This study assesses the antimicrobial activity and physical alterations of alginate impression material in the presence of silver nanoparticle (AgNP) solutions. The samples were assigned to five groups according to the type of alginate and solution: (JW) Jeltrate + distilled water; (JCHX) Jeltrate + 0.2% chlorhexidine digluconate; (JAgNP_0.2%) Jeltrate + 0.2% AgNP; (JAgNP_1%) Jeltrate + 1% AgNP; and (AW) Avagel + distilled water. AgNPs were synthesized from the fungus Trichoderma reesei. Fifty impressions were made (n=10) from a matrix, from which plaster models were fabricated. Surface detail reproduction and dimensional stability were analyzed under a light microscope. Surface detail reproduction was achieved by replicating a 50µm line on the plaster model. Dimensional stability was calculated from measurements of X' and X'' in the matrix and plaster models. The antimicrobial effect was assessed independently by measuring the formation of zones of inhibition around the alginate molds (n=3) in agar medium containing Streptococcus mutans and Candida albicans. Dimensional stability values were subjected to the ANOVA and Tukey's post-hoc test (α=0.05). JCHX showed the highest dimensional stability and differed significantly from the other groups (p<0.05). A 50µm line was reproduced in the plaster for all tested groups, regardless of the impression material and antimicrobial solution. AgNPs incorporated into the alginate mixture did not produce dimensional changes in the alginate mold. AW and JCHX exhibited antimicrobial potential, as evidenced by bacterial inhibition. Jeltrate or Avagel, regardless of AgNP concentration, did not demonstrate antimicrobial activity.
This study evaluated the bleaching efficacy, pH behavior, and reuse potential of a titanium dioxide nanoparticle (TiO₂) suspension as a photocatalytic, peroxide-free alternative to carbamide peroxide (CP) for at-home bleaching. Forty bovine incisors were subjected to a 21-day at-home bleaching regimen (2 h/day) using fresh or reused agents (n = 10): fresh CP (16% CP), reapplied CP (16% CP collected and reused), fresh TiO₂ (10 wt% TiO₂ suspension), and reapplied TiO₂ (reactivated 10 wt% TiO₂ suspension). TiO₂ suspensions were UV-activated daily (385 nm, 50 min), and the reused TiO₂ was reactivated prior to each application. The pH of the bleaching agents was assessed before gel application and after completion of the at-home protocol; all experimental groups showed a similar pH trend, with values increasing from 6.0 to 7.0 throughout the procedure. Bleaching efficacy was evaluated using CIEDE2000 (ΔE₀₀) and whiteness index (ΔWID) values obtained with a digital spectrophotometer (VITA Easyshade V). Data were analyzed with one-way ANOVA and Tukey's test (α = 0.05). ΔE₀₀ analysis showed that fresh TiO₂ produced the lowest color change, with values closest to the perceptibility and acceptability thresholds, differing significantly from reapplied TiO₂, fresh CP, and reapplied CP (p < 0.05). No significant differences were observed among the remaining groups, and all other conditions exhibited ΔE₀₀ values above the acceptability threshold. ΔWID values did not differ significantly among groups (p = 0.475). The UV-activated TiO₂ suspension (100 min total exposure) was able to bleach teeth without peroxide.
This in vitro study evaluated the influence of the incorporation of different concentrations of zinc-modified niobium nanoparticles (Nb/Zn) on the mechanical properties of a flowable resin composite (OptiFlow II, LC/Pac-Dent) by surface hardness (SH), depth of cure (DoC), flexural strength (FS), and modulus of elasticity (E). The morphology and composition of Nb/Zn nanoparticles were evaluated by Scanning Electron Microscopy and energy-dispersive X-ray spectroscopy (EDX). The Nb/Zn nanoparticles were incorporated at 3 different concentrations (0.3%; 0.6% e 0.9%), resulting in four groups: OptiFlowII, OptiFlow II+0.3%Nb/Zn, OptiFlow II+0.6%Nb/Zn, and OptiFlow II+0.9%Nb/Zn. SH was measured at the top and bottom of the specimens (n=6/group). FS and E were conducted using a Universal Testing Machine (Instron, 50N) (n=14/group). For SH, DoC, and FS, ANOVA followed by Tukey's test was used for statistical analyses, and for E, pairwise comparisons were conducted using a sandwich covariance matrix (p<0.05). The results showed that OptiFlow II+0.6%Nb/Zn exhibited the lowest top-SH values in all comparisons (p=0.003). Regarding DoC, the data indicated a significant difference between the groups with 0.3% and 0.6% Nb/Zn (p=0.04). For E, OptiFlow II+0.3%Nb/Zn presented higher values (E=3.48±0.15)a compared to OptiFlow II+0.6%Nb/Zn (E=3.3±0.18; p=0.02)b, OptiFlowII presented higher values (E=3.56±0.27)a than OptiFlow II+0.6%Nb/Zn (p=0.01) and OptiFlow II+0.9%Nb/Zn (E=3.3±0.27; p=0.02)b. Thus, the incorporation of Nb/Zn nanoparticles at different concentrations into the OptiFlow II affects its mechanical properties, without altering the depth of cure, but reducing flexural strength. The group with the lowest nanoparticle concentration showed E similar to that of the control group and higher than that of the higher-concentration groups. Overall, the incorporation of Nb/Zn nanoparticles influenced the mechanical behavior of the flowable resin composite. Lower concentrations performed similarly to the control, while higher levels impaired properties, highlighting the need for optimized nanoparticle loading.
This study aimed to evaluate the effect of dentin surface finishing protocols using ultrasonic CVD diamond tips on the bond strength of resin cement to dentin. Seventy-two bovine incisor crowns were prepared and assigned to four dentin surface finishing protocols (Groups 1-4, n = 18), including a conventional control group and experimental groups using ultrasonic CVD diamond tips applied sequentially with increasing fineness. One specimen per group was analyzed by scanning electron microscopy to assess surface topography and smear layer characteristics. The samples were bonded using light-cured resin cement in combination with three adhesive strategies: total-etch, self-etch, and universal adhesives. After 24 hours of storage in distilled water, microshear bond strength testing was performed (0.5 mm/min). Data were analyzed using two-way ANOVA and Tukey's post hoc test (α = 0.05). Groups 3 and 4 showed significantly higher bond strength than the control group (p < 0.05), while no significant differences were observed among adhesive strategies (p > 0.05). Surface analysis revealed that these protocols produced a more homogeneous and regular smear layer, whereas intermediate finishing resulted in a more irregular surface. It can be concluded that the sequential use of ultrasonic CVD diamond tips with increasing fineness improves the bond strength of resin cement to dentin and promotes a more favorable substrate for adhesion.
This study investigated whether wetting agent application alters surface microhardness, gloss, and color stability of a nanohybrid resin composite after simulated aging by brushing or thermocycling. Sixty discs of one nanohybrid resin composite were fabricated and divided into three conditions: no wetting agent, Wetting Resin (WR), or Modeling Resin (MR). Baseline evaluations included Knoop microhardness, color using the CIE Lab* system, and 60° gloss. Aging was performed by either standardized brushing or 10,000 thermocycles (5-55 °C). Post-aging values were compared with baseline data. Statistical analysis used two-way repeated-measures ANOVA/Tukey for microhardness, and nonparametric tests for gloss and ΔE (α = 0.05). Wetting agent application lowered baseline microhardness compared to controls, with MR showing the lowest values. Thermocycling reduced gloss, while brushing increased gloss in WR and maintained it in MR. Sealants also affected color stability, with material- and method-dependent responses. In conclusion, the wetting agent influenced the mechanical and optical behavior of the nanohybrid resin composite in a manner dependent on the agent and aging protocol. These materials reduced surface hardness and produced distinct gloss and color responses to brushing versus thermocycling.
To evaluate and compare the acid erosion resistance, surface topography, and fluoride release of restorative glass ionomer cements (GICs) subjected to erosive challenge. Specimens (n=6) of Vidrion R® (VD), Maxxion R® (MA), Vitro Molar® (VM), and GlasIonomer FX ULTRA® (GI) were prepared and stored in water at 5°C/24h. Baseline measurements of thickness, weight, and surface roughness (linear - Ra; volumetric - Sa) were obtained using a non-contact 3D profilometer. Specimens were immersed in 30 mL of a lactic acid buffer (pH 2.74) at 37°C/24h, after which final thickness (eroded depth), mass (eroded mass), and surface roughness were measured. Fluoride release was evaluated in duplicate using a calibrated fluoride-specific electrode. Data were analyzed using Jamovi 2.2.5 (p<0.05). All GICs showed a reduction in thickness; however, only VM exhibited an eroded depth below 0.17 mm (0.10 ± 0.03 mm, per ISO standards). Regarding mass loss, VD experienced the highest reduction and VM the lowest (p<0.05), with GI and MA showing similar losses (p>0.05). Regarding surface roughness, VD showed a reduction in Ra, whereas the other GICs showed increases (p>0.05). All specimens demonstrated a significant increase in Sa, with MA showing the greatest change (p<0.05). In fluoride release, MA and VD had the highest values (98.6 ± 11.8 and 91.4 ± 8.16), GI was intermediate (66.1 ± 4.12), and VM had the lowest (38.4 ± 9.97) (p<0.05). Although all products released fluoride and underwent significant changes in thickness, mass, and surface roughness under erosive challenge, only VM demonstrated adequate acid erosion resistance according to ISO standards.
To analyse the prevalence of complete and partial edentulism in the European adult population and to evaluate demographic and geographical factors associated with tooth loss and prosthetic rehabilitation needs using national health survey data. A cross-sectional ecological study used aggregated secondary data from the European Health Interview Survey (EHIS), Eurobarometer, and national oral health surveys from Germany, Spain, France, Italy, Poland, Romania, Sweden, and the United Kingdom. Surveys published between 2010 and 2023 were included, representing more than 250,000 adults. Prevalence of complete and partial edentulism was analyzed by age group, sex, and geographical region. Descriptive statistics were calculated as percentages and absolute numbers with 95% confidence intervals. A generalized linear model with binomial distribution estimated adjusted odds ratios for complete edentulism. Statistical significance was set at α = 0.05. Complete edentulism among adults aged 65-74 years ranged from less than 6% in Northern and Western Europe to more than 40% in Eastern Europe, corresponding to approximately 3,200 to over 4,500 individuals. Partial edentulism exceeded 65% in adults aged 45 years and older across all regions. Multivariable analysis identified advanced age as the strongest predictor of complete edentulism (aOR = 28.4 for ≥75 vs. 45-54; p < 0.001), followed by residence in Eastern Europe (aOR = 9.8; p < 0.001). Sex was not independently associated with complete edentulism. Edentulism prevalence in Europe varies by age and geographical region. These findings support region-specific planning of prosthetic rehabilitation services and public health strategies to reduce oral health inequalities.
This scoping review identified and mapped the adverse reactions and complications associated with the use of hyaluronic acid (HA) dermal fillers in facial aesthetic procedures. This scoping review was reported according to the PRISMA-ScR. Searches were conducted in three electronic databases (PubMed, Scopus, and Web of Science). Randomized clinical trials, cross-sectional studies, retrospective or prospective cohort studies, case series, or case reports published until 2024 that assessed or reported the use of HA for facial filling in healthy adult patients and documented any adverse reaction or complication were included. Study selection was conducted independently by two researchers. Data extraction was performed on half of the included studies by each reviewer, with cross-checking by a third reviewer. A descriptive analysis of the data was performed, considering the different study designs and the complications and adverse reactions reported. Data were presented in tables and graphs. Fifty-five studies met the eligibility criteria and were included. Most studies were case series and case reports (67.3%). Sample sizes ranged from 1 to 5,000, and participant ages ranged from 18 to 78 years. The most reported adverse reactions among the included studies were bruising (56.4%), ischemia (45.4%), and edema (41.81%), with itching less frequent (3.6%). The most severe complications reported were tissue necrosis (29.1%) and tissue embolism (20%), with some cases leading to blindness or stroke. Bruising and ischemia were the most frequently reported adverse reactions, while tissue necrosis was the most common severe complication reported.
This study investigated how tumour histopathological characteristics and immune cell phenotypes in the tumour microenvironment influence the prognosis of patients with oral squamous cell carcinoma. Thirty-one samples of oral squamous cell carcinoma were analysed using immunohistochemistry to assess tumour budding, perineural invasion, depth of invasion, tumour thickness, lymphovascular invasion, pattern of invasion, and tumour-stroma ratio. Anti-CD66b and anti-CD8 immunostaining were used to examine neutrophil and lymphocyte infiltration within the tumour core, invasive front, and overall tumour. Kaplan-Meier survival curves were employed to correlate these features with patient survival. High tumour budding was observed in lesions with perineural and lymphovascular invasion and was positively associated with tumour thickness. Dispersed tumours had the highest depth of invasion and thickness, while non-cohesive tumours exhibited more perineural invasion and greater CD66b+ cell infiltration at the invasive front. Increased CD66b+ counts, non-cohesive and dispersed patterns, were associated with shorter overall survival. A higher ratio of neutrophils to lymphocytes was observed in patients who died. In conclusion, high tumour budding, perineural and lymphovascular invasion, and increased CD66b+ infiltration at the invasive front are linked to aggressive tumour behaviour and poor prognosis. These features may serve as important predictors of patient outcomes.
The sleeve material in printed surgical guides directly influences the accuracy of guided implant surgery, yet its impact on the 3D position of implants remains unclear. This study evaluated the effect of metal and PEEK (Polyether ether ketone) sleeves on implant accuracy compared to planned virtual positioning. Using CT scans and virtual planning software (coDiagnostiX), a STRAUMANN® RC BLT 4.1 x 10 mm implant was planned in the element 36 region of a partially edentulous patient (Ethical approval #5.879.848). Twenty surgical guides of hemi-arch were printed (10 with metal sleeves, 10 with PEEK sleeves) and tested using a master model. Implants were inserted through static guides, and the positional deviations were analyzed by comparing planned versus inserted implants using angular, coronal, and apical metrics. Statistical analysis showed significantly lower angular deviation in the PEEK sleeve group (57.2% lower than metal sleeves, p < 0.001), indicating greater precision. However, coronal deviation was significantly higher in the PEEK group (66.3% higher than metal sleeves, p = 0.006). No significant differences were found in apical deviation (p = 0.186). These findings suggest that the choice of sleeve material significantly impacts guided surgery accuracy, with PEEK sleeves offering superior angular precision but higher coronal deviation compared to metal sleeves.
This study aimed to evaluate the association between genetic polymorphisms in the BMP2, BMP4, RUNX2, and SMAD6 genes and the presence of severe external apical root resorption (EARR) in orthodontic patients undergoing orthognathic surgery. EARR represents a significant adverse outcome in orthodontic treatments, and genetic susceptibility may influence its occurrence. A cross-sectional study was conducted with 158 orthodontic patients treated with fixed appliances and mono or bimaxillary orthognathic surgery. Postoperative panoramic radiographs were used to assess severe EARR. Genomic DNA was extracted from buccal epithelial cells. Seven single-nucleotide polymorphisms (SNPs) in the target genes were genotyped using real-time PCR with TaqMan assays. Statistical analyses were performed with Chi-square or Fisher's exact tests. No significant associations were observed for polymorphisms in BMP2 (rs1005464, rs235768), BMP4 (rs17563), RUNX2 (rs59983488, rs1200425), or SMAD6 (rs2119261). However, a significant association was found for SMAD6 rs3934908 (p < 0.05), with the CC genotype more frequent in patients with severe EARR. No deviations from the Hardy-Weinberg equilibrium were observed. The findings suggest that the SMAD6 rs3934908 polymorphism may be associated with an increased susceptibility to severe EARR in orthodontic surgery patients. While most SNPs showed no association, these results contribute to understanding the genetic factors involved in EARR. Further studies with larger samples are needed to confirm these findings and explore gene-environment interactions.
The objective of the present study was to characterize the internal anatomy of primary maxillary molars by evaluating the presence and distribution of accessory canals using micro-computed tomography (micro-CT). Seventeen primary maxillary molars from donors aged 2 to 8 years were scanned using micro-CT and reconstructed using NRecon software. Only teeth with at least two-thirds of the root structure preserved were included. Image analysis was performed with ImageJ, supplemented by CTan and CTvol software. Accessory canals were identified and counted at each root and categorized by root third. Statistical analyses, including Kruskal-Wallis and Mann-Whitney tests, were applied (p<0.05). A total of 47 roots were analyzed, with 68.08% exhibiting at least one accessory canal, totaling 96 canals. The apical third showed a higher number of accessory canals compared to cervical (p=0.01), with a mean of 0.87±1.05, accounting for 42.71% of all accessory canals identified. The middle third had a mean of 0.80±1.42, representing 39.58% of the total, while the cervical third exhibited the lowest mean (0.36±0.84), corresponding to 17.71% of the overall canals. Notably, 57.44% of the apical thirds had at least one accessory canal. Also, considering the presence of at least one accessory canal, the apical third also presented a higher prevalence (p<0.01). Accessory canals are highly prevalent in the apical third, highlighting the complexity of their internal anatomy and the importance of thorough endodontic management.
This study aimed to evaluate the bleaching efficacy and effects of dentifrices containing tricalcium phosphate (TCP) with activated charcoal (COAL) or hydrogen peroxide (HP) on dental enamel, compared with monofluorophosphate (MFP). Bovine enamel-dentin discs (n=10/groups) were stained and divided into TCP/HP, TCP/COAL, MFP/HP, MFP/COAL, and C (control - remineralizing solution) groups. Simulated toothbrushing (5.000 cycles) was performed, representing 6 months of clinical condition. The whiteness index (ΔWID), color changes (ΔE00, ΔL, Δa, and Δb), and surface microhardness and roughness (SMH, Ra) were evaluated after staining and treatments. Morphology and mineral content were analyzed under scanning electron microscopy and energy-dispersive X-ray spectroscopy. Data were analyzed using ANOVA/Tukey or Bonferroni tests (α=5%). MFP/COAL demonstrated significantly higher Δa and Δb than C. A statistically significant difference was observed in the TCP groups only for Δa. MFP-containing groups exhibited significantly higher ΔE00 than C. All groups showed negative ΔWID. MFP/COAL promoted greater darkening than TCP-containing and C groups (p<0.05). No statistical difference was detected among groups for ΔL, SMH, Ra, and %SHL (microhardness loss) (p>0.05). No morphological alterations were observed. TCP/HP showed lower mean Ca/P values. Therefore, dentifrices containing TCP associated with HP or COAL showed no bleaching efficacy and no harmful impact on enamel surface properties.
To evaluate the impact of different root canal filling techniques on the push-out resistance to dislodgment of the filling material to dentin, the quality of the filling interface, and root temperature variation in teeth with open apex. Forty-eight human maxillary canines with open apex were divided into 4 experimental groups, according to the technique for root canal filling: Group I - apical barrier with MTA and backfill technique, Group II - apical filling with conventional points and continuous wave technique (4mm/200ºC), Group III - apical filling with low-fusion gutta-percha points and continuous wave technique (4mm/100ºC), Group IV - conventional single cone technique. Temperature changes on the outer surface of the root were measured in thirds during the filling. BS was evaluated using the push-out test. The adhesive interface was examined using scanning electron microscopy. Analysis of variance was used to analyze BS and temperature variation data, while the chi-square test was used to analyze failure type. The fit of the filling material to the dentin wall was evaluated using non-parametric Mann-Whitney and Kruskal-Wallis tests, followed by Dunn's test. The group using the MTA barrier (4.5±3.5) showed higher BS values compared to the conventional points (2.8±1.1), low-fusion points (3.1±2.1), and the single cone technique (2.7±2.3) (p<0.05). In terms of temperature variation, a greater temperature increase was observed in the low-fusion points group (p<0.05). MTA barrier exhibited the highest BS values and adhesive interface quality, while the continuous wave condensation technique, regardless of the type of gutta-percha point used, showed intermediate values compared to the single cone technique.
This study aimed to carry out a scoping review to map the scope and nature of the literature on gender equity and discrimination in dental research and leadership, using an intersectional approach. The protocol of this scoping review is available online in the Open Science Framework platform. The literature search was carried out in February 2024. The terms of the search strategy encompassed three concept groups: gender inequality, the outcomes assessed, and dental science. PubMed, Scopus, Web of Science, and EMBASE were consulted. Two independent reviewers assessed the retrieved records. The initial search returned 2,322 references; after screening, 362 duplicates were removed, and 1,923 records were excluded because titles and abstracts did not meet the eligibility criteria. Inter-examiner agreement between reviewers was high (kappa = 0.931). For the updated search, 424 references were retrieved, and 52 duplicates were removed. After screening the titles and abstracts of the remaining 372 references, 11 were selected for full-text screening, of which 10 were included in the qualitative synthesis. Combining the two searches, 35 references were included in this scoping review. The studies included in this review were conducted by authors from multiple countries: Brazil, the United States, Canada, Saudi Arabia, Iran, Australia, and Austria, published between 1998 and 2024. The included studies showed persistent gender inequalities in dental research across different levels, particularly in leadership positions. There is a need to encourage further research on this topic under an intersectionality lens, on a broader scope of concepts, and to test interventions.
This study evaluated the effect of glaze application protocols on surface roughness, translucency, and fatigue behavior of a lithium disilicate-based ceramic (CEREC Tessera, Dentsply, Germany). Discs (A2 HT shade; Ø = 10 mm; thickness = 1 mm) were fabricated and randomly assigned to three groups (n = 7 for roughness and translucency; n = 12 for fatigue): CTRL (crystallization only), CCG (combined crystallization/glaze firing), and C+G (crystallization followed by additional glaze firing). Surface roughness (Ra, Rz) was measured using a contact profilometer, and translucency (TP00) was calculated from CIEDE2000 color coordinates. The ΔTP between groups was also determined. Specimens were cemented to glass fiber reinforced epoxy resin discs and subjected to cyclic fatigue testing under water immersion until failure. One-way ANOVA and Tukey's post-hoc tests were used for roughness and translucency, and Kaplan-Meier with Mantel-Cox for fatigue. One fractured specimen per group was examined by SEM to assess crack initiation and propagation. Glazing increased surface roughness, as CCG and C+G showed higher Ra and Rz values compared to CTRL (p > 0.05). TP00 ranged from 27.12 (C+G) to 28.33 (CCG), with no significant differences. ΔTP values (0.30 for CCG, 0.91 for C+G) were below the perceptibility threshold. Fatigue performance differed among groups (p < 0.05), with C+G showing higher mean cycles to failure compared to CTRL and CCG, although fatigue failure load did not differ significantly. SEM analysis revealed fractures initiating at the cementation surface under tensile stress and propagating toward the occlusal surface.
This study aims to compare the effects of two distinct healing periods (4 and 8 months) on bone formation after maxillary sinus floor elevation surgeries using sintered bovine bone grafts through histological and histomorphometric analyses. Using a split-mouth design, fourteen participants with bilateral edentulism in the posterior maxilla were included and randomized into two groups with 4 months (Test Group - TG) and 8 months (Control Group - CG) of healing periods. After the healing period, bone samples were collected and subjected to histomorphometric analysis to quantify the percentages of newly formed bone, residual bone substitute, and soft tissues. Comparison between the groups was performed using the paired Student's t-test (p<0.05). Twenty-eight maxillary sinus grafts were performed, and 54 dental implants were placed. Histological analysis revealed newly formed trabecular bone tissue in close contact with the bone substitute surface, with higher thickness observed in the CG. Collagen fibers in the CG exhibited greater birefringence, indicating increased thickness and organization compared to the TG. Histomorphometric analysis demonstrated a significant difference in the percentage of new bone formation between the CG (28.22 ± 6.29%) and TG (20.02 ± 5.97%; p<0,001), as well as in the percentage of residual bone substitute (TG: 39.12 ± 8.15%; CG: 31.65 ± 8.70%; p = 0.005). The proportion of soft tissues remained stable between groups. The 8-month healing period significantly increased bone tissue formation and maturation, suggesting that this interval optimizes the quality of grafted bone when using sintered bovine bone substitute.
The global increase in the use of dental implants also increases treatment-related complications. Peri-implantitis is a matter of concern at this stage. This study aimed to compare the behavior of an additive manufacturing implant with commercially available implants with different surface treatments, exposed or not to a peri-implantitis challenge. Eighty implants with three different surfaces (Straumann BLT [A], Noble Biocare Active [B], Plenum 3D printed titanium implants test [C], and Plenum 3D printed titanium implants served as a negative control [D]) were placed into male minipigs (Minipig Br1) mandibles on both sides. Three months after implant placement, peri-implantitis was induced with cotton ligatures in one side of the mandible, and an intraosseous implant served as a control on both sides. Histometric analysis of marginal bone loss did not present a statistical difference between groups (p>0,05), but regarding Bone to Implant Contact (BIC), the B group presented the highest percentage. The additive manufacturing implant performed like commercially available implants in all the performed analyses, suggesting that additive manufacturing could be an alternative for the fabrication of osseointegrated implants.
This study evaluated the effectiveness of the blooming artifact reduction (BAR) filter (e-Vol DX Software, CDT, Bauru, SP, Brazil) for detecting voids in root canals filled with various sealers, using two CBCT devices and micro-CT as a reference. Twenty mandibular incisors with long-oval root canals were filled with AH Plus Jet (AHPJ) or Bio-C Sealer (BCS). Each tooth was placed in the mandibular alveolar socket of a dry skull, covered with Mix-D material, and scanned with VeraView X800 and OP300 Maxio CBCT devices. Micro-CT images served as a reference. Three calibrated examiners assessed the CBCT scans, without and with the BAR filter (intensity level 1 for OP300 Maxio and level 3 for VeraView X800), for void detection using a 5-point scale. Diagnostic values (area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity) were compared using multi-way analysis of variance (p=0.05). Intra- and inter-observer agreement was evaluated using the weighted Kappa index. For OP300, using BAR filter 1 significantly improved ROC curve values for detecting voids in the apical third with AHPJ and BCS (p<0.05). It also increased specificity for detecting voids in the apical third with AHPJ (p<0.05). For VeraView X800, the ROC curve and sensitivity values were unaffected (p>0.05), but using BAR filter 3 significantly enhanced specificity for detecting voids in the cervical/middle thirds with BCS (p<0.05). The diagnostic performance of the BAR filter is CBCT-device dependent. In OP300 scans, it enhances the detection of voids in the apical third with AHPJ and BCS. In VeraView X800 scans, it improves specificity for detecting voids in the cervical/middle thirds with BCS.
This study evaluated the effect of F18 bioactive glass applied to gutta-percha by dip-coating or incorporation on surface bioactivity and bond strength to Bio-C Sealer (BCS) and AH Plus (AHP). Gutta-percha discs (n = 3 per group) were dip-coated with F18 bioactive glass at 2.5%, 5%, and 10% by weight and analyzed by SEM and EDS before and after 28 days of immersion in PBS. Uncoated gutta-percha served as the control for analyses. For the tensile bond strength test, twelve specimens per group (n = 12) were prepared using unmodified gutta-percha, 5% F18 dip-coated gutta-percha, or 2% F18-incorporated gutta-percha, each tested with BCS and AHP. Unmodified gutta-percha with each sealer served as the control. Bond strength was measured using a universal testing machine and analyzed by two-way ANOVA and Tukey's test (α = 0.05). After PBS immersion, the 5% and 10% dip-coated groups exhibited more pronounced F18 deposition and the formation of continuous bioactive surface layers, whereas the control group showed no such features. Regarding bond strength, the 5% F18 dip-coated gutta-percha showed higher values with BCS compared to the control (p < 0.05), and the 2% F18-incorporated gutta-percha also increased bond strength to BCS versus the control (p < 0.05). For AHP, 5% dip-coating reduced bond strength compared with the control (p < 0.05), whereas 2% incorporation did not differ (p > 0.05). F18 bioactive glass promoted surface mineralization of gutta-percha and improved its bond strength to Bio-C Sealer, whether applied by dip-coating or incorporation.
