Search Results (23)

The surface roughness (Ra) of indirect computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated dental restorations is crucial for their long-term durability. This study intended to evaluate the Ra of five different types of contemporary indirect CAD/CAM restorative materials with varying compositions that were glazed and finished/polished. A total of 75 specimens, disc-shaped (10 mm × 2 mm), were obtained from five materials (n = 15) (Tetric CAD, IPS e.max CAD, IPS e.max ZirCAD, CELTRA Duo, and Vita Enamic) and fabricated by CAD/CAM. One of the two surfaces for each specimen was subjected to glazing, while the other surface was subjected to finishing/polishing. The Ra of the two surfaces in micrometers (μm) was evaluated using a Profilometer, while the surface topography was examined using a scanning electron microscope. Using SPSS, the Kruskal–Wallis, post hoc Conover, and Mann–Whitney tests were used to statistically evaluate the data. A comparison of the Ra for the finished/polished surfaces of the five test materials showed significant differences (p < 0.0001). Among the finished/polished surfaces, the mean rank values of Vita Enamic were significantly higher than the other four test materials (p < 0.0001). A comparison of the Ra of glazed surfaces among the five study materials revealed significant differences (p < 0.0001). The Ra for the IPS e.max ZirCAD material was significantly higher than the rest of the four materials (p < 0.001). A comparison of the Ra for two types of surface conditioning within each of the five test materials showed a significant difference (p < 0.05). Only for IPS e.max ZirCAD was the Ra of the glazed surface significantly higher than the finished/polished surface (p < 0.0001). Significant variations in the surface roughness (Ra) were exhibited between the finished/polished and glazed surfaces of the five test materials. Hybrid ceramics showed the highest Ra values for the finished/polished surfaces, and zirconia exhibited the highest Ra values among the glazed surfaces among the tested materials. The Ra values of either finished/polished or glazed surfaces of the test materials were within the clinically acceptable range (0.2–0.5 μm), except for the glazed surface of the zirconia ceramics (0.84 μm). Full article

Cement film thickness may have an impact on the shear bond strength (SBS) of lithium disilicate dental ceramics luted to human enamel with resin cement. The objective of this study was to evaluate SBS of lithium disilicate ceramics adhered to enamel using resin cement at different thicknesses. In total, 50 ceramic specimens (3 × 3 × 3 mm) and 50 premolar teeth were prepared and randomly assigned to 5 groups (n = 10 each). Ceramic specimens were designed with five cement film thicknesses (50 μm; 100 μm; 150 μm; 200 μm; and 300 μm). Teeth surfaces (4 × 4 mm) were prepared with a high-speed handpiece mounted on a dental surveyor. Ceramic specimens were cemented to teeth with resin cement (3M^TM RelyX^TM U200, Resin-Self-Adhesive-Cement). The specimens were then thermocycled for 6000 cycles with a 30 s dwell time and a 5 s transfer time in water (5 °C and 55 °C). A Universal-Testing-Machine was used to measure SBS (MPa). Statistical analysis in SPSS included Anova and Tukey’s tests. The SBSs of ceramics adhered to teeth revealed significantly different values across all test groups (p = 0.000). The findings showed that as cement layer thickness increased, so did the SBS. The cement spaces at 50 and 300 μm had the lowest SBS (9.40 + 1.15 MPa) and maximum SBS (21.98 + 1.27 MPa), respectively. The SBS of the lithium disilicate ceramic luted to natural human enamel increased along with the cement layer thickness. Full article

Background and Objectives: An understanding of the anatomical complexity of teeth is a significant factor for a successful endodontic treatment outcome. The aim of this study was to explore the frequency and pattern of distribution of radix entomolaris (RE) in mandibular first molars (MFMs) of a Saudi Arabian subpopulation using CBCT scans. Materials and Methods: This study was conducted at dental clinics of Qassim University from February to May 2023 by evaluating CBCT scans that were previously obtained for diagnostic purposes. Scans of Saudi national patients with bilaterally present MFMs and fully formed root apices were included. Conversely, scans with one/or two missing MFMs, MFMs with incomplete root apices, full- or partial-coverage prosthesis, endodontic treatment, and associated radicular resorption were excluded from study. A total of 303 CBCT scans with 606 bilateral MFMs were analyzed by two calibrated evaluators for the presence of, and type according to Song’s typolgy of RE. The data were analyzed using SPPS-24. The descriptive variables were documented as frequencies and percentages. The chi-square test was used to determine the association between the prevalence of RE with the gender, jaw side and age group. Both inter-rater and intra-rater agreements were estimated for detecting and classifying RE using Cohen’s kappa test. Results: The sample had 63.7% males and 36.3% females. The prevalence of RE was 6.6%, with Song’s type III (57.5%) as the most common variant. Absolute agreement was noted between the raters about the presence of RE and very strong agreement was noted for the classification of the RE. Conclusions: RE is an uncommon finding among the mandibular first molars of the Saudi population without any gender and quadrant predilection. The clinicians’ knowledge of the presence and Song’s type of RE may contribute towards the enhancement of endodontic treatment outcomes. Full article

Background and Objectives: Lidocaine Hydrochloride has been the standard choice for local anesthesia in dentistry and Articaine’s unique structure and growing popularity make it a viable alternative. Due to contradictory results in prior research and a scarcity of trials conducted in the Pakistani population, this study aims to compare the anesthetic efficacy of Lidocaine with Articaine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis. Materials and Methods: This double-blinded, randomized controlled trial included 152 patients who were selected by consecutive non-probability sampling. The participants included patients who presented with symptomatic irreversible pulpitis in mandibular posterior teeth (molars and premolars) and depicted normal apical tissue radiographically. The patients were equally and randomly divided into two groups. The control group received 2% Lidocaine Hydrochloride injections, and the experiment group received 4% Articaine Hydrochloride injections. Participants scored their pain on the HP-VAS both before and after the administration of anesthesia. A value of 54 mm or less on the scale indicated effective anesthesia. The data obtained were analyzed using SPSS. Chi-square test was applied to analyze data for statistical significance. Results: There was no statistically significant difference in the efficacy of the two anesthetic agents. During access cavity preparation, Lidocaine demonstrated a success rate of 93%, whereas Articaine exhibited a slightly higher success rate of 97%. During initial instrumentation, the success rates for Lidocaine and Articaine were 72% and 71%, respectively. This suggests that both Lidocaine and Articaine were effective in achieving anesthesia during the dental procedure in patients with symptomatic irreversible pulpitis, with Articaine showing a slightly better success rate, although the difference was not statistically significant. Conclusions: The anesthetic efficacy of Articaine is similar to that of lidocaine in subjects with symptomatic irreversible pulpitis. Hence, Articaine can serve as an alternative to Lidocaine for local anesthesia administration in dentistry. Full article

The use of vaping or electronic cigarette devices (ECDs) has recently increased as an alternative to conventional tobacco smoking products. By recording the CIELAB coordinates (L*a*b*) and computing the total color difference (ΔE) values using a spectrophotometer, the effect of ECDs on contemporary aesthetic dental ceramics was investigated in this in-vitro study. A total of seventy-five (N = 75) specimens from five different (n = 15) dental ceramic materials (Pressable ceramics (PEmax); Pressed and layered ceramics (LEmax); Layered zirconia (LZr); Monolithic zirconia (MZr) and Porcelain fused to metal (PFM)) were prepared and exposed to aerosols produced by the ECDs. The color assessment was performed using a spectrophotometer at six time intervals (0 = baseline; 250-puff exposures; 500-puff exposures; 750-puff exposures; 1000-puff exposures; 1250-puff exposures; and 1500-puff exposures). By recording L*a*b* and computing total color difference (ΔE) values, the data were processed. A one-way ANOVA and Tukey procedure for pairwise comparisons were used to assess color differences between tested ceramics (p < 0.05). All test materials demonstrated significant color differences (ΔE) after exposure to vaping (p < 0.05). The LZr group displayed noticeably high ΔE values at all the distinct puff exposure intervals, with the highest ΔE value of (13.67) after 1500 puffs. The lowest (ΔE) values were observed in the PFM group after 250 and 500 puffs (0.85 and 0.97, respectively). With the exception of the group PEmax (p = 0.999), all groups produced readings of “ΔE” that indicated significant differences (p < 0.05) at various degrees of puff exposures. ECDs can noticeably alter the color of the dental ceramics affecting the esthetics of the patients. All the materials tested demonstrated significant color changes (ΔE > 3.33) above the clinically acceptable threshold, except for the PFM and PEmax group (ΔE < 3.33) which showed color stability after exposure to the ECDs. Full article

The optical qualities of cutting-edge aesthetic dental ceramics are crucial for great aesthetics and may be impacted by various bleaching methods. The objectives of this study were to evaluate how home bleaching affected the translucency parameter (TP), contrast ratio (CR), total color difference (ΔE), and surface roughness (Ra) of various aesthetic dental ceramics, including innovative ultra-translucent zirconia. The three varieties of ceramics that were tested—IPS e.max-Press (IPS); classic zirconia with feldspathic layering (LZr); and translucent zirconia (TZr)—were each represented by seven samples. The samples were bleached at home using 15% carbamide peroxide for six hours a day for seven days. Each specimen’s pre- and post-bleaching CIE L*a*b* values were measured using a spectrophotometer, and the TP, CR, and ΔE were determined. Ra values were measured via 3D profilometry. In comparison to the pre-stage results, statistical analysis showed a significant decrease in TP and increase in CR for LZr and TZr in the post-stage (p < 0.05), but not for IPS (p = 0.398). The results also showed substantial variations in ΔE for the three ceramics (p = 0.020). Ra readings during the post-stage were noticeably greater than those at the pre-stage (p = 0.018). Home bleaching had an impact on the optical characteristics and surface texture of the dental ceramics. Additionally, IPS had greater color stability than LZr and TZr. Full article

Cortisol has frequently been used as a stress marker, and the variation in cortisol levels in saliva and hair, as well as between males and females, has been reported. This study aimed to evaluate and compare the level of cortisol variation in hair and saliva among dental students of both genders. After giving written agreement, 151 students (79 males and 72 females) participated in the study. Saliva and hair samples were collected at two time intervals with a gap of three months from the same set of participants. Saliva and hair samples were utilized to measure the levels of cortisol using an enzyme-linked immunosorbent assay (ELISA). Each participant’s salivary and hair cortisol levels and demographic information, including age and gender, were recorded. To examine group comparisons, two-tailed Student’s t-tests were used (α < 0.05). The comparisons of salivary and hair cortisol levels showed significant difference (p < 0.05) at two time intervals. Genderwise comparisons of the salivary and hair cortisol’s levels showed significant differences (p < 0.05) for male students, while, for female students, the comparisons showed non-significant differences (p > 0.05). Comparisons between the cortisol levels of the two specimen collections at the two different time intervals indicated substantial variations (p = 0.000). Results confirm the variations in the cortisol levels in the saliva and hair samples. Cortisol concentrations in hair and saliva at the two times points varied. Significant variations between the male students salivary and hair cortisol levels and non-significant differences between the cortisol levels for the female students at the two time points were found. Cortisol levels in the selected subjects’ saliva and hair samples varied. Full article

(1) Background: An ideal bond strength between endodontic posts and root canal dentin is essential for optimal retention and good prognosis. This study aimed to evaluate the push-out bond strength (PBS) of prefabricated fiber and metal posts, luted with resin cement to natural dentin. (2) Methods: Extracted premolars with similar root dimensions were assigned into two groups of 30 each for the metal and fiber posts. Teeth were mounted in acrylic blocks exposing 2 mm of the coronal root. Teeth were subjected to endodontic treatment and post-space preparations. Two groups were further subdivided into three sub-groups (n = 10) according to the size of the posts (# 4, 5 and 6). Posts were cemented with resin cement. Specimens were sectioned into 4 mm slices and subjected to the PBS test. (3) Results: The mean PBS was similar for the metal and fiber posts bonded with resin cement, showing a statistically significant result. An increase in post size increased the bond strength initially, but a further increase in size did not show any marked difference. A total of 71.66% of tested specimens failed with the adhesive failure mode. (4) Conclusions: Metal posts showed slightly higher retention compared to the fiber posts, although the p-value was similar for both types. An increase in the size of posts showed increased retention. The most common mode of failure was adhesive failure between cement and dentin. Full article

Objective: The aim of the present in vitro study was to explore the differences in color matching of most frequently used shades for metal ceramic dental restorations fabricated by different laboratories. Materials and Methods: A total sample size of 180 discs of metal ceramic were prepared by six laboratories (labs): each lab prepared 30 samples, 10 for each shade (A1, B1, and C1). Instructions for standardization were provided. A spectrophotometer and CIE LAB system was used to find ΔE value for difference between shades observed by spectrophotometer. For statistical analysis, ANOVA and post hoc Tukey tests were used. Significance level was <0.05. Results: Significant variation (p = 0.000) was observed among the labs for ΔE. The maximum value for ΔE in shade A1 was 77.0 ± 0.065 and minimum value for ΔE noted for shade A1 was 69.19 ± 1.39. The values of ΔE for shade B1 were maximum 80.14 ± 0.16 and minimum 68.38 ± 0.40 and the values of ΔE for shade C1 were maximum 80.16 ± 0.14 and minimum 71.62 ± 1.23. Twelve out of 15 comparisons between labs for shade A1, 14 of 15 comparisons for shade B1, and 11 of 15 comparisons for shade C1 showed significant difference (p = 0.000). Conclusions: Similar tooth shades (A1, B1, and C1) when duplicated by different labs exhibited highly significant color variations. Full article

The aim of this study was to compare patients’ satisfaction and quality of life (QoL) when using implant overdentures vs. conventional dentures. The QoL of Saudi patients who were provided mandibular implant-supported overdentures was assessed using a structured questionnaire. Overall satisfaction; ability to speak, eat, and chew food; comfort; esthetics; stability; and satisfaction of general oral health were measured. A total of 48.3% vs. 6.9% were, overall, very satisfied with their implant overdentures and conventional dentures, respectively. A total of 37.9% of the patients were very satisfied regarding speaking with their implant overdentures vs. 17.2% with conventional dentures. Furthermore, 41.4% were very comfortable with their implant overdentures vs. 5.2% were very comfortable using conventional dentures. However, only 15.5% were very satisfied with the esthetics of the conventional dentures compared to 43.1% being satisfied with implant overdentures. Only 1.7% were very satisfied with the stability of conventional dentures vs. 44.8% being satisfied using implant overdentures. About 8.6% of the candidates were very satisfied regarding chewing food with conventional dentures vs. 36.2% being very satisfied using implant overdentures. Approximately 10.3% were very satisfied with their general oral health using conventional dentures compared to 29.3% being very satisfied using implant overdentures. Mandibular implant overdentures had a strong impact on patients’ quality of life over conventional complete dentures and should be considered the minimum standard of care provided to completely edentulous patients. Full article

This in vitro study compared the effects of conventional and electronic cigarettes on the aesthetics (color stability and translucency) of two types of composite resins: micro and nano-hybrid. Methods: A total of 120 specimens from two different composite materials Filtek Z250 XT (Nano-hybrid, 3M) and Filtek Z250 (Micro-hybrid, 3M) were divided into four groups (n = 30); shade A2 was used. The samples were exposed to conventional and electronic cigarette smoke via a custom made chamber device. The color values and measurements were recorded using a spectrophotometer before and after the exposure. The color and translucency were evaluated using the three-dimensional CIE Lab. Results: There was a significant change in the color (ΔE) and the translucency parameter (TP) in all of the specimens exposed to electronic cigarettes and conventional cigarettes. The results showed that the highest ΔE mean is for the nano-hybrid composite exposed to conventional cigarettes with 1.74 ΔE while the same material is 0.64 under the electronic cigarettes and the difference is significant with (p < 0.05). The micro-hybrid composite data showed less changes in color under both exposures with 0.85 ΔE mean under the conventional cigarette smoke and 0.48 under the electronic cigarette smoke with (p < 0.004). Conclusions: The conventional cigarette smoke has more effect on the color stability of the composite resins than electronic cigarettes. From a clinical point of view, the effect of smoke exposure on the tested specimens’ color, for the time duration to which the specimens were exposed, were moderate (ΔE < 2). The micro-hybrid composites showed better color stability as compared to the nano-hybrid composites. Full article

Background: To identify and compare the shade variations of various commonly used esthetic dental ceramics by calculating their total-color-difference (ΔE) and translucency parameter (TP) using a spectrophotometer. Methods: In total, 165 disc specimens from three shades (A1, B1, and C1) of five ceramic materials (N = 55/shade; n = 11/ceramic material group) were prepared (Metal-ceramic (MC), IPS e.max press (Emax-P), IPS e.max layer (Emax-L), Layered Zirconia (Zr-L) and Monolithic zirconia (Zr-M)). With a spectrophotometer, the L* a* b* values were obtained. Total color differences (ΔE = [(ΔL*)2 + (Δa*)2 + (Δb*)2]^1/2) and translucency parameter (TP = [(L*B − L*W)² + (a*B − a*W)² + (b*B – b*W)²]^1/2) were calculated. The statistical tests included ANOVA and Post hoc Tukey’s analysis (p < 0.05). Results: Significant differences (p = 0.000) were found between the groups for ΔE. Highest ΔE (A1) were found for Zr-L (80.18 ± 20) and lowest for Zr-M (62.97 ± 1.28). For B1, highest ΔE values were noted for MC (76.85 + 0.78) and lowest for the Emax-L (62.13 ± 1.49). For C1, highest ΔE values were found for the MC group (73.96 ± 0 67) and lowest for Emax-P (55.09 ± 1.76). Translucency variations between tested ceramics were revealed (p < 0.05). Highest TP values (A1) were found for Emax-L (2.99 ± 1.64) and lowest for Zr-L (0.35 ± 0.16). For B1, highest TP values were noted for Emax-P (3.50 ± 1.74) and lowest for MC (0.57 ± 0.40). For C1, highest TP values were found for Emax-P (4.46 ± 2.42) and lowest for MC (0.58 ± 0 48). Conclusions: Significant differences in ΔE and TP were found for tested ceramic groups. The color differences of the tested materials varied according to clinical acceptability, even with the selection of same color/shade. The color/shades of the various dental ceramics do not match with the vita shade guide tabs, to which they are compared most often. Shade differences are present between different lots of ceramic materials from the same or different brands. Full article

The aim is to compare the use of Cyanoacrylate adhesives (CAA) to the conventional suturing technique in terms of free gingival grafts (FGG) stability and healing in lower anterior and premolar regions. A split mouth design was initiated on 22 participants. Each side (from 2nd premolar to central incisor) was randomized to either the control or test groups. In the control group, sutures were used to stabilize the FGG, while, in the test group, the FGG was stabilized with butyl-cyanoacrylate. Full-periodontal clinical parameters were employed to assess the periodontal health. FGG-related parameters assessed included the keratinized tissue width (KTW), gingival tissue thickness (GTT), FGG shrinkage% and pain using the VAS score. No significant differences in the mean values of the KTW nor FGG shrinkage% across six time points (p < 0.05) were observed, whereas highly significant differences in the mean values of GTT across six time points (F = 3.32; p = 0.008) were observed. The use of CAA in FGG stability and healing is comparable to conventional suturing for soft tissue grafts in terms of success outcomes. With its cost effectiveness, lesser time consumption, post-operative pain and comparable graft stability and dimensions, the use of CAA may be a promising alternative for conventional and microsurgical techniques for the stabilization of FGG in the oral cavity. Full article

Optimal bond strength between the prefabricated post/dowel to the surrounding dentin is essential. The present study aimed to analyze and compare the effect of three different cement film thicknesses on the pull-out bond strength of three different prefabricated post systems. Extracted natural teeth (N = 90) with similar root dimensions were acquired. Teeth were mounted in resin blocks, endodontically treated, sectioned at cemento-enamel junction, divided into three groups (A: Parapost Fiber Lux plus; B: 3M ESPE Relyx fiber post; and C: Parapost XP), and stored. Uniform post spaces were prepared for the groups (A and C: Length = 8 mm, Width = 1.5 mm; B: Length = 8 mm, Width = 1.6 mm). Each group (N = 30) was further subdivided into three subgroups (n = 10) based on the size (4, 5, and 6) of the post and cemented with resin cement (MultiLink-N, Ivoclar Vivadent). After thermocycling, the specimens were subjected to a pull-out test using a universal testing machine, and tensile force was recorded (MPa). Digital microscopic evaluations were performed for modes of failure. ANOVA and Tukey-HSD tests were used for statistics. Significant differences were observed for each tested material (p = 0.000). The lowest and highest bond strength values were recorded for Group C (Titanium post) and Group A (000), respectively. Multiple comparisons showed significance (p < 0.05) among all the groups, except for space 1 and space 2 (p = 0.316) for Group A. Most of the failures occurred within the cement-dentin and post-cement interface (Adhesive failures, 73.5%). An increase in the luting cement film thickness results in the decrease in pull-out bond strength of prefabricated posts luted with resin cement, irrespective of the type/material/shape of the post. The serrated fiber posts showed the highest pull-out bond strength compared to the smooth surfaced fiber posts or serrated metal posts. Increased pull-out bond strengths were observed when appropriate post space was created with the same sized drill as the post size. Full article

Background: Resin-based composites (RBCs) provide excellent esthetics but the marginal micro-leakage in the proximal cavities remains a major concern. The aim of the present study was to assess the ability of various dental RBCs and techniques utilized for sealing deep dentin margin in class-II cavities. Methods: Box-cavities (class-II) on the distal and mesial surfaces of extracted (premolar) teeth were prepared with a gingival margin placed 1mm apical to the cemento-enamel junction. Teeth with prepared class II cavities were randomly divided into four study groups according to the type of restorative materials (conventional RBC; bulk-fill RBC; conventional RBC lined with flowable RBC and conventional RBC lined with resin-modified glass-ionomer-cement (GIC) as open sandwich-technique). Each group was further subdivided into a total-etch subgroup in which a separate etching step was performed before applying the bonding agent and a self-etch subgroup in which a self-etch adhesive system was used (n = 10). For each group, cavities were restored using the respective restorative materials and techniques, subjected to 1000 thermocycles, and placed in the methylene-blue dye. The specimen teeth were sectioned for further microscopic examination for micro-leakage. Results: The least dye penetration values were reported for group 4 (GIC) followed by the group Bulk-fill using the self-etch adhesive system (group 2b). The highest dye penetration was reported for the group Bulk-fill using the total-etch adhesive system (2a), followed by the group conventional RBC using the total-etch adhesive system). The total-etch adhesive system had significantly greater micro-leakage compared to the self-etch adhesive system (1a) (p = 0.026). Conclusions: The self-etch adhesive system significantly reduced the micro-leakage compared to the total-etch system. Bulk-fill RBC when bonded with the self-etch adhesive provided good marginal sealing ability comparable to open sandwich-technique using GIC. Full article