Search Results (38)

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

Background and Objectives: To systematically map and evaluate the current literature on the application of artificial intelligence (AI) in teleorthodontics, focusing on clinical use, technological approaches, outcomes, and limitations. Materials and Methods: A scoping review was conducted following a formal and recognized methodological framework. Three databases (PubMed, Scopus, Web of Science) were searched until 30 April 2025. Studies were included if they reported original data on AI applications in orthodontic remote monitoring or virtual care. Data extraction focused on study design, type of AI, clinical setting, reported outcomes, and main findings. Results: Nine studies met the inclusion criteria. Most research focused on the use of the Dental Monitoring™ (DM) system, which employs deep learning algorithms to analyze intraoral scans captured via smartphones. Reported benefits included reduced in-office visits (up to 33%), accurate 3D tracking of tooth movement, improved hygiene compliance, and high patient engagement. However, significant variability was observed in the repeatability and precision of AI decisions, especially in GO/NO-GO aligner progression instructions. One study explored an alternative system, StrojCHECK™, based on a decision tree algorithm, showing improved compliance with personalized feedback. Conclusions: AI-powered teleorthodontic systems show potential to enhance treatment efficiency and patient engagement, particularly in aligner therapy. However, their current clinical application remains narrowly focused on commercial monitoring platforms, with limited validation and transparency. This review highlights the early stage of real-world AI integration in orthodontics, underlining the need for independent validation, broader applications beyond monitoring, and robust ethical frameworks. In this context, AI should be used as a complementary tool, never a substitute, for clinical judgment. Full article

Background: This study aimed to evaluate the effect of in-office bleaching with 38% hydrogen peroxide (HP) on the surface roughness of a nanohybrid composite resin by comparing two measurement techniques: Scanning Electron Microscopy (SEM) and profilometry. Methods: Sixty composite specimens of identical shade and thickness were prepared, light-cured, and polished following the manufacturer’s guidelines. These samples were divided into six groups based on the applied surface treatments: group 1: fresh composite (the control group), group 2: old composite, group 3: bleached fresh composite, group 4: bleached old composite, group 5: old repolished composite, and group 6: old repolished bleached composite. Surface roughness was measured using profilometry and SEM. Results: Pearson correlation analysis revealed a moderately significant linear relationship (r = 0.548, p < 0.001) between the surface roughness measurements obtained using SEM and the profilometer, indicating that both methods provide comparable results. A comparison of most groups showed significant differences (p < 0.001), highlighting the increased surface roughness observed after bleaching both fresh and aged composites. Conclusions: Bleaching increased the surface roughness of nanohybrid composites. It might be better to use SEM and a profilometer together to obtain a more comprehensive understanding of the surface characteristics. Full article

The integration of 3D printing has transformed orthodontics, allowing for the creation of highly customized intraoral devices that support traditional orthodontic treatments. This review examines the innovations and applications of 3D-printed accessories in orthodontics, focusing on customization, precision, and workflow improvements. In-office 3D printing enables reduced dependence on external labs, enhancing efficiency and potentially lowering costs. Key topics include material properties, biocompatibility, and clinical applications, alongside an evaluation of both successes and limitations highlighted in recent studies. Unlike prior research focused on aligners and braces, this review centers on auxiliary devices, demonstrating how 3D printing can revolutionize these less-studied accessories in orthodontics. The rise of 4D memory shape materials signals a potential breakthrough in “smart orthodontics”, where directly printed devices can adapt over time. This innovation could lead to a new era of personalized dynamic orthodontic solutions with 3D-printed auxiliaries, providing unprecedented customization and expanding the scope of orthodontic care. Further research is essential to address challenges related to durability, biocompatibility, and long-term clinical performance to optimize 3D printing’s role in orthodontic treatments. Full article

In-office teeth bleaching is an esthetic dental procedure performed to whiten teeth. A desensitizing procedure often requires prior in-office bleaching to relieve tooth hypersensitivity. The objective of this study was to evaluate the bleaching efficiency of teeth specimens pre-treated with different desensitizing agents by analyzing the color parameters. A total of 25 bovine specimens were stained and divided into five groups (n = 5). The specimens were pre-treated with GLUMA, ICON, bonding, or fluoride varnish according to the manufacturer’s instructions. Subsequently, the samples underwent three consecutive 20 min bleaching sessions using an in-office bleaching product. Color values in the CIE L*, a*, and b* color space were initially recorded, both before any treatment and after each bleaching session. The color difference (ΔE) was then computed. The data were analyzed using SPSS 24.0 software. The color alteration after pre-treatment was analyzed using a one-way ANOVA test, and the color alteration in each bleaching session was compared using a repeated-measure ANOVA test. A one-way ANOVA analysis showed a statistically significant difference in the bleaching efficiency of teeth specimens pre-treated with different desensitizers (p < 0.001). The repeated-measure ANOVA analysis showed no statistically significant difference in additional bleaching sessions (p = 0.133). The ICON and bonding pre-treatment showed the color alteration of teeth specimens before the bleaching procedure. Although the different desensitizer pre-treatments showed significant differences in bleaching efficiency, the differences in color parameters of the teeth specimens at the end of three bleaching sessions were statistically insignificant. Desensitizer pre-treatment influenced the degree of color change during multiple bleaching sessions; however, the outcome of bleaching was not affected by desensitizer pre-treatment. Full article

Background/Objectives: Tooth whitening is a cosmetic dental treatment that improves the color of natural teeth, making them whiter and brighter; this review aimed to evaluate the greater effectiveness of in-office, at-home, and combined bleaching with hydrogen or carbamide peroxide, also in relation to possible relapses and side effects (tooth sensitivity). Methods: A literature search has been carried out through electronic databases, PubMed/MEDLINE, and Cochrane Library, focused on the use of the effectiveness of in-office, at-home, and combined dental bleaching. This review has been registered on PROSPERO (ID613248). Results: 30 articles have been included. Most of the studies did not find any more effective treatment than the proposed treatments; all types of bleaching have been shown to be effective in changing color; in the studies that have compared in-office and at-home bleaching, there was a lower recurrence of treatment with the use of the at-home trays with carbamide peroxide gel. There were no clear positions regarding tooth sensitivity, which would appear to be higher in professional in-office and combined dental bleaching. Conclusions: Bleaching is an effective treatment for the change of color of the tooth regardless of the type used (concentrations, type of gel, and duration of sessions), although, at home, it would seem to be more effective over time. It is, however, a clinical feature that may give a risk of tooth sensitivity after treatment. Full article

The growing need for collaborative healthcare teams to meet complex health challenges has led to physical therapists (PTs) being embedded in adult primary care settings for many years now. However, this model of care has not been found in pediatrics. This qualitative study sought to gain insights from pediatricians on the potential of embedding pediatric PTs in primary care. Participants were nine pediatricians practicing in both urban and rural, hospital-based and private settings. Semi-structured interviews were recorded, transcribed, and analyzed via thematic analysis per published methods, assuring trustworthiness. Three overarching themes emerged: pediatricians’ priorities aligned with the Quadruple Aim of Healthcare, embedded PTs could fill multiple roles in pediatrics, and they could see a wide variety of patients, highlighting real potential benefits in primary care. Participants endorsed in-office focused treatments, screening to determine optimal care pathways, and ongoing patient follow-up as potential PT roles in this setting. Providers thought that PTs could help manage care for musculoskeletal complaints, high-risk infants, medically complex children, autism, and obesity. An advanced-trained PT having attributes of confidence, adaptability, and open-mindedness was desired. All participants endorsed pediatric primary care PTs as having potentially high value in their practice. This is the first known study on the potential of embedding a PT in the pediatric primary care setting, offering valuable insights from pediatricians to be leveraged in implementation planning. Full article

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound’s efficacy and toxicity are established. Full article

The aim of this investigation was to conduct a systematic review and meta-analysis to determine the necessity of a white diet during or following a bleaching procedure. This systematic review and meta-analysis followed the PRISMA guidelines meticulously. The research question was: Is a white diet necessary during and/or after a bleaching treatment? In vitro studies or clinical trials reporting the color change in bleached enamel after the use of a free-staining diet were considered for full-text review. For the analyses, a random-effects model was employed. Statistical significance was defined as a p-value < 0.05. A total of 17 documents were eligible for qualitative analysis: 5 clinical trials and 12 in vitro studies. Only data from the clinical trials were included in the meta-analysis. For at-home bleaching, differences in the color among the subjects were not statistically significant during the first (p = 0.64), second (p = 0.26) or third (p = 0.43) weeks of treatment. Also, the color difference one month after finishing the bleaching treatment were not statistically significant (p = 0.27). The color difference one month after finishing an in-office treatment showed that the restrictions on diet did not significantly improve the bleaching outcomes (p = 0.90). According to the findings of this review, dietary restrictions are not necessary during or after bleaching procedures. Full article

The advent of telemedicine marked a significant turning point in the healthcare landscape, introducing a revolutionary approach to the delivery of medical care. Digital technologies easily connect health professionals and patients, overcoming geographical and temporal barriers. Telemedicine has been used for sleep disorders including obstructive sleep apnea syndrome (OSAS) since the mid-1990s. In adult patients with OSAS, telemedicine is helpful both for consultation and diagnosis, the latter obtained through remote recordings of oxygen saturation and further parameters registered with telemonitored respiratory polygraphy or polysomnography. Remote monitoring can be used to follow up the patient and verify adherence to daily treatments including continuous positive airway pressure (CPAP). In children, studies on the role of telemedicine in OSAS are scarce. This narrative review aims to describe the application of telemedicine in children with obstructive sleep apnea syndrome (OSAS), assessing its advantages and disadvantages. In patients with OSA, telemedicine is applicable at every stage of patient management, from diagnosis to treatment monitoring also in pediatric and adolescent ages. While telemedicine offers convenience and accessibility in healthcare delivery, its application in managing OSAS could be associated with some disadvantages, including limitations in physical examination, access to diagnostic tools, and education and counseling; technology barriers; and privacy concerns. The adoption of a hybrid approach, integrating both in-office and virtual appointments, could effectively meet the needs of children with OSAS. However, more studies are needed to fully assess the effectiveness and safety of telemedicine in the pediatric population. Full article

A prospective observational case series included six patients who presented with discoloured upper and lower teeth extending from the right second premolar to the left second premolar. The photoactivation dosimetry and treatment protocol were as follows: λ 450 nm, 1 W, CW; flattop beam profile; 1 cm²; 15 J/spot; 10 irradiated spots; an irradiation time of 15 s/spot; three whitening cycles in a single session. Blanc One ULTRA⁺ was the bleaching agent. A visual analogue scale (VAS) was utilised to evaluate the pain intensity and dental hypersensitivity during treatment immediately after complete treatment (T1), 24 h (T2), and 8 h (T3) postoperatively, and at an 8-month follow-up timepoint (T4), whereas the dental colour shade change was assessed using the VITA colour shade guide pre-treatment (T0), T1, and T4. The Gingival index and modified Wong Baker faces scale were utilised to evaluate gingival inflammation and patients’ treatment satisfaction, respectively. Our findings revealed a reduction in the dental colour shade of the six cases between 2 and 10- fold (average of 3.5-fold) at T1 and maintained at T4, indicating significant improvement in the colour shade change with optimal outcomes. The percentage of this improvement for all the patients was ranged between 16.6% and 33.3%. At all timepoints, a “0” score was provided for pain intensity, dental hypersensitivity, and gingival inflammation. Our study demonstrates the feasibility and safety of a λ 450 nm laser delivered with a flattop handpiece to achieve optimal whitening outcomes without adverse effects. This offers a useful guide for dental clinicians for vital in-office tooth whitening. Extensive clinical studies with large data are warranted to validate our study protocol. Full article

Study Design: The study was a retrospective cross-sectional database analysis. Objective: Deoxycholic acid (DOC) injections are a novel, in-office procedural alternative to submental liposuction or submentoplasty to address excess submental fat. Post-market safety data regarding this treatment is currently limited. The objective of this study is to analyze adverse events reported in the Manufacturer and User Facility Device Experience (MAUDE) database. Methods: The MAUDE database was queried for all reports related to adverse events involving deoxycholic acid using the search terms “KYBELLA” and “deoxycholic acid.” Reports were individually reviewed by 2 reviewers and categorized with special attention to adverse events. Results: A total of 34 medical device reports were identified from the database query. Thirteen of these reports (21 total events) were included in the analysis after excluding duplicates, unrelated adverse events, or events associated with the offlabel use of DOC. Reported adverse events include excessive swelling (n = 5, 24%), marginal mandibular nerve weakness (n = 4, 19%), unsatisfactory aesthetic outcome (n = 4, 19%), numbness (n = 3, 14%), dysphagia (n = 1, 5%), infection (n = 1, 5%), and skin necrosis (n = 3, 14%). Two patients required hospitalization for skin necrosis management; both had underlying systemic diseases. Conclusions: Adverse events following DOC injections included excessive swelling, dysphagia, numbness, infection, unsatisfactory aesthetic outcome, facial nerve weakness, and skin necrosis requiring hospitalization and/or surgery. Patient counseling regarding these adverse events should be discussed when offering DOC injections for submental convexity. Full article

Headache is a leading cause of disability and suffering. One major challenge in developing device treatments is demonstrating their efficacy given devices’ often-high placebo rate. This paper reviews the importance of validating sham devices as part of finalizing the design for larger-scale prospective randomized controlled trials in patients with chronic headache as well as the results of a prospective, single-blind trial to validate two potential sham noninvasive thermal nerve block devices. Study participants were trained to self-administer thermal nerve block treatment using sham devices in an office visit. Two different sham systems with different temperature profiles were assessed. Devices were offered for patients to use daily at-home for one week to assess the durability of sham placebo effects before participants were given active treatment in a second office visit followed by another optional week of self-administered active treatment at-home use. Sham treatments reduced pain scores by an average of 31% from 6.0 ± 2.3 to 4.3 ± 3.3, including two participants who fell asleep during the in-office treatment and woke up with no pain, but whose pain recurred after returning home during at-home use of the sham system. In-office active treatments reduced pain scores by 52% from 6.7 ± 2.1 to 3.3 ± 2.9 with sustained pain relief during optional at-home use. Successful blinding for the study was confirmed with an ideal Bang’s Blinding Index of 0 and an ideal James’ Blinding Index of 1. Both the sham and active treatments were viewed by participants as highly credible, and credibility increased from the beginning to end of sham treatments on average. Full article

(1) Background: Virtual reality and 3D printing are transforming orthopedic surgery by enabling personalized three-dimensional (3D) models for surgical planning and Patient-Specific Instruments (PSIs). Hospitals are establishing in-house 3D printing centers to reduce costs and improve patient care. Pediatric orthopedic surgery also benefits from these technologies, enhancing the precision and personalization of treatments. This study presents preliminary results of an In-Office 3D Printing Point of Care (PoC), outlining considerations and challenges in using this program for treating lower limb deformities in pediatric patients through Virtual Surgical Planning (VSP) and 3D-printed Patient-Specific Instruments (PSIs). (2) Materials and Methods: Pediatric patients with congenital or acquired lower limb deformities undergoing surgical correction based on VSP, incorporating 3D-printed PSIs when required, were included in this study. The entire process of VSP and 3D printing at the In-Office PoC was illustrated. Data about deformity characteristics, surgical procedures, and outcomes, including the accuracy of angular correction, surgical times, and complications, were reported. (3) Results: In total, 39 bone correction procedures in 29 patients with a mean age of 11.6 ± 4.7 years (range 3.1–18.5 years) were performed according to VSP. Among them, 23 procedures were accomplished with PSIs. Surgeries with PSIs were 45 min shorter, with fewer fluoroscopy shots. Optimal correction was achieved in 37% of procedures, while the remaining cases showed under-corrections (41%) or over-corrections (22%). Major complications were observed in four patients (13.8%). (4) Conclusions: The In-Office 3D Printing Point of Care is becoming an essential tool for planning and executing complex corrections of lower limb deformities, but additional research is needed for optimizing the prediction and accuracy of the achieved corrections. Full article

The aim of this review was to provide dentists with comprehensive information regarding dentin hypersensitivity. This includes presenting its etiology, outlining the process of diagnosis, discussing clinical management strategies, and exploring technical approaches aimed at alleviating sensitivity. Dentin hypersensitivity is characterized by distinctive short, sharp pain arising from exposed cervical dentin in response to various external stimuli. The etiological factors cause two specific changes in teeth. First, the dentin surface must be exposed and denuded, which requires the loss of enamel or gingival recession combined with the loss of cementum. The second condition is the opening of the dentin tubules to allow the sensory mechanisms in the pulpal area following stimulation of the dentin surface. The accurate diagnosis of dentin hypersensitivity before receiving therapies is critical for successful treatment. The diagnosis of the disease starts through investigating the medical history of the patient and examination. In the examination, some techniques such as air stream and water rinsing are used in order to simulate the stimulating factors and to determine the degree of pain of the patient. Numerous materials and methods have been proposed to reduce or alleviate sensitivity. These materials typically exert their effects by either sealing dentin tubules or disrupting the transmission of nerve impulses. Generally, the primary approach in addressing dentin hypersensitivity involves the utilization of toothpaste containing potassium salts and fluoride. Newly introduced materials and in-office methods for treating dentin hypersensitivity include bioactive glasses, iontophoresis, CPP-ACP, and lasers. Full article