Search Results (56)

Background: Preservation of tooth structure is a key principle in pediatric dentistry, where restorative materials must balance mechanical strength with the preservation of pulp vitality and minimally invasive techniques. The aim of this in vitro study, as it relates to pediatric dentistry, was to investigate the flexural strength of common composite resins, glass ionomer cements, and resin-modified glass ionomer cement within standardized and homogeneous laboratory conditions. Methods: This study evaluated the flexural strength of seven restorative materials: four composites (Filtek™ Z250, Filtek™ Supreme XT, Gradia, Premise), two GICs (Ketac™ Molar Easymix, GC Fuji IX GP), and one RMGIC (Vitremer). Standardized specimens were prepared and tested using a three-point bending protocol with a universal testing machine (Zwick-Roell Z005). A total of 49 specimens were fabricated and analyzed. Statistical analysis was performed with a one-way ANOVA followed by Tukey’s post hoc test. Results: The flexural strength value of composite resins was significantly greater than that of the glass ionomer and resin-modified glass ionomer cements (p < 0.001). Filtek™ Z250 had the highest flexural strength, and Vitremer, a resin-modified glass ionomer cement, exhibited intermediate performance. Ketac™ Molar Easymix had the lowest values among conventional glass ionomer cements, whilst the flexural strength values obtained for GC Fuji IX GP were similar to some composite materials but with higher variability. Conclusions: Composite resins remain the most durable option for pediatric restorations in stress-bearing areas, whereas RMGICs provide a compromise between mechanical performance and biological advantages such as fluoride release and biocompatibility. Conventional GICs, despite their lower flexural strength, retain clinical relevance in low-load sites and for patients at a high risk of caries. Material selection in pediatric dentistry should therefore be tailored to the child’s age, tooth location, and functional demands to ensure long-lasting, minimally invasive restorations. This study involved only mechanical properties alone, and biological aspects, such as fluoride release and biocompatibility, were not considered. Material selection in pediatric dentistry should therefore take into account mechanical requirements, restorative location, and clinical environment. Full article

Vital pulp therapy (VPT) seeks to preserve pulp vitality by using biocompatible with regenerative potential. This study tested the hypothesis that an injectable gelatin methacryloyl (GelMA) hydrogel containing piezoelectric barium titanate promotes odontogenic differentiation of dental pulp stem cells (DPSC) significantly better than a commercially available tricalcium silicate material used for vital pulp therapy. First, the light-curable, injectable piezoelectric hydrogel was engineered and characterized for its physicomechanical, piezoelectric properties and biocompatibility to DPSCs. The effect of this gel on the odontogenic differentiation of DPSCs was determined by measuring the expression level of key genes, compared to Biodentine XP. The hydrogel exhibited excellent injectability (<1 kgf of force), mechanical stability, and generated physiologically relevant voltages under cyclic loading mimicking mastication. MTT and ROS assays show no cytotoxic or damaging oxidative stress effects. When DPSCs were cultured over the materials under cyclic loading, the piezoelectric hydrogel significantly enhanced cell viability and upregulated COL1A1, DSPP, and DMP1 expression compared to Biodentine XP and non-piezoelectric hydrogel controls. These findings establish piezoelectric hydrogel as a self-powered, bioactive platform that converts physiological forces into regenerative bioelectric cues, offering a promising next-generation material for vital pulp therapy. Full article

In recent decades, there has been an upsurge in focus on the extraction of pyrite from sulfide ore deposits due to its vital role in the process of metal extraction and environmental management. This study explores the flotation behavior of pyrite in sulfide ores using mechanical-cell flotation. This study compared the performance of two commonly used flotation collectors, potassium butyl xanthate (KXT) and diethyl dithiophosphate (DTP), in the beneficiation of a sulfide ore from southwestern Spain. Statistical analysis performed using MiniTab 4.0 revealed that collector type, reagent dosage, and pulp pH were the principal factors affecting pyrite recovery. Under the tested conditions, KXT exhibited superior metallurgical performance and selectivity compared with DTP. The flotation kinetics demonstrate that the chemical was more efficacious throughout both the rougher and cleaner phases of the process. The findings robustly corroborate the notion that employing xanthate-based chemicals to enhance pyrite concentration facilitates metal extraction from the Sulfide Ore Deposit in southwestern Spain. The study sets out a basis for process growth, and it is proposed that further research be conducted under industrial water conditions to validate the findings. Full article

Background: Timely dental care is essential to prevent complications and preserve natural teeth, yet inefficient referral practices, low reimbursement rates and systemic barriers continue to disproportionately affect Medicaid-enrolled children. This study assessed the appropriateness of root canal therapy (RCT) referrals to a University-based Advanced Education in General Dentistry (AEGD) program and examined diagnostic and treatment characteristics of referred cases. Methods: A retrospective review was conducted of pediatric patients aged 6–17 years who were referred by external dental providers to two AEGD clinics in Nevada, United States, between February and August 2024 for endodontic evaluation of carious permanent teeth. Demographic, tooth-type, pulp-status, and treatment outcome data were analyzed using descriptive statistics, chi-square tests, Kruskal–Wallis comparisons, and multivariable logistic regression models. Results: Among 154 referred patients, 96.8% (n = 149) were Medicaid beneficiaries. A total of 247 teeth were evaluated; 74.1% were molars. Pulp testing showed that 41.3% had healthy pulps and 16.6% had reversible pulpitis, while only 37.2% of teeth required RCT. Age differed significantly across pulp diagnoses (p = 0.0012), and older age independently predicted appropriate referral (adjusted OR = 1.18, 95% CI 1.07–1.31). Gender was not associated with follow-up compliance (p = 0.47). By November 2024, 53.4% of referred teeth had completed treatment, and 9.3% had no follow-up. Conclusions: More than half of the referral teeth did not require RCT, indicating a high rate of potentially avoidable referrals and highlighting gaps in diagnostic confidence and decision-making at the primary care level. Practical Implications: Enhancing diagnostic training and decision support for general dentists, particularly in vital pulp therapy for young permanent teeth, along with improving Medicaid reimbursement and standardizing referral protocols, may reduce inappropriate specialty referrals. In combination with broader policy reforms, these measures can improve system efficiency and expand access to timely, equitable pediatric dental care. Full article

This study aimed to explore the added value and usage of laser Doppler flowmetry (LDF) in conjunction with continuous tissue (arterial) oxygen saturation (SO₂) monitoring, electrical pulp testing (EPT), cold stimulation (CS) testing, and apical X-rays (RX). LDF data were evaluated in relation to three different scenarios. LDF records of all four upper incisors from 30 randomly selected patients aged 21–40 were analysed in relation to the following scenarios: (a) simultaneous SO₂ measurements using a pre-manufactured splint handled by an experienced LDF dentist, (b) EPT, and (c) CS. A total of 120 teeth were analysed, of which 11 were non-vital (7 denervated and 4 traumatised). Data assessment showed the following mean LDF values: vital teeth: 23.6 Perfusion Units (PU), SD 6.3 and SaO₂ of 88.7%, SD 17.1. For non-vital teeth, the mean LDF value was 16.1 PU (SD 11.8) and the mean SO₂ value was 70.8% (SD 31.9). The standard deviation was found to be twice as high for non-vital teeth as for vital teeth. No direct relationship was found between LDF and SO₂ values at low SO₂. For vitality discrimination, the ROC curves showed an area under the curve of 0.799 for LDF and 0.643 for SO₂. EPT data assessment showed a mean value of 18.1 (SD 19.7) out of a possible score of 0–80. This was distributed as follows: seven non-vital teeth (80/80); 109 vital teeth; and four undecided teeth. This was compared to the LDF and SO₂ results. The data assessment showed nine non-vital teeth, 108 vital teeth, and three undecided teeth in comparison to LDF and SO₂ results. Conclusion: LDF and SO₂ do not complement each other sufficiently in detecting non-vital teeth when the selection criteria are applied. While LDF clearly contributes, the vital or non-vital classification still depends on a combination of X-ray, sensitivity, and vitality tests. Full article

Background/Aim: Third molar impaction with the consequent root resorption of second molars often creates complexities in treatment planning and execution. In the past, the root canal treatment (RCT) of second molars was required in these cases to avoid pulp necrosis and infection. The aim of this paper is to report a surgical/retrograde approach for the maintenance of pulp vitality, proposed as retrograde vital pulp treatment (rVPT), in cases of asymptomatic or reversibly affected teeth with root resorptions caused by impacted adjacent teeth. Methods: A case report on the rVPT of two upper second molars with root resorption due to third molar impaction is presented. The chief complaint of the patient was a slight pain during bite involving the upper second molars. Heat and cold sensitivity tests were performed, suggesting a healthy pulp status. A cone beam computed tomography (CBCT) scan was performed to aid the diagnosis and treatment planning, showing bilateral upper third molar impaction and both distal roots of the upper second molars affected by external root resorption (ERR). In both cases, the third molar was surgically extracted, the surface of the root with ERR was smoothened and rVPT was carried out by performing a 3 mm retrograde preparation of the root canal and its retrograde sealing using a hydraulic calcium silicate-based cement (hCSCs). Results: Heat and cold sensitivity tests were performed 1 month, 3 months, 6 months and 1 year after the treatment. The patient reported no pain, and the pulp sensitivity was maintained in all follow-up periods. A CBCT scan was performed 24 months after the treatment, reporting a complete perirradicular endogenous bone apposition. Conclusions: Based on the successful clinical and radiographic outcomes observed in the present case after two years of follow-up, rVPT is proposed for the maintenance of pulp vitality in cases of asymptomatic or reversibly affected teeth with ERR caused by impacted adjacent teeth. Full article

Background: The combination of two or more different types of traumatic dental injuries occurring concurrently to the same tooth presents a significant clinical challenge. By focusing on a rare combination of injuries, this case study explores the issues of delayed management of root fractures accompanied by coronal extrusions in immature maxillary permanent central incisors, underscoring the necessity for tailored approaches when guidelines for intervention were unmet. Methods: The case involves an eight-year-old boy who delayed seeking care for approximately a year after suffering trauma to his upper front teeth in a fall accident at school. The clinical examination revealed partial displacement of two maxillary central incisors in an incisal direction, resulting in increased mobility. Radiographs further showed horizontal root fractures in the apical third of both extruded incisors. Encouragingly, the injured teeth exhibited a normal response to electric pulp testing without signs or symptoms of pulpal pathology, suggesting pulp vitality and eliminating the need for root canal treatment. The extruded coronal fragments were repositioned orthodontically using a utility arch. Results: At the 14-month follow-up, the affected incisors were clinically asymptomatic, functionally satisfactory, and esthetically pleasing. Conclusions: Conservative orthodontic management of extrusive luxation concomitant with root fracture in immature permanent teeth may prove effective in select cases, particularly when long-term follow-up and proper oral care are maintained. Full article

Optical diagnostic techniques represent an attractive complement to conventional pulp vitality tests, as they can provide direct information about the vascular status of the pulp. However, the complex, multi-layered structure of a tooth significantly influences the detected signal and, ultimately, the diagnostic decision. Despite this, the impact of the various dental components on light propagation within the tooth, particularly in the context of diagnostic applications, remains insufficiently studied. To help bridge this gap and potentially enhance diagnostic accuracy, this study employs digital optical twins based on the Monte Carlo method. Using incisor and molar models as examples, the influence of tooth and pulp geometry, blood concentration, and pulp composition, such as the possible presence of pus, on spectrally resolved transmission signals is demonstrated. Furthermore, it is shown that gingival blood absorption can significantly overlay the pulpal measurement signal, posing a substantial risk of misdiagnosis. Strategies such as shifting the illumination and detection axes, as well as time-gated detection, are explored as potential approaches to suppress interfering signals, particularly those originating from the gingiva. Full article

Vital pulp therapy (VPT) preserves dental pulp and its functions, offering a minimally invasive alternative to root canal therapy. However, the impact of patient-related factors on success remains unclear. This study aimed to estimate the sample size for a multivariate model predicting VPT success for assessing capping material, age, sex, and pulp conditions. A prospective cohort study was conducted with the inclusion of twenty-seven adult patients with carious pulp exposure in mature permanent teeth. Treatment comprised direct pulp capping, partial pulpotomy, or complete pulpotomy with Mineral Trioxide Aggregate Plus (MTA+) or Biodentine. Success rates were evaluated at 6 months through clinical and radiographic examinations. Statistical analysis included Pearson’s Chi-square tests and logistic regression. The success rates were 64% in the Biodentine group and 92% in the MTA+ group (OR: 0.15; p = 0.108). Sex and age had no significant effect. Success declined with increasing pulp condition severity and treatment invasiveness. MTA+ had a higher incidence of discoloration, while Biodentine showed none. Sample size calculations suggested 140 participants would be needed to detect a significant effect of pulp condition. Both materials were effective, though MTA+ showed higher success based on the strict success criteria. More severe pulpitis correlated with lower success, but a larger study is needed for predictive models. Full article

Background/Objectives: Odontogenic cysts are pathological cavities lined by cells arising from odontogenic epithelial cells, occurring mostly on the tooth-bearing areas of the jaws. It is common to find that the apices of the teeth around the cyst are within the cyst’s cavities due to its expansion. This study aims to assess the outcome of cyst enucleation on the associated teeth, specifically the latter’s responsiveness after cyst enucleation. Methods: This retrospective study examined a sample of patients who had been previously treated for odontogenic cysts from 1 January 2000 to 31 December 2021. A list of patients was obtained and included whether they met the imposed inclusion criteria. The data collected included the patients’ preoperative and postoperative electric pulp testing readings and their timings. Results: In total, 77 individual teeth from 19 patients were included after meeting the inclusion/exclusion criteria. Overall, 57 out of the 77 (74%) teeth were responsive following long-term follow-up. Among the 57 teeth with a positive response, 8 teeth were initially non-responsive and regained their responsiveness after a period of time. Pulp responsiveness recovery was seen even 300 days after surgery. Conclusions: It is not certain that a tooth with apices involved in a cyst cavity will be non-vital following enucleation. It is recommended that these teeth be reassessed for a minimum of 10 months postoperatively before proceeding with root canal treatment. Full article

The development of laser technology has revolutionized dentistry, offering complementary and alternative approaches to traditional techniques. Lasers have been successfully integrated into various dental procedures, enhancing treatment outcomes and patient care. Several types of lasers can increase the acid resistance of enamel, thus preventing caries. Laser fluorescence has been utilized for the pre-operative diagnosis of dental caries, enabling early detection and effective treatment planning. The therapeutic application of lasers in caries treatment aligns with the contemporary philosophy of minimally invasive procedures. Clinicians can use laser Doppler flowmetry as a supplementary tool for pulp vitality testing by detecting pulpal blood flow. Lasers are also employed in various pulp-related interventions, such as managing dentine hypersensitivity and performing root canal therapy. These procedures benefit from the precision and reduced invasiveness provided by laser technology. Furthermore, laser fluorescence serves as an additional tool for subgingival calculus detection. High-power and low-power lasers are used in both nonsurgical and surgical therapies to treat periodontal and peri-implant diseases, oral mucosa conditions, and even cancer based on their specific properties. Lasers are also utilized to accelerate bone regeneration, promote adhesive strength, and remove ceramic brackets. In summary, laser technology has significantly impacted contemporary dentistry by facilitating early diagnosis, minimally invasive treatments, and precise operative procedures, ultimately improving patient outcomes and expanding the scope of dental practice. Full article

This study aimed to evaluate the diagnostic accuracy of an Optical Pulp Scanning (OPS) device. A total of 421 teeth from 107 emergency patients were investigated. Pulp vitality was assessed using conventional diagnostic methods (ConvDia), cold pulp testing (CPT), and a final diagnosis (FinDia) based on the pulp chamber contents (PCCs) of teeth requiring endodontic treatment (EmeTe). Following ConvDia, OPS screening was performed, endodontic access was prepared, and the FinDia was established. The specificity, sensitivity, as well as positive and negative predictive values of ConvDia, CPT, and FinDia were calculated against the OPS results. The null hypothesis stated that specificity and sensitivity would be equal to or lower than 90% and 80%, respectively. OPS sensitivity was 66.2% and 72.2% (EmeTe) for ConvDia, 66.2% and 69.8% (EmeTe) for CPT, and 76.9% for FinDia. Specificity was 26.4% and 25.5% (EmeTe) for ConvDia, 26.9% and 21.7% (EmeTe) for CPT, and 31.5% for FinDia. These results suggest that, at its current stage of development, the OPS device does not provide an acceptable level of diagnostic accuracy, particularly in vital teeth. Full article

Background/Objectives: Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. Methods: This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. Results: A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor’s degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master’s degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16–30 years. Conclusions: Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions. Full article

The research results and evaluation of the applicability of the original composition of hybrid paper based on silver nanowires (AgNWs), cellulose pulp (CP), and carbon nanotubes (CNTs) are presented and discussed. The material tested was used to manufacture sensors for mechanical deformation resulting from external influences or related to human activity interactions. The sensors were fabricated using an AgNWs + CP suspension and additives by the vacuum filtration method. The substrate obtained was machined and then laminated with a layer of poly(dimethylsiloxane) (PDMS). The recorded responses to selected types of imposed mechanical interactions in the form of changes in the relative resistance of the sensor throughout the tests showed a close cause-and-effect relationship. The response of the tested systems when applying an alternating magnetic field was also observed. The results indicate that the proposed solutions can find application in the monitoring of mechanical interactions resulting from the dynamic behavior of physical objects, as well as derived from selected human vital functions. Full article

Regenerative endodontics is a developing field involving the restoration of tooth structure and re-vitality of necrotic pulp. One of the most critical clinical considerations for regenerative endodontic procedures is the disinfection of the root canal system, since infection interferes with regeneration, repair, and stem cell activity. In this study, we aimed to provide the synthesis of injectable biopolymeric tissue scaffolds that can be used in routine clinical and regenerative endodontic treatment procedures using Gelatin methacryloyl (GelMA), and to test the antimicrobial efficacy of Gelatin methacryloyl/Silver nanoparticles (GelMA/AgNP), Gelatin methacryloyl/Hyaluronic acid (GelMA/HYA), and Gelatin methacryloyl/hydroxyapatite (GelMA/HA) composite hydrogels against microorganisms that are often encountered in stubborn infections in endodontic microbiology. Injectable biocomposite hydrogels exhibiting effective antimicrobial activity and non-cytotoxic behavior were successfully synthesized. This is also promising for clinical applications of regenerative endodontic procedures with hydrogels, which are proposed based on the collected data. The GelMA hydrogel loaded with hyaluronic acid showed the highest efficacy against Enterococcus faecalis, one of the stubborn bacteria in the root canal. The GelMA hydrogel loaded with hydroxyapatite also showed a significant effect against Candida albicans, which is another bacteria responsible for stubborn infections in the root canal. Full article