The aim of this study was to evaluate the color stability of bleached teeth after treatment with bioactive materials. Forty bovine teeth underwent four 45-minute bleaching sessions with 35% hydrogen peroxide (Whiteness HP, FGM), followed by application of the respective remineralizing agent after each bleaching session. After the final session, the specimens were randomly assigned (n = 10) to one of the following treatments: control (without gel), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) gel (MI Paste, GC Brasil), S-PRG-based gel (PRG Pro Care Gel, Shofu), or 2% sodium fluoride gel (NaF-Maquira), applied according to the manufacturers’ instructions. The specimens were then immersed in a coffee solution three times daily for 15 minutes over 14 days. Color measurements were performed using a spectrophotometer, evaluating Vita classical shade guide and CIELab* parameters at baseline, after bleaching, and after staining. Data were analyzed using generalized linear mixed models for repeated measures, as well as Friedman, Nemenyi, and Kruskal–Wallis tests (α = 5%). Bleaching significantly increased L* and Whiteness Index for Dentistry (WID) values and reduced a* and b* values (p < 0.05). After staining, L* and WID decreased, while a* and b* increased significantly (p < 0.05). Compared to baseline, sodium fluoride and S-PRG groups showed higher ΔEab and ΔE00 values than the control (p < 0.05). After coffee staining, no differences among groups were found for ΔE*ab, ΔE00, or ΔWID, indicating that none of the bioactive gels altered the susceptibility of bleached enamel to coffee-induced color change.
Wound closure is a critical part of periodontal and mucogingival surgery, as it directly affects tissue stability, healing, patient comfort, and esthetic outcomes. This focused review examines the current evidence on periodontal wound closure, with particular attention to suture materials, microsurgical suturing, tissue adhesives, and suture removal protocols. The available literature suggests that closure materials differ in their biologic and mechanical behavior, with monofilament and synthetic sutures generally demonstrating less bacterial retention and lower tissue reactivity than braided materials. Microsurgical suturing appears to offer advantages in soft tissue adaptation and esthetic refinement, although supporting evidence remains limited in certain regenerative procedures. Tissue adhesives, particularly cyanoacrylate-based formulations, may provide a useful alternative in selected cases, with studies reporting satisfactory healing and improved patient comfort, although the evidence remains limited. The studies also suggest that suture removal should be based on the specific surgical procedure and healing requirements rather than on a routine time-based rule. Overall, the evidence remains heterogeneous and often limited, supporting thoughtful material selection and procedure-specific clinical judgment rather than definitive recommendations.
Objective: Pulpectomy is an essential procedure for preserving primary teeth with irreversible pulpitis. Its success may vary according to lesion etiology, preoperative pulp condition, follow-up duration, obturation materials, restorations, and other clinical factors. This study aimed to evaluate the success of pulpectomy in primary teeth treated with different obturation materials. Materials and methodology: Records of children aged 4–10 years who underwent pulpectomy were retrospectively retrieved and assessed using clinical and radiographic records. The success rate was determined by considering clinical and radiographic findings together. Resorption of obturation materials was assessed radiographically at 3, 6, 9, and 12 months by comparing the follow-up radiographs with the immediate post-treatment radiographs. Data were analyzed using the chi-square test. Results: The study evaluated 225 pulpectomised primary teeth using Endoflas (n = 85), Metapex (n = 73), and zinc oxide eugenol (ZOE) (n = 67) as obturating materials. The success rates were comparable among the groups at 3 months. Significant differences were observed at 6 and 9 months (p < 0.05), with ZOE showing the highest success rate, followed by Endoflas and Metapex. At 12 months, a significant difference in success rate was also observed among the groups (p = 0.001) with ZOE still demonstrating the highest success rate (92.5%), followed by Endoflas (80%) and Metapex (42.5%). Rate of resorption differed significantly among the materials (p < 0.001), with Metapex showing the highest resorption rate at 6 months (29.9%), 9 months (43.8%), and 12 months (75.3%), followed by Endoflas and ZOE. Conclusion: Pulpectomy success rate was found to be highest when ZOE was used as the obturation material, followed by Endoflas and Metapex, at the 6, 9 and 12 months of follow-ups. Metapex exhibited the highest resorption rate among the three materials.
Purpose: To propose a radiographic classification system for evaluating outcomes of regenerative endodontic procedures (REPs) in immature necrotic permanent teeth. Methods: A two-phase retrospective study was conducted. In Phase I, radiographs of 20 cases (2015–2018) were analyzed to identify patterns of apical closure, root lengthening, dentinal wall thickening, intracanal calcification, and periapical healing. Based on these findings, a six-class radiographic classification was proposed: Class 1: Apical closure with increased root length and dentin thickness; Class 2: Apical closure with increased root length only; Class 3: Apical closure with increased dentin thickness only; Class 4: Apical closure without changes in root length or dentin thickness; Class 5: Barrier formation within the canal or coronal to the root end; Class 6: No root dimensional changes with periapical healing of a documented pretreatment periapical radiolucency. In Phase II, the classification was applied to 54 immature single-rooted permanent teeth from 44 patients aged 8–13 years treated with REPs between 2019 and 2023. Baseline and latest available follow-up radiographs were evaluated by two blinded examiners. Reproducibility was assessed using Cohen’s kappa, and associations with age and pre-treatment root stage were analyzed using Fisher’s exact test. Results: Class 1 was most frequent. Partial intracanal calcification occurred in 35.18% of cases, with no complete canal obliteration. Age (p = 0.215) and pre-treatment root stage (p = 0.872) were not significantly associated with outcome classes. Inter- and intra-examiner agreement were high (κ = 0.82 and 0.86). All cases were accommodated within the six proposed categories, and no additional outcome classes were observed. Conclusion: This proposed six-class radiographic framework demonstrated good internal reproducibility and may provide a structured basis for outcome reporting after REPs. Prospective multicenter validation is required.
Background: Mandibular knife-edge residual ridges present a significant challenge during complete denture impression making because of their narrow morphology and susceptibility to tissue distortion under pressure. This report describes the clinical application of the novel Sikri’s Magnetic Attachment Retained Two-Tray (SMART) impression technique, conceptualized, developed, and patented by Dr. Arpit Sikri (Patent/ROC No. L-156844/2024), for obtaining an accurate mucostatic impression of a mandibular knife-edge residual ridge without the application of manual finger pressure. The SMART technique employs a magnetically retained split custom tray design that facilitates pressure-free tray stabilization and precise impression making in anatomically challenging mandibular residual ridges. Materials and Methods: A completely edentulous patient with a pronounced knife-edge residual ridge in the anterior mandible was rehabilitated using the SMART impression technique. A custom-designed split two-part impression tray incorporating magnetic attachments for self-retention and retentive holes for impression material retention was fabricated. Magnetic attraction between the tray components ensured stable and reproducible tray positioning throughout the impression procedure, eliminating the need for operator-applied finger pressure and facilitating a pressure-free mucostatic impression of the residual ridge. Results: The SMART technique enabled accurate recording of the mandibular residual ridge anatomy without observable tissue displacement during impression making. The definitive impression produced a well-adapted master cast, resulting in a complete denture with satisfactory retention, stability, adaptation, and patient comfort during clinical evaluation. Conclusion: The SMART impression technique represents a simple, innovative, and clinically applicable approach for the prosthodontic management of mandibular knife-edge residual ridge. By eliminating manual tray stabilization and minimizing tissue displacement during impression making, it facilitates accurate mucostatic impressions and may improve denture fit, stability, and overall clinical performance. Further clinical studies involving larger patient populations are required to evaluate its reproducibility and long-term clinical effectiveness.
