PurposeThe aim of this study is to evaluate in vitro the morphological and physicochemical effects of an experimental epigallocatechin-3-gallate (EGCG) gel and its combinationwith sodium fluoride (NaF) on the progression of dentin erosion.Materials and MethodsInitial lesions were induced in bovine dentin samples (n=10/group) and divided into: Control (gel without active ingredients), NaF (1.23% NaF), EGCG (10% EGCG), and EGCG+NaF (10% EGCG + 1.23% NaF). Half of the sample was protected and the other half treated and subjected to erosive/abrasive challenges (0.3% citric acid, pH=2.6 and simulated brushing). Volume loss (VL) and surface roughness (Ra) were evaluated by 3D laser confocal microscopy. Dentin composition was analyzed by Raman spectroscopy, considering mineral/matrix ratio (MMR), collagen organization, and crystallinity.ResultsThe EGCG+NaF group presented the lowest VL values (p<0.05). The Control group had the highest MMR values, while the EGCG+NaF group presented the lowest (p<0.05). For the Amide I/III ratio, the Control group had the lowest values and the EGCG+NaF group the highest (p<0.05). No statistically significant differences among the groups regarding the crystallographic order (p= 0.668).ConclusionThe combination of EGCG and NaF demonstrates the ability to mitigate volume loss under erosive-abrasive challenges, preserve structural integrity, and enhance collagen cross-linking within the demineralized organic matrix of dentin.
Purpose:Edentulism compromises oral function and quality of life. The All-on-4 concept offers a fixed alternative to conventional dentures under immediate loading. However, evidence on outcomes in anatomically challenging arches, particularly with dynamic navigation, remains limited. This study reports early clinical and radiographic outcomes, and the feasibility, of immediate-loading all-on-4 in a real-world setting using an anatomy-driven allocation strategy with freehand and navigation workflows. Materials and Methods:This retrospective cohort included consecutive patients treated between November 2023 and February 2025. Dynamic navigation was selectively applied in unfavorable arches; freehand surgery was used otherwise. Four implants per arch supported screw-retained provisional prostheses delivered within 24-36 hours. Primary outcomes were implant and arch-level survival and marginal bone level (MBL) change. Secondary outcomes included complications and provisional prosthesis survival. Results:Twenty-two patients (23 arches; 92 implants) were analyzed: 13 arches freehand and 10 navigation. Median follow-up was 5.11 months. Five implants failed (5.43%), all in the maxilla, affecting four arches (one navigation, three freehand). Implant survival was 94.23% (freehand) and 95.00% (navigation). MBL change was negligible, consistent with early remodeling and measurement variability. Biological complications occurred in 8 implants (8.70%), and two provisional fractures were repaired; 22 of 23 prostheses remained functional (95.65%). Conclusion:Immediate-loading All-on-4 with selective navigation achieved high short-term implant and prosthesis survival and minimal MBL variation. These findings support the feasibility of navigation in demanding arches in routine practice, warranting confirmation in prospective studies with longer follow-up.
PurposeThe aim of this study is to compare trueness and precision of dental models from three LCD 3D printers with different horizontal resolutions (2K, 4K, 8K) and to evaluate their clinical suitability for orthodontic use.Materials and MethodsThirty models were printed using Creality Halot One (2K), Phrozen Mighty 4K, and Phrozen Mighty 8K printers, with ten models each using manufacturer-recommended resins. Master digital models from intraoral scans were compared to re-scanned printed models through surface superimposition using Geomagic Control X software. Trueness and precision were evaluated by point deviation and Root-Mean-Square (RMS) analysis, with differences assessed by one-way ANOVA (p = 0.05).ResultsMean RMS values for 2K, 4K, and 8K printers were 0.266 ± 0.015 mm, 0.223 ± 0.017 mm, and 0.121 ± 0.012 mm, respectively (p < 0.001). The 8K printer showed highest trueness and precision, with deviations mainly in occlusal and gingival regions. The 0.25 mm error limit was within acceptable range for 4K and 8K models, while 2K models exceeded this value (p < 0.05).ConclusionPrinter resolution significantly affects dimensional accuracy. The 8K LCD printer demonstrated superior accuracy and reproducibility, proving reliable for orthodontic models and clear aligners.
Purpose:The aim is to evaluate and compare the effects of single versus repeated applications of potassium iodide (KI) on SDF-induced discoloration in primary canines. Materials and Methods:Thirty-six extracted human primary canines with dentinal caries were randomly allocated into three groups: Group I received 38% SDF alone; Group II received SDF followed by a single KI application; and Group III received SDF followed by immediately application after SDF and repeated on days 1, 3, and 5. Color change (∆E) was assessed on Days 1, 14, and 30 using a spectrophotometer based on the CIE Lab* system. Statistical analysis included One-Way ANOVA with Tukey post hoc tests for between-group comparisons, and Repeated Measures ANOVA with Bonferroni adjustment for within-group comparisons. Results:All groups showed significant differences in ΔE values at each time point, except between the single and repeated KI groups on Day 1. The Group I exhibited the highest ΔE values throughout the study, indicating the greatest discoloration, while Group III resulted in the lowest values. Over time, a progressive increase in discoloration was observed in Groups II, whereas partial color stability was maintained in Group III. Conclusion:Repeated application of KI after SDF treatment can result in a higher reduction in tooth discoloration compared to a single-application. This protocol may enhance the clinical acceptability of SDF, especially for visible anterior teeth in pediatric patients.
Purpose:To determine whether low serum vitamin D levels are inversely correlated with clinical parameters and positively correlated with gingival crevicular fluid (GCF) 25(OH)D3, 1,25(OH)2D3, LL-37 and tumor necrosis factor-α (TNF-α) levels in periodontitis patients with well-controlled type-2 diabetes (T2DM). Materials and Methods:Twenty-six well-controlled T2DM patients with periodontitis and Vitamin D insufficiency (Vit.D-IS group), and 15 well-controlled T2DM patients with periodontitis and Vitamin D sufficiency (Vit.D-S group) were included. Papilla bleeding index, bleeding on probing (BOP), supragingival plaque, clinical attachment level (CAL) and probing depth (PD) were evaluated. GCF total amounts of 25(OH)D, 1,25(OH)2D3, LL-37 and TNF-α were analyzed by ELISA. Serum 25(OH)D3 levels were determined using liquid chromatography tandem-mass spectrometry. Results:Whole mouth CAL and BOP scores were higher in the Vit.D-IS group than those of Vit.D-S group (P=0.038, P=0.048, respectively). Whole mouth PD and plaque values were comparable in both groups. Differences were not detected in GCF 25(OH)D3, 1,25(OH)2D3, LL-37 and TNF-α levels between Vit.D-IS and Vit.D-S groups. Serum 25(OH)D3 levels were adversely associated with CAL and BOP scores (P=0.018, P=0.049, respectively). Also, GCF 1,25(OH)2D3 total amounts were positively related with GCF LL-37 total amounts (P=0.0001). Conclusion:Serum 25(OH)D3 insufficiency was related to periodontal inflammation and destruction in periodontitis patients with well-controlled T2DM. However, GCF 25(OH)D3, 1,25(OH)2D3, TNF-α and LL-37 total amounts were not correlated with serum vitamin D levels. We have opinion that obtaining and maintenance of periodontal health should be included in the diabetic treatment protocol in Vitamin D deficient patients with periodontitis and well-controlled T2DM.
Purpose:This study evaluated the effects of commonly consumed chromogenic beverages on the color stability and surface roughness of three CAD/CAM resin-matrix ceramics at different time intervals. The study aims to provide comparative data under standardized immersion conditions, addressing a gap in time-dependent color and surface alterations of CAD/CAM resin-matrix ceramics. Materials and Methods:A total of 168 specimens were prepared from three CAD/CAM resin-matrix ceramics (Vita Enamic HT 2M2, Cerasmart HT A2, and Brava HT A2). Specimens were immersed in distilled water, coffee, cola, or red wine at 37 °C for up to 12 days. Color (ΔE₀₀, CIE L*a*b*), and surface roughness (Ra) were measured at baseline, 3, 6, and 12 days. Two-way repeated-measures ANOVA (factors: beverage and time) followed by post-hoc tests (α=0.05) was used for statistical analysis. Results:Red wine produced the highest color change in all materials (p<0.001), followed by coffee, whereas cola and water resulted in significantly lower ΔE₀₀ values. At day 12, Vita Enamic showed greater discoloration and roughness than Cerasmart and Brava (p<0.05). Both ΔE₀₀ and Ra increased significantly with time (p<0.001). Conclusion:Exposure to chromogenic beverages significantly affected both color stability and surface roughness of CAD/CAM resin-matrix ceramics. Red wine and coffee were the most aggressive agents, while Cerasmart demonstrated the best stability. Routine dietary counseling and periodic repolishing may be advisable to preserve the long-term esthetic integrity of CAD/CAM restorations.
PurposeThe aim of this study was to verify the effect of multiple firing cycles on lithium disilicate and zirconia reinforced lithium silicate ceramics.Materials and MethodsSixty discs measuring 12 mm x 1.2 mm made with IPS E.max CAD (n=30) or Vita Suprinity (n=30) ceramic systems were divided into 3 subgroups submitted to 2, 3 or 5 firing cycles (C2, C3, and C5, respectively). Surface roughness, gloss, biaxial flexural strength, and Vickers hardness were evaluated, as well as scanning electron microscopy (SEM) analysis. Data was submitted to two-way ANOVA and Tukey’s test with a 5% significance level.ResultsFor surface roughness, Suprinity showed a significant decrease at C5 (p<0.05). For gloss, there was no statistical interaction and C5 showed higher gloss value for both ceramics (p>0.05). For flexural strength, Suprinity showed significant increase (p<0.05) and IPS E.max CAD decreased significantly at C5 (p<0.05). For Vickers hardness, there was no statistical interaction and hardness decreased at C5 for both ceramics (p>0.05). IPS E.max CAD showed no morphological difference while Suprinity showed micro irregularities for C5 in the SEM analysis.ConclusionFiring cycles promoted better effect on roughness and biaxial flexural strength parameters for the Suprinity compared with IPS E.max CAD. Both ceramics showed negative effects on the morphological aspect of the crystalline matrix and similar gloss or hardness values.
Purpose This study aimed to evaluate the effects of passive ultrasonic irrigation (PUI) and sonic activation (SA) on apical extrusion and the removal efficacy of bioceramic (BC), and calcium hydroxide (CH) based intracanal materials in simulated open-apex teeth. Materials and Methods Thirty-two extracted mandibular canines were prepared according to ISO #140, and an open-apex condition was created by apical resection. Specimens were randomly assigned to bioceramic (Bio-C Temp) and CH (DiaPaste) intracanal medication groups and subdivided among PUI or SA methods (n = 8). Extruded intracanal medicament was collected in pre-weighed tubes, and residual medicament was scored under a microscope. Residual intracanal medicament was evaluated using a four-grade scoring system. Normality was assessed using the Shapiro-Wilk test; group comparisons were performed with the Kruskal-Wallis test and Dunn's post-hoc test, with significance set at p<0.05. Results Apical Extrusion values were as follows: Group BC-PUI = 0.048 mg, Group BC-SA = 0.036 mg, Group CH-PUI = 0.052 mg, and Group CH-SA = 0.049 mg. No significant difference was observed in apical extrusion among the groups (p = 0.265). Median residual scores were Group BC-PUI = 0.5, Group BC-SA = 3, Group CH-PUI = 0.5 and Group CH-SA = 1. PUI resulted in significantly lower residual medicament scores than SA (p = 0.002). Conclusion Bio-C Temp demonstrated superior removal and apical extrusion characteristics were comparable to CH. These findings support its potential as a reliable alternative to CH.
PurposeOral Lichen Planus is a chronic immune-mediated mucosal disorder in which symptom control and lesion suppression remain the primary therapeutic goals. This review aimed to evaluate whether Aloe vera can effectively reduce the clinical manifestations of oral lichen planus by comparing its efficacy, safety, and impact on quality of life with those of Triamcinolone Acetonide. The review also sought to investigate the potential of Aloe vera as a safe and effective alternative to corticosteroids in the management of oral lichen planus.Materials and MethodsPubMed, Scopus, the Cochrane Library, and Google Scholar were systematically searched to identify clinical trials comparing Aloe vera with 0.1% triamcinolone acetonide for the management of oral lichen planus. A total of five clinical trials met the eligibility criteria and were included in this review. This review was registered in PROSPERO under the registration ID CRD420251166690.ResultsAloe vera demonstrated significant improvement in pain scores, burning sensation, and lesion severity in patients with oral lichen planus. Compared with 0.1% triamcinolone acetonide, Aloe vera showed comparable clinical efficacy in randomized clinical trials and greater improvement in functional symptoms in non-randomized comparative studies, suggesting enhanced day-to-day comfort during eating, speaking, and oral hygiene practices. No serious adverse effects were reported with Aloe vera, whereas prolonged corticosteroid therapy is known to be associated with potential adverse effects.ConclusionAloe vera appears to be an effective and well-tolerated topical therapy for oral lichen planus, providing clinical and symptomatic improvement comparable to that achieved with 0.1% triamcinolone acetonide, while offering additional advantages in terms of safety and indirect symptom relief. It may therefore represent a suitable alternative for patients requiring longterm or steroid-sparing therapy. Nevertheless, larger, methodologically rigorous randomized controlled trials using standardized Aloe vera formulations and longer follow-up periods are needed to strengthen the certainty of the evidence and to determine the long-term durability of its therapeutic effects.
Purpose:The aim of this study was to evaluate the effect of two plaque disclosing agents on the color stability of four different restorative materials. Materials and Methods:Twenty disc-shaped specimens (8 mm diameter, 2 mm thickness) were prepared for each material: Z250 (3M ESPE), Charisma Diamond (Heraeus Kulzer), Estelite Universal Flow Medium (Tokuyama Dental Corporation Inc.), and Beautifil II (Shofu Inc.). Baseline color measurements were conducted using the VITA Easyshade Compact after numbering the specimens and immersing them in distilled water at 37°C for 24 hours. Two plaque disclosing agents were applied to the specimens: Mira-2-Ton (Hager & Werken) to 10 specimens and ProPind plaque indicator gel (Promida Co.), containing erythrosin dye, to the remaining 10 specimens. Ten seconds after the application, each specimen was rinsed under running water for 30 seconds and air-dried. Color changes in the specimens were calculated using the CIEDE2000 formula. Statistical analysis was performed using One-way ANOVA, Kruskal-Wallis, and Mann-Whitney U tests (p<0.05). Results:The color changes were perceptible (ΔE00 > 0.8) in all experimental groups. Clinically unacceptable color changes (ΔE00 >1.8) were observed in all groups following Mira-2-Ton application, with Charisma Diamond exhibiting the highest color change (7.18 ± 2.65) and Z250 the lowest (2.98 ± 1.13). In contrast, all groups stained with ProPind gel showed clinically acceptable color changes (ΔE00 <1.8), with no statistically significant differences among materials (p>0.05). Conclusion:Plaque disclosing agents can significantly impact the color stability of restorative materials. Understanding the chemical composition of plaque disclosing agents is essential for clinicians to ensure the long term aesthetic stability of restorative materials. Further in vitro and in vivo studies are needed to assess the underlying mechanisms of discoloration caused by disclosing agents.
PurposeThe purpose of this ex vivo study was to investigate the effects of 5 distinct irrigant activation systems on bacterial colonization within dentinal tubules utilizing confocal laser scanning microscopy (CLSM).Materials and MethodsSixty extracted human mandibular premolars with single canals were prepared using resiprocal instruments. The teeth were embedded in acrylic resin blocks and the root canals were inoculated with Enterococcus faecalis. Root canals were irrigated using five different irrigant activation methods: standard needle irrigation, IrriFlex, EDDY, Endoactivator, and passive ultrasonic irrigation (PUI). Horizontal sections, 1 ± 0.1 mm in thickness, were obtained at distances of 2, 5 and 8 mm from the apical end of the teeth. Sections were visualized using a CLSM. The penetration depth of dead bacteria was measured to evaluate the antimicrobial efficacy of the irrigant activation systems. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction.ResultsPUI showed significantly greater penetration depth of dead bacteria in both the coronal and apical thirds compared to the other experimental groups (p<0.05).ConclusionAlthough a statistically significant reduction in bacteria was observed in all experimental groups compared to the control, the canal disinfection was not complete in any of the groups. According to our results, standard needle irrigation had the lowest disinfection efficiency, while PUI demonstrated the highest among the evaluated activation methods.
Purpose:The aim of this study was to evaluate the concordance between the histopathological diagnoses obtained from biopsies of maxillofacial lesions and the definitive histopathological diagnoses of the excised specimens, and to identify factors associated with diagnostic discordance. Materials and Methods:A retrospective cross-sectional study was conducted on 203 patients with maxillofacial lesions who underwent surgical excision following biopsy between 2005 and 2019. Sociodemographic, clinical, and histopathological data were collected and analyzed. Biopsy diagnoses were compared with the final excision diagnoses using Cohen's kappa coefficient and appropriate statistical tests. Results:The histopathological diagnosis of the excised specimen was consistent with the biopsy diagnosis in 87.8% of cases (p = 0.001). No significant differences were found between biopsy and excision diagnoses when the biopsy was performed by a specialist or a resident (p = 0.29), or when the histopathological evaluation was conducted by a resident or a specialist pathologist (p = 0.59). Likewise, no significant differences were observed according to whether the biopsy specimen consisted of a single fragment or multiple fragments (p = 0.65). Conclusion:Careful identification and management of factors contributing to diagnostic discordance may improve the reliability of biopsy diagnoses and consequently enhance patient management.
Purpose This study evaluated the effects of different endodontic irrigation solutions on the solubility, color alteration, and surface roughness alterations of PD MTA and Biodentine. Materials and methods Cylindrical samples of PD MTA and Biodentine were prepared and subsequently immersed in distilled water, 17% EDTA, 5% NaOCl, 9% HEDP, and 0.2% chitosan nanoparticle solutions for 24 hours. Solubility was determined as the percentage mass loss at 24 h compared to initial values. Color alteration was analyzed using a spectrophotometer (CIE Lab system), and surface roughness (Ra and Sa) was measured with a confocal microscope. Data were statistically analyzed with Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests at a 5% significance threshold. Results No significant differences in solubility were observed between PD MTA and Biodentine, but EDTA and chitosan nanoparticles significantly increased solubility compared to other solutions (p<0.05). Biodentine exhibited greater color alteration than PD MTA for all solutions except distilled water (p<0.05), with NaOCl causing the most pronounced color alteration (p<0.05). PD MTA showed higher surface roughness before and after immersion (p<0.05), with HEDP inducing the greatest roughness alterations in both materials (p<0.05). Conclusion Endodontic irrigants affect the physical properties of hydraulic cements, with varying impacts on solubility, color alteration, and surface roughness. Selecting appropriate irrigation solutions is essential to maintaining material integrity and esthetic outcomes in clinical practice.
Purpose:The aim of this study was to evaluate the influence of operator experience and four different nickel-titanium (NiTi) retreatment systems in curved canals with respect to procedural time, complications, and file distortions during root canal filling removal. Materials and Methods:Root canal treatment was performed on 80 acrylic blocks with a 30° curvature. The blocks were assigned to either an endodontist or an endodontic resident (n = 40 each) and further divided into four subgroups (n = 10) according to the retreatment system used: ProTaper Universal Retreatment, ROGIN Retreatment Files, FANTA AF Retreatment Files, and EndoArt Retreatment Gold. Procedural time, complications (perforation, ledge formation, and apical transportation), and file distortions (unwinding, tip deformation, and instrument separation) were recorded. Results:The median procedural time for the endodontist (120 [95-142]) was significantly shorter than that for the resident (145 [117-162]) (p = 0.007). No statistically significant differences were observed between operators with regard to complications. The ProTaper Universal Retreatment system exhibited the lowest overall complication rates numerically. Additionally, both the FANTA AF Retreatment Files and the ProTaper Universal Retreatment system demonstrated a lower incidence of ledge formation when used by the resident; however, this difference did not reach statistical significance. Conclusion:The endodontist completed the procedures faster than the endodontic resident. The ProTaper Universal Retreatment system showed the lowest overall number of complications across both operators. The FANTA AF Retreatment Files demonstrated the lowest incidence of ledge formation, whereas EndoArt Retreatment Gold exhibited the highest incidence.
Purpose:This study aimed to evaluate the direct and transdentinal antibacterial activity of some synthetic and biomimetic agents against different cariogenic strains. Materials and Methods:The antibacterial activity of synthetic and biomimetic agents, including chlorhexidine digluconate (CHX) (positive control), sodium hypochlorite (NaOCl), sodium fluoride (NaF), nisin, Biorepair, UltraDex, and distilled water (negative control) against different cariogenic species, including four Streptococcus strains (S); S. mutans, S. sobrinus, S. mitis, and S. sanguinis, and three Lactobacillus strains (L); L. acidophilus, L. gasseri, and L. casei were evaluated using direct and transdentinal diffusion tests. For the transdentinal test, 0.2mm human dentin discs were used, and their permeability was standardized using a modified fluid transport apparatus. Six replicates were made to determine the inhibition zone for each tested agent against each tested bacterial strain. Data were statistically analyzed using a multivariate analysis of variance using a general linear model. Results:CHX exhibited the highest antibacterial activity against all strains. Nisin showed moderate efficacy, particularly against S. mutans. NaOCl and Biorepair showed similar effects (p=1.000), as did NaF and UltraDex, which were least effective against Streptococcus. Biorepair showed notable transdentinal activity against S. sanguinis and L. acidophilus. Conclusion:Chlorhexidine remains the reference standard for cavity disinfection. Nisin demonstrated promising efficacy against the tested strains. Biorepair could be successfully recommended in caries management. S. mutans' marked resistance defines it as a primary target for antimicrobial intervention. Dentin, as a biological barrier, hinders the effectiveness of the tested antibacterial agents and should be considered in treatment planning.
Purpose The aim of this study was to compare the movement of mini-implants subjected to orthodontic forces in the sagittal and vertical directions. Materials and methods Twenty-four young patients with a total of forty-six mini-implants placed between the maxillary second premolar and the maxillary first permanent molar were divided into two groups. Group 1 (G1) consisted of patients undergoing distalisation, whereas Group 2 (G2) consisted of patients undergoing intrusion. In both groups, bilateral orthodontic forces were applied from the mini-implants in the sagittal (G1) and vertical (G2) directions, respectively. Linear and angular measurements were used to evaluate mini-implant displacement in both groups using cone beam computed tomography (CBCT) scans obtained before treatment (T1) and toward the end of treatment (T2). The Wilcoxon signed-rank test and the Mann-Whitney U test were used, respectively, to compare mini-implant displacement within and between the groups, respectively. A Kaplan-Meier survival curve was plotted to estimate the duration for which the mini-implants were likely to remain in the oral cavity. Results In G1, a statistically significant increase in both vertical and sagittal angulation of the mini-implants was observed, directed toward the occlusal and mesial directions, respectively (p = 0.016 and p<0.001). In G2, an increase in vertical angulation toward the occlusal direction and a mild distal angulation were observed; however, these changes were not statistically significant. In both G1 and G2, a statistically significant linear displacement of the mini-implants was detected, with movement toward the maxillary second premolar in G1 (p<0.001) and away from the maxillary second premolar in G2 (p = 0.006). Conclusion Mini-implant movement was greater under sagittal orthodontic forces than under vertical forces. Minor displacement of mini-implants occurs when subjected to orthodontic forces-particularly in the sagittal direction-but this movement may not necessarily indicate implant failure.
Purpose This study aimed to evaluate the effect of different vehicles and insertion/agitation methods on the penetration of calcium hydroxide (CH) paste into dentinal tubules. Materials and methods Eighty single-rooted premolars were standardized to 12 mm, prepared using the ProDesign 40.05 instrument, and randomly assigned to eight experimental groups (n = 10): CH-propylene glycol/camphorated paramonochlorophenol (PG/CPMC) + K-file (KF), CH-PG/CPMC + XP Clean (XP), CH-PG/CPMC + Easy Clean (EC), CH-PG/ CPMC + ultrasonic activation (UA); Ultracal XS (UC) + KF, UC + XP, UC + EC, and UC + UA. The CH paste was mixed with 0.1% Rhodamine dye and inserted into the specimens. Two 1-mm-thick sections were obtained at 2 mm and 5 mm from the apex, scanned using confocal microscopy, and analyzed with ImageJ software to calculate the percentage penetration and maximum penetration depth (MPD). Student's t-test, one-way ANOVA, andTukey's post hoc tests were used for statistical analysis (P < .05). Results The penetration of the PG/CPMC paste differed significantly between KF and EC, as well as between KF and UA, at both 5 mm (p< .05) and 2 mm (p < .05). UC showed enhanced penetration with UA, while EC outperformed KF at 2 mm. For MPD, no significant differences were observed at 5 mm. Conclusion Both the insertion/agitation methods and paste formulations influenced the percentage penetration of the paste into the root canal lumen and dentinal tubules. At 2 mm, aqueous and viscous vehicles optimized MPD, particularly when combined with UA and EC.
Purpose The aim of this study is to evaluate the effect of the use of cavity disinfectant on the amount of microleakage seen in composite restorations. Materials and methods Forty caries-free permanent molars extracted due to periodontal or orthodontic problems were used in the study. Class II box cavities were prepared in the mesial and distal of teeth. Then, the teeth were divided into subgroups (n:10) according to the use of universal adhesive and cavity disinfectant. Chlorhexidine digluconate (2%) was used as a cavity disinfectant. In the prepared cavities, universal adhesives were used with total and self-etch modes and restored with posterior composite resin. After the restoration of the teeth was completed, 1000 thermal cycles were applied. Microleakage analysis was performed with a micro-computed tomography device after the teeth were soaked in silver nitrate solution for 24 hours. Two-way analysis of variance test was used in the analysis of microleakage data and Tukey test was used to show the differences between groups in multiple comparisons (p<0.05). Results Application of universal adhesives to Class II cavities in self-etch mode caused more microleakage than total-etch mode (p<0.05). There was no statistically significant difference between the microleakage values of the universal adhesive (p>0.05). When universal adhesives are used with cavity disinfectants decreased the microleakage value in the self-etch mode (p<0.05), but it did not show a statistically significant decrease in the total etch mode (p>0.05). Conclusion While the use of cavity disinfectant in teeth restored with composite resin reduces the amount of microleakage in the self-etch mode, the total etch mode does not affect the amount of microleakage.
Purpose This study aimed to evaluate the accuracy of cephalometric analyses performed by deep learning-based AI programs (NemoCeph 2D, OrthoDx, AudaxCeph, and WebCeph) by comparing their results with the gold standard measurements obtained from 3D CT scans in orthognathic surgery patients. Materials and methods Orthognathic surgery candidates underwent pretreatment 3D CT scans. These scans were manually analyzed using 3D cephalometric software to establish gold-standard landmark positions. Two-dimensional cephalometric images were then derived from the 3D scans, and deep learning-based AI programs automatically identified the landmarks on these images. The AI-generated measurements were compared with the 3D gold standard, and the differences were analyzed statistically. Results While the ANB angle showed no significant differences between the methods (p=0.061), other measurements-including SNA, SNB, Wits appraisal, Y Axis Angle, and various facial height ratios-showed significant discrepancies (p<0.05). Conclusion AI-based cephalometric analyses showed notable errors compared with the 3D CT gold standard. These findings suggest that deep learning algorithms require further refinement before they can be reliably used for orthognathic surgery planning.
Purpose:Individuals with Attention Deficit Hyperactivity Disorder (ADHD) exhibit more parafunctional habits such as bruxism. Common medications for ADHD include methylphenidate and atomoxetine. This study aimed to investigate the effects of these medications and the severity of ADHD on bruxism. Materials and methods:A total of 181 individuals aged 5-18 years with ADHD were divided into three groups: methylphenidate, atomoxetine, and drug-naïve. The Bruxism Checklist and the Conners' Questionnaire (for assessing ADHD severity) were completed for each participant. The chi-square test was used to compare the severity of bruxism with both ADHD severity and medication type. A one-way analysis of variance (ANOVA) was conducted to compare bruxism and ADHD scores among the medication groups. Data were analyzed using SPSS version 21. Results:Bruxism scores were higher in males, whereas ADHD scores did not differ significantly between males and females. Participants treated with methylphenidate had the highest mean bruxism scores. As ADHD severity increased, bruxism scores also increased. A statistically significant difference was found in mean ADHD scores across bruxism severity levels (P = 0.004). ADHD scores were significantly lower in the nonbruxism group compared to both the mild bruxism and the moderate-to-severe bruxism groups (p less than 0.05). Conclusion:The severity of bruxism in children with ADHD appears to be related to the severity of ADHD rather than the type of medication. Bruxism is more common in males. Management of bruxism in children with ADHD should adopt a multidisciplinary approach integrating pharmacological, behavioral, and dental strategies.
