Search Results (986)

Objective: This study aimed to assess the impact of different adhesive systems on the color stability of composite veneers following their exposure to various common beverages. Materials and Methods: A single layer of commercially available adhesives (4th and 7th generations) and two experimental adhesives based on hydroxyapatite and bioactive glass were applied, followed by composite restoration on incisor typodonts. The typodonts were prepared with depths of 0.3, 0.5, and 0.7 mm at the cervical, middle, and incisal regions, respectively. Samples from each group were immersed in coffee, Cola, and deionized water, and color stability was analyzed on days 1 and 60. One-way and two-way analyses of variance were performed. Results: The interaction between groups and solutions was statistically significant (p = 0.001) across all tooth regions. Coffee and Cola caused significant color changes (p = 0.001). The 4th generation demonstrated better color stability than the 7th generation in the middle and cervical regions (p-values = 0.083 and 0.003, respectively). The findings showed that the bioactive glass-based bonding agent exhibited greater discoloration than the hydroxyapatite-based adhesive (p = 0.001). Conclusions: The composite thicknesses are influenced differently by adhesives with respect to shade matching. Bioactive materials-based adhesives showed more resistance towards color change than commercial adhesives. Full article

This study compares the two (2D)- and three-dimensional (3D) accuracy of tooth reduction depths in porcelain laminate veneer prepared using conventional and 3D-printed guide techniques. Forty 3D-printed maxillary casts were divided into four groups: freehand (FH) (n = 10), silicone guide (SG) (n = 10), cross-shaped 3D-printed guide (3D_C) (n = 10), and stackable 3D-printed guides (3D_S) (n = 10). Butt-joint veneer preparation was performed on the left central incisor. Two-dimensional analysis was performed to assess trueness using mean absolute differences (MADs) from the planned depth at eight designated points, while precision was compared within groups. Three-dimensional analysis evaluated trueness by superimposing post-preparation scans with reference casts and precision via intra-group superimposition, with deviation errors measured using the Root Mean Square (RMS) method. One-way ANOVA and Bonferroni post hoc tests were used (α = 0.05). In 2D analysis, 3D_S exhibited a significantly lower MAD than FH at most of the measured points (p < 0.05), more accurate incisal reduction at mesial and distal points compared to 3D_C (p < 0.001), and more accurate mesial (p = 0.011) and distal (p = 0.001) cervical margin preparation than SG. In the 3D trueness assessment, 3D_S exhibited significantly lower deviation errors than FH (p < 0.001) and SG (p = 0.012) while also achieving the highest overall 3D precision with the lowest RMS (0.067 ± 0.013), followed by 3D_C (0.086 ± 0.019). Veneer preparation guided by a stackable 3D-printed guide resulted in more accurate tooth reduction depths compared to the other three techniques. Full article

Background/Objectives: Facial and intraoral parameters are important guidelines in prosthetic planning and rehabilitation. This study aimed to analyze and determine the relationship between facial parameters and measurements on the upper anterior teeth using digital photography of the participants. Methods: This cross-sectional observational study included 82 student participants. Digital images (front facial and dental view) were taken of each participant, and then standardized images were used to measure facial and dental parameters. Results: The width of the maxillary anterior teeth and facial parameters were greater in males than in females, except for the medial canthus of the eye, which was slightly larger in females. A significant positive correlation was found between all facial parameters and the widths of the central and lateral incisors, as well as their combined sum. The strongest correlation was observed between the lateral canthus of the eye and the total width of the maxillary anterior teeth (r = 0.546; p < 0.001). In regression analysis, it was shown that the bizygomatic width had a statistically significant contribution to the prediction of the central incisor width (p = 0.045). It was also shown that the intraoral parameters, such as the height of the interdental papilla and interpapillary angle, are shape-dependent. Interincisal angles between the central incisors in all participants are significantly lower (p < 0.05) than the angles between incisal edges in other anterior teeth. Conclusions: Facial parameters cannot be used independently to predict dental parameters; nevertheless, when integrated with basic esthetic principles, they provide complementary information relevant to analytical procedures in restorative and prosthetic dentistry. Full article

This study evaluated the effectiveness and safety of mechanical debridement (MD) in treating experimental peri-implantitis (EPI) in rats with osseointegrated implants, specifically those treated with high-dose zoledronate. Senescent Wistar rats underwent the extraction of their upper incisor, followed by immediate implant placement. After 8 weeks, the implants were exposed, and a transmucosal component was placed. The animals were divided into four groups: Control (C), ZOL, ZOL-EPI, and ZOL-EPI-MD. In the 9th week, drug treatment commenced, consisting of the administration of 0.45 mL of a vehicle (for group C) or zoledronate (for groups ZOL, ZOL-EPI, and ZOL-EPI-MD) every 4 days over 10 weeks. After 5 weeks of drug treatment, a cotton bandage was placed around the implants to induce EPI in the ZOL-EPI and ZOL-EPI-MD groups. In the ZOL-EPI-MD group, the ligature was removed at week 16, and local treatment was performed using MD. Euthanasia was conducted at week 19. Histological sections were obtained and stained with hematoxylin–eosin for histopathological and histometric analyses, such as the percentage of total bone tissue (B.Ar/T.Ar) and the percentage of non-vital bone tissue (NVB.Ar/B.Ar). Immunohistochemical reactions were performed to detect TNFα, IL-1β, VEGF, OCN, and TRAP. In the peri-implant connective tissue, mild, intense, and moderate inflammatory infiltrates were observed in the ZOL, ZOL-EPI, and ZOL-EPI-MD groups, respectively. Immunolabeling for TNFα and IL-1β correlated with these histopathological findings. The ZOL and ZOL-EPI-MD groups showed lower immunolabeling for VEGF compared to the control group. There was a reduction in TRAP-positive cells and lower immunolabeling for OCN in the groups treated with zoledronate, with the ZOL-EPI-MD group displaying even lower levels of OCN compared to the ZOL group. While there was no significant difference in B.Ar/T.Ar across the groups, both the ZOL, ZOL-EPI, and ZOL-EPI-MD groups exhibited higher levels of NVB.Ar/B.Ar, with the ZOL-EPI-MD group showing the highest NVB.Ar/B.Ar compared to ZOL and the other groups. In conclusion, MD, as a standalone treatment, showed neither effectiveness nor safety in the management of EPI in rats that received high doses of zoledronate. Full article

The present work explores the effects of dental splints from a mechanical standpoint, aiming to provide a practical tool for the surgical decision-making process regarding splint cross-section dimensions. Our investigation centers on the anatomical structure of a pentamorphic dental arch encompassing central and lateral incisors and one canine on each side. Using parametric in silico models built up by means of an ad-hoc procedure, geometry, material properties, and boundary conditions are defined on a parametric anatomical model that can be tailored using RX-derived geometrical information. Two general cases have been considered, one with the splint and the other splintless, and a sensitivity analysis has been performed by varying the splint section height and thickness. The results show the diminishing mobility at the apex and basis of the diseased incisors, demonstrating the effectiveness of the periodontal treatment. Moreover, the stress due to physiological loads moves away from diseased teeth toward the healthy ones due to the splint effects, focusing on the splint–glue–canine contact zone and highlighting the crucial role played by the canine in fixing the entire dental structure. To establish a preliminary mechanical assessment of the dental structure’s safety and to confine its actual value within a mechanically reasonable range, a synthetic “traffic-light” indicator of stress-based failure risk is proposed. It is felt that the tool proposed in this study can help surgeons assess the pre-operative patient-specific mechanical effects of the splint treatment, driving the design and choice of periodontal splints. By linking splint geometry to mechanical safety via a stress-based indicator, the method supports the optimized design and selection of splints, improving treatment reliability while preserving comfort and clinical effectiveness. Full article

Background/Objectives: This article presents a novel approach that combines the Palatal Silicone Key and Injection Molding techniques as a viable alternative for complex anterior cases with high esthetic demands, where layering multiple shades is essential to achieve a natural appearance, rather than using a single monochromatic composite. Methods: The Palatal Silicone Key technique utilizes a silicone index to transfer palatal and incisal anatomy from a diagnostic wax-up, allowing freehand layering of proximal and buccal surfaces with multiple composite shades. The Injection Molding technique provides a simpler and more predictable workflow by using a transparent silicone index to replicate the wax-up. However, the original injection technique relies on a single-shade composite, limiting the esthetic outcomes. In the presented case canines and first premolars were reshaped to replace congenitally missing lateral incisors. Palatal surfaces were built with medium-viscosity enamel shade composite using the silicone key, and dentin anatomy was sculpted freehand with dentin shade composite. Buccal anatomy was restored by injecting enamel shade flowable composite into the transparent index. Results: This combined protocol facilitated the precise transfer of the wax-up, minimizing adjustments, while the use of multiple composite shades reproduced the natural translucency of adjacent teeth, resulting in highly esthetic restorations. Conclusions: Handling traditional composites in complex anterior cases can be time-consuming and technique-sensitive. The presented combination of techniques, while requiring a high level of skill and precision, integrates the strengths of both approaches, enabling a minimally invasive, additive workflow with reduced clinical time and more predictable esthetic outcomes. Full article

Horses’ hypsodont (high-crowned) teeth face permanent dental wear. This is compensated for by a continuous eruption, which requires a high adaptability of odontoblasts; otherwise, the dental pulp would be exposed. Here, we report on how equine odontoblasts respond to the challenge of maintaining a high production rate of dentin. We analyzed CD90, a marker of odontoblastic differentiation, and nestin, a marker of mature odontoblasts, in equine pulpal tissue via immunofluorescence. For comparison, we examined the hypselodont (ever-growing) incisors and brachydont (short-crowned) molars of rats. Immunofluorescence and Western blot analysis of pulpal tissue revealed a higher content of CD90-positive cells in hypsodont equine teeth than in brachydont and hypselodont rat teeth. The odontoblastic layer of hypsodont teeth was positive for CD90 (marker for differentiating odontoblasts), which was not the case for brachydont and hypselodont rat teeth. Most samples of hypsodont teeth were negative for nestin, whereas in hypselodont and brachydont teeth, odontoblasts were positive for nestin (marker for mature odontoblasts). Our findings suggest that there is a constant replacement of odontoblasts in the equine dentition, enabling a continuous high production rate of dentin. These results contradict the idea of lifelong vital, postmitotic and productive odontoblasts. Full article

Design: Retrospective observational cohort study conducted at university and private practice setting. Objective: To evaluate whether operator experience affects the predictability of orthodontic tooth movements and the overall treatment duration in clear aligner therapy. Materials and Methods: This retrospective observational study was conducted at the Dental School of the University of Turin and in private orthodontic settings. Seventy-two patients (50 females, 22 males; median age: 24.6 years; IQR = 5.9) with mild to moderate malocclusions were included and equally distributed between two groups: 36 patients treated by postgraduate orthodontic students (Group B) and 36 patients treated by experienced orthodontists (Group E). Post-treatment digital models were analyzed to assess discrepancies between the predicted and achieved tooth positions. The accuracy of specific movements—rotation, vertical displacement, and treatment duration—was statistically evaluated using the Mann–Whitney U test. Most of these differences, although statistically significant, remained below established thresholds for clinical relevance (0.5 mm/2°). Results: Expert operators achieved significantly greater accuracy in controlling the vertical movements of the upper central incisors (p = 0.01) and the rotational movements of the upper first molars (p = 0.03), upper lateral incisors (p = 0.03), lower incisors (p = 0.001), and lower premolars (p = 0.001). In contrast, non-expert operators demonstrated superior outcomes in the control of vertical movements of the upper premolars (p = 0.01) and in the rotational movement of the lower canines (p = 0.03). Treatment duration was significantly shorter in the expert group, with a median difference of 4.1 months (p = 0.0037). Conclusions: These findings confirm the importance of clinical experience in enhancing the predictability and efficiency of clear aligner therapy, particularly in complex movements. However, the improved performance of non-expert operators in selected areas—such as vertical control of upper premolars and rotation of lower canines—suggests that conservative movement planning may also play a role in improving clinical outcomes. Overall, expert clinicians achieved more predictable tooth movements and shorter treatment durations, underscoring the value of structured training and accumulated clinical expertise in optimizing clear aligner therapy. Full article

Background/objective: To evaluate the effectiveness of resin infiltration in managing anterior molar incisor hypomineralization (MIH) defects, focusing on color improvement, lesion size reduction, sensitivity outcomes and patient aesthetic perception. Enamel defects in MIH result from a combination of environmental, systemic, and genetic factors, indicating a multifactorial etiology. These defects, particularly in anterior teeth, pose significant aesthetic and emotional challenges due to their high visibility. This study provides one of the few prospective clinical evaluations of resin infiltration for anterior MIH lesions, assessing not only objective clinical outcomes but also patients’ aesthetic perception. It further introduces a patient-centered approach by comparing aesthetic evaluations made by children and dental professionals over time. Methods: A total of 109 MIH-affected anterior teeth were treated using Icon^® resin infiltration (DMG, Hamburg, Germany) in this registered prospective clinical study (ClinicalTrials.gov: NCT05597956). Participants were classified as children (6–12 years) and adolescents (13–17 years) according to standard pediatric age definitions. Of these, 101 teeth were available for evaluation at the 6-month follow-up due to patient loss to follow-up. The evaluation included photographic follow-up, measurement of lesion size and color, and assessment of sensitivity. During follow-up visits, patients rated the appearance of their lesions using the FDI scale. Results: Before treatment, spectrophotometric analysis showed that lesions exhibited a reddish hue (mean a* = 2.12), were distinctly yellowish (mean b* = 23.20), and clearly differed from surrounding enamel (ΔE = 8.62). The brightness level (L* = 69.81) indicated medium-high luminosity. Lesion size was reduced by an average of 4.5 percentage points. Significant increases in L values and reductions in a* and b* components were observed, with clinically perceptible ΔE changes. Sensitivity improved in 36.6% of patients, who reported a 1–2 point decrease on the SCASS. Moreover, patients’ aesthetic perception significantly improved after Icon^® infiltration resin. Conclusions: Resin infiltration produced noticeable improvements in color, reduced lesion size and sensitivity, and enhanced aesthetic perception, making it a valuable treatment option for managing MIH-affected anterior teeth in children. Full article

Aim: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of protective mouthguards. Methods: A cross-sectional study was conducted using a self-administered questionnaire among 333 parents in dental clinics in Split and Zagreb, Croatia. The questionnaire assessed sociodemographic data, parental knowledge of TDIs, and prior experience with dental trauma. Statistical analysis included chi-square test (p < 0.05). Results: The overall level of parental knowledge regarding traumatic dental injuries was generally low (7.6 out of 15 points). Almost all parents correctly identified the age when children have primary or permanent teeth. However, less than half knew that an avulsed primary tooth should not be replanted, while about three-quarters recognized that professional help should be sought within 30 min after trauma. Overall, 43.5% of parents reported that their child had experienced dental trauma, most often affecting primary teeth (60.7%), particularly the maxillary central incisor (76.6%). Mothers demonstrated significantly higher knowledge than fathers (p = 0.025), and prior experience or information about dental trauma significantly improved awareness (p < 0.001). Although 54.3% of respondents were unaware of the purpose of dental shields, 82.3% considered them necessary during contact sports, yet only 12.9% reported that their child actually uses them. Conclusions: Within the limitations of this clinic-based study, the findings indicate gaps in parental knowledge regarding the appropriate management of dental trauma. Strengthening parents’ understanding of emergency response and preventive measures may support timelier and appropriate care and contribute to improved outcomes for children experiencing traumatic dental injuries. Full article

Background/Objectives: Geometric morphometric analysis (GMA) is a statistical method that captures and quantifies shape variation. This study aimed to assess hard and soft tissue shape variations and changes following orthodontic treatment in Class III skeletal malocclusion using GMA. Methods: A retrospective study was conducted on 84 lateral cephalometric radiographs (pre-treatment and near-end treatment) of Class III patients aged 16–40 years (ANB < 2°). Thirty-five landmarks were digitized in Cartesian coordinates using MorphoJ software for shape analysis. Results: The sample included 62% females and 38% males, with a mean age of 24.7 ± 5.2 years. Vertical dimension variations (hypodivergent to hyperdivergent) contributed most to shape changes PC1 (23.35%), followed by anteroposterior variations PC2 (13.51%). Gender significantly influenced hard and soft tissue variation with 30.91%SS (F = 56.99, p < 0.0001). Males had significantly larger and longer ramus, body of the mandible, alveolar height, LAFH, TAFH and upper lip length. (PD: 0.026, p < 0.05). Significant shape changes were seen in the mandible (PD = 0.018, p < 0.05). SNB increased by 0.41° (from 81.73° ± 3.67°), and ANB improved by 0.46° but remained Class III (−0.33° ± 1.82°). Lower anterior facial height increased by 1.78 mm (p < 0.05). The lower incisors retroclined significantly (from 92° ± 8.56° to 87° ± 6.96°, p < 0.05), while the interincisal angle increased by 5.9°. Upper incisors remained procline (118° ± 11°, p > 0.05). Upper lip length increased by 0.4 mm (p < 0.05). Conclusions: Vertical and anteroposterior shape variations are notable within Class III malocclusion. Post-treatment changes in both hard and soft tissues indicate that orthodontic camouflage can enhance facial esthetics and skeletal balance. GMA provides objective quantification and visualization of these treatment-related craniofacial changes. Full article

Persistent Idiopathic Dentoalveolar Pain (PIDAP) is a persistent idiopathic toothache that frequently remains unresponsive to medical therapy. Precise targeting of the infraorbital nerve is essential for successful intervention, yet anatomical variability often limits the consistency of conventional radiofrequency ablation (RFA). This report describes a medial-to-lateral ultrasound- and computed tomography-guided approach, intended to align with the natural orientation of the infraorbital canal and potentially enhance electrode–nerve contact. A 48-year-old woman with refractory maxillary incisor pain underwent RFA after only transient benefit from a diagnostic nerve block. Ultrasound enabled accurate identification of the infraorbital foramen and confirmed the canal’s medial-to-lateral course, which then guided CT-assisted needle advancement into the orbitomaxillary segment. The patient experienced immediate analgesia. Pain reduction was maintained at the one-month follow-up. At the two-month assessment, although a mild symptom rebound was observed, no procedure-related complications were noted. This trajectory-based medial-to-lateral technique offers an anatomically grounded alternative for infraorbital nerve RFA and may represent a valuable option for refractory PIDAP. Full article

The spatial relationship between the incisive canal (IC) and maxillary central incisors (U1) is a critical anatomical consideration during orthodontic tooth movement, particularly in patients with maxillary dental midline deviation. This study aimed to evaluate the proximity between the IC and U1 roots in relation to maxillary dental midline deviation using cone-beam computed tomography (CBCT) images. Sixty-four patients with skeletal Class I malocclusion were divided into two groups according to the degree of the maxillary dental midline deviation. Group 1 (n = 32; mean age, 23.95 ± 5.40 years) exhibited < 2 mm deviation (0.28 ± 0.39 mm), whereas Group 2 (n = 32; mean age, 27.75 ± 6.21 years) showed > 2 mm deviation (2.45 ± 0.57 mm). CBCT images were analyzed to measure U1 root length and inclination, IC width, inter-root distance, and U1-IC proximity. In Group 2, the anteroposterior U1-IC distance on the deviated side was significantly shorter than on the contralateral side (p < 0.05), while the shortest U1–IC distances did not differ significantly between sides (p > 0.05). Moreover, a significant negative correlation was observed between differences in U1 inclination and root proximity at most vertical levels, indicating that a more proclined U1 on the deviated side tended to be closer to the IC. These findings suggest that maxillary dental midline deviation may be associated with asymmetric positioning of the U1 relative to the IC and underscore the importance of careful three-dimensional evaluation and individualized biomechanical control when planning orthodontic treatment in patients with midline asymmetry. Full article

Background: Artificial intelligence (AI) integrated with cone-beam computed tomography (CBCT) has rapidly advanced the diagnostic capability of orthodontics, particularly for quantifying external root resorption (ERR). High-risk scenarios such as bilateral maxillary canine impaction require objective tools to guide treatment decisions and prevent irreversible damage. Objectives: To evaluate the diagnostic accuracy and clinical applicability of AI-assisted CBCT for orthodontically induced ERR, and to demonstrate its value in a complex clinical case where decision-making regarding canine traction versus extraction required precise risk quantification and definition of biological limits. Methods: A systematic review following PRISMA 2020 guidelines was conducted in PubMed, ScienceDirect, and Cochrane Library (2015–September 2025). Eligible studies applied AI-enhanced CBCT to assess ERR in orthodontic patients. Additionally, a clinical case with bilaterally impacted maxillary canines was evaluated using CBCT with automated AI segmentation and manual refinement to quantify root volume changes and determine prognostic thresholds for treatment modification. Results: Nine studies met the inclusion criteria. AI-based imaging, predominantly convolutional neural networks, showed high diagnostic accuracy (up to 94%), improving reproducibility and reducing operator dependency. In the clinical case, volumetric monitoring showed rapid progression of ERR in the lateral incisors (LI) associated with a persistent unfavorable 3D spatial relationship between the canines and incisor roots, despite controlled distal traction with skeletal anchorage, leading to a timely change in the treatment plan and extraction of the severely compromised incisors with substitution by the canines. AI-generated data provided objective evidence supporting safer decision-making and prevented further structural deterioration. Conclusions: AI-enhanced CBCT enables early, objective, and quantifiable ERR assessment, strengthening prognosis-based decisions in orthodontics. Findings of this review and the clinical case highlight the translational relevance of AI for managing high-risk cases, such as maxillary canine impaction with extensive LI resorption, supporting future predictive AI models for safer canine traction. Full article

Background/Objectives: Three-dimensional virtual surgical planning (VSP) is increasingly central to contemporary orthognathic surgery, enhancing diagnostic precision and enabling more reliable forecasts of postoperative outcomes. NemoFAB (Nemotec, Madrid, Spain) is a recently developed digital platform that integrates CBCT data, digital dental models, and facial photographs into a single workflow. Despite its growing clinical use, independent validation of its predictive accuracy remains limited. This study evaluated how closely NemoFAB virtual predictions corresponded to actual postoperative results using standardized cephalometric parameters. Methods: Forty adult patients with dento-maxillofacial deformities requiring combined orthodontic–surgical treatment were included. Eleven cephalometric variables—common to both WebCeph (2D) and NemoFAB (3D)—were measured preoperatively, virtually in NemoFAB, and postoperatively. AI-assisted landmark placement was manually verified by two orthodontists. Statistical analyses included repeated-measures ANOVA, paired t-tests, Bland–Altman plots, and intraclass correlation coefficients (ICC) to evaluate agreement and predictive accuracy. Results: Overjet, overbite, maxillary incisor inclination, maxillary incisor exposure, mandibular incisor projection to the True Vertical Line, and occlusal plane angulation all showed statistically significant changes after surgery (p < 0.05). Bland–Altman analysis demonstrated the narrowest limits of agreement in Nemo–Post comparisons, indicating strong predictive alignment. ICC values showed excellent agreement for incisor angulation (ICC = 0.921–0.984) and Pogonion projection (ICC = 0.943). Consistently poor pre-Nemo agreement reflected expected discrepancies between initial anatomy and planned surgical correction. Conclusions: When predicting skeletal and dentoalveolar changes brought about by orthognathic surgery, NemoFAB showed a high degree of agreement, especially for parameters that are directly impacted by jaw repositioning. Its strong concordance with postoperative outcomes supports its reliability for virtual planning, interdisciplinary coordination, and surgical execution. Advances in soft-tissue modeling and AI-driven automation may further enhance predictive accuracy. Full article