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Aims: Assessment of the impact of different dentin bio-modifiers i.e., Bromelain, Riboflavin photosensitizer (RFP/Ultraviolet-A), and Chitosan nanoparticles (CHNPs) on the shear bond strength (SBS) and microleakage of composite bonded to acid etched carious affected dentin (CAD). Materials and methods: Sixty-four human molars in which carious lesions extend till the middle third of the dentin were included. The infected dentin was removed and CAD was exposed. All specimens were categorized into four groups based on the application of dentin bio-modifier (n = 16) Group 1 (No dentin modifier), Group 2 (Bromelain), Group 3 (RFP/UVA), and Group 4 (CHNPs). Dental adhesive application and composite buildup were performed. A dye penetration test was used to assess marginal leakage. Resin CAD interface assessment was performed using SEM. For SBS and failure pattern analysis, a universal testing machine and stereomicroscope were used respectively. One-way ANOVA followed by Bonferroni's posthoc test was employed to analyze the differences among various groups (p ≤ 0.05) Results: The lowest microleakage (13.27 ± 0.10) and highest SBS (11.64 ± 0.16 MPa) were observed in Group 2 (Bromelain). However, the maximum values of marginal leakage (37.21 ± 0.21) and minimum SBS (7.34 ± 0.07 MPa) were detected in Group 1 samples. The length of resin tags in the Group 2 specimens (Bromelain) was found to be the highest (102.11 ± 5.12 μm). However, Group 1 (No modifier) exhibited the lowest resin tag length (50.45 ± 2.37 μm). Conclusion: Caries-affected dentin modified with Bromelain resulted in satisfactory SBS with minimal microleakage scores. Chitosan nanoparticles and RFP/Ultraviolet-A also presented better outcomes in terms of microleakage and SBS than the control.

This study aimed to assess and evaluate the canal shaping ability of two different Ni-Ti rotary systems, Vortex Blue (VB) and TruNatomy (TN), using micro-computed tomography in extracted premolars. A total of 20 extracted bifurcated maxillary first premolars with two separate canals were randomly divided into two groups and prepared with either VB 35/0.04 (Dentsply Maillefer, Ballaigues, Switzerland) or TN Medium 36/0.03 (Dentsply Sirona). Pre- and post-instrumentation micro-CT scans were analyzed to measure the following parameters: percentage of untouched canal surface area, changes in canal surface area, changes in canal volume, structural model index (SMI), changes in canal angulation, changes in dentin thickness, transportation, and centering ability. Statistical analysis was performed with a significance level set at p-value < 0.05. Both VB and TN files showed a significant increase in the basic canal geometry parameters including canal surface area and canal volume. Both file systems showed no significant changes in SMI or dentin thickness after canal instrumentation (p > 0.05). Some degree of canal transportation and a similar centering ability ratio with no significant difference were observed in both file systems (p > 0.05). TN files showed less pre-cervical dentin removal when compared to VB files. A significant difference was found in the TN group regarding the dentin removal between coronal and apical thirds (p = 0.03). Both VB and TN files produced comparable root canal preparation with no considerable shaping mishaps and errors. Both files showed minimum canal transportation and minimum straightening of the canal curvature. TN files removed less pre-cervical dentin than apical dentin.

Abstract Background The aim of this study was to evaluate the effect of thermal and mechanical cyclic aging using a mastication simulator on push-out bond strength of mandibular premolars obturated with AH Plus and BioRoot RCS root canal sealers. Methods With REVO-S files up to SU/0.06 taper, 48 single-rooted premolar teeth were instrumented. The teeth were randomly divided into two main groups (n = 24) based on the two root canal sealers used (AH Plus and BioRoot RCS). All teeth were obturated with h matched-taper single-cone. Each main group was then subdivided into three subgroups (A, B, and C) (n = 8). Group A served as the negative control group (no-thermocycling aging). While groups B and C were subjected to thermal changes in a thermocycler machine (15,000 and 30,000 thermal cycles, respectively), followed by two different dynamic loading periods, 3 × 105 and 6 × 105 in a masticatory simulator with a nominal load of 5 kg at 1.2 Hz which represent roughly 1½ and 3 years of clinical function respectively. 2 mm slice at 3 levels, apical, middle, and coronal, to obtain 3 sections were prepared and subjected to push-out test using a universal testing machine. Statistical analysis was performed using analysis of variance (ANOVA) followed by a Tukey post hoc comparisons test and an independent T-test. A significance level of 5% was used. Results After thermal–mechanical cyclic aging, the two root canal sealers showed a significantly decreased in push-out bond strength (p

Aims: Bleached enamel reversal using antioxidants sodium ascorbate (SA), Green tea extract (GTE), grape seed extract (GSE), Curcumin photosensitizer (CP) and Er: YAG laser on the adhesive strength and marginal leakage of composite material bonded to the bleached enamel surface. Materials and methods: Enamel surface of hundred and twenty sound human first premolar teeth was cleansed using pumice and bleached with 35 % hydrogen peroxide. The samples were randomly divided into 5 groups based on the antioxidants used. n = 20 Group 1 (Control): No antioxidant agent, Group 2: 10 % SA solution, Group 3: 6.5 % GSE, Group 4: 5 % GTE, Group 5: Er: YAG laser and Group 6: CP. Following reversal, the composite was built and cured for 40 s. All the specimens were stored in distilled water at room temperature for 1 day. Microleakage, SBS, and failure mode were analyzed. Kolmogorov-Smirnov test, one-way analysis of variance, and Tukey's multiple post hoc test were used to analyze the data statistically. Results: Group 2 (SA) (20.11 ± 5.79 nm) exhibited minimum value of microleakage and highest SBS (10.22 ± 1.62 MPa). Whereas, Group 1 (No antioxidant agent) displayed maximum scores of marginal leakage (28.11±8.89 nm) and lowest SBS (7.02 ± 1.22 MPa). Conclusion: CP, GTE and GSE can be used as a potential alternative to the commonly used SA solution to reverse the negative impact of bleaching on the enamel surface. The use of reversal agents CP, GTE and GSE improves bond values with a decrease in microleakage scores However, future studies are still warranted to conclude the outcomes of the existing study.

Abstract Background To compare the efficiency of endodontic rotary and reciprocating systems in removing calcium silicate-sealer based fillings and to investigate the impact of passive ultrasonic irrigation (PUI) on their efficiency. Materials and methods 160 root-canals were instrumented, filled with gutta-percha and calcium silicate based-sealer and divided into 10 equal groups. Five groups in which the reciprocating systems (WaveOne-Gold, Reciproc-Blue and R-Motion) and rotary systems (Fanta-AF-One and Tango-Endo) were used to remove root-canals’ fillings. In the other five groups the fillings were removed by the same systems then additionally with PUI. The times to complete retreatments procedures were recorded. Micro-computed tomography’s analysis of the root-canals fillings’ volume before and after retreatments was used to determine the remaining filling materials (RFMs) volumes. Results The RFMs after using rotary systems (10.1%) was greater than after using reciprocating systems (3.8%) (P

Abstract Background There have been no reports on the impact of different reciprocating angles on retreatment performance of reciprocating files. This ex-vivo study compared the efficiency of three reciprocating systems in removing MTA-type sealer-based filling materials and investigated the influence of different reciprocating angles on their retreatment ability. Methods 140 root-canals were instrumented to a 35 apical size and filled with an MTA-type sealer and gutta-percha cones. Samples were scanned by micro-computed-tomography and the root-canals fillings volumes were measured. Samples were divided into 7 groups according to the reciprocating angles at which the WaveOne-Gold (WOG), Reciproc-Blue (RB) and R-Motion (RM) systems were reciprocated to remove the root-canals’ fillings. The WOG-150/30, WOG-90/30, RB-150/30, RB-90/30, RM-150/30 and RM-90/30 groups in which the systems were reciprocated at 150/30 and 90/30 (counterclockwise/clockwise) angles. In the RB-270/30 group the RB system was reciprocated at 270/30 angles. Samples were re-scanned and the remaining filling materials’ (RFMs) volumes were measured. The percentage of the RFMs volume and its mean value for each group were calculated and data were statistically analysed at 0.05 significance level. Results The WOG system resulted in less RFMs (2.24%) when reciprocated at 90/30 angles compared to that resulted from the 150/30 angles (4.96%) [P = 0.002]. The RB system reciprocated at 90/30 angles resulted in less RFMs (2.67%) compared to that resulted from the 270/30 angles (6.64%) [P = 0.001]. The RFMs after using RM system reciprocated at 90/30 (6.02%) and 150/30 (7.61%) were greater than those of WOG (2.24 and 4.96%) and RB (2.67 and 4.34%) reciprocated at the same angles (P

Dental resin composites (DRCs) have gained immense popularity as filling material in direct dental restorations. They are highly valued for their ability to closely resemble natural teeth and withstand harsh oral conditions. To increase the clinical performance of dental restorations, various fillers are incorporated into DRCs. Herein, the effect of incorporating pre-polymerized triethylene glycol dimethacrylate (P-TEGDMA) as a co-filler in varying proportions (0%, 2.5%, 5%, and 10% by weight) into bisphenol A-glycidyl methacrylate (BisGMA)/TEGDMA/SiO2 resin composite was investigated. The obtained DRCs were examined for morphology, rheological properties, degree of crosslinking (DC), Vickers microhardness (VMH), thermal stability, and flexural strength (FS). The results revealed that SiO2 and P-TEGDMA particles were uniformly dispersed. The introduction of P-TEGDMA particles (2.5 wt.%) into the resin composite had a remarkable effect, leading to a significant reduction (p ≤ 0.05) in complex viscosity, decreasing from 393.84 ± 21.65 Pa.s to 152.84 ± 23.94 Pa.s. As a result, the DC was significantly (p ≤ 0.05) improved from 61.76 ± 3.80% to 68.77 ± 2.31%. In addition, the composite mixture demonstrated a higher storage modulus (G′) than loss modulus (G″), indicative of its predominantly elastic nature. Moreover, the thermal stability of the DRCs was improved with the addition of P-TEGDMA particles by increasing the degradation temperature from 410 °C to 440 °C. However, the VMH was negatively affected. The study suggests that P-TEGDMA particles have the potential to be used as co-fillers alongside other inorganic fillers, offering a means to fine-tune the properties of DRCs and optimize their clinical performance.

Aqueous leaf extract of Plectranthus barbatus was used, for the first time, for preparation of (2, 6 mol%) silver (Ag)-doped zinc sulfide nanoparticles (ZnS NPs), acting as a stabilizing and capping agent for NPs’ production. The obtained metal oxides were characterized by FTIR, UV-visible, XRD, and SEM methods. The results revealed that 0.02 and 0.06% Ag-doped ZnS had optical bandgaps of 3.20 and 3.03 eV. The XRD evinced the crystalline nature, while the FTIR confirmed the doped structure of the prepared oxides. The bioactivity investigations revealed that the biosynthesized Ag-doped ZnS NPs are more active against S. aureus than E. coli. Furthermore, the hemolytic tests indicated no potential harm to red blood cells if utilized at a low dose. Such enhanced optical and biological properties of Ag-doped ZnS may promote its prospective use in electronics and as an antibacterial agent.

Nanomaterials have unique physicochemical properties compared to their bulk counterparts. Besides, biologically synthesized nanoparticles (NPs) have proven superior to other methods. This work aimed to biosynthesize zinc oxide (ZnO) NPs using an aqueous extract of Lepidium sativum seed. The obtained ZnO NPs were characterized by X-ray diffraction, scanning electron microscopy, Fourier transform infrared, and ultraviolet-visible spectroscopy. The in vitro antibacterial activity of ZnO NPs against Gram-positive (S. aureus) and Gram-negative (E. coli) bacteria was assessed using the disk diffusion technique. The hemolytic impact was quantified spectrophotometrically. The results indicated a 24.2 nm crystallite size, a hexagonal structure phase, and a 3.48 eV optical bandgap. Antibacterial studies revealed a dose-dependent response with comparable activity to the standard drug (gentamicin) and higher activity against S. aureus than E. coli, e.g., the zone of inhibition at 120 mg/mL was 23 ± 1.25 and 16 ± 1.00 mm, respectively. The hemolysis assay showed no potential harm due to ZnO NPs toward red blood cells if utilized in low doses. As a result, it could be concluded that the reported biogenic method for synthesizing ZnO NPs is promising, resulting in hemocompatible NPs and comparable bactericidal agents.

A new eugenyl dimethacrylated monomer (symbolled BisMEP) has recently been synthesized. It showed promising viscosity and polymerizability as resin for dental composite. As a new monomer, BisMEP must be assessed further; thus, various physical, chemical, and mechanical properties have to be investigated. In this work, the aim was to investigate the potential use of BisMEP in place of the BisGMA matrix of resin-based composites (RBCs), totally or partially. Therefore, a list of model composites (CEa0, CEa25, CEa50, and CEa100) were prepared, which made up of 66 wt% synthesized silica fillers and 34 wt% organic matrices (BisGMA and TEGDMA; 1:1 wt/wt), while the novel BisMEP monomer has replaced the BisGMA content as 0.0, 25, 50, and 100 wt%, respectively. The RBCs were analyzed for their degree of conversion (DC)-based depth of cure at 1 and 2 mm thickness (DC1 and DC2), Vickers hardness (HV), water uptake (WSP), and water solubility (WSL) properties. Data were statistically analyzed using IBM SPSS v21, and the significance level was taken as p < 0.05. The results revealed no significant differences (p > 0.05) in the DC at 1 and 2 mm depth for the same composite. No significant differences in the DC between CEa0, CEa25, and CEa50; however, the difference becomes substantial (p < 0.05) with CEa100, suggesting possible incorporation of BisMEP at low dosage. Furthermore, DC1 for CEa0–CEa50 and DC2 for CEa0–CEa25 were found to be above the proposed minimum limit DC of 55%. Statistical analysis of the HV data showed no significant difference between CEa0, CEa25, and CEa50, while the difference became statistically significant after totally replacing BisGMA with BisMEP (CEa100). Notably, no significant differences in the WSP of various composites were detected. Likewise, WSL tests revealed no significant differences between such composites. These results suggest the possible usage of BisMEP in a mixture with BisGMA with no significant adverse effect on the DC, HV, WSP, and degradation (WSL).

Abstract Background Matrix metalloproteinases (MMPs) catalyzes the degradation of the extracellular matrix components and have a major role in many physiological processes including wound healing. In the current study, we examined the correlation of baseline MMPs 1, 2, 7, and 9 expressions with periapical wound healing after surgical endodontic treatment. Methods 27 patients aged between 15 and 57 years presenting with chronic apical periodontitis or chronic apical abscess of an anterior tooth with previously attempted or failed root canal treatment were included in this study. During surgical endodontic treatment, tissue from the periapical lesion sample was collected and used for gross histopathological analysis as well as mRNA expression analysis of MMPs 1, 2, 7, and 9. Patients were recalled for follow-up after 6 months to evaluate the healing status both clinically and radiographically and healing was correlated with baseline MMP expression. Results Out of 27 patients, healing was observed in 15 patients at the end of 6 months, and in 21 patients after 12 months.. Six patients showed no healing even after 12 months. Analysis of baseline MMP 1, 2, 7, and 9 expression levels with healing status showed the mean relative expression of MMP2 and MMP9 to be considerably increased in the non-healing group as compared to the healing group. Conclusion Overexpression of MMP2 and MMP9 may be considered as a potential prognostic biomarker for periapical wound healing after surgical endodontic treatment. However, further studies are desirable to establish its precise relationship with periapical wound healing.

Background: A pits and fissures sealant is an effective method for preventing dental caries. Using a bonding agent before applying the sealant may increase its retention. This study aimed to compare the microtensile strength (µTBS) of a fissure sealant with and without a bonding agent and to characterize the enamel-sealant interface using confocal laser scanning microscopy (CLSM). The null hypothesis was that the use of a bonding agent before fissure sealant application would not change the microtensile strength or the enamel-sealant interface. Materials and methods: Twenty caries-free premolars were used. Each tooth was divided into four parts. The first two parts were assigned to the bonded group, where a bonding system was used before sealant application. The remaining two parts were treated only with a fissure sealant (i.e., the nonbonded group). In each group, the µTBS was examined after 24 h (n = 20) and after a 3-month aging period (n = 20). Five other caries-free extracted premolars were used to assess the enamel-sealant interface using CLSM. Two-way analysis of variance (ANOVA) and Pearson chi-square statistical analysis tests were used to analyze the µTBS and the enamel-sealant interface, respectively. Results: The mean µTBS for the bonded group was significantly higher (p = 0.001) in the immediate group (36.87 ± 14.95 MPa) and the aged group (31.08 ± 15.88 MPa) than in the respective nonbonded groups (19.77 ± 9.67 MPa and 19.52 ± 14.14 MPa). The µTBS was not significantly different in either group after aging (p = 0.46 [bonded group] and p = 0.98 [nonbonded group]). In addition, using a dental adhesive, before applying a fissure sealant resulted in a significantly higher (53%) resin penetration into the enamel with the continuous integrity of the resin. Conclusion: The use of a bonding agent before the application of fissure sealant resulted in superior microtensile bond strength immediately and after aging. In addition, the enamel-sealant interface characteristics were improved.

Abstract Background This in-vitro study aimed to investigate the effect of two different antibacterial disinfectants on the microleakage performance of newly developed bulk-fill composite, bonded to different tooth structures. Methods Class V cavities were prepared in 30 sound premolar teeth, with enamel occlusal margins (OM) and dentin cervical margins (CM). Two disinfectants, 2% chlorhexidine gluconate (CHX) and Listerine Miswak (ListM), were used. Teeth were divided into three groups (n = 10): G1, Control; G2, CHX; and G3, ListM. Disinfectants were applied to the cavity preparation walls after they were etched with 35% phosphoric acid. The Single Bond Universal adhesive system was then used, and teeth were restored with Filtek One Bulk Fill composite. Samples were examined, after thermocycling aging, by stereomicroscopy for the evaluation of marginal dye penetration. Results The highest mean microleakage score was reported in the CM of G1 (2.60 ± 1.174), which was significant compared with that of G2 only (p = 0.02). OM in G1 showed no microleakage, with no significant differences found among groups (χ2 = 1.39, p = 0.50). No significant differences were reported between G2 and G3 (p = 0.45 OM; p = 0.17 CM). Conclusions Cavity pretreatment with CHX is not significantly different to pretreatment with CHX. In contrast, CHX improved the cervical marginal seal as compare to the control group (G1).

Resin composite mimics tooth tissues both in structure and properties, and thus, they can withstand high biting force and the harsh environmental conditions of the mouth. Various inorganic nano- and micro-fillers are commonly used to enhance these composites’ properties. In this study, we adopted a novel approach by using pre-polymerized bisphenol A-glycidyl methacrylate (BisGMA) ground particles (XL-BisGMA) as fillers in a BisGMA/triethylene glycol dimethacrylate (TEGDMA) resin system in combination with SiO2 nanoparticles. The BisGMA/TEGDMA/SiO2 mixture was filled with various concentrations of XL-BisGMA (0, 2.5, 5, and 10 wt.%). The XL-BisGMA added composites were evaluated for viscosity, degree of conversion (DC), microhardness, and thermal properties. The results demonstrated that the addition of a lower concentration of XL-BisGMA particles (2.5 wt.%) significantly reduced (p ≤ 0.05) the complex viscosity from 374.6 (Pa·s) to 170.84. (Pa·s). Similarly, DC was also increased significantly (p ≤ 0.05) by the addition of 2.5 wt.% XL-BisGMA, with the pristine composite showing a DC of (62.19 ± 3.2%) increased to (69.10 ± 3.4%). Moreover, the decomposition temperature has been increased from 410 °C for the pristine composite (BT-SB0) to 450 °C for the composite with 10 wt.% of XL-BisGMA (BT-SB10). The microhardness has also been significantly reduced (p ≤ 0.05) from 47.44 HV for the pristine composite (BT-SB0) to 29.91 HV for the composite with 2.5 wt.% of XL-BisGMA (BT-SB2.5). These results suggest that a XL-BisGMA could be used to a certain percentage as a promising filler in combination with inorganic fillers to enhance the DC and flow properties of the corresponding resin-based dental composites.

Objectives. The study designed to compare the effect of erbium, chromium: yttrium-scandium-gallium-garnet (Er, Cr: YSGG) laser at different power outputs and short periods of time (5 and 10 s) and acid etching on the shear bond strength (SBS) and failure mode of metallic orthodontic brackets. Material and methods. A total of sixty-nine human premolars extracted for orthodontic purposes were used. 60 teeth were randomly assigned to one of the five treatment groups. (n = 12): group 1: 37% phosphoric acid etching and groups 2–5: the enamel surface irradiated by the Er, Cr: YSGG laser operated at different power outputs (1 W, 1.5 W, 2 W, and 2.5 W), each laser group was divided into two subgroups (n = 6) according to exposure time (5 s and 10 s). Nine teeth were not subjected to SBS testing but were prepared for scanning electron microscopy (SEM). The nonparametric Kruskal–Wallis test was used to evaluate the data; the SBS and adhesive remanent index (ADI) were evaluated. Results. The mean SBS for all laser groups and the acid-etched group were comparable, with no significant differences except for the 1 W group for 5 and 10 s and the 1.5 W group for 5 s. For the ARI scores, no statistically significant difference was found among the groups (P=0.059), and the majority of the samples had ARI type 2 or 3. Conclusion. The laser irradiation at 2 and 2.5 W for 5 s was similar to that produced by acid etching, whereas the laser irradiation at 2 and 2.5 W at 10 s was higher compared with that obtained with acid etching and adequate to etch the enamel.

With the advancement in tissue engineering, researchers are working hard on new techniques to fabricate more advanced scaffolds from biocompatible polymers with enhanced porosity, appropriate mechanical strength, diverse shapes and sizes for potential applications in biomedical field in general and tissue engineering in particular. These techniques include electrospinning, solution blow spinning, centrifugal spinning, particulate leaching (salt leaching), freeze-drying, lithography, self-assembly, phase separation, gas foaming, melt molding, 3-D printing, fiber mesh and solvent casting. In this article we have summarized the scaffold’s fabrication techniques from biocompatible polymers that are reported so far, the recent advances in these techniques, characterization of the physicochemical properties of scaffolds and their potential applications in the biomedical field and tissue engineering. The article will help both newcomers and experts working in the biomedical implant fabrication to not only find their desired information in one document but also understand the fabrication techniques and the parameters that control the success of biocompatible polymeric scaffolds. Furthermore, a static analysis of the work published in all forms on the most innovative techniques is also presented. The data is taken from Scopus, restricting the search to biomedical fields and tissue engineering. Keywords: Biocompatible polymeric Scaffolds, Scaffolds fabrication techniques, Tissue engineering, Biomedical application

Abstract Background The aim of this study was to evaluate the effect of universal adhesives (UA) and silane on the microtensile bond strength (μTBS) of resin cement to a hybrid ceramic Vita Enamic (VE). Methods VE specimens were acid etched using hydrofluoric acid (HF) and were assigned to three groups (n = 10) based on the applied bonding technique. In group 1 (S), a silane-based primer was used as a surface treatment prior to the application of a resin cement (Variolink Esthetic DC). In group 2, a silane-containing UA, Clearfil Universal Bond (CUB) was used for the surface treatment, and in group 3, A silane-free UA, Tetric N-Bond Universal (TNU) was used for surface treatment. Resin cement build-ups were prepared. The bonded specimens were sectioned into resin-ceramic beams. Half of the beams of each group were stored for 24 h at 37 °C and the other half were subjected to a thermo-cycling aging. The microtensile bond strength (μTBS) was measured at a crosshead speed of 0.5 mm/min. Failure modes were assessed accordingly. Data were analyzed using a) two-way analysis of variance ANOVA followed by one-way ANOVA and Tukey tests between groups and b) independent t-test to detect differences (α = 0.05) for each group. The surface topographies of the ceramic surface were evaluated using scanning electron microscopy. Results The results showed that silane-based primer (S) application resulted in significantly higher (p

Systemic and localized oral disease instigates alterations in salivary composition and content. The objective of the study was to evaluate the levels of salivary amylase, mucin, total protein levels, and periodontal inflammatory parameters in Type 2 Diabetes mellitus (T2DM), hypertensive (HTN) patients, and healthy controls. The study sample was divided into three groups: healthy, T2DM, and HTN. Salivary samples were collected from the included participants and salivary flow rate (SFR) and pH were measured. The salivary levels of amylase, mucin, and total protein concentration were analyzed using an enzyme-linked immunosorbent assay. The effect of anti-hypertensive and hypoglycemic drugs on the salivary flow rate, salivary pH, mucin, amylase, and total protein concentrations was evaluated. The results were analyzed with Chi-squared and analysis of variance to compare the means and standard deviations of variables among the study groups. SFR was significantly (p < 0.01) lower among diabetics (0.78 ± 0.45 mL/min) in comparison to healthy (1.52 ± 0.62 mL/min) and hypertensive (1.07 ± 0.7 mL/min) subjects. PISA values were significantly higher in T2DM (1029 ± 234.6 mm2) and HTN (799.4 ± 155.05 mm2) subjects when compared to controls, indicating a high inflammatory burden of oral cavity caused by these conditions, and showed statistically significant difference between the groups (p-value < 0.001). Mucin levels were significantly higher (p-value < 0.05) in hypertensive patients (4.6 ± 1.17 units) compared to diabetics (3.59 ± 1.03 unit/mL) and healthy (2.26 ± 1.09 units/mL) subjects. Amylase levels were significantly higher among healthy subjects (1.76 ± 0.75 mg/mL) compared to both hypertensive (1.33 ± 1.0 mg/mL) and diabetic (0.88 ± 0.57 mg/mL) patients. Total protein concentration was significantly raised (p-value < 0.001) in diabetics (37.67 ± 3.12 mg/mL) compared to healthy (29.3 ± 3.22 mg/mL) subjects. Significant differences in BOP, CAL, and PPD was observed (p-value < 0.001). Use of antihypertensive and hypoglycemic drugs showed a significant influence on salivary flow rate, protein, mucin, and amylase levels. T2DM and HTN induced irregularities in salivary flow rate, pH, amylase, and mucin levels and showed an increased incidence of moderate to severe periodontitis in patients. UWS levels of SFR, mucin, amylase, and total protein can be used as diagnostic and therapeutic biomarkers in patients with T2DM and HTN with oral disease.

Objective: To evaluate the effects of surface treatment and repair material on the repair shear bond strength (SBS) of the bioactive restorative material. Methods: A total of 240 Activa BioActive Restorative (Activa) discs were prepared, aged, and polished, and divided randomly into eight groups ( n = 30). Groups 1–4 discs were repaired with bulk-fill flowable resin-based composite (Bulk-RBC), and Groups 5–8 discs with Activa. Surface treatment used for each repair material type were air abrasion with silica-coated 30-m Al 2 O 3 particles (air abrasion) (Groups 2 & 6), Air abrasion with universal primer (Groups 3 & 7), and Air abrasion with universal adhesive (Groups 4 & 8). Groups 1 and 5 were controls without surface treatment. SBS test was performed, and the failure mode and surface topography were assessed. Results: Surface treatment with air abrasion significantly improved the SBS for repair using both Activa and Bulk-RBC. Repair SBS using Activa was significantly higher compared with Bulk-RBC. Cohesive failure in substrate and mixed failures were most common in the surface-treated groups (2–4, 6–8). Air abrasion produced prominent surface topography changes compared with polishing. Conclusion: Air abrasion enhances the repair SBS of aged bioactive restorative material. The use of the same material (Activa) for repair affords a higher bond strength compared with the use bulk-RBC.

Wound healing following periapical surgery is influenced by age, gender, smoking, periapical lesion size, type of root-end filling, method of root-end cavity preparation and the use of microsurgical or conventional technique. This study aimed to evaluate the influence of various preoperative factors such as age, gender, smoking, preoperative pain, and preoperative periapical lesion size on the outcome of surgical endodontic treatment. A thorough history, examination, and investigation were performed to establish patient age, gender, smoking status, periapical lesion size, and the presence of preoperative pain. Forty patients aged between 15–57 years presented with persistent chronic apical periodontitis of single-rooted anterior teeth after conventional re-root canal treatment were enrolled for periapical surgery. Following periapical surgery, all patients were recalled for evaluation of periapical healing after 12 months based on clinical and periapical X-ray examination due to inaccessibility of an advanced imaging system (CBCT). Chi-squared and Fisher’s exact test were applied, which revealed a statistically significant association of periapical healing with age (p = 0.025), smoking (p = 0.029), and lesion size (p < 0.001). Although, the success of periapical healing was higher in males 78.6% (22/28) compared to females 58.3% (7/12) however, no statistically significant relationship was found between gender and healing (p = 0.254). Patient age, smoking status, and size of the preoperative lesion had a strong influence on periapical healing after surgical endodontic treatment.

The aim is to assess the influence of fabrication techniques—conventional (CN), CAD-CAM (CC), and 3D printing (3D)—on the marginal fit, adaptation, surface roughness, and wear of interim restorations of crowns. Thirty interim crowns were fabricated using CN, CC, and 3D techniques. Sixty discs were fabricated to evaluate surface wear and surface roughness properties, with 10 disc samples in each group (n = 10). Internal adaptation and marginal integrity of interim crowns were analyzed with micro CT to detect microgaps at selected points. Average surface micro-roughness (Ra) was calculated in micrometers (μm) using an optical non-contact surface microscope under cyclic loading. Surface wear was evaluated by surface area measurements (mm3) using a micro CT. Analysis of variance (ANOVA) and Tukey’s post hoc comparison tests with Pearson correlation were performed for data analysis. The highest adaptation means were for CN (269.94 ± 64 μm), and the lowest mean value was observed for 3D (197.82 ± 11.72 μm) crowns. CN and CC specimens showed comparable adaptation (p > 0.05), which were significantly higher (p < 0.05) than 3D crowns. CN crowns showed significantly higher marginal misfit compared to 3D (p < 0.05) and CC (p < 0.05) crowns. The highest mean surface roughness was observed in the 3D crowns (5.61 ± 0.33 µm), whereas the lowest was found in CC crowns (3.28 ± 0.34 µm). Better restoration Ra was observed using the CC method followed by CN. CN had the highest wear (17.79 ± 2.78 mm3), and the lowest wear was observed in the 3D (10.81 ± 2.00 mm3) specimen. Low surface wear was observed using 3D printing, followed by CN and CC techniques. The printed specimen showed comparable outcomes to CAD-CAM restoration; however, they were better than CN restoration. A positive correlation between adaptation and surface roughness was observed, indicating an effect of the fabrication technique on material physical property.

The objective of this work was to investigate the advantages of using dichloro bisphenol A-glycidyl methacrylate (dCl-BisGMA) as a potential matrix for dental resin composites. A series of model composites containing 65 wt% resin (urethane dimethacrylate/triethylene glycol dimethacrylate/BisGMA as 1:3:1) and 35 wt% silanated silica were prepared. Thus, BisGMA was replaced by dCl-BisGMA as 0, 25, 50, and 100 wt% to obtain UTBC0, UTBC25, UTBC50, and UTBC100, respectively. The composites’ rheological properties, degree of double-bond conversion (DC), water sorption (WSP), and water solubility (WSL) were examined. The data revealed a statistically significant reduction in the complex viscosity of composites containing dCl-BisGMA, compared with UTBC0. No significant differences between DCs were detected (p < 0.05). A significant enhancement in the reduction of the dCl-BisGMA composite WSP was also detected, and conversely, WSL was increased. Although the viscosity, DC, and WSP characters were enhanced, a WSL increase is an undesirable development. However, WSL is supposedly caused by cyclization of small flexible chains, which is more likely to occur in the presence of hydrophobic monomers such as dCl-BisGMA and more prone to leaching than are crosslinked networks. We concluded that dCl-BisGMA is a monomer that could potentially be used as an alternative or in combination with traditional monomers, including BisGMA, in resin-based dental composites, and it deserves further investigation.

The aim was to evaluate the effect of ceramic lumineers on inflammatory periodontal parameters, gingival crevicular fluid (GCF) flow rate and cytokine profile. Patients were provided with lumineers using standardized technique including minimal to no preparation. Ceramic lumineers were etched with hydrofluoric acid and teeth with phosphoric acid followed by adhesive cementation. Periodontal parameters (Plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment loss (CAL)) were recorded at baseline and after 4, 12, and 24 weeks of lumineer cementation. Assessment of GCF flow rate and levels of IL-6 and TNF-α was made using enzyme linked immunosorbent assay (ELISA). The statistical significance was determined by the t-test, analysis of variance and post hoc Tukey’s test. It was found that PI, BOP, PPD, and CAL at baseline and 24 weeks were comparable (p > 0.05). The GCF volume at baseline was comparable to the GCF at week 24 (p > 0.05). The IL-6 levels at baseline (5.4 ± 3.6) were similar to those at 24 week (7.4 ± 5.2) (p > 0.05). The TNF-α at week 4 (65.3 ± 16.2), 12 (25 ± 10.2), and 24 (21.3 ± 7.6) was higher than the baseline (13.7 ± 5.8) (p < 0.05). Clinical periodontal parameters and GCF volume among patients treated with ceramic lumineers at baseline and twenty-four week follow-up were comparable. The GCF TNF-α levels significantly increased after ceramic lumineer cementation at 24-week follow-up.

The purpose of this critical review is to explore the research supporting the effectiveness of problem-based learning (PBL) as a teaching method in dental education. PBL was developed more than 40 years ago in reaction to the problems and limitations of traditional teaching approaches. Here, aspects of the PBL teaching approach are reviewed, and the reasons for the substantial effect of this approach on dental education are discussed. Evidence shows that students in PBL-based courses exhibit superior professional skills and effective learning compared with those instructed using traditional approaches. Keywords: Dental education, Problem-based learning, Effectiveness, Critical review

Cention N (CN; Ivoclar Vivadent, Schaan, Liechtenstein), advertised as an alkasite, is a bioactive bulk-fill resin-based composite (BF-RBC) with alkaline fillers. This study evaluated the resin-dentin micro-tensile bond strength (μTBS) and cytotoxicity of CN. Methods: Flat dentin surfaces were obtained, bonded with a universal adhesive, and randomly distributed into two groups. CN (group I) and a flowable BF-RBC, namely, Tetric N-Flow Bulk Fill, Ivoclar Vivadent, Schaan, Liechtenstein (group II), were used. After thermocycling, bonded samples were sectioned into micro-beams for μTBS evaluation. Resin-based composite (RBC) discs with a thickness of 2 and 4 mm were tested on human gingival fibroblast cells (HGFCs). Cytotoxicity was assessed by cell viability and growth using AlamarBlue® (Biosource, Camarillo, CA, USA) over a seven-day period. Independent t-test was utilized to statistically analyze μTBS data, while one- and two-way analysis of variance (ANOVA) and Tukey’s post-hoc tests were utilized to analyze the cell viability data. Results: There was no statistically significant difference (p > 0.05) in the μTBS between the flowable BF-RBC and CN. For both materials, the HGFCs were viable, with constant growing over the seven-day period. Conclusion: CN provided a resin-dentin μTBS that was comparable to that provided by the flowable BF-RBC. Both materials showed acceptable cytotoxicity over the seven-day period at a thickness of both 2 and 4 mm.

Abstract The aim of the present study was to compare the clinical and radiographic periodontal parameters in prediabetes, type 2 diabetes mellitus (T2DM), and non-diabetic patients. Forty-one patients with prediabetes (Group 1), 43 patients with T2DM (Group 2), and 41 controls (Group 3) were included. Demographic data were recorded using a questionnaire. Full-mouth clinical (plaque index [PI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [CAL], missing teeth [MT]) and radiographic (marginal bone loss [MBL]) parameters were measured on digital radiographs. In all groups, hemoglobin A1c (HbA1c) levels were also measured. P values less than 0.05 were considered statistically significant. The mean age and HbA1c levels of participants in Groups 1, 2, and 3 were 53.4±3.5, 60.1 ± 0.6, and 56.6 ± 2.5 years and 6.1%, 8.4%, and 4.8%, respectively. The mean duration of prediabetes and T2DM in patients from Groups 1 and 2 were 1.9 ± 0.3 and 3.1 ± 0.5 years, respectively. PI, BOP, PD, MT, CAL, and MBL were significantly higher in Groups 1 (p < 0.05) and 2 (p < 0.05) than in Group 3. There was no statistically significant difference in these parameters in Groups 1 and 2. Periodontal parameters were worse between prediabetes and T2DM patients compared with controls; however, these parameters were comparable between prediabetes and T2DM patients.

This study investigated the cyclic fatigue resistance of three brands of nickel-titanium rotary files—Unicone (size 25 0.06; Medin), Navigator Evo (W-4; size 25 0.06; Medin) and Protaper Next (X2; size 25 0.06 Dentsply Tulsa Dental)—in reciprocating and continuous motion, during artificial canal instrumentation. Seventy-two samples—Unicone (n = 24), Navigator Evo (n = 24), and Protaper Next (n = 24)—each measuring 25 mm in length, were allocated to reciprocating (n = 36) and continuous motion (n = 36) experimental subgroups, and rotated in a simulated steel curved canal until fracture occurred. Fracture times and fragment lengths of samples in the experimental subgroups were recorded. One of the Unicone, Navigator Evo and Protaper Next fractured samples was randomly selected and analyzed for topographic characteristics by using scanning electron microscopy. Times to fracture and fragment lengths of samples were evaluated by analysis of variance and Tukey’s tests. Independent sample t test was used to compare mean values between the different groups. Protaper Next samples displayed significantly higher resistance to cyclic fatigue in reciprocating motion than Unicone and Navigator Evo samples (p < 0.001). Unicone samples exhibited the least fracture-resistant in continuous and reciprocating motion.

New poly (δ-valerolactone)/titanium dioxide (PDVL/TiO2) nanocomposites with different TiO2 nanoparticle loadings were prepared by the solvent-casting method and characterized by Fourier transform infra-red, differential scanning calorimetry, X-ray diffraction and scanning electron microscopy, and thermogravimetry analyses. The results obtained reveal good dispersion of TiO2 nanoparticles in the polymer matrix and non-formation of new crystalline structures indicating the stability of the crystallinity of TiO2 in the composite. A significant increase in the degree of crystallinity was observed with increasing TiO2 content. The non-isothermal crystallization kinetics of the PDVL/TiO2 system indicate that the crystallization process involves the simultaneous occurrence of two- and three-dimensional spherulitic growths. The thermal degradation analysis of this nanocomposite reveals a significant improvement in the thermal stability with increasing TiO2 loading.