Advances in Dental Materials

Background: There are certain disadvantages to using CAD/CAM technologies. Marginal and internal accuracy of fit is valued as one of the most important criteria for the clinical quality and success of all-ceramic crowns. The assessment of the marginal fit of lithium disilicate and zirconia CAD/CAM crowns before and after ceramic layering is crucial. Methods: One ideally prepared model tooth was duplicated into 64 plaster models. A standardized wax pattern for a monolithic crown and a coping were produced and used to mill 16 lithium disilicate monolithic crowns and 16 cores using a soft milling process. 16 zirconia crowns and 16 cores were also fabricated. A factorial design with (material) (lithium disilicate [E] or zirconia [Z]); (design) (monolithic, [M] or (core) [C]); and (finish) (as-produced [P] or veneered/glazed [G]) was used to create the following groups: ZMP, ZMG, ZCP, ZCG, EMP, EMG, ECP, and ECG (n = 8). The milled restorations were treated accordingly using ZirLiner, IPS e.max Ceram, and IPS e.max Glaze. The restorations were cemented to their dies, embedded in epoxy resin, and sectioned into two planes with a diamond saw. Vertical and horizontal marginal fit at the finishing line was measured in a standardized way at four locations (mesial, distal, facial, and lingual). Results: There were no differences, p > 0.05, between all Z groups; however, they had significantly wider horizontal gaps, p < 0.05, (116 ± 5 µm) than E groups (64 ± 13 µm). Among lithium disilicate groups, the glazed monolithic (EMG) and veneered/glazed coping (ECG) subgroups showed significantly smaller horizontal gaps (approximately 50 ± 6 µm). Statistical analysis was performed using two-way ANOVA with a significance level set at α = 0.05. Conclusions: Veneering techniques did not affect zirconia. Lithium disilicate had a better marginal fit than zirconia, but this was influenced by veneering techniques. Lithium disilicate veneering and/or glazing significantly improved the marginal fit. Full article

Background/Objectives: Changes in the mechanical behavior of orthodontic archwires during clinical use are not fully understood, particularly when different bracket systems are employed. Self-ligating (SL) brackets have gained considerable popularity in orthodontic practice in recent years, largely due to claims of improved treatment efficiency and biomechanical performance. Nevertheless, current evidence has not consistently demonstrated statistically significant differences between conventional ligation (CL) brackets and SL systems. The aim of this study was to evaluate changes in the mechanical properties and degradation over time of nickel-titanium (NiTi) archwires after clinical use in orthodontic treatments performed with CL and SL brackets. Methods: A comparative study was conducted using archwires retrieved from orthodontic patients. Round 0.014-inch NiTi wires (GC Orthodontics America Inc., IL, USA) were analyzed. The archwires were used in 60 patients treated with either CL or SL appliances and evaluated at four time points: before clinical use (T0), and after 1 month (T1), 2 months (T2), and 3 months (T3) of intraoral service. Mechanical testing was performed according to ISO 15841:2014 + Amd. 1:2020 using a three-point bending test with a universal testing machine (Z005 Test Control II Universal Testing Machine, Zwick Roell, Kennesaw, GA, USA). The variables analyzed included the mean force delivered by the archwires at deflections of 3 mm (F3), 2 mm (F2), 1 mm (F1), and 0.5 mm (F0.5), as well as the slope of the superelastic plateau at 2 mm, 1 mm, and 0.5 mm. The static and dynamic friction coefficients, as well as the friction forces associated with the wires and the two types of brackets, were determined using a modified MTS-Bionix servo-hydraulic testing machine. The tests were conducted at 37 °C in a saline environment. Results: Both groups showed changes in the superelastic behavior of NiTi archwires. Alterations increased with longer intraoral exposure. In the SL group, significant modifications were already observed after one month of clinical use, with a reduction in the force delivered and a loss of superelastic characteristics. These changes remained relatively stable thereafter, with no statistically significant differences during the following months. In contrast, the CL group showed a progressive reduction in force delivery and superelasticity over time. This is due to the difference in friction between the wire and the CL bracket compared to the SL bracket, which results in greater force transfer for tooth movement. Conclusions: Overall, differences in the mechanical behavior of archwires between CL and SL systems were observed during the initial stages of clinical use. However, these differences diminished over time, and no significant differences were detected after three months. Considering the progressive degradation of mechanical properties, the reuse of archwires that have remained intraorally for more than three months may not be advisable. Full article

Background and Objectives: Conventional dental adhesives doped with magnetic nanoparticles (MNPs) hold the promise of preventing microleakages. However, esthetic concerns have motivated the quest for coatings capable of masking the dark color of MNPs. This study aims to quantify regional chromatic differences between teeth restored using dental adhesives with different MNP content. Materials and Methods: We prepared cavities in 42 artificial molars and 9 extracted teeth and divided them into 6 groups: Group 0 (G0), G1, and G2, comprising 14 artificial teeth each and G0e, G1e, and G2e, comprising 3 extracted teeth each. In G0 and G0e, we applied the commercial adhesive, in G1 and G1e we applied the adhesive loaded with MNPs with dual coating (SiO₂ followed by Ca(OH)₂), whereas in G2 and G2e we applied the adhesive doped with uncoated MNPs. For the statistical analysis of color differences, we employed Bland–Altman plots and the one-sample t-test. Results: G1 was similar to G0 in terms of color coordinate distribution, whereas G2 was different. Compared to G0, dental fillings from G1 had mean differences of (−0.56, 0.18, −0.07) in the CIELAB color coordinates (L*, a*, b*), respectively, whereas the mean differences between G2 and G0 were (−15.6, −3.5, −15.7). The CIEDE2000 color differences were 1.5 [1.3, 1.6] between G1 and G0 (mean [95% confidence interval]) and 17.0 [16.0, 18.0] between G2 and G0. Nevertheless, 24.4% of the point pairs compared exceeded the acceptability limit for color difference (1.8). Conclusions: Although the silica and calcium hydroxide coating is highly effective in alleviating the esthetic impact of MNP-laden dental adhesives, further research is warranted to reduce between-specimen variability. Full article

Background: Regenerative endodontic procedures (REPs) aim to restore pulp vitality and promote root development in immature necrotic permanent teeth. Scaffold materials provide a 3D framework to support cellular migration, proliferation, and differentiation and play a critical role in regenerative interventions. Commonly used scaffolds include PRP, PRF, and collagen; however, hyaluronic acid has also demonstrated promising treatment outcomes. Objective: To evaluate whether hyaluronic acid (HA) provides superior regenerative outcomes compared to PRP, PRF, and collagen scaffolds. Methods: A systematic electronic search was conducted across PubMed, Scopus, and EBSCOhost. A total of 952 articles were identified in the initial search, of which 19 articles were included in the final review. Due to heterogeneity, a narrative synthesis was performed. Results: PRF demonstrated the most consistent improvement in root development and dentinal wall thickening. Apical closure and periapical healing were achieved across all scaffold types. Evidence for HA was limited, with no clear superiority identified. Conclusions: Current evidence does not support the superiority of HA over established scaffolds. Further standardised clinical trials are required to make definitive comparisons on scaffold effectiveness. Full article

Background/Objectives: Modern restorative dentistry increasingly focuses on achieving optimal aesthetic integration while simplifying clinical procedures. Single-shade resin composites were introduced to reduce the complexity of conventional multi-shade layering techniques through enhanced color adjustment potential and structural color technology. However, concerns remain regarding their long-term color stability. The aim of this systematic review was to evaluate the color stability and aesthetic performance of single-shade resin composites compared with conventional multi-shade systems under different staining and aging conditions. Methods: This systematic review was conducted according to PRISMA 2020 guidelines and registered in the Open Science Framework. A systematic search was performed in PubMed, Scopus, and Cochrane Library up to 31 October 2025. Studies evaluating color stability using the CIEDE2000 (ΔE₀₀) formula after staining and aging procedures were included. Risk of bias was assessed using the RoBDEMAT tool. Results: The search identified 169 records, of which 11 in vitro studies met the inclusion criteria. Across the included studies, discoloration increased progressively over time, and chromogenic agents frequently induced ΔE₀₀ values exceeding clinical acceptability thresholds. Turmeric and red wine demonstrated the highest staining potential, whereas distilled water and artificial saliva showed minimal color variation. Single-shade composites generally exhibited greater susceptibility to discoloration than multi-shade systems, although variability among materials was observed depending on composition and experimental conditions. Conclusions: Single-shade resin composites simplify restorative procedures and provide initial aesthetic integration; however, they appear more susceptible to clinically relevant discoloration under experimental conditions. Further clinical and in vitro investigations are required to confirm these findings. Full article

Background/Objectives: Denture stomatitis is closely associated with Candida albicans colonization of denture-base surfaces. This in vitro study compared early adhesion (1 h) and initial biofilm formation (24 h) of C. albicans across five denture-base-related material groups using adhered cell counts and adhered/inoculum proportions. Methods: A 5 × 2 factorial design (five material groups; 1 and 24 h) evaluated a comparator pattern resin, heat-polymerized acrylic resin, autopolymerizing acrylic resin, milled CAD/CAM PMMA, and microwave-polymerized acrylic resin. All specimens underwent standardized finishing and mechanical polishing before microbiological testing. Data were log10-transformed and analyzed by two-way ANOVA (material group, time) with Tukey’s post hoc test. An external SEM-based qualitative laboratory report was used as complementary documentation of C. albicans presence after 1 h and 24 h; representative micrographs and quantitative SEM image outputs were unavailable. Results: Material group, time, and their interaction significantly affected adhered C. albicans counts (p < 0.05). At 1 h, the comparator pattern resin showed the highest adhesion, whereas at 24 h, milled CAD/CAM PMMA showed the highest adhered load. For the adhered/inoculum fraction, both material group and time were significant; at 24 h, the heat-polymerized acrylic resin showed the lowest adhered fraction. Conclusions: Under the standardized finishing and mechanical polishing conditions of this in vitro model, the tested material groups showed different C. albicans adhesion/biofilm patterns over time; clinical extrapolation should be made with caution. Full article

Objectives: This study characterised the bioactive properties (i.e., ion release, pH rise, and apatite formation) of a newly developed Voco Profluorid + BioMin F varnish. Three additional varnishes were investigated for comparison: Clinpro™ White Varnish (3M™, St. Paul, MN, USA), MI Varnish (GC, Tokyo, Japan), and Profluorid varnish (VOCO GmbH, Cuxhaven, Germany). The Clinpro™ White and MI varnishes were chosen for comparison due to their similar composition of active ingredients. Profluorid served as a standard fluoride-only varnish reference. Methods: Dental varnish ingredients were characterised using ATR-FTIR, XRD, and ¹⁹F and ³¹P MAS-NMR. Coated coverslips were immersed in Tris buffer and artificial saliva (pH 4.0 and 7.0) for 2–24 h. Ion release was analysed using ICP-OES and a fluoride ion-selective electrode whilst monitoring pH changes. Post-immersion, coverslips were analysed by XRD and MAS-NMR to assess possible apatite formation. Results: XRD and ¹⁹F MAS-NMR detected NaF in all four varnishes. BioMin F varnish showed a ³¹P peak matching BioMin F glass, with an additional brushite peak, indicating partial reaction of the bioactive glass (BAG) with rosin resin water. All varnishes released fluoride and calcium, but only BioMin F and MI varnishes released phosphate, which is essential for the formation of calcium fluorapatite. Post-immersion analysis confirmed fluorapatite formation in BioMin F and, to a lesser extent, the Profluorid varnish. No apatite formation was observed in the other two varnishes. MI varnish exhibited calcium fluoride formation before and after immersion, as evidenced by XRD and ¹⁹F MAS-NMR analysis. Conclusions: The novel BioMin F varnish potentially promotes remineralisation by providing a sustained and slow release of therapeutic ions that are essential for the formation of fluorapatite. Full article

Background/Objectives: To make a dental office more environmentally conscious, it is essential to use eco-friendly disinfectants without compromising patient safety. Our aim was to examine and compare the effectiveness of the commonly used conventional disinfectants in Romania with the effectiveness of available eco-friendly disinfectants. Methods: Two traditional (Gigasept, Zeta 1 Ultra), and two eco-friendly (IDactiv, Sekusept Aktiv) disinfectants and an eco-friendly (gigazyme) cleaning agent were compared. For a thorough evaluation, minimal inhibitory and bactericidal concentration (MIC/MBC) tests were conducted, along with a Bradford assay to measure the concentration of residual proteins on instruments contaminated by controlled contamination and dental office use after disinfection. Results: During the MIC test, with the exception of Gigazyme^®, which is an enzymatic cleaner, all of the tested disinfectants were effective in the case of the bacterial reference strains used at the concentration prescribed by the manufacturers. After disinfection, the amount of protein remaining on the dental instruments did not exceed the maximum concentration according to the ISO 15883-5:2005 protocol, and the protein removal efficiency was between 96.04% and 99.03% for all disinfectants. In the MIC/MBC test, the peracetic acid-based Sekusept Aktiv was the most effective, while Gigazyme^® and BossKlein IDactiv^® showed the highest protein removal efficiency. Conclusions: The tested eco-friendly disinfectants meet the necessary performance criteria and thus offer a sustainable alternative to traditional disinfectants. Full article

Background and Objectives: This study aimed to evaluate and compare the effects of immersion and brushing on resins used for temporary crowns, including two 3D-printed resins (Nanolab and PrintaX) and one self-curing resin (Duralay), with different surface finishing protocols. Materials and Methods: Printed specimens were designed using specialized software, followed by slicing and printing. Self-curing resin samples were fabricated using silicone matrices, with the printed specimens serving as references. Square samples (7.0 × 7.0 × 2.0 mm, n = 90) were divided into three groups based on surface finishing: extrinsic pigment with glaze, glaze only, and polish only. The samples were immersed in 15 mL of cola soft drink, energy drink, or distilled water for six days at 37 °C in a dark environment before undergoing a brushing test (180 cycles/minute, 65,700 cycles, 2 N, 37 °C). Color alterations, surface roughness, and Knoop microhardness were then analyzed. Results: Statistical analyses revealed that all factors significantly influenced the tested properties (p < 0.05). Nanolab exhibited the most pronounced color alterations, with ∆E₀₀ values reaching up to 22.21 ± 3.13 in specific conditions (e.g., Glaze, Cola soft drink). It also presented increased surface roughness, particularly when compared to PrintaX. Conversely, Duralay consistently displayed the highest Knoop microhardness changes (e.g., ranging from −1.84 ± 0.36 to 0.47 ± 0.45 in different conditions) across most experimental groups. Polishing consistently provided better outcomes in terms of color stability, surface roughness, and microhardness compared to extrinsic pigment + glaze or glaze-only treatments. The first immersion generally led to the greatest color change. Conclusions: The acidic challenge promoted significant changes in the optical and surface properties of the evaluated resins, increasing ∆E₀₀ and roughness and reducing microhardness to different extents depending on the material. Clinically, these findings highlight the relevance of material selection and limiting exposure to acidic beverages during provisional use. Full article

Background: The piezoelectric saw is a technology used in osteotomies, providing precise and minimally invasive cuts, especially in areas close to vital structures. Despite its advantages, limitations such as prolonged surgical time and restrictions in use for larger bones have motivated the development of ultrasonic tips with more efficient geometries. Methods: A laboratory trial was conducted with 40 ultrasonic tips (n = 40), divided into 2 groups: the test group (n = 20), with an ultrasonic tip featuring a multidirectional angular cutting-tooth geometry, and the control (n = 20), with a straight-tooth ultrasonic tip. Two operators performed standardized osteotomies on synthetic bone blocks, with monitoring of variables including cutting time (in seconds), maximum block and blade temperature (in °C), and bone mass loss (in grams). Sample randomization was block-based, and blade coding ensured operator and evaluator blinding. Results: The results showed a statistically significant reduction of approximately 26% in cutting time with the multidirectional ultrasonic tips (Test = 52.85 s; Control = 71.55 s; p < 0.001), regardless of the operator. No significant differences were observed between groups regarding maximum bone temperature (Test = 30.45 °C; Control = 29.40 °C; p = 0.337), blade temperature variation (Test = 5.30 °C; Control = 4.10 °C; p = 0.337), overall temperature variation (Test = −0.19 °C; Control = 0.06 °C; p = 0.285), or bone mass loss (Test = 0.1355 g; Control = 0.0350 g; p = 0.387). A significant interaction between operator and blade type in some variables, such as bone temperature variation (p = 0.001), reinforces the influence of technical experience on the results. Conclusions: The multidirectional angular geometry of the ultrasonic tip significantly improves cutting efficiency without compromising thermal safety, representing a promising advancement for optimizing osteotomies in surgical settings. The use of this new geometry may enhance productivity, particularly in complex procedures, and deserves future clinical investigation to expand its applicability across different surgical specialties, including orthopedics. Full article

This study evaluated the influence of various surface treatments on the bonding performance and mechanical behavior of zirconia, with particular emphasis on the effect of laser surface texturing (LST) compared with conventional 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) and airborne particle abrasion (APA) methods. Two zirconia compositions, 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) and 5 mol% partially stabilized zirconia (5Y-PSZ), were subjected to four surface treatment protocols: as-milled, 10-MDP, APA, and LST (n = 12). Shear bond strength (SBS) to titanium and biaxial flexural strength (BFS) of zirconia were measured. Surface morphology, failure mode, and phase composition were analyzed using scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), and X-ray diffraction (XRD). Data were analyzed with two-way ANOVA and Tukey’s post hoc test (α = 0.05), and the reliability of flexural strength was assessed using Weibull analysis. Surface treatment significantly affected SBS (p < 0.05). The LST groups exhibited the highest SBS values and a higher proportion of mixed failures, whereas other groups predominantly showed adhesive failures. However, LST-treated specimens, particularly 5Y-PSZ, showed reduced BFS. XRD confirmed phase stability, although localized microstructural changes were observed after LST. LST enhanced the zirconia–titanium interfacial bond strength and promoted mixed failure modes; however, this improvement was accompanied by a reduction in flexural strength, particularly in 5Y-PSZ. Full article

Objectives: This study aims to evaluate the efficacy of hydroxyapatite-tricalcium phosphate (HAP-TCP) as a bone substitute in subantral augmentation for dental implants. Specifically, it investigates the effects of HAP-TCP on bone quality, density, and integration with implants over time. Methods: A prospective controlled longitudinal study was conducted on 22 patients (39–75 years of age) undergoing subantral augmentation and dental implantation. A total of 52 sites of augmented bone and 67 sites of native bone were analyzed using computed tomography (CT) to assess bone density in Hounsfield Units (HU), insertion torque measurements, and the Misch classification for bone quality. Augmented and native bone measurements were compared within each patient. Results: The augmented bone exhibited an average density of 1132.6 ± 334.9 HU, which is significantly higher (45.9%) than the average density of native bone at 519.3 ± 395.0 HU. Insertion torque values in the HAP-TCP augmented sites averaged 35 N·cm, showing a 71.4% increase compared to adjacent native bone sites (25 N·cm). The study found notable improvements in bone homogeneity and vascularization within the augmented zones. Conclusion: HAP-TCP demonstrates significant potential as a reliable and effective synthetic bone substitute for subantral augmentation in dental implants. It yields higher radiodensity and insertion torque than adjacent native bone, while mitigating complications associated with autogenous grafts. These observational findings support the potential clinical use of HAP-TCP for sinus augmentation. Full article

This study analyzed how different downward loads and rotational kinematics influence NiTi rotary instrumentation outcomes. Heat-treated NiTi instruments were used to prepare extracted human single-rooted premolars with a moderate canal curvature. Instrumentation was performed using an automated endodontic instrumentation device with controlled downward loading and torque/force sensing, under different downward load settings (1, 2, and 3 N), employing either continuous rotation (CR) or optimum torque reverse (OTR) motion, which is a torque-sensitive reciprocation. Instrumentation was completed without instrument fracture or ledge formation in all six groups. OTR-3N specimens displayed a significantly lower upward force (i.e., screw-in force) than OTR-2N specimens (p < 0.05). OTR-1N specimens required a significantly longer instrumentation time than CR-1N specimens and the other OTR specimens (p < 0.05). At 1 mm from the apex, CR-2N specimens showed a significantly larger canal-centering ratio (i.e., larger deviation) than OTR-2N specimens (p < 0.05). Overall, applying a downward load of 2–3 N in OTR mode provided shaping efficiency similar to CR, but with a reduced screw-in force and enhanced canal-centering in the apical region, supporting the use of OTR as a promising alternative to CR for curved canal preparation using heat-treated NiTi instruments. Full article

Introduction: The success of metal–ceramic restorations depends on the mechanical and adhesive properties of the metal–ceramic interface. With the emergence of additive manufacturing technologies such as selective laser melting (SLM), there is growing interest in comparing these methods with conventional casting. This pilot study aimed to generate hypothesis-forming data on how fabrication method (casting and 3D printing) and alumina sandblasting with two particle sizes (125 μm and 250 μm) influence flexural performance of Co-Cr metal–ceramic systems within the standardized ISO 9693 framework. Materials and Methods: Rectangular Co-Cr alloy specimens were manufactured using two techniques: conventional casting and 3D printing via SLM. Each group was divided based on the sandblasting particle size. After ceramic application in accordance with ISO 9693:2012, samples underwent a three-point bending test using a universal testing machine (Instron 8872) to assess the displacement force required to fracture the ceramic layer. Five specimens were tested per group, and mean values and standard deviations were calculated. Data were statistically analyzed using two-way ANOVA followed by Tukey’s HSD post hoc test (p < 0.05). Results: Cast samples exhibited significantly higher displacement strength than printed ones. Among all groups, the cast samples sandblasted with 250 μm particles (CCT_250) showed the best performance (mean: 12.48 ± 0.91 N), while the 3D-printed group treated with 125 μm particles (CCP_125) showed the lowest strength (mean: 7.24 ± 0.65 N). Larger abrasive particles (250 μm) improved bond strength in both fabrication techniques. Two-way ANOVA revealed significant main effects of manufacturing method (F(1,16) = 13.63, p = 0.002, η² = 0.46) and particle size (F(1,16) = 6.17, p = 0.024, η² = 0.28), with no interaction between factors. Conclusions: Both the manufacturing method and the sandblasting protocol significantly influence the flexural performance of Co-Cr ceramic systems. Conventional casting combined with 250 μm particle sandblasting ensures the highest ceramic adhesion, while SLM-printed substrates may require additional surface treatments to improve bonding efficiency. Complementary surface treatments such as bonding agents or chemical oxidation may enhance the metal–ceramic bond in SLM-fabricated frameworks. Full article

Background: The use of zirconia-based restorations has increased in dentistry due to their aesthetics, high strength, and biocompatibility. However, achieving durable adhesion between resin cements and zirconia remains a challenge in restorative dentistry. Adhesive failures can lead to complications ranging from dentin hypersensitivity to the loss of the restored tooth. This review evaluates the impact of surface treatments based on silica coatings as a strategy to improve the adhesion of resin cements to zirconia. Methods: A systematic review was conducted following PRISMA guidelines. Searches were performed in Scopus, Web of Science, PubMed, EBSCO, and ScienceDirect. In vitro studies were included if they (1) evaluated silica-based coatings on zirconia surfaces; (2) measured bond strength at the zirconia–cement interface through shear tests (MPa) and reported failure type (adhesive, cohesive, mixed); (3) used ≥8 specimens per group; and (4) included an untreated zirconia control group. Data were extracted and compared for conditions before and after thermocycling in the studies that reported this procedure. Results: The average bond strength for silica-coated zirconia was 15 MPa without thermocycling and 11.97 MPa after thermocycling, regardless of the coating technique. These values were significantly higher than those of untreated zirconia (8.45 MPa and 6.41 MPa, respectively). Cohesive and mixed failures predominated in silica-treated groups, suggesting more effective adhesion compared to controls, which presented mainly adhesive failures. Conclusions: Silica coatings, especially when combined with adhesion promoters, MDP-based primers, significantly enhance the bond strength of resin cements to zirconia. This reduces the risk of secondary caries, sensitivity, restoration debonding, and potential tooth fractures. However, the effectiveness of these coatings varies depending on the technique used, suggesting the need to standardize protocols to optimize clinical outcomes. Full article

This study aimed to examine how downward load applied during instrumentation affects the stress generation and shaping properties in thermally treated and non-treated NiTi rotary instruments. ProTaper Universal (PTU; non-thermally treated) and ProTaper Gold (PTG; thermally treated) were used to prepare J-shaped canals in resin blocks. Load-controlled automated instrumentation and torque/force sensing devices were employed with preset downward loads of 1, 2, or 3 N (n = 10 each). The torque/force, instrumentation time, and canal-centering ratio were measured and analyzed using two-way or one-way analysis of variance with Tukey’s test (α = 0.05). In the PTU-1N group, instrumentation was not completed because a ledge was formed in all canals. The PTU-3N group showed significantly greater upward force (screw-in force) and clockwise torque, along with a significantly smaller canal-centering ratio (less deviation) at the apical 0 mm level, than the PTU-2N group (p < 0.05). The downward load did not influence the instrumentation time (p > 0.05). In the PTG groups, these effects of downward load on the force generation and canal-centering ratio were not significant (p > 0.05). In the non-thermally treated PTU instruments, greater downward loads enhanced screw-in force while decreasing apical canal deviation; however, these effects were abolished in the thermally treated PTG instruments. This study highlights the importance of adapting the instrumentation technique with instrument characteristics: thermally treated flexible instruments facilitate smoother use, while stiffer, non-thermally treated ones may require precise control of downward loads. Full article

Background and Objectives: This in vitro trial aimed to investigate if there is a correlation between the homogeneities of different composite materials and their adhesion to glass fiber posts (GFPs). Materials and Methods: Twenty intact human upper jaw central incisors extracted due to periodontal diseases were selected for this trial. Endodontic treatment was performed according to ISO recommendations. A total of 4 mm of guttapercha was left in the apical region. Canals were prepared for post insertion. Teeth were randomly allocated into the two following groups depending on the core restorative material (n = 10): I—cores build up with light cured composite; II—cores build up with dual cured composite resin. GFPs were inserted and cores were rebuilt with different composite resins. Longitudinal cuts were made across the axis of the teeth and examined under a scanning electron microscope (SEM). Statistical analysis was accomplished using Mann–Whitney U and Spearman tests (p < 0.05). Results: In the group where the number and size of pores at the interface of GFPs were analyzed, pores were found only in the specimens restored with the light-cured “bulk-filled” composite. In the group where the number and size of pores in the core material were analyzed, pores were found in specimens restored with both the light-cured “bulk-filled” composite and dual-cured resin composite. However, the dual-cured resin composite yielded better results in terms of core integration. Conclusions: There is no statistically significant correlation between the homogeneities of different composite materials and their adhesion to GFP. Full article

Background and Objectives: Complete dentures remain a primary solution for oral rehabilitation in aging and medically compromised populations. The integration of digital workflows, regenerative materials, and smart technologies is propelling prosthodontics towards a new era, transcending the limitations of traditional static prostheses. Materials and Methods: This narrative review synthesizes historical developments, current practices, and future innovations in complete denture therapy. A comprehensive review of literature from PubMed, Scopus, and Web of Science (2000–2025) was conducted, with a focus on materials science, digital design, patient-centered care, artificial intelligence (AI), and sustainable fabrication. Results: Innovations in the field include high-performance polymers, CAD–CAM systems, digital impressions, smart sensors, and bioactive liners. Recent trends in the field include the development of self-monitoring prostheses, artificial intelligence (AI)-driven design platforms, and bioprinted regenerative bases. These advances have been shown to enhance customization, durability, hygiene, and patient satisfaction. However, challenges persist in terms of accessibility, clinician training, regulatory validation, and ethical integration of digital data. Conclusions: The field of complete denture therapy is undergoing a transition toward a new paradigm of prosthetics that are personalized, intelligent, and sustainable. To ensure the integration of these technologies into standard care, ongoing interdisciplinary research, clinical validation, and equitable implementation are imperative. Full article

Objectives: Dental caries remains a prevalent issue in pediatric dentistry, necessitating restorative materials that not only repair decay but also provide protective benefits. Fluoride-releasing restorative materials have a key function in preventing recurrent caries by inhibiting bacterial activity and promoting remineralization. The objective of this study was to examine fluoride release from three pediatric dental restorative materials—Riva Light Cure HV, Fuji IX GP Fast, and the Cention Forte Filling Material—under different pH and temperature conditions. Methods: Specimens (10 mm diameter and 2 mm thickness; n = 3 for each material) were prepared according to the manufacturers’ instructions; immersed in buffer solutions at pH 4.8, 6.8, and 8.8; and stored at 37 °C and 44 °C. Fluoride release was quantified using ion chromatography at three time points (1 day, 7 days, and 28 days). Results: The data revealed that fluoride release was significantly influenced by pH, temperature, and time (p < 0.05). Riva Light Cure HV exhibited the highest release, particularly in acidic conditions (pH 4.8), reaching 40.14 mg/L at 44 °C after 28 days. The Cention Forte Filling Material and Fuji IX GP Fast also showed increased release over time, but with lower cumulative concentrations. Higher temperatures generally enhanced fluoride diffusion across all materials. Conclusions: These findings emphasize the pivotal impact of environmental factors in fluoride release dynamics. Riva Light Cure HV demonstrated superior fluoride release, particularly in acidic environments, suggesting its potential for high-caries-risk pediatric patients. These insights can inform the selection of restorative materials in pediatric dentistry, optimizing caries prevention strategies. Full article

Background and Objectives: Contemporary caries treatment seeks to preserve hard dental tissues as well as to promote lesion remineralization and biological tissue regeneration. While fluoride-based treatments remain the gold standard, their effectiveness has limitations, prompting interest in innovative remineralization technologies. Nano-hydroxyapatite (nano-HA) varnish and self-assembling peptide (SAP) P11-4 are promising biomimetic materials that promote enamel repair, yet long-term data on their efficacy are limited. The objectives of this study were to evaluate the effectiveness of nano-HA varnish and peptide P11-4 in restoring enamel surface hardness after artificial lesions in vitro and to compare them to a control group and fluoride varnish. Materials and Methods: Artificial enamel lesions were created on the buccal surfaces of 36 extracted human molars, which were randomly divided into four groups (n = 9): control, peptide P11-4, fluoride varnish, and nano-hydroxyapatite varnish. After applying the materials as per manufacturer instructions, specimens were stored in artificial saliva for 14 days. Enamel surface hardness was measured using the Vickers hardness test (HV) at baseline, after demineralization, and after remineralization. Statistical analysis was performed with “IBM SPSS 27.0” using non-parametric Kolmogorov–Smirnov, Kruskal–Wallis, Dunn’s, and Wilcoxon tests. Results: The mean baseline enamel hardness value was 323.95 (SD 33.47) HV. After 14 days of demineralization, the mean surface hardness of artificial enamel lesions significantly plummeted to 172.17 (SD 35.96) HV (p = 0.000). After 14 days of remineralization, the mean value significantly increased to 213.21 (SD 50.58) HV (p = 0.001). The results of the study revealed statistically significant enamel remineralization of the peptide P11-4 group in regard to the demineralized enamel (p < 0.05). In contrast, there were no significant results in other treatment groups (p > 0.05). Remineralization of enamel was the highest in samples from the P11-4 group (54.1%), followed by the nano-HA group (35.4%), FV group (17.8%), and control group (11.2%). There was a significant difference (p < 0.05) in the remineralizing ability between the peptide P11-4 and all other treatment groups. Conclusions: Self-assembling peptide P11-4 effectively remineralized artificial enamel lesions and proved to be significantly more effective compared to fluoride varnish and nano-hydroxyapatite varnish, showcasing its superior performance as a remineralizing agent. Full article

Dental implant therapy is a widely used clinical procedure for restoring missing teeth in patients. Zirconia implants were introduced as an alternative to titanium implants due to their excellent biocompatibility and esthetic properties. The nuclear factor kappa B (NF-κB) signalling pathway is responsible for multiple aspects of innate and adaptive immune functions and serves as a significant and crucial mediator of inflammatory processes. The dysregulation of NF-κB activation induces pathological processes in multiple diseases. The purpose of this study was to investigate the activation of the NF-κB pathway upon stimulation with tumour necrosis factor (TNF)-α in osteoblast-like cells (MG-63) cultured on zirconia surfaces in comparison to titanium surfaces. Several methods such as immunoblot, immunofluorescence, MTT assay, and flow cytometry were used in this study. We observed that human recombinant TNF-α caused a strong activation of the NF-κB pathway on both zirconia and titanium discs and in wells without any discs. This activation was marked by the upregulation of MHC class I proteins in MG-63 cells grown on both titanium and zirconia discs; however, there was no effect on MHC class II protein expression. In summary, the present study has shown that TNF-α stimulation equally activates the NF-κB pathway in MG-63 cells cultured on both titanium and zirconia surfaces. Full article

Objectives: This retrospective cohort study aimed to compare and evaluate the 1-year stability of two Korean implant brands, Osstem and Toplan, both treated with alumina- sandblasting and acid- etching (SA) surface modification. Methods: This retrospective analysis evaluated patients with American Society of Anesthesiologists grade I or II, >20 years, with alveolar bone volume suitable for implant placement, who received immediate or delayed placement after extraction, and with Osstem (n = 57) or Toplan (n = 87) implants. The insertion torque value (ITV) measured on the day of implant placement and the implant stability quotient (ISQ) measured on the day of implant placement, 1 month post-surgery, and 2–3 months after implantation were analyzed. Results: Both implants had significantly increased ISQs over time, and the ISQs did not significantly differ between Osstem and Toplan implants at any time point. Osstem implants showed significantly higher ISQs in D2 than in D3 bone, and in the mandible than in the maxilla at all time points. Toplan implants with diameters >4.0 mm showed higher initial ISQs. Osstem implants showed a significant correlation between ITV and ISQ on the day of placement (r = 0.349, p < 0.01) but not at later time points. For Toplan implants, no significant correlation was confirmed between ITV and ISQ at any time point. At the 1-year follow-up, both implants were still providing functional service. Conclusions: Osstem and Toplan implants with SA surface treatment showed a high level of stability for 1 year, and no significant difference in stability was observed between the two implants. Both implants are considered clinically reliable products. Full article

Background: Dental restoration success relies on the physical properties of luting cements. Luting cements fill the space between teeth and the restoration, provide retention and protection from occlusal forces, and act as a barrier to microleakages in the oral environment. Objective: This review aims to evaluate and compare the solubility of the three most used dental luting cements: glass ionomer (GI), resin-modified glass ionomer (RMGI), and resin cement (RC). Methods: The studies selected for review compared the solubilities of combinations of GI, RMGI, and RC in solutions with different pH levels to replicate acidic oral pH. Results: A review of the studies concluded that resin cement had the overall lowest degree of solubility at all pH values and all storage periods, followed by RMGI and GI cement. Conclusions: The success of the restoration is dependent upon the choice of luting cement. The results of the studies reviewed show that all dental luting cements showed some degree of dissolution. Resin cement overall demonstrated the least amount of solubility, followed by RMGI and GI cement. Full article

Background and Objectives: This study aimed to investigate the effect of zinc phosphate (ZnP) cement, glass ionomer cement (GIC), and nano-integrated bio-ceramic (NIB) cement on mineralization when placed in contact with bone tissue-forming cells. Materials and Methods: ZnP cement, GIC, and NIB cement were divided into direct and indirect groups. A total of 72 cement pellets (24 pellets of each test sample) of 3 × 1 mm (width × height) were prepared using polytetrafluoroethylene molds. A total of 3 sample groups were demarcated using 96- cell well culture plates. In the control group, 24 wells were filled with mineralized osteoblasts and 1 µL of gingival crevicular fluid (GCF). In test group 1, to show a direct effect, 36 samples were plated with mineralized osteoblasts and 1 µL GCF for 24 h; the cells were directly exposed to cement pellets. A total of 36 samples were immersed in GCF for 24 h; later the supernatant was transferred to the mineralized osteoblasts to demonstrate an indirect effect in test group 2. To assess the mineralization, osteoblasts were stained with alizarin red and later observed under an inverted phase-contrast microscope. Data were analyzed using the statistical package for social sciences. An independent t-test compared the direct and indirect effects of the ZnP cement, GIC, NIB cement, and control groups on the mineralization of osteoblasts derived from hDPCs. Results: A statistically significant difference was observed between the ZnP cement, GIC, and NIB cement groups (p < 0.05). ZnP cement exhibited a moderate, NIB cement the least harmful effect, and GIC showed the most harmful effect on the mineralization of osteoblast cells. Conclusions: The biocompatibility of dental luting cements is an important aspect that clinicians should consider during their selection. Nano-integrated bio-ceramic cement showed the least negative effect on the mineralization of osteoblast cells which is beneficial for the cementation of cement-retained implant prostheses. However, further studies are needed to evaluate osteoblast and osteoclast activity in vivo. Full article

This study presents a scanning electron microscopy analysis of a failed PEEK retainer in an orthodontic patient. After 15 months of use, the patient reported a gap opening between teeth 41 and 42. The PEEK retainer was removed and sent for electron microscope analysis. To investigate the failure, scanning electron microscopy was employed to assess the microstructure and composition of the retainer at various magnifications. These findings suggest that the failure of the PEEK retainer was multifaceted, implicating factors such as material defects, manufacturing flaws, inadequate design, environmental factors, and patient-related factors. In conclusion, this scanning electron microscopy analysis offers valuable insights into the failure mechanisms of PEEK retainers in orthodontic applications. Further research is necessary to explore preventive strategies and optimize the design and fabrication of PEEK retainers, minimizing the occurrence of failures in orthodontic practice. Full article