Search Results (208)

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

Introduction: Digital planning and evolution of technology is allowing dentistry to be more efficient in time than before. In orthodontics the main purpose is to obtain fewer patient visits and to reduce the bonding time. For that, indirect bonding planned with CAD-CAM softwares is used to obtain a shorter treatment period, in general, and less chair-time. This waste of chair-time should also be reduced in other fields of dentistry such as endodontics, surgery, prosthodontics, and aesthetics. Methods: A total of 504 teeth were embedded into epoxy resin models mounted as a dental arch. Customized lingual multibracket appliances were bonded by a current adhesion protocol. After that, they were debonded, the polishing of cement remnants was performed with three different burs and two drills. The polishing time of each group was recorded by an iPhone 14 chronometer. Results: Descriptive and comparative statistical analyses were performed with the different study groups. Statistical differences (p < 0.005) between diamond bur and tungsten carbide and white stone burs and turbine were obtained, with the first being the slowest of them. Discussion: Enamel roughness was widely studied in orthodontics polishing protocol as the main variable for protocols establishment. However, in lingual orthodontics, due the difficulty of the access to the enamel surfaces, the protocol is not clear and efficiency should be considered. It was observed that the tungsten carbide bur is the safest bur. It was also recommended that a two-step protocol of polishing by tungsten carbide bur be followed by polishers. Conclusions: A tungsten carbide bur mounted in a turbine was the most efficient protocol for polishing after lingual bracket debonding. Full article

Background/Objectives: The increasing clinical integration of 3D-printed definitive resins requires a comprehensive understanding of their physicochemical properties and adhesive behavior. However, there is limited evidence regarding the optimal surface treatment and bonding strategies for clear aligner composite attachments on these materials. This study aimed to characterize a 3D-printed definitive resin, evaluate the effects of surface treatments on its surface topography, and compare the shear bond strength (SBS) of the bonded attachments using different adhesive systems, both before and after thermocycling. Methods: A total of 120 rectangular specimens were fabricated from a 3D printed dental resin (Crowntec^®, SAREMCO Dental AG—Mexico City, Mexico). For physicochemical characterization, six samples underwent scanning electron microscopy/energy-dispersive spectroscopy, X-ray diffraction, and thermogravimetric analysis. To evaluate surface topography, 42 polished specimens were assigned to three groups: untreated (control), etched with 4% hydrofluoric acid (HFA), or sandblasted with 50 µm Al₂O₃ (AA). Each group was subdivided for SEM observation and surface roughness (Ra) measurement. For SBS testing, 72 additional samples received the same surface treatments and were further subdivided according to the adhesive system: Transbond™ XT Primer (TXT) or Single Bond Universal (SBU). Results: The AA group showed the highest Ra (2.21 ± 0.30 µm), followed by HFA (0.81 ± 0.20 µm) and control (0.07 ± 0.30 µm) (p < 0.001). The highest SBS was observed in the AA + SBU group, followed by AA + TXT. Conclusions: Sandblasting with Al₂O₃ particles, combined with a universal adhesive, significantly improved bond strength, suggesting a viable protocol for 3D printed definitive composites in aligner attachment applications. Full article

Background: Monolithic zirconia has attracted considerable interest in dentistry due to its favorable physical and mechanical properties, making it a promising alternative for crown fabrication. Nonetheless, a standardized finishing protocol for this material has yet to be established. Objective: This study aimed to evaluate the surface characteristics and in vitro biofilm formation of zirconia finished by either polishing or glazing. Methods: A total of 72 zirconia specimens were fabricated and divided into control, glazing, and polishing groups. Surface analysis included roughness, wettability, and surface free energy. Microbiological analysis included CFU (colony-forming units per mL) counts, microbial adhesion at 2, 4, 6, and 8 h, biofilm biovolume, and qualitative biofilm assessment via scanning electron microscopy (sEm). Results: The glazing group showed significantly greater roughness than the polishing (p = 0.006) and control (p = 0.016) groups, along with a lower contact angle (polishing—p = 0.002; control—p < 0.001) and higher surface energy (polishing—p = 0.005; control—p < 0.001). No significant differences were observed in CFU counts for the tested microorganisms (C. albicans, p = 0.158; L. casei, p = 0.610; S. mutans, p = 0.904). Regarding microbial adhesion, the polishing group showed a smaller biofilm-covered area compared to the control group for both total biofilm (p = 0.008) and viable biofilm (p = 0.005). no statistically significant difference was observed in biofilm biovolume (p = 0.082). Conclusions: These findings suggest that, despite the surface differences among the groups, biofilm formation was not significantly affected. Full article

Background: Prematurely born newborns with low birth weight constitute a group of patients who require special care from the first days of life. Prematurity and low birth weight affect about 13.4 million infants. Risk factors include placental disorders but also factors related to the mother, such as smoking, alcohol drinking, drug use, malnutrition, or certain diseases. It is imperative to educate women of reproductive age (15–49) about the basic factors influencing embryonic development, such as oral health, diet, medicine intake, and harmful habits. Even though most women are aware of the negative impact of harmful habits on the fetus, still too little attention is paid to oral health in pregnant women. Poor oral health may influence the well-being of the future mother, as well as of the child. Therefore, women of reproductive age and those who are pregnant must have adequate knowledge on this subject. The aim of this study was to assess the knowledge of Polish women of reproductive age (15–49) regarding oral health during pregnancy, including the impact of dental treatment, oral hygiene, and maternal oral conditions on pregnancy outcomes and the health of the newborn. Materials and Methods: This was a cross-sectional study of 508 women, in the reproductive age, whose age ranged from 18 to 49 years old. The surveys were conducted from April 2020 to November 2020. The questionnaire was originally developed based on the available literature and consisted of seven sections: basic information, general health and habits, pregnancy status and dental care, knowledge of treatment options during pregnancy, oral health status and its association with the risk of preterm birth, prematurity and the child’s oral health, and breastfeeding and oral development. Results: After excluding incomplete questionnaires, a total of 499 questionnaires were included in the analysis. Women participating in the study had a fairly good understanding of the impact of oral health on the fetus and the role of breastfeeding in the development of the stomatognathic system (from 50% to 70% correct answers). However, even though most respondents had completed higher education (344/68.94%), their knowledge of oral health, preterm birth, and low birth weight was very limited (including the impact of inflammation on the intrauterine development of the child or bacteria and transfer across the placenta). In these sections, the percentage of correct answers ranged from less than 20% to 50%. When analyzing knowledge by age, education, number of births, and place of residence, the highest levels of knowledge were observed among respondents with higher education, particularly those aged 27–32. Conclusions: Respondents had a fairly good understanding of the general impact of oral health during pregnancy and recognition of the importance of breastfeeding for infants. However, their knowledge about the impact of bacteria and inflammation in the mother’s oral cavity on prematurity and low birth weight was limited. Therefore, educating women of reproductive age and pregnant women on this topic is essential, as it may help reduce the adverse consequences of prematurity. Full article

This study examined the relationship between microhardness, morphology, and phase composition of dental yttria-stabilized tetragonal zirconia polycrystals (Y-TZP), which directly impact their long-term clinical performance and durability. The primary objective was to investigate the effects of yttria content and polishing on the surface properties and hardness of these materials. Samples from ZirCAD Prime, Cercon ht ML, ZIRCONIA YML, and ZirCAD LT were analyzed using Vickers hardness testing, Powder X-ray Diffraction (PXRD), and Scanning Electron Microscopy (SEM). SEM analysis revealed a gradual increase in grain size and porosity with higher yttria content in unpolished samples. Polishing resulted in a relatively uniform surface morphology with observable striations across all samples, subsequently leading to similar Vickers hardness values for all polished samples. PXRD and SEM analyses identified that these similar hardness values were likely due to the predominant monoclinic phase on the surface, induced by polishing. These findings underscore the significant influence of yttria content and polishing on Y-TZP microstructure and surface hardness, highlighting their critical role in the long-term success and clinical applicability of dental restorations. Full article

This in vitro study aimed to compare the effects of various surface treatments and hydrothermal aging on the phase composition, microstructure, and compressive strength of dental zirconia (ZrO₂). Forty-eight zirconia cubes (8 × 8 × 8 mm) were fabricated using CAD/CAM from two materials: infrastructure zirconia (Group S1) and super-translucent multilayered monolithic zirconia (Group S2). Four samples of each material were analyzed in their pre-sintered state (S1-0, S2-0). The remaining specimens were sintered and assigned to sub-groups based on surface treatment: untreated, sandblasted with 30 µm or 50 µm Al₂O₃, polished, or polished and glazed. Characterization was performed using EDX, SEM, XRD with Rietveld refinement, Raman spectroscopy, and compressive testing before and after accelerated hydrothermal aging, according to EN ISO 13356:2015. EDX revealed a higher yttria content in monolithic zirconia (10.57 wt%) than in infrastructure zirconia (6.51 wt%). SEM images showed minimal changes in polished samples but clear surface damage after sandblasting, which was more pronounced with larger abrasive particles. XRD and Raman confirmed that sandblasting promoted the tetragonal (t-ZrO₂) to monoclinic (m-ZrO₂) phase transformation (t→m), amplified further by hydrothermal aging. The polished groups showed greater phase stability post-aging. Compressive strength decreased in all treated and aged samples, with monolithic zirconia being more affected. Polished samples displayed the best surface quality and structural resilience across both materials. These findings underline the impact of clinical surface treatments on zirconia’s long-term mechanical and structural behavior. Full article

The aim of this study was to evaluate and compare the surface roughness and gloss—both initially and after simulated toothbrushing—of three 3D-printed crown materials subjected to different surface treatments: varnishing, polishing with diamond-impregnated rubber polishers, and polishing with a bristle brush and paste. Disc-shaped specimens (n = 90) were 3D-printed using three commercially available crown resins (Rodin Sculpture, VarseoSmile TriniQ, and OnX Tough 2) and post-processed per manufacturers’ instructions. Specimens were divided into three surface treatment groups: application of a light-cured varnish, polishing with a two-step diamond-impregnated rubber polisher, or polishing with a bristle brush and abrasive paste. Surface roughness and gloss were measured after treatment and again following 20,000 cycles of simulated toothbrushing. Additional specimens were prepared for Vickers microhardness testing and determination of filler weight percentage (wt%). Statistical comparisons were performed using two-way ANOVA with significance set at p < 0.05. Results: The varnish provided the statistically lowest roughness of all surface treatments for all materials. The bristle brush and abrasive paste polishing protocol produced the greatest gloss for the softest material (VarseoSmile TriniQ) and lowest gloss for the hardest material (Rodin Sculpture), whereas the two-step diamond-impregnated rubber polisher produced an equivalent gloss on all materials. Following toothbrushing, roughness was minimally affected; however, gloss was considerably reduced. Conclusions: All tested polishing and varnishing methods achieved clinically acceptable surface roughness (Ra < 0.2 µm) that persisted after simulated toothbrushing. Notably, the two-step diamond-impregnated rubber polisher produced consistent gloss across all materials, while the bristle brush and abrasive paste polishing protocol performed better on softer materials, and varnish application resulted in equal or superior gloss and roughness retention compared to polishing. Full article

Background: Prophylactic polishing pastes (PPPs) are widely used to clean teeth and dental restorations; however, their effects on restorative materials are crucial for clinical outcomes. This study investigates the impact of PPPs on the susceptibility of CAD/CAM restorative materials to staining and the relationship between surface roughness and discoloration. Methods: Samples of tested materials (resin nanoceramic, hybrid ceramic, feldspathic ceramic, and lithium disilicate-reinforced glass ceramic) were treated with various PPPs (Cleanic, CleanJoy, Detartrine, Proxyt). Surface roughness and color parameters were recorded before and after the PPP application and following coffee immersion for 12 days. Initial measurements of surface roughness (Ra1) and color were taken. The specimens were divided into groups based on the PPP applied. After PPP application, secondary roughness (Ra2) and color values were measured. Changes in roughness (ΔRa), color (ΔE*ab, ΔE00), and whiteness index (ΔWID) were calculated post-application and after coffee immersion. Data normality was tested with the Shapiro–Wilks test. Two-way ANOVA evaluated the effects of material type and PPP on ΔE, ΔWID, and ΔRa. One-way ANOVA, Tukey HDS test, and Pearson correlation were used for further analysis, with significance set at p < 0.05. Results: The Vita Enamic–Detartrine group showed the highest ΔEab 1 and ΔE001 values, while Cerasmart–control showed the lowest. The Vita Enamic–Proxyt group had the lowest ΔWID1, and Vita Enamic–Cleanjoy exhibited the highest values of ΔEab 2, ΔE002, and ΔWID2. The E.MAX–control group had the lowest values for these metrics. No significant correlation was found between ΔRa and color changes (ΔE*ab 2, ΔE002, ΔWID2); however, a moderate positive correlation was found between values of ΔE1 and ΔE2. Conclusions: These findings indicate that PPPs significantly affect the discoloration and surface features of CAD/CAM materials, with both types of PPPs and materials. Full article

Background/Objectives: Implant placement in cases of severe bone atrophy or compromised alveolar bone requires careful planning, especially in the anterior maxilla. The nasopalatine canal (NPC) and its cortical walls offer potential anchorage sites. This study evaluates the NPC’s anatomical characteristics using cone beam computed tomography (CBCT) to assess its suitability for implant anchorage. Methods: A retrospective analysis of 150 CBCT scans from three dental clinics in Poland was conducted. NPC measurements—including length, width, number of canals, and distances to adjacent anatomical structures—were taken in the sagittal, coronal, and axial planes. Statistical tests included Pearson correlation and Student’s t-test to explore relationships between NPC dimensions and gender. Results: The mean NPC length was 10.27 mm and mean width 3.55 mm. Significant gender differences were observed in the canal length, width, and distances to the labial and palatal plates (p < 0.05). Strong positive correlations were found between the canal width at the palate base and other parameters, such as the midpoint width (r = 0.58) and diameter (r = 0.44). The distance from the palatal opening to the labial plate showed the strongest correlation (r = 0.67), indicating enhanced cortical anchorage potential with increased canal dimensions. Discussion: NPC morphology varied (cylindrical, funnel-like, hourglass), aligning with prior studies. Larger diameters were linked to single-canal configurations. Implant placement strategies—such as direct canal insertion or lateralization—can be effective, especially with polished, single-piece implants that reduce soft tissue ingrowth and improve primary stability. Conclusions: Understanding NPC anatomy is crucial for implant planning in atrophic maxillae. With the proper technique, NPC use for cortical anchorage is a viable treatment option. Full article

Background: Human papillomavirus (HPV) is a virus belonging to the Papillomaviridae family. Infection may be asymptomatic, mildly symptomatic, or clinically evident. It is mostly transmitted through sexual activity. It is estimated that approximately half of sexually active individuals will be infected with HPV, and among women over 50, this percentage increases to 80%. The aim of this study was to assess the level of awareness among medical and dental students regarding the impact of HPV infection on oral health. Materials and methods: This was a prospective study of 562 Polish medical and dental students. The questionnaire was originally designed based on the available literature and consisted of two sections: demographic questions and detailed questions about HPV and its impact on oral health. The data were analyzed using Statistica v. 13.3. All tests were considered statistically significant at p ≤ 0.05. Results: After excluding incomplete questionnaires, 541 remained and were included in the analysis. The medical students achieved a significantly higher average score compared to the dental students (p < 0.001). The students of higher years of studies were more knowledgeable. This tendency was observed both among all respondents together and among the medical and dentistry students separately. Conclusions: The medical students demonstrated a significantly higher level of knowledge on the discussed topic. However, both groups provided correct answers at a relatively unsatisfactory level because the overall value of the results obtained was below 60%. By the end of their education, the students in both fields demonstrated improved knowledge. The dental students gave an average of 74% correct answers, while the medical students achieved 73%. Therefore, the quality of university education regarding the relationship between HPV infection and oral lesions should be improved. Full article

Dental implants are recognized as one of the most effective long-term solutions for the replacement of one or multiple missing teeth, addressing both aesthetics and functionality. However, one of the leading causes of implant failure is peri-implant diseases. This study aims to evaluate the effectiveness of air polishing with sodium bicarbonate compared to erythritol in reducing the bacterial concentration on dental implant surfaces in vitro. A sample of twenty-four implants (12 JD Evolution and 12 Straumann) was utilized and divided as follows: 10 implants contaminated with biofilm treated with sodium bicarbonate air polishing (1 min); 10 implants contaminated with biofilm treated with erythritol aeropolishing (1 min); two implants contaminated with biofilm (negative control); and two sterile implants (positive control). The entire experiment was performed in triplicate. The bacterial culture included P. gingivalis, S. gordonii, and F. nucleatum. Optical density (OD) at 600 nm was measured before and after the decontamination protocol to analyze the results. The JD Evolution implant demonstrated a slightly greater reduction in bacterial concentration, but the difference was not statistically significant (p > 0.05). Similarly, no differences were observed between erythritol and sodium bicarbonate in the Straumann implants. An increase in surface roughness is observed in the JD Evolution implant treated with erythritol, whereas the one treated with bicarbonate exhibits a smoother surface compared to the untreated implant. The findings suggest that air polishing with erythritol is as effective as sodium bicarbonate in reducing the bacterial concentration on dental implants in vitro. This could suggest the use of erythritol during air polishing due to its antimicrobial capacity and its increase in surface roughness on implant surfaces compared to bicarbonate. Full article

Background. Despite dentistry’s alarmingly high energy use, plastic waste, and travel emissions, research on Romanian dental students’ sustainability awareness is absent. This study aimed to assess their knowledge of the environmental impact of dental materials and practices, hypothesizing that early exposure to sustainability education would benefit preclinical students most. Materials and Methods. A cross-sectional survey using a form questionnaire with 15 items was conducted on 1800 dental students at Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, for one week in March 2022. The questionnaire, consisting of socio-demographics, students’ perspectives on sustainability in dentistry, and personal sustainability, was analyzed using SPSS 26. Data analysis included the Shapiro–Wilk test for normality, Fisher’s exact test for categorical variables, the Mann–Whitney U test for non-parametric quantitative comparisons, and Z-tests with Bonferroni correction for contingency tables. Results. A response rate of 26.06% was achieved, with 469 participants. The majority (51.1%), particularly males (66.1%), perceived sustainability as promoting durability. The most common definition of sustainability (33.8%) was related to environmental protection, with significantly higher agreement among female students (39.4%) (p = 0.001). While 49.3% of participants identified single-use plastics in patient care as having the greatest environmental impact in dental practices, 39.2% of female students, primarily from clinical study years (50%), ranked patient paperwork and records as the most significant factor (p = 0.031). The highest-carbon-footprint dental procedures were considered to be amalgam and composite fillings (50.7%), with clinical year students indicating this as the most relevant issue (62.8% vs. 47.7%) (p = 0.011). Students aged 25–30 were more actively engaged in sustainability initiatives compared to the younger group (p = 0.005), while all students over 30 identified scaling and polishing as the most impactful procedure (p < 0.001). A majority of students supported future university sustainability initiatives (62.7%) and an elective course on sustainability in dentistry (65%). Female students showed significantly greater interest than male students in both initiatives (66.3% vs. 52.7%, p = 0.003 and 70.8% vs. 49.6%, p < 0.001, respectively). Conclusions. Greater awareness of sustainability was found in preclinical-year dental students and among female students, with knowledge gaps in clinical-year students, particularly regarding the environmental impact of dental practices and materials. Introducing sustainability courses could better prepare future dentists for sustainable practices in dentistry. Research collaborations and curriculum reforms to further promote sustainability would also be beneficial. Full article

This study assessed the bleaching and abrasiveness levels of different kinds of toothpaste with various RDA values on nanohybrid and microhybrid composite samples using a novel Press-on Force-Guided brushing simulator. One hundred and forty disc-shaped samples were prepared using two nano-hybrid and three microhybrid composites and divided randomly into four subgroups (n = 7). The samples were immersed in a coffee solution for 144 h and then brushed using R.O.C.S. (Remineralizing Oral Care Systems) brand toothpaste with different RDA values [Sensitive Instant Relief (SIR), Sensation Whitening (SW), and their combination with PRO Polishing (PP) (once a week)] using a brushing simulator for 140, 280 and 560 strokes (140 strokes correspondence to one week of real-time brushing). The level of surface roughness and color change (ΔE) were measured before and after the simulated brushing. Color changes were evaluated in Photoshop CC software through ∆E₀₀* values generated from before and after L, a*, b* parameters on sample photographs taken by a mobile dental photography tool. The surface structure of samples was measured before and after the brushing using a profilometer. The measurements were analyzed in SPSS V23 software by Analysis of Variance and the Bonferroni Test, and the level of significance was set at <0.05. Regarding ΔE values comparisons, there were no significant differences between the toothpastes after 2 weeks of brushing. SW (2.82 ± 1.24), SIR + PP (2.78 ± 0.98), and SW + PP (2.84 ± 1.22) values were found to be similar after one month of brushing (p < 0.007). Regarding surface roughness comparisons between the toothpastes, two-week and one-month brushing values were found to be similar and statistically rougher than the initial values. Using R.O.C.S. PRO Polishing with low-abrasive toothpaste may increase the whitening effect by enhancing color recovery. Full article

An integral part of daily dental practice is preparing and polishing placed composite restorations. When these procedures are performed, significant amounts of composite dust are released from the grinding material. This systematic review aims to enhance the existing body of knowledge, encourage further dialogue, and expand the understanding of composite dust and its related risks. Following inclusion and exclusion criteria, twelve studies were included. Several studies highlight that composite dust contains nanoparticles capable of deep lung penetration, posing significant health risks to both dental staff and patients. Inhalation of composite dust can lead to respiratory diseases such as pneumoconiosis. Studies have shown that water cooling during composite grinding reduces dust emissions but does not eliminate them completely. Researchers suggest that thermal degradation of the composite material, not just filler particles, may be the source of the nanoparticles. In vitro studies have shown the toxicity of composite dust to bronchial and gingival epithelial cells, especially at high concentrations. Further research is needed on the health effects of composite dust and the development of effective methods to protect staff and patients. Full article