 mm in half-width at 3 mm in ADM and control groups respectively. Densitometry analysis showed higher bone densities in Hounsfield units in the ADM group considering all factors analysed regardless of time point and socket third (coronal, middle, or apical). Histologically, there were no signs of inflammation or foreign body reaction, and dentin particles were surrounded by and in close contact with bone tissue. Conclusion: These results add to the evidence that dentin can be used successfully as a material for alveolar socket preservation, given its desirable mechanical and biological properties, and warrant larger studies. [ABSTRACT FROM AUTHOR]

Odontodysplasia is an uncommon dental developmental disorder associated with enamel, dentin, pulp abnormalities, and overall tooth morphology. The affected tooth is grossly abnormal in size and contour and is commonly associated with swelling of the affected area and failure of eruption. Histologically, the enamel and dentin are hypoplastic and hypomineralized. Odontodyplasia occurs most commonly in response to direct trauma to the developing tooth bud (enamel organ and dental follicle). Data on the prevalence and features of non-traumatic odontodysplasia are lacking. Medical records of dogs diagnosed with odontodysplasia were reviewed at the William R. Pritchard Veterinary Medical Teaching Hospital (VMTH), University of California, Davis, for 10 years (from 2013 to 2023). Dogs with a known history of facial trauma, persistent deciduous tooth or teeth over the region of odontodysplastic tooth or teeth, and endodontic disease of the persistent deciduous tooth or teeth were excluded from the study. Twenty-eight dogs were included in this retrospective study, representing an incidence of 1.4 per 100 dogs presenting over 10 years. Regional odontodysplasia (RO) was identified in twenty-two dogs, and generalized odontodysplasia (GO) was found in six dogs. Both comprehensive oral examination and diagnostic imaging were essential in diagnosing and assessing the presence of odontodysplasia. Awake oral examination failed to identify odontodysplasia in almost 70% of the RO cases. Secondary diseases or lesions in odontodysplastic teeth, such as periodontal disease, endodontal disease, and perio-endo lesions, were commonly seen and were particularly more frequently identified in strategic teeth (canine and carnassial teeth) than non-strategic ones. Similarities, such as female predilection, maxilla more commonly affected, and clinical signs, were observed between RO in dogs and those reported in people. The exact etiology of non-traumatic odontodysplasia remains elusive, and the condition may be of multifactorial causality. [ABSTRACT FROM AUTHOR]

Background: This study aims to determine the smear layer removal from the root canals using different irrigant solutions with diode laser. Methods: A set of sixty human upper incisor teeth were chosen. Access cavity preparation was done followed by canal instrumentation. Samples were divided into six groups (Group A: sodium hypochlorite NaOCl, Group B: NaOCl + diode laser, group C: NaOCl + EDTA ethylene diamine tetra-acetic acid solution, Group D: NaOCl + EDTA + diode laser, Group E: NaOCl + garlic extract, Group F: NaOCl + garlic extract + diode laser. Examining the smear layer removal at the coronal, middle and apical thirds of the root canals was done by using electron microscope analysis. Using an energy-dispersive X-ray, the calcium/phosphorus Ca/P ratio was measured. Results: Among the examined groups, there were not any significant differences regarding the smear layer removal. The elimination of smear layers at the middle and coronal thirds was greater in all examined groups than in the apical third. EDX analysis revealed no statistically significant variation between the tested groups. Conclusions: Using diode laser with sodium hypochlorite and ethylene diamine tetra-acetic acid irrigant solution was more effective for the elimination of smear layers. Garlic extract could be used as an alternative irrigant solution in debris removal. [ABSTRACT FROM AUTHOR]

The incorporation of automatic segmentation methodologies into dental X-ray images refined the paradigms of clinical diagnostics and therapeutic planning by facilitating meticulous, pixel-level articulation of both dental structures and proximate tissues. This underpins the pillars of early pathological detection and meticulous disease progression monitoring. Nonetheless, conventional segmentation frameworks often encounter significant setbacks attributable to the intrinsic limitations of X-ray imaging, including compromised image fidelity, obscured delineation of structural boundaries, and the intricate anatomical structures of dental constituents such as pulp, enamel, and dentin. To surmount these impediments, we propose the Deformable Convolution and Mamba Integration Network, an innovative 2D dental X-ray image segmentation architecture, which amalgamates a Coalescent Structural Deformable Encoder, a Cognitively-Optimized Semantic Enhance Module, and a Hierarchical Convergence Decoder. Collectively, these components bolster the management of multi-scale global features, fortify the stability of feature representation, and refine the amalgamation of feature vectors. A comparative assessment against 14 baselines underscores its efficacy, registering a 0.95% enhancement in the Dice Coefficient and a diminution of the 95th percentile Hausdorff Distance to 7.494. [ABSTRACT FROM AUTHOR]

The use of micro-computed tomography (micro-CT) has become widespread in the examination of dental tissue due to its great precision in small-scale work. Its usefulness in measuring tissue mineral density has been demonstrated; however, it is necessary to develop image acquisition protocols that ensure the reproducibility of observations and offer a detailed step-by-step process. This study proposes a standardised protocol to quantify mineral density using volumetric measurements from micro-CT images, evaluating the reproducibility of density measurements at different points of enamel and dentine. The sample comprised 30 bovine incisors that were scanned using a micro-CT system. Using the MIMICS software v.26, seven reference points in enamel and dentine (crown, cervix, and root) were identified, and mineral density was calculated by using Hounsfield units. The reproducibility of the measurements among the three observers was assessed by calculating Lin's concordance correlation coefficient (CCC). There was substantial to almost perfect correlation for the enamel (CCC = 0.986–0.995) and dentine (CCC = 0.965–0.997), with the latter showing better results for the cervix (CCC = 0.987–0.997) and crown (CCC = 0.987–0.995) compared with the root (CCC = 0.965–0.985). In the lingual area, the concordance results were broader (CCC = 0.965–0.997) compared with the buccal area (CCC = 0.979–0.995). Despite this difference, the proposed volumetric measurements reached a high level of agreement, which demonstrates the replicability of the present protocol. [ABSTRACT FROM AUTHOR]

Background: Azathioprine is one of the earliest immunosuppressants prescribed for several autoimmune diseases. Yet there is a lack of research on the impact of azathioprine on pulp healing following the pulp capping procedure. Aim: This study aimed to investigate the effect of azathioprine on the healing ability of mechanically exposed dogs' dental pulps following direct pulp capping with mineral trioxide aggregate (MTA), bio-aggregates (BA), and Calcium hydroxide (Ca(OH)2). Methods: Four mongrel dogs were randomly assigned to two groups (two dogs/30 teeth in each group): immunosuppressed (group I) and control (group II). Group I received azathioprine for two months before surgical treatments and until the dogs were euthanized. Fifteen class V buccal cavities were performed in each dog. Each group was randomly divided into three subgroups (10 teeth each) based on the pulp capping substance. The pulps in subgroups A, B, and C were immediately capped with MTA, BA, and Ca(OH)2, respectively. Inflammation and dentine bridge development were histopathologically evaluated and scored at one and two months. The data were statistically analyzed. Results: The immunosuppressed group exhibited statistically greater inflammatory cell count and decreased dentine bridge thickness, compared to the control group in all subgroups (p < 0.05). Conclusion: Azathioprine has an adverse effect on the healing of exposed dogs' dental pulp following direct pulp capping with MTA, BA, and Ca(OH)2. Therefore, patients using azathioprine as an immunosuppressive medication may experience delayed healing of mechanically exposed pulps following capping with MTA, BA, or Ca(OH)2. [ABSTRACT FROM AUTHOR]

Atlantoceratodus iheringi (Ameghino, 1898) from Argentine territory is restudied based on its known tooth plates and newly discovered material, which includes previously unknown skull roof bones and vomerine tooth plates. The latter represent the first records of such elements from the Mesozoic era in South America. The comparative morphological analysis reveals its distinctiveness from other dipnoans, and offers valuable data for future systematic and phylogenetic research. The pterygopalatine tooth plates display narrow-based first denticulations and lack anterior wear facets, with the inner angle positioned at the level of the second denticulation. Similarly, the prearticular tooth plates feature straight mediolingual edges, and a wide-based first denticulation without sinuosities at the tip. Histological sections are performed and analyzed in detail for the first time. A. iheringi presents in this aspect distinctive features such as: large-lumen denteons tending to cluster together, circumdenteonal dentine arranged in a double band (an inner birefringent and an outer monorefringent), and a disordered interdenteonal dentine, with birefringence surrounding denteons and areas with monorefringence. A. iheringi exhibits histological structure closer to Mesozoic and Cenozoic dipnoans than Paleozoic, especially resembling the disposition observed in the Upper Cretaceous Patagonian species Metaceratodus baibianorum. The wide distribution of features designated as diagnostic for Atlantoceratodus is discussed. [ABSTRACT FROM AUTHOR]

Dentin pulp has a complex function as a major unit in maintaining the vitality of teeth. In this sense, the Wnt/β-Catenin pathway has a vital part in tooth development, maintenance, repair, and regeneration by controlling physiological activities such as growth, differentiation, and migration. This pathway consists of a network of proteins, such as Wnt signaling molecules, which interact with receptors of targeted cells and play a role in development and adult tissue homeostasis. The Wnt signals are specific spatiotemporally, suggesting its intricate mechanism in development, regulation, repair, and regeneration by the formation of tertiary dentin. This review provides an overview of the recent advances in the Wnt/β-Catenin signaling pathway in dentin and pulp regeneration, how different proteins, molecules, and ligands influence this pathway, either upregulating or silencing it, and how it may be used in the future for clinical dentistry, in vital pulp therapy as an effective treatment for dental caries, as an alternative approach for root canal therapy, and to provide a path for therapeutic and regenerative dentistry. [ABSTRACT FROM AUTHOR]

Application of alveolar bone graft (ABG) in alveolar augmentation is done to prevent excessive bone resorption due to tooth extraction, missing teeth, or other diseases/conditions affecting the alveolar bone. The use of autogenous dentin-derived ABG has been considered as the composition of dentin appears to be nearly analogous to that of bone. This systematic review aims to assess the efficacy of dentin-derived ABG for alveolar augmentation of post-extraction sockets or other alveolar bone defects by evaluating volume gain and histomorphometric data. A search of systematic literature was conducted in Pubmed, Scopus, Web of Science, and Embase from database inception to October 2023. The review included both randomized controlled trials (RCT), pilot studies, clinical trials, and retrospective studies reporting on dentin-derived ABG use for alveolar augmentation. Overall, 298 articles were obtained from the initial search. From these articles, 21 articles met the inclusion criteria and were included for descriptive analysis. All of the studies indicated low risk of bias. Studies of dentin-derived ABG, which used bone-derived grafts as the control group, have shown significantly higher percentages of new bone formation, gain in vertical and horizontal dimensions, and less reduction in dimensions. Dentin-derived ABG was effective in volume maintenance, indicating promising results via histomorphometric and radiographic analysis. [Display omitted] [ABSTRACT FROM AUTHOR]

External cervical resorption (ECR) is an aggressive disease characterized by resorption of the tooth root structure. While the pericanalar resorption-resistant sheet (PRRS) impedes ECR progression towards the pulp, the underlying mechanisms of its protective role in human teeth remain unclear. This study aimed to elucidate the pathology of ECR in a 31-year-old female patient by employing radiographic, histological, and immunohistochemical analyses of an extracted tooth. Histological examination revealed that the PRRS comprised dentin, predentin, and reparative bone-like tissue. Notably, clastic cells were observed on the surfaces of all three tissues within the same specimens. Immunohistochemical staining for cathepsin K demonstrated diminished resorptive activity of clastic cells on predentin compared to dentin and bone-like tissue. These findings suggest a potential role for predentin in attenuating clastic cell activity, potentially serving as the final barrier safeguarding the pulp tissue. [ABSTRACT FROM AUTHOR]

4-methacryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin is used for indirect restorations. We aimed to evaluate effects of immersion in 4-META/MMA-TBB-activated liquid on the bond strength of root canal dentin. We used freshly extracted single-rooted human teeth. After decoronation, each root was vertically sectioned into halves; their dentin walls were polished and flattened. The control group underwent dentin treatment with Green Activator. The immersion group was treated with Green Activator and Teeth Primer and immersed in 4-META/MMA-TBB-activated liquid. After bonding the resin blocks with Super-Bond, microtensile bond strength (μTBS) tests were performed (n = 6), and fracture surfaces were analyzed. Before surface treatment, dentin was immersed in a sodium fluorescein solution for 3 h, and resin blocks were bonded with Super-Bond with rhodamine B as in the bond strength test. The bonded cross section was observed using confocal laser scanning microscopy (CLSM). μTBS was significantly higher in the immersion group than in the control group (61.5 [51.3–66.7] vs. 33.0 [20.4–57.8] MPa; P < 0.05). Fracture mode analysis showed that, compared with the control group, the immersion group had a significantly lower rate of adhesive failure at the dentin interface and a significantly higher rate of cohesive failure in Super-Bond (P < 0.01). CLSM showed a water droplet-like accumulation of fluorescein dye above the hybrid layer in the control group, not in the immersion group. Immersion in a 4-META/MMA-TBB-activated liquid inhibited water exudation from the root canal dentin and improved the bond strength. [ABSTRACT FROM AUTHOR]

The dental adhesive market is constantly evolving to meet the demands of dentists and patients, but new products and upgrades should be rigorously evaluated before being used in clinical practice. This study investigated the physicomechanical properties and dentin bonding efficacy of a newly upgraded universal adhesive compared to its predecessor. Twenty-four molars were divided into four groups (n = 6/group) based on adhesive (new vs. predecessor) and application mode [self-etch (SE) vs. etch-and-rinse (ER)] for evaluating their dentin microtensile bond strength (μTBS), failure pattern, and bonding interface. Additional thirty-six molars' crowns were perpendicularly sectioned to obtain flat mid-coronal dentin discs. The opposing dentin surfaces of each disc received contrasting treatments (new/predecessor adhesive applied in SE/ER mode), resulting in six interventions. The bonded discs (n = 6/intervention) were used to assess the adhesives' survival probability employing a double-sided μTBS test. The other physicomechanical properties examined were adhesives' oxygen inhibition layer (OIL), viscosity, hardness, elastic modulus, degree of conversion (DC), and in-situ DC. Both adhesive versions showed similar μTBS (P > 0.05), failure pattern (P > 0.05), and survival probability (P > 0.008). ER mode promoted resin tag formation and exhibited a slender adhesive layer for both adhesives. The newer adhesive version showed a thinner adhesive layer in general with narrower OIL (P < 0.001), less viscosity (P < 0.001), higher hardness (P < 0.05), elastic modulus (P < 0.05), DC (P < 0.001), and in-situ DC (P < 0.001). While the newly updated adhesive had superior physicomechanical properties with more fluidity, its dentin bonding efficacy and survival probability were comparable to its predecessor. [ABSTRACT FROM AUTHOR]

Copyright of Current Research in Dental Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Current Research in Dental Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: Endodontic success hinges on a multifactorial interplay, with meticulous canal shaping, proper disinfection, and three-dimensional obturation being paramount. Among these factors, the amount of dentin remaining after instrumentation directly influences the biomechanical resilience and longevity of the tooth. Aims: This study aims to evaluate the impact of various rotary instrumentation systems, including single-file, two-file, and multiple-file configurations, on the remaining dentin thickness (RDT) following canal preparation. Settings and Design: This was an in vitro study, original research article. Materials and Methods: Sixty mandibular premolar human extracted teeth were decoronated at the cementoenamel junction with a diamond disc. Samples were randomly assigned to three groups using a simple random sampling technique (n = 60). Group I - Single-file system (One Curve, MicroMega) (n = 20), Group II - Two-file systems (2Shape, MicroMega) (n = 20), and Group III - Multiple-file system (Hero Gold, MicroMega) (n = 20). Preoperative cone-beam computed tomography (CBCT) scans were obtained after the sample was mounted on a modeling wax sheet. The biomechanical preparation of canals followed the manufacturer's protocols for every system. Postoperative CBCT scans were obtained. Pre- and postoperative scans were compared at standardized depths (4 mm, 7 mm, and 11 mm) within the canals (coronal, middle, and apical thirds), allowing for a comprehensive assessment of RDT throughout the canal. Statistical Analysis and Results: According to one-way ANOVA, the highest mean was seen in Group I, followed by Group II and Group III. Hence, a statistically significant difference was found between all the groups. Post hoc Tukey's test was done for intergroup comparison. Conclusions: A single-file system preserved more dentin with less aggressive cutting compared to two-file and multiple-file systems. [ABSTRACT FROM AUTHOR]

Aim: The objective of the present research was to assess and compare the residual dentin thickness after biomechanical preparation of teeth using three distinct rotary nickel-titanium (Ni-Ti) file systems. Materials and Methods: In the current experimental study, a total of 45 single-rooted teeth were selected for the analysis. The cementoenamel junction of each tooth was decoronated using a diamond disc. The teeth were randomly allocated to three groups, with each group representing a different rotary file system: Group 1: Hero GOLD (Micro Mega), Group 2: One Curve (Micro Mega), and Group 3: HyFlex electro-discharge machining (EDM) (Coltene-Whaledent, Altstatten, Switzerland). To evaluate the initial condition of the teeth, cone-beam computed tomography (CBCT) scans were conducted before the biomechanical preparation. The teeth were positioned on a modeling wax sheet, and the CBCT scans provided baseline measurements. The biomechanical preparation of the root canals followed the manufacturer's recommended guidelines for each file system. After the completion of the canal preparation, follow-up CBCT scans were conducted. The postprocedure CBCT scans were then compared with the initial scans to assess any changes in the residual thickness of dentin in the teeth. Statistical Analysis: Post hoc Tukey analysis of variance tests was utilized to examine differences between the groups. A statistically significant result was defined as P = 0.05 or less for every test. Results: The comparison of preinstrumentation and postinstrumentation CBCT images showed that the HyFlex EDM group removed less dentin clinically compared to the other two groups, i.e., Hero GOLD and One Curve. No significant statistical difference was found between Hero GOLD versus One Curve, One Curve versus HyFlex EDM, and Hero GOLD versus HyFlex EDM. Conclusion: Based on the results of this study, the HyFlex EDM file system exhibited superior cutting efficiency at various levels. Nonetheless, additional investigations are required to comprehensively assess the influence of Ni-Ti rotary file systems on the remaining dentin thickness. [ABSTRACT FROM AUTHOR]

Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after 20 days of treatment with a tri-antibiotic paste (ciprofloxacin, metronidazole, and minocycline), and with a double-antibiotic paste (ciprofloxacin and metronidazole), with calcium hydroxide [Ca(OH)2] UltracalTM XS-treated dentin as comparison. Material and Methods: Human mandibular premolars (n = 48) had the root canals cleaned and shaped and were used to produce dentin slices. Dentin slices remained immersed in the medications for 20 days. The Knoop microhardness (KHN) test was performed before (baseline/Day-0) and after treatment (Day-20) with the medications. Indentations were made at 25 µm, 50 µm, and 100 µm distances from the root canal lumen. The KHN was compared intra-group using Wilcoxon's test. Independent groups were compared using Mann–Whitney's and Kruskal–Wallis' tests, at α = 5%. Results: The microhardness in all the tested groups was reduced at Day-20 in comparison with Day-0 (p < 0.001) (intra-group comparison/same distances). The Day-0 values were similar, and the Day-20 values were higher for the Ca(OH)2 group (p < 0.05) (comparison between groups/same distances). Conclusions: Calcium hydroxide for 20 days would be preferred rather than antibiotic pastes to minimize the expected reduction in dentin microhardness during regenerative procedures. [ABSTRACT FROM AUTHOR]

Ionizing radiation in therapeutic doses alters the composition and properties of dentin and resin composites. This may influence the adhesion of restorative materials to irradiated dentin and compromise the success of the restorative treatment. The objective of this study was to evaluate the effect of ionizing radiation on the shear bond strength (SBS) of bulk-fill composite materials to dentin. Coronal dentin slabs (N = 90) were embedded in acrylate and randomly assigned to six groups (N = 15) depending on the time of radiation (70 Gy) and material (SDR Plus Bulk Fill Flowable and Tetric EvoFlow Bulk Fill (TET)): (1) control group (CG) SDR; (2) CG TET; (3) radiation + SDR; (4) radiation + TET; (5) SDR + radiation; and (6) TET + radiation. Composite cylinders were bonded to the dentin slabs using Scotchbond Universal Plus Adhesive. The specimens were stored in distilled water and fractured in shear mode after 7 weeks. Radiation before and after restoration resulted in an SBS decrease. The SBS was statistically significantly lower in groups 5 and 6 (p < 0.05). The difference between the bulk-fill composites was not significant (p > 0.05). In the CGs, adhesive fractures prevailed. In groups 3 and 4, cohesive fractures in the dentin were more frequent, and in groups 5 and 6, cohesive fractures in the material. Radiotherapy affects the SBS of bulk-fill composites to dentin. Immediate radiation after restoration resulted in the lowest SBS in both bulk-fill composite materials. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Immediate dentin sealing (IDS) was introduced to overcome the disadvantages of delayed dentin sealing like pollution of dentin tubules, microleakage, and bond strength destruction over time. The effect of IDS on the bond strength of indirect restorations is still debatable.Purpose: This study was conducted to determine the effect of IDS on the bond strength of ceramic restorations to dentin.Materials and Method: In this systematic review and meta-analysis, the study protocol was registered on the PROSPERO database under the registration number CRD420202014 27. MEDLINE (PubMed), Web of Science, Scopus, and ProQuest databases were searched until January 2021 and updated in January 2022. Worldcat.org and Opengrey.eu, ProQuest dissertation and thesis, and Google Scholar were searched to explore the grey literature. The in vitro studies evaluating the bond strength of ceramic restoration to dentin with and without IDS were included. Seven criteria were assessed to evaluate the risk of bias in the study. Statistical analyses were conducted using RevMan 5.3. The inverse variance method was used to determine the mean difference of micro-tensile bond strength (µTBS) and shear bond strength (SBS).Results: A total of 10 studies (20 datasets) were included in the meta-analysis. Regarding the µTBS analysis, IDS had a significantly higher bond strength than Delayed Dentin Sealing (DDS) (MD:1.16, 95%CI:0.28_2.03, I2=0%). However, no significant difference was found between them in the SBS analysis (MD:0.25, 95%CI: -0.56-1.06, I2=96%). All studies were categorized to have a moderate or high risk of bias.Conclusion: Most in vitro evidence showed favorable results for the effect of IDS on the bond strength and durability of indirect restorations. The adhesive system and the type of ceramic and its treatment before cementation are determining factors. Due to the heterogeneity of the outcomes and studies with a moderate/high risk of bias, the quality of the evidence was low.

Enterococcus faecalis is the main pathogen causing refractory apical periodontitis (RAP). This bacterium can tolerate harsh environments and trigger periapical immune inflammatory responses that result in persistent infection inside and outside the root canal. Adhesion to the dentin wall of root canals and the subsequent formation of biofilms significantly enhances the drug resistance and anti-erosion ability of Enterococcus faecalis, which is the key factor mediating its pathogenesis. The adhesion of Enterococcus faecalis to dentin involves non-specific adhesion and specific adhesion, and the latter is mediated by adhesion-related virulence factors, mainly including the adhesin of collagen from enterococci (Ace), extracellular surface protein (Esp), gelatinase (GelE), serine protease (SprE), endocarditis and biofilm associated pilus (Ebp) and aggregation substance (AS), which is regulated by multiple two-component systems. The two-component system Fsr can promote the expression of gelE and sprE when the cell population density increases. GelE can further reduce Ace, while the two-component system GrvRS directly downregulates ace expression in response to the serum environment. The two-component systems CroRS and WalRK may also promote and inhibit the expression of various virulence factors, including ace and gelE, thus affecting the adhesion of Enterococcus faecalis. In addition, the mechanochemical preparation and the internal environment of the root canal can also influence the adhesion of Enterococcus faecalis to dentin. Avoiding the introduction of Enterococcus faecalis and using adhesion-interfering medications during root canal treatment can effectively prevent the adhesion of Enterococcus faecalis, and a variety of activated irrigation protocols can also be effective at increasing the clearance of Enterococcus faecalis from the root canal. The design of rational drugs targeting key factors involved in and regulators of the adhesion of Enterococcus faecalis to dentin is expected to provide new ideas and strategies for root canal infection control. The present paper reviews the adhesion of Enterococcus faecalis to dentin and its influencing factors.

Abstract Background The healing process after tooth removal involves bone remodelling which implies some loss of alveolar bone volume. Among materials proposed for minimising this remodelling and preserving the bone, autologous dental tissue is a promising option, but more data are needed. In this context, we evaluated size and density changes using cone beam computed tomography in autologous dental material (ADM)-preserved sockets compared to controls, and assessed biological responses by histological analysis. Methods A split-mouth study was conducted including 22 patients, who underwent removal of ≥ 2 single-rooted teeth with intact sockets, assigning one socket to the experimental group which received ADM for alveolar preservation and another to the control group, which only underwent blood clot stabilisation. Cone beam computed tomography was performed postoperatively (week 0) and at weeks 8 and 16 to assess socket size and bone density. Histological analysis was carried out on trephine biopsies taken (Ø4 × 4.5 mm) from the experimental group. Results Less horizontal shrinkage was observed in the ADM group, especially at week 16 considering the group-by-time interaction for the following variables: difference in height between the lingual and buccal alveolar crests (-1.00; p

Background/purpose: The dental adhesive market is constantly evolving to meet the demands of dentists and patients, but new products and upgrades should be rigorously evaluated before being used in clinical practice. This study investigated the physicomechanical properties and dentin bonding efficacy of a newly upgraded universal adhesive compared to its predecessor. Materials and methods: Twenty-four molars were divided into four groups (n = 6/group) based on adhesive (new vs. predecessor) and application mode [self-etch (SE) vs. etch-and-rinse (ER)] for evaluating their dentin microtensile bond strength (μTBS), failure pattern, and bonding interface. Additional thirty-six molars’ crowns were perpendicularly sectioned to obtain flat mid-coronal dentin discs. The opposing dentin surfaces of each disc received contrasting treatments (new/predecessor adhesive applied in SE/ER mode), resulting in six interventions. The bonded discs (n = 6/intervention) were used to assess the adhesives’ survival probability employing a double-sided μTBS test. The other physicomechanical properties examined were adhesives’ oxygen inhibition layer (OIL), viscosity, hardness, elastic modulus, degree of conversion (DC), and in-situ DC. Results: Both adhesive versions showed similar μTBS (P > 0.05), failure pattern (P > 0.05), and survival probability (P > 0.008). ER mode promoted resin tag formation and exhibited a slender adhesive layer for both adhesives. The newer adhesive version showed a thinner adhesive layer in general with narrower OIL (P

Background/purpose: 4-methacryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin is used for indirect restorations. We aimed to evaluate effects of immersion in 4-META/MMA-TBB-activated liquid on the bond strength of root canal dentin. Materials and methods: We used freshly extracted single-rooted human teeth. After decoronation, each root was vertically sectioned into halves; their dentin walls were polished and flattened. The control group underwent dentin treatment with Green Activator. The immersion group was treated with Green Activator and Teeth Primer and immersed in 4-META/MMA-TBB-activated liquid. After bonding the resin blocks with Super-Bond, microtensile bond strength (μTBS) tests were performed (n = 6), and fracture surfaces were analyzed. Before surface treatment, dentin was immersed in a sodium fluorescein solution for 3 h, and resin blocks were bonded with Super-Bond with rhodamine B as in the bond strength test. The bonded cross section was observed using confocal laser scanning microscopy (CLSM). Results: μTBS was significantly higher in the immersion group than in the control group (61.5 [51.3–66.7] vs. 33.0 [20.4–57.8] MPa; P

Purpose: This study investigated the effect of toothbrush bristle stiffness and brushing force on the cleaning efficacy in vitro. Materials and Methods: Eighty bovine dentin samples were allocated to eight groups (n=10). Two custom-made toothbrushes of different bristle stiffness (soft and medium) were tested at four different brushing forces (1, 2, 3 and 4 N). Dentin samples were stained in black tea and brushed (60 strokes/min) for a total of 25 min in a brushing machine with an abrasive solution (RDA 67). Photographs were taken after 2 and 25 min of brushing time. Cleaning efficacy was measured planimetrically. Results: After 2 min of brushing, the soft-bristle toothbrush did not cause statistically significantly different cleaning efficacy at different brushing forces, while the medium-bristle toothbrush cleaned statistically significantly less efficaceously only at 1 N. Comparing the two different toothbrushes, higher cleaning efficacy was observed only at 1 N for the soft-bristle brush. At 25 min brushing time, the soft-bristle cleaned statistically significantly better at 4 N compared to 1 N and 2 N and at 3 N compared to 1 N. Using the medium-bristle, cleaning efficacy increased with increasing brushing force. After 25 min of brushing, no statistically significant difference was observed between the two different toothbrushes. Conclusion: Irrespective the brushing force, the use of a soft or medium toothbrush results in comparable cleaning efficacy. At 2 min brushing time, increasing the brushing force does not increase the cleaning efficacy. [ABSTRACT FROM AUTHOR]

Purpose: To assess the root surface roughness and substance loss induced by chemical and chemomechanical challenges on root surfaces pretreated with ultrasonic instrumentation, a hand scaler, or erythritol airflow. Materials and Methods: One hundred twenty (120) bovine dentin specimens were used in this study. Specimens were divided into eight groups and treated as follows: groups 1 and 2: polished with 2000- and 4000-grit carborundum papers but not instrumented ('untreated'); groups 3 and 4: hand scaler; groups 5 and 6: ultrasonic instrumentation; groups 7 and 8: erythritol airflow. Samples from groups 1, 3, 5, and 7 then underwent a chemical challenge (5 x 2 min HCl [pH 2.7]), whereas samples from groups 2, 4, 6, and 8 were subjected to a chemomechanical challenge (5 x 2 min HCl [pH 2.7] + 2 min brushing). Surface roughness and substance loss were measured profilometrically. Results: The least substance loss through chemomechanical challenge was noted after erythritol airflow treatment (4.65 ± 0.93 μm), followed by ultrasonic instrumentation (7.30 ± 1.42 μm) and the hand scaler (8.30 ± 1.38 μm); the last two (hand scaler and ultrasonic tip) did not differ statistically significantly. The highest roughness after chemomechanical challenge was observed on ultrasonically treated specimens (1.25 ± 0.85 μm), followed by hand-scaled specimens (0.24 ± 0.16 μm) and those subject to erythritol airflow (0.18 ± 0.09 μm); there was no statistically signficant difference between the latter two, but they both differed statistically significantly from the ultrasonically treated specimens. No statistically significant difference in substance loss through the chemical challenge was observed between specimens pretreated by the hand scaler (0.75 ± 0.15 μm), ultrasonic tip (0.65 ± 0.15 μm), and erythritol airflow (0.75 ± 0.15 μm). The chemical challenge smoothed the surfaces treated with the hand scaler, ultrasonic tip, and erythritol airflow. Conclusion: Dentin pretreatment with erythritol powder airflow resulted in a higher resistance to chemomechanical challenge than did dentin treated ultrasonically or with the hand scaler. [ABSTRACT FROM AUTHOR]

Purpose: To synthesise and characterise nanosilver sodium fluoride (NSSF) and assess the effect of applying this formulation in vitro on artificially demineralised root dentin lesions, compared with the application of silver diamine fluoride (SDF), sodium fluoride (NAF) or no treatment, in terms of mechanical, chemical and ultrastructural properties. Materials and Methods: NSSF was prepared using 0.5 wt% chitosan solution. On 40 extracted human molars, the buccal aspect of the cervical thirds of roots were prepared and divided into 4 groups of 10 each: control (no treatment), NSSF, SDF and NaF (n = 10). The specimens were examined using scanning electron microscopy (SEM), atomic force microscopy (AFM), and x-ray photoelectron spectroscopy (XPS). Fourier transform infrared spectroscopy (FTIR), surface and cross-sectional microhardness and nano-indentation tests were performed to determine the mineral and carbonate content, microhardness, and nanohardness, respectively. Statistical analysis was performed to determine the differences between the different treatment groups for the set parameters using parametric and non-parametric tests. Tukey's and Dunnet's T3 post-hoc tests were further used for multiple comparisons between groups (α = 0.05). Results: The control group (no treatment) was found to have statistically significantly lower mean scores for surface and cross-sectional microhardness compared with all other test groups (NaF, NSSF and SDF) (p < 0.05). Spearman's rank correlation test showed statistically insignificant differences between the mineral-to-matrix ratio (M:M) and carbonate content of all groups (p < 0.05). Conclusions: Treatment of root lesions with NSSF yielded comparable results to SDF and NaF under in-vitro conditions. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of the supplementation of energy drinks with green tea extract on abrasive and erosive dentin wear. Materials and Methods: Six groups, each comprising 15 bovine dentin samples, were prepared, yielding a total of 90 samples. Erosion was performed by immersing the samples in Red Bull and Red Bull light with and without green tea extract. Tap water with and without green tea extract was used as the control groups. The samples were subjected to abrasive/erosive cycling for five days. The following cycling was performed daily: toothbrush abrasion (20 brushstrokes; 2.5 N); eight erosive cycles (2 min storage in the respective solutions); in between the erosive cycles, storage in artificial saliva (60 min) and again toothbrush abrasion (20 brushstrokes; 2.5 N). During the night, samples were again stored in artificial saliva. Abrasive/erosive dentin wear was measured using a stylus profilometer (μm, accuracy = 40 nm). The measured dentin loss results from the vertical position shift on the y-axis from base to final profile after the wear process in 2D. Pairwise comparisons between the groups were carried out using Wilcoxon signed-rank test. Results: The following dentin wear (median [IQR]) was measured: Red Bull: 1.9 μm (0.5); Red Bull Light: 1.3 μm (0.3); Red Bull with green tea extract: 0.8 μm (0.3); Red Bull Light with green tea extract: 0.3 μm (0.5); Tap water with green tea extract: -0.2 μm (0.7); Tap water: -1.0 μm (1.2). The comparison of all tested groups to each other proved to be statistically significant (p < 0.05). Conclusion: The supplementation of energy drinks with green tea extract provide a protective effect against erosive/ abrasive wear in vitro. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the absolute wear caused by toothpastes with highly discrepant REA (Relative Enamel Abrasivity) and RDA (Relative Dentin Abrasivity) values on both enamel and dentin: Candida Peppermint (CP; REA: 1; RDA: 42), Colgate Total Original (CTO; REA: 4; RDA: 100), Signal White System (SWS; REA: 8; RDA: 143), and Candida White Diamond (CWD; REA 244; RDA: 12). Materials and Methods: Eighty (80) bovine enamel samples and 80 dentin samples were divided into four groups each (n = 20) and investigated after a 6-h brushing procedure (21,600 cycles, 60 cycles/min, load of 2.5 N) with the four toothpastes. The abrasive enamel and dentin wear were registered using a contact profilometer. The median and interquartile range (IQR) of the abrasive enamel and dentin wear were calculated for each group. Pairwise comparisons were conducted using the Wilcoxon signed-rank exact test, and the p-value was adjusted according to Holm (statistical significance set at 0.05). Results: CWD led to the highest abrasive enamel wear (9.86 μm [5.77]). CTO caused the highest abrasive dentin wear (166.70 μm [69.90]), being statistically significantly higher than the wear for CP (54.20 μm [24.00]) and CWD (17.00 μm [7.80]) (p = 0.00001). The abrasive dentin wear for CWD was statistically significantly lower in comparison to all other groups (p = 0.00001). Conclusion: Toothpastes with highly discrepant REA and RDA values presented statistically significantly different absolute wear on enamel and dentin. REA and RDA values should both be declared for every toothpaste. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of carbodiimide (EDC) and chitosan (CHI) on the enzymatic activity (EA) and bond strength (BS) of different composite cements to root dentin. Materials and Methods: Ninety (90) maxillary canines were sectioned, standardizing the length of the roots. The roots were endodontically treated, prepared, divided into 3 groups according to dentin treatment (distilled water [DW], CHI 0.2 wt%, or EDC 0.5M), and further subdivided into 3 subgroups according to composite cement (RelyX ARC [3M Oral Care], Panavia F 2.0 [Kuraray Noritaki], or RelyX U200 [3M Oral Care]). Of the slices obtained by sectioning, the most cervical of each third were subjected to a push-out test and the most apical were subjected to in-situ zymography. Half of the slices were analyzed immediately, and the other half after 6 months. The results were analyzed with ANOVA or the chi-squared test. Results: RelyX ARC showed higher BS associated with CHI, while RelyX U200 showed higher BS associated with EDC (p = 0.044). For Panavia F 2.0, the treatment did not influence BS (p > 0.05). For the cervical and middle thirds, no differences were observed between the cements, while the apical third revealed higher BS for RelyX U200 (p < 0.001). The highest percentage of adhesive-to-dentin failures was observed for Panavia F 2.0. EDC showed the lowest percentage of adhesive-to-dentin failures. According to zymographic analysis, DW and CHI showed greater fluorescence for RelyX ARC, while EDC exhibited the lowest fluorescence of all cements (p > 0.05). Conclusion: The different mechanisms of action of solutions for pre-treatment of intraradicular dentin yielded different results depending on the adhesive used. EDC resulted in higher bond strength and higher enzyme inhibition for RelyX U200, while the treatment with chitosan resulted in higher bond strength and lower enzymatic activity for RelyX ARC. Although EDC and chitosan treatments did not influence the bond strength for Panavia F 2.0, both resulted in higher enzyme inhibition for this composite cement. [ABSTRACT FROM AUTHOR]

Purpose: This study compared a 2%-CHX dentin pre-treatment with three CHX adhesives (experimentally admixed 0.1% CHX in primer or bonding agent, or industrially added 0.2% CHX in universal adhesive) by evaluating dentin bond strengths after biological loading in a fully automated artificial mouth model. Materials and Methods: The occlusal dentin of 50 freshly extracted human third molars was exposed, and the teeth were randomly assigned to 5 groups according to the adhesive protocol (n = 10): 1. control, Scotchbond Multipurpose (3M Oral Care; CTRL); 2. 2% CHX dentin pre-treatment (DENT); 3. 0.1% CHX experimentally admixed into the primer (PRIM); 4. 0.1% CHX experimentally admixed into the bonding agent (BOND); 5. Peak Universal Bond containing 0.2% CHX (Ultradent; PEAK). The teeth were restored with composite resin. Microtensile bond strength testing (bonding area 0.46 mm2 ± 0.04 mm², crosshead speed 1 mm/min) was performed after 24-h storage in distilled water (baseline) or after 2-day biological loading with S. mutans (demineralization 1 h / remineralization 5 h). The mode of fracture was recorded and exemplary sticks were evaluated under SEM. Results: CTRL exhibited significantly higher μTBS at baseline in comparison to PRIM (p = 0.000), BOND (p = 0.002), and PEAK (p = 0.000). After undergoing the caries model, CTRL demonstrated significantly lower μTBS compared to DENT (p = 0.000), PRIM (p = 0.008), and PEAK (p = 0.000). The same behavior was observed for BOND vs DENT (p = 0.000), PRIM (p = 0.003), and PEAK (p = 0.001). After biological loading, DENT (p = 0.041), PRIM (p = 0.000), and BOND (p = 0.000) exhibited significantly fewer adhesive fractures than CTRL. Conclusions: CHX addition to the primer protects dentin bond strength from declining after biological loading. Thus, it may offer some clinical advantage in terms of secondary caries inhibition around composite restorations. However, since loss of adhesion at baseline was less when 2% CHX was used as a dentin pre-treatment, it can be suggested as a safer option. so that bonding is not undermined by potential chemical interactions from CHX with the adhesives. [ABSTRACT FROM AUTHOR]

Background: The long-term success of adhesive restorations is contingent on minimizing microleakage, which can lead to postoperative sensitivity and secondary caries. Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) irrigation are commonly employed during adhesive restorative procedures, but their impact on microleakage remains a concern. Proanthocyanidin (PA), a naturally derived agent, has shown potential in enhancing bond strength. Aim: This study aimed to compare and evaluate the effect of treatment with or without 30% PA of the pulp chamber dentin after 1% NaOCl and 17% EDTA irrigation on the microleakage of adhesive restorations. Materials and Methods: Forty caries-free, freshly extracted permanent human molars were used. The pulp chamber roof was removed, and the roots were resected. Canal orifices were enlarged and sealed. Specimens were divided into four groups based on adhesives (OptiBond All-In-One and Adper Easy One) and irrigation regimens. After irrigation, pulp chambers were restored with Filtek Bulk-Fill composite resin. Microleakage was assessed using methylene blue dye penetration. Results: Microleakage was observed in all groups, irrespective of irrigation protocol and adhesives. PA application showed reduced dye penetration compared to without PA, although not statistically significant. Statistical analysis was performed using Kruskal–Wallis and Mann–Whitney tests at P < 0.05. Conclusion: Irrigation protocols and the use of PA had no significant effect on the microleakage of self-etch adhesives to pulp chamber dentin. A 1-min application of 30% PA solution after NaOCl and EDTA irrigation did not improve the bonding of self-etch adhesives to pulp chamber dentin.