Association between salivary /microbiological parameters, oral health and eating habits in young athletes

BACKGROUND

Athletes' oral health can impact overall well-being and sports performance. This study aimed to evaluate the interactions between eating habits and oral health of 120 young athletes as compared to 30 age-matched individuals not practicing sports based on a questionnaire and the analysis of saliva.

METHODS

One hundred twenty subjects practicing various sports activities (test group) and 30 subjects not practicing sports (control group) were selected. A self-administered questionnaire was used to obtain personal data, hours and frequency of weekly training, complete pathological history, history of hard and soft tissues of the oral cavity, family history, and oral hygiene practices. The eating habits of the young participants were analyzed by investigating the number of daily meals; use and frequency in sports practice of supplements/energy drinks, fruit/juices, snacks, chocolate; daily diet; and differences between usual diet and pre-competition diet. At baseline (T0), each participant was clinically assessed for the determination of the number of decayed, missing, and filled teeth (DMFT), Silness & Löe Plaque Index (PI), and the Löe & Silness Gingival Index (GI) and qualitative analysis for the presence/absence of stains and dental erosions. At T0, before (T1) and after training sessions (T2), saliva was collected to determine resting pH, Streptococcus mutans, and Lactobacillus spp counts.

RESULTS

Test groups were trained more than 2 h, 5 times a week. Soccer players and skiers had a high percentage of caries; water polo players demonstrated the highest percentage of erosions and dental stains. Salivary resting pH showed statistically different values in three different observations between the groups. S. mutans was harbored by 60% of soccer and 70% of water polo players, while Lactobacillus spp in 43.33% of the swimmers and soccer players. Combining all the 56 variables including the clinical examination, self-reported parameters, and salivary analysis, we have identified water polo players as a distinct at-risk group for developing dental defects, expressed as an aggregate disease score. In particular, we have found that energy snacks/chocolate intake is strongly associated with ratio of S. mutans/Lactobacillus spp and that S. mutans is linked to dental defects (R = 0.88). Linear regression analysis indicates that energy snacks/chocolate intake in the study population represents a strong driver for oral dysbiosis and dental disease.

CONCLUSIONS

Our study clearly shows that athletes should follow a balanced diet that not only satisfies their nutritional needs but also avoids oral dysbiosis and subsequent dental damage.

Porphyromonas gulae and canine periodontal disease: Current understanding and future directions

Porphyromonas gulae has emerged as a notable pathogen in canine periodontal disease, akin to Porphyromonas gingivalis in human periodontitis. This review examines the initial isolation, phylogenetic analysis, habitat, host range, relationships with host health status and age, and key pathogenic determinants, including fimbriae, proteases, citrullinating enzyme, and lipopolysaccharide. Control strategies discussed include polyphosphate to disrupt haeme/iron utilization, clindamycin with interferon alpha to reduce bacterial load and enhance the immune response, and a protease inhibitor. Further research is needed to understand strain-level diversity of virulence factors and interactions between P. gulae and other oral bacteria, particularly Fusobacterium nucleatum, a common pathogen in both dogs and humans. The potential for interspecies transmission between dogs and humans warrants further research into these interactions. Extensive in vivo studies across various breeds are crucial to validate the effectiveness of proposed treatment strategies. This review emphasizes P. gulae's role in periodontal health and disease, setting the stage for future research and improved management of canine periodontal disease.

Comparative study of dentin remineralization with Nano-amorphous calcium phosphate-modified bioactive restoratives

Objective

Modern caries management emphasizes minimally invasive techniques to promote remineralization through a balanced pH and mineral ion availability. Bioactive restorative materials, including giomer (Beautiful II, SHOFU Dental GmbH, Japan), and ACTIVA BioACTIVE (Pulpdent Corp., Watertown, MA, USA), release fluoride, calcium, and phosphate to enhance dentin remineralization. Nano-amorphous calcium phosphate (NACP) is a highly reactive mineral with proven remineralization capabilities due to its high surface area and solubility. The synergistic effects of NACP and the bioactive materials remain underexplored. This study evaluates the remineralization potential of giomer and ACTIVA BioACTIVE with and without NACP integration using energy-dispersive X-ray spectroscopy (EDX) microanalysis and Knoop hardness number (KHN) assessments.

Materials and methods

Four restorative composite materials: Beautifil II, Beautifil II with NACP, ACTIVA BioACTIVE, and ACTIVA BioACTIVE with NACP, were evaluated on demineralized dentin cavities created in non-carious molars. The mineral content (Ca, P, F) was analyzed via EDX, and the microhardness was measured using KHN. Statistical analyses included analysis of variance (ANOVA) and post hoc Tukey tests.

Results

NACP significantly increased calcium and phosphate deposition, with ACTIVA BioACTIVE with NACP demonstrating the highest remineralization (Ca/P ratio: 2.16). Fluoride intensities were higher in the giomer-based materials, promoting fluorapatite formation. KHN analysis revealed that Beautifil II with NACP exhibited the highest hardness, whereas ACTIVA BioACTIVE with NACP showed reduced hardness despite enhanced mineral content.

Conclusion

The incorporation of NACP into giomer and ACTIVA BioACTIVE facilitated the accumulation of calcium and phosphate ions, leading to enhanced mineralization.

Near-infrared light triggered bio-inspired enhanced natural silk fibroin nanofiber composite scaffold for photothermal therapy of periodontitis

Periodontitis is one of the major oral health issues worldwide, with significant impacts on oral health and patients's quality of life, but current therapies have not achieved optimal regeneration of periodontal tissue. This study developed scaffolds using natural tussah silk fibroin (TSF) cross-linked with regenerated silk fibroin (SF) nanofibers to improve mechanical properties and wet-state stability. Zinc oxide (ZnO) and polydopamine (PDA) composite nanoparticles were loaded into scaffold to impart its antibacterial and photothermal properties to construct a photo-responsive composite scaffold (ZnO/PDA/TSF-SF). After characterization, ZnO/PDA/TSF-SF demonstrated excellent antibacterial ability, biocompatibility, and photothermal stability. In vitro cell evaluations under 635 nm red light irradiation-mediated photo-biomodulation (PBM) demonstrated that ZnO/PDA/TSF-SF promoted fibroblast proliferation and enhanced expression of proteins and genes associated with tissue repair, such as collagen I (Col I), fibronectin (FN), and alpha smooth muscle actin (α-SMA). A rat model of periodontitis developed for evaluations of antibacterial and tissue repair effects showed that ZnO/PDA/TSF-SF improved alveolar bone and reversed bone loss. ZnO/PDA/TSF-SF improved inflammation significantly through reduction in tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), and IL-6 levels in serum and gingival tissues of modeled rats. Also, the scaffold markedly increased levels of anti-inflammatory cytokine interleukin-10 (IL-10) and elevated protein and mRNA expression levels of tissue repair-related proteins and endothelial cell markers. ZnO/PDA/TSF-SF scaffold exhibited good biocompatibility, osteogenesis, and photo-responsive antibacterial properties, thereby demonstrating therapeutic potential in treating periodontitis.

Antimicrobial hybrid coatings: A review on applications of nano ZnO based materials for biomedical applications

The extreme survivability of infectious microorganisms on various surfaces prompts for the risk of disease transmissions, posing a perilous concern for global health. Thus, the treatment of these pathogenic microorganisms using the nanomaterials functionalized with antimicrobial coatings reaps relevant scope in the ongoing trend of research. Driven by their admirable biocompatibility, cost-effectiveness, and minimal toxicity, ZnO nanoparticles (ZnO-NPs) based antimicrobial hybrid coatings have emerged as a robust material to prevent the growth of infectious microorganisms on various surfaces, which in turn boosted their applications in the area of biomedical sciences. In this context, the current review focuses on the synthesis of ZnO-NPs based hybrid coatings using different polymers and inorganic materials for effective utilization in biomedical domains including dentistry, orthopedics, implantable medical devices and wound healing. The synergistic effect of ZnO-NPs hybrids with remarkable antibacterial, antifungal and antiviral property has been discussed. Finally, we highlight the future potential of ZnO-NPs based antimicrobial hybrid coatings for potential clinical translation.

Magnification: The game changer in dentistry

During dental examinations and treatments, many dentists are using magnification to improve their vision. The dental operating microscope serves as the most effective tool for this purpose, enhancing the quality, longevity, and outcome of clinical work. This review will explore the latest research and data on the importance of magnification devices in dentistry, including diagnostic methods, treatment options and ergonomics in specialities such as restorative dentistry, endodontics, pedodontics, periodontics, and prosthodontics. This review aims to provide insights into the optimal magnification for different clinical situations, the specific benefits of dental operating microscopes for each dental branch, and their limitations.

Isolation of Pseudonocardia strains associated with the shallow water hydrothermal vent crab Xenograpsus testudinatus from a metal-rich environment: Biochemical characterization and enzymatic characterization, molecular identification, antibacterial, antibiofilm and antioxidant activity

A shallow hydrothermal vent at Kueishantao Island, Taiwan provides a challenging environment and has been less explored for its microbial communities, especially the actinomycetes and their antibacterial and antioxidant activity. Nine actinomycete strains were isolated from the endemic hydrothermal vent crab Xenograpsus testudinatus and were identified as belonging to the rare actinomycete genus Pseudonocardia sp. Physiochemical results showed that the optimum growth conditions of these nine isolates were at pH 7, 35 °C, and 0.5-2% NaCl. Biochemical characterization showed differences between the strains. These isolates were further characterized at genetic barcoding (16s rRNA sequencing) and phenotypic levels and identified at the species/strain level as Pseudonocardia alni SCSW01, Pseudonocardia yuanmonensis SCSW02, Pseudonocardia sp. strains SCSW03, SCSW04, SCSW05, SCSW06, BCSW29, ECSW09, and ECSW018. The morphology of the strains was analyzed using an environmental scanning electron microscope (ESEM). The nine isolates showed potential antibacterial activity against gram-positive and gram-negative pathogenic strains. The confocal laser scanning microscopy (CLSM) images show live and dead cells and biofilm/antibiofilm activity of the actinomycete supernatant and crude extracts against pathogenic bacterial strains. The crude extracts of SCSW02, SCSW06, BCSW29, ECSW09, and ECSW018 showed antibiofilm activity against P. aeruginosa, E. coli, and S. aureus. The antioxidant activity such as DPPH and H2O2 scavenging assay results showed that the nine actinomycetes crude extracts hold more substantial radical scavenging properties than supernatants. Our results marked the first report of Pseudonocardia genera from the vent crab Xenograpsus testudinatus of the HV region at Kueishantao island, Taiwan.

Individualised Therapy for Obstructive Sleep Apnoea: Predictive Models and Anatomical Phenotyping of Mandibular Advancement Devices Responses

OBJECTIVES

This non-randomised clinical study aimed to identify the phenotypic characteristics that distinguish responders from non-responders. Additionally, it sought to establish a predictive model for treatment response to obstructive sleep apnoea (OSA) using mandibular advancement devices (MAD), based on the analysed phenotypic characteristics.

MATERIAL AND METHODS

This study, registered under identifier NCT05596825, prospectively analysed MAD treatment over 6 years using two-piece adjustable appliances according to a standardised protocol. Two response definitions aligned with the latest International Consensus Statement on OSA severity were established. Logistic regression and CHAID models integrated baseline clinical, anthropometric, cephalometric anatomical, soft tissue characteristics and physiological upper airway variables.

RESULTS

A total of 112 patients completed the study: 64 responders and 48 non-responders according to response definition 1, and 81 responders and 31 non-responders according to response definition 2. Responders to MAD treatment had lower body mass index (BMI), neck and waist circumference, Epworth Sleepiness Scale scores, apnoea-hypopnea index (AHI), snoring intensity on the Visual Analog Scale, CPAP pressure, and higher T90% and minSaO2. Patients exhibiting greater anatomical imbalance, smaller airway volume, smaller minimum cross-sectional area (CSAmin) and longer airway length demonstrated a poorer response to treatment.

CONCLUSIONS

Airway length, initial T90% and anterior facial height collectively formed a highly predictive logistic regression model for response definition 1. Jarabak's ratio, gonial angle, CSAmin, airway length, initial BMI and baseline AHI constituted a highly predictive model for the second response definition. Furthermore, the CHAID regression tree established cutoff values for the variables that form the predictive models.

Customized CAD/CAM coral hydroxyapatite block for horizontal ridge augmentation in severe bone defects: A case report

Limited data are available on the application of customized bone blocks for horizontal ridge augmentation, particularly those fabricated using coral hydroxyapatite (CHA). The present case report describes a technique for bone augmentation using a customized CHA bone block. The efficacy and clinical feasibility of the technique were evaluated in a 21-year-old man with missing mandibular central incisors and a severe bone defect, with a horizontal bone width of only 2-3 mm. A customized CHA bone block for guided bone regeneration was designed using preoperative cone-beam computed tomography (CBCT) data and computer-aided design and fabricated using a computer-aided manufacturing technique. Following augmentation surgery using the CHA bone block, the soft tissue healed well without dehiscence or infection. After 10 months, CBCT showed that the bone width had increased to 4-8 mm and the implant was inserted. When assessed 7 months later, the value of the implant stability quotient was 70, and the definitive restoration was completed. The customized CHA bone block simplified the surgical procedure, reduced surgical time and minimized postoperative reactions. Therefore, it may serve as a potential alternative to the autogenous bone graft. However, enhancement of the osteoinductive and osteogenic properties of the CHA block would be beneficial, and further studies are required to achieve this.

Biaxial flexural strength and surface characterization of multilayer zirconium dioxide after polishing, glazing and clinical adjustments

PURPOSE

To evaluate how laboratory polishing and glazing and clinical adjustments, i.e., by grinding and polishing affect the biaxial flexural strength and surface characterization of multilayer zirconia.

METHODS

Specimens of KATANA™ Zirconia YML, containing Enamel-Body 1 or Body 2-3 layers, and UTML were divided into 18 groups (n = 11) according to material/layer and finish treatment: laboratory polishing, glazing, or both, or followed by clinical adjustments. The surface roughness, surface structure and elemental composition were evaluated. Thermocyclic-mechanical cyclic loading and biaxial flexural strength test were performed. Three- and two-way ANOVA were used (α = 0.05).

RESULTS

The yttrium amount decreased in the order UTML, YML Enamel-Body 1, and YML Body 2-3. Body 2-3 showed higher flexural strength than Enamel-Body 1 and UTML, in that order. Flexural strength after clinical adjustments was higher in Body 2-3 but lower in Enamel-Body 1 and UTML. Finish treatments had indistinguishable impact on Enamel-Body 1. Body 2-3 had higher strength after polishing, polishing and glazing, and glazing, in that order. UTML displayed the highest strength after polishing and glazing or glazing. The surface roughness was lowest after polishing regardless of material/layer.

CONCLUSIONS

Laboratory treatments and clinical adjustments of multilayer zirconia affect the flexural strength and surface roughness differently depending on the zirconia type. Composition-gradient zirconia should be polished, and shade-gradient zirconia (≥ 5 mol% yttria) should be polished and glazed. Clinical adjustments of zirconia with higher yttria content are detrimental for the flexural strength and should be performed with caution.

Linc-PINT downregulation of TGF-β signaling pathway in heart arrhythmia: an in silico analysis

Heart Arrhythmias (HA) is one of the heart diseases that occurs due to heart dysfunction or contraction of myocardial cells. Long non-coding RNAs (LncRNAs) are one of the factors that play a role in the physiopathology of HA. TGF-β plays a pivotal role in the pathogenesis of HA. Recently, it has been shown that linc-PINT can play a role in regulating TGF-β expression. However, the interaction of these two molecules in HA has not been investigated in silico, so we evaluated this issue in this study. We accessed the GSE133420 (platform: GPL20795 HiSeq X Ten (Homo sapiens)) dataset containing RNA-seq data from human atrial appendage tissues from patients with atrial fibrillation (AF) and healthy controls. It deals with RNA isolates obtained from plasma samples. To identify potential binding sites for linc-PINT within the promoters of TGF-β signaling genes, we used LncRRIsearch. To further validate and supplement these predictions, we also referenced target genes from LncTar and starBase, which were then integrated into the protein-protein interaction (PPI) network. The results showed that the expression of linc-PINT was significantly decreased in patients compared to the control group (p < 0.01). On the other hand, the expression of SMAD2, SMAD3, SMAD5 and TGF-βR1 genes was significantly increased in patients compared to the control group. The expression of SMAD6 in both groups was almost equal and there was no significant relationship between them (P > 0.05). It can be said that examining the expression of TGF-β and linc-PINT can be helpful in identifying patients at high risk of HA, and by applying therapeutic strategies, clinical symptoms can be improved.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-025-01609-5.

Study on the Antibacterial Properties and Optical Characteristics of Clear Orthodontic Aligners Coated With Zinc Oxide and Magnesium Oxide Nanoparticles

OBJECTIVES

This study aimed to evaluate and compare the antibacterial properties and optical characteristics of clear orthodontic aligners coated with zinc oxide (ZnO) and magnesium oxide (MgO) nanoparticles.

MATERIALS AND METHODS

In this experimental laboratory study, polyethylene terephthalate glycol (PETG) aligner samples were coated with nanoparticles of ZnO, MgO and a combination of both (ZnO + MgO). The surface coatings were analysed before and after stability testing using field emission scanning electron microscopy (FESEM). Colour changes and translucency were measured using a spectrophotometer, and the antimicrobial and antibiofilm properties were evaluated against Streptococcus mutans and Lactobacillus species. Statistical analysis was conducted using SPSS, with significance set at p < 0.05.

RESULTS

Significant statistical differences were found in the colour changes between the groups (p < 0.001), with the greatest change in MgO-coated aligners (0.94 ± 0.09), followed by ZnO + MgO (0.75 ± 0.05) and ZnO (0.5 ± 0.09). ZnO-coated aligners exhibited the highest translucency (47.6 ± 0.44) compared to MgO (45.07 ± 0.74) and ZnO + MgO (45.76 ± 0.7) (p = 0.002 and p = 0.026, respectively). Nanoparticle-coated aligners showed significantly reduced bacterial growth (p < 0.05). The ZnO + MgO combination demonstrated superior antibacterial effects compared to individual coatings. Nanoparticles remained stable after 24-h agitation in artificial saliva and brushing, maintaining 60%-65% stability.

CONCLUSION

The aligners coated with ZnO nanoparticles exhibited the least colour change and the highest translucency compared to those coated with MgO nanoparticles and the ZnO + MgO combination. The highest antibacterial properties were observed in the aligners coated with a combination of ZnO and MgO nanoparticles.

Advanced biomaterials for targeting mature biofilms in periodontitis therapy

Periodontitis is a chronic inflammatory disease primarily caused by bacteria, leading to inflamed and bleeding gums, periodontal pocket formation, and bone loss. Affecting 70%-90% of adults over 65, periodontitis is a leading cause of tooth loss and significantly impacts quality of life. Standard treatments, including subgingival scraping and antibiotics, have limitations, and antibiotic resistance among periodontal pathogens is an increasing concern. Biofilms are barriers to drugs and immune responses, contributing to bacterial resistance and reducing antibiotic effectiveness. Due to their adjustable physicochemical properties, bioactive materials potentially eliminate bacterial biofilms, presenting a promising alternative for periodontitis therapy. In this review, the recent innovations in biomaterials for removing mature biofilms in periodontitis are examined, and their broader potential is discussed. Additionally, the compositions of bacterial biofilms, formation pathways, and intrinsic drug resistance mechanisms are discussed. Finally, the strategies for optimizing subgingival biofilm removal in periodontitis are highlighted, such as targeting biofilms-embedded bacteria, disrupting the extracellular polymeric substances, and utilizing combined approaches. A comprehensive understanding of the properties of biomaterials guides the rational design of highly targeted and effective therapies for periodontitis.

A state-of-the-art review of the recent advances in drug delivery systems for different therapeutic agents in periodontitis

Periodontitis (PD) is a chronic gum illness that may be hard to cure for a number of reasons, including the fact that no one knows what causes it, the side effects of anti-microbial treatment, and how various kinds of bacteria interact with one another. As a result, novel therapeutic approaches for PD treatment must be developed. Additionally, supplementary antibacterial regimens, including local and systemic medication administration of chemical agents, are necessary for deep pockets to assist with mechanical debridement of tooth surfaces. As our knowledge of periodontal disease and drug delivery systems (DDSs) grows, new targeted delivery systems like extracellular vesicles, lipid-based nanoparticles (NPs), metallic NPs, and polymer NPs have been developed. These systems aim to improve the targeting and precision of PD treatments while reducing the systemic side effects of antibiotics. Nanozymes, photodermal therapy, antibacterial metallic NPs, and traditional PD therapies have all been reviewed in this research. Medicinal herbs, antibiotics, photothermal therapy, nanozymes, antibacterial metallic NPs, and conventional therapies for PD have all been examined in this research. After that, we reviewed the key features of many innovative DDSs and how they worked for PD therapy. Finally, we have discussed the advantages and disadvantages of these DDSs.

Three-dimensional volumetric analysis of the temporomandibular joint space using a standard conical object

OBJECTIVE

The objective was to present a novel method for the assessment of the temporomandibular joint space volume (TMJSV) in cone beam computed tomography (CBCT) examinations with TMJ region landmarks. The significance of differences in measurements of mandibular head width (MHW) and volume (MHV) as well as TMJSV was calculated comparing right vs. left sides and males vs. females.

STUDY DESIGN

CBCT images from 50 Angle Class I adults were evaluated using 3D image software. MHW and MHV were obtained from each TMJ. The representative TMJSV was found through Boolean subtraction using a standard conical object in .stl format. Paired t-tests were used to compare right and left sides. The Pearson correlation coefficient was used to assess the correlation between numerical variables. Student t-tests were used to compare MHW, MHV, and TMJSV between males and females. P < .05 indicated significant difference.

RESULTS

The right and left mean MHW, MHV, and TMJSV values were 19.46 and 19.47 mm, 1431.51 and 1401.39 mm3, and 475.51 and 461.13 mm3, respectively, with no significant differences between sides (P ≥ .381). Correlation of these measurements with ipsilateral and contralateral values was moderate to strong (.70 - .89). Males presented higher mean values for all measurements (P ≤ .023).

CONCLUSIONS

The results are comparable to those of other studies, indicating the reliability of our method as a nuanced analysis of the intricate TMJ anatomy.

In Vitro Biomechanics of Attachment Use and Their Placement for Extrusive Tooth Movement by Aligner Mechanotherapy

The objective of the presented study was to evaluate the biomechanics of aligners utilising attachments and the effect of their placement for extrusion. An in vitro Orthodontic SIMulator (OSIM) was used to measure forces and moments produced through aligners incorporating attachments. The maxillary teeth on OSIM were digitally scanned to generate an STL model that was modified by placing a rectangular shaped attachment. Four models were designed with variation in attachment placement: Model NA-no attachment; model BA-buccal attachment; model LA-lingual attachment; model BL-both buccal and lingual attachments. Aligners (n = 30/model) were fabricated using a 0.75 mm thick polyethylene terephthalate material using a Biostar machine following the manufacturer's recommendations. A one-way MANOVA, followed by one-way ANOVA was used to test the effect of models on occlusogingival force (Fz) and mesiodistal moment (Mx) at 0.20 mm of gingival displacement of the left lateral incisor. The BL model exerted maximum Fz (1.22 ± 0.20 N), followed by models BA (1.18 ± 0.25 N) and LA (1.07 ± 0.19 N). The model NA exerted a negligible Fz (0.14 ± 0.08 N) that was statistically different from all other models. The models BA and LA generated Mx that has the tendency to tip the crown of tooth lingually (10.00 ± 3.12 Nmm) and buccally (-1.29 ± 2.26 Nmm), respectively. The models show statistically significant differences between models BL, BA and LA. There was no statistically significant difference between models BL and NA. The experimental evidence suggest that attachments on the lateral incisor could improve the predictability of extrusion forces applied with aligners. The models BL and LA provided favourable biomechanics by generating clinically significant extrusion forces without significant tipping of the lateral incisor tooth.

Impact of Periodontal Lipopolysaccharides on Systemic Health: Mechanisms, Clinical Implications, and Future Directions

Periodontal diseases, particularly periodontitis, are complex inflammatory conditions caused by interactions between oral microbiota and the host immune response. Lipopolysaccharides (LPSs) from Gram-negative bacteria like Tannerella forsythia, Treponema denticola, and Porphyromonas gingivalis are key in pathogenesis. This review examines how LPS impacts systemic health through direct invasion, compromised oral barriers, increased vascular permeability, and immune cell transport. LPS triggers inflammation in periodontal tissues, leading to tissue destruction and disease progression. In the bloodstream, LPS contributes to conditions, such as cardiovascular diseases, diabetes, respiratory diseases, and rheumatoid arthritis. Current treatments include mechanical debridement, antibiotics, antimicrobial mouthwashes, and anti-inflammatory therapies. Despite progress, gaps remain in understanding the molecular mechanisms of LPS in systemic diseases. Future research should focus on longitudinal studies, the gut-oral axis, biomarkers for early detection, and the lymphatic system's role in LPS dissemination. Maintaining periodontal health is crucial for overall systemic well-being.

Magnesium-substituted zinc-calcium hydroxyfluorapatite bioceramics for bone tissue engineering

Hydroxyfluorapatite (HFAp) materials possess a structural and compositional similarity to bone tissue and dentin. These bioceramics facilitate various physiological functions, including ion exchange within surface layers. Additionally, magnesium (Mg) serves as a primary substitute for calcium in the biological apatite found in the calcified tissues of mammals, while zinc (Zn) contributes to overall bone quality and exhibits antibacterial properties. Although multiple studies have examined the individual substitution of ions within the hydroxyapatite (HAp) structure, no research to date has investigated the simultaneous substitution of zinc, fluoride, and varying amounts of magnesium in calcium HAp. This study explores the incorporation of magnesium into the structure of zinc-calcium hydroxylfluorapatite. A series of ion-substituted apatites, represented as Ca9.9-xZn0.1Mgx (PO4)6(OH)F with 0 ≤ x ≤ 1, were synthesized. Characterization of the produced samples confirmed that they were monophase apatite, crystallizing in the hexagonal P63/m space group, with only a slight impact on crystallinity due to magnesium doping. Pressure-less sintering of the samples demonstrated that maximum densification, approximately 94%, was achieved at 1200 °C with a sintering dwell of 1 h for the sample with x = 0.1. Furthermore, the Young's and Vickers hardness of this sample reached peak values of 105 and 5.02 GPa, respectively. When immersed in simulated body fluid, the formation of an amorphous CaP which can subsequently be crystallized into crystalline phase on the surface of dense specimens was observed, indicating the ability to bond with bone in a living organism and their potential use as substitutes for failed bone and dentin filling and coating.

Polish Version of the Malocclusion Impact Questionnaire (MIQ): Translation, Cross-Cultural Adaptation and Validation

AIM

To translate the malocclusion impact questionnaire (MIQ) into Polish, adapt it for Polish cultural conditions, and validate its usage.

SUBJECTS AND METHODS

The original MIQ was translated into Polish following a seven-stage cross-cultural adaptation protocol. A total of 121 orthodontic patients participated in the study: 21 in the translation and cultural adaptation phase (5 males, 13.4 ± 1.5 years; 16 females, 13.6 ± 1.9 years) and 100 in the validation phase (53 males, 13.1 ± 1.6 years; 47 females, 12.9 ± 1.7 years). Confirmatory factor analysis (CFA) was conducted to confirm the one-dimensional structure of the MIQ_PL. Reliability was assessed using Cronbach's alpha for internal consistency and intraclass correlation coefficients (ICCs) for test-retest reliability, whereas construct validity was evaluated by comparing MIQ_PL scores with responses to global questions 1 and 2 from the MIQ_PL questionnaire and the aesthetic component of the index of orthodontic treatment need (IOTN-AC).

RESULTS

The MIQ_PL was generally well understood by the test group and required only minor adjustments, indicating it is well adapted to the Polish cultural context. The internal consistency, measured by Cronbach's alpha, was 0.68, and the intraclass correlation coefficient for test-retest reliability was 0.75, indicating adequate reliability. Many questionnaire items had a high floor effect. The correlation coefficients between global questions 1 and 2 and the MIQ_PL scores were 0.269 and 0.407, respectively, whereas the correlation between the IOTN-AC and MIQ_PL was 0.235.

CONCLUSIONS

The MIQ_PL is culturally adapted for Polish conditions but demonstrates lower than expected reliability and internal consistency. Further validation in non-clinical settings with a more diverse sample is recommended.

Assessment of Clinical Predictability of Overbite Reduction and Curve of Spee Levelling in Clear Aligner Treatment

OBJECTIVE

This retrospective study aims to assess the predictability of Overbite (OVB) reduction and Curve of Spee (COS) levelling in patients with deep bite malocclusion treated with Clear Aligner Therapy (CAT). The research evaluates the accuracy of the prescribed movements in growing and non-growing patients.

MATERIALS AND METHODS

Thirty-six patients treated with Invisalign from January 2018 using SmartTrack were included. Digital models at pre-treatment, virtual plan and post-treatment phases were collected and analysed using Geomagic Control X. Accuracy was assessed for COS levelling, OVB reduction and individual tooth movements. Statistical analyses included descriptive statistics, paired t-tests and linear regression between accuracy of the movements and the age of the patient.

RESULTS

The study found that the prescribed movements in ClinCheck often overestimated the achieved outcomes. The mean accuracy for COS levelling was 62%, and for OVB reduction, it was 61%. No significant association was observed between the accuracy and the age of the patient.

CONCLUSION

Clear Aligner Therapy demonstrated moderate accuracy in achieving prescribed movements for COS levelling and OVB reduction. Clinicians should exercise caution in virtual treatment planning and may need to consider potential modifications to software projections to enhance desired outcomes. Further research comparing different aligner protocols and brands is warranted to advance understanding and improve treatment predictability.

Efficacy of different gingival graft de-epithelialization methods: A parallel-group randomized clinical trial

OBJECTIVES

The clinical outcomes of either extra-oral (eo) or intra-oral (io) de-epithelialized connective tissue graft (DE-CTG) techniques to the recipient site have not been fully elucidated yet. There is an ongoing debate regarding the possible complications caused by incomplete elimination of the epithelial layer. The aim of this study is to compare clinical effectiveness and de-epithelialization efficacy of ioDE-CTG and eoDE-CTG in recession treatment.

MATERIALS AND METHODS

Forty patients, with a single gingival recession, were treated with coronally advanced flap combined with eo- or ioDE-CTG. Data consisted of surgical chair-time, recipient site periodontal and patient-based variables. To evaluate the efficacy of de-epithelialization, histological analyses were also performed via graft imprints.

RESULTS

There was no significant inter-group difference in terms of treatment outcomes. Aesthetic results were also similar for both groups. While chair-time was significantly shorter in the ioDE group, less epithelial remnants were showed with eoDE technique.

CONCLUSIONS

Similar clinical outcomes were obtained with eo- and ioDE-CTG. While ioDE is less effective in removing the epithelial layer, no long-term complications due to the epithelial residues were detected. Both techniques can be recommended in recession treatment.

CLINICAL RELEVANCE

This study demonstrates that extraoral and intraoral de-epithelialized connective tissue grafts in root coverage procedures led to similar clinical results without any further events. The study protocol was registered at ClinicalTrials.gov (NCT05494294).

Retreatment of Two Bioceramic Sealers Included Two Different Percentages of Calcium Silicate Using Two Endodontic File Systems: An In Vitro Study

Calcium silicate materials are widely used in endodontic treatment. Different calcium silicate percentages can be included in bioceramic sealers. The aim of this in vitro study was to investigate the effect of the calcium silicate percentages on mineral deposition into dentinal tubules at 7 days, 1 month, and 4 months of aging, as well as the effect of calcium silicate percentages on the quality of retreatment using two endodontic retreatment systems.Single rooted premolars were used in the present study. After the shaping and irrigation steps, the obturation was performed using high (Ceraseal "CRS") and low (AH Plus Bioceramic "AHB") calcium silicate percentage sealers. ReTreaty (RT) and ProTaper Universal Retreatment (PUR) were used to perform the retreatment process. The time required to achieve the apex was recorded. A digital microscope and a cone-beam computed tomography (CBCT) were used to evaluate the remaining materials after the retreatment procedure. Scanning electron microscope was used to investigate the presence of mineral deposition into dentinal tubules and the change in mineral morphology at 7 days, 1 month, and 4 months. The data was statistically analyzed using two-way analysis of variance and t-test.Both materials (CRS and AHB) demonstrated different mineral depositions onto their surfaces after 24 hours, 1 month, and 4 months, and showed mineral depositions into dentinal tubules at 4 months. RT was faster in achieving the apex for CRS group compared to PUR (p < 0.001), while no difference was found between both systems among the AHB groups. Both retreatment systems were quicker to achieve the apex in AHB compared to the CRS group (RT p = 0.035 and PUR p < 0.001). CBCT demonstrated a more precise measurement compared to the digital microscope in which the instrument and the material factors influence the removal ability at the coronal and middle thirds (p < 0.05). No significant difference was found at the apical third.The retreatment of AHB was easier and faster than CRS. RT demonstrated higher removal ability and faster time compared to PUR. The apical third proved to be a difficult area to achieve an optimal cleaning. Calcium silicate percentages included in bioceramic sealers could play an important role in root canal retreatment. Higher percentages of calcium silicate can decrease the capacity of the retreatment process and increase the needed time to remove the materials.

Cemento-osseous dysplasia: a multi-centre analysis of surgical management

PURPOSE

Cemento-osseous dysplasia (COD) is a fibro-osseous lesion whose management is highly controversial in the literature. Due to scarcity of comprehensive studies on its management, the aim of this study was to analyse its management and develop a treatment protocol.

METHODS

A multi-centre retrospective cohort analysis was conducted at two tertiary referral hospitals on 124 patients diagnosed with COD from 2005 to 2023. Demographic, clinical, and radiological data were analysed and correlated with treatment methods. Post-operative complications such as osteomyelitis or pathological fracture were documented along with follow-up visits to evaluate the need for further treatment. Data was analysed using Student's t-test and Fisher's exact test. Statistical significance was set at P < 0.05.

RESULTS

The patients' ages ranged from 22 to 78 years (mean: 48.5 years), with majority being females (90.4%) and of African descent (95.9%). Radiopaque CODs presented significantly higher rate of symptoms compared to radiolucent or mixed lesions (p = 0.02). The majority of incidental CODs were managed through observation (72%), while six incidental CODs underwent biopsy due to suspicion of more sinister lesions. Symptomatic lesions were mainly treated by curettage (29.7%) or local excision (48.6%), while only one symptomatic case was managed with observation and antibiotics (p = 0.0001).

CONCLUSION

Biopsy of asymptomatic COD should only be reserved for cases with inconclusive clinico-pathological features. The decision to surgically treat COD should be based on the presence of symptoms and infection. Early curettage or excision of infected COD is the most effective approach to eradicate the disease and prevent progression into osteomyelitis.

CLINICAL TRIAL NUMBER

Not applicable.

Relational study between sleep quality, daytime sleepiness state, anxiety, stress, depression in possible bruxist and non-bruxist: cross-sectional study

This study aims to analyze whether individuals who self-report as possible bruxism differ from non-bruxism in terms of sleep quality, daytime sleepiness, and emotional disorders (depression, anxiety, and stress). Additionally, it examines the relationships between these emotional disorders, sleep quality, and daytime sleepiness in both groups. An online questionnaire was administered to 400 Spanish participants without cognitive impairments. The questionnaire included self-report measures of sleep bruxism, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Depression, Anxiety, and Stress Scale-21. Statistical analyses, including the Chi-square test and the T-test, were conducted to assess associations. A total of 21.8% of participants self-reported as possible bruxism, with a higher prevalence among women and individuals under 50 years of age. No significant differences were found between bruxism and non-bruxism regarding the percentage of participants with poor sleep quality or excessive daytime sleepiness (p > .05). However, significant differences were observed in levels of depression, anxiety, and stress, which were higher among possible bruxism. Possible sleep bruxism is not associated with excessive daytime sleepiness but is linked to poorer sleep quality and greater severity of depression, anxiety, and stress. Stronger associations between sleep quality and both depression and anxiety were observed in the bruxism group compared to non-bruxism, suggesting that psychological disorders have a more consistent impact on sleep quality in bruxism. Women, middle-aged individuals, and those with a university education reported higher rates of bruxism symptoms. Bruxism is associated with poorer sleep quality and psychological disorders such as depression, anxiety, and stress, which negatively impact quality of life. Understanding these associations, their prevalence, and the psychological profile of bruxism can help in designing more effective intervention programs to mitigate these adverse effects.

Effect of Nd:YAG Laser Surface Pretreatments and Bonding Protocols on Shear Bond Strength of Monolithic Zirconia with Varying Yttria Contents to Composite Resin

This study aimed to evaluate the impact of different surface pretreatments and bonding protocols on the shear bond strength (SBS) of two monolithic zirconia materials to composite resin.A total of 200 zirconia specimens, 3Y-TZP (n = 100) and 5YSZ (n = 100), were allocated into five groups: Control with no treatment, air-particle abrasion (APA), Nd:YAG (neodymium-doped yttrium aluminum garnet) laser treatment (L), a combination of APA and L, and laser treatment followed by cold plasma (CAP). Half of the specimens received a primer application before bonding with resin cement. Surface morphology was assessed using scanning electron microscopy, and SBS testing was conducted with a universal testing machine.The SBS analysis was done using multiway analysis of variance (p ≤ 0.05).Different surface pretreatments and 10-methacryloyloxydecyl dihydrogen phosphate primer application significantly increased SBS values (p ≤ 0.001). APA was associated with the highest SBS values, followed by APA + laser and laser + CAP. However, the combination of APA with L slightly reduce the bond strength. While the application of laser alone possesses the lowest SBS among the surface pretreatment methods, the control group was the worst by far. Different zirconia materials showed no impact on SBS values.APA surface pretreatment might still be the gold standard for zirconia adhesion. Laser surface pretreatment is a viable, less destructive option. Combining APA with laser slightly reduces SBS, while combining two inert surface pretreatment methods, such as laser and CAP, leads to enhancement of SBS compared with laser alone. Zirconia primer is highly recommended for bonding protocol. No special considerations should be taken for different yttria contents, as both materials reported comparable bond strength within the same coupled variables.

Adipose-Derived Mesenchymal Stem Cell Osteodifferentiation after Exposure to Beta-Tricalcium Phosphate Bioceramic Granules with 300 to 600 and 600 to 1,000 µm Sizes

Beta-tricalcium phosphate (β-TCP) is a synthetic graft material with excellent biocompatibility, osteoconductivity, and osteoinductivity. β-TCP may induce adipose-derived mesenchymal stem cells (ADMSCs) osteodifferentiation. This study aims to investigate the osteoinductivity of 300 to 600 and 600 to 1,000μm β-TCP in ADMSCs.ADMSCs were obtained from the visceral adipose tissue of young male rabbits. To determine the osteoinductive ability, bone morphogenic protein 2 (BMP-2), Osterix, runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), osteopontin, and osteonectin expression was examined using an immunochemical assay on ADMSCs conditioned with an osteogenic medium and a β-TCP bioceramic with granule sizes of 300 to 600 and 600 to 1,000 µm (100 ng diluted to 100 nmol as the final concentration). A 3,3'-diaminobenzidine staining kit was used for immunocytochemical staining. Anti-BMP-2, anti-Osterix, anti-Runx2, anti-ALP, anti-osteopontin, and anti-osteonectin monoclonal antibodies were employed at a 1:500 dilution. A light microscope with magnifications of 400× and 1,000× was used to manually observe and examine cultures in five different fields of view.BMP 2, Runx2, Osterix, and ALP expression was higher in ADMSCs + β-TCP 300 to 600 µm compared with the control group (p < 0.05). Osteonectin and osteopontin expression was higher in ADMSCs + 300 to 600 µm β-TCP compared with the control group (p < 0.05) and ADMSCs + 600 to 1,000 µm β-TCP (p < 0.05).ADMSC osteodifferentiation was influenced by β-TCP bioceramic granule size. The considerable difference in osteonectin and osteopontin expression supports the idea that 300 to 600 µm β-TCP induce ADMSCs osteodifferentiation than 600 to 1,000 µm β-TCP.

Torsional resistance of additively, subtractively, and conventionally manufactured occlusal devices

OBJECTIVES

To investigate the torque load (TL) and angular rotation (AR) of additively, subtractively and conventionally manufactured occlusal devices.

MATERIALS AND METHODS

Specimens (N = 120) were fabricated from four additive manufacturing resins (GR-10 guide, ProArt Print Splint clear, V-Print Splint, V-Print Splint comfort), five subtractively (BioniCut, EldyPlus, ProArt CAD Splint clear, Temp Premium Flexible, Thermeo) and one conventionally manufactured (Pro Base Cold) materials. The TL and AR were tested initially (24 h, 37 °C, H2O) as well as after thermal cycling (5,000 thermal cycles, 5/55°C). Data were analyzed using Kolmogorov-Smirnov, one-way ANOVA, Scheffé post-hoc, t-test, chi-square and Ciba-Geigy table (p < 0.05).

RESULTS

Initially, the mean TL values ranged from 63.7 to 104 Ncm for additively, 39.2 to 265 Ncm for subtractively, and 204 Ncm for conventionally manufactured materials. The initial mean AR values were 41.7 to 143 deg for additively, 38.4 to 138 deg for subtractively, and 29.3 deg for conventionally manufactured materials. After thermal cycling, the mean TL values ranged from 45.7 to 88.1 Ncm for additively, 31.2 to 246 Ncm for subtractively, and 138 Ncm for conventionally manufactured materials. The mean AR values after aging ranged from 19.9 to 124 deg for additively, 48.1 to 131 deg for subtractively, and 19.5 deg for conventionally manufactured materials.

CONCLUSIONS

The torsional resistance of additively, subtractively, and conventionally manufactured materials for occlusal devices varies and is affected by aging processes.

CLINICAL RELEVANCE

Material selection for occlusal devices should be guided by the clinical needs of the patients.

On design, fabrication, and pre-clinical validation of customized 3D-printed dental implant assembly

In the past few decades, 3D-printed dental implants have been manufactured, and significant studies have demonstrated the pre-clinical validation of such systems. However, studies have yet to tackle the ever-present issue of preventing the jumping gap to enhance overall outcomes. The present study details the utilization of patient computed tomography (CT) data to design and subsequently fabricate a multi-component customized dental implant assembly and customized instruments using direct metal laser sintering (DMLS) technology. The workflow was validated for two patient data sets (cases 1 and 2), which were used to render and print custom implant assemblies; the simulation data for these were compared with a commercially available solution. The present study incorporated a prototype stage as well as subjecting the customized implant assemblies to both static (Case 1: 38.889-77.815 MPa vs 75.47-158.09 MPa; Case 2: 83.947-106.65 MPa vs 55.225-126.57 MPa) and dynamic finite element analysis (Case 1: 41.076-84.09 MPa vs 75.448-187.91 MPa; Case 2: 106.81-108.7 MPa vs 79.176-135.48 MPa) along with resonance frequency analysis (Case 1: 7763.2 Hz vs 7003.6 Hz; Case 2: 7910.1 Hz vs 7102.1 Hz) as well as residual stress analysis. The assembly's stress patterns and resonance frequencies were evaluated against a commercially available implant system. It was observed that the customized implant assemblies tended to outperform the commercially available solution in most simulated scenarios.

Analysis of factors influencing delayed treatment seeking for dental caries in preschool children: a cross-sectional study

OBJECTIVE

This study investigated the prevalence of treatment delays among preschoolers with dental caries, identified the associated influencing factors, and predicted the risk of delayed treatment. The findings of this study provide an evidence base for future interventions designed to reduce treatment delays in this population.

METHODS

A convenience sample of 264 preschool children with dental caries and their parents who visited the paediatric dental department between October 2023 and May 2024 was surveyed. Data were collected using a general information questionnaire, a medical status questionnaire, the Children's Fear Survey Schedule-Dental Subscale, the Modified Version Dental Anxiety Scale, the Short-Form Health Literacy Dental Scale, and the Illness Perception Questionnaire Revised for Dental. Influencing factors were analysed using univariate analysis and binary logistic regression, whereas the risk of occurrence was predicted using the receiver operating characteristic (ROC) curve.

RESULTS

The prevalence of delayed treatment among preschool children with dental caries was 71.21%, with an average delay of 117.5 days. Binary logistic regression analysis identified several independent factors significantly associated with delayed treatment (P < 0.05), including the primary caregiver, initial symptom recognition, children's dental fear, parental dental anxiety, and parental oral health literacy. Predictive analyses indicated that children's dental fear (AUC: 0.765, 95%CI: 0.707-0.823) and parental oral health literacy (AUC: 0.738, 95%CI: 0.673-0.802) demonstrated relatively high predictive values for delayed treatment.

CONCLUSION

Efforts to reduce delayed treatment should prioritise addressing children's dental fear and improving parental oral health literacy. Targeted and effective strategies in these areas may facilitate early prevention, diagnosis, and intervention, thereby minimising treatment delays, reducing disease burden, and promoting oral health among preschoolers.

Association between salivary immune markers and oral health conditions in pregnant women

This study aims to assess levels of salivary immune markers in women during the 3rd trimester of pregnancy and explores the association between immune markers and dental caries, as well as oral carriage of oral pathogens Candida albicans and Streptococcus mutans. These organisms are known to be associated with oral infectious diseases such as dental caries and oral candida infection. Methods: Pregnant women from underserved background participated in this study (n = 181). Participants received a comprehensive oral examination by trained and calibrated dentists. Levels of 36 immune markers in unstimulated saliva samples were measured using Bio-Plex200 (Luminex). Salivary S. mutans and C. albicans were quantified using viable count (CFU/ml). Quantities of immune markers and colony-forming-units of S. mutans and C. albicans were converted to natural log data for statistical analysis. Latent class analysis was used to assess the clustering effect of immune markers among the participants. Results: The study found high quantities of salivary immune markers in pregnant women with varying detection rates. Univariate analysis found a higher salivary level of IFN-g and TNF-b among women with < 4 decayed teeth, compared to those with ≥ 4 decayed teeth (p < 0.05). Among women with more than 105 CFU/ml S. mutans in saliva, FLT-3 L, IL-17a, TNF-B, and VEGF-a levels were significantly decreased (p < 0.05), while G-CSF levels were significantly increased (p < 0.05). Lower levels of VEGF-a, Eotaxin and IL-9 were found among the individuals with salivary C. albicans (p < 0.05). Two distinct clusters were identified among the 181 participants, low-level and high-level of immune markers. The logistic regression model with Least Absolute Shrinkage and Selection Operator (LASSO) penalty identified several potential variables associated with high-level of salivary immune markers. Debiased results indicated statistically significant association between plaque C. albicans and S. mutans and immune markers (p < 0.05), with higher levels of these variables correlating with lower level of immune markers. In summary, our research underscores the intricate relationship between caries status, microbial populations, and immune markers in pregnant women.

The Inhibition of Streptococcus mutans Biofilms following Exposure to Different Chocolate Ingredients

This project aimed to investigate the anticariogenic effect of four chocolate ingredients (polyphenol, theobromine, cacao, and flavanol) against Streptococcus mutans biofilms grown in vitro.Stored S. mutans (UA 159) was transferred to Brain Heart Infusion (BHI) broth and incubated in aerobic incubator for 24 hours at 37°C in 5% CO2. Following this, 190 µL of each ingredient concentration (0.78-200 mg/mL) and 10 µL of the culture were added to a 96-well plate and incubated for 24 hours at 37°C in 5% CO2. Then, biofilms were fixed, stained with crystal violet, and analyzed for formation using a spectrophotometer. Control groups included negative control with only S. mutans and sterility control with BHI media.One-way analysis of variance and Tukey tests analyzed the data.Flavonoid at the 6.25 to 25 mg/mL concentrations reduced the S. mutans biofilms (p < 0.001) by 5- to 33-fold. Meanwhile, 50 mg/mL concentrations and higher completely eradicated biofilm growth. Similarly, cocoa concentrations ranging between 12.5 and 200 mg/mL revealed massive antibiofilm action from a 22-fold reduction at 12.5 mg/mL to complete biofilm eradication at 200 mg/mL. Polyphenol was the only ingredient showing biofilm inhibition at all concentrations ranging from almost 10-fold reduction to complete biofilm eradication, which were all significant (p < 0.001) compared to the control. Regarding theobromine, 3.125 mg/mL of it significantly increased the growth of S. mutans biofilms. At the concentration of 6.25 mg/mL, theobromine significantly (p < 0.001) inhibited the S. mutans biofilms by 3.35-fold. While at the range of 25 to 200 mg/mL, theobromine resulted in a reduction between 11-fold and complete biofilm eradication.The findings suggest that flavonoid, cacao, polyphenol, and theobromine may serve as effective adjuncts in preventing dental caries by inhibiting S. mutans biofilm formation.

Asarum sieboldii, a Potential Ethnomedicinal Herb in Dentistry and Oral Health

Asarum sieboldii, a species of wild ginger native to East Asia, has long been recognised as an important herb in Asian traditional medicine. It has been applied in the treatment of toothache, cough, asthma, and sinusitis. A. sieboldii has gained global interest because it offers solutions to multiple health concerns. The plant is renowned for its anti-inflammatory, analgesic, antimicrobial, antifungal, and antioxidant properties. Its roots exhibit a wide range of biological and pharmacological effects. The plant contains several chemical constituents, including methyleugenol, 3,4,5-trimethoxytoluene, and safrole, which contribute to its medicinal benefits. Whereas literature search highlights the potential application of A. sieboldii in herbal medicine, to date its application in dentistry remains largely unexplored, with the existing literature vastly fragmented in various sources. This review therefore, provides a comprehensive overview of the potential application of A. sieboldii in dentistry and oral health. The plant shows considerable promise and appears to be effective for managing common oral diseases such as tooth decay, periodontal diseases, toothache, oral cancer, oral ulcers, and gingivitis. Its ability to inhibit nitric oxide release, along with its neuroprotective effects, further enhances its potential for relieving pain and inflammation. With these therapeutic benefits, A. sieboldii presents a promising natural alternative or a complementary option to conventional dental treatments, capable of addressing a wide range of oral health conditions. The findings from this review could serve as a solid foundation for future research, supporting the development of high-quality, safe, and effective A. sieboldii-based products in dentistry and oral health.

Self-Perceived Confidence of Final-Year Dental Students in Oral Surgery for Adults and Children

INTRODUCTION

Undergraduate dental training should nurture students' self-confidence to perform basic oral surgical procedures. Inadequate confidence can lead to hesitance and anxiety, which may compromise patient safety and the quality of dental care.

AIMS

This study aimed to evaluate the confidence levels of final-year dental students in performing oral surgical procedures for adults and children and to explore the factors that influence their confidence.

METHODS

A structured questionnaire was distributed electronically to dental students at the end of their final year. Descriptive statistics and Spearman's correlation (p-value ≤ 0.05) were used to analyse the data.

RESULTS

N = 503 participated. Students were very confident in giving infiltration and Inferior Alveolar Nerve Block (IANB) (73.8% N = 371, 58.8% N = 296), performing simple permanent (anterior: 56.9% N = 286, posterior: 51.1% N = 257) and primary tooth extraction (anterior: 53.7% N = 270, posterior: 51.7% N = 260). However, they were 'somewhat confident' performing third molar extraction (upper: 37% N = 186, lower: 39.6% N = 199), writing drug prescriptions (42.7% N = 210), managing postoperative swelling (37.85 N = 190) and extracting for the medically compromised patients (37.2% N = 187). Students were not confident performing root separation (32.4% N = 163), bone removal (41.6% N = 209) or raising a flap (43.3% N = 218). Half of the students indicated, 'I did not encounter or have the chance to extract certain types of teeth', as a factor that lowers their confidence (50.1% N = 252).

CONCLUSION

Students were less confident performing third molar extraction, surgical extraction procedures, writing drug prescriptions and extraction for medically compromised patients. Further clinical exposure to such procedures is expected to raise students' confidence.

Preventing white spot lesions around orthodontic brackets: efficacy of pre-reacted glass-ionomer barrier coat versus silver diamine fluoride: an in vitro study

OBJECTIVES

to compare the effect of using a pre-reacted glass-ionomer (PRG) barrier coat versus silver diamine fluoride (SDF) varnish treatment before orthodontic bracket bonding to prevent white spot lesions (WSL). The effect of these materials on the shear bond strength of orthodontic brackets was evaluated through an in vitro study.

METHODS

One hundred-five premolars were used; forty-two specimens were designated for comparing SDF versus PRG-barrier coat using a scanning electron microscope (SEM) with elemental analysis and microhardness testing (n = 21/group). Tested materials were applied in a split-tooth design protocol (side A: control, side B: treated). Measurement was made at baseline and after bracket placement and exposure to the pH cycle. A polarized light microscope (PLM) was used for qualitative examination. Sixty-three specimens were intended for shear bond strength (SBS) testing after the pH cycle as follows: control group (no treatment), SDF group, and PRG-barrier coat group (n = 21/group). Statistical analysis was done using Paired T-test.

RESULTS

SEM for specimens treated by SDF or PRG revealed enamel remineralization with calcium deposits and small porosities between the crystallites. All groups had a significant difference regarding the Ca/P ratio and microhardness. Baseline hardness for both groups was significantly higher than the treated sides, which was significantly higher than the non-treated sides (P = 0.000*) and (P = 0.000*) in accordance with the Paired T-test. In comparing SDF with PRG-coat groups, the T-test showed non-significant differences in mean differences between treated and baseline hardness values (T = 0.32, P = 0.74). PLM for treated specimens by SDF or PRG depicted an evident remineralized surface enamel layer. SBS values did not differ significantly between groups.

CONCLUSIONS

As confirmed by SEM and PLM, applying either SDF varnish or PRG-barrier coat before bonding orthodontic brackets could effectively prevent the development of WSL and achieve surface enamel protection. In addition, the two applied varnishes showed slightly higher shear bond strength of orthodontic brackets compared to the control group, with the SDF slightly higher than PRG. Also, clinical translation is needed in future research to evaluate the study.

Comparison of the remineralization effectiveness of three remineralizing agents on artificial enamel lesions: an in vitro study

INTRODUCTION

Early enamel demineralization can be reversed through remineralization, which restores lost minerals to strengthen enamel and prevent decay.

AIM

This study evaluated the remineralization efficiency of three commercial treatments on artificially demineralized primary enamel.

METHODS

Forty exfoliated primary anterior teeth were demineralized and divided into five groups: untreated control, artificial saliva, fluoridated toothpaste, Curasept toothpaste, and BioMin toothpaste. The treatments were applied for 28 days. Remineralization efficacy was assessed using Vickers microhardness testing, surface roughness measurement, and Scanning electron microscope combined with EDX (SEM-EDX). One-way ANOVA and Tukey's HSD test were used for statistical analysis.

RESULTS

Microhardness and surface roughness tests confirmed BioMin's superior remineralization potential. Scanning electron microscopy showed that untreated enamel exhibited extensive demineralization, whereas treated groups displayed varying degrees of remineralization. BioMin demonstrated the highest calcium, phosphate, and fluoride incorporation, followed by Curasept and fluoridated toothpaste. The artificial saliva group showed no significant improvement over the control.

CONCLUSION

BioMin, followed by Curasept and fluoridated toothpaste, effectively remineralized demineralized enamel. BioMin's bioactive glass formulation provided the highest mineral gain, suggesting its potential for non-invasive enamel restoration in pediatric dentistry.

Sensible Solutions to Perennial Problems of the Interdental Col

This article highlights the perennial problems posed by the interdental col as well as their consequences for patients' dental health and for many aspects of general dentistry. When the interdental col is not considered properly during restorative procedures new problems can arise instead of resolving existing ones. Dental professionals must be constantly vigilant because any oozing of inflammatory gingival crevicular fluid, or frank bleeding, from the col regions can impact adversely on adhesive bonding, pulpal health, impression accuracy, and restoration cementation. This article emphasises the importance of patients accepting their responsibilities early on for gaining and maintaining their dental health by appropriate cleaning of their col areas. In addition, this article demonstrates practical and cost-effective adjustments of interproximal restorations that promote periodontal health. It highlights that restored teeth often need to be made anatomically different to natural teeth to reduce the likelihood of perpetuating problems of the col. Careful design and precise execution of interproximal restorations are both essential to prevent reproducing problems which often necessitated those restorations in the first place.This article also provides some practical hints on restoring teeth near the interdental col which will become ever more important in general practice following the imminent banning of dental amalgam.

The impact of blade geometry (nonflat, flat or hybrid) and metallurgical composition on the mechanical performance of NiTi endodontic instruments: A multimethod laboratory study

AIM

To evaluate the influence of blade design (conventional, flat and hybrid) and metallurgical properties on the mechanical performance of nickel-titanium endodontic instruments.

METHODOLOGY

Two hundred and seven NiTi instruments (25 mm in length) with three different blade designs were selected for analysis: conventional (n = 69, CC One Blue, size 25/0.08v), flat (n = 69, Platinum V.EU, size 25/0.06) and hybrid (n = 69, Flash Endo Power, size 25/0.06v). The instruments were evaluated regarding geometric design (scanning electron microscopy), alloy elements composition (energy-dispersive X-ray spectroscopy) and phase transformation temperatures (differential scanning calorimetry). Additionally, their mechanical behaviour was investigated by testing cyclic fatigue resistance, torsional resistance, bending resistance, buckling resistance, cutting efficiency and microhardness. Statistical significance was determined using One-Way anova and Kruskal-Wallis tests (α = 5%).

RESULTS

Platinum V.EU and Flash instruments exhibited design inconsistencies within the same lot, including nonstandard positioning and variations in the length of the flat side. All instruments were composed of a nickel-titanium alloy with equiatomic ratios of nickel and titanium. At 20°C, Flash instruments exhibited a mixed R-phase and austenitic arrangement, transitioning fully to austenitic at 36°C, while CC One Blue and Platinum V.EU displayed a complete R-phase at 20°C and retained a mixed R-phase and austenitic arrangement at 36°C. The CC One Blue exhibited superior performance in time to fracture (156 ± 34 s), maximum torque (1.5 N·cm) and buckling strength (372 ± 31 gf) (p < .0001), while no differences were found in maximum rotation angle (p = .602). In terms of flexibility, the Flash (328 gf) and CC One Blue (341 gf) outperformed the Platinum V.EU (376 gf) (p = .006). Flash (121 gf) and CC One Blue (137 gf) also outperformed Platinum V.EU (253 gf) in terms of cutting efficiency (p < .0001). Conversely, the Platinum V.EU demonstrated significantly higher microhardness (386 ± 45 HVN) compared to CC One Blue and Flash (p = .0340).

CONCLUSIONS

Overall, instruments featuring either flat-side (Platinum V.EU) or hybrid (Flash) active blades demonstrated inferior mechanical performance compared to the conventional nonflat instrument (CC One Blue).

Enhanced Bone Regeneration Using Demineralized Dentin Matrix: A Comparative Study in Alveolar Bone Repair

OBJECTIVES

Alveolar bone resorption following tooth extraction presents significant challenges for implant-supported rehabilitations. Demineralised dentin matrix (DDM) has emerged as a promising scaffold for bone tissue regeneration. This study evaluates the bone-regenerating potential of varying degrees of dentin demineralisation.

MATERIALS AND METHODS

Thirty-two male white New Zealand rabbits underwent extraction of the left mandibular anterior tooth and were assigned to 4 groups: undemineralised dentin matrix (UDDM), partially demineralised dentin matrix (PDDM), completely demineralised dentin matrix (CDDM), and a control group with no treatment. At 4 and 8 weeks post extraction, cone-beam computed tomography (CBCT) was used to assess alveolar bone height and width. Histological analyses using H&E and Masson trichrome stains evaluated new bone formation, and immunohistochemistry detected osteopontin expression.

RESULTS

CBCT imaging revealed progressive increases in alveolar bone height and width across all groups over time. Histological analysis showed new bone formation in all groups, with the PDDM group demonstrating closer integration of newly formed bone trabeculae compared with the others. IHC results showed higher osteopontin expression in the PDDM group, highlighting its superior bone-inductive potential.

CONCLUSION

Among the tested materials, PDDM exhibited the most effective bone induction and tissue regeneration capabilities, outperforming CDDM and UDDM in promoting alveolar bone repair. These findings position PDDM as a valuable scaffold for enhancing bone tissue regeneration in clinical applications.

CLINICAL RELEVANCE

The use of PDDM in tooth extraction sockets significantly promotes efficient and reliable bone regeneration, making it a valuable option for clinical applications in implant dentistry.

Knowledge level of diagnostic procedures and risk factors for oral cancer among oral healthcare providers in Germany

BACKGROUND

Oral cancer is an underestimated and growing public health problem. The majority of cases are diagnosed at a late stage, even though oral cancer can be detected early by routine visual and tactile examination. Dental healthcare providers thus play a vital role in its early detection. This study assessed dental healthcare providers' knowledge of diagnostic procedures and risk factors for oral cancer.

METHODS

A cross-sectional, observational study was conducted using a validated survey of 38 items focusing on knowledge of diagnostic procedures and risk factors, and questions on continuing education. From October to December 2023, the online survey invitation was sent via all German state Dental Associations to their members. Participants' socio-demographic data and responses in the "knowledge, opinion and continuing education" section were analysed descriptively. Linear regressions assessed the associations between participants' characteristics or opinions and their knowledge of oral cancer (knowledge score).

RESULTS

Overall, 8,132 participants began the survey. After filtering for reliability and completeness, data from 3,458, 3,472, and 2,933 participants were available for "socio-demographics", "knowledge", and "opinions and continuing education", respectively. Most participants were women (60%), between 30 to 49 years old (48%). The majority knew the most common type of oral cancer and the most common lesions associated with it. Furthermore, almost 89% of the participants were aware that early detection improves survival rates. The main risk factors (tobacco, alcohol, prior oral cancer) were well known. However, the potential for improvement in knowledge of localisation, signs, stage of diagnosis and the specific age group at risk was noted. Fewer years in the dental profession and since attending the last continuing education course were associated with higher levels of knowledge.

CONCLUSIONS

Knowledge of localisation, signs, stage of diagnosis, and specific risk groups can be improved. These topics should thus be integral to the dental curriculum and addressed through structured continuing education programmes, as the study's results suggest that knowledge declines over time without continuing education.

"A Patient-Centred Care of Dentist Scale: Perceptions of Dentists' in Thai Community Hospitals: A Multi-Group Analysis"

INTRODUCTION AND AIMS

Providing high-quality dental services at the primary care level requires a patient-centred approach. However, there is a lack of specific instruments to measure PCC in this context. This study aimed to develop and validate a tool to assess patient-centred care (PCC) among dentists working in Thailand's primary care settings and to examine how personal characteristics influence PCC.

METHODS

A set of 61 statements was developed for the Patient-Centred Care of Dentist Scale (PCCDS-D). Responses were collected using a Google Form. The validity and reliability of the scale were assessed through confirmatory factor analysis (CFA), exploratory factor analysis (EFA), Cronbach's alpha, and the intraclass correlation coefficient (ICC). Responses from dentists in large hospitals were compared with those from dentists in small hospitals. The influence of dentist attributes on PCC was examined.

RESULTS

The randomized samples for EFA and CFA included 754 and 305 dentists, respectively. The final version of the PCCDS-D contains 36 statements across seven components: dentist-patient relationship, disease-illness, integrated care, communication, shared information and decision-making, holistic, and empathy and anxiety management. The PCCDS-D demonstrated satisfactory reliability and validity, with good model fit and invariance across different dentist groups. The Cronbach's alpha and ICC were 0.94 and 0.93, respectively. The frequency of dentists practicing at primary care units (PCU) was found to influence the delivery of PCC.

CONCLUSIONS

The PCCDS-D included 36 statements across seven domains and showed consistency among dentists in various-sized hospitals. It demonstrates robust reliability and validity. Additionally, experiences gained from practicing at PCU appear to impact the delivery of PCC.

Novel 3D printed resin crown versus prefabricated zirconia crown for restoring pulpotomized primary molars: in vitro evaluation of fracture resistance and marginal gap

AIM

This in vitro study aimed to evaluate the marginal gap and fracture resistance of 3D printing microfilled hybrid resin crowns in comparison to prefabricated zirconia crowns on pulpotomized primary teeth.

MATERIALS AND METHODS

Twenty primary molars were selected for the study and randomly divided into two groups (n = 10). Group1 received 3D printed microfilled hybrid resin crowns; Group 2 received prefabricated zirconia crowns. To simulate 6 months of oral conditions, thermodynamic cycling was performed, and the marginal gap was measured using a stereomicroscope with digital camera at 40 × magnification. For each sample, eight points along the margins for each axial surface were captured. The fracture resistance of each group was assessed by applying increasing load till crown fracture using a computer-controlled universal testing machine. Data were tested for normality using the Shapiro-Wilk test. Data were analyzed using an independent t test. A significant level was set at P < 0.05.

RESULTS

Regarding fracture resistance, 3D printed crowns group had statistically significant higher mean values than the prefabricated zirconia crowns group; the values were 1235.97 ± 412.12 N and 576.56 ± 221.53 N, respectively (P < 0.001). However, there was no significant difference in the marginal gap between the two types of crowns with average 32.00 ± 7.54 for 3D printed crowns and average 34.14 ± 9.79 for zirconia crowns (P < 0.001).

CONCLUSION

3D printed microfilled hybrid resin crowns could be a suitable esthetic alternative for restoring pulp-treated primary molars. It is possible to provide an additional esthetic solution for the parents/children to satisfy the need for esthetic restoration of primary molars.

CLINICAL TRIAL

Not applicable (in vitro study).

The effect of supplementary methods on root canal cleaning: a study using 3D-printed mandibular molar models

This study investigated the cleaning effect of different irrigation and activation techniques in removing residual tissue from the root canal system using 3D-printed resin models based on micro-CT scans of natural teeth. Eleven first mandibular molars with different anatomies were selected, scanned, and replicated six times each, resulting in 66 3D resin models. A hydrogel-based like pulp tissue was injected into the canals to simulate tissue. The samples were divided into six groups: (1) irrigation with saline solution without activation (control), (2) use of positive pressure with NaOCl, (3) sonic activation, (4) wireless PUI activation, (5) conventional wired PUI activation, and (6) XP-Endo finisher agitation. Cleaning efficiency was evaluated by comparing the images before and after irrigation using ImageJ software, quantifying the percentage of remaining tissue. Statistical analysis was performed using one-way ANOVA and post-hoc Tukey's test (p < 0.05). Rinsing with saline solution showed the worst cleaning performance in all canal thirds (p < 0.05). XP-Endo Finisher, Sonic Activation, Wireless PUI, Conventional PUI, and Conventional Syringe Irrigation with NaOCl significantly outperformed saline irrigation. In the apical third, XP-Endo Finisher achieved the lowest residual tissue percentage (5.79%), while saline had the highest (53.82%). No significant differences were found among activation techniques (p > 0.05), not even between the activation techniques and positive pressure irrigation with NaOCl. Sonic Activation and XP-Endo Finisher eliminated tissue in some samples of the middle third. NaOCl irrigation alone effectively dissolves the hydrogel tissue even without activation. Although activation techniques do not provide a consistent statistical advantage, they remain valuable in complex anatomies. Complete tissue removal, particularly in the apical third, remains a challenge. Future research should validate these results in clinical settings and optimize irrigation protocols for improved outcomes.

Long-term survival of endodontically treated teeth: A retrospective analysis of predictive factors at a German dental school

OBJECTIVES

The aims were to investigate the survival rate of endodontically treated teeth (ETT) at a German dental school and to identify potential prognostic factors influencing tooth survival.

METHODS

Dental records of patients were retrospectively screened for nonsurgical root canal treatment of at least one permanent tooth between 2000 and 2015. Individual-, tooth-, and treatment-related variables were recorded, and survival was defined as the presence of the ETT in the oral cavity until the date of censoring. Survival rates of ETT were assessed by Kaplan-Meier statistics, and mean annual failure rates (mAFRs) after 5- and 10-years were calculated. The effect of the assessed variables on survival was determined by univariable log-rank test and multivariable Cox regression analysis with shared frailty (p < 0.05).

RESULTS

Overall, 3049 teeth from patients with a mean age of 41.53 ± 15.75 years were included. Survival of ETT after 5 and 10 years amounted to 88.0 % and 77.4 % (mAFR: 2.51 % and 2.54 %), respectively. The following variables significantly increased the tooth survival rate: patient age ≤ 60 years (p ≤ 0.035), 2 proximal contacts (p < 0.001), absence of apical periodontitis (p < 0.001), multiple visits (p = 0.033), use of a chelator (p = 0.022), and placement of a new indirect restoration (p < 0.001).

CONCLUSION

Root canal treatment is effective for maintaining natural teeth. Tooth survival was affected by several individual-, tooth-, and treatment-related variables.

CLINICAL SIGNIFICANCE

This retrospective study confirms the long-term retention of root-filled teeth after nonsurgical (re-)treatment. Several pre-, intra- and postoperative factors significantly reduced survival rates.

Evaluating a Novel Visualization Device for Improving File Insertion Accuracy During Root Canal Treatment

This study aimed to evaluate whether adopting a horizontal viewpoint, facilitated by a novel digital assistive device, could enhance endodontic file placement accuracy and reduce operator-dependent variability during root canal treatment.A total of 40 modified upper jaw dental stone models, each accommodating a plastic tooth replacing the upper right second molar, were divided into two groups (n = 20 each). The mesiobuccal canal of each tooth was prepared to a standardized working length of 21.0 mm and a working width of size 35. A size 40 file with a stopper preadjusted to 19.0 mm was then inserted. In the first (conventional) group, files were placed without assistance; in the second (device-assisted) group, a horizontal-view digital device was designed, developed, and used to align and insert the file. The second operator, blinded to the device's purpose, performed all insertions under simulated clinical conditions. An intraoral scanner subsequently captured the vertical distance from the stopper's bottom surface to a standardized anatomical landmark. Pairwise comparisons between the two groups were computed using alignment software to account for potential measurement artifacts.Normality in both groups was confirmed via the Shapiro-Wilk test. An independent-samples t-test compared mean vertical distances. Additionally, differences in stopper positioning were calculated for all aligned virtual models in CloudCompare.The device-assisted group exhibited a significantly shorter mean stopper-to-landmark distance (0.425 mm, standard deviation [SD] = 0.225) than the conventional group (0.971 mm, SD = 0.432) (t = -5.014, p = 2.534 × 10-5). Pairwise analysis highlighted closer apical positioning in the device-assisted group, closely matching pilot study findings that a 26.57° vertical viewing angle can distort perceptions by 0.5 mm. The device's mean intraoral mounting time was 224 s (SD = 35.2), considered negligible over the full treatment duration.Adopting a horizontal perspective with a novel digital assistive device significantly improved file placement accuracy and reduced operator-dependent variability during root canal treatment. Optimizing this device's design and assessing its cost-effectiveness may facilitate broader clinical adoption and further enhance endodontic procedural outcomes.

Time efficiency and cost of fabricating removable complete dentures using digital, hybrid, and conventional workflows: A systematic review

STATEMENT OF PROBLEM

Analysis of the cost and time efficiency of removable complete dentures (RCDs) fabricated using conventional and computer-aided design and computer-aided manufacturing (CAD-CAM) processes remains limited.

PURPOSE

The purpose of this systematic review was to evaluate the time efficiency and cost of conventional, hybrid, and completely digital workflows throughout the entire process of RCD fabrication.

MATERIAL AND METHODS

Article selection followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines and was registered with the international prospective register of systematic reviews (PROSPERO). The bibliographic search covered the PubMed and Cochrane databases using keywords related to removable complete dentures, digital workflows, and economic factors and covered articles from January 2010 to June 2024. In total, 1188 articles were identified and assessed. A bottom-up search identified an additional 10 articles through cited works. Data on cost and time analyses were reported in a qualitative synthesis.

RESULTS

The qualitative synthesis included 8 articles published between 2015 and 2024 showing that digital and hybrid workflows generally reduced both clinical and laboratory time and overall costs compared with conventional workflows. The hybrid protocol required significantly less clinical time, with reductions ranging from approximately 1 to 4 hours. Hybrid and completely digital workflows reduced laboratory manufacturing time by approximately 6 to 7 hours compared with conventional workflows. Cost analyses revealed that digital and hybrid workflows were more profitable and cost effective than conventional workflows.

CONCLUSIONS

The findings suggest that digital and hybrid workflows for RCD fabrication are more time efficient and cost effective than conventional methods.

Influence of proximal box elevation on microleakage in 3Y-TZP zirconia ceramic fixed dental prostheses after thermomechanical loading: A laboratory study

STATEMENT OF PROBLEM

Deep subgingival defects at the abutment teeth for fixed dental prostheses (FDPs) are a common problem in prosthodontics. Surgical crown lengthening or orthodontic extrusion of the abutment teeth have been recommended treatment options. However, disadvantages such as extended treatment time, treatment costs, or surgical problems have to be considered. Proximal box elevation has been proposed as an alternative, but microleakage studies are lacking.

PURPOSE

The purpose of this in vitro study was to investigate the influence of proximal box elevation (PBE) and conventional foundation restoration on the microleakage of 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) ceramic FDPs after thermomechanical loading (TML).

MATERIAL AND METHODS

Sixteen molars and 48 premolars were divided into 4 groups (n=8). Either fixed-to-fixed (premolar, molar) or cantilever FDPs (premolar, premolar) were fabricated. The pontic of both groups had a mesiodistal width of 7 mm. The proximal foundation restorations were placed using a self-etch adhesive system and a dual-polymerizing composite resin, and a standardized tooth preparation design was carried out. All FDPs were adhesively luted and subjected to TML (1.2 million cycles, 5/55 °C, 49 N). After TML, all specimens were placed in fuchsin and then sectioned in a sagittal direction. The sections were evaluated with respect to the penetration depth of the dye by light microscopy at 4 different interfaces: tooth and luting composite resin (TC), luting composite resin and restoration (CR), tooth and foundation restoration (TB), foundation restoration and luting composite resin (BC). As data were not normally distributed, nonparametric tests were used for statistical analysis (α=.05).

RESULTS

Statistically significant differences were observed between the PBE and the control group (P<.05). Microleakage at the TB interface was detectable in all specimens of the PBE group, while 84.4% of the specimens of the control group showed leakage at the TC and TB interfaces. Leakage was detected at the CR interface in 3.1% of all specimens. No leakage was observed at the interface BC. Additionally, statistically significant differences were found within the same study specimen between the control (conventional foundation restoration) and the study side (PBE) (P<.05).

CONCLUSIONS

Irrespective of the pretreatment (experimental PBE or conventional foundation restoration), the adhesive bond of the foundation restoration and the luting composite resin to the dentin represented a limiting factor with regard to microleakage in fixed-to-fixed and cantilever FDPs. PBE was more frequently affected by microleakage than a conventional foundation restoration.

Digital Workflows in Implant Dentistry Utilizing Intraoperative CT Scanning

Many digital workflows have been utilized in the past few years in the acquisition of implant positions for full arch implant positions intraoperatively and postoperatively. The goal of the different workflows is to offer speed, precision, and predictability. This study outlines the steps for an innovative fully digital full arch workflow that ensures predictable and fast outcomes using digital tools available in most dental implant centers.

Worst pattern of invasion in oral squamous cell carcinoma: An independent prognostic indicator

Introduction

Oral squamous cell carcinoma is a malignancy that is biologically aggressive.

Objective

To investigate the correlation between various histopathological factors and the worst patterns of invasion at the tumor-host interface, which were classified as cohesive (1-3) and non-cohesive (4&5).

Methods

Neck dissections were performed on 81 cases of oral squamous cell carcinoma those had been diagnosed. The selection was limited to paraffin-embedded blocks that contained sections from the tumor. Tumor staging, nodal staging and other factors such as lymphovascular invasion, perineural invasion, extra nodal extension, depth of invasion, margin status and tumor differentiation grades were documented.

Results

The findings indicate a higher frequency of non-cohesive worst invasion patterns in numerous anatomical sites. A prediction accuracy of 69.1 % was obtained from the logistic regression analysis, suggesting that the predictive performance has also improved. The chi square test results demonstrated a statistically significant correlation between the variable of interest and extranodal extension showing a p value of 0.008 while lymph node status also showed significant with a p value of 0.000. Another factor that depicted a significance with worst pattern of invasion was tumor margin status having a p value of 0.046. Lymphovascular invasion and the worst pattern of invasion also exhibited a statistically significant correlation, with a p-value of 0.013.

Conclusion

The results of this investigation indicate that aggressive tumor biology is associated with non-cohesive worst pattern of invasion. Non-cohesive worst pattern of invasion is associated with moderate differentiation grade, lymphovascular invasion, perineural invasion, extranodal extension, closed or involved tumor margins and nodal metastases.

Fluoride Concentrations in Different Brands of Toothpaste Marketed in Saudi Arabia

OBJECTIVES

This study aimed to evaluate the concentrations of total fluoride (TF), total soluble fluoride (TSF) and ionic fluoride (IF) in various toothpaste brands marketed in Saudi Arabia and compare them with the labelled values.

METHODS

Twenty toothpaste brands were randomly selected from supermarkets and hypermarkets in Riyadh, Saudi Arabia. For each brand, two samples from different production batches were purchased and labelled as sample 1 and sample 2. TF and TSF were determined chemically, while IF was measured with fluoride electrodes. The measured fluoride concentrations were compared with the labelled values and the recommended 1000-1500 ppm range for effective caries prevention.

RESULTS

In total, 40 toothpaste samples were analysed (20 from each of two batches). For TF, six toothpastes in sample 1 exceeded the standard limit of 1500 ppm, with a range of 2102-2462 ppm, while nine in sample 2 surpassed the limit, ranging from 1538 to 1846 ppm. Conversely, eight toothpastes in sample 1 and two in sample 2 were below the minimum recommended level of 1000 ppm, with ranges of 308-923 ppm and 615-923 ppm, respectively. The TSF ranged from 924 to 2157 ppm in sample 1 and 923-2154 ppm in sample 2. The IF varied from 615 to 2462 ppm in sample 1 and 308-2154 ppm in sample 2.

CONCLUSIONS

Most toothpaste brands had fluoride levels within the recommended concentration range. However, a significant number exhibited fluoride levels either below the minimum effective dose or exceeding the maximum recommended limit. Fluoride variance in toothpaste demands awareness for dentists and public health to guide optimal caries prevention.

Oral cavity and oropharyngeal cancers in Texas: examining incidence rates in dental health professional shortage areas

PURPOSE

Oral cavity (OC) and oropharyngeal (OP) cancer rates have increased annually rising in the U.S. and Texas. Dental providers could play a key role in lowering OC/OP cancer rates through prevention and screening, but Texas faces a significant shortage of dental health professionals, affecting access to dental care, including OC/OP cancer prevention and early detection. This study aims to explore the link between OC/OP cancer rates and these dental shortage areas in Texas.

METHODS

We analyzed OC/OP cancer incidence in Texas using SEER-Medicare data for patients aged 65 and over from 2012 to 2017. Rates per 100,000 were stratified by age, gender, and dental health provider shortage area (DHPSA) status (yes/no). Zero-Inflated Poisson Regression models were used to adjust for patient characteristics in studying cancer incidence, Late-stage diagnoses were assessed using logistic regression.

RESULTS

The incidence rate was 27.3 per 100,000 people in Texas. DHPSA counties had lower incidence rates (24.3 per 100,000) compared to non-DHPSA counties (29.8 per 100,000; p = 0.0423). Among patients with OC/OP diagnoses, those living in a DHPSA county had lower odds of advanced stage diagnoses (aOR: 0.79; CI: 0.64-0.96) than those in non-DHPSA counties.

CONCLUSION

The findings highlight the complex link between dental providers and OC/OP cancer diagnoses, noting differences in indicators of need based on DHPSA location. Limited local dental services may lead to underreported cancer cases. Further research on dental service usage could improve OC/OP outcomes by prioritizing interventions from dental professionals.