Alveolar bone atrophy after tooth extraction presents significant difficulties when planning delayed-immediate implant treatment to replace a lost tooth. Socket augmentation is an effective therapy that limits the post extraction volumetric changes and facilitates implant placement whilst reducing the need for staged grafting. However, socket augmentation and osteoconductive graft conversion is a slow process that could take 4-6 months. PRF and its variants have significant bio-enhancement effect on wound healing and regeneration through release of platelet drived growth factors, bioactive substances, cytokines. Leukocytes in PRF also play a significant role in enhancing tissue regeneration as part of osteo-immune response. Use of PRF during socket augmentation is highly effective in enhancing extraction site healing and graft integration by angiogenesis, cell proliferation, recruitment, and differentiation through release of growth factors and bioactive substances mediated by platelets and leukocytes. PRF with SA is recommended as an adjunct to SA as a sole biomaterial or in combination with xenograft or allograft bone substitutes to enhance tissue regeneration and to reduce risk of infection, osteitis and postoperative pain in extraction sockets

Purpose Professional oral hygiene procedures are recommended by dentists, twice a year. BioHPP is a polyetheretherketone polymer used in prosthetic dentistry as a frame material. The aim was to investigate whether routine dental cleaning procedures such as ultrasonic scaling and brushing affect the surface proprieties of prosthetic BioHPP restorations. To evaluate the surface properties of different restorations based on BioHPP (veneered with composite resin and polished) after brushing and ultrasonic scaling exposure. Materials and Methods The 66 BioHPP specimens were divided into three groups (n=22). The first group was the control group, and no further treatment was applied. The specimens in the second group were veneered with composite resin and in the third group the specimens were veneered with composite resin and polished. Each group of samples was divided into 3 subgroups: 0- no treatment, 1-exposed to tooth brushing, 2-exposed to ultrasonic scaling. The surface morphology was investigated by atomic force microscopy (AFM). The structure of samples was analysed using the XRD technique, and the surface wettability was done. Results Control group specimens were significantly rougher compared to other groups (p ≤ 0.05). There was no statistically significant difference in the contact angle of water analyses between the samples. Conclusion: Composite veneered BioHPP showed the highest surface resistance to brushing and ultrasonic scaling.

Introduction: The aim of the present systematic review was to evaluate the clinical and radiographic success of partial pulpotomies in deep caries processes or post-eruptive defects in young, vital permanent teeth. Methods: Electronic databases, PubMed, Scopus, and Embase, were searched, followed by a manual search. Randomized controlled trials evaluating partial pulpo-tomy with a follow-up period of ≥12 months were included. Meta-analyses using a random effect model were performed. Results: A total of 3.127 articles were retrieved, and after duplicate re-moval, 2.642 were screened by title and abstract; 1 additional article was found during the manual search in the reference lists, and 79 were identified. Finally, 6 papers were included in the review. Regardless of the partial pulpotomy modalities or material used, there were no signifi-cant differences between clinical and radiographic success rates (cumulative success rate 91,8%-92,3%, respectively). Five studies were included in the meta-analysis that did not indicate any statistically significant differences in success rates when Mineral Trioxide Aggregate was compared to other materials (95% CI 0,239 to 1,016 p=0.055). Conclusion: This research system-atically evaluates the evidence and summarises the available data on partial pulpotomy in young permanent teeth. Given its high clinical and radiographic success rate, partial pulpotomy should be considered when vital pulpal therapy needs to be performed in highly damaged young per-manent teeth, as this procedure provides a biological benefit and allows more invasive endodon-tic treatments to be postponed.

Various vestibuloplasty techniques have been reported to increase the attached mucosa (AM) and vestibular depth around dental implants. However, these surgical methods have disadvantages, such as limitations in manipulation, necessity of suturing, postoperative discomfort, swelling, and pain. This study aimed to evaluate the efficacy of laser-assisted periosteal fenestration (LA-PF) in treating a patient with a shallow vestibule and insufficient AM around dental implants. The LA-PF technique was performed using an Er:YAG laser. First, a partial-thickness apically positioned flap (APF) was performed. Horizontal periosteal fenestration was performed using an Er:YAG laser to expose the bones. Periosteal suturing was not required. After 12 months, sufficient AM and deepened vestibule were obtained and maintained. Thus, the LA-PF technique may be a simple and predictable treatment modality for vestibuloplasty around dental implants.

Angiotensin II (Ang II) plays a role in several inflammatory diseases and is capable of inducing the release of inflammatory mediators in several cell types. The objective was to investigate the potential of Ang II to induce mRNA expression of inflammatory mediators by cultured primary human periodontal cells. A synergistic effect of a co-treatment with Ang II and IL1β on mRNA expression of inflammatory mediators was also explored. Primary cultures of human fibroblast-like cells isolated from gingival and periodontal ligament tissues from 3 subjects were established using explant techniques. Immunophenotyping of STRO-1, AT1 and AT2 receptors was performed by flow cytometry analysis. Cell cultures were challenged with Ang II (1M) for 3, 6 and 24h with or without a co-treatment with IL1β (0.1ng/mL) for 24h. mRNA expression of inflammatory mediators was performed by real time quantitative polymerase chain reaction (RT-qPCR). We present, for the first time, a precise quantification for AT1 and AT2 receptors on human gingival and periodontal fibroblast-like cell types; the percentage of positive immunostaining compared to the total population of cells varied from 3.35% through 5.29% for AT1 and 2.97% through 4.57% for AT2. Ang II slightly upregulated mRNA expression of IL6 and CCL2/MCP1 in gingival cells and IL8 and PTGS2/COX2 in periodontal ligament cells. IL1β induced upregulation of IL8, IL6 CCL2/MCP1, PTGS2/COX2 and IL1β mRNA in both cell types. Co-treatment with Ang II and IL1β did not show a synergistic effect under these experimental conditions. Ang II shows a low potential to induce mRNA upregulation of inflammatory mediators in cultured primary human gingival and periodontal ligament cells, most likely due to the low percentage of Ang II receptors in such cells, and no synergistic effect with the co-treatment with IL1β.

Background: The present study was carried out to evaluate the roles of proliferation and angiogenesis in locally aggressive biologic behavior of ameloblastoma versus ameloblastic fibroma; Methods: 30 formalin-fixed paraffin embedded blocks (15 cases of ameloblastoma & 15 cases of ameloblastic fibroma) were used. To evaluate the proliferation, the tissue sections were stained with AgNORs stain. CD105 was used as immunohistochemical marker of angiogenesis. Quantitative evaluations of AgNORs were performed. The mean vascular density was evaluated as a measure for CD105 protein expression by using image analyzer computer system; Results: The mean number of AgNORs dots per nucleus was significantly higher in ameloblastoma as compared to ameloblastic fibroma. Also, the protein level of CD105 showed positive expression and wide distribution that the mean vascular density was significantly higher in ameloblastoma as compared to ameloblastic fibroma; Conclusion: Quantitative evaluation of AgNORs stain & the mean vascular density utilizing CD105 protein expression may reflect a higher proliferative activity and a more locally aggressive biologic behavior of ameloblastoma when compared to ameloblastic fibroma, that other factors may be involved in biologic behavior of ameloblastic fibroma.

Oral diseases remain a major health problem worldwide, with the World Health Organisation reporting that oral health neglect affects almost half of the world’s population. Quorum sensing molecules (QSMs) influence oral biofilms in various ways with knowledge of direct oral QSM-host interaction being limited, and such studies could provide more insight into the cross-kingdom communication occurring during oral disease development. This review aims to explore the literature on oral QSM-host interaction and to highlight areas of advancement in this field. QSM CSP-1 produced by Gram-positive oral bacteria was found to interact with T2R receptors, activating NF-kB signalling and leading to remodeling of the cytoskeleton. AI-2 in the oral cavity was found in various studies to elicit an inflammatory response in specific oral cells. Overall AHL detection methods remain an area for development, through which greater understanding of oral QSMs’ influence on host cells can be achieved. In conclusion, from the current literature it can be inferred that that QSMs are utilised by host cells to detect bacterial presence and in the majority of cases elicit an immune response towards the environmental QSMs. This may provide a base to target QSMs as novel treatment of oral diseases.

Background: In regenerative dentistry the graft material influences the success. It should act as an osteoconductive scaffold, providing a mineral substrate during resorption and inducing the activity of osteoinductive cells capable of producing new bone, platelet growth factors, and cell differentiation factors inducing the differentiation of undifferentiated mesenchymal cells into. Given that dentin shares many biochemical characteristics with bone tissue, it has recently attracted considerable interest as a biomaterial for bone repair. The aim of this study is to compare two grinder types in order to determine the optimal method for producing dentinal particles using a mechanical grinder. Materials and methods: A sample of 40 natural human teeth without restorations, prostheses or root canal treatments was used and divided into two groups subjected to two different grinder speeds (high-speed and low-speed). The high-speed showed a greater dispersion (53.5+-9.89% of the tooth) due to the pulverisation (highly thin granules) of part of the tooth. The low-speed grinder does not pulverize the dentin and the percentage of tooth loss is 9.16+/-2.34%. Conclusion: The low-speed gringer allows to save a major part of the tooth and to have a maximum quantity of graft material but requires more time. Further studies must be promoted to optimise the grinding procedures.

Background: To compare photodynamic therapy 41 and the use of probiotics in reducing halitosis assessed through gas chromatography and microbiome analysis. Methods: Participants aged from 18 to 25 years, showing sulfide (SH2) ≥ 112 ppb on gas chromatography, were selected. They were divided into 4 treatment groups: Group 1 - Tongue Scraping; Group 2- Antimicrobial Photodynamic Therapy (aPDT); Group 3- Probiotics; Group 4- Antimicrobial Photodynamic Therapy (aPDT) and Probiotics. The halimetry process was performed before, immediately after the treatments, 7 days, 14 days and 30 days after the initial collection. The collections for later microbiological analysis were made along with the halimetry, for the microbiome analysis. Results: Treatment with aPDT or probiotics under these experimental conditions was not able to change the bacteria present in the biofilm of the tongue. Conclusions: More research is needed to know the behavior of the oral microbiome in the presence of halitosis and the effectiveness of new treatments.

The aim of this systematic scoping review was to provide scientific evidence on the efficacy and methods of application of hyaluronic acid in the coverage of gingival recessions in terms of recession depth (RD) reduction, clinical attachment level (CAL) gain, probing depth (PD). An electronic search of the literature on the main databases was conducted. Initially, 405 articles were identified. Finally, 4 studies were included after the review process. It was not possible to perform a meta-analysis of the articles selected because of the differences among the surgical treatments and commercial formulations and compositions of hyaluronic acid. Both randomized controlled trials in this research examined Recession Type 1 gingival treated with coronally advanced flap. Recessions were treated with either modified coronally advanced tunnel or laterally closed tunnel combined with subepithelial connective tissue graft and hyaluronic acid (HA) in all case series. The studies analyzed no significant variation was found in PD variable. The results of RD reduction are in accordance with the literature. Modifications of CAL are connected to variations of RD. HA seems to improve the clinical outcomes of the described surgical treatment.

Abstract: Background: To determine the impact of a patient's ethnicity on the seeking preventive dental services at the Community Health Centers (CHCs) in South-Central Texas. Methods: Pri-mary electronic health records (HER) data were collected regarding each patient's medical and dental history, and comprehensive treatment planning. The researchers retrieved EHR from Jan-uary 2016 to 2022. Bivariate analysis was completed to test outcome with predicator and covariates using appropriate statistical tests. A multiple linear regression model was used to understand the association between the predictor and outcome variable while controlling for confounders. Results: The study findings revealed significantly higher dental visits (2.26 ± 2.88) for Hispanic patients. The results from the multiple regression model indicated that non-Hispanic patients had a 8% fewer chance of visiting the CHCs for preventive dental services compared to the Hispanic population (p-value<0.001) when all other variables are held constant. However, the study results were not significant as the effect size was small to conclude the effect of ethnicity on the patients visiting the dental clinic at the CHCs for preventive services. Conclusion: The study concluded that there is no difference in the preventive dental services completed by Hispanics and Non-Hispanics when all other variables are controlled.

: An innovative and stable probiotics-containing mucoadhesive gel (AL0020), integrated with botanical extracts, has been developed to rebalance the dysbiosis associated with periodontal diseases. Tau-Marin gel was tested against some pathogenic bacteria, belonging to the so-called "red complex", recognized as the most important pathogens in plaque specimens, adherent to the epithelial lining of periodontal pockets. A detailed physico-chemical profile of AL0020 and its in vitro efficacy in protecting activity against pathogenic bacteria as well as soothing or irritative effect on gingival epithelium were reported. Moreover, a clinical-dermatological trial on 20 volunteers using the product once a day for 30 days was also performed.

Background: Spinal pain is highly prevalent and in Spain it produces a very high economic cost and the scientific evidence supporting treatments shows low to moderate evidence for exercise. Therefore, the aim of this study was to assess the effectiveness of a therapeutic group exercise protocol in reducing pain intensity and disability in patients with spinal pain in primary health care setting. Methods: A total sample of 149 patients who suffered from chronic non-specific spinal pain. Patients received a therapeutic exercise protocol, including exercises of auto-mobilization of the neck and lumbar regions, as well as core stabilization exercises. Pain intensity and disability were evaluated before and after the therapeutic exercise protocol. Results: Statistically significant differences (P&lt;0.05) were shown for pain intensity and disability of patients with neck and low back pain with an effect size from moderate to large. Conclusions: A therapeutic exercise protocol may provide beneficial effects on disability and pain intensity in patients with chronic non-specific spinal pain, including neck and low back pain conditions. Clinicians should consider the use of self-administered exercise protocols, demonstrate great effectiveness, and be less costly.

CBCT significantly impacts dental procedures and has brought significant reforms in our approach to diagnosis & treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable in-sight into paranasal sinus pathologies with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study revealed that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening and was statistically significant (p=0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overes-timating the real impact of radiographic findings.

The aim of this study was to evaluate and compare the fracture resistance of definitive zirconia dioxide restorations obtained using a computer-aided design and manufacturing (CAD/CAM) system. Methods: Two groups of ten samples were analyzed for each material (n: 20), the first group was Zolid Gen X Amann Girrbach (ZGX) and the second group was Cercon HT Dentsply Sirona (CDS). The restorations were designed with identical parameters and milled with a CAD/CAM system. Each specimen was load tested at a speed of 0.5 mm/min with a direction parallel to the major axis of the tooth and with an initial preload of 10N until fracture using a universal testing machine (Universal/Tensile Testing Machine, Autograph AGS-X Series) equipped with a 20 kN load cell. The results obtained were recorded in Newtons (N), using software connected to the testing machine. Results: Statistically significant differences were found, and the fracture toughness of the monolithic zirconia crowns was lower in the CDS group (1744.84 ± 172.8 N), compared to the ZGX group (2387.41 ± 516 N). Conclusions: The monolithic zirconia CAD-CAM zirconia crowns showed sufficient fracture strength to be used in posterior molar and premolar zones with either material as they withstood fracture loads greater than the maximum masticatory force.

Introduction: Dental students’ use of online material to supplement learning has been studied, but educator awareness and reaction to the findings of this research is unknown. This small local study aimed to investigate dental students’ use of online content as a learning tool from an educator’s perspective.Methods: Educators at an Irish dental school completed a survey based on dental students’ use of online learning. Quantitative descriptive analyses were carried out as appropriate on the data collected, and a subsequent focus group was held to gain deeper insight into survey results. Data were analysed for themes by deductive and inductive coding methods.Results: This study found a sample of educators were aware of some student behaviours around online videos. Most educators correctly thought that students are likely to refer to online videos to prepare for dental procedures. Several educators believed that teachers should incorporate videos into their learning, but do not themselves upload or recommend online videos. Most recalled discussing accuracy and/or relevancy of online content with their students. Fewer thought that students would discuss contradictory videos with them. Focus group participants expressed concern over the accuracy of online content. This along with a lack of time were some reasons deterring them from referring students to online videos. Conclusions: An opportunity exists for dental educators and their students to have local dialogue around (1) student use, critical appraisal, and sharing of dental procedural video material; and (2) perceived benefits and challenges of incorporating both school-produced and online videos into teaching and learning. Although arguably non-generalizable beyond this context, this study may inform future research and serve to spark conversations within schools regarding video use for teaching clinical dental procedures.

In the field of orthodontics, providing patients with accurate treatment time estimates is of utmost importance. As orthodontic practices continue to evolve and embrace new advancements, incorporating machine learning (ML) methods becomes increasingly valuable in improving orthodontic diagnosis and treatment planning. This study aimed to develop a novel ML model capable of predicting the orthodontic treatment duration based on essential pre-treatment variables. Patients who completed comprehensive orthodontic treatment at the Indiana University School of Dentistry were included in this retrospective study. Fifty-seven pre-treatment variables were collected and used to train and test 9 different ML models. The performance of each model was assessed using descriptive statistics, intraclass correlation coefficients, and one-way analysis of variance tests. Random Forest, Lasso, and Elastic Net were found to be the most accurate, with a mean absolute error of 7.27 months in predicting treatment duration. Extraction decision, COVID, intermaxillary relationship, lower incisor position, and additional appliances were identified as important predictors of treatment duration. Overall, this study demonstrates the potential of ML in predicting orthodontic treatment duration using pre-treatment variables.

The influence of preoperative examination of oral squamous cell carcinoma (OSCC) mucosal surrounding by VELscope (Visually Enhanced Lesion Scope) on the radicality of surgical treatment of OSCC was the goal of this study.It is the first analysis of its kind with a total number of 122 patients suffering from OSCC with homogenous distribution of different tumor stages randomized into a study and a control group and enrolled in our study after meeting the inclusion criteria. The preoperative checkup by VELscope accompanied by the marking of the range of a loss of fluorescence in the study group was performed before the surgery. We have developed a unique mucosal tattoo marking technique for this purpose. The pathohistological results after surgical treatment, i.e. the margin status, were then compared. We achieved the pathological free margin (pFM) in 55 patients, the pathological close margin (pCM) in 6 cases and we encountered no case of the pathological positive margin (pPM) in the mucosal layer in the study group. In comparison, the control group results revealed pPM in 7 cases, pCM in 14 cases and pFM in 40 of all cases in the mucosal layer. This study proved that the preoperative autofluorescence evaluation of a tumor mucosal surrounding can enhance the ability to reach the pFM resection.

This study compares the action of different handpieces (turbine, high-speed electric handpiece and piezoelectric device) on surface roughness of enamel and dentin when using diamond-coated working tips and burs of the same grit size. Experiment was conducted on 15 extracted first molars from patients aged 45 to 60 years. The occlusal portion was removed using a diamond-coated water wheel and then refined with a 120-130 μm grit bur in order to obtain a flat surface with an adequate exposition of the dentin core. Each surface was divided into three portions and every portion was finished with one of the three tested instruments. Rotary burs and piezoelectric tips had the same grit size (60 μm) and load on handpiece during preparation never exceeded 150 g. Surface roughness parameters (Ra, Rsk, Rku) were recorded with an optical profilometer and SEM analysis of treated surfaces and working tips was conducted. Ra and Rsk differed significantly between enamel and dentin only after using turbine (p=0.004 and p=0.007, respectively). No significant differences were observed in Ra, Rsk, and Rku between enamel and dentin when using high-speed electric handpiece or piezoelectric device. Turbine produced higher Ra and Rsk values on dentin than the other devices, while no significant differences were found between piezoelectric handpiece and high-speed electric contra-angle on both substrates. Summarizing, the findings of the present study demonstrated that turbine generated rougher surfaces on dentin compared to the other handpieces. Moreover, the turbine produced more asymmetrical surface profiles on both enamel and dentin. However, it should be considered that these differences in roughness (Ra) were within the range of 0.25-0.30 μm: it is still unclear if these variations, although statistically significant, will influence final clinical outcomes.

This review explores the field of retreatment strategies for the cases filled with calcium silicate-based root canal sealers. Since the introduction of calcium silicate-based materials in dentistry, calcium silicate-based root canal sealers have become popular among dentists because of their biocom- patibility, bioactivity, and sealing ability. Therefore, effective retreatment strategies are indispensable. This article aims to identify the challenges associated with the removal of calcium silicate-based sealers itself and gutta-percha with the sealers during retreatment, evaluate current techniques and materials, and provide future directions for research in this field. Regarding the strategies of removal of root canal sealers, calcium silicate-based sealers are still relatively new materials for clinicians compared with the traditional sealers such as epoxy- or eugenol-based sealers. First, no clinically established solvents have been reported. Second, calcium silicate-based sealers are currently utilized by clinicians in either cold sealer-based technique or warm vertical condensation technique. Third, the setting process of calcium silicate-based sealers generates byproducts primarily calcium hydroxide and secondarily hydroxyapatite, which could interact with dentine. Lastly, there is a lack of clinical studies evaluating the efficacy of retreatment protocols for teeth filled with calcium silicate-based sealers. Therefore, it is important to investigate chemo-mechanical properties of calcium silicate- based sealers itself and their reactions to solvents and/or mechanical instruments, and identify the interfacial properties of calcium silicate-based sealers in respect to dentine and gutta-percha. In addition, researchers in clinical field need to actively gather and report data on retreatments of teeth filled with calcium silicate-based sealers.

Porphyromonas gingivalis is a periodontopathogenic bacterium that can adhere and colonize periodontal tissues leading to inflammatory process, and consequently tissue destruction. New therapies using flavonoids such as hesperidin are being studied, and its promising properties have been highlighted. The aim of this study was to evaluate the effect of hesperidin on epithelial barrier function, reactive oxygen species (ROS) production and on inflammatory response caused by P. gingivalis in in vitro models. Integrity of the epithelial tight junctions challenged by P. gingivalis was determined by monitoring the transepithelial electrical resistance (TER). P. gingivalis adherence to a gingival keratinocyte monolayer and a basement membrane model were evaluated by a fluorescence assay. A fluorometric assay was used to determine the ROS production in gingival keratinocytes. The level of pro-inflammatory cytokines and matrix metalloproteinases (MMPs) secretion was evaluated by ELISA, while to assess NF-κB activation, the U937-3xjB-LUC monocyte cell line transfected with a luciferase reporter gene was used. Hesperidin protected against gingival epithelial barrier dysfunction caused by P. gingivalis and reduced the adherence of P. gingivalis to the basement membrane model. Hesperidin dose-dependently inhibited P. gingivalis-mediated ROS production by oral epithelial cells as well as the secretion of IL-1β, TNF- IL-8, MMP-2 and MMP-9 by macrophages challenged with P. gingivalis. Additionally, it was able to attenuate NF-κB activation in macrophages stimulated with P. gingivalis. These findings suggested that hesperidin has a protective effect on the epithelial barrier function, in addition to reduce ROS production and attenuate the inflammatory response associated with periodontal disease.

It is known that complexes based on natural polysaccharides are able to eliminate bone defects. Prolonged hyperglycemia means low bone regeneration and a chronic inflammatory response. The purpose of the study was to increase the efficiency of early bone formation in a cavity of critical size in diabetes mellitus in the experiment. The polyelectrolyte complex contains high molecular ascorbate of chitosan, chondroitin sulfate, sodium hyaluronate, heparin, adgelon serum growth factor, sodium alginate and amorphous nanohydroxyapatite (CH-SA-HA). Studies were conducted on 5 groups of white female Wistar rats: group 1 - regeneration of a bone defect in healthy animals under a blood clot; group 2 - regeneration of a bone defect under a blood clot in animals with diabetes mellitus; group 3 - bone regeneration in animals with diabetes mellitus after filling the bone cavity with a collagen sponge; group 4 - filling of a bone defect with a CH-SA-HA construct in healthy animals; Group 5 - filling of a bone defect CH-SA-HA in animals with diabetes mellitus. Implantation of the CH-SA-HA construct into bone cavities in type I diabetic rats can accelerate the rate of bone tissue repair. The inclusion of modifying polysaccharides and apatite agents in the construction may be a prospect for further improvement of the properties of implants.

Microbiological control of dental pathologies presents a significant clinical challenge for dental surgeons, particularly considering drug-resistant microorganisms. To address this issue, Antimi-crobial Photodynamic Therapy (PDT) has emerged as an effective and complementary technique for microbial reduction. This therapy involves the application of a photosensitizer dye (PS) either topically or systemically, followed by exposure to low-power lasers with appropriate visible light wavelengths. PDT has found a valuable place in dentistry across various specialties, including surgery, periodontics, endodontics, dentistry, implantology, orthodontics, and pediatrics. In the realm of pediatric dentistry, managing microorganisms during dental treatments has become a major challenge.This article reviews the evidence supporting the potential of photodynamic therapy in combating bacteria, fungi, and viruses, with a particular focus on areas such as endodontics, restoration in deciduous teeth, implantology, and periodontics for bacterial control. Additionally, PDT has shown promise in stomatology, specifically in the treatment of mucositis and herpes. Considering its promising results and ease of application, photodynamic therapy presents an in-teresting alternative for clinical practice. However, it is important to note that specific protocols must be followed for each application, encompassing the type of photosensitizer, concentration, pre-irradiation time, light type, wavelength, energy, power, and mode of light delivery. Researchers have been steadily refining these protocols to facilitate PDT's integration into clinical practice.

The present review compared the efficacy of soft tissue substitutes (STS) and autogenous free gingival graft (FGG) or connective tissue graft (CTG) in mucogingival procedures to increase keratinized tissue (KT) width around teeth and implants. Two independent examiners performed the electronic search on Medline and Cochrane Library based on the following PICO’s format: (P) adult patients; (I) soft tissue substitutes and FGG/CTG; (C) STS vs CTG; STS vs FGG; STS vs CTR; (O) KT width gain; (S) Systematic Reviews, Randomized Controlled Trials. Results showed that around teeth, all biomaterials showed superior performance compared to CAF alone for treating gingival recessions. However, when compared to CTG, ADM yields the most similar outcomes to the gold standard (CTG), even though in multiple recessions CTG still continue to be considered the most favorable approach. Use of STSs (acellular matrix or tissue engineered) in combination with an apically positioned flap resulted in a significantly less gain of KTW compared to what achieved with FGG and APF. Around dental implants, free gingival grafts were deemed more effective than soft tissue substitutes in enhancing keratinized mucosa width.

The aim of this systematic review was to describe clinical and genetic features of syndromes showing oligodontia as a sign. The review was performed according to the PRISMA 2020 checklist guidelines, and the search was conducted using PubMed, Scopus, Lilacs, Web of science, Livivo and EMBASE and supplemented by a gray literature search on Google Scholar and ProQuest, applying key terms relevant to the research questions. The systematic review identified 49 types of syndromes in 91 studies, and the most common was hypohidrotic ectodermal dysplasia, which was reported in 24 patients in 22 studies. Other commonest syndromes that reported oligodontia included Axenfeld-Rieger syndrome, Witkop’s syndrome, Ellis-van Creveld syndrome, blepharocheilodontic syndrome and oculo-facio-cardio-dental syndrome. The X-linked mode of inheritance was the most reported (n=14 studies), followed by the autosomal dominant (n=11 studies). The review describes the main syndromes that may have oligodontia as a clinical sign and reinforce the need of oro-dental-facial examining for adequate diagnosis and treatment of the affected patients. Molecular analysis in order to better understand the occurrence of oligodontia is imperative.

The aim was to assess the precision and accuracy of cephalometric analyses performed by artificial intelligence (AI) with and without human augmentation. Four dental professionals with varying experience levels and AI identified 31 landmarks on 30 cephalometric radiographs twice. These landmarks were re-identified by all examiners with the aid of AI. Precision and accuracy were assessed by using intraclass correlation coefficients (ICCs) and mean absolute errors (MAEs). AI revealed the highest precision with a mean ICC of 0.97, while the dental student had the lowest (mean ICC: 0.77). AI/human augmentation method significantly improved precision of the orthodontist, resident, dentist, and dental student by 3.26%, 2.17%, 19.75%, and 23.38%, respectively. The orthodontist demonstrated the highest accuracy with a MAE of 1.57 mm/˚. AI/human augmentation method improved the accuracy of the orthodontist, resident, dentist, and dental student by 12.74%, 19.10%, 35.69%, and 33.96%, respectively. AI demonstrated excellent precision and good accuracy in automated cephalometric analysis. The precision and accuracy of the examiners with the aid of AI improved by 10.47% and 27.27%, respectively. The AI/human augmentation method significantly improved the precision and accuracy of less experienced dental professionals to that of an experienced orthodontist.

Background and Objectives: Trichomonas tenax is a protozoan, participating in the human oral microflora. It is considered as a potential paradontopathogen. This microorganism is also reported in the respiratory tract. We aimed to analyze the available literature about the prevalence of Trichomonas tenax in the population affected by periodontal disease. Materials and Methods: Тhe searching with keywords: ,,Trichomonas tenax” and “periodontal diseases’’ in Scopus, PubMed and ScienceDirect databases was able to identify several systematic reviews and original articles until July 2023. All studies with suffering from periodontal disease people, mentioned year of publication, country, specified detection methods, total number of tested samples as well as the percentage of those infected with Trichomonas tenax were included. Irrelevant articles were excluded. Results: We found 137 studies, but only 64 studies about distribution of Trichomonas tenax in patients with gum disease underwent qualitative analysis. The highest number of studies have been conducted in Iran, Poland and Iraq. Different methods have been used to detect the unicellular organism, each with different specificity and sensitivity. Conclusions: Interest in Trichomonas tenax has grown considerably since 2000. Because of its association with periodontal disease, Trichomonas tenax role in the inflammatory process shouldn’t be overlooked.

Temporomandibular disorders (TMD) affect a high percentage of children and adults worldwide. Surgery may be indicated in severe or recalcitrant case. Several recent advancements in the TMD and temporomanidbular joint (TMJ) surgery have elevated understanding and ability to treat affected patients. We discuss recent advances in TMD epidemiology, juvenile idiopathic arthritis (JIA) of the TMJ, and surgical techniques and technologies. Technical advancements have been identified in TMJ arthroscopy, treatment of TMJ subluxation and dislocation, and extended prosthetic total TMJ reconstruction (eTMJR). Overall, this review provides valuable insights into significant recent advancements of TMJ disorders and their surgical management.

To determine the fracture rate of ceramic crowns and causes of ceramic crown failure, this study used keywords—namely “endocrown,” “veneered fixed dental prosthesis,” “monolithic lithium disilicate (LS2),” and “all-ceramic single crown”—to search for articles published in English from 2005 to 2023 in the PubMed electronic database. Rather than using the Boolean logic algorithm between MESH terms and keywords, we accurately calculated the numbers of final clinically tracked cases with crown fractures from the contents of articles. The titles and abstracts of many related articles focused on implant or abutment fracture, while crown fracture was investigated and mentioned only in the main texts of the articles. Our studies included those crowns as well as having more complete data collection. Our search yielded 228, 93, 404, and 358 articles for the keywords “endocrown,” “veneered fixed dental prosthesis,” “monolithic lithium disilicate (LS2),” and “all-ceramic single crown,” respectively. We used the Newcastle–Ottawa Scale (NOS) to assess article quality, and our inclusion criteria were randomized controlled trials (RCT) and cohort study articles involving more than 3 years of follow-up and more than 20 cases. After reviewing, 16 high-quality articles were selected for analysis. The 4.4% crown fracture rate recommended on the basis of most clinical results was achieved in only 6 of the 16 articles. In these 6 articles, the researchers concluded the following reasons that may cause the crown fractures: the thickness of the veneer ceramic material; the connector dimensions; pontic span of the fixed prosthesis; the type of cement; the treatment of the ceramic surface before luting. Other articles inferred that the computer-aided design libraries that were insufficient for the creation of appropriate anatomically supported frameworks for prostheses with ceramic veneers; the thermal expansion coefficient and fracture toughness of the framework material did not match those of the veneer ceramic, resulting in an insufficient area supporting the ceramic veneer then leads to premature crown failure after a long period chewing. The future prospective for material developing could focus on solving those problems and have better clinical results.

This study compared condylar volume, length, and articular eminence (AE) characteristics in normal individuals and those with unilateral and bilateral juvenile idiopathic osteoarthritis (JOA). The 116 patients were divided into four groups: control (n=16), affected condyle of unilateral JOA (Aff-Uni) (n=36), non-affected condyle of JOA (NonAff-uni) (n=36), and bilateral JOA (Bi-JOA) (n=28). Volume and length differences in the condyle and AE were analyzed using ANOVA and Bonferroni post hoc tests. The results showed that Bi-JOA had significantly different condylar volume, especially in the condylar head (p&lt;0.01), specifically the middle, anterior, and medial parts (p&lt;0.05). Condylar length also differed among the groups, with differences observed between the control group and the other three groups, as well as between the bilateral group and the other three groups (p&lt;0.01). AE total volume differed between the control group and Aff-Uni. In the detailed comparison, Aff-Uni and NonAff-Uni were smaller than the control group in the posterior, lateral, and medial sections (p&lt;0.05). In conclusion, depending on the involvement of unilateral or bilateral JOA, there were differences in condylar volume and AE compared to the normal control group. Therefore, prognosis should be evaluated by distinguishing between patients with unilateral and bilateral JOA.

In interceptive treatments in which impacted teeth (incisor or first permanent molar) should be included into the dental arch, the main clinical problem is the provision of an anchorage area and a suitable appliance. The use of laser sintered metal orthodontic grids, designed and printed digitally, has expanded the boundaries of orthodontic treatment, especially in its interceptive phase. Our aim is to describe a digital model for providing anchorage during orthodontic-surgical traction of impacted teeth in the mixed dentition period. We present the treatment of three clinical cases with digitally projected and printed metal grids used for anchorage. In the described clinical cases, individually designed anchorage systems were used. They were created through design software and after that the metal grids were printed. The devices are placed in the oral area and don’t disturb the aesthetics of the patient in any way. The advantages of individual designed metal support grids allow to accommodate the features of relief of the hard palate and alveolar bone. This makes the grids comfortable for the patient and rigid enough to perform orthodontic tractions at the same time. The printed additional grids are applicable in mixed dentition and in complicated clinical cases in permanent dentition. Their individuality allows segmental treatments or treatments in cases requiring additional anchorage further from the active force.

Diabetes may cause an increase blood levels of cytokines inducing a rising of C reactive protein (PCR) and fibrinogen stimulating a subclinical inflammation which lead to adhesive molecules expression and to endothelial disfunction. A comprehensive panel of type 1 diabetes mellitus (T1DM) interleukins polymorphisms is not provided yet. As chronic periodontitis (CP) is considered the sixth complication of DM, a clarification is needed about the inflammatory role managed by single nucleotides polymorphisms (SNPs). The goal of this review is to focus on the significant diversity of SNPs in T1DM patients with and without CP. After a digital search on PubMed and Scopus with reference to the last 5 years, 21 items were enrolled. Several ILs were analyzed. T1DM still needs to be thoroughly explored regarding the ILs polymorphisms panel, however the last 5 years have led to the increased independence of this condition, causing autonomous inflammatory effects which requires further investigations. CP and T1DM association in children and adolescents represents a severe gap in literature that should be filled, the scarce presence of studies also about adults serves as a motivation for ulterior clinical researches

Introduction: Due to the great development of digital technology, through CAD (Computer - Aided Design) and CAM (Computer - Aided Manufacturing) systems, digital models could be used in orthodontic treatment planning decision-making, as there are numerous studies in the literature that support the validity of measurements of digital models of anterior teeth and the total coefficient of Bolton analysis. The aim of the study was to compare the average length value of the current upper and lower arches with that of a hypothetical nickel-titanium wire and the accuracy of the Bolton index measurement. In the present study, 138 dental casts were analyzed using Ortho3Shape software. Using the Ortho3Shape software, it was possible to measure the real and ideal lower arch lengths and, with regard to Bolton analysis, the values of the anterior and total Bolton coefficients. By comparing the values obtained with those of the study by A. Anand Kumar et al. using CBCT and plaster casts, the reliability of the measurements obtained with such CAD/CAM orthodontic software was evaluated. Considering the validity of digital measurements demonstrated by the studies and systematic reviews in the literature, it can be stated that CAD/CAM digital models can be a viable alternative to plaster models in the coming years, as they can facilitate model preservation and retrieval. For future studies and research, it would be preferable to use intra-oral scanners (IOS) in order to ensure greater accuracy, requiring only one step and ensuring a better outcome for the patient.

The odontogenic cysts can lead to a bone destruction that can hamper the dental implant place-ment in the ideal 3D position. Different biomaterials and techniques that allow bone regeneration are described in the literature, each with its advantages and disadvantages. This clinical case with 18 months of follow-up shows the enucleation of an odontogenic cyst fol-lowing the guide bone regeneration with fence technique. After 6 months 2, dental implants were placed at the region of tooth 11 and 21, being rehabilitated nine weeks after. The fence technique allowed the recovery of the bone morphology and the placement of the dental implants in the 3D ideal position.

We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP) and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted to statistical analysis (α=0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD and CAL, which were statistically significant at 90 and 180 days (p&lt;0.0001). Importantly, NSPT significantly reduced the blood level of CRP (p&lt;0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.

The unsolved problem in three-dimensional surgical planning for patients with facial deformity, dysgnathia, or asymmetry is the lack of a normative database of “norm skulls” that can be used as treatment objectives. A study was conducted on 90 Eurasian persons (46 male and 44 female adults) with normal and balanced facial appearance, skeletal Class I pattern, and proper interincisal relationship with normal occlusion. Cone-beam computed tomography was performed. 18 landmarks were digitized and 3D cephalometric measurements of overall facial features, skull, midface and mandible were performed and analyzed by means of proportions calculated from the landmarks. Male and female skulls were analyzed as well as subdivisions revealed by cluster analysis. The data showed that four subtypes of skulls were distinguishable with statistical significance (p< 0,05). A male and a female type subdivided in a brachiocephalic and dolichocephalic phenotype could be identified. For each type then a mean shape was calculated by a Procrustes transformation, which in turn was used to create four template skulls from a male and a female skull by means of a thin plate spline transformation. The normative data of the subtypes can individually serve as a guide for orthodontic surgery, especially helpful in 3D plan-ning and execution of craniofacial operations.

Introduction: Cleft lip with or without cleft palate (CL/P) is the most common congenital face anomaly in the world of multifactorial etiology. Objective: To determine the prevalence and characteristics of cleft palate. To identify associated risk factors to guide prevention and/or prenatal detection for early intervention and better health outcomes. To assess the rehabilitation protocols after operations in cleft palate. Design: Retrospective descriptive and clinical study. Patients: One hundred and three children with cleft palate treated in the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, were included in the study. Methods: Records evaluation was conducted regarding sex, cleft type, mother occupation, parents education, histories of cleft in any of parents. The data were analyzed using R (R core team 2021) and the ordinal logistic regression analyses. Results: Children of stressed mothers during pregnancy had 9.4 times higher odds of having bilateral cleft. While there was no evidence that children sex, order of birth, and body mass as well as risk of maternal toxicity at work or reporting infections or drugs toxicity had a significant effect on the dependent variable. Conclusions: Children of parents with cleft history and having low educated mothers had higher probability of bilateral cleft palate. Children of stressed mothers during pregnancy had higher odds of having bilateral cleft. In literature, there is a lack of reports about rehabilitation in different operations methods in children with cleft palates.

Objective. Whether a minimum quantity of saliva is needed to inhibit the caries process is unclear. Here, we evaluated the effect of saliva dilutions on an in vitro caries model with Streptococcus mutans (S. mutans) biofilms. Methods. S. mutans biofilms were grown on enamel and root dentin slabs, in culture media containing different proportions of saliva (v/v): 0%, 5%, 10%, 25%, 50%, 75% and 100% saliva, and exposed to a 10% sucrose solution (5 min, 3x/day), with appropriate controls. After 5 (enamel) and 4 (dentin) days, demineralization, biomass, viable bacteria and polysaccharide formation were analyzed. The acidogenicity of the spent media was monitored overtime. Assays were carried out in triplicate in 2 independent experiments (n=6). Results. An inverse relationship was observed between acidogenicity, demineralization, and saliva proportion, both in enamel and dentin. A marked reduction in enamel and dentin demineralization was observed when small amounts of saliva were incorporated in the medium. For both tissues, a significant reduction in biomass, viable S. mutans cells and polysaccharides were observed when saliva was present, in a concentration-dependent manner. Conclusions. High quantities of saliva can almost completely inhibit sucrose-induced cariogenicity, but small amounts can also exert a dose-dependent caries-protective effect.

The mechanical properties, structure, and morphology of milled and 3D printed Ti-6Al-4V alloys produced by selective laser melting were investigated in this study. The mechanical properties were investigated by means of nanoindentation, a tensile test, and a three-point bending test. The Atomic Force Microscope (AFM) was used to study the surface topography and roughness of both titanium alloys. The surface structure and phase analysis were studied by a scanning electron microscope (SEM) and through powder X-ray diffraction (XRD). The results from the nanoindentation experiments showed that the 3D-printed sample has higher indentation hardness and modulus than the milled one. The AFM observation of the surface topography of the samples showed that the milled sample has a higher roughness than the 3D-printed one. The tensile test results showed that the 3D printed sample by means of Selective Laser Melting (SLM) technology has about 26% higher tensile strength and smaller elongation than the milled one. The 3-point bending test revealed that the 3D printed Ti-6Al-4V sample has higher flexural strength than the milled one. It was found that the 3D-printed sample has a smaller crystal size than the milled one, which, according to the Hall-Petch relationship, leads to its higher indentation hardness.

The purpose of the study was to evaluate the success of procedural conscious sedation, using inhaled equimolar nitrous oxide-oxygen (NOIS – EMONO), in patients undergoing routine dental and oral surgery procedures in a Swiss university hospital setting. Materials and methods: The authors conducted a retrospective cohort study of patients that underwent NOIS-supported procedures between 2018 and 2022 at the oral surgery department of the University Hospital of Geneva (HUG), Switzerland. The primary outcome was the measurement of the procedure success and efficacy as defined by the European Society of Anesthesiology. Secondary objectives included the analysis of the types of treatments performed, their indications, patient behavior, and the patient - clinician satisfaction score. Results: 55 patients were included in the study, 85% underwent surgical procedures, the remaining 15% underwent restorative and preventive procedures. The overall treatment success rate was 98.2%, and 97.9% for surgically treated patients. 62% of patients appeared relaxed, calm, and serene, while 16% expressed pain or fear during the procedure. Infiltrative administration of local anesthesia caused stress in 22% of patients, this was significantly lower in sub cohorts who received local topical anesthetics (0%) or a combination of systemic and local topical analgesics (7%). Patients (75%) and clinicians (91%) were satisfied with the procedure. Conclusion: Inhaled equimolar nitrous oxide-oxygen procedural sedation used during dental procedures and oral surgery results in high treatment success and satisfaction rates. The administration of additional topical anesthetics helps reduce the anxiety and stress related to infiltrative anesthesia. Further dedicated studies and prospective trials are needed to confirm these findings.

The purpose of this study is to identify gender by highlighting common coordinates and discriminating coordinates in the two sexes through palatal rugoscopy, comparing sagittal sections of the hard palate and evaluating the assistance given by digital technology and its applicability in this method. In this study, 85 digital impressions were examined. The impressions were in .stl format. The palatal rugae, retroincisal papilla, and the palatal cusps of the second premolars were isolated using Meshmixer software (Autodesk Inc., San Rafael, CA, USA) by eliminating everything else from the scan. Then the impressions were aligned using the same software so as to be subsequently imported to Geomagic® Control 14 software (3D System, NC, USA). Results: 2,223 impression sections were studied and 145 coordinates that were present with a frequency greater than 50% in one or both groups were obtained: 52 discriminating traits (DT) in the male group, 29 discriminating traits in the female group, and 64 common traits (CT). The sum of all the coordinates found in the 57 impressions was 9,328: 4,569 in the male group and 4,759 in the female group (P=0). The DTs in the female group showed no statistically significant difference from the same coordinates in the male one (P=0.832). Statistically significant differences were observed in the DTs in the male group compared to the same coordinates in the female group (P=0.018). No statistically significant differences were observed in the frequency of DTs in both sexes (P=0.056). Further research in forensic odontology is needed to determine its scientific certainty. It is certain that digital technology may one day be a valuable support for the forensic odontologist but to date the lack of dedicated and certified programs limits its reliability.

The present study sought to determine the effect of incorporating a Chitosan-TiO2 nano-composite on the color stability of pigmented Room Temperature Vulcanization (RTV) maxillofacial silicone subjected to a variety of accelerated aging conditions. The experimental setup consisted of one hundred groups of five disk-shaped specimens (22mm diameter, 2mm thick) each, created using RTV silicon elastomer type A-2186, with the total sample distributed into four groups based on the pigments combined with the silicon—specifically, brilliant red, blue, and yellow dry intrinsic pigments (at 0.2% concentration by weight) and a fourth group that remained non-pigmented. Each of these primary groups was further subdivided into five categories corresponding to the silicon variants treated with different nanoparticles—2% TiO2, 3% Chitosan, a hybrid nano-combination of 1% TiO2/Chitosan, 1% synthesized Chitosan-TiO2 Nanocomposite, and a control group devoid of nanoparticle additions. The synthesized Chitosan-TiO2 Nanocomposite was effectively prepared using the core-shell method. The color stability of each silicon category, irrespective of whether pigmented or non-pigmented was evaluated by calculating the color difference (ΔE) pre- and post-subjection to five distinct accelerated aging conditions: 30 hours in an antibacterial cleaning solution, six months in sebum, six months in sweat, UV-accelerated aging for 720 hours, and outdoor weathering for six months. Color measurements were taken using a Colorimeter within the CIELAB color system. Statistical analyses, including one-way ANOVA at a significance level of p < 0.05, were employed to discern significant differences among the various accelerated aging conditions across the five silicon categories. Further comparisons were made using Dennett's T3 multiple comparison test, Tukey HSD multiple comparisons, and a t-test, with SPSS for Windows version 27.0 as the software platform. Results indicated that all silicon types, whether pigmented or not, exhibited varying degrees of color change under different aging conditions. Red-colored samples, across all silicon categories, demonstrated significant color alterations after 720 hours of UV-accelerated aging, with the most pronounced change in the 3% Chitosan samples and the least in the 2% TiO2 samples. Six months of outdoor weathering led to a marked increase in ΔE values across all categories. The blue-pigmented silicon samples treated with 2% TiO2 showed the highest color modification, while the yellow-pigmented silicon and non-pigmented silicon also underwent significant color shifts, particularly in the control and Chitosan-TiO2 categories, respectively. The study underscores the pervasive influence of outdoor weathering on color stability across all silicon categories. It also demonstrates that while nanoparticle incorporation offers some resilience against accelerated aging, it fails to provide adequate protection against the specific effects of UV radiation encountered during outdoor weathering.

Current scientific knowledge and guidelines in bone and soft tissue augmentation, suggest the use of
staged surgical workflows as gold standards in regenerative procedures during implant therapy. In this
context, the process is always the same regardless of the techniques applied: an
alternate series of surgical acts is following one another after the completion of a specific period of
osseointegration or graft maturation. As a result, the overall surgical treatment is often long, invasive and
induce scar tissue formation.
This article proposes a novel, fast and less invasive biphasic protocol with the use of a well documented
cortical barrier mounted on stock healing abutments that are further replaced by customised abutments
on an early second stage. 2 cases are reported, one for an upper maxillary edentulous area and the other
for a mandibular, with a total of 4 implants placed.
Results at 4 months post op, showed an optimal soft tissue configuration for both cases with adequate
cervical profile generation and sufficient supracrestal complex height above the implant platforms.
Significant bone gains were also recorded through CBCT data collection either with alveolar width
measurements on axial slices, superposition of preop and postop datasets and 3D visualization after bone
volume segmentation.
Further studies will be needed in the future to evaluate the efficacy of this protocol in both hard and soft
tissue augmentation for edentulous sites in need of implant rehabilitation.

This study aimed to identify and differentiate the factors that may affect the incidence of temporomandibular joint (TMJ) dysfunction in children with type 1 diabetes. We analyzed the TMJ symptoms, clinical and laboratory parameters of type 1 diabetes in a cohort of 101 consecutive patients. The participants were evaluated regarding the presence of pain in the masticatory muscles, TMJ sounds, mouth opening, maximum mouth opening, lateral and protrusive excursions, and Fonseca scores. The overall cohort showed a mean Fonseca score of 20 ± 13.89, referred to mild TMJ dysfunction. Of patients, 34.65% presented at least one clinical symptom and were defined as having dysfunction. The most frequently recorded symptom was TMJ sounds, presented in 16.8% of children. In subjects with dysfunction compared to those without dysfunction, a significant difference was found at height standard deviation scores, Fonseca scores and maximum mouth opening (p&lt;0.001). HbA1c levels, diabetes duration, age and gender did not reveal any significant differences between the patients with and without dysfunction. Type 1 diabetes is often associated with limited mouth opening and mild TMJ dysfunction. This dysfunction may reflect a more chronic condition and possibly exceeds the prevalence of cheiroartropathy. This study could be a starting point towards enhancing our understanding of clinically evident TMJ involvement in type 1 diabetes.

Recurrent infections after root canal treatments often involve Enterococcus faecalis, a microorganism closely associated with therapy failures due to its biofilm production, survival in nutrient-deprived conditions, and antibiotic tolerance. Essential oils (EOs), which display anti-inflammatory, antimicrobial, and antibacterial properties, exhibit inhibitory effects on the growth of many microorganisms including E. faecalis. This study assessed the in vitro efficacy of combining antibiotics (Gentamicin 1.5mg/ml, Streptomycin 2.5 mg/ml, Ampicillin 5 mg/ml, and Kanamycin 2.5 mg/ml) with Cinnamon (1.25% to 5%) or Clove (25% to 50%) EOs using disk diffusion tests. Disks were treated with EOs-only, antibiotics-only, or EO-antibiotic combinations, placed on BEA agar plates, incubated for 24 hours, and zones of inhibition were measured against E. faecalis. Results showed robust growth inhibition by cinnamon and clove EOs across all tested concentrations. Furthermore, there were synergistic antimicrobial effects when gentamicin, streptomycin and kanamycin were combined with 2.5% and 50% concentrations of cinnamon and clove EOs, respectively, leading to significant growth inhibition of E. faecalis by 139% to 193% compared to using antibiotics or EOs alone. Clove EO showed positive synergism with three antibiotics (gentamicin, streptomycin, and kanamycin) whereas cinnamon EO showed synergism with two antibiotics (streptomycin and kanamycin). These findings suggest that combining cinnamon and clove EOs with aminoglycoside antibiotics can significantly reduce the expansion of E. faecalis compared to antibiotics alone. Further in vivo studies should determine the safety, efficacy, and treatment duration, with the potential to reduce antibiotic dosages and associated toxicity while preventing recurrent infections.

The aim of our study was to assess the relationship between the concentration/activity of salivary stress biomarkers (cortisol, α-amylase) and the psychological profile of patients with oral lichen planus (OLP) and primary burning mouth syndrome (BMS). A total of 160 subjects participated in this cross-sectional study: 60 patients with OLP; 60 patients with primary BMS; 40 control subjects. Unstimulated whole saliva (UWS) was collected between 9 and 10 am. Salivary biomarkers were analyzed by enzyme-linked immunosorbent assay (ELISA). Psychological assessment was evaluated with the Depression, Anxiety, and Stress Scale (DASS-21). Patients with primary BMS had higher salivary cortisol concentrations and α-amylase activity (0.52 vs. 0.44 µg/dl; 160531 vs. 145804 U/L) compared with patients with OLP. Patients with primary BMS had statistically significantly higher scores for depression, anxiety, and stress compared with patients with OLP and control subjects (p <0.001, Kruskal-Wallis test). There was a strong positive correlation between anxiety and depression, stress and depression, stress and anxiety in patients with OLP and BMS (p <0.001 and p <0.001, respectively). There was a good positive correlation between symptom intensity (pain/burning) and psychological profile (depression, anxiety, stress) in patients with primary BMS (r=0.373, p=0.003; r=0.515, p <0.001; r=0.365, p= 0.004, respectively). Patients with BMS show a stronger association with mental disorders compared to patients with OLP. However, an interdisciplinary psychoneuroimmunological approach is equally important in both patient groups (OLP and BMS), regardless of whether mental disorders are the cause or the consequence.

Peri-implant bone resorption has been reported around some implants after loading and this could create problems for the long-term stability of peri-implant soft and hard tissues. The causes are still not completely known, but a relevant importance could be assumed by the presence of a bacterial contamination at the micro-gap level of the implant-abutment junction. In this regard, external and internal implant-abutment assemblies have been shown to be much more permeable to bacterial colonization than Cone-Morse or conical connections. A subcrestal implant placement could have aesthetic advantages allowing a better prosthetic emergence profile. In literature controversial experimental and clinical results have been reported about bone resorption around implants placed equicrestally and subcrestally. Interestingly, Finite Element Analysis (FEA) studies revealed to be extremely useful for assessing the peri-implant bone strain and stress. Thus, the aim of this study was a FEA evaluation of implants with a Cone-Morse implant-abutment assembly (Implacil De Bortoli, São Paulo, Brazil) inserted into a bone block model (width: 10 mm, vertical height: 17.5 mm, thickness of the cortical area: 1.5 mm) mimicking equicrestal and subcrestal placements (1 and 2 mm). The results demonstrated that maximum stresses were observed within the cortical bone around the equicrestally placed implants, the lowest in the implant placed 2-mm subcrestally and intermediate stresses within the implant placed 1-mm subcrestally. Cortical bone was more stressed under lateral loads than axial loads. In conclusion, this FEA study suggested that implant placement at -1 mm could be recommended.

Regenerative endodontic procedures (REPs) aim at recreating dental pulp tissue using biomaterials such as hydrogels. Their bioactivity is mostly linked to the nature of biomolecules or chemical compounds that will compose the endodontic hydrogel. However, many other parameters, such as hydrogel concentration, type, bioactive molecules solubility, of apex size were reported to influence the hydrogel behavior, leading to the inability to predict the clinical outcome. This lack of knowledge and the various parameters that should be considered, suggest that biological activity of endodontic hydrogel is impossible to anticipate and could hinder the bench to bedside transition. We formulated in this article our opinion that most of these parameters could be identified, described, and studied. A second part of the document lists some challenges and perspectives, including development of future mathematical models able to explain and predict the bioactivity of these endodontic hydrogel in clinic.

The aim of this article was to evaluate properties of new polymer material, based on PEEK, for FPDs in patients with parafunctions. Methods: Prospective clinical study involved patients with diagnosed signs and symptoms of parafunctions, restored with 100 units, PEEK based FPDs, veneered with composite material. During one year observation period the following parameters were evaluated: color changes, periodontal indices, treatment success using FDI criteria, occlusal parameters, patient-reported outcome measures (OHIP-49) and occurrence of complications. Results: Spectrophotometry revealed that 63% of bridges experienced changes for L*, a*, b* color parameters, but it was not clinically significant for patients. Periodontal indices (PI, GI, BOP) revealed statistically significant higher values around restorations. According to FDI criteria, therapy was considered successful and 86.7% of FPDs were acceptable. Computerized occlusal analysis demonstrated no significant difference in the number of occlusal contacts and the intensity of relative forces between restoration and control side. Results of OHIP-49 questionnaire showed improved patient’s quality of life. Complications appeared in a limited number of cases. Conclusion: PEEK based FPDs could be indicated for successful prosthodontic rehabilitation in patients with parafunctional activities, but further material improvements and long-term clinical trials should be conducted to analyze performance of this material in challenging cases, for patients with CMD and in implant therapy.

Our research aimed to explore how resolving periodontal inflammation impacts cytokine expression in the colon of aged Wistar rats. Animal studies have been used to investigate the two-way relationship between periodontitis and Inflammatory Bowel Disease (IBD), where chronic inflammation in either the mouth or intestines can negatively affect the other. We allocated sixteen male Wistar rats, aged between 8-11 months, into four groups: (1) Ligature-induced periodontitis (LIP) without the resolution of periodontal inflammation (RPI) (LIP; n=4), (2) LIP + RPI (n=4), (3) LIP + DSS-induced colitis (DIC) without RPI (n=4), and LIP+DIC+RPI (n=5). We performed histopathological and immunological analyses on the periodontal and intestinal tissues and analysed cytokine expressions using a Rat Cytokine 23-Plex Immunoassay. Our findings showed that animals with and without DIC who underwent RPI showed significantly lower levels of IL-2, IL-4, IL-5, IL-10, IL-13, IL-17, IL-18, and TNF-α in the intestine compared to those without treatment. The RPI effectively reduced the number of inflammatory cells in the lamina propria and restored the epithelial barrier in the intestine in animals with DIC. The resolution of periodontal inflammation significantly reduced the levels of pro-inflammatory cytokines and chemokines in the intestine of aged rats with and without DSS-induced colitis.

OPMDs (Oral Potentially Malignant Disorders) are a group of disorders affecting the oral mucosa that are characterized by aberrant cell proliferation and a higher risk of malignant transformation. Vitamin D (VitD) and its receptor (VDR) have been extensively studied for their potential contributions to the prevention and therapeutic management of a range of diseases and neoplastic conditions, including oral cancer. Observational studies suggest correlations between VitD deficiency and higher cancer risk, worse prognosis, and increased mortality rates. Interestingly, emerging data also reveals a link between VitD insufficiency and the onset or progression of OPMDs. Understanding the role of the VitD-VDR axis not only in established oral tumors but also in OPMDs might thus enable early detection and prevention of malignant transformation. With this article, we want to provide an overview of current knowledge about OPMDs and VitD, and investigate their potential association and ramifications for clinical management of OPMDs.

Enamel erosion is a process which happens every time we eat and it may be accelerated by some particular acid foods, drinks or other agents. Dental enamel when damaged by low pH substances becomes chalky, rough, opaque, yellowed and it can be related to dentinal hypersensitivity. To the present day, several possible solutions are available, therefore the aim of this study was to evaluate the effect of a biocompatible minerals serum based on calcium silicate, sodium phosphate and fluoride (Regenerate™) on the damaged enamel by four different acid liquids. 135 ovine teeth were equally divided into 5 groups and submerged for one week into lemon juice, energy drink, coffee, tea and physiologic solution for the negative control. The first 4 groups were evaluated for their color with an analogical color scale (Vita® Scale) and for their surface assigning a qualitative aspect among opaque, rough, chalky or smooth. Then they were treated with hydroxyapatite gels and re-evaluated for the same parameters. Data were checked for the normal distribution with Shapiro-Wilk test and analyzed with dependent t-test or Wilcoxon Signed Rank test, every test with a p≤0.05. Both color and surface aspect showed a strongly significant improvement after the treatment. Biocompatible minerals serum based on hydroxyapatite is able to reverse teeth erosion, improve the color and restore the smoothness of the dental enamel.

The goal was to assess dental students' perception of digital technologies after participating in a CAD/CAM exercise for scanning, designing, and manufacturing computer-aided provisional fixed dental restorations. A survey was conducted among second-year dental students (pre-D2 and post-D2), first- (D1, negative control), third-, and fourth-year dental students (D3 and D4, positive controls). Only OSU College of Dentistry students who completed the activity and completed the surveys were included. Seven questions were rated, which evaluated changes in knowledge, skill, interest, the importance of technology availability in an office, patients' perception of technology, the importance of having the technology, and the expected frequency of clinics utilizing the technology. Statistical analysis was performed with a significance level of 0.05. A total of 74 pre-D2 and 77 post-D2 questionnaires were completed. Additionally, 63 D1, 43 D3, and 39 D4 responded to the survey. Significant differences were found for "knowledge" and "skill" between pre-D2 and post-D2, and pre-D2 and control groups (p<0.001). There was a significant difference between post-D2 and all controls for “interest” (p=0.0127) and on practice preference for technology availability (p<0.05). There were significant results between post-D2 and all controls regarding the importance of technology availability in an office (p<0.001) and the expected frequency of clinics utilizing the technology (p=0.01). No significance was found for "patient's value of technology" and "the importance of having the technology". The presence of technology in the practice and educational academic environments significantly improved students’ interest and perception of knowledge and skill.

Background: Radiotherapy is an important part of the medical therapy concept treating tumors in the head and neck region; however, the impact on the field of dentistry could be im-mense. The objective of this study was to evaluate the microtensile bond strength (µTBS) of uni-versal adhesives and to compare the results of different application modes (etch-and-rinse and self-etch) on irradiated and sound human dentin. Methods: Dentin specimen of 180 extracted human wisdom teeth were divided in two superordinate groups. Ninety teeth received either no irradiation (control group) or the high-level therapeutic dose of 60 Gy (test group) applied frac-tionally (2 Gy/day, 5 days/week, 6 weeks). Samples from each group were randomly divided in-to six subgroups assigned to three established universal adhesives (Futurabond® U, VOCO; AdheSE® Universal, Ivoclar Vivadent; Xeno® Select, Dentsply) in both conceivable application modes: etch-and-rinse and self-etch (n = 15). Bond strength was assessed with a universal testing machine immediately after application and light curing of the adhesive materials. Statistical analysis was performed using two-way ANOVA (p<0.01) and Tukey's test (p<0.05). Results: The effect of dentin irradiation and application mode for the adhesive restoration was found to be significant (p<0.01, ANOVA). In all groups, a decrease of µTBS could be observed when used on irradiated dentin. However, no significant influence of high level radiation on the bond strength of Futurabond® U and AdheSE® Universal in both modes could be evaluated (p>0.05, Tukey´s test). Solely in the case of the adhesive system Xeno® Select, significantly reduced bond strength could be determined in self-etch mode after irradiation (group 60 Xse) compared to the control group (0 Xse) (p<0.05, Tukey´s test). Conclusions: Within the limitations of an in vitro study, some effects of high-level tumor irradiation on the bond strength of universal adhesives can be detected. However, these effects were strongly depending on the used material and application mode.

Objective: The aim of this in vitro study was to evaluate the accuracy of resin-based fixed dental restorations, namely veneers, single crowns, and four-unit fixed partial dental prosthesis (FPDs) using two different 3D printers and polymer-based materials. Materials and Methods: A standard maxillary polyurethane jaw model containing prepared teeth was scanned using an intraoral scanner. The generated STL data were used to design the restorations virtually using CAD software. Two 3D printers were utilized for the provisional digital light processing and stereolithography for the castable resin patterns. Each printer produced 10 specimens of each type of restoration, for a total of 80 restorations. The 3d-printed restorations were then 3D scanned using the same intraoral scanner and evaluated for external and internal dimensional accuracy in terms of trueness and precision. A one-way ANOVA and Two-sample T-Test were implemented to compute the precision (variability between groups) and trueness (with the designed CAD model). A level of statistical significance of p-Value

The purpose of this in vitro study is to evaluate the effectiveness of incorporating a new irrigation system into a surgical guide and monitor its effect on heat generation during implant bed preparation. A total of 48 surgically guided osteotomies were performed on 12 bovine ribs divided into 4 groups, using different irrigation techniques: Group A (test) had entry and exit channels incorporated into the guide; Group B had a similar design with an entry channel only; Group C had conventional external irrigation; Group D (control) had no irrigation. Heat generation during the osteotomies was measured using thermocouples placed at a depth of 2 mm and 6 mm. The lowest mean temperature was observed in Group A (22.1°C at 2mm and 21.4°C at 6mm), this was statistically significant when compared with Groups C and D (p&lt;0.001). Group A showed a lower mean temperature compared with Group B as well, however statistically significant only at 6mm depth (p&lt;0.05). In conclusion, the proposed guide has significantly reduced heat generation during implant osteotomy. The integration of an exit cooling channel can resolve limitations found in previously designed surgical guides and can be easily incorporated into computer designing and 3D printing software.

Objective: A study was made of the salivary levels of adenosine deaminase (ADA), ferritin (FRR) and total proteins in healthy individuals and in patients with oral potentially malignant disorders (OPMD), assessing the potential role of saliva as a diagnostic tool. Methods: A total of 91 subjects participated in the study, divided into two groups: 59 patients with OPMD (oral leukoplakia or oral lichen planus )and 32 healthy controls with measurements being made of salivary ADA, ferritin (FRR) and total proteins (TP). Results: There were no significant differences in salivary ADA between the OPMD group and the controls (p=0.934), though the levels of both FRR and TP were significantly higher in the OPMD group (p=0.001). Patients with oral lichen planus showed significant differences in terms of FRR (p=0.009) and TP (p=0.003). Conclusions: The promising findings of this study suggest a potential role for FRR and TP in the salivary diagnosis of OPMD. In addition, saliva appears to be a reliable tool offering an interesting alternative for the screening of large populations.

The removable partial denture, despite new technologies and new materials, continues to play a significant role in clinical dental practice. The purpose of the following study was to evaluate the design of new retention devices in Kennedy's second grade classrooms. For the study of "lamellar" retentive devices, 4 prosthetists were chosen and selected, according to inclusion and exclusion criteria, 16 patients, 8 women and 8 men, whose upper arch had to be rehabilitated with a removable partial prosthesis. The results showed that the parameters taken into consideration such as satisfaction, stability, aesthetics and retention had an average score higher than 3.30 (range 1-4), with an average standard deviation of 0.6225 in the 4 indicative parameters that the data they are relatively homogeneous and coherent. In conclusion we can state that the skeletonized prosthesis with lamellar retentions, designed in Kennedy's second grade classes, has shown good acceptance in selected patients

Vitamin D has important anti-inflammatory, anti-microbial properties and plays a central role in host immune response. Due to the crucial role of the kidneys in the metabolism of vitamin D, patients with chronic kidney disease (CKD), are prone to vitamin D deficiency. The resultant reduction in the production of calcitriol, the activated form of vitamin D in patients with CKD is responsible for exacerbating the existing renal impairment and periodontal inflammation. Recent evidence suggests a bidirectional, causal relationship between periodontitis and renal functional status. Both conditions have shared pathophysiologic mechanisms including oxidative stress, increases in the systemic inflammatory burden and impaired host response. This review explores the association between vitamin D, CKD and periodontitis. The review summarises the current evidence base for the classical and non-classical vitamin D metabolic pathways, the biological mechanisms linking vitamin D deficiency, CKD and periodontitis, as well as the bidirectional relationship between the two chronic inflammatory conditions. Finally, the paper explores the impact of vitamin D deficiency on CKD, periodontitis, and related co-morbidities.

The purpose of this study was to evaluate the outcomes of implants placed in horizontally augmented alveolar ridges using porcine bone grafts and to investigate the long-term stability of the porcine bone grafts. A retrospective analysis was conducted on 55 sites that underwent horizontal ridge augmentation using porcine bone grafts and implant placement with a follow-up period longer than 5 years. Furthermore, additional analysis was conducted on 24 sites where porcine bone grafts were used exclusively and implants were placed simultaneously with horizontal ridge augmentation. The mean follow-up period after prosthesis loading was 67.3 months, with a mean marginal bone loss of 0.18 mm at 1 year and a cumulative mean marginal bone loss of 0.37 mm over the entire follow-up period. Of the 55 implants, 2 were lost and 4 did not meet the success criteria, resulting in a survival rate of 96.4% and a success rate of 89.1%. In 24 sites, the mean marginal bone loss was 0.22 mm at 1 year and 0.40 mm at 65.8 months, with 100% survival and success rates. Porcine bone grafts can be successfully used in horizontal ridge augmentation for implant placement in cases of ridges with insufficient horizontal width.

In implantology, among the key choices, to obtain predictable results, it is essential to establish, on the basis of radiographic examinations, the bone site where to insert the implants; these selected locations must be identified first on the mucosa and then on the cortical bone. Surgical guides represent a valid aid especially in complex cases with more than 3 or 4 implants, whereas in single implant cases they are rarely used. This study evaluates the clinical precision with which the implant sites, on the patient's mucosa, are identified in surgical procedures planned without any templates. The verification of this precision is carried out through thermo-printed templates with radiopaque references which could however help the clinician to identify these sites in a simple, rapid and economical way.

A tricalcium silicate nanoparticle-containing cement (NPC) was developed to overcome the disadvantages of existing mineral trioxide aggregate (MTA) dental materials. This study aimed at evaluating the effects of NPC on the osteogenic differentiation of human periodontal ligament fibroblasts (HPLFs) in vitro, and on the healing of furcal perforations created experimentally in rat molars in vivo, in comparison to MTA. The in vitro studies performed the following assays; pH measurement using a pH meter, the release of calcium ions using a calcium assay kit, cell attachment and morphology using SEM, cell proliferation using a coulter counter, marker expression using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and cell mineralized deposit formation using Alizarin Red S (ARS) staining. In the in vivo studies, MTA and NPC were used to fill the rat molar perforations. Rat molars were processed at 7, 14 and 28 days for analysis of inflammatory processes using hematoxylin and eosin (HE) staining, immunohistochemical staining of Runx2 and tartrate-resistant acid phosphate (TRAP) staining. The results demonstrate that the nanoparticle size distribution of NPC is critical for osteogenic potential at an earlier stage compared to MTA. Further studies are required to elucidate the mechanism of action of NPC in osteogenic differentiation.

The frequency of selected polymorphisms, one in each gene coding for proteins with antioxidative properties (CAT, SOD2, GPX1, NQO1) was compared between patients suffering from pain-related temporomandibular disorders (TMDp;n=85) and control subjects (CTR;n=85). According to the Oral Behaviours Checklist score participants were divided into high-frequency parafunction (HFP;n=98) and low-frequency parafunction (LFP;n=72) groups. In addition, we have investigated the association of selected polymorphisms with participants' psychological (anxiety, depression) and psychosomatic (hypervigilance, somatosensory amplification) characteristics. Polymorphisms rs1001179, rs4880, rs1050450, rs689452 were genotyped using the genomic DNA extracted from buccal mucosa swabs and real-time TaqMan genotyping assays. No differences in genotype distribution between TMDp patients and control subjects were found. Still, TMDp patients who were homozygous for minor allele A, related to the GPX1 polymorphism rs1050450 reported significantly more waking-state oral behaviours compared to GA+GG genotype carriers (score: 30 vs. 23, p=0.019). Frequency of genotype AA for rs1050450 polymorphism was higher in HFP compared to LFP participants (14.3% vs. 4.2%, p =0.030). Most important predictors of waking-state oral behaviours were depression, anxiety, AA genotype (rs1050450) and female sex. Explored genetic factors were not found to be significant risk factors for either TMDp or sleep-related oral behaviours. The association of waking-state oral behaviours with selected gene polymorphisms additionally supports previous assumptions that the daytime bruxism is more closely linked to various stress manifestations, which might also be reflected through the variability related to cellular antioxidative activity.

Pain is a complex multidimensional feeling combined with sensorial and emotional features. The majority of patients undergoing orthodontic treatment reported various degrees of pain, which is perceived as widely variable between individuals, even when the stimulus is the same. Orthodontic pain is considered the main cause of poor-quality outcomes, patients' dissatisfaction, and lack of collaboration up to the interruption of the therapy. A deep understanding of pain and how it influences the patient’s daily life is fundamental to establishing proper therapeutic procedures and obtaining the correct collaboration. Because of its multifaced and subjective nature, pain is a difficult dimension to measure. The use of questionnaires and their relative rating scales is actually considered the gold standard for pain assessment. Depending on the patient’s age and cognitive abilities is possible to choose the most appropriate instrument for self-reported pain records. Although several scales have been proposed and a lot of them are applied, it remains uncertain which of these tools represents the standard and performs the most precise, universal, and predictable task. This review aims to give an overview of the aspects which describe pain, specifically the pain experienced during orthodontic treatment, the main tool to assess self-perceived pain in a better and more efficient way, the different indications for each of them, and their correlated advantages or disadvantages.

Introduction: Silver nanoparticles have been extensively investigated in dental and orthopedic materials. However, the impregnation of bone graft with silver nanoparticles has been poorly investigated. Objectives: The aim of this study was to evaluate the in vitro antibiofilm activity of a bovine bone impregnated with silver nanoparticles. Methods: Bone scaffolds from cancellous bovine femur were used for the tests and impregnated with silver nanoparticles (50nm) by physical adsorption. Silver nitrate minimal inhibitory and bactericidal concentration were performed Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Enterococcus faecalis, Acinetobacter baumannii, and Escherichia coli. Disc diffusion tests for silver nanoparticles susceptibility and quantification of biofilm production on plate and bone with sessile cell count were also performed. Results: All pathogens were susceptible to silver with low minimal inhibitory concentration (0.25 – 4 mg/L). The scaffold impregnated with silver nanoparticles presented a significant reduction in the biofilm cells for all microorganisms with a reduction of more than 3 logs in colony forming units count. Conclusion: Bone scaffolds impregnated with silver nanoparticles can significantly reduce biofilm, and it can be a strategical material to be used as an implant for different approaches.

Background and Objectives: Mechanical and biological complications can lead to system fracture or screw loss on dental implants. Narrow and regular platforms have been used without a consensus about the effect of distance the abutment from the prosthetic platform margin. The aim of this study is to evaluate different insertion torques in the deformation of tri-channel platform connections through two- and three-dimensional measurements with micro-CT. Materials and Methods: 164 implants were divided into groups (platform diameter and type): 3.5, 3.75, and 4.3 mm NP (Narrow Platform), and 4.3 mm RP (Regular Platform). Each implant-platform group was then divided into four subgroups (n = 10) with different torques: T45 (45 Ncm), T80 (80 Ncm), T120 (120 Ncm) and T150 (150 Ncm). The implant-abutment-screw assemblies were scanned and the images obtained were analyzed. Results: A significant difference was observed for the linear and volume measures between the different platforms (p &lt;0.01) and the different implant insertion torques (p &lt;0.01). Qualitative analysis suggested higher deformation resistance for the 3.75 NP compared to the 3.5 NP, and RP was more resistant compared to the NP. Conclusions: The 0.25-mm increment in the implant platform did not increase the resistance to the applied insertion torques; the 4.3-mm implant was significantly stronger compared to the 3.5-mm implant and the proposed micro-CT analysis was considered valid for both 2D and 3D analyses of micro gaps, qualitatively and quantitatively.

Surgical ciliated cysts occur primarily in the maxilla after radical maxillary sinus surgery. We report a first case of a surgical ciliated cyst that developed in the infratemporal fossa 25 years after the patient sustained severe facial trauma. The patient complained of mandibular pain and limited mouth opening. The patient’s condition was completely resolved 5 months after marsupialization via Le Fort I osteotomy. Surgical morbidities can be minimized by proper diagnosis and less invasive surgery.

This study aimed to evaluate if the change of vehicle for CTZ (chloramphenicol, tetracycline, zinc oxide, and eugenol) paste improves the inhibition of Enterococcus faecalis in vitro. The vehicles evaluated alone and mixed with CTZ were eugenol, propylene glycol (PG), chitosan, su-per-oxidized solution (SOS), grapefruit-seed extract (GSE), and as a negative control, 0.9% saline solution. A clinical isolated of E. faecalis was morphological and biochemical characterized, in-cluding antimicrobial susceptibility was tested using 20 antimicrobial agents. Once character-ized, the clinical isolated was cultivated to performed Kirby–Bauer disc diffusion method with paper discs embedded with the different vehicles mixed or used alone, incubating at 37 ºC for 24 h. Data were analyzed by One-way ANOVA and the means were compared using Tukey test with a significance level of p<0.05. For vehicles used alone, GSE presented the greatest inhibition showing a statistically significant difference with the rest of the vehicles. When vehicles were mixed with the CTZ paste, PG showed a greater inhibition with a statistically significant differ-ence from the rest of the vehicles. In conclusion, the vehicle used to mix the CTZ paste plays an im-portant role in the inhibition of E. faecalis in vitro, therefore we consider that this can be an im-portant factor to achieve success in the use of this technique.

Osteoconductive granulated biopolymers (OGB) are used to restore the lost volume of the jaw bone. OGB is employed as a loose fraction and exhibits physical traits common to bulk mixtures. By removing air bubbles and industrial dust from the OGB fraction through special processing, more accessible spaces are left over for the adsorption of bone growth factors. The recipient site's biological environment alters the OGB fraction's physical characteristics. This is the cause of the OGB fraction's volume changing uncontrollably during the first three weeks following surgery. Predictive indicators for describing the physical processes of osteoconduction include the compaction coefficient and adsorption capacity. Taking into account the prognostic indicators of the dynamics of changes in the physical properties of the OGB fraction in the postoperative period, 3D planning of the bioengineered structure should be done. The OGB fraction's adsorption and drainage properties are optimized by raising the purity of OGB production and preparing the biopolymer for clinical studies.

A three-arm, randomized, placebo controlled clinical study has been performed to evaluate the effects of a lyophilized pineapple extract titrated in bromelain (Brome-Inf®), and purified bro-melain on pain, swelling, trismus and quality of life (QoL) after the surgical removal of the lower third molars. Moreover, the need for non-steroidal anti-inflammatory drugs (NSAIDs) has also been evaluated and compared with a placebo group. The study included 42 people that required the extraction of a single mandibular third molar under local anesthesia. The patients were ran-domized and distributed to receive Brome-Inf®, purified bromelain or placebo and started the treatment the day of surgery and continued it for the next 7 days. The primary outcome was the requirement of NSAIDs in the three groups. The outcome variables were pain, swelling and trismus, which were measured postoperatively at 1, 3, and 7 days. The differences in the efficacy of the freeze-dried pineapple extract and single-component bromelain were also evaluated. At the end of the study, the assumption of ibuprofen (from days 1-7) was statistically higher in the placebo group (p

Irrigation is crucial in cleaning and disinfection of the root canal system, because endodontic instruments are unable to reach a large part of the root canal system (isthmuses, accessory canals, apical ramifications) and bacteria that can reside. Sodium hypochlorite (NaOCl) is currently used as irrigant in root canal therapies for its non-specific protheolytic and antimicrobial properties, but undesirable effects may be observed especially when used near the terminus of apical foramen. This study aims to evaluate antimicrobial properties of Thyme Essential Oil (TEO) used alone or in combination with NaOCl against different bacterial strains, especially Staphylococcus aureus and Streptococcus mutans. TEO non-cytotoxic concentration (9,28mg/mL) showed antimicrobial properties comparable to NaOCl after 1min of contact, both in presence of organic material (6% sheep blood). Moreover, the combination of TEO and NaOCl did not compromise their individual antimicrobial properties at the same time of contact. These data suggest that TEO could be used as antimicrobial irrigant in root canal therapies in association with NaOCl, to reduce concentration of NaOCl and its undesirable side effects. Due to the absence of cytotoxic effects at tested dilution, TEO could be safely used also near the terminus of apical foramen for its cytocompatibility.

The development of biomaterial as substitution to connective tissue graft for treating gingival recession is growing nowadays. Hydrogels received attention as potential scaffold to be used in gingival tissue engineering since their capability to mimic soft tissue characteristic as they can hold amount of water. Gelatin is a natural polymer that widely used in hydrogel preparation with good biological properties, but it has poor physical stability for the used as scaffold. Chemical crosslinking strategy using EDC/NHS was performed in this study to overcome its limitation. One uncrosslinked gelatin and two crosslinked gelatin hydrogels different concentration of EDC/NHS were prepared in this study. This study investigated the difference of physical characterization from the prepared gelatin hydrogels. Our findings suggest the crosslinking strategy using EDC/NHS increase physical properties of the gelatin hydrogels without interfering the chemical structure of the gelatin. The higher crosslinker concentration will result in better morphology and more resilient to biodegradation. As a result, the crosslinked gelatin hydrogel with gelatin:EDC:NHS mass ratio of 12:1:1 met the physical characteristic for future use as scaffold for gingival tissue regeneration.

Dental-implant-supported reconstructions provide comfort and improvements in prosthetic function, adaptation, and stability over conventional treatment options. The objective of this study was to evaluate the effect of multiple cleaning solutions on dentures and their influence on the deterioration and loss of retention of overdenture attachments in a 12-month clinical-use simulation. In this way, four different brands of retentive caps made of Teflon (OT Equator, Locator®, Kerator®, and Locator R-Tx®) were immersed in five different cleaning solutions (Kukident®, Benfix®, Corega®, and Protefix®), and tap water was used as the control group, in a simulation that lasted 12 months. Data were analyzed using two-way ANOVA and a Tukey HSD. Furthermore, a Levene Test and Shapiro–Wilk tests were performed to assess the validation of the ANOVA assumptions. The statistical analysis was performed using R version 4.2.2 software with the significance level set to p &lt; 0.05. There were significant statistical differences between the different manufacturers on the retention forces of the attachment’s retentive caps. For the cleaning solution groups, different statistical results between Kukident® and Benfix® were observed. There were no significant statistical differences between Corega®, Protefix®, and tap water despite the fact that the retention forces decreased in all of them.

Background and Objectives: The prevalence of osteoporosis is high, reportedly affecting 200 million people worldwide. A major problem associated with osteoporosis is that femoral fractures cause a decline in general function and loss of independence, greatly reducing patients’ quality of life. Notably, osteoporosis is an asymptomatic chronic metabolic disease, and its detection is thus often delayed. Interestingly, mandibular cortical index (MCI) classification using dental panoramic radiography is reportedly useful for early detection of osteoporosis. However, this visual classification method can lead to differences in diagnosis among surgeons. Therefore, this preliminary study was performed to analyze cone-beam computed tomography (CBCT) data and examine an objective MCI classification using the findings obtained. Materials and Methods: MCI classification (classified as C1, C2, or C3) was performed by three examiners on 70 women (91 sites) aged ≥20 years. The mandibular cortical width of all sites was measured using CBCT images. Results: The results showed that the mandibular cortical width was not particularly correlated with age or number of present teeth, and no significant quantitative differences were found between C1 and C2. However, coronal CBCT images of C2 revealed multiple characteristic bone trabecular structures. Conclusions: These structures may be an important finding affecting the classification of two-dimensional dental panoramic radiography images.

Dentinal Hypersensitivity (DH), a prevalent oral health issue affecting approximately one-third of adults. In this six-months retrospective study, a comparison was made to assess the effectiveness of two diode lasers with different wavelengths (980 nm and 1064 nm) in the treatment of tooth affected by DH. In total, 160 patients were divided into two treatment groups: one receiving treatment with a 980 nm diode laser (n=80) and the other with a 1064 nm diode laser (n=80). Pain was assessed using the Visual Analogue Scale (VAS) at baseline, immediately post-treatment, and at 3- and 6-months follow-up. Both groups followed the same treatment protocol, involving the application of a graphite paste to the exposed dentin before laser irradiation. Both lasers operated at an output power of 0.5 W in continuous and non-contact mode, with a 320 µm spot size. A significant reduction in mean VAS scores at all follow-up intervals compared to baseline was noted. 980 nm group had mean VAS scores of 7.9, 2.36, 2.31, and 2.38, while the 1064 nm group had scores of 8.01, 1.01, 1.16, and 1.13 at baseline, immediately post-treatment, and at 3 and 6 months, respectively. At all times of follow-up, the 1064 nm wavelengths showed a statistically significant reduction in mean values of VAS compared to the 980 nm. The findings may inform future research on optimizing laser-based treatments for DH.

Background - Mandibular flexion (MF) is a complex biomechanical phenomenon, which involves a deformation of the mandible, due mainly to the contraction of the masticatory muscles, and can have numerous clinical effects. The main aim of the current systematic review is to highlight the different factors that can increase MF, to help clinicians, identify patients to whom they should pay more attention. As a secondary outcome, we wanted to analyze the preventive measures and suitable techniques to be adopted to minimize the negative effects of this phenomenon on oral fixed rehabilitations. Methods - The review, which was carried out in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) flowchart, was recorded in the “International Prospective Register of Systematic Reviews” (PROSPERO). As research questions, “Patient/Population, Intervention, Comparison and Outcomes” (PICO) questions were employed. Using the ROBINS-I technique, the risk of bias in non-randomized clinical studies was evaluated. Results - The initial electronic search identified over 1300 potential articles, of which 54 studies were included in this systematic review. Information regarding the relationship between MF and individual factors, mandibular movements, impression-taking and fixed rehabilitations were obtained. Conclusions – The studies included in this systematic review showed that MF is greater during protrusive movements, in the posterior areas of the lower jaw, and in patients with brachial facial type, greater jaw length, small gonial angle and less density, length and bone surface of the symphysis. The biomechanical effects of mandibular flexion on fixed restorations are debated. Prospective clinical and radiological observational studies should be conducted to evaluate the potential short-, medium- and long-term consequences of MF.

Background: Restorative materials might significantly affect load transmission at peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used as frameworks for implant-supported prostheses. Methods: A masticatory robot was used to compare the shock absorption capacity of polyether-ketoneketone (PEKK) Pekkton®ivory (Cendres+Mètaux) and glass fiber-reinforced composite (GFRC) TRINIATM (Bicon). Five identical sample crowns for each of the materials was tested un-der the same conditions described in previously published papers (Menini et al. 2013). Forces transmitted at the simulated periimplant bone were recorded and statistically analysed. Results: The statistical analysis of forces transmitted at the simulated dental implant revealed significant differences between all the materials tested and significant differences with the mate-rials tested in a previously published paper (Menini et al. 2013: zirconia, glass ceramic, composite resin, acrylic resin). Only differences between PEKK and veneered PEKK and between PEKK and one of the previously tested composite resins were not statistically significant. PEKK samples demonstrated significantly greater shock absorption capacity compared to GFRC. Conclusions: PEKK revealed optimal shock absorption capacity. Further studies are needed to evaluate its efficacy in case of long span prostheses with reduced prosthetic volume.

Background: This study aimed to evaluate survival rate, marginal bone levels, and full arch prosthetic success on short implants when placed in areas of severely resorbed and edentulous mandibles. Methods: This is a systematic review of all randomized controlled trials of at least 10 patients with a control group in which bone augmentations were performed that were published between January 2010 and February 2023. Only 3 relevant studies met the inclusion criteria. Results: It obtained demonstrate that short-term dental implant survival rates ranged from 94.2% to 97.4% with a 5-year follow-up and the prosthetic success rate varied by 62% during the same follow-up. The mean marginal bone level values ​​of the affected short implants ranged from 0.2 mm to 0.6 mm. Conclusions: The data obtained demonstrated that short dental implants positioned with criterion and precision as a full-arch fixed support are a valid therapeutic choice for the medium-long term rehabilitation of severe edentulous mandibular atrophy.

Age estimation is an important tool when dealing with human remains or undocumented minors. Although the skull, the skeleton or the hand-wrist are used on age estimation as maturity indicators, they often present lack of good conditions for a correct identification or estimation. Few systematic reviews (SRs) have been recently published; therefore, this umbrella review critically assesses their level of evidence and provides a general comprehensive view. An electronic database search was conducted in four databases (PubMed, Cochrane, WoS, LILACS) up to December 2022, focusing on SRs of age estimation through forensic dentistry procedures. The methodological quality was analyzed using the measurement tool to assess SRs criteria (AMSTAR2). Eighteen SRs were included, five of critically low quality, six of low quality, three of moderate quality and four of high quality. The SRs posited that Willems’ method is more accurate and less prone to overestimation; most methods seem to be geographically sensitive; and 3D-Imaging and artificial intelligence tools demonstrate high potential. The quality of evidence on age estimation using dental approaches was rated as low to moderate. Well-designed clinical trials and high standard systematic reviews are essential to corroborate the accuracy of the different procedures of age estimation in forensic dentistry.

Although the connection of implant abutments to implant analogs and implant bodies has been evaluated separately, comparative evaluation of connections to implant analogs and implant bodies has not been evaluated. The objective of this study was to identify whether torque applied during laboratory manufacturing and during restoration cementation affects the compatibility between the implant body-abutment and the implant analog-abutment, as well as to spot any structural differences. Three different implant system with internal conical connection (Bioinfinity, Dant, and Dentist) were used. For each group, straight abutments (n=20) were tightened to implant analogs (n=10) and implant bodies (n=10) with hand tightening and using torque wrench device. The fitting of componenets were evaluated for each group using linear and volumetric micro-CT analysis. For linear analysis, when the mean differences (difference between measurements of the linear distance of abutments during hand tightening and applying torque) values between implant analog and implant body were compared within groups, There was no statistically significant difference observed in all groups (p&gt; 0.05). Throughout the fabrication and clinical phases, it is recommended to tighten the abutments on the analogs with a torque wrench instrument to minimize the risk of prosthetic incompatibility.

A partial or complete pulpotomy is a type of vital pulp therapy (VPT) that aims to remove the in-flamed, infected pulp, leaving behind healthy, vital pulp that is capable of healing. VPT has gained renewed popularity as a treatment option in permanent mature posterior teeth with irre-versible/moderate-severe pulpitis, its high success rates matching that of root canal treatment (RCT). There is currently no consensus regarding diagnostic and prognostic predictors of success of pulpotomies for managing such cases. Therefore, we conducted a scoping review to identify and analyze how these factors affect the outcome of treatment. A literature search using the PRISMA guidelines was undertaken using PubMed and Scopus on July 7, 2023. A total of 22 studies met the inclusion criteria and were qualitatively analyzed by two reviewers. The follow-ing diagnostic and prognostic factors were recognized and discussed; presenting signs and symptoms, periapical diagnosis, bleeding time, indicators of inflammation (bleeding time, con-centration of inflammatory biomarkers), patient age and medical status, the depth, activity and location of caries, and restorative factors. Based on the studies assessed, there is limited evidence to support their prognostic value. Further research is necessary to identify solid predictors of outcome.

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 x 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in case of cystic periapical lesion represents a good valid alternative to standard treatment.

(1)Background: The prognosis of orthodontic treatment for a patient with impacted canine teeth can be affected by many factors and understanding some of the characteristics of impacted teeth can increase the effectiveness and reduce the duration of treatment. This study aims to explore the effects of positions and dentoalveolar morphological characteristics of impacted maxillary canines on the prognosis of orthodontic treatment. (2)Methods: In this study, a total of 46 adolescent individuals were divided into 3 groups: CC(no impaction), BC(unilateral maxillary buccal canine impaction), and PC(unilateral maxillary palatal canine impaction). The impacted canine and adjacent teeth were evaluated in terms of position, angulation, inclination, MD and BL widths, root length, dilaceration angle, root resorption. (3)Results: The mean values of U3Ang and U3/U2 angles were statistically significantly higher in the BC and PC groups(p&lt;0.001). The mean values of U2RL(U3root length) and U3RD (U3root dilaceration) angle were statistically significantly lower in the BC and PC groups. (4)Conclusions: The results of this study suggest that shorter lengths and reduced volumes of the maxillary lateral incisors may lead to the ectopic eruption of canines. The higher canine angulations in the PC group make treatment more difficult and increase the degree of root resorption.

Chlorhexidine digluconate (CHX) has shown the ability to significantly reduce inflammation and marginal bone loss (MBL) at 1-year follow-up but limited data exists regarding its long-term efficacy in peri implant stability. The objective was to compare the long-term effects of a placebo gel (16 patients in Group A) or a 0.20% CHX gel (15 patients in Group B) used at each previous surgical and prosthetic stage. Follow-ups were conducted in 2022, investigating by biological, radiological, clinical, mechanical evaluation the long-term effects. Data were statistically analyzed. The research achieved a 96.7% implant success rate over five years, but 41.9% of patients didn't attend annual oral hygiene check-ups. The average MBL was 1.04 ± 0.39 mm, with no significant differences between the two groups. Notably, patients who attended regular periodontal check-ups experienced significantly less MBL than those who didn't (p &lt;0.05). At five years, the effects of CHX were reduced, with both groups showing moderate bone loss. The results suggest early disinfection could enhance both short and long-term outcomes. In fact, patient with initial minor MBL preserve this advantage also at 5 years of follow-up. Additionally, the data underscore the importance of annual check-ups in early detection and management of biological and mechanical complications.

The aim of this review was to search in literature, data regarding the inflammasome, involvement in, oral pathologies (mainly periodontitis) and other diseases and the approaches to control the inflammasome-related pathogenic mechanisms. The review also investigated how phytochemicals and pharmaceutical substances could be used to inhibit the inflammasome activity. Inflammasomes are involved in inflammatory, autoimmune and autoinflammatory diseases. Pharmaceutical substances can control the inflammasome by three mechanisms: inhibiting of intracellular signaling pathways (Allopurinol and SS-31), blocking inflammasome components (VX-765, Emricasan and VX-740), and inhibiting cytokines mediated by the inflammasome (Canakinumab, Anakinra and Rilonacept). Phytochemical inhibit the inflammasome, by neutralization of reactive oxygen species. Biomaterials functionalized by the adsorption of therapeutic agents on different nanomaterials may represent a future research direction to facilitate multimodal and sequential treatment in oral pathologies.

Background and objective: Research shows that 60–90% of school children have caries, representing a serious public health issue. Here, we present a model of oral health promotion that has been conducted in the Primorje-Gorski Kotar County (PGC), Croatia, from 2008 to 2019. We assessed the oral status of first and fifth grade elementary students and determined the sustainability and influence of our model on the status and behavior regarding the children’s oral status. Additionally, during the observed period, promotional and preventative activities aiming to improve oral health were conducted. Since 2014, the Program has begun to be continuously, comprehensively, and systematically introduced into preschools as well. Material and methods: We assessed the number of children with caries by analyzing the changes in the decayed, missing, and filled teeth for primary teeth (dmft)/decayed, missing, and filled teeth for permanent teeth (DMFT) index mean during the observed period. Results: From 2008 to 2019 we assessed 44422 children in the PGC (21714 first grade and 22708 fifth grade students). The average response rate throughout the Program has been 83%. We have noted a dmft/DMFT index decrease from 4,66 to 3,73 (first graders) and from 2,50 to 1,00 (fifth graders). Conclusions: The Program has improved the behavior and oral health of children; stakeholders from various professions have been included, such as health visitors, school medicine teams, and pediatricians, avoiding additional financial expenses, increasing the number of children in care, and proving the sustainability of our oral health improvement model.

Background and Objectives: The aim of this study was to determine the job-related and individual features that influence BS and depression levels among dentists working in faculties, oral and dental health centres (ODHC) and private clinics. Materials and Methods: This prospective, cross sectional study was carried out on dentists working in different regions of Turkey. Data were collected using an on-line questionnaire created using Google Forms. The questionnaire consisted of demographic data, Maslach BS Inventory (MBI) and Beck Depression Inventory (BDI) sections. Demographics were age, height, weight, marital status, blood type, gender, monthly income, income satisfaction and having enough free time. The dentists were divided into 3 groups as faculty, private clinic and ODHC according to the institutions in which they worked. Results: Of the total 290 dentists enrolled in the study, there were 172 males and 118 females with a mean age of 36.98±5.6 years. 128 of the dentists worked in faculties, 72 in private clinics and 90 in ODHCs. It was observed that women's EE scores were higher than men's (P&lt;0.05). No statistically significant difference was found between the groups when comparing BS and depression scores according to marital status and blood group (P&gt;0.05). There was no significant relationship between emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA) and depression scores according to age, BMI and work experience, age, work experience and BMI (P&lt;0.05). It was found that the EE scores of the dentists working in the faculty and private clinic were lower than those of the dentists working in the ODHC (P&lt;0.05). Monthly income was associated with depression (r = -0.35). Conclusions: This study showed that dentists working in ODHCs had more EE. These findings suggest that there is a need for improvement in the working conditions of dentists, particularly in ODHCs.

Abstract: A biomaterial is proposed for closing extensive bone defects in the maxillofacial region. The composition of the biomaterial includes high-molecular chitosan, chondroitin sulfate, hyaluronate, heparin, alginate and inorganic nanostructured hydroxyapatite. The purpose of the study is to demonstrate morphological and histological early signs of reconstruction of a bone cavity of critical size. The studies were carried out on 84 white female rats weighing 200-250 g. The study group consisted of 84 subjects in total, 40 in the experimental group and 44 in the control group. In all animals, three-walled bone defects measuring 0.5 x 04 x 05 cm were applied subperiosteally in the region of the angle of the lower jaw and filled in experimental group using lyophilized gel mass of chitosan-alginate-hydroxyapatite (CH-SA-HA). In control animals, the bone cavities were filled with an auto-blood clot after bone trepanation and bleeding. The observation periods are 3.5.7 days, 2.3.4.6.8 and 10 weeks. The control of bone regeneration was carried out using multiple morphological and histological analyses. Results showed that following implantation the chitosan construct actively replaced early-stage defects with the formation of a full-fledged new bone tissue as compared to the control group. Already, by the 7th day morphological analysis showed that formation of spongy bone tissue could be seen. After 2 weeks there was a pronounced increase in bone volume (P<0.01), and at 6 weeks after surgical intervention the closure of the defect was 70-80%, after 8 weeks - 100% without violation of bone morphology with a high degree of mineralization. Thus, the use of modified chitosan after filling eliminates bone defects of a critical size in the maxillofacial region, reveals early signs of bone regeneration, and serves as a promising material in reconstructive dentistry.

Wirobond C is a commercial dental casting alloy suitable for the fabrication of crowns, bridges as well as metal-ceramic restorations. This work aims with the study of the effect of ready-to-use Listerine® and Meridol® mouthwashes and sodium fluoride on corrosion resistance of the CoCrMo dental alloy to electrochemical corrosion in artificial saliva at 37 °C. SEM, EDS, SKP, and microhardness investigations were carried out to characterize the material under study. In vitro corrosion resistance of the CoCrMo alloy was conducted by the open circuit potential method, electrochemical impedance spectroscopy, and anodic polarization curves. The presence of Co 59.8(8) wt.%, Cr 31.5(4) wt.%, and Mo 8.8(6) wt.% was confirmed. The CoCrMo alloy was characterized by Vickers microhardness of 445(31) µHV0.3. Based on EIS data, the capacitive behavior and high corrosion resistance of CoCrMo alloy was revealed. The kinetics of pitting corrosion in the artificial saliva was lower after the modification with NaF and Listerine and Meridol mouthwashes. The potentiodynamic characteristics revealed the passive behavior of CoCrMo alloy in all solutions. Based on the SKP measurements of the CoCrMo alloy after corrosion tests, the effect of artificial saliva modification on electronic properties of Bego Wirobond C dental alloy was found.

Today, dental implantology is a reliable technique for the treatment of partial and total edentulism. The fixing of dentures on dental implants can be achieved by a number of different techniques. The choice of technique depends on the specific needs of the patient, the condition of the jawbone and the design of the prosthesis itself. Currently, the two most common types of prosthetic abutment connections are cemented or screwed connections, both of which have disadvantages and ad-vantages. The aim of this study is to analyze, with Finite Element Analysis (FEA), a new Cone Morse connection system between the prosthesis and implant. The connection retention has been analyzed by adopting three different approaches: analytical, in vitro and the FEA method. The systems formed by abutment, healing-cap, and crown with three different inclination conditions were modeled in 3D: 0°, 15° and 30°. With Ansys finite element software, the effect of tilt on system retention was studied. The FEA analysis showed comparable results with in vitro studies regarding the retention strength for an abutment-cap system with a taper of 4°, obtaining 66.6 N compared to 68 N calculated through an in vitro study. The inclination of the abutment affects the retention of the system because the hole made on the surface of the abutment, decreases the contact area between the components. The Cone Morse prosthesis implant connection system is the most stable and efficient system compared to the threaded or cemented system. Retention is influenced by factors such as abutment conicity, insertion strength and the contact surface be-tween components.

This study aimed to establish and verify the validity of an acoustic simulation method during sustained phonation of the Japanese vowels /i/ and /u/. The study participants were six healthy adults. First, vocal tract models were constructed based on computed tomography (CT) data, such as the range from the frontal sinus to the glottis, during sustained phonation of /i/ and /u/. Next, cylindrical shapes virtually extended by 12 cm were added to the vocal tract models to imitate the trachea between the tracheal bifurcation and lower part of the glottis. The Kirchhoff–Helmholtz integral equation was formulated as the wave equation for sound propagation, and the boundary element method was used for discretization. As a result, the relative discrimination thresholds of the vowel formant frequencies for /i/ and /u/ against actual voice were 1.1%–10.2% and 0.4%–9.3% for the first formant and 3.9%–7.5% and 5.0%–12.5% for second formant, respectively. In the vocal tract model with nasal coupling, a pole–zero pair was observed at around 500 Hz, and for both /i/ and /u/, a pole–zero pair was observed at around 1000 Hz regardless of the presence or absence of nasal coupling. These findings demonstrated that /i/ and /u/ could be simulated with high validity in a vocal tract model constructed from CT data obtained during sustained phonation using the boundary element method.

This study aimed to estimate scattered radiation and its spatial distribution around three Cone Beam Computed Tomography (CBCT) devices, in order to determine relatively safe positions for an operator to stand if needed to be inside the CBCT room. The following devices were tested: Morita Accuitomo (CBCT1), Newtom Giano HR (CBCT2), Newtom VGi (CBCT3). Scattered radiation measurements were performed using different kVp, mA and Field of View (FOV) options. An anthropomorphic phantom (NATHANIA) was placed inside the x-ray gantry to simulate clinical conditions. Scattered measurements were taken with the ionization chamber Inovision model 451P Victoreen once placed at fixed distances from each irradiation isocenter, away from the primary beam. A statistically significant (p<0.001) difference was found in the mean value of the scattered radiation estimations between the CBCT devices. Scattered radiation was reduced with a different rate for each CBCT device as distance was increased. For CBCT1 the reduction was 0.047μGy, for the CBCT2 0.036 μGy and 0.079 μGy for CBCT3, for every one meter away from the x-ray gantry. Therefore, at certain distances from the central x-ray, the scattered radiation was below the critical 1mGy. Consequently, an operator could stay inside the room accompanying the patient being scanned, if necessary.

Dental polymers are often advertised and selected for use in restorations based upon the flexural strength of prefabricated discs, which may not accurately reflect their performance in dental applications. The objectives of this study were, therefore, to determine whether the three-point bending (3PB) test for flexural strength would be predictive of the “crunch-the-crown” CTC test for the failure load. Three brands of polymers (Trilor, Juvora, and Pekkton) were fabricated into rectangular bars and fully contoured crowns (10 specimens of each polymer brand, 30 specimens of each shape). Bars were tested in 3PB to determine flexural strength, and crowns were CTC tested to determine failure load after luting to resin abutments. Statistical significance was evaluated by one-way ANOVA ( = 0.05) and Pearson’s correlation coefficient. The fracture mechanisms were characterized by scanning electron microscopy (SEM). There were significant differences (p < 0.05) in the mean crown failure loads (Trilor [7,033 N] > Juvora [5,217 N] > Pekkton [3,023 N]) and mean flexural strengths of the bars (Trilor [468 MPa] > Juvora [197 MPa] = Pekkton [192 MPa]). There were no correlations between flexural strength and failure load. The mode of crown fracture was different between the polymers, and included deformation (Juvora), ductile-to-brittle fracture (Pekkton), and a combination of cracks and deformation (Trilor). The flexural strength was not correlated with the corresponding crown failure load. Dental practitioners should not rely on the value of flexural strength obtained from the three-point bending test, as advertised from the manufacturer, to predict the performance of polymeric crowns.

The present study aimed to characterize the microstructure of a temporary 3D printing resin (Resilab Temp), evaluating the optical properties and mechanical behavior according to different post-processing curing times. For the analysis of the surface microstructure and establishment of the best printing pattern, samples in bar format following ISO 4049 (25 x 10 x 3 mm) were designed in CAD software (Rhinoceros 6.0), printed on the W3D printer (Wilcos), and light-cured in Anycubic Photon at different times (without curing, 16 minutes, 32 minutes, and 1 hour). For the structural characterization, analyses were carried out in FTIR (Fourier Transform Infrared Spectroscopy) and Scanning Electron Microscopy (SEM). The mechanical behavior of the resin was based on flexural strength tests and Knoop microhardness. Color and translucency analysis were performed with a spectrophotometer (VITA Easy Shade Advanced 4.0), which was evaluated following CIELab, using gray, black, and white backgrounds. All analyses were performed immediately after making the samples and repeated after thermal aging with 2 thousand cycles (5-55 °C). The results obtained were statistically analyzed with a significance level of 5%. FT-IR analysis showed about a 46% degree of conversion on the surface and 37% in the center of the resin sample. The flexural strength was higher for the groups polymerized for 32 min and 1h, while the Knoop microhardness did not show a statistical difference between the groups. Color and translucency analysis also did not show statistical differences between groups. According to all the analyses carried out in this study, for the evaluated material, the post-polymerization time of 1 hour can be suggested to improve the mechanical performance of 3D-printed devices.

Surface chemistry evaluation plays a crucial role in assessing the efficacy of chemical decontamination products for titanium implants. This study aimed to investigate the effectiveness of chemical decontamination solutions in cleaning a contaminated dental implant surface and to evaluate the potential of combining Pluronic gel with hydrogen peroxide (NuBone®Clean) by evaluating pellicle disruption and re-formation on implant surfaces. In addition, ensuring safety with in- vitro and human testing protocols. X-ray Photoelectron Spectroscopy (XPS) was utilized for surface analysis. All the tested gels had some effect on the surface cleanness except for PrefGel®. Among the tested chemical decontamination candidates, NuBone®Clean demonstrated effectiveness in providing a cleaner titanium surface. Furthermore, none of the tested chemical agents exhibited any cytotoxic effects, and the safety assessment showed no adverse events. The results of this study highlight the significance of conducting comprehensive evaluations, encompassing safety and efficacy, before introducing new chemical agents for dental treatments. The findings suggest that NuBone®Clean shows potential as a chemical decontamination solution for implant surfaces. However, further investigation through randomized clinical trials is necessary. By adhering to rigorous testing protocols, the development of safe and efficient chemical decontamination strategies can be advanced, benefiting patients and promoting progress in the field of implant dentistry.

Antimicrobial photodynamic therapy (aPDT) used to sterilize carious dentin may irritate the pulp tissues because of tissue-penetrating laser and singlet oxygen generation. This study aimed to assess the effects of aPDT on rat pulp tissues. A cavity formed in a rat maxillary first molar was treated with aPDT. The combined photosensitizer and laser irradiation conditions in the aPDT groups were as follows: methylene blue and 100 mW for 60 s, brilliant blue (BB) and 100 mW for 60 s, BB and 50 mW for 120 s, and BB and 200 mW for 30 s. Each cavity was treated with an all-in-one adhesive and filled with flowable resin. aPDT was not applied for the control. In each group, the rats were sacrificed on postoperative days 1 and 14, and thin sections of the treated teeth were prepared. Pulp tissue disorganization (PTD), inflammatory cell infiltration (ICI), and tertiary dentin formation (TDF) were evaluated. At 1 day evaluation, there were significant differences between the aPDT group and controls with respect to PTD and ICI. 14 days later, almost all specimens showed tertiary dentin formation. aPDT caused temporarily reversible injury to the rat dental pulp, which healed with tertiary dentin formation.

Bone morphogenetic proteins (BMPs), belonging to the transforming growth factor-β superfamily, regulate many cellular activities including proliferation and neovascularization. The use of recombinant human bone morphogenic protein 2 (rh-BMP 2) in oral and maxillofacial surgery has seen a tremendous increase, especially with bone grafting materials to promote bone reconstruction processes; even though its interactions with the other essential processes in the human tissues are still not fully clear. investigating the effect of administrating rh-bmp2 on the clinical values of the gingival cell proliferation index Ki67 marker expression in the gingival tissue in comparison with normal human gingival tissue. The study includes 2 groups in a randomized controlled Clinical Trial: 40 gingival samples; 20 normal and 20 have been treated with 0.25µg of rh-BMP2 during dental implantation in the posterior mandible area, taken 3 months later in the time of healing abutments installation using a tissue puncher. Samples will be stained with hematoxylin-eosin and immunohistochemically. The expression of Ki67 will be measured in one way: the number of cells that express the marker. The comparison between groups will be done using One -a way ANOVA test in the numerical data SPSS 17.0 will be used as software. Differences would be considered significant at P=0.05. It is considered that rh-BMP2 can improve gingival tissue proliferation in patients undergoing dental implant treatment, and indicates better healing.

Introduction: maxillary hypoplasia and mandibular asymmetry may be corrected with orthognathic surgery at the completion of growth. Many patients require segmental Le Fort I osteotomies to obtain the most stable results. Unfortunately, if Invisalign is chosen for pre-surgical preparation, ClinCheck © software does not allow for prediction when these complex surgeries are planned. The objective of this paper was to show the potential of aligners beyond its software in most complex cases like multiple-piece maxillary osteotomies in cleft and non-cleft patients. Method: Thirteen patients who underwent pre-surgical treatment with clear aligners-Invisalign (study group) were matched in terms of diagnosis, surgical procedure, and orthodontic complexity with thirteen patients treated using fixed appliances (control group). A technique based on simple superimposition was devised to enhance the software for creating a suitable occlusion for segmental pre-surgical treatments. Virtual curves following the lower arch were employed to guide the correct pre-surgical positions of the upper teeth. The amount of impressions required in both groups to achieve satisfactory pre-surgical alignment of the segmented arches was compared. Results: one or no refinement phase were needed in the Invisalign group to reach an acceptable pre-surgical occlusion while the amount of pre-surgical impressions taken in order to reach adequate coordination with fixed appliance treatment was slightly higher. The average overall treatment duration did not show a statistically significant variation between the groups. Conclusions: it appears that clear aligner could serve as an effective treatment for individuals with skeletal discrepancies, including cleft and craniofacial anomalies, necessitating segmental Le Fort I osteotomies when aided by the suggested superimposition approach during digital pre-surgical movement simulations. More sophisticated softwares will certainly be implemented in the future.

Background: Diabetes mellitus (DM) and periodontitis are two chronic diseases that are interconnected. The coexistence of these conditions leads to increased severity of periodontitis and challenges in controlling blood glucose levels in diabetic patients. Objectives: The aim of this study was to evaluate both the influence of periodontal disease and its treatment in patients with DM in terms of a reduction in glycosylated hemoglobin levels at 3 and 6 months after treatment. Methods: A sequential, nonprobabilistic, controlled, prospective and longitudinal case−control study was carried out at the University Dental Clinic of the Morales Meseguer Hospital in Murcia, Spain. Thirty diabetic patients were divided into two groups: patients with periodontitis (test group) and patients without periodontitis (control group). The periodontal and endocrine-metabolic variables were measured at baseline and at 3 and 6 months after periodontal treatment for both groups. Results: Statistically significant differences were found at 3 and 6 months after periodontal treatment with respect to HbA1c levels in the group of periodontal patients. However, these differences were not observed in the control group. Conclusion: The presence of periodontal disease increased HbA1c levels in patients with DM. Nonsurgical periodontal treatment significantly decreased the degree of periodontal inflammation and the HbA1c level at 3 and 6 months after treatment.

Background: The conformation of the recipient site for an inlay graft presents an increased contact with the parent bone compared to the onlay graft. This might favor bone growth within the inlay compared to the onlay grafts. Hence, the objective of this study was to compare bone incorporation and remodeling process of xenogeneic en bloc grafts, placed using two bone grafting techniques, i.e., onlay vs. inlay. Methods: In this prospective, randomized, split-mouth study (test and control sides in the same animal), two bone grafting techniques were comparatively evaluated on the lateral aspect of the rabbit mandibles. One side was prepared with perforations (onlay site), whereas the other side was prepared with trephines and drills to obtain a wide (7 mm) standardized recipient site (inlay site). A xenogeneic bone block was fixed in the center with a titanium screw in both sides of the mandible and covered with a collagen membrane. Two healing periods were applied in the study: 2 and 10 weeks of healing. Results: after 2 weeks of healing, the mean percentage of new bone was 10.4% and 23.3% at the onlay and inlay grafts, respectively (p=0.022). After 10 weeks of healing, new bone increased to 13.2% and 25.4%, respectively (p=0.080). In this period of healing, the inlay grafts presented new bone percentage &gt;20% in all regions examined while the onlay graft presented a lower percentage in the most external regions of the graft. Conclusion: The percentage of new bone increased faster and was higher in the inlay compared to the onlay grafts. The composition of the grafts allowed new bone to reach the most peripheral regions in both graft groups, even though it was higher in the inlay group. A marginal closure of the defects by newly formed bone was observed in the inlay group.