Search Results (105)

The evidence for photobiomodulation in reducing postoperative pain after endodontic instrumentation is classified as low or very low certainty, indicating a need for further research. Longitudinal pain assessments over 24 h are crucial, and studies should explore these pain periods. Background/Objectives: This double-blind, randomized controlled clinical trial evaluated the effect of PBM on pain following single-visit endodontic treatment of maxillary molars at 4, 8, 12, and 24 h. Primary outcomes included pain at 24 h; secondary outcomes included pain at 4, 8, and 12 h, pain during palpation/percussion, OHIP-14 analysis, and frequencies of pain. Methods: Approved by the Research Ethics Committee (5.598.290) and registered in Clinical Trials (NCT06253767), the study recruited adults (21–70 years) requiring endodontic treatment in maxillary molars. Fifty-eight molars were randomly assigned to two groups: the PBM Group (n = 29), receiving conventional endodontic treatment with PBM (100 mW, 333 mW/cm², 9 J distributed at 3 points near root apices), and the control group (n = 29), receiving conventional treatment with PBM simulation. Pain was assessed using the Visual Analog Scale. Results: Statistical analyses used chi-square and Mann–Whitney tests, with explained variance (η²). Ten participants were excluded, leaving 48 patients for analysis. No significant differences were observed in postoperative pain at 24, 4, 8, or 12 h, or in palpation/percussion or OHIP-14 scores. Pain frequencies ranged from 12.5% to 25%. Conclusions: PBM does not influence post-treatment pain in maxillary molars under these conditions. These results emphasize the importance of relying on well-designed clinical trials to guide treatment decisions, and future research should focus on personalized dosimetry adapted to the anatomical characteristics of the treated dental region to enhance the accuracy and efficacy of therapeutic protocols. Full article

Orthognathic surgery (OS) is a complex procedure commonly used to treat dentofacial deformities (DFDs). These conditions, related to jaw position or size and often involving malocclusion, affect approximately 15% of the population. Due to the complexity of OS, accurate planning is essential. Digital assessment using computer-aided design (CAD) and computer-aided manufacturing (CAM) tools enhances surgical predictability. However, limitations in soft tissue simulation often require surgeon input to optimize aesthetic results and minimize surgical impact. This study aimed to evaluate the accuracy of virtual surgery planning (VSP) by analyzing the relationship between planning deviations and surgical satisfaction. A single-center, retrospective study was conducted on 16 patients who underwent OS at San Pedro University Hospital of La Rioja. VSP was based on CT scans using Dolphin Imaging software (v12.0, Patterson Dental, St. Paul, MN, USA) and surgeries were guided by VSP-designed occlusal splints. Outcomes were assessed using the Orthognathic Quality of Life (OQOL) questionnaire and deviations were measured through pre- and postoperative imaging. The results showed high satisfaction scores and good overall outcomes, despite moderate deviations from the virtual plan in many cases, particularly among Class II patients. A total of 63% of patients required VSP modifications due to poor soft tissue fitting, with 72% of these being Class II DFDs. Most deviations involved less maxillary advancement than planned, while maintaining optimal occlusion. This suggests that VSP may overestimate advancement needs, especially in Class II cases. No significant differences in satisfaction were observed between patients with low (<2 mm) and high (>2 mm) deviations. These findings support the use of VSP as a valuable planning tool for OS. However, surgeon experience remains essential, especially in managing soft tissue behavior. Improvements in soft tissue prediction are needed to enhance accuracy, particularly for Class II DFDs. Full article

Background: Inadequate presurgical planning is a key contributor to suboptimal outcomes in orthognathic surgery. This study aims to assess the accuracy of a digital surgical planning workflow conducted prior to any orthodontic intervention. Methods: Digital planning was performed for 26 patients before orthodontic treatment (T0) and compared to the actual preoperative planning (T1). Digitized plaster casts were merged with CBCT data and converted to orthodontic setups to create a 3D virtual head model. After voxel-based registration of T0 and T1, dental arches were virtually osteotomized and repositioned according to planned outcomes. These T0 segments were then aligned with T1 planning using bony landmarks of the maxilla. Anatomical landmarks were used to construct virtual triangles on maxillary and mandibular segments, enabling assessment of positional and orientational differences. Transformations between T0 and T1 were translated into clinically meaningful metrics. Results: Significant differences were found between T0 and T1 at the dental level. T1 exhibited a greater clockwise rotation of the dental maxilla (mean: 2.85°) and a leftward translation of the mandibular dental arch (mean: 1.19 mm). In SARME cases, the bony mandible showed larger anti-clockwise roll differences. Pitch variations were also more pronounced in maxillary extraction cases, with both the dental maxilla and bony mandible demonstrating increased clockwise rotations. Conclusions: The proposed orthognathic surgical planning workflow shows potential for simulating mandibular outcomes but lacks dental-level accuracy, especially in maxillary anterior torque. While mandibular bony outcome predictions align reasonably with pretreatment planning, notable discrepancies exceed clinically acceptable thresholds. Current accuracy limits routine use; further refinement and validation in larger, homogeneous patient groups are needed to enhance clinical reliability and applicability. Full article

This study evaluated the effects of conventional cigarette smoke compared to aerosol from a heat-non-burn tobacco product on the color stability of two UDMA-based dental composite resins, namely a monochromatic (Omnichroma) and a polychromatic (Vittra APS) resin. Twenty disc-shaped specimens were prepared, divided into two groups of ten, and exposed to 105 cigarettes or 105 aerosol tobacco sticks via a custom-made smoking chamber. Puff duration was 2 s, with a 60 s interval between puffs in which smoke saturated the chamber for 30 s; then, clean air was introduced into the chamber for 30 s. Six puffs and six intervals were simulated. Color parameters were measured before and after exposure and following brushing of each specimen with 15 strokes. Color differences were determined based on the CIEDE2000 formula. Significant color change was found in all specimens exposed to cigarette and tobacco aerosol. The highest color-change mean value was obtained from composite resin exposed to cigarette smoke. Although both cigarette and thermal heating systems cause discoloration, the aerosol causes reduced composite resin discoloration, which compromises aesthetics and increases patient dissatisfaction, impacting the overall dental care. Color stability is the hallmark of success, as it is the main reason for replacing dental restorations. Full article

Background: Eighty-five percent of peri-implant malignancies are oral squamous cell carcinomas (OSCCs), and most of them are misdiagnosed as peri-implantitis because of their clinical and radiological presentation; few studies have focused on addressing and solving the diagnostic issues related to peri-implant OSCCs. Objectives: The study aimed to describe the clinicopathological features of peri-implant OSCCs and to report the staging issues related to the diagnosis of these lesions. Methods: This retrospective cohort study included patients who received a diagnosis of and treatment for peri-implant OSCCs at the Unit of Dentistry of the “Aldo Moro” University of Bari (Italy) from 2018 to 2024. By using descriptive statistics, the authors highlighted the diagnostic issues related to the clinical presentation, radiological features, and histology of peri-implant OSCCs. Results: A total of 13 women and 8 men with a mean age of 70.6 ± 11.7 years met the inclusion criteria; the medical history of the participants showed potentially malignant disorders (OPMDs) in 52.4% of patients, whereas 14.3% had already developed an OSCC. The patients showed 24 peri-implant OSCCs; the clinical presentation was leuko-erythroplakia-like (41.7%) or erythroplakia-like (58.3%), thus simulating peri-implantitis; in addition, 52.0% of dental implants involved had a probing pocket depth ≥ 10 mm, further mimicking peri-implantitis. Panoramic radiograms and cone beam computed tomography were of little use in studying bundle bone–implant interfaces; in particular, the tomography showed circumferential bone resorption only in peri-implantitis-like OSCCs. In total, 91.6% of histological examinations of OSCCs showed peri-implantitis-like inflammation; early-stage lesions (pTNM I-II) accounted for 33.3%, whereas late-stage lesions (pTNM III-IV) accounted for 66.7%; lymph nodal metastases occurred in 25.0% and 62.5%, respectively. The mean follow-up was 3.4 ± 1.0 years; all patients with OPMDs had poorly differentiated tumors and thus showed a worse prognosis than those without OPMDs (mean disease-free survival of 15.5 ± 7.7 months and 44.7 ± 12.1 months, respectively). Conclusions: The results of the study showed that peri-implant OSCCs occurred most frequently in patients with OPMDs or previous OSCC; in addition, peri-implant OSCCs required demolition rather than conservative excision, and the prognosis of patients strictly depended on the grade of the cancer. In the authors’ experience, the clinical–radiological presentation simulating peri-implantitis was the feature that concurred most in complicating the diagnosis of those tumors. Full article

Objectives: To introduce a novel method for apical lesion sampling using a protected paper point device and to evaluate its effectiveness and robustness during the sampling process in vitro. Methods: A prototype for apical sample collection was developed as an adaptation of the Micro-Apical Placement System—the device features a highly tapered screw head with a thin, hollow, stainless-steel tube and an internal wire piston. Standardized 5 mm paper points (ISO 10; PD Dental, Switzerland) served as carrier material. The prototype was tested using 30 × 3D-printed, single-rooted tooth models inoculated using two bacterial strains (Staphylococcus epidermidis and Escherichia coli) to simulate apical and intraradicular bacterial infections, respectively. The sampling process involved collecting and analyzing samples at specific timepoints, focusing on the presence or absence of E. coli contamination. Following sample collection, cultural detection of bacterial presence was performed by incubating the samples on agar plates to confirm the presence of E. coli. Samples were collected as follows: S0 (sterility control of the prototype), P0 (sterility control of the tooth model), P1 (apical sample collected with the CAPS (controlled apical sampling) device, and P2 (contamination control sample to check for the presence of E. coli inside the root canal). Results: Handling of the CAPS prototype was straightforward and reproducible. No loss of paper points or complications were observed during sample collection. All sterility samples (P0, S0) were negative for tested microorganisms, confirming the sterility of the setup. P2 samples confirmed the presence of E. coli in the root canal in all trials. The P1 samples were free from contamination in 86.67% of trials. Conclusions: The CAPS method for apical sampling demonstrated advances in the successful and precise sample collection of apically located S. epidermidis and will be a useful tool for endodontic microbiological analysis. Its user-friendly design and consistent performance highlight its potential for clinical application, contributing to more accurate microbial diagnostics and later patient-specific therapeutic approaches in endodontic treatments. Full article

(1) Background: Advancements in dental imaging technologies have significantly transformed diagnostic and surgical practices. The integration of cone beam computed tomography (CBCT), artificial intelligence (AI), augmented reality (AR), and virtual reality (VR) is enhancing clinical precision, streamlining workflows, and redefining dental education. This review examines the evolution, applications, and future potential of these technologies in modern dental practice. (2) Methods: A narrative literature review was conducted, synthesizing findings from recent studies on digital radiography, CBCT, AI-assisted diagnostics, 3D imaging, and involving simulation tools (AR/VR). Peer-reviewed journal articles, systematic reviews, and clinical studies were analyzed to explore their impact on diagnosis, treatment planning, surgical execution, and training. (3) Results: Digital and 3D imaging modalities have improved diagnostic accuracy and reduced radiation exposure. AI applications enhance image interpretation, automate clinical tasks, and support treatment simulations. AR and VR technologies provide involved, competency-based surgical training and real-time intraoperative guidance. Integrating 3D printing and portable imaging expands accessibility and personalization in care delivery. (4) Conclusions: The integration of CBCT, AI, AR, and VR represents a paradigm shift in dentistry, elevating precision, efficiency, and patient outcomes. Continued research, standardization, and ethical practice will be essential for widespread adoption and maximizing clinical benefits. Full article

The color stability of dental ceramics in the oral cavity is influenced by multiple factors, including the patient’s dietary habits and oral hygiene practices, which can affect the optical and surface properties of resin-containing dental restorative materials. The purpose of this study was to evaluate the effects of surface finishing procedures and simulated tooth-brushing on the surface roughness, surface gloss, and color stability of resin matrix ceramics before and after coffee immersion. Forty specimens were prepared from a resin matrix ceramic and divided into four experimental groups according to surface finishing procedures, coffee immersion, and simulated tooth-brushing. The surface roughness, surface gloss, and color stability of the tested material were measured, and the data were statistically analyzed at a significance level of p < 0.05. The surface finishing procedures, measurement times, and application sequences affected surface roughness, surface gloss, and color stability. The most significant color differences occurred after coffee immersion; however, tooth-brushing had a more significant effect on the surface roughness and surface gloss. Coffee caused perceivable and clinically unacceptable color differences in the resin matrix ceramics. Tooth-brushing had a positive impact on the tested parameters. This study presents a novel approach by integrating both chemical (coffee immersion) and mechanical (tooth-brushing simulation) degradation processes to assess their combined and isolated effects on a resin matrix ceramic material. The findings provide clinically relevant insights into how finishing procedures and oral hygiene may influence the long-term esthetic performance of such restorative materials. Full article

Titanium and its alloys, as well as stainless steel, are commonly used materials for implants in the human body due to their excellent biocompatibility, corrosion resistance, and mechanical properties. However, the long-term performance of these materials in the oral cavity can be affected by the complex oral environment, including the ingestion of food, beverages, and oral hygiene products, leading to the presence of various ions, pH fluctuations, and inflammatory processes. In this study, the corrosion properties of two biocompatible materials, Ti6Al4V and AISI 316L stainless steel, are investigated under varying oral inflammatory conditions. Using potentiodynamic polarization, electrochemical impedance spectroscopy (EIS), SEM, and EDS analysis, the corrosion behaviour of both materials was analysed in environments simulating mild and severe inflammation. Results indicate that Ti6Al4V exhibits superior corrosion resistance at low H₂O₂ concentrations mimicking mild inflammation, with significantly lower corrosion rates compared to AISI 316L. However, at higher H₂O₂ concentrations, which correspond to severe inflammation, AISI 316L shows better resistance despite its susceptibility to pitting corrosion. Both alloys show reduced passivation after 72 h, with corrosion products accumulating on the surface after 96 h, contributing to repassivation. These results emphasise the need for individualized material selection in dental applications based on a patient’s susceptibility to oral inflammation. Full article

Aim: Class II Division I malocclusion poses significant challenges in orthodontics. The combination of a Herbst appliance and miniscrew anchorage emerged as a practical solution to improve skeletal and dental outcomes. This study employed finite element analysis to evaluate the biomechanical effects of a miniscrew-supported Herbst appliance on mandibular advancement and dentition movement. Methods: High-definition CBCT scans captured the maxilla and mandible’s detailed dental anatomy. The scans were stored in DICOM format for seamless integration with Mimics software (Mimics Innovation Suite research version 21.0, Materialise NV, Leuven, Belgium) for 3D reconstruction and model refinement. The appliance, designed with a maxillary fixed palatal arch and mandibular acrylic splint connected by telescoping rods, incorporated titanium TADs and elastic chains. STL models were optimized in Geomagic x Design for finite element analysis in Abaqus, assigning validated mechanical properties for materials. Tetrahedral meshing and realistic boundary conditions simulated biomechanical interactions. Tetrahedral C3D4 elements were used for meshing, ensuring a balance between computational efficiency and detailed anatomical representation. Tetrahedral meshing and realistic boundary conditions simulated biomechanical interactions. Dynamic simulations in CATIA evaluated mandibular movement. FEA analyzed displacement across dentoalveolar structures along the X, Y, and Z axes to assess treatment efficacy and biomechanical stability. Results: The Z displacement analysis revealed that the incisal edges of the lower central, lateral, and canines shifted lingually by 0.41, 0.4, and 0.47 mm, respectively. Additionally, the apices of the lower central, lateral, and canines displaced backwards by 0.05 mm, 0.05 mm, and 0.07 mm, respectively. Conclusions: The appliance facilitated mandibular advancement, bodily retracted the lower incisors, well-controlled the upper ones, and mesial-tipped the upper posterior teeth. In contrast with traditional functional appliances, it caused the lower anterior teeth to move backwards, while skeletal anchorage overcame some shortcomings of nonsurgical treatments. This method might be a good treatment option for growing skeletal Class II patients. Full article

Background: Peri-implantitis, the most prevalent cause of implant failure, is a multifaceted issue that is influenced by various factors that promote biofilm formation around the implant. Although various innovative methods for microbiological decontamination of dental implants exist, a universally accepted standard protocol has not yet been established. However, the potential of a device that generates an electric current (Ximplant^®) in reducing the survival of microorganisms within the biofilm is a promising development. Methods: In this in vitro study, five dental implants, contaminated using a microbial culture from a sample of saliva of a patient suffering from peri-implantitis, were decontaminated using the Ximplant^® peri-implantitis protocol. The experimental conditions included a simulated peri-implant site and a subsequent fluorescent assessment of the Live/Dead microbial population. Results: The qualitative and quantitative image analyses showed a predominant dead light signal on the treated sample, demonstrating the potential efficacy of applying the electrostatic field to the contaminated implant surface in reducing the viability of the microorganisms within the biofilm around dental implants. Conclusions: These findings could inspire a new era in peri-implantitis treatment. Full article

Background/Objectives: Most orthodontic forces are absorbed–dissipated before reaching the dental pulp and its neuro-vascular bundle (NVB); nonetheless, no data are available about this issue during the periodontal breakdown. The current study’s objective was to investigate how much orthodontic force reaches the dental pulp and NVB during the orthodontic movements in periodontal breakdown. Methods: Herein, an assessment was performed on the second lower premolar of nine patients (72 3D models) and included 1440 numerical simulations. A gradual horizontal periodontal breakdown (1–8 mm loss) was simulated. Five orthodontic movements (intrusion, extrusion, rotation, translation, and tipping) under 0.5 N/5 KPa and 4 N/40 KPa were assessed. The numerical methods used were Von Mises/VM (overall homogenous) and Tresca (shear non-homogenous), suitable for the ductile resemblance of dental tissues. Results: Both methods showed similar color-coded projections for the two forces. Quantitatively, Tresca was 1.14 times higher than VM and lower than the maximum physiological hydrostatic circulatory pressure. During the bone loss simulation, the NVB stress was 5.7–10.7 times higher than the pulpal stress. A gradual tissue stress increase was seen, strictly correlated with the bone loss level. For 1 mm bone loss, only 2–3% of the applied force manifested at the NVB level (0.27–0.5% for pulp), while for 8 mm loss, the received stress was 4–10% for the NVB (0.6–0.9% for pulp) when compared to the applied force. Only translation displayed pulpal stress. Conclusions: When assessing NVB stress, the tooth absorption–dissipation ability of dental tissues varied between 90 and 93% (8 mm loss) and 97% (1 mm bone loss) and 99% when assessing pulpal stress. Full article

Background/Objectives: Dental pulp and its neuro-vascular bundle (NVB) are among the least studied dental tissues. This study identified the best method for evaluating ischemic risks in the dental pulp and NVB of healthy lower premolars under orthodontic forces and in intact periodontium. Methods: Nine 3D models of the second lower premolar were reconstructed based on the CBCT scans from nine patients. Nine patients (CBCT scan) were subjected to 3 N of intrusion, extrusion, rotation, tipping, and translation. Five numerical methods, Tresca, von Mises (VM), Maximum and Minimum Principal, and hydrostatic pressure were used to biomechanically assess (totaling 225 simulations) the color-coded stress distribution in pulp and NVB. The results (both qualitative and quantitative) were correlated with the physiological maximum hydrostatic pressure (MHP) and known tissular biomechanical behavior. Results: All five methods displayed quantitative amounts of stress lower than MHP and did not seem to induce any ischemic risks for the NVB and pulp of healthy intact premolars. Among the five movements, rotation seemed the most stressful, while translation was the least stressful. The NVB displayed higher amounts of stress and tissular deformations than the pulp, seeming to be more exposed to ischemic risks. Higher tissular deformations are visible in NVB during intrusion and extrusion, while pulpal coronal stress is visible only during translation. Only the VM and Tresca methods showed a constant stress display pattern for all five movements. The other three methods displayed various inconsistencies related to the stress distribution pattern. Conclusions: Only the Tresca and VM methods can provide correct qualitative and quantitative data for the analysis of dental pulp and NVB. The other three methods are not suitable for the study of the pulp and NVB. Full article

Objectives: Sinus lifting, a procedure to augment bone in the maxilla, may cause complications such as sinusitis due to impaired drainage. This study aimed to assess how sinus lifting impacts airflow in the sinus cavity, which is essential for patients undergoing dental implants. Using computational fluid dynamics (CFD), this research analyzed airflow changes after sinus floor elevation, offering insights into the aerodynamic consequences of the procedure. Methods: Digital modeling and CFD analysis were performed using patient cone-beam computed tomography data. Three different sinus elevation scenarios, each with varying implant heights, were simulated. Airflow simulations were conducted to assess how reshaping the sinus cavity affects aerodynamics and airflow dynamics. Nasal resistance, calculated through pressure drops and flow rates, and wall shear stress, indicating potential mucosal damage, were evaluated. Results: Although some airflow changes occurred post-surgery, the implants primarily affected the front and rear of the elevated area, with little impact being seen on air entry points. Conclusions: Maxillary sinus lifting for dental implant placement may impair sinus drainage, especially at higher elevations, increasing the risk of mucosal damage due to intensified airflows in the reduced sinus volume. A more uniform, simplified intra-sinus structure may enhance fluid dynamics and reduce complications. Full article

Objectives: Cleaning splints (CSs) can facilitate interdental brush (IDB) insertion and guide IDBs during cleaning movement. Cleaning efficacy with and without CSs was to be assessed and compared for a fully dentate (FD) and a partially edentulous (PE) situation. Methods: For two maxillary typodont models simulating either an FD situation or a PE situation with every second tooth missing, suitable IDBs were selected and each cleaning splint was designed and fabricated by 3D-printing. Before and after standardized cleaning, model teeth were photographed at three timepoints: (T1) clean surface, (T2) surface coated with artificial plaque, and (T3) after IDB cleaning. For each of the four test groups differing in dental status (FD, PE) and CS use (without, with), n = 10 tests/group were completed. After aligning corresponding photographs, pixel-based color difference ratios (T2-T3)/(T2-T1) were calculated. Approximal cleaning efficacy was set as the mean value over predefined regions of interest. Effects of CS use and dental status were analyzed with two-way ANOVA (α = 0.05). Results: CS use significantly improved mean approximal cleaning efficacy for the PE model (p = 0.001), whereas no difference was found with the FD model (p = 0.381). Improved cleaning efficacy with the PE model was only found in combination with a CS (factor combination model × CS use: p = 0.003). Conclusions: Cleaning splints might have the potential to improve interproximal hygiene and can be recommended for clinical use. Clinical studies should validate the results of this in vitro study and clarify if CSs could be beneficial for patients with restricted manual skills. Full article