Search Results (45)

Background/Objectives: Immediate dentin sealing (IDS) has been widely investigated in sound dentin; however, its efficacy on demineralized dentin remains insufficiently explored. This in vitro experimental study aimed to evaluate the shear bond strength (SBS) of indirect composite resin restorations bonded to demineralized dentin using IDS, assessed at 24 h and after 6 months of aging. Methods: Twenty-five extracted premolars were randomly divided into five groups: (1) control (no sealing), (2) IDS applied to sound dentin (sound-IDS), (3) IDS applied to demineralized dentin (carious-IDS), (4) delayed dentin sealing (DDS) on sound dentin (sound-DDS), and (5) DDS on demineralized dentin (carious-DDS). SBS values were analyzed using a three-way analysis of variance (ANOVA) with dentin condition (sound vs. demineralized), aging time (24 h vs. 6 months), and sealing strategy (control, IDS, DDS) as independent variables. Statistical analyses were performed using SigmaPlot 12.0, with significance set at p < 0.05. Results: The results showed that IDS led to significantly higher SBS than DDS (p < 0.05). Bond strength was significantly influenced by dentin condition (p < 0.05), and all interactions between variables—particularly between dentin condition and sealing strategy, and between aging time and treatment—were statistically significant (p < 0.001). Overall, bond strength was higher at 24 h than after 6 months. IDS showed optimal performance in sound dentin, while DDS resulted in better long-term outcomes in demineralized dentin. Conclusions: These findings suggest that DDS may be the more effective approach in cases of carious or demineralized dentin. Full article

Background: Accuracy of optical impressions—defined by the intraoral scanner (IOS)’s trueness and precision per International Organization for Standardization (ISO) standards—is influenced by both operator- and patient-related factors. Thus, this in vitro study aimed to (1) evaluate how scanning distance affects the accuracy of three different intraoral scanners (IOSs), and (2) identify the optimal scanning distance for each scanner. Methods: A maxillary arch model was obtained using polyvinyl siloxane impression material and poured with Type IV stone (Octa-rock royal^®, Kulzer, Germany). Using three different types of IOSs—the trios 3 shape (TRIOS ^® cart, 3Shape, Copenhagen, Denmark); the Helios 500 (Eighteeth ^®, Changzhou, China); and the Heron (3Disc ^®, Herndon, VA 20170, USA)—ten scans were performed with each of the IOSs with five predetermined distances: 0 mm, 2.5 mm, 5 mm, 7.5 mm, and 10 mm. Spacers of varying heights were designed using Meshmixer version 3.5 (Autodesk, Inc., Mill Valley, CA, USA) and three-dimensional printed with the Form 2 printer (Formlabs, Somerville, MA, USA). The scanned data was processed using Geomagic Control X (Version 16.0.2.16496, 3D Systems, Wilsonville, OR, USA). Statistical analyses were performed using R Statistical Software (version 4.2.2), with significance set at α = 0.05. Results: Scanning distance significantly influenced scan accuracy for all three scanners. The 3Disc scanner (3Disc, Herndon, VA, USA) demonstrated the highest accuracy at a 7.5 mm distance, while both the Helios 500 (Eighteeth, Changzhou, China) and Trios 3 (3Shape, Copenhagen, Denmark) scanners achieved their best accuracy at a 5 mm distance, as indicated by the lowest root mean square (RMS) values (p < 0.05). Conclusions: To conclude, each IOS has an optimal scanning distance for best accuracy. Trios 3 (3Shape, Copenhagen, Denmark) outperformed the others in both trueness and precision. Future studies should examine these effects under full-arch and clinical conditions. Full article

Background: Digital dental photography is increasingly essential for documentation and smile design. This study aimed to compare the linear measurement accuracy of various smartphones and a Digital Single-Lens Reflex (DSLR) camera against digital models obtained by intraoral and desktop scanners. Methods: Tooth height and width from six different casts were measured and compared using images acquired with a Canon EOS 250D DSLR, six smartphone models (iPhone 13, iPhone 15, Samsung Galaxy S22 Ultra, Samsung Galaxy S23 Ultra, Samsung Galaxy S24, and Vivo T2), and digital scans obtained from the Helios 500 intraoral scanner and the Ceramill Map 600 desktop scanner. All image measurements were performed using ImageJ software (National Institutes of Health, Bethesda, MD, USA), and statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey’s post hoc test (α = 0.05). Results: The results showed no significant differences in measurements across most imaging methods (p > 0.05), except for the Vivo T2, which showed a significant deviation (p < 0.05). The other smartphones produced measurements comparable to those of the DSLR, even at distances as close as 16 cm. Conclusions: These findings preliminary support the clinical use of smartphones for accurate dental documentation and two-dimensional smile design, including the posterior areas, and challenge the previously recommended 24 cm minimum distance for mobile dental photography (MDP). This provides clinicians with a simplified and accessible alternative for high-accuracy dental imaging, advancing the everyday use of MDP in clinical practice. Full article

Purpose: The aim of this in vitro study was to evaluate the influence of different models of commercially available portable dental radiometers on the measurement of light irradiance emitted by light-emitting diode (LED) photocuring units. Materials and Methods: Eight LED photocuring units, all emitting light in a single-wavelength spectrum, were tested. Light irradiance (mW/cm²) was measured using six portable dental radiometers: four digital models (D1–D4) and two analog models (A1, A2). Digital model D1 was used as the reference (control). All measurements were conducted under standardized conditions, and each LED–radiometer combination was tested in triplicate. Data were analyzed using Sigma Plot 12.0 (Palo Alto, CA, USA) to verify the assumptions of normality and homogeneity of variances. A one-way analysis of variance (ANOVA) was used to assess the effect of the radiometer model on irradiance values, followed by Tukey’s post hoc test for multiple comparisons. The significance level was set at α < 0.05. Results: No statistically significant difference in irradiance was found between D1 (control) and D2. However, significantly lower values were recorded with A2, while D3, D4, and A1 produced significantly higher irradiance values compared to the control (p < 0.05). Conclusion: Irradiance measurements can vary significantly depending on the radiometer model used. Clinicians should be aware of this variability and are encouraged to regularly check the irradiance of the light-curing units used in daily practice, ensure their proper maintenance, and implement periodic monitoring to maintain effective clinical performance. Full article

The fundamental goal of endodontic surgery is to remove the infection cause and create an ideal environment for periapical tissue and bone recovery. This systematic review aims to present evidence-based findings regarding the healing ability of endodontic materials in retrograde treatment. The study evaluates the advantages and drawbacks of commonly utilized materials, empowering clinicians with valuable insights for preoperative planning in endodontic surgery. A comprehensive search was conducted across multiple databases, including MEDLINE, Scielo, Web of Science, Scopus, Embase, and Google Scholar, using the PIOT framework. A total of 3124 papers were identified, of which 2534 remained after removing duplicates. Following a stringent selection process, 35 clinical studies were included for qualitative assessment. The risk of bias was assessed using the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I) tool for non-randomized trials, the Newcastle–Ottawa Scale for cohort studies, and the Joanna Briggs Institute (JBI) critical appraisal checklist for cross-sectional studies. Due to high heterogeneity in study designs and outcomes, a meta-analysis could not be performed. The review identified Super Ethoxybenzoic Acid (Super EBA), Mineral Trioxide Aggregate (MTA), and Intermediate Restorative Material (IRM^®), Retroplast, Endosequence^®, and gutta-percha as the primary retrograde root filling materials. Follow-up periods ranged from 6 months to 17.5 years. Although the materials showed varying degrees of success, the overall findings highlighted that no single material demonstrated universally superior healing ability. The review also emphasized the need for standardization in future clinical trials to facilitate better comparisons. The selection of retrograde filling materials plays a pivotal role in the success of endodontic surgery. New bioceramic materials like MTA and Biodentine offer improved sealing, biocompatibility, and tissue regeneration compared to traditional materials, leading to better clinical outcomes. Full article

Objectives: The widespread adoption of three-dimensional (3D)-printed resins in restorative dentistry has introduced significant challenges in establishing strong and lasting bonds with resin-based cements. Despite the development of numerous surface treatment techniques designed to improve adhesion, a clear consensus on the most effective approach remains elusive. This systematic review and meta-analysis critically examined the impact of various surface treatment protocols on the bond strength of 3D-printed resins. By comparing treated versus untreated surfaces, the study aimed to determine the most reliable strategies for enhancing adhesion, ultimately offering evidence-based guidance to inform clinical decision-making. Methods: This review identified relevant studies through a comprehensive search of MEDLINE via PubMed, Web of Science, Scielo, Scopus, and EMBASE databases, supplemented by manual reference checks, to identify in vitro studies published up to February 2025. Studies assessing the bonding of 3D-printed resins following various surface treatments and bonding protocols were included. Data on bond strength outcomes, such as shear bond strength, microtensile bond strength, and microshear bond strength, were extracted. Data extraction included study details, type of 3D-printed resin and printing technology, surface treatment protocols, bond strength testing methods, storage conditions, and results. The quality of included studies was assessed using the ROBDEMat tool. Meta-analyses were performed using the Review Manager Software (version 5.4, The Cochrane Collaboration, Copenhagen, Denmark), with statistical significance set at p < 0.05. Statistical heterogeneity among studies was evaluated using the Cochran Q test and the I² inconsistency test. Results: Nine studies met the criteria for qualitative analysis, with eight included in the meta-analysis. The findings revealed that surface treatment protocols significantly enhanced the immediate bond strength to 3D-printed resins (p = 0.01), with only sandblasting and silane demonstrating a statistically significant effect (p < 0.007). Similarly, after aging, surface treatments continued to improve bond strength (p = 0.01), with sandblasting and hydrofluoric acid being the only methods to produce a significant increase in bond strength values (p < 0.001). Conclusions: This meta-analysis underscores the importance of combining mechanical and chemical surface treatments, especially sandblasting and silane application, to achieve reliable and durable bonding to 3D-printed resins. Full article

Background: Dental fluorosis can affect the micromorphology of dentin, a fact that could present constraints relating to the structural, mechanical, and chemical stability of dentin when it is demineralized in operative maneuvers. Introduction: The aim of this article is to quantify the amount of calcium and the microhardness of both a healthy and a fluorotic dentin through conditioning with a two-step self-etching system (Optibond Versa, Kerr, CA, USA). Methods: Dentin samples were obtained from healthy molars diagnosed with mild, moderate, and severe fluorosis. The amount of calcium was quantified utilizing an atomic absorption spectrophotometer. The hardness was evaluated using a Vickers durometer. Two dentin samples from each study group were examined using scanning electron microscopy (SEM). Results: A one-way analysis of variance (ANOVA) and Tukey–Kramer test were applied as post hoc tests for determining the differences in calcium values between the study groups and to show the difference in the hardnesses evaluated. The Student’s t-test was applied to related samples. The level of significance was set at p < 0.05. Statistically significant results were obtained for the amount of calcium and microhardness of the healthy dentin group. The SEM images demonstrated irregular etching patterns in the fluorotic dentin, indicating potential bonding challenges. Conclusion: In conclusion, there is a lower amount of calcium and a significant reduction in microhardness in healthy dentin when applying the self-etching system compared to fluorotic dentin. Fluorotic dentin is more resistant to demineralization, which may influence adhesive bonding strategies. Clinicians should consider adjusting conditioning protocols for optimal adhesion in fluorotic teeth. Full article

Soft-tissue expansion is a critical challenge in regenerative oral surgeries. This scoping review maps the research on polymers used in osmotic self-inflating expanders, assessing their applications, characteristics, and potential in oral surgical procedures. The study analyzed 19 articles from the PubMed, Scopus, Web of Science, and Embase databases, primarily focusing on in vivo research (78.9%) investigating polymeric tissue expanders. The review examined polymer compositions, methodologies, and tissue responses across various animal models. Osmed^® hydrogel was the most studied material, with research exploring its expansion capabilities in rabbits, goats, pigs, rats, and beagle dogs. The findings showed diverse tissue expansion ranges and minimal inflammatory responses, indicating the potential for oral surgical applications. Despite promising results, gaps such as inconsistent expansion measurements and the lack of standardized protocols were identified. These findings highlight the need for further research to develop new polymer formulations and optimize device design to enhance safety, efficacy, and clinical predictability. This review provides a foundation for advancing polymeric tissue expander technologies, offering the potential for safer and more effective minimally invasive regenerative oral surgeries. Full article

Dental caries is a widespread issue impacting global oral health. White spot lesions, the earliest stage of caries, compromise enamel’s esthetics and integrity. Remineralization therapies, both fluoride and non-fluoride based, aim to restore enamel, but limited comparative data exist on their effects on lesion depth and microhardness. Thus, the aim of this systematic review was to evaluate the efficacy of remineralizing agents on lesion depth and microhardness of human teeth. The literature search included the following five databases: PubMed, Web of Science, Scielo, SCOPUS, and EMBASE from the period 2012 to October 2022. Studies evaluating lesion depth and microhardness in human teeth after the application of a remineralizing agent were considered for review. The meta-analysis was performed using RevMan 5.4 (The Cochrane Collaboration, Copenhagen, Denmark). A random effect model was used to pool estimate of effect and its 95% confidence intervals (CIs) for surface microhardness and depth lesion. Subgroup analyses were performed considering the presence of fluoride or not in the remineralization agent. Thirty-three studies were included in the qualitative review. Of these, twenty-six studies were included in the meta-analysis. The main risks of bias associated with the studies included a lack of blinding of the test operator and failure to obtain sample size. To conclude, fluorinated agents are more effective in remineralizing artificially induced white spot lesion than non-fluoride remineralizing agents. Full article

In recent decades, the integration of nanotechnology into dentistry has led to groundbreaking advancements in dental materials and applications. This article explores the role of nanoparticles (NPs) in modern dentistry, highlighting their definitions, unique properties, and various applications. The introduction establishes the significance of nanotechnology in dental health care, emphasizing the potential of NPs to transform traditional practices. The overview includes a discussion of the fundamental properties of NPs, which contribute to their effectiveness in dental applications. The article categorizes NPs into three main groups: antimicrobial, therapeutic, and material property-improving NPs, detailing their clinical uses and mechanisms of action. Furthermore, it addresses current innovations in dental products incorporating NPs and examines emerging trends in the field. The research for this review was conducted using high-quality, peer-reviewed scientific databases, including PubMed, Scopus, Web of Science, and Google Scholar, with no time restriction as an inclusion criterion. These databases were selected for their credibility and comprehensive collections of relevant studies. In conclusion, NPs represent a promising avenue for innovation in dental materials and therapeutics. Their unique properties enable the development of enhanced antimicrobial agents, effective drug delivery systems, and improved material performance. However, the risks associated with cytotoxicity and stability must be carefully managed to ensure safe and effective use. Ongoing research is essential to fully understand and optimize the applications of NPs in dentistry, balancing their benefits against potential health risks. As the field advances, the integration of NPs into clinical practice will likely revolutionize approaches to dental care and treatment. Full article

This systematic review aims to evaluate whether the application of antioxidant solutions can enhance the bond strength of resin-based materials to sodium hypochlorite (NaOCl)-treated dentin. This study follows the PICOT strategy: population (sodium hypochlorite-treated dentin), intervention (application of antioxidants), control (distilled water), outcome (bond strength), and type of studies (in vitro studies). The systematic review and meta-analysis were conducted following PRISMA guidelines. Electronic databases were searched for in vitro studies evaluating the effects of antioxidants on bond strength to sodium hypochlorite-treated dentin. Two independent reviewers screened articles, extracted data, and assessed risk of bias. Meta-analyses were performed using a random-effects model to compare standardized mean differences in bond strength between antioxidant pretreatment and control groups. Inclusion criteria consisted of in vitro studies that examined the bond strength of resin-based materials to NaOCl-treated dentin with antioxidant application, while exclusion criteria included studies with incomplete data, those not using a control group, or those that did not directly measure bond strength. From 3041 initial records, 29 studies were included in the qualitative analysis and 25 in the meta-analysis. Ascorbic acid, sodium ascorbate, grape seed extract, green tea, and rosmarinic acid significantly improved bond strength to sodium hypochlorite-treated dentin (p < 0.05). The effectiveness of grape seed extract varied with adhesive system type. Hesperidin, p-toluene sulfonic acid, and sodium thiosulfate did not significantly improve bond strength. Most studies had a high risk of bias. This suggests that the conclusions drawn from these studies should be interpreted with caution, and further research with more robust methodologies may be needed to confirm the findings. In conclusion, this systematic review implies that certain antioxidants can improve bond strength to sodium hypochlorite-treated dentin, with efficacy depending on the specific agent and adhesive system used. Further standardized studies are needed to optimize protocols and confirm these findings. Full article

The central aim of adhesive dentistry is to improve the compatibility between current adhesives and a range of substrates by employing diverse application techniques. Therefore, the overarching objective of this review is to offer a comprehensive analysis of dentin bonding systems, starting with an introduction to adhesion and a detailed overview of enamel and dentin structures, their histology, and the impact of dentin structure on resin–dentin bonding. It covers the mechanisms of resin–dentin bonding, including resin adhesive application, bonding mechanisms, and factors influencing efficacy. Further, this review explores the composition of resin adhesive systems, including acidic components, cross-linking monomers, solvents, and other critical elements. It also examines various adhesive strategies—etch-and-rinse, self-etch, and universal adhesives—highlighting their applications and advantages. The review extends to clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), demonstrating the practical implications of adhesive systems in enhancing restoration longevity and performance. In conclusion, despite significant advancements, no gold-standard method for optimal adhesion exists. Each adhesive system has distinct strengths and limitations. The review emphasizes the importance of evaluating methods for achieving durable adhesion and staying current with technological advancements in adhesive systems. Summary: This review provides a thorough analysis of dentin bonding systems, delving into the structures and bonding mechanisms of both enamel and dentin. By exploring various adhesive systems and their components, it highlights the ongoing challenges in achieving optimal resin–dentin adhesion. The review also addresses the clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), illustrating how different adhesive techniques impact clinical outcomes. It underscores the necessity for continuous innovation and assessment of adhesive systems to enhance long-term bonding effectiveness in clinical practice. Full article

Bioceramic endodontic cements, known for their antibacterial properties, calcium ion release, and alkaline pH, may come into contact with various irrigants after furcal perforation repair. This study aimed to evaluate the effect of different irrigating solutions and setting times on the shear bond strength (SBS) of Biodentine^® (Septodont, Saint-Maur-des-Fosses Cedex, France) to a self-adhering flowable composite. Sixty Biodentine^® (Septodont, Saint-Maur-des-Fosses Cedex, France) blocks were prepared and divided into two groups based on the setting time: 72 h and 7 days. These were further subdivided into five subgroups based on the irrigation solution applied: distilled water, sodium hypochlorite, ethylenediaminetetraacetic acid, chlorhexidine, and phosphoric acid. They were then restored with Dyad Flow^TM (Kerr^TM, Orange, CA, USA). SBS and failure modes were assessed at 24 h and 6 months. A two-way analysis of variance (ANOVA) test was performed to analyze the effect of the different irrigating solutions and setting times on the SBS of Biodentine^® (Septodont, Saint-Maur-des-Fosses Cedex, France) and Dyad Flow^TM (Kerr^TM, Orange, CA, USA). The level of significance was set at a ≤0.05. At 24 h, SBS was significantly influenced by both the irrigant solution (p = 0.029) and setting time (p = 0.018); at 6 months, SBS was influenced only by the irrigating solutions (p < 0.001). The predominant mode of bond failure was adhesive across all groups. In conclusion, while the setting time did not affect the bond strength, certain irrigating solutions reduced it. Thus, careful consideration of surface treatments applied to Biodentine^® is crucial for successful endodontic and restorative outcomes. Full article

The present case report presents a digital workflow for designing an aesthetic rehabilitation of the upper anterior teeth in an adult male. The patient suffered from a gummy smile resulting from an unfavorable ratio between upper lip length and gingiva/tooth display. In addition, the tooth shapes, color, and position were not accepted by the patient. The treatment planning included gingivectomy based on a digitally designed PMMA guide performed using a soft tissue SOGA laser (Shenzhen Soga Technology Co., Ltd., Shenzhen, China). The preparation was guided by the plastic guides for preparation control created digitally in Exocad software (Rijeka 3.1. Darmstadt, Germany) and printed in three-dimensional plastic. Next, both arches and maximum intercuspation were scanned. The milled lithium disilicate veneers were manufactured using CAD-computer-aided manufacturing (CAM) equipment. The restorations were cemented using a translucent light-cure resin cement (RelyX Universal, 3M ESPE, St. Paul, MN, USA). Next, occlusion adjustment and polishing were executed. Based on the present case report, it can be assumed that the application of digital techniques allows us to achieve an aesthetic and functional result with reduced work time and errors. Emphasizing the clinical impact, these methods enhance patient satisfaction and treatment accuracy in intricate aesthetic rehabilitations. Full article