Search Results (31)

Background: This systematic review evaluates the evidence on sustainable practices in dentistry. It focuses on effective measures, innovative technologies, strategies for reducing the carbon footprint, life cycle assessments (LCA), attitudes toward “green” dentistry, and educational approaches. Methods: A systematic search was conducted in five databases (Cochrane Library, Embase, LILACS, MEDLINE via PubMed, and Scopus) without language restrictions in accordance with PRISMA. The review was registered in PROSPERO (CRD420251056821). Results: A total of 2395 records were identified; after removing 394 duplicates, 2001 remained for screening. After title and abstract screening, 154 full-text articles were evaluated, of which 51 studies were included. The included studies addressed life cycle assessments of dental materials, sustainable clinical practices, and educational measures. Environmentally friendly materials and procedures, such as reusable personal protective equipment and water-saving technologies, demonstrate significant potential for reducing environmental impact. Despite generally high acceptance among dentists and patients, implementation is often limited by financial and knowledge-related barriers. Conclusions: The implementation of sustainable materials and procedures is crucial for reducing environmental impact. Equally important are the integration of ecological content into education and appropriate financial and political frameworks to promote sustainable dentistry. Full article

In medicine and dentistry, bone-loss treatment often uses hydroxyapatite combined with collagen membranes. The biocompatibility of these biomaterials depends on their composition and physical/mechanical properties. In this study, a graft composed of synthetic hydroxyapatite nanoparticle (Blue Bone^®) and a bovine type I collagen membrane (Green Membrane Perio^®) was developed compared with commercial Bio-Oss^® graft and Mucograft^® membrane. The materials were characterized by roughness, wettability, tensile testing, DSC, SEM, and TEM. In vivo, temporoparietal bone defects were created in 40 Wistar rats divided into five groups (n = 8): sham (no biomaterial); Bio-Oss^®; Bio-Oss^® + Mucograft^®; Blue-Bone^®; and Blue-Bone^® + Green Membrane Perio^®. Immunohistochemistry showed Green Membrane Perio^® was made of thin, well-organized type I collagen fibers and was free of contaminants. Immunohistochemistry, histology, and immunohistochemical analyses indicated that Blue Bone^® and Green Membrane Perio^® were biocompatible and supported tissue regeneration. The Blue Bone^® groups demonstrated higher collagen content than the Bio-Oss^® + Mucograft^® group. Quantitative and qualitative outcomes included morphological, thermal, mechanical, and surface property measurements, as well as cellular compatibility testing. The results showed comparable wettability and surface roughness, adequate membrane tensile strength, osteoconductive nanoparticle morphology, no adverse inflammatory reactions, and similar new bone formation metrics compared with controls. In conclusion, the combination of synthetic hydroxyapatite nanoparticles (Blue Bone^®) and a bovine type I collagen membrane (Green Membrane Perio^®) showed good performance when compared to established products and was considered safe and biocompatible for bone repair applications. Full article

Silver diamine fluoride (SDF) is widely used in pediatric dentistry for caries arrest; however, concerns exist regarding its cytotoxicity. Green-synthesized nano-silver fluoride (NSF) is a potential alternative to SDF, offering antimicrobial efficacy with improved biocompatibility. This study aimed to evaluate the in vitro safety profile of green-synthesized NSF with 5% (w/v) fluoride using Camellia sinensis extract and to compare it with 38% SDF + potassium iodide (KI) formulation in human gingival fibroblasts (HGFs). Eluates of NSF and SDF+KI were tested at serial concentrations of 5%, 1%, 0.1%, 0.01% and 0.005%. Cell viability was assessed after 24, 48, and 72 h using the MTT assay. Additionally, the formation of reactive oxygen species (ROS) in HGFs was detected through fluorescence microscopy. Exposure to 5% SDF+KI resulted in almost complete loss of cell viability at all time points, whereas NSF demonstrated significantly higher viability under the same conditions. Lower concentrations of both materials maintained acceptable biocompatibility. ROS analysis revealed increased oxidative stress in response to 5% SDF+KI, while NSF induced significantly lower ROS levels. NSF exhibited superior biocompatibility compared to SDF+KI, supporting its potential as a safer silver-based material for caries management. Further in vitro and in vivo studies are needed to confirm its clinical safety profile. Full article

Glass ionomer cements (GICs) are widely used in restorative and luting dentistry due to their fluoride release and chemical adhesion to dental tissues; however, their limited mechanical strength necessitates reinforcement strategies. The objective of this study was to investigate the effects of hemp-derived, green-synthesized titanium dioxide (TiO₂) nanoparticles on the surface and mechanical properties of two commercially available GICs with different clinical indications. TiO₂ nanoparticles were synthesized using Cannabis sativa leaf extract via a biogenic reduction method and characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX), confirming anatase-phase crystallinity, spherical morphology, and nanoscale particle size (28–49 nm). The nanoparticles were incorporated into Ketac™ Molar Easymix (restorative) and Ketac™ Cem Radiopaque (luting) GICs at 1%, 3%, and 5% (w/w), with nanoparticle-free formulations serving as controls (n = 10). Surface roughness, Vickers microhardness, and flexural strength were evaluated. Surface roughness increased in a concentration-dependent manner in both materials, with the highest values observed at 5% TiO₂ incorporation. In Ketac™ Molar Easymix, 1% and 3% TiO₂ significantly enhanced flexural strength and microhardness, whereas 5% resulted in reduced performance, consistent with SEM-observed nanoparticle agglomeration. In contrast, Ketac™ Cem Radiopaque exhibited no significant changes in flexural strength, although maximum microhardness values were recorded at 1% TiO₂ concentration. These findings demonstrate that low concentrations of hemp-derived TiO₂ nanoparticles can effectively reinforce restorative GICs and highlight the potential of green nanotechnology as a sustainable approach for improving dental biomaterials. Full article

Background/Objectives: Climate change is a major global issue affecting all facets of society, including dentistry. In response, the idea of green dentistry has developed, prioritising the reduction in environmental damage and the protection of patient health. This scoping review seeks to assess the level of awareness, understanding and practices of oral health professionals concerning the proper management of biomed. Methods: Searches were carried out in the Medline/PubMed, Scopus, Web of Science, Embase, and Google Scholar databases, analysing studies published between 2020 and 2025. Out of a total of 822 articles, 27 met the eligibility criteria. Results: In most of these studies, the respondents’ level of knowledge was found to be unsatisfactory or average, and only 17% of the studies reported respondents having a positive attitude towards adherence to sustainability principles. Although many professionals stated they were aware that dental waste could negatively impact the environment and human health if not properly managed, some still failed to provide correct answers to all the questions. Conclusions: The synthesis results indicated that oral health professionals have significant gaps in certain aspects of biomedical waste management, highlighting the need for proper training and to supplement the undergraduate and postgraduate curricula with courses on this topic. Full article

Background/Objectives: Phytotherapy, the use of plant-derived bioactive compounds for therapeutic purposes, has gained increasing attention in dentistry as a natural, well-tolerated, and culturally acceptable adjunct to conventional treatments. In pediatric dentistry, its potential relevance lies in its antimicrobial, anti-inflammatory, and antioxidant properties, which may support oral health, caries prevention, pulp vitality, and gingival health. This narrative review aimed to summarize the current clinical evidence regarding the application of phytotherapeutic agents in pediatric oral care. Methods: A narrative review was conducted according to SANRA guidelines, including clinical studies on plant-based products used for preventive or therapeutic purposes in children and adolescents. Results: Forty-three clinical studies met the inclusion criteria. The most commonly investigated agents included licorice, green tea, cocoa husk, cranberry, pomegranate, Aloe vera, and miswak. These agents demonstrated antimicrobial activity against cariogenic bacteria, reduction in plaque and gingival indices, and favorable healing in pulp therapies. In endodontics, Aloe vera-derived acemannan and Ankaferd Blood Stopper^® showed outcomes comparable to conventional materials, while pomegranate and apple cider vinegar exhibited partial antibacterial effects as irrigants. Conclusions: Phytotherapy shows promise as a complementary approach in pediatric dentistry, contributing to caries prevention, gingivitis control, and pulp healing. However, current evidence remains limited by small sample sizes, short-term follow-ups, and heterogeneity in formulations. Further trials are required to confirm efficacy, ensure safety, and standardize phytotherapeutic applications in pediatric oral care. Full article

In systemic diseases, controlling oral bacteria and cancer is an important issue. As biomaterials, recently, carbon dots (DSs) are the focus of a variety of studies owing to their extensive applicability in life sciences. In this study, the effectiveness of carbon dots (CDs) for the elimination of both oral bacteria and oral cancer in vitro was assessed using a dental light-curing unit (LCU) as a light source. CDs were synthesized using an amino acid. The absorbance of CDs and the emission spectrum of the LCU were measured. The production of reactive oxygen species (ROS) was evaluated spectroscopically. Changes in glutathione (GSH) content were evaluated. Using oral bacteria and cancer cells, in vitro antibacterial and antitumor capabilities of CDs were evaluated under light irradiation. Confocal microscopy was used to observe live/dead cells and intracellular lipid peroxidation (LPO). The emission spectrum of the LCU fully matched the absorbance of CDs. After CD treatment, the initial peak absorbances of the p-nitrosodimethylaniline-imidazole (for singlet oxygen assay) and nitroblue tetrazolium (for superoxide oxide assay) solutions changed under light irradiation. The initial peak absorbance of the GSH assay solution decreased during and after light irradiation. Both CD-treated oral bacteria and oral cancer cells were near totally eliminated at 50 and 200 μg/mL concentrations, respectively, after light irradiation. In the live/dead cell and C11-BODIPY^581/591 dye assays, red and green fluorescent spots were, respectively, observed in the CD-treated and light-irradiated cells. Accordingly, CDs effectively eliminated both oral bacteria and cancer cells in vitro in conjunction with dental LCU with less damage to normal cells through ROS-induced or ROS-initiated GSH depletion-induced intracellular LPO. Dental LCU plays a crucial role in ROS production through CD photoexcitation. Dental LUC has the potential to be used as a light source in dentistry for the treatment of oral bacteria and cancer cells. Full article

The increased incidence of periodontitis, the resistance of periodontal pathogens to antibiotics, and the adverse effects of certain drugs used in general dentistry present a strong rationale for seeking safe and effective plant-based treatments for periodontitis. HPLC-DAD analysis of a commercial herbal tincture confirmed the presence of rosmarinic acid (1102.79 ± 21.56 µg/mL), luteolin-7-O-glucoside (358.06 ± 5.64 µg/mL), and isorhamnetin (24.17 ± 0.49 µg/mL), bioactive phytochemicals known for their antimicrobial and anti-inflammatoryproperties. The randomized prospective study analyzed Tinctura paradentoica^® as an adjunct to anti-infectious non-surgical periodontal therapy (NSPT) on clinical and microbiological parameters in patients with moderate periodontitis (Stage II, Grade A). All 60 recruited participants were randomly allocated to either the intervention group (NSPT + Tinctura paradentoica^®) or the control group (NSPT alone). The rate of prevalence of the following periodontopathogenic microorganisms (Treponema denticola, Tannerella forsythensis), assessed by polymerase chain reaction (PCR) analysis, was significantly lower in the intervention group (p < 0.001), but no statistically significant difference was found for Porphyromonas gingivalis. The herbal tincture, combined with NSPT, produces a short-term reduction in periodontal clinical parameters (Green–Vermilion plaque index, bleeding on probing index (BOP), and clinical attachment level (CAL), without clinical relevance, and the prevalence of the following bacteria species (Tannerella forsythensis, Treponema denticola). Full article

Background/Objectives: While dentistry plays a critical role in promoting oral health, it also contributes significantly to environmental degradation through high energy consumption, water usage, and reliance on disposable, non-recyclable materials. Periodontology, in particular, involves resource-intensive procedures such as full-mouth disinfection, frequent surgical interventions, and aerosol-generating instrumentation. The aim of the present narrative review is to synthesize current knowledge and delineate feasible, evidence-informed strategies to operationalize sustainability across the full spectrum of periodontal treatment settings. Methods: The electronic search of the present narrative review was performed across PubMed/MEDLINE, Web of Science, BioMed Central, Scopus, CINAHL, and Cochrane Library databases. Results: The review identified actionable sustainability strategies across pre-workplace (e.g., eco-conscious procurement and transport reduction), workplace (e.g., energy- and water-saving technologies, digital workflows, and pollution control), and waste management (e.g., reuse protocols, recycling, and sustainable material selection). Particular emphasis was placed on the role of dental education, life cycle assessments, and digital innovations. Conclusions: The transition toward sustainable periodontology requires the adoption of evidence-based practices and leveraging digital innovation to reduce the environmental impact while maintaining high standards of care. Full article

This study investigated the effects of color shade and curing time on the degree of conversion (DC) and microhardness of colored compomers. A total of 162 samples (81 for DC, 81 for microhardness) were prepared, with nine samples per color group (gold, blackberry, green, pink, orange, lemon, blue, silver) and for the control. Samples were subdivided into three polymerization subgroups (3 s/3200 mW/cm², 10 s/1000 mW/cm², 20 s/1000 mW/cm²). The DC was analyzed via fourier transform infrared spectroscopy (FTIR) and microhardness was measured using Vickers testing. Statistical analysis included two-way ANOVA and Spearman correlation (α = 0.05). The colored compomers demonstrated a significantly lower DC compared to the control group (p ≤ 0.001). Among the tested colors, green exhibited the lowest DC (33.3%), while orange showed the highest (51.0%). A significant difference in DC was observed across curing times (p = 0.005), with the 3 s and 20 s groups exhibiting significantly higher conversion rates than the 10 s group. Microhardness values exhibited significant variation depending on the color (p < 0.001). Gold compomers demonstrated the lowest microhardness, whereas silver compomers showed comparable performance with the control group (p = 0.154). A moderate correlation between DC and microhardness was observed overall (ρ = 0.42, p = 0.003). However, the observed relationships were color-dependent: orange displayed a strong positive correlation (ρ = 0.78), whereas pink revealed no meaningful association (ρ = −0.15). Color and curing time critically influence compomer performance. High-intensity short curing is viable for lighter colors, while darker colors require extended curing. Customized protocols are essential to optimize clinical outcomes in pediatric dentistry. Full article

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This study aimed to evaluate the remineralization potential and aesthetic effects of novel, green-synthesized nano-silver fluoride (NSF) on artificial white spot lesions in primary teeth in comparison to 38% silver diamine fluoride (SDF) and silver diamine fluoride/potassium iodide (SDF/KI). Materials and Methods: NSF was synthesized using green tea extract. Sixty primary teeth specimens with artificial enamel lesions were randomly divided into five groups depending on the applied material: 38% SDF, 38% SDF/KI, single and double application of NSF, and control group. Treatments were followed by pH cycling. Surface microhardness and photographic analysis were conducted to assess remineralization and staining. Statistical analysis was conducted using non-parametric tests including Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Results: The greatest increase in microhardness was observed in the group receiving double NSF application. Its remineralizing potential was comparable to that of 38% SDF/KI, with no statistically significant difference (p = 1.000). Importantly, NSF-treated samples exhibited no teeth discoloration, unlike the black staining observed in SDF and SDF/KI groups. Conclusions: Green-synthesized NSF is a promising alternative to conventional SDF and SDF/KI, offering remineralization benefits without compromising aesthetics. The eco-friendly formulation and non-staining properties support its potential for clinical use in pediatric dentistry. Full article

Objectives: The objective of this narrative literature review was to highlight all dental procedures attributable to sectoral waste and to consider possible alternatives in line with the concept of sustainable development. Methods: An extensive search of electronic databases, including the Cochrane Oral Health Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PubMed, EMBASE, and Google Scholar. Search words included ‘Green Dentistry’, ‘Dental Pollution’, ‘Pollutants and Dentistry’, ‘Disinfectants and Dentistry’, and ‘High-tech Dentistry’. All of them allowed an assessment of the impact of dental practice on the external environment, and new frontiers currently applied or possibly applicable for green dentistry were included in the study. Non-full-text papers, animal studies, studies in languages other than English, and studies not related to the topic under consideration were excluded. Results: According to the inclusion criteria, 76 papers were selected for the study. The topics analyzed were the impact of dental practice on the outdoor environment, currently applied and potentially applicable principles of green dentistry, and the ‘Four Rs’ model (Rethink, Reduce, Reuse, and Recycle). Conclusions: With the limitations of the present study, the concept of green dentistry could be applicable provided that the measures already taken to reduce indoor and outdoor risk factors are continued and improved. Full article

Clear aligners have transformed orthodontic care by providing an aesthetic, removable alternative to traditional braces. However, their significant environmental footprint, contributing to approximately 15,000 tons of plastic waste annually, poses a critical challenge. To address this issue, advancements in 4D printing have introduced “smart” aligners with shape memory properties, enabling reshaping and reducing the number of aligners required per treatment. This study focuses on ClearX aligners, an innovative 4D-printed solution aimed at extending usage duration and minimizing environmental impact. Using a comprehensive suite of tests, including morphological, optical, and mechanical evaluations conducted via scanning electron microscopy, UV-Vis spectroscopy, infrared spectroscopy, and bending and strain assessments, we evaluated the optical and mechanical stability of the ClearX material before and after thermal activation. Our results demonstrate that ClearX aligners retain their structural and functional properties after reshaping. Temporary changes in transparency, observed only under prolonged treatment durations exceeding manufacturer recommendations, are fully reversible within 12 h and do not compromise the aligner’s usability. These findings support the potential of ClearX aligners to effectively combine patient-centered, high-quality orthodontic care with sustainable practices. Full article

Objectives: The study addresses the challenge of cross-infection in dentistry, focusing on improving disinfection protocols for dental hydrocolloid gel materials. This research aimed to incorporate chlorhexidine, natural plant extracts, and green-synthesized silver nanoparticles (AgNPs) into dental alginate to enhance safety and hygiene standards in dental practices. Methods: Conventional dental alginate served as the control, with experimental groups including alginate modified with 0.2% chlorhexidine (CHX-group) and alginate incorporating AgNPs synthesized from Syzygium aromaticum (SA) and Zingiber officinale (ZO) extracts (SA + AgNPs and ZO + AgNPs groups). Plant extracts were analyzed via GC/MS to confirm their composition. UV–visible spectroscopy, SEM, and EDX characterized the synthesized AgNPs. Antimicrobial efficacy against Candida albicans, Streptococcus mutans, and methicillin-resistant and methicillin-sensitive Staphylococcus aureus was evaluated using agar well diffusion assays. The dimensional accuracy of alginate impressions was assessed according to ISO 21563:2021 standards. Results: Chemical analysis of SA and ZO extracts identified 60 and 43 active compounds, respectively, supporting their use in AgNP synthesis. UV–visible spectroscopy, SEM, and EDX confirmed the formation of spherical AgNPs using SA and ZO extracts. Modified groups showed inhibitory activity against Streptococcus mutans and methicillin-resistant (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA), in contrast to the unmodified control. Both AgNP-modified groups demonstrated efficacy comparable to the CHX-group against MRSA and MSSA, with SA + AgNP showing superior performance against C. albicans. The dimensional accuracy of all groups was within clinically acceptable ranges as reported in the literature (0.027–0.083 mm). Discussion: CHX, silver nitrate, and green-synthesized AgNPs present promising options for developing self-disinfecting alginate impression materials. Utilizing plant extracts in AgNP synthesis offers a safe, efficient, and synergistic approach between metal ions and phytotherapeutic agents. This approach could potentially enhance disinfection efficacy without compromising material performance, improving dental safety and hygiene. Full article

Background: Severe early childhood caries (S-ECC) is recognized as a significant chronic disease which affects the quality of life starting at very young ages and has a very rapid evolution towards pulp complication and loss of dental tissue. Children with a high caries index DMFT are more likely to develop high levels of dental anxiety, which will influence the degree of cooperation during dental procedures. Emotions play an important role in the psychosomatic development of children, and all the factors that contribute to the modeling of these emotional states must be known and taken into consideration. Aim: The aim of this study was to assess the association between dental anxiety in children with S-ECC and the color preferences for the components of the dental environment to reduce the levels of dental anxiety during medical visits. Material and Method: For this study, 91 children between 3 and 6 years of age diagnosed with S-ECC were selected from the Pediatric Dentistry Department of UMFST from Targu Mures and from a private dental office. The level of dental anxiety was determined by measuring the pulse rate, and a questionnaire was completed to establish the color preferences for the dental office environment and the dentist’s attire. For this purpose, six different colors and their variants with three shades less intensity were chosen by using RGB (Red, Green, and Blue) identification codes for each color. Result: The results showed that there was a statistically significant difference between the age of the subjects and dental anxiety levels, but there was no significant correlation between the DMFT score and dental anxiety. Also, the results showed that there was no significant difference between girls and boys when choosing the colors preferred by them for the dental office, but when comparing the colors that represented happiness, significant statistical difference was found between the girls’ and boys’ groups (p = 0.0039). For all the subjects, the colors associated with happiness were light yellow and pink, while the colors associated with anxiety were red and dark blue. Conclusion: The data obtained showed that dental anxiety is strongly influenced by age, and an important role in inducing positive emotions is played by the dental environment if dressed in specific colors in order to reduce dental anxiety and create familiar conditions, especially for young children with S-ECC. Full article