Search Results (102)

Background: Gingival recession is a common condition involving apical displacement of the gingival margin, leading to root surface exposure and associated complications such as dentin hypersensitivity and root caries. Among the most effective treatment options are the tunneling technique (TUN) and the coronally advanced flap (CAF), both combined with connective tissue grafts (CTGs). This study aimed to evaluate and compare the clinical outcomes of TUN + CTG and CAF + CTG in terms of root coverage and keratinized tissue width (KTW) over a 6–12-month follow-up. Methods: A randomized, double-blind clinical trial was conducted following CONSORT guidelines (ClinicalTrials.gov ID: NCT06228534). Participants were randomly assigned to receive either TUN + CTG or CAF + CTG. Clinical parameters, including gingival recession depth (REC) and KTW, were assessed at baseline as well as 6 months and 12 months postoperatively using a calibrated periodontal probe. Statistical analysis was performed using descriptive statistics and linear mixed models to compare outcomes over time, with a significance level set at 5%. Results: Both techniques demonstrated significant clinical improvements. At 6 months, mean root coverage was 100% in CAF + CTG cases and 97% in TUN + CTG cases, while complete root coverage (REC = 0) was observed in 100% and 89% of cases, respectively. At 12 months, root coverage remained stable, at 99% in the CAF + CTG group and 97% in the TUN + CTG group. KTW increased in both groups, with higher values observed in the CAF + CTG group (3.53 mm vs. 3.11 mm in TUN + CTG at 12 months). No significant postoperative complications were reported. Conclusions: Both TUN + CTG and CAF + CTG are safe and effective techniques for treating RT1 and RT2 gingival recession, offering high percentages of root coverage and increased KTW. While CAF + CTG achieved slightly superior coverage and tissue gain, the TUN was associated with better aesthetic outcomes and faster recovery, making it a valuable alternative in clinical practice. Full article

Background: Gastroesophageal reflux disease (GERD) is a chronic condition that causes an abrupt decrease in salivary pH in the oral cavity, which can lead to demineralization, erosion, hypersensitivity, functional impairment, and possibly fracture of dental elements. The aim of this clinical study is to compare two types of treatment in patients with dental erosion diagnosed with gastroesophageal reflux. Methods: Thirty patients were enrolled in this randomized clinical trial. Each patient underwent clinical evaluation and esophageal pH measurement, in order to diagnose GERD. After an initial examination and assessment by an experienced dentist, the Trial group (15 patients) was assigned to home treatment with a zinc hydroxyapatite-based toothpaste and a hydroxyapatite-based paste, while the Control group (15 patients) was assigned to home treatment with zinc hydroxyapatite-based toothpaste only. The following indices were measured: Basic Erosive Wear Examination Index (BEWE); Schiff Air Index (SAI); Plaque Index (PI); and Bleeding Score (BS). Each index was assessed at T0 during the first visit, one month (T1), three months (T2), six months (T3), nine months (T4), and 12 months (T5). The Kolmogorov–Smirnov test was used to analyze the normality of the data, while Friedman’s test followed by Dunn’s post hoc test were used to compare the two groups (significance threshold: p < 0.05). Results: The results showed no statistically significant change in the BEWE and SAI indexes (p > 0.05). However, an improvement in dentin sensitivity and BS was observed. Plaque control also improved. Conclusions: The results of this study indicate that the additional hydroxyapatite paste did not significantly improve the outcomes of the study in respect to hydroxyapatite toothpaste alone. However, there was an improvement in the oral health of GERD patients using hydroxyapatite-based remineralizing treatment in terms of oral and periodontal indices calculated. Full article

(1) Background: Tannic acid (TA), a water-soluble polyphenol extensively found in numerous plant species, possesses antimicrobial, anti-inflammatory, antioxidant, and adhesive properties. This scoping review aims to synthesize existing knowledge on TA applications and unveil its potential uses in dentistry. (2) Methods: A comprehensive search across six electronic databases (PubMed, Cochrane, Embase, Scopus, Web of Science, and Opengrey) was conducted in October 2024. Two reviewers performed the screening and risk of bias analysis independently following the PRISMA-ScR guidelines. The findings are presented in a narrative summary. (3) Results: Five hundred and twelve records were identified from the electronic databases. After removing duplicates and applying eligibility criteria, ninety-six studies were ultimately included in this review. Results indicate that TA has been employed in managing dentin hypersensitivity, dental caries, periodontal and mucosal diseases, as well as dentition defects with prostheses. Furthermore, TA displays potential in enhancing the performance of bonding adhesives, root canal irrigants, and root canal filling materials. However, it is noteworthy that the included studies exhibit varied experimental settings, inconsistent outcome measures, a lack of extensive clinical research, and insufficient observation periods. (4) Conclusions: TA is a promising biomaterial with applications to various dental fields, such as endodontics, periodontology, prosthodontics, and dental public health. Its antimicrobial, anti-inflammatory, antioxidant, and adhesive properties warrant future exploration to unleash these potentials and provide robust scientific evidence that guides clinical practice and advances oral healthcare. Full article

Background and Clinical Significance: Dental demineralization is a multifactorial process influenced by biofilm activity, diet, and systemic conditions. While gastroesophageal reflux disease (GERD) is known for its role in enamel erosion, its contribution to cariogenic processes remains underexplored. Additionally, Brugada syndrome, a genetic arrhythmia disorder, may indirectly affect oral health due to medical complexities and reduced motivation for dental care. This case highlights the management of extensive mineral loss in a patient with GERD and Brugada syndrome, emphasizing the importance of personalized remineralization strategies and interdisciplinary collaboration. Case Presentation: A 27-year-old male with Brugada syndrome, treated with a subcutaneous implantable cardioverter defibrillator (S-ICD), presented with widespread enamel demineralization, multiple active carious lesions, and gingival inflammation. Clinical evaluation revealed a high DMFT index (15), significant plaque accumulation, and an oral pH of 5.8, indicating an elevated risk of mineral loss. Poor hygiene habits, frequent sugar intake, and GERD-related acid exposure contributed to his condition. The therapeutic approach included patient education, fluoride-functionalized hydroxyapatite toothpaste and mousse, dietary modifications, and restorative procedures. After 120 days, improvements included enhanced enamel integrity, a reduction in plaque index (from 50% to 25%), and the resolution of gingival inflammation (BOP: 38% to 12%). Conclusions: This case underscores the importance of an integrated approach to managing dental demineralization in patients with systemic conditions. The combination of remineralization therapy, behavioral modifications, and structured follow-up yielded significant clinical benefits. Further research is needed to develop standardized protocols for individuals at high risk due to systemic factors affecting oral health. Full article

This article reviews the topic of stannous fluoride as an anti-caries additive in toothpastes. It is based on a literature survey carried out using Science Direct, supplemented by information from PubMed. The keywords used were stannous fluoride, toothpaste, clinical effects, caries, hypersensitivity, gingival health, structure and aqueous solutions. The initial searches covered the period 2015–2024 and identified 57 references. Older references cited in these papers, and also papers already known to the author, were also included. The information thus obtained shows that stannous fluoride has three main effects, namely, reduction in the viability of the oral biofilm, increase in remineralisation of the hydroxyapatite tooth mineral and occlusion of dentinal tubules leading to reduced hypersensitivity. Stannous fluoride was shown to be the most effective of all the fluoride additives used in toothpastes. In much of the dental literature, this is attributed to the effects of Sn²⁺ ions. However, as has been shown extensively in the wider scientific literature, free Sn²⁺ ions do not occur in aqueous systems. Rather, the initial products of the dissolution of SnF₂ is undissociated, hydrated SnF₂ and SnF⁺ ions. These gradually exchange fluoride to form Sn(OH)₂ and Sn(OH)⁺. Their likely mechanism of action based on their toxicity towards oral micro-organisms and their interaction with hydroxyapatite is discussed. Full article

In practice, continuous and pulse direct current (DC) methods are embodied in classical dental iontophoresis systems (CDISs) for the treatment of dentin hypersensitivity (DH). Changes in body electrical resistance and polarization occurrence are the main problems in dental iontophoresis applications. Moreover, continuous DC application may cause discomforts such as irritation, burning and itching on the skin. For these reasons, it is preferred to use pulse DC instead of continuous DC. However, in pulse DC applications, the treatment period is prolonged depending on the decrease in the electrical charge flow. On the other hand, the pain threshold of teeth when the electric current is applied varies from person to person. In this study, in order to reduce the problems caused by the use of CDIS methods for the treatment of DH, a microcontroller-based switched-mode dental iontophoresis system (SMDIS) using a dual-return probe (RP) is designed, and its performance is compared with CDIS methods. According to the results, the new SMDIS both reduces the polarization effect as in the classical pulse DC method and shortens the prolonged treatment duration in pulse DC by raising the pain threshold of teeth due to increased ion transfer, which is a great advantage over former methods. Full article

Dentine hypersensitivity (DH) causes pain from exposed dentine, triggered by external stimuli. Limited evidence exists on its impact on quality of life (QoL), the effectiveness of hypersensitivity toothpaste (HT) and the dental behaviors of DH sufferers. This study therefore aimed to generate evidence to address these evidence gaps and validate the existing science behind the effectiveness of HT. An observational retrospective cross-sectional survey was conducted in Indonesia, which included the Dentine Hypersensitivity Experience Questionnaire-15 (DHEQ-15), items related to the perceived effectiveness of HT and self-reported dental health behaviors. A total of 511 respondents completed the survey. The mean (standard deviation) DHEQ score of participants was 82.44 (14.41), showing the substantial impact of DH on QoL. Nearly all HT users (97.7%) reported relief from DH, with additional benefits like long-lasting fresh breath (96.4%) and cleaner teeth (97.1%), with regular HT users experiencing greater benefits such as improvements in DH (R-HT users [4.65 (0.55)] vs. E-HT users [4.46 (0.65)], p < 0.01). Compared to HT users, mainstream toothpaste (MT) users were significantly less likely to brush their teeth at least three times a day (HT users [41.9%], MT users [18.7%], p < 0.05) and to have had a dental check-up within the past year (HT users [82.5%], MT users [47.3%], p < 0.05). This study found that DH significantly impacts QoL, and that HT effectively relieves DH symptoms, particularly for regular users, who also show better dental health behaviors than users of mainstream toothpaste. The preliminary results indicate that educating users about dental products, like hypersensitivity toothpaste, can improve oral health behaviors and outcomes. Full article

Objectives: Dental erosion has evolved into a common condition with growing concern in the dental community. The aim of this study was to explore the protective effects of two highly fluoridated products, silver fluoride solution (silver diamine fluoride-potassium iodide solution, SDF-KI) and fluoride varnish, on dental erosion in mouse. Methods: Two groups of ten young CD-1 mouse were given a cola drink ad libitum over a 6-week period. A prophylactic treatment with a silver fluoride solution (38% SDF 48,000 ppm F with a silver concentration of 253,900 ppm) and a fluoride varnish (NaF, 22,600 ppm F) were applied on the mandibular molars, performed under sedation twice a week during the whole experiment. Furthermore, two control groups of ten mice were included, a positive (cola drink) and a negative (distilled water) control. A terminal procedure was followed by dissection of mandibular molars and analysis of them using scanning electron microscopy (SEM). The first molars were transversely ground, further analyzed by SEM, and measured for tooth height and tooth tissue loss. Results: Analyses of mandibular molars treated with a fluoride varnish indicated a 5% decreased tooth tissue loss, compared to the molars which served as a positive control. The best effect was achieved with the application of silver fluoride solution, displaying a 35% decreased tooth tissue loss compared to the positive control group. Conclusions: Preventive treatment with a solution of silver fluoride solution exhibits greater protection against dental erosion compared to a traditional fluoride varnish. This study indicates that silver fluoride solution is an effective fluoride compound and is highly beneficial in a clinical setting with the aim of preventing dental erosion. Full article

The development of laser technology has revolutionized dentistry, offering complementary and alternative approaches to traditional techniques. Lasers have been successfully integrated into various dental procedures, enhancing treatment outcomes and patient care. Several types of lasers can increase the acid resistance of enamel, thus preventing caries. Laser fluorescence has been utilized for the pre-operative diagnosis of dental caries, enabling early detection and effective treatment planning. The therapeutic application of lasers in caries treatment aligns with the contemporary philosophy of minimally invasive procedures. Clinicians can use laser Doppler flowmetry as a supplementary tool for pulp vitality testing by detecting pulpal blood flow. Lasers are also employed in various pulp-related interventions, such as managing dentine hypersensitivity and performing root canal therapy. These procedures benefit from the precision and reduced invasiveness provided by laser technology. Furthermore, laser fluorescence serves as an additional tool for subgingival calculus detection. High-power and low-power lasers are used in both nonsurgical and surgical therapies to treat periodontal and peri-implant diseases, oral mucosa conditions, and even cancer based on their specific properties. Lasers are also utilized to accelerate bone regeneration, promote adhesive strength, and remove ceramic brackets. In summary, laser technology has significantly impacted contemporary dentistry by facilitating early diagnosis, minimally invasive treatments, and precise operative procedures, ultimately improving patient outcomes and expanding the scope of dental practice. Full article

It is challenging to deliver therapeutics in the oral environment due to the wet surfaces, the nature of the mucosa and the potential for saliva washout. In this study, the development of a mucoadhesive dimethicone-based oral carrier system for adhesion to the hard tissue and mucosa in the mouth was examined. This study reports the viscosity and mucoadhesion of dimethicone based polymer blends. The viscosity of the materials was measured using a rheometer. The mucoadhesion of these materials was determined as the work of adhesion and peak tack force using the tensile test method with a texture analyzer. Materials were prepared with either calcium and phosphate salts or sodium fluoride as potential therapeutics for promoting remineralization and treating dentin hypersensitivity by mechanical occlusion. Scanning electron microscopy was used to look at mineral deposition on the surface of dental hard tissue after the application of the dimethicone-based formulations. The results of this study confirm the potential for using these dimethicone-based materials as mucoadhesive therapeutic delivery systems in the oral environment. Full article

When dentin is directly exposed to the oral cavity for various reasons, such as a lack of enamel on the tooth surface, external stimuli to the dentin often cause transient discomfort known as dentin hypersensitivity. In order to block the incoming stimulus signal, an ideal treatment is to induce the production of minerals to block the dentinal tubules. In this work, a dentin-desensitizing plugging material was prepared by modifying mesoporous bioactive glass with gelatin, the mineralization and desensitization effects of which were compared with Gluma in in vitro experiments. These experiments confirmed that gelatin-modified bioactive glass (MBG@PDA@Gel) is more effective than traditional desensitizing agents at blocking dentin tubules. Following the successful synthesis of MBG@PDA@Gel, as confirmed by scanning electron microscopy, transmission electron microscopy, and other tests, the treatment of demineralized dentin with MBG@PDA@Gel demonstrated that the dentinal tubules were tightly blocked under scanning electron microscopy. MBG@PDA@Gel induces minerals in deeper layers of dentinal tubules, promoting remineralization and forming a unified structure with the tubule blockage. Animal studies showed that MBG@PDA@Gel can remineralize demineralized dentin, and it is stable in the oral cavity and does not fall out. MBG@PDA@Gel not only enhances the biocompatibility of the nanoparticle but also results in an overall uniform and rapid remineralization of the demineralized dentin. Full article

Objective: The purpose of this scoping review was to identify gaps in the literature and summarize findings from studies examining the use of silicon-, silica-, and silicate-based toothpastes for the remineralization and repair of mineralized tooth tissues. Methods: A 10-year literature search was conducted using PubMed and Scopus, adhering to PRISMA 2020 guidelines. A total of 331 studies were initially identified, with 56 full-text review articles. After selecting the manuscripts, 27 studies were qualitatively analyzed by four reviewers, focusing on the results of both in vivo and in vitro methods. Results: The findings suggest that toothpastes containing silicon, silica, and silicate demonstrate promising results for remineralization and enamel repair, with evidence of mineral layer formation and/or deep enamel surface remineralization under various conditions. Additionally, the use of these toothpastes can lead to the obliteration of dentinal tubules within a few days. The results collectively support the efficacy of these toothpastes in enamel repair. Most of the clinical studies focused on dentine hypersensitivity, followed by white spot lesions. Conclusions: Silicon-, silica-, and silicate-based toothpastes (bioactive Si-toothpastes) can be considered effective based mostly on laboratory studies. There remains a need for more in vivo research studies on enamel and dentin mineral repair. Existing studies provide strong evidence that these technologies can reduce dentin hypersensitivity and promote enamel–dentin repair. Full article

Background: The objective of this study was to evaluate how effectively the bioelectric toothbrush can alleviate dentin hypersensitivity (DHS) by using electrostatic forces to remove biofilm from the tooth surface. Methods: This study divided inpatients of a preventative dental clinic between March and October 2023 into the following two groups: a bioelectric toothbrush group (BET, n = 25) and a non-bioelectric toothbrush group (NBET, n = 18) as a control group. This was a randomized double-blind, placebo-controlled trial study. A survey, the number of hypersensitive teeth, the O’Leary index, the visual analogue scale (VAS), and the Schiff Cold Air Sensitivity Scale (SCASS) were also investigated. Results: When fluoride toothpaste was applied with a bioelectric toothbrush, the subjects’ VAS and SCASS scores reflecting symptoms of hyperesthesia significantly decreased over time, as did the number of hypersensitive teeth and the O’Leary index. Moreover, the bioelectric toothbrush was confirmed to be effective in removing dental plaque. Conclusions: Dental clinics must actively promote bioelectric toothbrushes and fluoride toothpaste for patients suffering from hyperesthesia and pain. Furthermore, these items can be suggested as preventative oral care products to patients with potential hyperesthesia. Full article

Divalent cations have captured the interest of researchers in biomedical and dental fields due to their beneficial effects on bone formation. These metallic elements are similar to trace elements found in human bone. Strontium is a divalent cation commonly found in various biomaterials. Since strontium has a radius similar to calcium, it has been used to replace calcium in many calcium-containing biomaterials. Strontium has the ability to inhibit bone resorption and increase bone deposition, making it useful in the treatment of osteoporosis. Strontium has also been used as a radiopacifier in dentistry and has been incorporated into a variety of dental materials to improve their radiopacity. Furthermore, strontium has been shown to improve the antimicrobial and mechanical properties of dental materials, promote enamel remineralization, alleviate dentin hypersensitivity, and enhance dentin regeneration. The objective of this review is to provide a comprehensive review of the applications of strontium in dentistry. Full article

The aim of this study was to evaluate a newly formulated mouth rinse containing cymenol in patients undergoing supportive periodontal care in terms of safety (primary outcome) and the impact on dental biofilm and gingival inflammation (secondary outcomes). This research was designed as a pilot, controlled, randomized, parallel, triple-blinded, single-center, clinical trial of a 12-week duration. Adverse events and product perception were assessed by a questionnaire. Clinical, patient-reported outcomes (PROs), compliance, tooth staining, dentin hypersensitivity and microbiological variables were also evaluated. Student T, Mann–Whitney-U and Chi-square tests were applied. Thirty participants (15 per group) were included, randomized and followed for 12 weeks. No adverse events were reported. The questionnaire showed an overall rating of 7.2 (out of 10) in the experimental group and of 8.2 in the control group (p = 0.165) at 12 weeks. No statistically significant differences were observed in terms of gingival health, tooth staining, dentin hypersensitivity or microbiological outcomes between groups at baseline, 6- and 12-week visits. The adjuvant use of the new mouth rinse formulation proved to be as safe as the control product and no significant differences were observed in terms of clinical efficacy. Full article