Search Results (916)

Objective: With a global prevalence ranging from 50% to 100%, gingivitis is considered the most common oral disease in adults worldwide. It is characterized by clinical signs of inflammation, such as redness, swelling and bleeding, on gentle probing. Although it is considered a milder form of periodontal disease, gingivitis plays an important role in overall oral health. Early detection and treatment are essential to prevent progression to more severe conditions. Typically, diagnosis is performed by dental professionals, as individuals are often unable to accurately assess whether they are affected. Therefore, the aim of the present study was to determine to what degree gingivitis is visually detectable by an easy-to-use camera-based application. Materials and methods: Standardized intraoral photographs were taken using a specialized intraoral camera and processed using a custom-developed filter based on a machine-learning algorithm. The latter was trained to highlight areas suggestive of gingivitis. A total of 110 participants were enrolled through ad hoc sampling, resulting in 320 assessable test sites. A dentist provided two reference standards: the clinical diagnosis based on bleeding on probing of the periodontal sulcus (BOP) and an independent visual assessment of the same images. Agreement between diagnostic methods was measured using Cohen’s kappa statistic. Results: The agreement between the application’s output and the BOP-based clinical diagnosis was low, with a kappa value of 0.055 [p = 0.010]. Similarly, the dentist’s visual assessment of clinical photos showed low agreement with BOP, with a kappa value of 0.087 [p < 0.001]. In contrast, the agreement between the application and the dentist’s photo-based evaluations was higher, with a kappa value of 0.280 [p < 0.001]. Conclusions: In its current form, the camera-based application is not able to reliably detect gingivitis. The low level of agreement between dentists’ visual assessments and the clinical gold standard highlights that gingivitis is difficult to identify merely visually. These results underscore the need to refine visual diagnostic approaches further, which could support future self-assessment or remote screening applications. Full article

Recent evidence suggests that nano-TiO₂ particles improve antimicrobial and physical properties when incorporated into dental prosthetic materials. However, there exists a paucity of information regarding their impact on material properties when the prosthetic materials are 3D-printed over time. The purpose of this study was to evaluate the time-dependent printability and surface property changes occurring in a 3D-printed denture base resin containing nano-titanium dioxide (TiO₂) particles. A 0.4 wt% concentration of 30 nm rutile TiO₂ nanoparticles was ultrasonically dispersed into a denture base resin. Disks were printed weekly using a Form 2 SLA printer until printing failed. Printability, surface roughness (R_a), color difference (ΔE_ab), and translucency parameters were measured across timepoints. Surface roughness was assessed via profilometry, while color and translucency were evaluated using a spectrophotometer under standardized conditions. Print failure occurred at week 8, beyond which the resin could no longer reliably produce full specimens. R_a roughness decreased from 3.83 µm to 0.48 µm, which denoted a significant time-dependent decrease (ρ = −0.733, p = 0.016). Color difference with the unmodified control declined from 26.32 to 17.13 ΔE_ab units (ρ = −0.976, p < 0.001). All printed samples exceeded the clinically acceptable thresholds for both R_a (0.2 µm) and ΔE_ab (<3.7). Although the printability of the resin–TiO2 mixture was maintained for 7 weeks, mixture homogeneity declined over time. TiO₂ additions to a denture polymer produced significant changes in surface roughness and color that were not clinically acceptable. Results from this study illustrate the time dependence required for retaining surface properties in 3D-printed dentures containing nano-TiO₂. Full article

Background/Objectives: The functionalization of various forms of graphene, such as graphene nanoplatelets, graphene oxide, and reduced graphene oxide, in biomaterials is a promising strategy in dentistry, particularly regarding their antimicrobial potential. However, conclusive studies on the toxicity and biocompatibility of graphene-based materials remain limited, and standardized guidelines for their production, handling, and dental applications are still lacking. This scoping review aims to map the available studies on various types of graphene, synthesize evidence on their antimicrobial effectiveness, and describe the main biological responses when functionalized in dental biomaterials. Methods: An electronic search was conducted in the Clarivate, PubMed, and Scopus databases using the descriptors as follows: ‘graphene’ AND ‘antimicrobial effect’ AND ‘bactericidal effect’ AND (‘graphene oxide’ OR ‘dental biofilm’ OR ‘antibacterial properties’ OR ‘dental materials’). Article screening and eligibility assessment were performed based on predefined inclusion and exclusion criteria, following the PRISMA-ScR guidelines. Results: The search identified 793 articles. After removing duplicates, applying the eligibility criteria, and performing a full-text analysis of 64 articles, 21 studies were included in the review. Graphene oxide, particularly at low concentrations, was the most commonly studied graphene variant, demonstrating significant antimicrobial efficacy against S. mutans, S. faecalis, E. coli, P. aeruginosa, and C. albicans. Both mechanical and chemical mechanisms have been linked to the biological responses of graphene-doped biomaterials. The biocompatibility and cytotoxicity of these compounds remain controversial, with some studies reporting favorable outcomes, while others raise significant concerns. Conclusions: Graphene shows great promise as an antimicrobial agent in dental biomaterials. Despite encouraging results, more in vitro and in vivo studies are needed to better understand its biocompatibility and cytotoxicity in dental applications. Additionally, standardized production protocols, clearly defined clinical applications in dentistry, and regulatory guidelines from the World Health Organization concerning handling procedures and occupational risks remain necessary. Full article

Background: The aim of this review is to summarize and evaluate the properties of antibacterial polysaccharides for application in dental implantology to identify knowledge gaps and provide new research ideas. Methods: The electronic databases PubMed, Medline, ProQuest, and Google Scholar were used to search for peer-reviewed scientific publications published between 2018 and 2025 that provide insights to answer research questions on the role of antibacterial polysaccharides in combating pathogens in dental implantology without triggering immune reactions and inflammation. Further research questions relate to the efficacy against various dental pathogens and the understanding of the antibacterial mechanism, which may enable the development of functionalized polysaccharides with long-term antibacterial activity. Results: Biomedical implants have revolutionized medicine but also increased the risk of infections. Implant infections are a major problem in implantology and lead to implant failure and replacement. An antibacterial coating could be an excellent strategy to extend the lifespan of implants and improve the quality of the patient’s life. Bacterial resistance to antibiotics poses significant challenges for researchers, forcing them to search for new ways to prevent bacterial infections in implantology. Antibacterial natural polymers have recently received considerable research attention due to their long-term antibacterial activity. Polysaccharides from marine sources, such as chitosan and alginate, or pectin, xanthan, etc., from various plants, appear to be promising biopolymers for such applications in implantology due to their antibacterial activity, biocompatibility, and osteogenic properties. The antibacterial activity of these natural biopolymers depends on their chemical and physical properties. Nanopolysaccharides exhibit higher antibacterial activity than conventional polysaccharides, but their toxicity to human cells must be considered. Their antibacterial activity is based on the disruption of bacterial DNA or RNA synthesis, increased cell wall permeability, membrane disruption, and cytoplasmic leakage. Conclusions: Polysaccharides are a class of natural polymers with a broad spectrum of biological activities. They exhibit antioxidant, immunomodulatory, anticoagulant, anticancer, anti-inflammatory, antibacterial, and antiviral activity. Furthermore, polysaccharides are non-cytotoxic and exhibit good biocompatibility with osteogenic cells. Bactericidal polysaccharides are attractive new antibacterial materials against implant infections and open up new perspectives in implantology. Full article

Aim: Pacifiers play a critical role in the early stages of craniofacial and palate development during infancy. While they provide comfort and aid in soothing, their use can also have significant impacts on the growth and function of the oral cavity. This study aimed to simulate and predict the behavior of six different types of pacifiers and their functional interaction with the tongue and palate, with the goal of understanding their potential effects on orofacial growth and development. Materials and Methods: Biomechanical analysis using Finite Element Analysis (FEA) mathematical models was employed to evaluate the behavior of six different commercial pacifiers in contact with the palate and tongue. Three-dimensional solid models of the palate and tongue were based on the mathematical framework from a 2007 publication. This allowed for a detailed investigation into how various pacifier designs interact with soft and hard oral tissues, particularly the implications on dental and skeletal development. Results: The findings of this study demonstrate that pacifiers exhibit different interactions with the oral cavity depending on their geometry. Anatomical–functional pacifiers, for instance, tend to exert lateral compressions near the palatine vault, which can influence the hard palate and contribute to changes in craniofacial growth. In contrast, other pacifiers apply compressive forces primarily in the anterior region of the palate, particularly in the premaxilla area. Furthermore, the deformation of the tongue varied significantly across different pacifier types: while some pacifiers caused the tongue to flatten, others allowed it to adapt more favorably by assuming a concave shape. These variations highlight the importance of selecting a pacifier that aligns with the natural development of both soft and hard oral tissues. Conclusions: The results of this study underscore the crucial role of pacifier geometry in shaping both the palate and the tongue. These findings suggest that pacifiers have a significant influence not only on facial bone growth but also on the stimulation of oral functions such as suction and feeding. The geometry of the pacifier affects the soft tissues (tongue and muscles) and hard tissues (palate and jaw) differently, which emphasizes the need for careful selection of pacifiers during infancy. Choosing the right pacifier is essential to avoid potential negative effects on craniofacial development and to ensure that the benefits of proper oral function are maintained. Therefore, healthcare professionals and parents should consider these biomechanical factors when introducing pacifiers to newborns. Full article

This narrative review explores the role of additive manufacturing (AM) technologies in the production of dental implants, focusing on materials and key AM methods. The study discusses several materials used in implant fabrication, including porous titanium, trabecular tantalum, zirconium dioxide, polymers, and composite materials. These materials are evaluated for their mechanical properties, biocompatibility, and suitability for AM processes. Additionally, the review examines the main AM technologies used in dental implant production, such as selective laser melting (SLM), electron beam melting (EBM), stereolithography (SLA), selective laser sintering (SLS), and direct metal laser sintering (DMLS). These technologies are compared based on their accuracy, material limitations, customization potential, and applicability in dental practice. The final section presents a data source analysis of the Web of Science and Scopus databases, based on keyword searches. The analysis evaluates the research trends using three criteria: publication category, document type, and year of publication. This provides an insight into the evolution and current trends in the field of additive manufacturing for dental implants. The findings highlight the growing importance of AM technologies in producing customized and efficient dental implants. Full article

Background/Objectives: Anterior dental trauma in adolescents presents complex restorative challenges due to ongoing craniofacial development and high aesthetic expectations. This study evaluated the long-term clinical performance of feldspathic ceramic veneers and lithium disilicate crowns used in the anterior region following dental trauma in adolescents. Methods: A total of 209 restorations were placed in 85 adolescents (50 females, 35 males), aged 11.1–17.9 years (mean age: 15.1 years). Of these, 144 were lithium disilicate crowns, and 65 were feldspathic ceramic veneers. All restorations were fabricated using minimally invasive protocols and followed up for periods ranging from 3 to 60 months. Outcomes were assessed based on standardized clinical criteria for success and failure. Results: Lithium disilicate crowns exhibited superior long-term performance, with the majority of failures occurring in feldspathic veneers (p < 0.001), primarily due to chipping or structural fracture. Age and gender had no statistically significant influence on failure rates. Conclusions: Both feldspathic and lithium disilicate ceramic restorations represent viable treatment options for anterior dental trauma in adolescents. However, lithium disilicate demonstrates greater mechanical reliability, particularly in teeth with significant hard tissue loss. These results support the use of durable ceramic materials in adolescent restorative protocols involving dental trauma. Full article

This study aimed to develop experimental filler-reinforced resin composites for vat-photopolymerization 3D printing and to evaluate the effects of filler addition on their mechanical, physicochemical, and bonding properties for dental restorative applications. Silanized nano- and/or micro-fillers were incorporated into acrylic resin monomers to formulate photocurable resins suitable for vat-photopolymerization. The rheological behavior of these liquid-state resins was assessed through viscosity measurements. Printed resin composites were fabricated and characterized for mechanical properties—including flexural strength, flexural modulus, and Vickers hardness—both before and after 8 weeks of water immersion. Physicochemical properties, such as water sorption, water solubility, and degree of conversion, were also evaluated. Additionally, shear bond strength to a resin-based luting agent was measured before and after artificial aging via thermocycling. A commercial dental CAD-CAM resin composite served as a reference material. Filler incorporation significantly improved the mechanical properties of the printed composites. The highest performance was observed in the composite containing 60 wt% micro-fillers, with a flexural strength of 168 ± 10 MPa, flexural modulus of 6.3 ± 0.4 GPa, and Vickers hardness of 63 ± 1 VHN, while the commercial CAD-CAM composite showed values of 152 ± 8 MPa, 7.9 ± 0.3 GPa, and 66 ± 2 VHN, respectively. Filler addition did not adversely affect the degree of conversion, although the relatively low conversion led to the elution of unpolymerized monomers and increased water solubility. The shear bond strength of the optimal printed composite remained stable after aging without silanization, demonstrating superior bonding performance compared with the CAD-CAM composite. These findings suggest that the developed 3D-printed resin composite is a promising candidate for dental restorative materials. Full article

Background/Objectives: The growing demand for biocompatible and fluoride-free alternatives in oral care has led to the development of formulations containing nano-hydroxyapatite (nanoHAP). This study aimed to evaluate the antimicrobial, antibiofilm, antioxidant, and anti-inflammatory properties of a novel mouthwash containing nanoHAP, zinc lactate, D-panthenol, licorice extract, and cetylpyridinium chloride, with particular focus on its efficacy against Staphylococcus aureus and its biofilm on various dental materials. Methods: The antimicrobial activities of the mouthwash KWT0000 and control product ELM were assessed via minimal inhibitory concentration (MIC) testing against selected Gram-positive and Gram-negative bacteria and Candida fungi. Antibiofilm activity was evaluated using fluorescence and digital microscopy following 1-h exposure to biofilms of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The efficacy was compared across multiple dental materials, including titanium, zirconia, and PMMA. Antioxidant capacity was determined using the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) assay, and anti-inflammatory potential via hyaluronidase inhibition. Results: KWT0000 exhibited strong antimicrobial activity against S. aureus and C. albicans (MICs: 0.2–1.6%) and moderate activity against Gram-negative strains. Fluorescence imaging revealed significant biofilm disruption and bacterial death after 1 h. On metallic surfaces, especially polished titanium and zirconia, KWT0000 reduced S. aureus biofilm density considerably. The formulation also demonstrated superior antioxidant (55.33 ± 3.34%) and anti-inflammatory (23.33 ± 3.67%) activity compared to a fluoride-based comparator. Conclusions: The tested nanoHAP-based mouthwash shows promising potential in antimicrobial and antibiofilm oral care, particularly for patients with dental implants. Its multifunctional effects may support not only plaque control but also soft tissue health. Full article

Moringa oleifera (MO), a nutritionally and pharmacologically potent species, is emerging as a sustainable candidate for applications across bioenergy, agriculture, textiles, pharmaceuticals, and biomedicine. This review explores recent advances in MO-based biotechnologies, highlighting novel extraction methods, green nanotechnology, and clinical trial findings. Although MO’s resilience offers promise for climate-smart agriculture and public health, challenges remain in standardizing cultivation and verifying therapeutic claims. This work underscores MO’s translational potential and the need for integrative, interdisciplinary research. MO is used in advanced materials, like electrospun fibers and biopolymers, showing filtration, antibacterial, anti-inflammatory, and antioxidant properties—important for the biomedical industry and environmental remediation. In textiles, it serves as an eco-friendly alternative for wastewater treatment and yarn sizing. Biotechnological advancements, such as genome sequencing and in vitro culture, enhance traits and metabolite production. MO supports green biotechnology through sustainable agriculture, nanomaterials, and biocomposites. MO shows potential for disease management, immune support, metabolic health, and dental care, but requires further clinical trials for validation. Its resilience is suitable for land restoration and food security in arid areas. AI and deep learning enhance Moringa breeding, allowing for faster, cost-effective development of improved varieties. MO’s diverse applications establish it as a key element for sustainable development in arid regions. Full article

Background and Objectives: Dental restorations can be composed of various materials, including amalgams and methacrylate-based resins. The health risks associated with the components of the restorative materials have always been a concern, even more so with the ageing of the restorations. As the micronucleus (MN) test is a standard, accessible, and minimally invasive technique for studying the genotoxic effect of clastogenic chemicals on oral mucosal cells, the current study was conducted to determine the frequency and morphological properties of MN in the exfoliated oral mucosal cells. Materials and Methods: A total of 115 aged composite and amalgam restorations were included in this study. Epithelial cells were collected from the gingival tissue adjacent to the restorations of each patient and stained with a hematoxylin–eosin (HE) stain. After evaluation of the slides, the results were subjected to statistical analysis using Chi-square tests. The level of significance was set at 0.05. Results: The mean number of MN was significantly lower for composite restorations compared to amalgam restorations. There were no statistically significant differences between composite restorations aged 1–5 years, 5–10 years, over 10 years, and amalgam restorations aged over 10 years in the location (p = 0.11), staining (p = 0.11), or morphological characteristics (p = 0.18) of the MN. Conclusions: Despite the main limitation of this study, the lack of a control group, our results suggest that long-term exposure to restorative fillings and the ageing of these materials can cause DNA damage locally in the adjacent sites of oral cavity. Full article

Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. Although recommendations for remineralizing agents include both the prevention of lesion progression and the stimulation of tissue remineralization, the clinical efficacy of ACP-based materials remains under debate. This systematic review, registered in the PROSPERO database (CRD42024540595), aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs and to compare these outcomes with those achieved using non-bioceramic approaches. Inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Studies involving artificial WSLs or non-cariogenic enamel lesions were excluded. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes. Full article

Two-component dental materials are commonly used by the dentist for various applications (cementation of indirect restorations, filling of a cavity without layering, etc.). These materials are cured by redox polymerization. The (hydro)peroxide/thiourea/copper salt redox initiator system is well established and can be found in a wide range of commercially available dental materials. The thiourea is a key component of the initiator system. This study explores the influence of the nature of the thiourea reducing agent on the reactivity and efficiency of redox initiator systems. In this work, six different thiourea structures were investigated, in combination with copper(II) acetylacetonate and cumene hydroperoxide (CHP), to understand their impact on polymerization kinetics and mechanical properties of methacrylate-based materials. Various experimental techniques, including mass spectrometry (MS) and spectroscopic analyses, were employed to elucidate the underlying mechanisms governing these redox systems. The results highlight that thiourea plays a dual role, acting both as a reducing agent and as a ligand in copper complexes, affecting radical generation and polymerization efficiency. Structural modifications of thiourea significantly influence the initiation process, demonstrating that reactivity is governed by a combination of factors rather than a single property. Self-cure dental flowable composites exhibiting excellent flexural strength (>100 MPa) and modulus (>6000 MPa) were obtained using hexanoyl thiourea, N-benzoylthiourea, or 1-(pyridin-2-yl)thiourea as a reducing agent. The adjustment of the Cu(acac)₂ enables to properly set the working time in the range of 100 to 200 s. These findings provide valuable insights into the design of the next generation of redox initiating systems for mild and safe polymerization conditions. Full article

Hydroxyapatite (HA) has become a widely used material for bone grafting and surface modification of titanium-based orthopedic implants due to its excellent biocompatibility. Among various coating techniques, microplasma spraying (MPS) has gained significant industrial relevance. However, the clinical success of HA coatings also depends on their adhesion to the implant substrate. Achieving durable fixation and reliable biological integration of orthopedic implants remains a major challenge due to insufficient coating adhesion and limited osseointegration. This study addresses challenges in dental and orthopedic implantology by evaluating the microstructure, mechanical properties, and biological behavior of bilayer coatings composed of a zirconium (Zr) sublayer and an HA top layer, applied via MPS onto titanium alloy. Surface roughness, porosity, and adhesion were characterized, and pull-off and shear tests were used to assess mechanical performance. In vitro biocompatibility was tested using rat mesenchymal stem cells (MSCs) to model osteointegration. The results showed that the MPS-fabricated Zr–HA bilayer coatings achieved a pull-off strength of 28.0 ± 4.2 MPa and a shear strength of 32.3 ± 3.2 MPa, exceeding standard requirements. Biologically, the HA top layer promoted a 45% increase in MSC proliferation over three days compared to the uncoated titanium substrate. Antibacterial testing also revealed suppression of E. coli growth after 14 h. These findings support the potential of MPS-applied Zr-HA coatings to enhance both the mechanical integrity and biological performance of titanium-based orthopedic implants. Full article

This study presents a methodology for developing and validating digital models of tooth-inlay systems, aiming to trace the complete workflow from clinical procedures to simulation by involving dental professionals—dentists for manual cavity preparation and dental technicians for restoration modelling—while integrating micro-computed tomography (micro-CT) imaging with finite element analysis (FEA). The proposed workflow includes (1) the acquisition of high-resolution 3D micro-CT scans of a non-restored tooth, (2) image segmentation and reconstruction to create anatomically accurate digital twins and mesh generation, (3) the selection of proper resin and the 3D printing of four typodonts, (4) the manual preparation of cavities on the typodonts, (5) the acquisition of high-resolution 3D micro-CT scans of the typodonts, (6) mesh generation, digital inlay and onlay modelling and material property assignment, and (7) nonlinear FEA simulations under representative masticatory loading. The approach enables the visualisation of stress and deformation patterns, with preliminary results indicating stress concentrations at the tooth-restoration interface integrating different cavity alternatives and restorations on the same tooth. Quantitative outputs include von Mises stress, strain energy density, and displacement distribution. This study demonstrates the feasibility of using image-based, tooth-specific digital twins for biomechanical modelling in dentistry. The developed framework lays the groundwork for future investigations into the optimisation of restoration design and material selection in clinical applications. Full article