Search Results (93)

Background: The rising demand for aesthetic dental treatments has spurred interest in peroxide-free color correctors as alternatives to traditional hydrogen peroxide formulations, which are associated with tooth sensitivity and potential enamel demineralization. This systematic review evaluates the whitening efficacy and safety profile of hydrogen peroxide-free color corrector (HPFCC) products, focusing on color change metrics, enamel and dentin integrity, and adverse effects. Methods: Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Science throughout January 2025 for randomized controlled trials, observational studies, and in vitro experiments comparing HPFCC to placebo or peroxide-based agents. The data extraction covered study design, sample characteristics, intervention details, shade improvement (ΔE00 or CIE Lab), enamel/dentin mechanical properties (microhardness, roughness, elastic modulus), and incidence of sensitivity or tissue irritation. Risk of bias was assessed using the Cochrane tool for clinical studies and the QUIN tool for in vitro research. Results: Six studies (n = 20–80 samples or subjects) met the inclusion criteria. In vitro, HPFCC achieved mean ΔE00 values of 3.5 (bovine incisors; n = 80) and 2.8 (human molars; n = 20), versus up to 8.9 for carbamide peroxide (p < 0.01). Across studies, HPFCC achieved a mean ΔE00 of 2.8–3.5 surpassing the perceptibility threshold of 2.7 and approaching the clinical acceptability benchmark of 3.3. Surface microhardness increased by 12.9 ± 11.7 VHN with HPFCC (p < 0.001), and ultramicrohardness rose by 110 VHN over 56 days in prolonged use studies. No significant enamel erosion or dentin roughness changes were observed, and the sensitivity incidence remained below 3%. Conclusions: These findings derive from one clinical trial (n = 60) and five in vitro studies (n = 20–80), encompassing violet-pigment serums and gels with differing concentrations. Due to heterogeneity in designs, formulations, and outcome measures, we conducted a narrative synthesis rather than a meta-analysis. Although HPFCC ΔE00 values were lower than those of carbamide peroxide, they consistently exceeded perceptibility thresholds while maintaining enamel integrity and causing sensitivity in fewer than 3% of subjects, supporting HPFCCs as moderate but safe alternatives for young patients. Full article

Background/Objectives: Dental cavity preparation is a critical procedure in restorative dentistry that involves the removal of decayed tissue while preserving a healthy tooth structure. Excessive stress during tooth preparation leads to enamel cracking, dentin damage, and long term compressive pulp health. This study employed finite element analysis (FEA) to investigate the stress distribution in dental structures during cavity preparation using round diamond burs of varying diameters and depths of cut (DOC). Methods: A three-dimensional human maxillary first molar was generated from computed tomography (CT) scan data using 3D Slicer, Fusion 360, and ANSYS Space Claim 2024 R-2. Finite element analysis (FEA) was conducted using ANSYS Workbench 2024. Round diamond burs with diameters of 1, 2, and 3 mm were modeled. Cutting simulations were performed for DOC of 1 mm and 2 mm. The burs were treated as rigid bodies, whereas the dental structures were modeled as deformable bodies using the Cowper–Symonds model. Results: The simulations revealed that larger bur diameters and deeper cuts led to higher stress magnitudes, particularly in the enamel and dentin. The maximum von Mises stress was reached at 136.98 MPa, and dentin 140.33 MPa. Smaller burs (≤2 mm) and lower depths of cut (≤1 mm) produced lower stress values and were optimal for minimizing dental structural damage. Pulpal stress remained low but showed an increasing trend with increased DOC and bur size. Conclusions: This study provides clinically relevant guidance for reducing mechanical damage during cavity preparation by recommending the use of smaller burs and controlled cutting depths. The originality of this study lies in its integration of CT-based anatomy with dynamic FEA modeling, enabling a realistic simulation of tool–tissue interaction in dentistry. These insights can inform bur selection, cutting protocols, and future experimental validations. Full article

Background/Objectives: Tooth bleaching is a widely requested aesthetic procedure in modern dentistry. However, the structural effects of high-concentration peroxide-based bleaching agents on enamel remain insufficiently understood. This study aims to evaluate and compare the effects of three in-office bleaching agents—Opalescence Boost (40% hydrogen peroxide [HP]), Opalescence Quick (45% carbamide peroxide [CP]), and BlancOne Ultra + (35% hydrogen peroxide [HP])—on enamel surface characteristics and color change using confocal laser scanning microscopy (CLSM) and spectrophotometric analysis. Methods: Forty-two extracted human teeth were sectioned and divided into experimental and control halves. Each experimental specimen underwent bleaching according to the manufacturer’s protocol. Color measurements were conducted at baseline, immediately post-treatment, at 3 days, 7 days, and 6 months following treatment using the Vita Easyshade^® spectrophotometer. Color differences were calculated using the CIEDE2000 (ΔE₀₀) formula. Enamel surface morphology was assessed by CLSM. Data were analyzed using Wilcoxon and Kruskal–Wallis tests (p < 0.05), performed with SPSS v23. Results: All bleaching agents produced clinically perceptible color changes (ΔE₀₀ > 3.3). Opalescence Boost achieved the highest and most consistent whitening effect (mean ΔE₀₀ > 11), while Opalescence Quick showed moderate efficacy (ΔE₀₀ ~6–8), and BlancOne Ultra+ induced milder changes (ΔE₀₀ ~4–5). CLSM imaging revealed surface alterations in all bleached samples, with more pronounced changes observed in specimens treated with higher peroxide concentrations. Conclusions: All three bleaching systems were effective in improving enamel color, with Opalescence Boost delivering the most substantial and durable effect. CLSM analysis confirmed morphological changes in enamel without evidence of severe damage. These results underscore the importance of selecting bleaching protocols that balance efficacy with enamel safety. Further in vivo studies are recommended to validate long-term structural effects and support clinical decision-making. Full article

Oral caries is one of the most common oral diseases worldwide, affecting about 2.4 billion people. This phenomenon always starts with enamel demineralization, eventually progressing to tooth cavitation and loss when not properly treated. Nowadays, the standard diagnostic techniques to detect demineralization strongly depend on the operator’s expertise and are characterized by fairly low sensitivity and specificity, and/or involve ionizing radiation. This study investigates the feasibility of a non-invasive, effective, rapid, and radiation-free approach employing impedance spectroscopy for early caries detection. Two binary classifiers were developed for automated assessment and validated using a dataset obtained by in vitro demineralization of human teeth. A computationally efficient single-neuron classifier, utilizing a single impedance phase measurement at 15 Hz, achieved 88% accuracy, offering a lightweight, low-power solution suitable for microcontroller implementation and rapid measurements. A Multi-Layer Perceptron (MLP) classifier, utilizing equivalent circuit element values, yielded a similar accuracy of 86%. A prototype of a diagnostic portable tool was developed and characterized, demonstrating reliable impedance phase measurement (uncertainty < 2°). The performance of these classifiers meets or exceeds the existing AI-based methodologies for caries detection relying on radiographic data. This work introduces a novel application of AI to tooth impedance spectra, addressing a significant research gap in non-invasive diagnostics and laying the foundation for a novel, accessible, and accurate tool for early caries management. Full article

C-terminal-binding proteins (CtBPs) dimerize and function predominantly as transcriptional corepressors by recruiting various chromatin-modifying factors to promoter-bound repressors. Hypotonia, ataxia, developmental delay, and tooth enamel defects syndrome (HADDTS) is a recently discovered neurodevelopmental disorder resulting from a heterozygous missense mutation in CTBP1. It is often associated with the early onset of profound cerebellar atrophy in patients. Allen Institute’s Allen Brain Cell (ABC) atlas of human brain data was used to localize CTBP1 expression in the brain to elucidate the etiology of HADDTS. Based on the ABC atlas, CTBP1 is highly expressed in the upper rhombic lip supercluster, which gives rise to cerebellar cells and provides insights into the cerebellar pathophysiology observed in HADDTS patients. Full article

The human laminin family is composed of five α, four β, and three γ chains. Laminins are heterotrimers of α, β, and γ chains. Laminins play critical roles during organogenesis, mostly as basement membrane components. The expression of all and the localization of most laminin chains were characterized in mouse developing teeth. Primary laminin isoforms in basement membranes along the inner enamel epithelium before the secretory stage and outside of the outer enamel epithelium were laminins 111 (α1β1γ1) and 511. The mouse laminin α3 chain has two variants, α3A and α3B. Although a basement membrane structure is absent, laminin 3A32 was localized along the secretory surface of the secretory stage ameloblast Tomes’ processes. Laminin 3A32 was localized along the atypical basement membrane of maturation stage ameloblasts and the specialized basement membrane of junctional epithelium facing the enamel surface. The endothelial basement membrane in the dental papilla and outside of the enamel organ contained laminins 411 and 511. Laminin 332 was detected in the extracellular matrix but not the basement membrane of the apical loop. Laminin 111 was localized in the extracellular matrix of the apical dental papilla without forming a visible basement membrane. These findings suggest the multifaceted functions of laminins in tooth development and set the foundation for functional investigations. Full article

Background/Objectives: This systematic review aims to investigate the potential association between vitamin D levels and the occurrence of developmental enamel defects (DDE) in children, including conditions like molar–incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPMs). DDEs, which occur during tooth development, can result in significant aesthetic and functional issues, and their exact etiology remains unclear, with both genetic and environmental factors contributing. Among environmental factors, vitamin D deficiency has been proposed as a possible risk factor, given its role in enamel mineralization. Methods: A thorough literature search was conducted in PubMed, Scopus, and Embase. The search strategy included terms such as “vitamin D”, “vitamin D deficiency”, “developmental defects of enamel”, “enamel hypoplasia”, “molar-incisor hypomineralization”, and “hypomineralized second primary molars”. Studies were included if they were original human observational research (cohort, case–control, or cross-sectional) conducted in children under 18 years of age or involving maternal–child cohorts. Ten studies were included in the analysis, with a total of 15,891 participants. The primary data extracted from the selected studies included the following: study design, participants’ age, sample size, vitamin D status in relation to developmental defects of enamel, and statistical significance Results: The findings were mixed, with only a few studies suggesting a significant association between low vitamin D levels and the presence of DDEs. Specifically, one study found a link between insufficient maternal vitamin D levels during pregnancy and an increased number of teeth affected by MIH in children. However, the majority of the studies did not report a significant association. Conclusions: This review concludes that while there is some evidence to suggest a possible relationship between vitamin D and DDEs, more research is needed to confirm these findings and better understand the underlying mechanisms. Full article

The human tooth’s morphology, which includes variations in cusp numbers and patterns, is of tremendous interest to anthropologists, morphologists, and dentists. Cusp 6 is an additional cusp that is very seldom encountered in primary or permanent mandibular molars, especially first molars. A supernumerary cusp located lingual to the distobuccal cusp at the crown’s distal border is cusp 6. According to the literature, cusp 6 is also known by other anthropologic designations, such as “Tuberculum Sextum” or “Entoconulid”. This case offers a unique instance of a bilateral tuberculum sextum in the maxillary permanent first molars, characterized by an additional cusp on the lingual surface. The patient, an adolescent, exhibited no associated symptoms. Early detection of such dental anomalies is essential for treatment planning, particularly in maintaining occlusal balance and preventing future complications. Regular monitoring is necessary to manage a bilateral tuberculum sextum in order to avoid enamel fractures and occlusal interference. To preserve functional occlusion and avoid problems, prophylactic sealants or selective grinding may be taken into consideration. This report highlights the importance of recognizing a tuberculum sextum for proper clinical management. Full article

Dentin and enamel are the two main constituents of human teeth, and the detailed characterization of their biochemical properties is of fundamental relevance in many fields of dentistry research. Vibrational spectroscopies such as Fourier-Transform Infrared (FT-IR) spectroscopy and Raman spectroscopy can be adopted to obtain precise information before and after chemical or physical teeth treatments. In the present work, the two above-mentioned spectroscopic techniques were used to investigate dentin and enamel powders and few mm thick disks cut from human molar teeth. The FT-IR and Raman spectra clearly show the contributions of different sample components. The spectra obtained from the dentin and enamel powders evidence differences due to their chemical composition. The spectra from the human tooth disks present different characteristics depending on the region of the samples from which they were collected, thus enabling a spatial characterization of the samples themselves on different scales. These results confirm that vibrational spectroscopies allow a detailed characterization of hard dental tissues at the microscopic level. Full article

Restorative dentistry often uses ceramic laminate veneers for aesthetic anterior teeth restorations due to their natural appearance and minimal invasiveness. However, the understanding of their clinical performance and how ceramic microstructure and processing affect longevity is limited. Objective: This study aimed to address this gap by determining the mechanical behavior, fracture load, and failure modes of CAD-CAM processed laminate veneers made of either lithium-disilicate-based glass ceramic (IPS e.max CAD) or feldspathic porcelain (Vita Mark II). It also aimed to develop a mechanical cycling methodology capable of determining the lifetime and failure modes of thin ceramic laminate veneers. Materials and Methods: Eighteen human maxillary central incisors were used to create the specimens. Minimal enamel preparation was required to ensure the proper adaptation of the thin ceramic laminates. Ceramic laminates made from lithium disilicate and feldspathic porcelain (Vita Mark II) were produced via CAD-CAM, with the final thicknesses less than 0.5 mm, then cemented with resin cement. Results: The mean fracture load for the glass ceramic was 431.8 ± 217.9 N, while for the porcelain, it was 454.4 ± 72.1 N. Failure modes differed considerably: porcelain showed more chipping, while lithium disilicate was associated with tooth structure failure. Conclusion: The material used did not significantly affect the fracture load of thin ceramic laminates in static tests. However, failure modes differed considerably. It was not possible to determine a set of mechanical cycling parameters that could establish the fatigue properties of thin ceramic laminates, as the maximum number of cycles reached was 536,818. Full article

Background: There is only limited research on the coronal cementum of a tooth, and the mechanisms of its forming process are not well-defined. This report presents a coronal cementum on the occlusal surfaces of enamel in an impacted wisdom tooth in a human, which is not nearly the cervical portion. Materials and Methods: The tooth (Tooth #1) was derived from a 46-year-old female. Histological analysis, including hematoxylin and eosin (HE) and toluidine blue (TB) staining, and Scanning Electron Microscopy and Energy Dispersive X-ray Spectrometer (SEM-EDS) analysis of the extracted tooth were conducted. Radiographic examination showed that Tooth #1 was horizontally impacted in the maxilla and had the apex of a single root placed between the buccal and palatal roots of Tooth #2. Results: Coronal cementum was distributed widely on the enamel, and reduced enamel epithelium was also found with enamel matrix proteins histologically. The formation of acellular cementum was observed to be more predominant than that of the cellular cementum in Tooth #1. SEM showed that the occlusal cementum connected directly with enamel. Calcium mapping revealed an almost similar occlusal cementum and enamel. In addition, the spectrum of elements in coronal cementum resembled the primary cementum according to SEM-EDS. Discussion: Thus, coronal cementogenesis in impacted human teeth might be related to the existence of reduced enamel epithelium. Full article

Fahr’s syndrome is a rare neurodegenerative disorder with limited research on its oral manifestations. This study investigates the dental features and genetic background of Fahr’s syndrome through a pedigree analysis and a retrospective literature study. A clinical examination and whole-exome sequencing (WES) were conducted on a female patient with Fahr’s syndrome and pseudohypoparathyroidism, along with her family members. The patient presented with super-numerary teeth, tooth agenesis, enamel hypoplasia, and abnormal tooth eruption. The WES did not reveal any known pathogenic mutations related to pseudohypoparathyroidism or Fahr’s disease. However, genetic variations in KIF1A, FZD8, and PDGFA may underlie these dental abnormalities. Additionally, a retrospective analysis of 22 reported cases from PubMed and the Human Gene Mutation Database (1 January 1965–30 June 2024) was conducted with keywords such as “Fahr’s disease”, “Fahr’s syndrome”, “dental”, and “hypoparathyroidism”. The analysis showed that patients with Fahr’s syndrome, pseudohypoparathyroidism, and idiopathic hypoparathyroidism exhibited similar oral abnormalities, including tooth agenesis, root dysplasia, dental malformations, and abnormal tooth eruption. Variations in the incidence of tooth agenesis and dental malformation among these groups may be linked to differences in parathyroid hormone metabolism. These findings suggest oral abnormalities are the key local features of Fahr’s syndrome and related parathyroid disorders. Full article

Identifying the boundary between the tooth and the resin-based composite (RBC) is difficult when replacing restorations. Ultraviolet (UV) light has been reported to assist the viewer by causing the RBC to fluoresce. Using a laboratory-grade fiberoptic spectrometer, 46 RBCs were exposed to UV light from the Woodpecker O-Star curing light. The opalescence and fluorescence were measured relative to a human tooth that contained just dentin and a tooth that contained both enamel and dentin. After these quantitative measurements, 10 RBCs with large differences in light emittance were compared qualitatively to assess their brightness when exposed to UV light compared to the dentin specimen and the specimen containing both enamel and dentin. It was found that, when exposed to UV light, some of the RBCs were less bright compared to the two samples of teeth used for comparison, but most were brighter; some were up to six times brighter. The filler appears to affect the opalescence peaks, while the resin appears to affect the fluorescence peaks. It was concluded that because RBCs emit very different levels of opalescence and fluorescence, UV light from the Woodpecker O-Star cannot be relied upon to detect all brands of RBC on the tooth. The opalescence and fluorescence can also be used to detect changes in the formulation of the RBC. Full article

Nano-hydroxyapatite (nHA) demonstrates favorable biological activity, cell adhesion, cell proliferation, and osteoconductivity, making it highly valuable in biomedicine. It is extensively used as a bone substitute and in bone transplantation within the dental and orthopedic fields. This study employed oyster shells as a calcium source to synthesize nHA at 150 °C with various hydrothermal reaction durations (10 min, 1 h, 6 h, and 12 h). As a control, HA synthesized via a wet precipitation method for 1 h at room temperature was utilized. Subsequent material analyses, including XRD, FE-SEM, FTIR, and ICP-MS, were conducted, followed by comprehensive evaluations of the bioactivity, cell attachment, cell proliferation, and sintering properties of the synthesized nHA. The results indicated that nHA synthesized through the hydrothermal reaction produced nanoscale crystals, with the aspect ratio of nHA particles increasing with the duration of hydrothermal treatment. Notably, rod-like nHA particles became prominent with hydrothermal durations exceeding 6 h. nHA particles derived from oyster shells contained carbonate and trace elements (Na, Mg, K, and Sr), similar to constituents found in human hard tissue such as bone and teeth. The immersion of nHA synthesized at 150 °C for 1 h (HT2) in simulated body fluid (SBF) for 28 d led to the formation of a bone-like apatite layer on the surface, indicating the excellent bioactivity of the synthesized nHA. The cell culture results revealed superior cell attachment and proliferation for nHA (HT2). Following the sequential formation and sintering at 1200 °C for 4 h, HT2 ceramics exhibited enhanced microhardness (5.65 GPa) and fracture toughness (1.23 MPa·m^0.5), surpassing those of human tooth enamel. Full article

Interproximal enamel reduction (IER) is a minimally invasive therapeutic procedure commonly used in orthodontics to address both functional and aesthetic issues. Its mechanical effects on enamel surfaces induce the formation of grooves, furrows, scratches, depressions, and valleys. The aim of this study was to assess the enamel surface roughness resulting after the application of currently available methods for interproximal reduction. Ninety freshly extracted human teeth were divided into six groups and subjected to the stripping procedure, using a different method for each group (diamond burs, abrasive strips of 90 μm, 60 μm, 40 μm, 15 μm, and abrasive discs). A single individual performed stripping according to the manufacturer’s recommendations, involving interproximal reduction on one tooth’s proximal face and leaving the other side untreated. Qualitative and quantitative assessment of the enamel surfaces was carried out using Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM), obtaining 2D and volumetric 3D images of the enamel surface microstructure and nanostructure. The study found that diamond burs and abrasive strips of 60 μm and 90 μm increased enamel roughness due to intense de-structuring effects, while the 40 μm polisher had a gentler effect and 15 μm abrasive strips and polishing discs preserved enamel surface quality and removed natural wear traces. Full article