Search Results (905)

Modern prosthetic dentistry has been significantly reshaped by adhesive dentistry, CAD/CAM technologies, and advanced ceramic materials, leading to the development of minimally invasive all-ceramic restorative approaches. However, the longevity of the adhesive interface is fundamental to the long-term effectiveness of these restorations. With a focus on bond durability and clinical performance, this narrative review aims to evaluate modern adhesive strategies, tooth preparation requirements, and cementation techniques in all-ceramic minimally invasive restorations. Methods: A narrative review of the literature was performed using Google Scholar, Web of Science, and PubMed/MEDLINE databases. Publications from 2000 to 2026 were analysed. In vitro research, narrative reviews, and systematic reviews related to adhesive systems, resin cements, CAD/CAM materials, and minimally invasive prosthodontic principles were the core subjects of the research. Results: The findings indicate that material selection, surface conditioning techniques, and cementation methods have a significant impact on the clinical effectiveness of all-ceramic restorations. Retention and marginal sealing are greatly enhanced by resin-based adhesive systems. Nevertheless, hydrolytic degradation, procedure sensitivity, and substrate-related factors remain a challenge to the adhesive interface. Advances in CAD/CAM and ultra-conservative designs, like occlusal veneers and partial-coverage restorations, have increased treatment alternatives while ensuring acceptable functional and aesthetic results. Conclusions: Minimally invasive all-ceramic restorations represent a conservative and clinically effective treatment approach in modern prosthodontics. Their long-term performance is primarily dependent on adhesive interface stability and adherence to evidence-based clinical protocols. Continued developments in adhesive materials and ceramic systems are expected to improve bond durability and broaden clinical indications. Full article

Accurate tooth segmentation plays a crucial role in computer-aided dental diagnosis and treatment planning, particularly in applications such as tooth detection, lesion localization, orthodontic analysis, and implant surgery. However, panoramic dental X-ray images often suffer from tooth adhesion, low contrast, and blurred boundaries, making precise delineation difficult and potentially compromising downstream clinical analysis. To address these challenges, we propose a boundary-aware segmentation framework, termed Boundary-Aware ResU-Net (BA-ResUNet), which is built upon a ResU-Net backbone and enhanced with Coordinate Attention (CA) and explicit boundary modeling mechanisms. Specifically, CA modules are introduced into the encoder to improve spatial representation and positional awareness. In addition, a Boundary Extraction Module (BEM) is designed to capture boundary priors from shallow and deep features, while a Boundary Injection Module (BIM) progressively incorporates these cues into the decoder through foreground enhancement and background suppression. This design enables the network to better preserve inter-tooth gaps and improve boundary delineation. Experiments on the MICCAI STS-2D dental dataset demonstrate that the proposed method achieves superior performance in terms of Dice and IoU compared with representative existing methods. Ablation and qualitative analyses further show that CA and BEM/BIM play synergistic roles in improving regional overlap and boundary localization, particularly in challenging cases involving adhesion, low contrast, and indistinct contours. These results indicate that the proposed framework provides a reliable and effective solution for panoramic tooth segmentation and has promising potential for computer-aided dental applications. Full article

Osseointegration is defined as the structural and functional integration between alveolar bone and a dental implant. Photo-functionalization (PF) refers to ultraviolet (UV)-induced surface modifications of titanium implants, including changes in physicochemical properties and biological responsiveness. The aim of this study was to evaluate the effects of PF on early osteoblast responses related to osseointegration on titanium dental implants in vitro. We hypothesized that PF applied to titanium implants enhances early osteoblast responses related to osseointegration. Sixteen titanium dental implants were divided into two equal groups of eight: untreated (PF−) and PF-treated (PF+). PF+ implants were exposed to UV light at 172 nm for 10 s. An additional cell-only control group was incubated without an implant. All groups were cultured in vitro with SAOS-2 human osteoblast-like cells. Cell proliferation and viability were assessed using standard in vitro assays, and DNA damage was evaluated using the Terminal deoxynucleotidyl transferase [TdT] dUTP Nick End Labeling (TUNEL) assay. Early cellular responses related to osseointegration were assessed by evaluating adhesion-related vinculin levels and alkaline phosphatase (ALP) activity. After 24 h of incubation, cell proliferation was comparable between the groups, whereas after 48 h, cell number was significantly lower in the PF− group compared with the PF+ group and the control group (p = 0.039). Osteoblast viability was significantly lower in the PF− group than in the control group (53% vs. 94%, p = 0.002), while the PF+ group showed a numerically higher viability value than the PF− group (70% vs. 53%). TUNEL assay showed no statistically significant difference in DNA damage among the groups, although the PF− group showed a slightly higher TUNEL-positive cell ratio (p = 0.563). Vinculin levels were significantly higher in the PF+ group at both 24 and 48 h compared with the PF− group and control group (p < 0.0001). ALP activity increased significantly over time in cells incubated with PF-treated implants (p < 0.0001). Within the limitations of this exploratory pilot in vitro study, UV photo-functionalization was associated with more favorable early osteoblast-like cell responses on titanium dental implants, particularly in terms of proliferation, adhesion-related vinculin levels, and ALP response. PF did not increase TUNEL-positive cell ratios compared with untreated implants under the present experimental conditions. These findings should be interpreted as preliminary biological evidence and require confirmation through larger experimental designs, detailed physicochemical surface characterization, and in vivo validation. Full article

Background/Objectives: Image-based finite element analysis (FEA) is increasingly used in dental biomechanics; however, its reliability is often limited by insufficient experimental benchmarking and a lack of standardized workflows. This study aimed to quantitatively benchmark a Cone beam computed tomography-based (CBCT) finite element pipeline using experimentally measured strain in restored human molars. Methods: Extracted human mandibular molars were restored using a total-etch adhesive system and bulk-fill composite resin. Specimen-specific finite element models were generated from CBCT data using a standardized segmentation and meshing workflow. Numerical simulations were compared with experimentally measured strain obtained during mechanical loading using Digital Image Correlation. Agreement between numerical and experimental data was assessed using regression analysis, Bland–Altman analysis, and equivalence testing. Results: A total of 304 spatially clustered paired measurements nested within 16 specimens were analyzed. FEM predictions showed strong correlation with experimental data (r = 0.91–0.97; R² up to 0.937) and low relative error (~5–6%). The model systematically overestimated deformation by approximately 10–15%. Equivalence was confirmed within ±15% for dentin and composite, and within ±20% for enamel. Bland–Altman analysis revealed proportional bias and heteroscedasticity, particularly in dentin. Conclusions: The proposed CBCT-based finite element workflow demonstrates strong benchmarking agreement with experimental measurements and provides reproducible estimates of mechanical behavior within defined tolerance limits under controlled experimental conditions. Despite systematic overestimation, the model exhibits stable and reproducible behavior under controlled conditions. These findings support the use of experimentally benchmarked, image-based FEA workflows in dental biomechanical research. Full article

Fiber contamination originating from disposable dental microapplicators has received limited attention despite its potential influence on adhesive procedures. The aim of this pilot in vitro study was to evaluate fiber-like structure release associated with different microapplicator types during the application of universal adhesive systems. Three universal adhesives (Clearfil Universal Bond Quick, Gluma Universal, and G-Premio BOND) and five microapplicator types (X-Slim, Clinique, Prima, Single TIM, and ZerofloX silicone-bristle microapplicators) were evaluated. A total of 75 adhesive applications were performed on standardized sandblasted glass substrates under controlled laboratory conditions. Adhesives were actively applied for 10 s, and fiber-like structures were quantified microscopically using ImageJ software. Statistical analysis included descriptive statistics, two-way ANOVA, and Tukey post hoc testing (α = 0.05). Significant differences were observed among microapplicator types. X-Slim applicators produced the highest fiber counts, whereas Single TIM applicators demonstrated substantially lower values. No detectable fiber-like structures were observed in specimens treated with the ZerofloX silicone-bristle microapplicator. Adhesive system type showed a comparatively smaller influence on fiber counts than microapplicator design. Within the limitations of this pilot in vitro study, microapplicator type appeared to be the primary factor influencing visible fiber contamination during adhesive application. Further studies are required to determine whether the contamination patterns observed influence adhesive performance under clinically relevant conditions. Full article

Background: Dental caries is a chronic disease mediated by biofilm, which is caused by Streptococcus mutans, and enamel genetics modulates susceptibility. The variants of ENAM might alter the adhesion of enamel and bacteria. One important anti-viral target is sortase A (SrtA), which restricts colonization but does not have an impact on bacterial survival. Aim: The aim of this study was to find out the relationship between ENAM rs3796704 and dental caries vulnerability among adult Iraqi Arab females and to assess the antibiofilm capacity of eugenol and cinnamic acid against S. mutans SrtA using molecular docking, ADMET prediction, and molecular dynamics modeling. Methods: A case–control study was done on 240 women (aged 25–30 years; 120 caries, 120 controls). HRM real-time PCR was done to genotype ENAM rs3796704. An analysis of allelic and genotypic distributions was done using chi-square tests and odds ratios (p < 0.05). An in silico docking analysis aimed at SrtA (PDB: 4TQX) was performed in AutoDock Vina, and this was followed by ADMET profiling and a 50 ns molecular dynamics simulation (OPLS4/TIP3P, NPT 300 K/1 atm). Results: The level of the G allele was found to be lower in the cases than in the controls (60% vs. 70; OR = 0.6429; p = 0.02), but the level of the A allele was found to be higher in the cases (40% vs. 30; OR = 1.5556; p = 0.02). Docking showed a minor difference in binding affinities with eugenol (−4.961 kcal/mol) and cinnamic acid (−4.939 kcal/mol) as compared with chlorhexidine (−4.692 kcal/mol). Both compounds showed stable binding for more than 50 ns as well as desirable predicted pharmacokinetics. Conclusions: The caries vulnerability in this sample was associated with ENAM rs3796704. Eugenol and cinnamic acid undergo stable dissociative interactions with SrtA and were found to have favorable safety profiles in silico. Therefore, they may be considered as adjunctive anti-virulence agents in the prevention of caries. Full article

This study investigated the impact of conventional chlorhexidine (CHX) and anti-discoloration system (ADS)-containing CHX mouthrinses on the color stability of diverse dental polymers, both alone and in combination with coffee. Specimens (n = 180) were prepared from a nanohybrid composite (Charisma Diamond; Kulzer GmbH, Hanau, Germany), a monochromatic composite (Vittra Unique APS; FGM Dental Group, Joinville, Brazil), and a dual-cure alkasite (Cention Forte; Ivoclar Vivadent, Schaan, Liechtenstein). Following a 14-day cycle of mouthrinse immersion (2 min/daily) and coffee exposure (15 min/daily at 85 °C), color changes (ΔE₀₀) were analyzed using the CIEDE2000 system. All materials exhibited significant discoloration across all protocols (p < 0.001). Cention Forte showed the highest susceptibility to staining, particularly in the CHX + coffee group (ΔE₀₀ = 21.10), while Charisma Diamond remained the most stable (0.95–8.60). Conventional CHX (Kloroben; Drogsan Pharmaceuticals, Ankara, Turkey) induced significantly higher staining than ADS-CHX (Curasept ADS; Curasept S.p.A., Saronno, Italy) across all materials (p < 0.05). Notably, ADS technology significantly inhibited coffee-induced pigmentation in Cention Forte (p = 0.003) and Charisma Diamond (p = 0.046), effectively reducing the synergistic staining layer. In conclusion, while coffee consumption dramatically increases discoloration following CHX use, ADS technology serves as a protective barrier, reducing pigment adhesion. For patients with high dietary pigment intake, ADS-containing mouthrinses offer a significant clinical advantage in preserving the aesthetic longevity of polymeric restorations. Full article

Background/Objectives: Titanium alloy Ti₆Al₄V remains the gold standard in dental implantology due to its excellent mechanical properties, corrosion resistance, and biocompatibility. However, implant-associated infections and insufficient osseointegration continue to represent major clinical challenges, mainly related to bacterial biofilm formation and suboptimal surface–tissue interactions. Biofilm formation refers to the adhesion, accumulation, and growth of microbial communities embedded within a self-produced extracellular polymeric matrix on implant surfaces, which contributes to bacterial persistence and resistance to host defense mechanisms. This review aims to critically evaluate recent advances in multifunctional bioceramic coatings for dental implants, with a particular focus on zirconia (ZrO₂)-based systems and their antibacterial mechanisms. Methods: A structured literature analysis was conducted using major scientific databases including PubMed, Scopus, and Web of Science, focusing mainly on studies published between 2015 and 2025 related to CaP, Ag, and ZrO₂-based coatings for dental implants. The review examines their physicochemical properties, antibacterial strategies, ion release behavior, and biological responses, including osteogenic activity and biofilm inhibition. Particular attention is given to hybrid systems integrating multiple functional phases. Results: CaP coatings exhibit excellent osteoconductivity and promote early osseointegration but show limited intrinsic antibacterial activity. Ag-based coatings provide strong broad-spectrum antimicrobial effects through controlled Ag⁺ ion release, although concerns regarding cytotoxicity and dose-dependent responses remain. ZrO₂ coatings significantly enhance corrosion resistance and surface stability, while their antibacterial performance can be improved through nanostructuring, laser surface modification, and ionic doping. Hybrid Ag–CaP–ZrO₂ coatings demonstrate improved antibacterial activity, enhanced corrosion resistance, and better regulation of ion release kinetics and osteogenic response compared with single-component coating systems. Conclusions: Multifunctional bioceramic coatings represent a promising strategy for improving the performance of dental implants and addressing the dual challenge of infection control and tissue integration. However, challenges remain regarding long-term stability, controlled ion release, and limited clinical validation. Future research should focus on the development of smart, stimuli-responsive coatings and standardized evaluation protocols to facilitate clinical translation. Full article

Background/Objectives: Methods of smoking have evolved over the years, including heated tobacco products. The impact of exposure to traditional tobacco smoke and heated/electronic tobacco products (IQOS) on biofilm formation has not been previously compared in vitro. Aims and objectives: The present study aimed to evaluate the impact of tobacco and electronic smoking on microbial biofilm formation on dental hard tissues. Materials and Methods: Thirty premolars were randomly assigned to six groups (n = 10 per group) according to tissue type and smoking exposure: Six experimental groups were defined: Group 1, non-exposed enamel; Group 2, enamel subjected to conventional cigarette smoke (CS); Group 3, enamel subjected to heated tobacco (HT); Group 4, non-exposed cementum; Group 5, cementum subjected to conventional cigarette smoke; and Group 6, cementum exposed to heated tobacco. Enamel and root discs were then immersed in 2 mL of an adjusted, standardized bacterial suspension of Streptococcus mutans (S. mutans) to allow bacterial biofilm adhesion after incubation for 48 h at 37 °C. The mean colony-forming unit (CFU) count was calculated, and the surface topography and roughness were assessed using scanning electron microscopy and ImageJ software with the SurfCharJ plugin, respectively. Results: Conventional cigarette smoking showed significantly higher S. mutans adhesion on the enamel and root discs compared with IQOS and control groups. Both IQOS and cigarette smoking increased roughness on enamel and root versus the control group, and cigarette smoking produced significantly higher roughness on the enamel surface when compared to IQOS; however, there were no significant differences in the roughness between the two smoking methods on the root surface. SEM analysis showed the most extensive enamel and root microtopography change in IQOS smoking. Conclusions: Aerosols from heated tobacco products (IQOS) alter the surface topography and roughness of enamel and root, while traditional cigarette smoking significantly increases bacterial colonization. Further in vivo studies are warranted to simulate the dynamic nature of the oral cavity. Full article

This study investigated the influence of solvent evaporation on the ultimate tensile strength (UTS) and water-related weight changes in contemporary universal dental adhesives. Two two-step universal adhesives (OptiBond eXTRa Universal and G2-BOND Universal) and two one-step universal adhesives (OptiBond Universal and BeautiBond Xtreme) were evaluated. Adhesives were used either under normal storage conditions or after active solvent evaporation by removal of the bottle caps and storage at 37 °C for 2 weeks. Hourglass-shaped specimens were prepared, light-cured, and stored in water at 37 °C for 1 h or 7 days prior to UTS testing (n = 10). Specimen weights were measured before and after water storage. For OptiBond eXTRa Universal, no significant difference in UTS was observed between the original and desiccated groups after 7 days of water storage (p > 0.05). In contrast, G2-Bond Universal exhibited significantly higher UTS values in the desiccated group compared with the original group (p < 0.05). In the original group, the one-step universal adhesives failed to polymerize under the original (non-evaporated) conditions, whereas adequate polymerization was achieved following active solvent evaporation. Weight changes after water storage varied depending on the adhesive composition. These results suggest that residual solvent may influence the polymerization behavior, mechanical performance, and water-related properties of universal dental adhesives, emphasizing the importance of adequate solvent evaporation before light curing. Full article

Background and Objectives: Conventional dental adhesives doped with magnetic nanoparticles (MNPs) hold the promise of preventing microleakages. However, esthetic concerns have motivated the quest for coatings capable of masking the dark color of MNPs. This study aims to quantify regional chromatic differences between teeth restored using dental adhesives with different MNP content. Materials and Methods: We prepared cavities in 42 artificial molars and 9 extracted teeth and divided them into 6 groups: Group 0 (G0), G1, and G2, comprising 14 artificial teeth each and G0e, G1e, and G2e, comprising 3 extracted teeth each. In G0 and G0e, we applied the commercial adhesive, in G1 and G1e we applied the adhesive loaded with MNPs with dual coating (SiO₂ followed by Ca(OH)₂), whereas in G2 and G2e we applied the adhesive doped with uncoated MNPs. For the statistical analysis of color differences, we employed Bland–Altman plots and the one-sample t-test. Results: G1 was similar to G0 in terms of color coordinate distribution, whereas G2 was different. Compared to G0, dental fillings from G1 had mean differences of (−0.56, 0.18, −0.07) in the CIELAB color coordinates (L*, a*, b*), respectively, whereas the mean differences between G2 and G0 were (−15.6, −3.5, −15.7). The CIEDE2000 color differences were 1.5 [1.3, 1.6] between G1 and G0 (mean [95% confidence interval]) and 17.0 [16.0, 18.0] between G2 and G0. Nevertheless, 24.4% of the point pairs compared exceeded the acceptability limit for color difference (1.8). Conclusions: Although the silica and calcium hydroxide coating is highly effective in alleviating the esthetic impact of MNP-laden dental adhesives, further research is warranted to reduce between-specimen variability. Full article

Dental composite dust generated during finishing procedures or mastication may adversely affect gingival epithelia. However, the mechanistic distinction between particulate and chemical (eluate) exposures and their respective signaling consequences remains insufficiently defined. Dust particles and corresponding eluates from three restorative composites, Admira Fusion, Ceram.x Spectra ST, and Filtek Supreme XTE, were evaluated under standardized high-dose in vitro exposure conditions. Human gingival keratinocytes were assessed for proliferation, adhesion, differentiation, fibronectin (FN1) remodeling, and IL-8 secretion, alongside analysis of ERK, p38, and NF-κB signaling and phosphorylation of the stress-responsive regulator SIRT1 at Ser682 (SIRT1-S682). Particulate exposure elicited more pronounced impairment of cellular adhesion, proliferation, and differentiation than eluates. Dusts derived from Ceram.x Spectra ST and Filtek Supreme XTE suppressed ERK activity, reduced FN1 abundance, and decreased nuclear SIRT1-S682, consistent with a generalized stress response. In contrast, Admira Fusion dust preserved FN1, activated ERK signaling, reduced SIRT1-S682, and induced robust IL-8 secretion. Across all materials, particulate exposure reduced nuclear SIRT1-S682 without affecting total SIRT1 levels, indicating a shared permissive stress modification. Notably, only Admira Fusion coupled this permissive state with p38 activation and sustained NF-κB p65 Ser536 phosphorylation, resulting in transcriptionally active NF-κB and elevated IL-8 production, whereas Ceram.x Spectra ST and Filtek Supreme XTE failed to activate this ERK–FN1–p38–NF-κB axis, yielding either transcriptionally inactive NF-κB or no detectable enrichment. These findings support a material-associated in vitro response pattern in which a shared SIRT1-S682 reduction is accompanied by distinct ERK/FN1, p38, NF-κB, and IL-8 readouts. SIRT1-S682 reduction alone did not define the inflammatory phenotype, because it occurred across particulate exposures, whereas IL-8 secretion was observed only under conditions that also showed p38 activation and comparatively maintained NF-κB p65 Ser536 phosphorylation. This signature arises from the convergence of a permissive SIRT1-S682 background with ERK- and p38-dependent MAPK signaling to enable NF-κB-mediated IL-8 expression, highlighting that both composite composition and particulate properties critically determine inflammatory potential and underscoring the importance of incorporating particulate fractions into cytocompatibility testing strategies. Full article

Background/Objectives: Modern dentistry increasingly requires biomaterials that not only replace damaged tissues but also actively regulate healing processes, modulate inflammation, and provide controlled delivery of therapeutic agents under the complex physicochemical conditions of the oral cavity. This review aims to analyze the potential of PCHs, particularly methacryloyl gelatin (GelMA), as multifunctional platforms for drug delivery in dental applications. Methods: This review provides a structured narrative synthesis of the literature, focusing on the physicochemical, biological, and translational aspects of photocrosslinkable hydrogels in dentistry. Special attention was given to the key functional requirements for hydrogels used in dentistry, including adhesion in a wet environment, antimicrobial properties, and the ability to provide sustained and localized release of active compounds. Natural, synthetic, and semi-synthetic polymers were comparatively evaluated to justify the selection of GelMA as a leading platform due to its tunable mechanical properties, biocompatibility, and photopolymerization capacity. The review also analyzes mechanisms of drug release activation and provides a comparative assessment of commonly used photoinitiators, including Irgacure 2959, lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP), and camphorquinone, with emphasis on their cytocompatibility with oral tissues. Results: Applications of these hydrogels in endodontics, periodontology, peri-implantitis therapy, and regeneration of bone and dental pulp are summarized. Conclusions: Overall, photocrosslinkable GelMA-based hydrogels (PC-GelMA) represent promising multifunctional platforms for localized drug delivery and regenerative strategies in modern dentistry. Full article

Matrix metalloproteinases (MMPs) are zinc-dependent proteolytic enzymes involved in extracellular matrix remodelling in oral and dental tissues, including the periodontal ligament, alveolar bone, dentin, dental pulp, and periapical tissues. This narrative review summarises selected evidence on the role of MMPs and tissue inhibitors of metalloproteinases (TIMPs) in orthodontic tooth movement, dental trauma and root resorption, restorative adhesive dentistry, and pulp/periapical disease. Particular attention is given to signalling pathways that regulate MMP/TIMP activity, including nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPK), Wnt/β-catenin, and transforming growth factor beta (TGF-β)/Smad-related mechanisms. The review also discusses the biomarker potential and translational status of MMP-targeted strategies. Across clinical contexts, MMP activity contributes to both matrix degradation and tissue repair, and its biological effect depends on local stimuli, TIMP-mediated regulation, pathway crosstalk, and the stage of disease or treatment. Full article

Background: The rapid evolution of dental adhesive systems presents both opportunities and challenges for clinical practice, particularly regarding the translation of emerging evidence into routine use. Aim: This study aimed to assess the knowledge, attitudes, and self-reported practices related to modern adhesive systems among Romanian dentists and to explore factors associated with their clinical decision-making. Materials and Methods: An observational cross-sectional study was conducted between November 2025 and February 2026 using a 115-item online questionnaire. A convenience sample of 372 Romanian dentists participated. Statistical analysis included descriptive statistics, chi-square and Kruskal–Wallis tests, and multivariate models (multiple linear regression, binary logistic regression, and multinomial logistic regression). Internal consistency of the knowledge scale was assessed using Cronbach’s alpha. Results: The knowledge scale demonstrated good reliability (Cronbach’s α = 0.873). Although 68.0% of respondents reported familiarity with universal adhesives, a discrepancy between awareness and reported clinical application was observed for several key concepts, including MMP inhibitors and hydrolytic stability. Notably, 14.8% of participants were unaware whether their preferred adhesive system contained 10-MDP. Continuing education frequency was the only independent predictor of higher knowledge scores (β = 1.63, p = 0.024), while greater clinical experience was inversely associated with rubber dam use (OR = 0.550, p = 0.024). Conclusions: The findings suggest a discrepancy between theoretical knowledge and the clinical implementation of modern adhesive concepts. Structured continuing education plays a critical role in improving knowledge and may help bridge this gap in clinical practice. Full article