Search Results (1,865)

Pure titanium (Ti) and its alloys are the gold standard for dental implants because a stable titanium dioxide passive film provides excellent corrosion resistance in physiological environments. In this study, we aimed to examine electrochemical interactions between Ti and cobalt–chromium–molybdenum alloy (CoCrMo), and between a novel Ti–magnesium composite (BIACOM TiMg) and CoCrMo, when immersed in everyday solutions representing beverage or oral hygiene exposure. Test solutions included Coca-Cola^®, lemon juice, Elmex^® fluoride gel, Listerine^® Cool Mint, and Sensodyne^® fluoride paste. Immersion experiments paired Ti sticks with CoCrMo sticks and, separately, BIACOM TiMg with CoCrMo sticks, with three measurements per configuration. When galvanically coupled with CoCrMo, immersion in Coca-Cola produced galvanic potential differences of ~983 mV for the BIACOM TiMg-CoCrMo couple and 830 mV for the commercially pure grade 4 (CP4) Ti-CoCrMo couple, indicating significant electrochemical instability. Both materials showed significant potential increases in Elmex fluoride gel. Listerine Cool Mint and Sensodyne fluoride exposure produced electrochemical interactions exceeding 200 mV. Significant differences in corrosion stability were observed between CP4 Ti and BIACOM TiMg. These findings indicate that material pairing and electrolyte environment significantly influence galvanic behavior, with the Ti-Mg composite showing greater susceptibility than CP4 Ti, informing dental/biomedical material selection in oral environments. Full article

Background/Objectives: Caries adjacent to restorations remain a leading cause of restoration failure and replacement. Conventional diagnostic methods are limited by subjectivity and restricted visualization. Fluorescence-enhanced three-dimensional (3D) imaging has been proposed to improve detection accuracy, but evidence on its clinical perception and usability remains scarce. The objective of this study was to evaluate the perceived diagnostic value of fluorescence-enhanced 3D imaging in detecting caries adjacent to direct restorations. Methods: A cross-sectional questionnaire-based survey was distributed to undergraduate dental students and licensed dentists (n = 94). Participants assessed images of extracted teeth with direct restorations presented in three formats: conventional photographs, monochromatic 3D models, and 3D models with fluorescence. Responses were analyzed using descriptive statistics, chi-square tests, and Cohen’s kappa to measure inter-rater agreement. Results: Overall, 64.9% of respondents reported that fluorescence-enhanced images improved their diagnostic decision-making, while 29.8% reported partial benefit. Fluorescence was mainly perceived as helpful in defining cavity margins (53.3%) and assessing lesion volume (42.4%). Most participants preferred 3D models with fluorescence over conventional images for diagnostic value. However, inter-rater agreement was generally poor (κ range: –0.05 to 0.25; median κ = 0.02; only 4 images showed weak but statistically significant agreement), with only a few images demonstrating weak but statistically significant agreement. Notably, 39.3% of participants reported prior experience with 3D imaging, which was associated with greater confidence in interpreting fluorescence-enhanced images. Participants with prior 3D imaging experience reported greater confidence in fluorescence interpretation. Conclusions: While fluorescence-enhanced 3D imaging is perceived as a useful adjunct for visualizing lesion margins and depth, it does not currently yield consistent diagnostic agreement across clinicians. Training, calibration, and integration of artificial intelligence support may enhance the clinical reliability of this technology. Full article

Using multifunctional dual-cure smart bioactive resin luting agents (DRLs) offers benefits in adhesive dentistry, but their optical stability remains a concern. Their pre-cured form is a shear-thinning structure with thixotropic gel-like behavior. The effect of their hydrophilicity and different thicknesses of nanoceramic hybrid on the final shade of milled esthetic restorations needs further investigation. This study examined how the optical function deterioration of dual-cure smart bioactive resin luting agents used to bond a CAD/CAM nano-ceramic hybrid composite would influence the restoration’s final shade at three different thicknesses. A nanoceramic hybrid composite (GD) was cut into blocks and grouped by thickness (0.8, 1.0, 1.5 mm). Ten blocks from each group were assigned to subgroups based on the DRL type: Panavia SA Universal (PN), Predicta Bioactive (PR), and ACTIVA BioACTIVE (AC). Color and whiteness changes after a 24 h/day (24 days) coffee immersion were analyzed using statistical methods (ANOVA and Tukey’s HSD for ΔE₀₀; Welch’s ANOVA and Games-Howell for ΔWI_D and ΔL*). DRL type significantly affected ΔE₀₀, ΔWI_D, and ΔL* (p < 0.001). All materials showed the least color change and optical function deterioration at a restoration thickness of 1.5 mm, which was below the acceptability threshold (AT). Despite PR’s bioactive functionality, it maintained its primary optical function with the least color change at GD thicknesses of 1.0 and 1.5 mm (p < 0.001). AC exhibited the greatest ΔE₀₀ above AT, especially at a thickness of 0.8 mm (p < 0.001). ΔL*, ΔE₀₀, and ΔWI_D varied significantly based on DRL type, GD thickness, and the interaction between DRL and thickness (p < 0.05). This suggests that although dual-cure smart DRLs containing bioactive glasses are advantageous, their optical function shifts may become more noticeable in thin, translucent restorations. Increasing the restoration thickness can help mitigate this by altering the optical pathway. Full article

Periodontal disease represents a major global concern characterized by chronic biofilm-driven inflammation, excessive oxidative stress, progressive tissue destruction, and impaired regenerative capacity. Beyond conventional antimicrobial approaches, recent progress has shifted toward host-directed and regenerative therapeutic strategies aimed at restoring both oral function and tissue homeostasis. This review consolidates current developments in nanobiotechnology-based materials that modulate immune responses, scavenge reactive oxygen species, and promote angiogenesis and osteogenesis, thereby facilitating the effective regeneration of dental and periodontal tissues. Emphasis is placed on bioresponsive hydrogels, bioactive scaffolds, and gas-releasing platforms that integrate therapeutic regulation with tissue repair. The discussion further highlights key advances in polymeric and inorganic biomaterials designed to balance antibacterial action with cellular compatibility and regenerative potential. By linking pathophysiological mechanisms with material-guided healing processes, this review provides a comprehensive perspective on emerging nanobiotechnological solutions that bridge patho-therapeutics with regenerative and clinical dentistry. Full article

This in vitro study evaluated the shear bond strength (SBS) of four CAD/CAM (Computer aided design/Computer aided manufacturing) polymer-based indirect composites bonded to dentin and microhybrid composite substrates using two resin cements. Gradia Plus (GP), Ceramage (Ce), Tescera ATL (TA), and Lava Ultimate (LA) were fabricated into cylindrical specimens (3 × 3 mm). Dentin substrates were obtained from extracted molars, while composite substrates were prepared from Filtek Z250 (4 mm × 2 mm). Bonding was performed using either a self-adhesive resin cement (RelyX U200; RU200) or a dual-cure adhesive resin cement (RelyX Ultimate; RU), resulting in 16 experimental groups (n = 12 per group). SBS was measured using a universal testing machine (1 mm/min), and failure modes were assessed under stereomicroscopy. Bond strength was significantly higher on composite substrates than on dentin (p < 0.001), primarily due to favorable polymer–polymer compatibility and matrix interdiffusion, which improved stress accommodation at the adhesive interface. TA and Ce showed superior adhesion when combined with RU, while LA exhibited the lowest values, particularly on dentin bonded with RU200. Overall, the dual-cure adhesive system provided stronger bonding than the self-adhesive system (p < 0.05). These findings highlight the influence of substrate type, composite architecture, and cement chemistry on interfacial performance in indirect polymer-based restorations. Full article

Background/Objectives: Malocclusion is one of the most prevalent oral health concerns in paediatric dentistry, with anterior open bite (AOB) and posterior crossbite (PCB) being among the most common forms. Non-nutritive sucking habits (NNSHs), including digit-sucking habits (DSHs) and pacifier-sucking habits (PSHs), have been linked to malocclusion development. While both habits are known to impact dental and skeletal development, their comparative effects remain unclear. This systematic review and meta-analysis aims to determine the difference in the development and prevalence of anterior open bite and posterior crossbite between patients with digit-sucking and pacifier-sucking habits. Materials and Methods: An exhaustive review of the literature was conducted on the 25 November 2024 across three databases, namely EBSCOhost (including PubMed-Medline), Web of Science and Scopus. The following PICO question was constructed for the systematic review: “In children and teenagers, is there a difference in the development and prevalence of malocclusions (Anterior Open bite & Posterior Crossbite) between patients with a history of digit sucking habits and patients with a history of pacifier sucking habits?”A meta-analysis was also performed with the selected studies, and the software used to carry out the meta-analysis was R 4.3.1 (R Core Team (2023)). Results: From the initial search, 102 articles were found and a further 11 articles were obtained from manual findings. 12 articles were included in the final systematic review and meta-analysis. The meta-analysis indicated that the risk of AOB and PCB was increased by both DSH and PSH. Conclusions: Both DSH and PSH significantly increased the risk of AOB and PCB. PSH posed a significantly higher risk than DSH for PCB development (OR = 2.66, p < 0.001), while no significant difference in AOB prevalence was observed between DSH and PSH (OR = 1.77, p = 0.150). Full article

Extracellular vesicle (EV)-based therapies have emerged as promising, cell-free approaches for dental tissue regeneration. This narrative review integrates mechanistic insights, therapeutic efficacy data, and safety and delivery considerations from in vitro and in vivo studies to elucidate the molecular mechanisms by which EVs, particularly those from dental pulp stem cells (DPSCs) and mesenchymal stem cells (MSCs), drive regenerative processes via key signalling axes (PI3K/Akt, MAPK, BMP/Smad, and Hedgehog). Preclinical studies demonstrate that unmodified and engineered EVs enhance odontogenic differentiation, angiogenesis, bone repair, and immunomodulation in models of pulp regeneration, alveolar bone defects, osteonecrosis, and periodontitis. Isolation and purification methodologies were also evaluated, comparing ultracentrifugation, size-exclusion chromatography, and density-cushion approaches, and discussing how protocol variations affect EV purity, dosing metrics, and functional reproducibility. Early-phase clinical evaluations report only low-grade transient adverse events, underscoring a generally favourable safety profile. Despite these encouraging results, significant challenges remain: heterogeneity in EV cargo composition, lack of standardised potency assays, and incomplete long-term safety data. The review highlights the urgent need for rigorous, harmonised regulatory frameworks and robust quality control measures to ensure that EV-based modalities can be translated into safe, effective, and reproducible therapies in regenerative dentistry. Full article

Background: Digital intraoral scanning has become an essential component of modern restorative dentistry, offering enhanced accuracy, workflow efficiency, and patient comfort compared to conventional impression techniques. Despite these advantages, the accuracy of intraoral scanners (IOS) can be affected by multiple parameters, among which scanning strategy and device design are particularly influential. Purpose: This study aimed to investigate the effect of different scanning strategies on scan accuracy and precision, focusing on two widely used intraoral scanners (Medit i700 and Trios 5) in a controlled in vitro environment. Materials and Methods: A standardized digital test object was created according to ISO 20896-1 specifications to ensure uniformity and comparability. The object was printed using a high-precision 3D printer and scanned multiple times with both IOS systems, employing distinct scanning strategies under identical environmental conditions. Data analysis was performed using descriptive and comparative statistics, including Mean, Median, Mean Absolute Deviation (MAD), Root Mean Square Error (RMSE), Standard Deviation (SD), and Variance, to evaluate trueness and precision. Results: The Medit i700 consistently exhibited lower deviation values and greater precision compared with the Trios 5, reflecting higher trueness and precision. Scanning strategy influenced scan outcomes; structured, systematic scanning paths produced more stable and accurate datasets. The Trios 5 demonstrated higher variability, suggesting increased sensitivity to operator motion and scanning trajectory. Conclusions: Both the scanner type and scanning strategy substantially affect intraoral scan accuracy. The superior performance of the Medit i700 indicates greater robustness and operator-independent stability. Clinically, these results underscore the importance of standardized scanning protocols, as operator consistency may be a key determinant of digital impression accuracy and, consequently, of clinical outcomes. Full article

Objectives: The aim of this study was to present and describe a digital workflow integrating Digital Smile Design (DSD) with computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing technologies for the fabrication of dental preparation guides, focusing on workflow feasibility, design reproducibility, and clinical handling. Materials and Methods: A digital workflow was implemented using intraoral scanning and Exocad DentalCAD 3.1 Elefsina software to design dental preparation guides based on digitally planned restorations. Preparation margins, insertion paths, and minimal material thickness were defined virtually. The guides were fabricated using both subtractive (PMMA milling) and additive (stereolithographic-based 3D printing) manufacturing techniques. Post-processing included chemical cleaning, support removal, additional light curing, and manual finishing. The evaluation was qualitative and descriptive, based on visual inspection, workflow performance, and guide adaptation to printed models. Results: The proposed digital workflow was associated with consistent fabrication of preparation guides and predictable transfer of the virtual design to the manufactured guides. Digital planning facilitated clear visualization of preparation margins and insertion axes, supporting controlled and minimally invasive tooth preparation. The workflow demonstrated good reproducibility and efficient communication between clinician and dental technician. No quantitative measurements or statistical analyses were performed. Conclusions: Within the limitations of this qualitative feasibility study, the integration of DSD with CAD/CAM and 3D printing technologies represents a viable digital approach for designing and fabricating dental preparation guides. The workflow shows potential for improving predictability and communication in restorative dentistry. Full article

Background: Patients with dental phobia frequently require intravenous sedation (IVS) to undergo dental treatment; however, some can gradually discontinue IVS through repeated clinical experiences. The physiological and psychological factors influencing successful IVS withdrawal remain unclear. This study aimed to compare physiological (sAA, HR) and subjective (VAS) measures between patients who discontinued IVS and those who remained dependent on IVS. Methods: This prospective cohort study included 51 patients with dental phobia treated under IVS. Participants were classified into a Non-Sedation Group (NSG; n = 25) and a Sedation-Dependent Group (SDG; n = 26) based on their ability to discontinue IVS during the course of treatment. Salivary alpha-amylase (sAA), heart rate (HR), and visual analog scale (VAS) scores for fear, tension, and anxiety were assessed at predefined time points from the waiting room to venous cannulation. Treatment satisfaction and expectations for future treatment were also evaluated. Results: sAA activity was significantly higher in the SDG than in the NSG at T0 and T1 (p < 0.05), indicating higher levels of selected physiological measures during anticipatory phases; however, the difference at T2 was not significant. HR differed significantly only in the waiting room, whereas no between-group differences were observed in self-reported VAS scores for fear, tension, or anxiety at any time point, indicating a dissociation between physiological and subjective stress measures. Treatment satisfaction and expectations for future treatment were significantly higher in the SDG. Conclusions: Patients who remained dependent on IVS showed higher levels in selected physiological measures at the group level during anticipatory stages, whereas no corresponding differences were observed in self-reported subjective measures. These findings are exploratory and descriptive in nature and do not imply predictive or causal relationships. Full article

Objectives: This systematic review aims to evaluate the effectiveness of autologous Plasma Rich in Growth Factors (PRGF) in enhancing post-extraction socket healing by synthesizing evidence from randomized controlled trials and assessing outcomes related to bone regeneration, soft-tissue healing, and postoperative discomfort. Methods: A comprehensive search was conducted in MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, and CINAHL, using a fully reproducible Boolean search strategy. Non-English studies were screened but excluded only when a reliable translation was not feasible. Only randomized controlled trials (RCTs) involving PRGF application in human extraction sockets were included. Risk of bias was assessed using the Cochrane RoB2 tool. A meta-analysis could not be performed due to substantial heterogeneity in PRGF preparation protocols, follow-up duration, and outcome measurements. Results: Seven RCTs met the eligibility criteria. Four studies demonstrated significantly improved healing outcomes in the PRGF group compared with controls, whereas two studies reported comparable results. Pain reduction was consistently observed in PRGF-treated sockets in studies that reported standardized postoperative analgesic protocols. Mineralized tissue formation favored PRGF in high-quality trials. Considerable heterogeneity was identified in PRGF centrifugation parameters, outcome tools, and evaluation timelines. Conclusions: Evidence from current RCTs supports PRGF as an effective and well-established adjunct for enhancing early post-extraction healing. The novelty of this review lies in its updated methodological rigor, corrected risk-of-bias analysis, standardized data handling, and clarification of long-standing gaps in reporting PRGF preparation variability. Future trials with standardized PRGF protocols and long-term follow-up are needed to improve comparability and strengthen clinical recommendations. Full article

Background: This study aimed to investigate the association between occlusal splint use and several key parameters, including body position perception, tongue pressure, temporomandibular joint dysfunction (TMD) severity, jaw functional limitation, and neck muscle endurance. Methods: A total of 157 individuals diagnosed with bruxism were screened, and 52 eligible participants were enrolled and divided into two groups: occlusal splint users (n = 26) and non-users (n = 26). Body position perception was assessed with a digital inclinometer, tongue pressure was measured using the Iowa Oral Performance Instrument (IOPI), and neck muscle endurance was evaluated by the Cranio-Cervical Flexion Test (CCFT). TMD severity and jaw functional limitation were assessed via the Fonseca Anamnestic Questionnaire and Jaw Functional Limitation Scale-20, respectively. Gender-based analyses showed higher TMD severity and mandibular limitation scores in females using occlusal splints than in males. Results: No statistically significant differences were found between the splint and non-splint groups in body position perception, tongue pressure and neck muscle endurance (p > 0.05). However, significant differences were observed in the Jaw Functional Limitation Scale (CFKS) subscales. Splint users reported higher functional limitations in chewing, mobility, and expression compared to non-splint users (all p = 0.000), with small effect sizes (d = 0.23–0.29). Conclusions: Occlusal splint use was not associated with better proprioception, orofacial muscle function, or TMD-related symptoms compared with non-splint users. However, splint users were associated with higher mandibular functional limitation based on CFKS subscale scores. Full article

Background/Objectives: The clinical application of CAD/CAM restorative materials continues to evolve due to increasing demand for aesthetic, durable, and minimally invasive indirect restorations. Hybrid nanoceramics, such as Grandio disc (VOCO GmbH, Cuxhaven, Germany), are increasingly used in indirect restorative dentistry due to their favourable combination of mechanical strength, polishability, wear resistance, and bonding potential. One challenge associated with adhesive protocols for CAD/CAM materials lies in achieving durable bonds with resin cements. Extensive post-polymerization during fabrication reduces the number of unreacted monomers available for chemical interaction, thereby limiting the effectiveness of traditional adhesive strategies and necessitating specific surface conditioning approaches. This study aimed to evaluate, in a preliminary, non-inferential manner, the influence of several combined conditioning protocols on surface micromorphology, elemental composition, and descriptive SBS trends of a CAD/CAM hybrid nanoceramic. This work was designed as a preliminary pilot feasibility study. Due to the limited number of specimens (two discs per protocol, each providing two independent enamel bonding measurements), all bond strength outcomes were interpreted descriptively, without inferential statistical testing. This in vitro study investigated the effects of various surface conditioning protocols on the adhesive performance of CAD/CAM hybrid nanoceramics (Grandio disc, VOCO GmbH, Cuxhaven, Germany) to dental enamel. Hydrofluoric acid (HF) etching was performed to improve adhesion to indirect resin-based materials using two commercially available gels: 9.5% Porcelain Etchant (Bisco, Inc., Schaumburg, IL, USA) and 4.5% IPS Ceramic Etching Gel (Ivoclar Vivadent, Schaan, Liechtenstein), in combination with airborne-particle abrasion (APA), silanization, and universal adhesive application. HF may selectively dissolve the inorganic phase, while APA increases surface texture and micromechanical retention. However, existing literature reports inconsistent results regarding the optimal conditioning method for hybrid composites and nanoceramics, and the relationship between micromorphology, elemental surface changes, and adhesion remains insufficiently clarified. Methods: A total of ten composite specimens were subjected to five conditioning protocols combining airborne-particle abrasion with varying hydrofluoric acid (HF) concentrations and etching times. Bonding was performed using a dual-cure resin cement (BiFix QM) and evaluated by shear bond strength (SBS) testing. Surface morphology was examined through environmental scanning electron microscopy (ESEM), and elemental composition was analyzed via energy-dispersive X-ray spectroscopy (EDS). Results: indicated that dual treatment with HF and sandblasting showed descriptively higher SBS, with values ranging from 5.01 to 6.14 MPa, compared to 1.85 MPa in the sandblasting-only group. ESEM revealed that higher HF concentrations (10%) created more porous and irregular surfaces, while EDS indicated an increased fluorine presence trend and silicon reduction, indicating deeper chemical activation. However, extending HF exposure beyond 20 s did not further improve bonding, suggesting the importance of protocol optimization. Conclusions: The preliminary observations suggest a synergistic effect of mechanical and chemical conditioning on hybrid ceramic adhesion, but values should be interpreted qualitatively due to the pilot nature of the study. Manufacturer-recommended air abrasion alone may provide limited adhesion under high-stress conditions, although this requires confirmation in studies with larger sample sizes and ageing simulations. Future studies should address long-term durability and extend the comparison to other hybrid CAD/CAM materials and to other etching protocols. Full article

Background/Objectives: This systematic review and meta-analysis aimed to evaluate the clinical performance and survival of bulk-fill resin composite restorations in posterior primary teeth, compared with conventional resin composites and glass ionomer cements (GICs). Methods: The protocol was registered in PROSPERO (CRD42024539097) and conducted according to PRISMA guidelines. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, and Cochrane databases up to December 2025. Randomized clinical trials (RCTs) evaluating bulk-fill resin composite restorations in primary molars were included. Restoration survival was considered the primary clinical endpoint. Secondary outcomes included marginal integrity, marginal discoloration, color match, postoperative sensitivity, secondary caries, retention, and anatomical form, assessed using USPHS or FDI criteria. Meta-analyses were performed for color match, marginal discoloration, and marginal integrity using a random-effects model. Comparisons involving GICs were synthesized descriptively. Risk of bias was assessed using the RoB 2 tool, and certainty of evidence was evaluated using GRADE. Results: Six RCTs involving 1220 restorations in children aged 3 to 10 years were included, with follow-up periods ranging from 6 to 24 months. Survival rates were high across all materials. Meta-analyses up to 12 months showed no significant differences between bulk-fill and conventional resin composites for color match, marginal discoloration, or marginal integrity. Most RCTs were judged as having low risk of bias, with one study presenting some concerns. The certainty of evidence was rated as moderate, mainly due to imprecision related to sample size and limited reporting of confidence intervals. Conclusions: Bulk-fill resin composites demonstrate clinical performance and survival comparable to conventional resin composites in posterior restorations of primary teeth over follow-ups of up to 12 months. Based on RCTs with predominantly low risk of bias and moderate certainty of evidence, bulk-fill composites represent a reliable and efficient restorative option in pediatric dentistry. Full article

Background and Objectives: Periodontal disease, characterized by progressive destruction of tooth-supporting tissues, often results in substantial alveolar bone loss, necessitating regenerative interventions such as guided bone regeneration (GBR). Insulin-like growth factor 2 (IGF-2) has emerged as a promising biomolecule for periodontal regeneration because of its osteogenic and immunomodulatory properties. Materials and Methods: A comprehensive literature search was conducted across five electronic databases (Scopus, ScienceDirect, PubMed, Wiley, and EBSCO). Studies examining the use of IGF-2 in periodontal or alveolar bone regeneration, including randomized controlled trials, animal studies, and in vitro experiments, were included. Results: Three studies met the inclusion criteria. In vitro, IGF-2 was associated with enhanced osteogenic differentiation and mineralization of mesenchymal stem cells, along with upregulation of key osteogenic markers. In animal models, IGF-2 treatment was associated with increased osteogenesis, greater bone volume, and a shift in macrophage polarization toward a less inflammatory phenotype. However, heterogeneity in study designs, protocols, and outcome measures limited direct comparisons. Conclusions: In vitro, IGF-2 was associated with enhanced osteogenic differentiation and mineralization of mesenchymal stem cells, accompanied by upregulation of key osteogenic markers. In animal models, IGF-2 treatment was associated with increased osteogenesis, greater bone volume, and a shift in macrophage polarization toward a less inflammatory phenotype. Full article