Search Results (10)

Background: There are very few studies in literature concerning the bonding between 3D-printed resin posts and the core build-up material. This study aimed to evaluate and compare the adhesion of 3D-printed and milled resin posts to composite resin core build-up material following different surface treatments. Methods: Three types of resin posts were utilized in this study: ready-made glass-reinforced fiber post (3M ESPE, Germany), milled PEEK POST (Bredent, Germany), and 3D-printed resin post (CROWNTEC, Saremco Dental AG, Switzerland). Each type of post was categorized into three groups based on surface treatments: C: untreated surfaces; SB: Air abrasion with 50 μm aluminum oxide particles was applied to the posts’ surfaces.; HO: the posts’ surfaces were immersed in 30% H₂O₂ for 5 min. A dual-cured composite resin (Grandio DC; VOCO) was utilized for core build-up in each group to evaluate adhesion through the push-out bond strength test. The modes of failure were analyzed, and the surface morphology of the post was characterized using SEM. Data were analyzed using a two-way analysis of variance (ANOVA) along with Tukey’s test. Results: The two-way ANOVA indicated a significant effect for surface treatment (F = 583.54, p < 001), post type (F = 79.96, p < 0.001), and their interactions (F = 265.74, p < 0.001). Regarding 3D-printed resin post, 30% H₂O₂ for 5 min recorded the highest statistically significant bond strength value (13.11 ± 1.61) compared to other groups. Regarding the milled PEEK post, the air particle abrasion recorded the highest statistically significant value (23.88 ± 1.66) compared to other groups. Adhesive failure was the predominant failure type, with an occurrence rate of 70.35%. Mixed failure was noted in 24.07% of the cases, with a significant prevalence in the PEEK post within the air particle abrasion group (58.3%). Cohesive failure was noted in 5.54% of cases, with a significant prevalence in the air particle abrasion group, occurring at rates of 16.6% in the resin fiber post group and 33.3% in PEEK posts. Conclusions: Air particle abrasion significantly improved the push-out bond strength of milled PEEK posts, but it did not have a similar effect on the 3D-printed resin posts. The application of 30% H₂O₂ for 5 min to 3D-printed resin post enhanced the adhesion to core build-up material. The manufacturing method of posts, the surface treatments utilized, and their interactions affect the interfacial bond strength between posts and the composite resin core build-up material. Full article

Background: This study evaluated and compared the effects of thermal aging on the color stability and mechanical properties of CAD/CAM polymers utilized for provisional restorations. Material and Methods: Three CAD/CAM polymers in this study: CAD-Temp (CAT), Everest C-Temp (CT), and PEEK (PK). Forty specimens of each material were randomly assigned to two subgroups. Subgroup A was immersed in distilled water for 24 h, whereas Subgroup B was subjected to 5000 thermal cycles. The color stability, flexural strength (FS), survival probability, and microstructures were evaluated following thermal cycling. Data analysis was conducted utilizing two-way ANOVA along with Tukey’s test. Results: The CAT (3.74 ± 0.39) and CT (3.51 ± 0.54) groups exhibited the highest color variations, while PEEK (2.95 ± 0.45) showed the lowest color change. The baseline groups showed that the CT group had the highest flexural strength value (p < 0.05). The flexural strength values of CAT and CT groups significantly decreased (p < 0.05) following thermal cycling. No significant decrease in FS was observed following thermal cycling in the Pk group (p = 0.16). Conclusions: The color measurement and flexural strength outcomes were significantly influenced by CAD/CAM materials and thermal cycling. The CT group demonstrated superior flexural strength compared to the other groups, both before and after thermal cycling. The PK group shows the lowest color change compared to other groups. Regardless of aging condition, C-Temp and PEEK materials recorded the highest survival probability, a 95% significance level compared to CAD-Temp. Full article

In recent years, CAD/CAM technology has allowed indirect ceramic restorations to become a part of everyday chairside clinical practice. Therefore, the impact of different cavity-preparation designs on the fracture resistance of CAD/CAM fabricated ceramics was assessed in this study. Three designs of cuspal covering (none, palatal, and entire) and two widths of the occlusal isthmus (75% and 100% of the intercuspal distance) were used for the preparation of inlays and onlays to form six groups (n = 10/group). Moreover, thermomechanical cyclic loading was applied to every tooth under a chewing simulator. A universal testing machine was used to measure each group’s fracture resistance. The tested specimens were inspected for any signs of fractures and cracks to categorize failure patterns. Thereby, the values of fracture strength showed that there were statistically nonsignificant differences between the tested groups (p < 0.05). However, a significant difference (p = 0.01) was found between group 1 (inlays) (1950 ± 405) and group 6 (onlays) (3900 ± 770). Type III or type IV fracture modes were seen in the majority of the specimens. In conclusion, inlays and onlays made of zirconia using CAD/CAM technology were deemed reliable for restoring premolars, irrespective of the cavity-preparation design, except for inlays with a 75% intercuspal distance. Full article

Background and objectives: Even with the demand for high esthetics, the strength of the material for esthetic applications continues to be important. In this study, monolith zirconia (MZi) crowns fabricated using CAD/CAM were tested for fracture resistance (FR) in teeth with class II cavity designs with varying proximal depths, restored through a deep marginal elevation technique (DME). Materials and Methods: Forty premolars were randomly divided into four groups of ten teeth. In Group A, tooth preparation was conducted and MZi crowns were fabricated. In Group B, mesio-occluso-distal (MOD) cavities were prepared and restored with microhybrid composites before tooth preparation and the fabrication of MZi crowns. In Groups C and D, MOD cavities were prepared, differentiated by the depth of the gingival seat, 2 mm and 4 mm below the cemento-enamel junction (CEJ). Microhybrid composite resin was used for DME on the CEJ and for the restoration of the MOD cavities; beforehand, tooth preparations were conducted and MZi crowns were and cemented using resin cement. The maximum load to fracture (in newtons (N)) and FR (in megapascals (MPa)) were measured using the universal testing machine. Results: The average scores indicate a gradual decrease in the load required to fracture the samples from Groups A to D, with mean values of 3415.61 N, 2494.11 N, 2108.25 N and 1891.95 N, respectively. ANOVA revealed highly significant differences between the groups. Multiple group comparisons using the Tukey HSD post hoc test revealed that Group D had greater DME depths and showed significant differences compared with Group B. Conclusions: FR in teeth decreased when more tooth structure was involved, even with MZi crowns. However, DME up to 2 mm below the CEJ did not negatively influence the FR. Strengthening the DME-treated teeth with MZi crowns could be a reasonable clinical option, as the force required to fracture the samples far exceeded the maximum recorded biting force for posterior teeth. Full article

Titanium is the main component of dental implants. It is also routinely used as a framework material for implant-supported full-arch prostheses due to its low density, biocompatibility, and other mechanical properties. Remarkable mechanical properties such as lesser mass density and higher young’s modulus of graphene have gained popularity among scientists, improving the properties of biomedical implants. Thus, our study aimed to compare the outcome through the von Mises stresses generated on All-on-6 and All-on-3 implant models, as well as on the framework, and evaluate the effect of stress patterns on the crestal bone around implants in the mandible. FEA (Finite Element Analysis) study was carried out using edentulous mandible models. Four 3D FEA models with 3 and 6 implants were used (Model 1: Titanium bar-supported 6 straight implants; Model 2: Graphene bar-supported 6 straight implants; Model 3: Titanium bar-supported 3 implants with 30 degrees-tilted; Model 4: Graphene bar-supported 3 implants with 30 degrees-tilted) in order to simulate endosseous implant designs. The implant measuring 4.2 mm in diameter and 11.5 mm in length were used. The most distal implants in the 3-implant models were placed with angulation of 30 degrees; in 6 implants, they were vertically placed. All the models were analyzed for vertical and oblique axis with a single force magnitude of 100 N. In all four implant models and under loading conditions, the peak stress points were always on the neck of the most distal implant. von Mises stresses were within the normal stress range. In a conventional six-straight implant model supported by a titanium framework, the cortical stress in the region of implants was 25.27 MPa, whereas, in the graphene framework, it was 12.18 MPa. Under vertical load, there was a significant difference in the cortical stress around the tilted implants (30 degrees) in the 3-implant system of titanium and graphene frameworks, respectively, 70.31 MPa and 21.27 MPa. The graphene framework demonstrated better results than the titanium framework for the conventional six-implant system under vertical load, achieving stress of 30.09 MPa and 76.60 MPa, respectively. In the case of the 3-implant system, a significant difference in the bar stress was observed between graphene and titanium, respectively, 256.32 MPa and 180.1 MPa of bar stress. Within the limitation of this study, the peri-implant stresses were decreased using graphene framework models. Hence, it was possible to conclude that the best load-bearing capacity results were found in the graphene framework group compared to the titanium framework for All-on-6 and All-on-3 implant models, even though both materials are reliable options used as framework materials in implant-supported full-arch prostheses. Full article

Accomplishing painless endodontic treatment, especially in the mandibular molar region, is challenging. Hence, the aim of the study was to compare the efficacy of 2% lidocaine and 4% articaine when used as supplemental intra-ligamentary (IL) anesthesia in mandibular molars having symptomatic irreversible pulpitis with symptomatic apical periodontitis after failed Inferior Alveolar Nerve Block (IANB) injection. In this prospective study, one-hundred and forty-seven adult patients diagnosed with irreversible pulpitis in a mandibular tooth were included who received IANB with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. Patients who experienced pain were recorded using the Heft–Parker visual analog scale (HP-VAS score ≥ 55 mm) and received supplement intra-ligament injection with either4% articaine or 2% lidocaine with 1:100,000 epinephrine. Supplementary intra-ligament injections resulted in 82.6% and 91.3% of profound anesthesia in the first molar region for 2% lidocaine and 4% articaine, respectively. Similarly, an additional IL injection of articaine success percent (78.9%) in the second molar region was higher than lidocaine (63.1%). The overall success ratio revealed no significant difference in achieving profound anesthesia of either solution. In this study population, there was no difference in the success ratio of anesthesia between 2% lidocaine and 4% articaine when used as supplemental IL injection. Full article

Background: It is essential for practicing dentists to have adequate knowledge of HIV/AIDS and its implications in the dental practice. Their attitudes should also be up to the professional expectations. This study aimed to assess knowledge of HIV/AIDS infection and attitudes towards its patients among dental students in Saudi Arabia. Methods: A questionnaire was prepared and distributed among a sample of dental students in Saudi Arabia. Twenty questions related to knowledge, attitudes, and oral manifestation of HIV were presented. Results: A total of 405 questionnaires were completed (67% response rate). Participants showed low knowledge of safety regarding HIV (39.5%) and 44.2% indicated that they would take an HIV test after needle stick injury. The proportion of correct answers regarding transmission of HIV through saliva, cardiopulmonary resuscitation, and aerosols by hand pieces was 41%, 37.5%, and 26.4%, respectively. Almost 50% of the surveyed dental students expressed unwillingness to treat HIV-positive patients. Poor knowledge was noted regarding oral manifestations of HIV (32.7%). Of the participants, 57.8% indicated that infection control procedures are very important for the treatment of HIV patients and 50.6% believed that a dentist can make a decision to reject the treatment of HIV patients. According to the participating dental students, the three major oral manifestations in HIV patients are hairy leukoplakia (47.4%), oral candidiasis (44.7%), and Kaposi’s sarcoma (43.5%). Conclusion: Inadequate knowledge and unprofessional attitude towards HIV/AIDS patients were identified among this group of dental students in Saudi Arabia. Dental educators and health care planners in Saudi Arabia should plan to promote the knowledge and attitudes of dental students in Saudi Arabia towards the treatment of HIV patients. Full article

The success of dental restorations depends mainly on the ability to bond to other filling materials and tooth substances, in order to resist the multitude of forces acting on the bond within the oral cavity. Although the shortcomings of composite resins have been significantly reduced over the past three decades, microleakage due to shrinkage under masticatory loads is unavoidable. In order to overcome such problems, two materials laminated with matched properties can be used to achieve optimum results. The sandwich technique is an approach in which dentine is replaced by glass ionomer cement (GIC), and enamel is replaced by composite resin. In the past, numerous materials have been proposed with adequate properties to be used in this manner, but the results are conflicting in terms of bonding to the various forms of GIC, and the appearance of microcracks or gap formation during functional loading. This study aimed to evaluate the shear bond strength (SBS) and mode of failure between the following core materials: composite resins (CR) (Methacrylate Z350™, Ceram X™, and Spectrum™) with a base material of glass ionomer cement (GIC, Ketac Molar™). Eight samples were made with the help of polytetrafluoroethylene sheets (TEFLON, Wilmington, DE, USA). Each sheet consisted of holes which were 4 mm in diameter and 2 mm in thickness. The combination of materials was sandwiched. The samples were stored in distilled water and then placed in an incubator for 24 h in order to ensure complete polymerization. The samples were thermocycled for 500 cycles between 5–55 °C/ 30 s. Following thermocycling, SBS testing was performed using a universal testing machine. Additionally, scanning electron microscopy (SEM) was performed on representative samples for the bond failure analysis between GIC and the composite resins. The Ceram-X™ nanocomposite showed significantly higher bond strength than Methacrylate Z350™ or Spectrum™ (p = 0.002). The Methacrylate Z350™ and the Spectrum™ composite specimens demonstrated a similar SBS (p = 0.281). The SBS of the Ceram X™ to GIC was the highest compared to Methacrylate Z350™ and Spectrum™. Therefore Ceram X™ may produce a better bond with GIC, and may protect teeth against recurrent caries and failure of the restoration. Methacrylate Z350™ is comparable to Spectrum™ CR and can be used as an alternative. A combination of adhesive and mixed failure was observed in Methacrylate Z350™ CR and GIC, while adhesive failure was predominantly found in both Ceram X™ and Spectrum™ with GIC restorations. Full article

This systematic review aimed to compare the efficacy of herbal agents with ethylene diamine tetraacetic acid (EDTA) in removing the smear layer during root canal instrumentation. The research question in the present study was to assess: “Is there a significant difference in reducing smear layer comparing EDTA and herbal agents?” Electronic databases (PubMed, Scopus, and Web of Science) were searched from their start dates to April 2022 using strict inclusion and exclusion criteria, and reviewed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Only in vitro studies comparing herbal agents with EDTA were included in the current systematic review. Two reviewers independently assessed the included articles. A total of 625 articles were obtained from an electronic database. Eighteen papers were included for review of the full text, out of which, ten papers were excluded because they did not meet the inclusion criteria. Finally, eight articles were included in the systematic review. The present systematic review considered only in vitro studies; hence, the result cannot be completely translated to strict clinical conditions. The results of the present systematic review have shown that quixabeira, morindacitrifolia, oregano extract, and neem show better smear layer removal compared to other herbal agents, whereas they showed reduced smear layer removal when compared with EDTA. Although, it was seen that most of the included studies did not report a high quality of evidence. Hence, the present systematic review concludes that herbal agents have reported to show inferior smear layer removal when compared to EDTA. Thus, as far as herbal based alternatives are concerned, there is no highest level of evidence to state its real benefit when used as a chelating root canal irrigant. Full article

Conventional osteotomy techniques can, in some cases, induce higher stress on bone during implant insertion as a result of higher torque. The aim of the present study was to evaluate and compare the stress exerted on the underlying osseous tissues during the insertion of a tapered implant using different osteotomy techniques through a dynamic finite element analysis which has been widely applied to study biomedical problems through computer-aided software. In three different types of osteotomy techniques, namely conventional (B1), bone tap (B2), and countersink (B3), five models and implants designed per technique were prepared, implant insertion was simulated, and stress exerted by the implant during each was evaluated. Comparison of stress scores on the cortical and cancellous bone at different time points and time intervals from initiation of insertion to the final placement of the implant was made. There was a highly statistically significant difference between B1 and B2 (p = 0.0001) and B2 and B3 (p = 0.0001) groups. In contrast, there was no statistically significant difference in the stress scores between B1 and B3 (p = 0.3080) groups at all time points of implant placement. Overall, a highly significant difference was observed between the stresses exerted in each technique. Within the limitations of our study, bone tap significantly exerted lesser stresses on the entire bone than conventional and countersink type of osteotomy procedures. Considering the stress distribution at the crestal region, the countersink showed lower values in comparison to others. Full article