Objectives The aim of this study is to evaluate the effectiveness of polyelectrolyte-cation complexes pre-precursor (PCCP) process using polymaleic acid (PMA) for inducing intrafibrillar mineralization, dentin remineralization and occlusion of dentinal tubules. Methods Collagen fibrils were successively treated with PMA-Ca suspension and phosphate solution, 5 min each, and incubated in artificial saliva for 2 days. Demineralized dentin of human dentin disks and rabbit’s incisors were treated as aforementioned, 20 min each, and followed by 2 days of incubation. They were identified by scanning/transmission electron microscopy (SEM/TEM) and high resolution TEM (HRTEM) with selected area electron diffraction (SAED). The mechanical properties of de- and remineralized dentin were evaluated by nanoindentation test. The dentin permeability testing of de- and remineralized dentin treated with different ways was conducted. The oral mucosa irritations of mineralization media were evaluated. Results The intrafibrillar mineralization and in vitro/in vivo remineralization of demineralized dentin were successfully achieved. The mechanical properties of remineralized dentin were recovered from demineralized dentin (P < 0.001) close to natural dentin (P > 0.05). The dentinal tubules were occluded exceeding 100 µm and dentin permeability was significantly decreased (P < 0.001). No evident mucosa irritation was detected. Conclusions The PMA-Ca suspension following phosphate group could effectively induce in vitro/in vivo remineralization of demineralized dentin with in-depth occlusion of open dentin tubules and great reduction of dentin permeability. The effectiveness of PCCP process using PMA was validated. Clinical significance The PCCP process using PMA could be used for management of dentin caries and dentin hypersensitivity.

Objectives To evaluate the survival and success rates of zirconia dental restorations (ZDRs) and their complications. Data & Sources Electronic searches of PubMed, Cochrane, Embase and Web of Science were conducted up to January 1, 2026. Clinical studies with at least 1-year follow-up evaluating zirconia dental restorations in natural teeth were included. Survival rates, success rates, and biological and mechanical complications were analyzed. Risk of bias was assessed using RoB 2, Newcastle-Ottawa Scale (NOS), and Joanna Briggs Institute tools (JBI). Certainty of evidence was evaluated using the GRADE approach. Study selection & Results Sixty-six studies published between 2008 and 2025 were included. Pooled survival rates ranged from 92.9% to 98.7% up to 10 years for single crowns (SCs), 77.6% over 10 to 13 years for fixed dental prostheses (FPDs), 97.4% for resin-bonded FPDs (RBFPDs) over 10 to 15 years, from 50.0% to 52.6% over 9 to 13 years for conventional cantilever FPDs (CFPDs) and 89.0% for inlay-retained FPDs (IRFPDs) over 10 years. Pooled success rates were 46.1% for SCs over 10 years, 40.1% for FDPs over 10 to 13 years, 84.3% for RBDPDs over 10 to 15 years, 12.5% to 22.6% for CFPDs over 9 to 13 years and 70.3% for IRFPDs over 10 years. Biological and mechanical complication rates were 12.1% and 53.9% for SCs at 10 years, 19.4% and 46.7% for FPDs over 10 to 13 years, 50.0% and 37.5% for CFPDs at 9 years, 21.4% and 14.3% for IRFPDs at 3 years, and 3.3% and 8.0% for RBFPDs over 10 to 15 years. Restorations treated with airborne-particle abrasion (APA) combined with 10-methacryloyloxydecyl dihydrogen phosphate (MDP) achieved favorable short-term clinical outcomes, with pooled survival and success rates of 98.6% and 97.7% for SCs, and 98.1% and 70.1% for IRFPDs, respectively. The included studies were assessed as having low to moderate risk of bias using RoB 2, NOS, and JBI tools, but GRADE assessment yielded evidence of very low certainty. Conclusions ZDRs generally demonstrated acceptable to excellent short- to long-term survival and success outcomes. Mid- to long-term clinical performance was varied according to restoration types. The RBFPDs had relatively low complication rates, followed by the SCs, the FPDs and the IRFPDs. CFPDs exhibited relatively low success rates and high complication rates. The predominant biological complications were secondary caries and pulpitis or apical periodontitis, while chipping and debonding were the most common mechanical complications. APA treatment followed by application of MDP is capable of producing favorable short-term clinical outcomes. Clinical significance ZDRs except for CFPDs could achieve favorable mid- to long-term clinical performance. CFPDs should be conducted with caution.

OBJECTIVES:To investigate the concentration-dependent effects of strontium on the mineralization of reconstituted type I collagen and demineralized dentin remineralization. METHODS:Sr²⁺ at varying concentrations (0, 0.1, 0.25, 0.5, 0.75, 1 mM) was incorporated into polyacrylic acid-stabilized amorphous calcium phosphate (PAA-ACP) mineralization solutions. The mineralization solutions with 1 mM Sr²⁺ were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). Cytocompatibility was assessed using the CCK-8 assay. Reconstituted type I collagen and demineralized dentin models were employed to explore mineralization differences; high-resolution TEM (HRTEM) and selected area electron diffraction (SAED) were applied to investigate the underlying biphasic mineralization mechanism of Sr²⁺. RESULTS:In the reconstituted type I collagen model, early crystalline mineralization was detected at 12 h in the 0.25 mM group, while 0.5 mM Sr²⁺ induced more ordered apatite crystal alignment along the collagen long axis. The observed lattice expansion (d-spacings of 0.35-0.37 nm and 0.29 nm) was consistent with the formation of Sr-containing apatite-like mineral. At ≥ 0.75 mM Sr²⁺, the minerals deposited preferentially on the fibril surface replaced intrafibrillar mineralization. In the demineralized dentin model, a consistent biphasic concentration-dependent pattern was observed: 0.1-0.5 mM Sr²⁺ was associated with increased density of the remineralized layer and enhanced dentinal tubule occlusion, the enlarged lattice spacing (d-spacings of 0.35 nm) was consistent with that observed in the reconstituted type I collagen model. In contrast, 0.75-1 mM Sr²⁺ was associated with reduced remineralization and intratubular mineral filling. Both the collagen and dentin models suggested the biphasic effect of strontium on biomimetic mineralization. SIGNIFICANCE:Sr²⁺ shows a biphasic concentration-dependent response on collagen mineralization and dentin remineralization. These findings provide preliminary concentration-response information for the rational design of Sr-containing biomimetic materials.

STATEMENT OF PROBLEM:A high prevalence of localized tooth wear has been reported among the adult population. The Dahl concept is a method of gaining space for restoring localized tooth wear, but a systematic review and meta-analysis is lacking. PURPOSE:The purpose of this study was to systematically assess the clinical outcomes of fixed Dahl restorations for treating localized tooth wear. MATERIAL AND METHODS:Electronic searches were conducted in the PubMed, Embase, Cochrane Central Register of Controlled Trial, Web of Science, and Scopus databases and in the website ClinicalTrials.gov up to June 2025. Randomized clinical trials (RCTs), cohort studies, and case series were identified. The revised Cochrane risk of bias tool, the Newcastle-Ottawa scale, and the Joanna Briggs Institute critical appraisal were respectively adopted to assess the quality of the RCTs, cohort studies, and case series. The certainty of the evidence was evaluated using the Grading of Re--ations, Assessment, Development, and Evaluation (GRADE). Poisson regression was used to compare the clinical results of direct and indirect materials (α=.05). Meta-analysis and meta-regression were conducted for occlusal re-establishment. RESULTS:A total of 11 studies were included in the review, with 8 studies classified as low risk and 3 as moderate risk of bias. Annual failure rates (AFRs) and annual complication rates (ACRs) of fixed Dahl restorations using direct materials were 0% to 8.7% and 5.2% to 30.2%, respectively, after 1.3 to 7 years of follow-up. AFRs and ACRs of indirect restorations were 0 to 0.7% and 5.6% to 7.2%, respectively, after 1.7 to 2.2 years of follow-up. The AFRs of indirect materials were much lower than those of direct materials (P<.05). Restoration fracture, wear, and loss accounted for most failures and complications. Occlusal re-establishment after fixed Dahl restorations was mainly reported between 1 and 25.4 months. The pooled proportions of no occlusal contact, partial, and complete occlusal re-establishment were 0.6%, 10.0%, and 86.9%, respectively. These values were not influenced significantly by the patient's age. GRADE revealed low to moderate levels of evidence for the pooled proportions. CONCLUSIONS:Based on low- to moderate-level evidence, fixed Dahl restorations were found to be a suitable treatment option for treating localized tooth wear. Most of the patients treated with the fixed Dahl restorations were satisfied with the clinical outcomes, even though the range of time of therapy was wide and a high propensity for restoration failures and complications was found.

OBJECTIVES:This study aimed to develop a synergistic strategy integrating in-situ deposition of cerium hydroxide with laser irradiation to achieve efficient and acid-resistant occlusion of dentinal tubules (DTs) for dentin hypersensitivity (DH) management, while conferring antibacterial activity to the dentin surface. METHODS:An "alternate soaking" approach, involving alternating immersions in 5 wt% cerium nitrate and 0.5 wt% sodium hydroxide solutions, was utilized to deposit cerium hydroxide onto type I collagen fibrils and demineralized dentin. Subsequent Nd:YAG laser irradiation of the remineralized dentin surface converted cerium hydroxide into cerium oxide, effectively sealing the DTs. The morphology and occlusion stability were characterized using SEM, TEM, and EDX, while FTIR, XRD and SAED analyses examined the laser-induced conversion of cerium hydroxide to cerium oxide. The antibacterial activity against Streptococcus mutans was assessed using colony forming unit (CFU) assay and SEM, while the biocompatibility was evaluated via CCK-8 assay, CLSM and oral mucosa irritation test. RESULTS:The alternating soaking approach rapidly mineralized type I collagen fibrils with cerium hydroxide. Under irradiation of Nd:YAG laser, cerium hydroxide underwent conversion to cerium oxide, achieving deep occlusion of dentinal tubules with acid-resistant properties. The modified dentin surface demonstrated significant antibacterial activity against S. mutans and excellent biocompatibility. SIGNIFICANCE:Alternate soaking with cerium nitrate and sodium hydroxide, followed by Nd:YAG laser irradiation, promotes rapid mineralization of demineralized dentin, effectively occludes DTs, and imparts antibacterial properties to the dentin surface. This underscores its potential as a novel approach for managing DH.

This study presents an innovative heteropolysaccharide hydrogel system engineered through the synergistic combination of hydroxypropyl methylcellulose‑calcium (HPMC-Ca) and carboxymethyl chitosan-phosphate (CMCS-P). This dual-network hydrogel uniquely leverages the complementary physicochemical properties of both polysaccharides to achieve simultaneous biomimetic mineralization of enamel and dentin—addressing a long-standing challenge in restorative dentistry. The hydrophobic domains of HPMC-Ca facilitate sustained calcium ion release, establishing a stable mineralization reservoir, while CMCS-P provides phosphate sources that interact with calcium to form mineralization-competent amorphous calcium phosphate (ACP). Furthermore, the hydrogel acts as a biomimetic template, guiding dentin remineralization and enabling epitaxial growth of enamel-like structures. Advanced characterization techniques—including FTIR, Cryo-TEM, molecular simulations, and nanoindentation—collectively demonstrate that molecular-level interactions between HPMC and CMCS critically regulate the mineralization process. Remarkably, the system restores mechanical properties comparable to natural tooth tissues within just 7 days, confirming effective regeneration of both dentin and enamel. Beyond elucidating fundamental mechanisms of polysaccharide-mediated biomineralization, this work also provides new ideas for the research and development of dental caries prevention and restoration materials.

Objective:To report the in situ synthesis of amorphous fluorinated calcium phosphate (AFCP) nanoparticles within a dual-component hydrogel and evaluate their efficacy for enamel remineralization and dentinal tubules (DTs) occlusion. Materials and Methods:The AFCP hydrogel was constructed using hydroxypropyl methylcellulose (HPMC) and carboxymethyl chitosan (CMC) to stabilize calcium, phosphate, and fluoride ions in a metastable amorphous state. Physicochemical characterization was performed by FTIR, XRD, TEM, and SEM-EDX. Biocompatibility was assessed via CCK-8 assays and oral mucosal irritation test. Demineralized enamel and dentin specimens (n=8) were treated with deionized water, fluoride (NaF, 2000 ppm F), 10% CPP-ACP with 900 ppm F (GC Tooth Mousse Plus, Japan), or AFCP hydrogel, and immersed in artificial saliva for 7 days. Remineralization was evaluated by SEM, XRD, and nanoindentation, followed by in vivo validation in a rabbit model. Results:The hydrogel generated AFCP nanoparticles (30-80 nm) that remained amorphous in artificial saliva for over 2 hours before crystallizing into hydroxyapatite. The hydrogel exhibited negligible cytotoxicity and no oral mucosal irritation. After 7 days, the AFCP hydrogel induced dense mineral deposition that completely occluded exposed DTs and formed a ~32 µm remineralized layer on acid-etched enamel, substantially outperforming fluoride and CPP-ACP + NaF. XRD confirmed the newly formed mineral as hydroxyapatite-like. Treatment with the AFCP hydrogel restored the mechanical properties of enamel and dentin to near-physiological levels, achieving the greatest recovery among the four groups (P < 0.05). In vivo results further validated its remineralization and tubule-occluding efficacy. Conclusion:The AFCP hydrogel functions as an exogenous mineral reservoir, enabling sustained ion release or direct transformation into hydroxyapatite for in situ enamel remineralization and DTs occlusion. This non-invasive strategy offers a promising therapeutic approach for early caries and dentin hypersensitivity.

This study was to investigate the enamel thickness in different anatomical landmarks of occlusal surfaces of first molars and to evaluate probability of dentin exposure (DE) and percentage of remaining occlusal enamel areas following occlusal veneer preparation at different depths. Cone beam computed tomography (CBCT) images of maxillary and mandibular first permanent molars (N = 90, each 45) were used to measure occlusal enamel thickness at specific landmarks. The probability of DE after different preparation depths was calculated. Two freshly-extracted first molars were scanned using a Micro-CT to obtain STLm files. 72 resin models were 3D-printed and randomly assigned to 12 groups (n = 6) before they were prepared for occlusal veneer at 0.6–2.0 mm of depths. The prepared models were scanned to obtain STLp files that were aligned and superimposed to STLm. Prepared occlusal enamel surface areas and dentin exposure areas were analyzed. Enamel thickness ranged from 0.93 to 1.93 mm in maxillary first molars and 0.98–1.91 mm in mandibular first molars. The central fossa (CF) showed the thinnest enamel in both maxillary and mandibular first molars. After tooth preparation of occlusal veneer of first molar, probability of DE was zero at 0.6 mm, < 20

The narrow and challenging-to-clean properties of dental unit water lines (DUWLs) allows for unchecked bacterial growth, while conventional daily disinfection struggles to eradicate persistent bacteria, posing a significant health risk. However, the existing coating preparation methods fail to achieve a long-term antibacterial effect and are arduous to prepare, thus rendering them inapplicable in the clinical practice of DUWLs. Herein, we prepared a smart, catechol-based temperature/acid dual-responsive antibacterial surface, combining stimulusresponsive polymers with bactericide just by immersion on the inner face of pipes. The synergistic effect of poly(N-isopropylacrylamide) (PNIPAM) on chain conformation transformation greatly promotes short-term bacterial release in response to temperature switching to maintain the antibacterial properties of polylysine (PL). The acid sensitivity of the imine bond joining polymers to PA facilitates the degradation of old coating and the synthesis post-renewal of new coating, thereby enhancing the long-term anti-bacterial response of DUWL finishes. The surface exhibits antimicrobial performances as below: (i) killing similar to 85.0 % of the attached bacteria, (ii) releasing similar to 96.8 % of the bacteria killed under temperature switching, (iii) further releasing under acid environment and (iv) restores the bactericidal and release effects after recoating. Moreover, the coating still exhibits excellent antibacterial/release performance in the clinical setting. This research offers an efficient, straightforward approach for resolving surface-associated bacterial challenges in DUWLs.

Complex crown-root fractures in the esthetic zone refer to a type of dental trauma occurring in the anterior region, characterized by concurrent fractures involving both the crown and the root, with associated pulp exposure and periodontal tissue injury. These injuries consistently exhibit critical anatomical features, including a fixed palatal fracture location below the alveolar crest, compromised residual tooth structure, and frequent encroachment of the biological width. To predict treatment outcomes, a risk assessment framework based on the restoration-tooth-periodontium interface was developed. Resistance risk was evaluated by assessing the type of residual dentin ferrule and the length of the root within the alveolar bone, while periodontal risk was assessed according to gingival phenotype and alveolar bone morphology. Based on these risk dimensions and the principles of aesthetics, stability, and minimally invasive treatment, a diagnostic classification system was established to categorize fractures into three types: favorable, intervention and high-risk. Type-specific management strategies were proposed: for favorable cases, crown lengthening combined with deep margin elevation to reduce periodontal risk is recommended; for intervention cases, orthodontic extrusion or surgical extrusion is applied to simultaneously address both ferrule deficiency and biological width violation; for high-risk cases, extraction followed by implant restoration is advised due to limited root preservation value. The presented classification enables clinicians to adopt a scientific and structured approach to treatment planning for these complex crown-root fractures in the aesthetic zone.

Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.

Alendronate (ALN), a potent bisphosphonate, plays a significant role in both bone formation and osteoporosis therapy. However, its potential to promote biomimetic mineralization of type I collagen fibrils and demineralized dentin remains unclear. This study reveals that ALN-pretreated collagen fibrils form ester bonds between the hydroxyl groups of ALN and the carboxyl groups of collagen, accompanied by a reduction in collagen surface potential. Additionally, an adsorption equilibrium of ALN to collagen was achieved at 25 mM ALN. ALN pretreatment facilitates intrafibrillar mineralization of type I collagen fibrils in a dose-dependent manner, as well as mineralization of demineralized dentin in synergy with polyelectrolyte-stabilized Amorphous Calcium Phosphate (ACP) nanoparticles. This process effectively restores the mechanical properties of demineralized dentin to levels comparable to natural dentin. Thus, ALN holds potential for localized applications aimed at promoting remineralization of demineralized dentin.

Dental caries is a global oral dilemma leading to demineralization of tooth hard tissues and exposure of dentinal tubules (DTs). Multifunctional restorative strategies, including remineralization, antibacterial properties, and DT occlusion, are urgently needed for dental caries management but remain a significant challenge. Herein, the polyaspartic acid‐calcium‐lanthanum suspension (5 g L −1 ‐3.06 м‐0.34 м) followed by phosphate solution (2.04 м) is adopted to conduct polyelectrolyte‐cation complexes pre‐precursor process. This strategy, for the first time, successfully induces La‐doped intrafibrillar mineralization of collagen fibrils with lanthanum‐doped hydroxyapatite (La‐HAp). After sequential application of two mineralization media, the demineralized dentin is fully remineralized and the DTs are deeply occluded to a depth of 100 µm with La‐HAp after 7 d of incubation in artificial saliva or oral cavity of rabbit. The remineralized dentin demonstrates antibacterial properties against cariogenic bacteria ( Streptococcus mutans ) both in vitro and in vivo, and its mechanical properties are almost restored to those of intact dentin. The mineralization media cause no apparent irritation to oral mucosa or dental pulp. Hence, this multifunctional strategy confers the remineralized dentin surface with antibacterial properties and blocks the invasion of cariogenic bacteria through DTs, providing insight into the clinical management of dentin caries accompanied by dentin hypersensitivity.

Aim or purpose: This study evaluates occlusal errors and their influencing factors in free-end implant restorations using a hybrid digital workflow. The findings aim to provide evidence-based recommendations for workflow optimization and error reduction. Materials and methods: This study included patients who received free-end implant restorations, with approval from the Ethics Committee. Restorations were fabricated with a hybrid digital workflow based on intraoral scanning. Key time intervals—including digital impression, model printing, model scanning, and prosthesis delivery—were recorded. Pre- and post-occlusal adjustment digital impressions were analyzed using 3D reverse engineering software. The occlusal adjustment metrics, including the average adjustment, maximum adjustment, cusp adjustment, adjustment area, and RMS value were measured. Patients were grouped based on their periodontal condition, number and position of missing teeth, type and location of edentulous arches, and the type of prosthesis and opposing teeth. Statistical analyses were conducted using the Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation analysis. Results: 1. Periodontal condition significantly influences occlusal adjustment in free-end implant restorations. 2. The occlusal adjustment of second molar implant restorations increases with the number of missing free-end teeth. 3. Occlusal adjustments are significantly correlated with the duration of the hybrid digital workflow, particularly the model printing and model scanning-to-prosthesis delivery intervals. Conclusions: In the hybrid digital workflow, it is advisable to optimize the prosthetic procedures and reduce the time intervals between model printing, model scanning, and prosthesis delivery to decrease occlusal errors.

Aim or purpose: To consruct an RNA-Ca complex induced type I collagen intrafibrillar mineralization system and preliminarily explore its mechanism. Materials and methods: TEM, HRTEM, SAED, and EDX were used to characterize the RNA-Ca solution. The non-magnetic nickel grid-loaded reconstructed type I collagen model was utilized. Collagen was independently treated with RNA-Ca and phosphate solution, followed by 2 d artificial saliva incubation. FTIR and circular dichroism (CD) was used to analyze collagen interactions. 3D-STORM was used to visualize spatial relationships between complexes and collagen. Results: Intrafibrillar mineralization induced by RNA was confirmed in single-layer type I collagen models by TEM, HRTEM and SAED.RNA-Ca complexes were amorphous with Ca and trace P elements. The alignment of HAp along collagen fibers was verified by SAED. FTIR revealed RNA-specific peaks and amide I red shifts. Stabilized triple helices were denoted by CD. In the meantime, 3D-STORM revealed that RNA-Ca was evenly distributed throughout collagen. Conclusions: RNA-Ca complexes induced intrafibrillar mineralization via PCCP process, expanding the horizon of PCCP process for biomedical applications. These findings expand the application of PCCP process in biomimetic mineralization and hold considerable promise for clinical translation in dental hard tissue regeneration.

To evaluate short, mid and long-term clinical outcomes and patients’ satisfaction of minimally invasive full-mouth rehabilitation using different materials and techniques for patients with moderate to severe tooth wear. Furthermore, materials were analyzed to identify their influences on clinical results. Search was conducted in PubMed, Cochrane Central Register of Controlled Trial, Embase, Web of science and Scopus until December 19, 2024. Randomized clinical trials (RCT), cohort studies and case series with at least mean period of 3 years were included. The revised Cochrane risk of bias tool, Newcastle–Ottawa scale and Joanna Briggs Institute Critical Appraisal were used to evaluate the quality of RCT, cohort studies and case series. Meta-analysis and Poisson regression were conducted. Ten studies in this review included three case series, six cohort studies and one RCT with three low, six moderate risks and one some concerns. Annual failure rates (AFRs) and annual complication rates (ACRs) of direct composite restorations were 0–6.2

Aim or purpose: The hydration layer within caries-like demineralized dentin matrixn (DDM) creats a barrier effect, impeding the rapid permeation of mineralization mediums. This study aimed to overcome this barrier effect using ultrasound for treating artificial dentin caries (ADC) lesion via Polyelectrolyte-Cation Complexes Preprecursor (PCCP) process. Materials and methods: Ultrasound-mediated permeation rates of mineralization mediums, such as calcium or phosphate liquid, were evaluated with confocal laser scanning microscopy for screening out the optimal ultrasound treatment duration. Comsol Multiphysics simulations were integrated with experimental data to analyze the mechanism by which ultrasound enhanced permeation of mineralization mediums. After the dentin disks with ADC were treated with mineralization mediums and incubated in artificial saliva for 21 days, they were characterized with micro-CT, scanning electron microscopy, high-resolution transmission electron microscopy with selected-area electron diffraction and nanoindentation testing. Results: Ultrasound greatly enhanced the permeation rate of mineralization medium by the force of acoustic flow field. The calcium and phosphate liquids achieved full-thickness permeation through the DDM via 1h and 5min ultrasonic treatments respectively, demonstrating 2000% and 12000% enhancements compared to that of immersion. After incubation, heavy remineralization within the collagen fibrils and mostly remineralization outside the fibrils were achieved in ADC lesion, whose mechanical strength was recovered to approximately 70% compared to that of natural dentin. Conclusions: The ultrasond could assist in mineralization mediums to break through the barrier effect of caries-like DDM and improve the biomimetic mineralization of ACD. This should shed light on ultrasond-mediated PCCP process for treating dentin caries lesions.

STATEMENT OF PROBLEM:The disinfection of removable dental prostheses and orthodontic appliances is essential to preventing transmission of pathogens. However, whether different disinfection solutions and durations affect the physical properties of denture base resins is unclear.PURPOSE:The purpose of this systematic review and meta-analysis was to statistically analyze the influence of disinfectants on the physical properties of denture base resins.MATERIAL AND METHODS:A systematic search in Medline, Embase, PubMed, and Cochrane Library databases was conducted to evaluate the effects of chemical disinfection on the physical properties of denture base resins such as surface morphology, roughness, hardness, and flexural strength. Of 1909 studies, 44 studies were included in the systematic review and 41 in the meta-analysis. Heterogeneity was analyzed by using I2 statistics. The influence of different disinfection solutions and durations on the physical properties was further analyzed, and the risk of bias evaluated. Statistical analyses were performed by using the RevMan 5.4 software program with the standardized mean differences (SMDs) and 95% confidence intervals (CIs).RESULTS:Of the 44 included studies, 40 studies were assessed as having a low risk of bias, and 4 had an unclear risk of bias. Meta-analysis results showed that compared with the control, disinfection could not significantly affect surface roughness and hardness within 60 minutes of immersion in disinfectant solutions or flexural strength within 30 minutes (roughness: P=.79, I2=0%; flexural strength: P=.08, I2=0%; hardness: P=.05, I2=19%). In addition, the physical properties were not significantly affected when glutaraldehyde, chlorhexidine, and peracetic acid were repeatedly used for more than 30 minutes.CONCLUSIONS:Most of the disinfectants did not reduce the physical properties of denture base resin within 30 minutes of immersion. Glutaraldehyde, chlorhexidine, and peracetic acid are recommended if longer immersion or repeated disinfection is required.

Decades of research have been conducted on 10-Methacryloyloxydecyl dihydrogen phosphate (MDP) through numerous studies. The mechanisms by which its residual calcium salts benefit dentin bonding remain undetermined. The objective of the research was to investigate the role and process of remaining calcium salts in the priming procedure and their capacity for remineralization. The investigation focused on the variations in topological structure, mechanical properties, and chemical interactions between the main agent and the dentin surface. Two adhesive modes including prime-and-rinse(P&R) and prime-and-nonrinse (P&NR) utilized to evaluate the bonding performance and remineralization ability. The findings indicated that both P&R and P&NR methods could eliminate the smear -layer, uncover dentinal -tubules, and generate a textured/rough surface on the dentin. Collagen fibrils exhibited a greater presence of inorganic minerals in the P&NR mode. Compared to control group, both P&R and P&NR groups improved immediate and aging bond strength significantly (P < 0.05). AFM and 3D -STORM revealed MDP and its residual calcium salts distributed in collagen fibrils and expanded collagen matrix. In the P&NR group, TEM revealed that the dentin collagen matrix experienced some remineralization, and there was also mineralization within the collagen fibrils embedded in the bonding interface. Thus, MDP priming improved dentin bonding stability. Residual calcium salts of P&NR process can enhance topological structure of the collagen matrix and induce intrafibrillar mineralization.