The emergence of the Metaverse and Extended Reality (XR) technologies, including Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR), has created innovative opportunities for healthcare education and training. These immersive technologies show promise in enhancing infection prevention and control, especially during infectious disease outbreaks. This systematic review aims to evaluate the current application of XR technologies in infection control education, identifying key trends, benefits, and limitations of VR and AR-based interventions. A comprehensive literature search was conducted on January 12, 2025, for the Web of Science and PubMed databases using keywords related to hygiene, infection prevention, and XR technologies. An initial pool of 162 articles was screened, resulting in 38 studies that met inclusion criteria. These studies were descriptively analyzed to assess their contributions, focus areas, and outcomes. The review indicates most studies show XR tools effectively improve practical skills, behaviors, or attitudes, while a smaller number reveal limited or no significant gains, especially in knowledge and compliance. This result shows that XR tools have the potential to improve knowledge retention, practical skills, and provide real-time feedback, outperforming traditional training methods. XR tools specifically enhanced hand hygiene, proper use of personal protective equipment, and emergency response training, areas critical during outbreaks like COVID-19. Nevertheless, widespread adoption remains limited due to the need for more long-term efficacy data and strategies for integrating XR into standard curricula. To fully realize this potential, it is essential to address existing limitations related to cost, safety, and validation, while establishing robust frameworks for curriculum integration and policy implementation. XR technologies play a crucial role in advancing infection control education by offering potential benefits for healthcare training and education. Future research should prioritize evaluating long-term outcomes and developing effective implementation strategies to facilitate broader adoption, maximize their educational impact and, and mitigate potential barriers. Not applicable.

This study evaluated the shear bond strength (SBS) of two dual-cure resin cements to a stereolithography-fabricated 3D-printed permanent crown material after various surface pretreatment protocols. Disc-shaped specimens were fabricated from a permanent crown resin (Permanent Crown, Formlabs) and post-processed according to the manufacturer’s instructions. After standardized surface preparation, specimens (n = 48) were randomly assigned to six experimental groups (n = 8), based on surface treatment (sandblasting, silane application, or 9

This in vitro study evaluated the color stability of polyetheretherketone (PEEK) and graphene-reinforced polymethyl methacrylate (G-CAM) following direct exposure to a high-concentration in-office bleaching gel. Thirty square-shaped specimens (10 × 10 × 3 mm) were prepared: 15 PEEK (BioHPP, Bredent, Germany) in shade A2 and 15 G-CAM (Graphenano Dental, Spain) in shade A2, with baseline color coordinates recorded using a spectrophotometer (VITA Easyshade Advance 4.0, Vita Zahnfabrik, Germany). All specimens were surface-ground, ultrasonically cleaned, and stored in distilled water at 37 °C for 24 h prior to measurements. A 40

This in vitro study evaluated the impact of simulated gastric acid exposure on the optical (ΔE00, translucency parameter TP, contrast ratio CR) and surface (roughness Ra) properties of monolithic zirconia ceramics under varying sintering rates and surface treatments. Forty-eight disc specimens (10 mm × 10 mm × 1.0 mm) were randomly allocated into four groups (n = 12): slow sintering + polishing; slow sintering + glazing; fast sintering + polishing; and fast sintering + glazing. Specimens were aged in 0.06 M of HCl (hydrochloric acid) for 96 h, and all measurement parameters were assessed against white and black backgrounds before and after aging. Statistical analyses (Shapiro–Wilk, Kruskal–Wallis, Wilcoxon tests; α = 0.05) revealed that acid aging caused a significant increase in ΔE00 across all groups (p < 0.05), with the smallest change observed in the fast-sintering + glazing group and the largest in the slow-sintering + glazing group. Contrast ratios remained high in all groups (CR > 0.92), while only the slow-sintering + glazing group exhibited a significant reduction in TP (p < 0.05). Surface roughness decreased following aging in all groups, with the lowest Ra detected in the fast-sintering + glazing group. These results suggest that fast sintering combined with glazing enhances color stability and yields smoother surfaces under acidic conditions, recommending this protocol particularly for patients at elevated risk of increased oral acidity.

Aim: Artificial intelligence (AI) chatbots hold promise with regard to patient education because of their ability to deliver human-like responses to inquiries, yet their reliability in providing accurate information on the use and care of implant-supported prostheses – a critical aspect of prosthodontics – remains uncertain. This study sought to assess the alignment of responses from six AI chatbots to questions on this topic with the current literature on implant-supported prostheses. Materials and Method: Twenty-five questions related to the usage and maintenance of implant-supported prostheses were posed to six AI chatbots: ChatGPT-4, ChatGPT 01-Preview, ChatGPT 01-Mini, Gemini Advanced, Co-pilot, and Claude 3.5 Sonnet. The accuracy of their responses was assessed by two prosthodontists using a five-point Likert scale, and the average scores were calculated. Differences among the chatbots were analyzed using one-way ANOVA, with the significance level set at α=0.05. As the post-hoc comparison test, Tamhane’s T2 test was used. Results: The accuracy and relevance of the responses provided by the six AI chatbots to questions about the maintenance and use of implant-supported prostheses were evaluated. In terms of accuracy, ChatGPT 01-Preview achieved the highest mean score (4.80±0.08), while Co-pilot received the lowest score (3.22±0.20). ANOVA and Tamhane’s T2 tests revealed statistically significant differences between the models (p

BACKGROUND:This study aimed to evaluate the performance of seven AI-based chatbots (ChatGPT-4, ChatGPT-3.5, ChatGPT 01-Preview, ChatGPT 01-Mini, Microsoft Bing, Claude, and Google Gemini) in answering multiple-choice questions related to prosthetic dentistry from the Turkish Dental Specialization Mock Exam (DUSDATA TR). Additionally, the study investigated whether these chatbots could provide responses at an accuracy level comparable to general practitioners. METHODS:A total of ten multiple-choice questions related to prosthetic dentistry were selected from a preparatory exam by a private educational institution. Two groups were formed: (1) General practitioners (Human Group, N = 657) and (2) AI-based chatbots. Each question was manually input into the chatbots, and their responses were recorded. Correct responses were marked as "1" and incorrect responses as "0". The consistency and accuracy of chatbot responses were analyzed using Fisher's exact test and Cochran's Q test. Statistical significance was set at p < 0.05. RESULTS:A statistically significant difference was found between the accuracy rates of chatbot responses (p < 0.05). ChatGPT-3.5, ChatGPT-4, and Google Gemini failed to provide correct answers to questions 2, 5, 7, 8, and 9, while Microsoft Bing failed on questions 5, 7, 8, and 10. None of the chatbots answered question 7 correctly. General practitioners demonstrated the highest accuracy rates, particularly for question 10 (80.3%) and question 9 (44.4%). Despite variations in accuracy, chatbot responses remained consistent over time (p > 0.05). However, Bing was identified as the chatbot with the highest number of incorrect responses. CONCLUSION:The study findings indicate that The performance of AI-based chatbots varies significantly and lacks consistency in answering prosthetic dentistry-related exam questions, necessitating further improvement before implementation.

AIM or PURPOSE The aim of this study was to create 3D anterior and posterior tooth models in virtual reality (VR) and to investigate their potential advantages and disadvantages compared to traditional physical educational models. MATERIALS and METHOD Through 3D modeling, standard triangle language (STL) files for anterior and posterior dental models were created and converted to FBX format using Rhinoceros software. These models were then integrated into the Unity program. Fifteen prosthodontists utilized Oculus Rift VR headsets to evaluate the models based on dimensions, morphology, surface texture, and anatomical accuracy. A 7-point Likert scale questionnaire, with 16 items for anterior teeth and 18 for posterior teeth, gathered subjective evaluations. The data underwent statistical analysis using an independent T-test and correlation analysis via SPSS version 22.0. RESULTS The Likert scores for the anterior and posterior teeth were 6.39 and 6.45, respectively, and there was no statistically significant difference between the two groups (p ≥0.05). When the correlation coefficients of the responses to the anterior and posterior tooth models were evaluated, it was found that there was a strong correlation between both groups (r: 0.001). Volunteers found the VR experience generally easy to view the shapes and use the control devices and strongly agreed on the potential benefits to the training with an average score of 6.47. CONCLUSION(S) The results indicate a positive approach to the use of 3D models presented in VR for the dental education programs. The results, highlighting the perceived ease of use, usefulness for anatomy education, and teaching potential.

INTRODUCTION The Ehlers-Danlos syndrome (EDS) is a rare hereditary disorder of connective tissues which is characterized by hypermobility and hyperextensible skin. Temporomandibular joint (TMJ) of EDS patients is hypermobile, subluxes and can dislocate. Bruxism is challenging factor hypermobile TMJ. Multiple treatments such as occlusal splint therapy and physical therapy can be applied for EDS. CASE DESCRIPTION A thirty years old female patient is presented with Ehlers-Danlos syndrome. The patient was complaint about bruxism and luxation of temporomandibular joint. She had myofacial pain and discomfort. Intra-oral and physical examinations were done and it was detected that interocclusal distance was increased. She had knee operations due to the luxation of joints before. Treatment protocol was planned to solve the myofacial pain and subluxation of TMJ. Anterior positioning splint was made and used for 3 weeks. After that period, stabilization splint was done. At the end of the first year, it was seen that the patient's interocclusal distance was decreased and luxations were diminished. DISCUSSION Temporomandibular joint disorders (TMD) and treatment modalities of EDS patients are limited and still developing. Proper diagnosis and precise treatment of TMD is complex. Hypermobility and pain are the chief complaints of these patients. Multidisciplinary approach should be thought for these patients. CONCLUSION/CLINICAL SIGNIFICANCE The occlusal splint therapy was decreased the symptoms of EDS patients as luxation and pain. Optimum occlusion ensures more stable TMJ and prevents possible symptoms due to the bruxism.

STATEMENT OF PROBLEM:The impact of various preparation designs on the fracture resistance and fracture type of mandibular premolars restored with 3 dimensionally (3D) printed, 1-piece endodontic crowns remains unclear. PURPOSE:The purpose of this study was to investigate the effect of different preparation designs on the fracture resistance and fracture patterns of mandibular premolars restored with 3D printed 1-piece endodontic crowns after thermal aging. MATERIAL AND METHODS:Forty-five freshly extracted mandibular premolars received 3 different preparation designs: with at least 2 intact cuspal walls (2CW), with only 1 intact cuspal wall (1CW), and no cuspal wall present (NoCW). One-piece endodontic crowns were designed by using a computer-aided design (CAD) software program, 3D printed, cemented to the prepared teeth with self-adhesive resin cement, and thermocycled between 5 °C and 55 °C in artificial saliva. Subsequently, all specimens were subjected to a fracture test. The results were statistically analyzed using 1-way ANOVA (α=.05), and fracture types of all specimens were examined using a light microscope. RESULTS:The analysis of fracture resistance values across separate designs revealed no statistically significant differences (P>.05). Mean fracture resistance values were 724.5 N in 2CW, 713 N in 1CW, and 861 N in NoCW. In 2CW and 1CW, the 1-piece endodontic crowns mostly displayed Type III fractures, whereas those in NoCW exhibited a combination of Type II and Type III fractures. CONCLUSIONS:The mandibular premolar 1-piece endodontic crowns tested in this study exhibited similar fracture resistance and type of fracture with different preparation designs.

AIM or PURPOSE The fracture of acrylic resins are challenging for dentures. The aim of this study was to evaluate the fracture resistance and surface roughness of repaired heat polimerizing polymethyl methacrylate which is the most commonly used material under different surface treatment methods with laser. MATERIALS and METHOD A total of 60 (n=15) heat polymerized rectangular specimens were fabricated in a flask with 65x10x3.3 mm dimensions. Group 1; control group (without surface treatment) Group 2; surface treated specimens with Er;Cr;YSGG laser application 2W-20 Hz, Group 3; surface treated specimens with Er;Cr;YSGG laser application 2,5W-20 Hz, Group 4; surface treated specimens with Er;Cr;YSGG laser application 3W-20 Hz.Tthe surface roughness measurement of the samples was made with an optical profilometer (Phase View Optical Profiler, Verrieres Le Buisson, France) Three point bending test was applied to measure transverse strength. All data were analysed using one way ANOVA test. RESULTS The highest Ra were measured in Group 1 (control group ) (Ra: 0,17±0.04 μm), the lowest Ra were measured in Group 4 (Er;Cr;YSGG laser application 3W-20 Hz) (Ra: 0,012±0.004 μm). When the flexural strength was examined, the highest fracture resistance was found in Group 1 (control group; 39,2±4,9), the lowest fracture resistance was found in Group 2 (Er;Cr;YSGG laser application 2W-20 Hz; 22,8±2,2). CONCLUSION(S) Er;Cr;YSGG laser significantly influences the surface roughness and the flexural strength of the material. Specifically, laser surface treatment at varying intensities was found to decrease surface roughness, with the most substantial reduction observed at the highest intensity of 3W-20 Hz.

AIM or PURPOSE Monolithic zirconia restorations are popular in dentistry due to advances in digital systems and zirconia blocks. This study evaluates the acceptability of color changes in monolithic zirconia restorations in the aesthetic area over time, influenced by different sintering methods. To investigate the impact of sintering and aging on the color stability of monolithic zirconia restorations. MATERIALS and METHOD Monolithic zirconia blocks (Copran Zr-i) were divided into 10 samples for fast and slow sintering processes. Post-sintering, samples underwent aging in an autoclave without surface treatment. Color measurements were taken pre- and post-aging using a spectrophotometer against white and black backgrounds. Statistical analysis was conducted with SPSS, setting the significance level at α=0.05. RESULTS Both sintering methods resulted in clinically acceptable color changes post-aging (∆E00: 1.22 for fast sintering, ∆E00: 0.91 for slow). Translucency decreased with aging in both groups, indicating a significant effect on aesthetic outcomes. CONCLUSION(S) Different sintering processes significantly affect the color and translucency of monolithic zirconia restorations, underscoring the importance of these processes in achieving optimal aesthetic results in restorative dentistry.

PURPOSE:Avatars, representing users in the digital world, can influence users' behavior and attitudes. This study evaluates the impact of representing dental students receiving temporomandibular joint (TMJ) education in the metaverse via an anonymous or identified avatar. METHODS:Participants included 80 dental students in their fourth and fifth years of study. They were randomly assigned to either the avatar group (identified avatar) or the control group (anonymous avatar). Prior to training, participants completed a demographic questionnaire and a pretraining knowledge assessment. TMJ training was conducted in the metaverse for both groups. Pre- and post-training assessments included the Spielberger State-Trait Anxiety Inventory and a shyness scale to ensure group comparability. A post-test consisting of five questions was administered to both groups after 2 weeks of training. RESULTS:There were no significant differences in pretraining scores for prior knowledge (p = 0.67), trait anxiety (p = 0.28), state anxiety (p = 0.92), or shyness (p = 0.42) between the avatar and control groups, indicating comparability at baseline. Post-training analysis revealed significantly higher post-test scores in the avatar group (median = 80) compared to the control group (median = 60) (p = 0.03). CONCLUSIONS:Metaverse environments offer various benefits for students, educators, and educational institutions in health education programs. Representing learners and their identities in training environments can enhance learning outcomes.

Objective: Obstructive sleep apnea syndrome (OSAS) is a sleep disorder with occurs in the upper airway during sleep and is characterized by recurrent collapses. The mandible advancement device (MAD) is a successful treatment option for patients with moderate and severe OSAS. This study examines the effectiveness of the MAD appliance in patients diagnosed with OSAS. Material and methods: The angle between A point, Nasion and Sella (ANB), angle between B point, Nasion and Sella (SNB) and lower respiratory tract changes in 20 cases diagnosed with OSAS and treated with MAD appliances were examined. The lateral cephalometric films of the patients before and after the appliance were evaluated by matching. The obtained data were statistically evaluated with the paired comparison t-test. Results: In the measurements made with lateral cephalometric imaging of patients with and without appliances, the SNB and posterior airway size (PAS) values increased while the ANB values decreased. No change was observed in the SNA values. Conclusion: According to lateral cephalometric imaging analysis, it can be said that MAD appliances are effective in the treatment of OSAS.

Objective: The method used to clean and disinfect dentures can affect the surface properties and flexural strength of dentures. The purpose of this study was to evaluate the effects of eight different disinfection methods on the surface roughness and flexural strength of heat-polymerized acrylic resins. Material and Methods: A total of 108 acrylic resin blocks were divided into nine groups (n=12) according to disinfection procedure: Group 1: distilled water (control group), Group 2: 100% white vinegar, Group 3: 50% white vinegar, Group 4: 2% glutaraldehyde, Group 5: 3% hydrogen peroxide, Group 6: 5% sodium hypochlorite, Group 7: 2% sodium hypochlorite, Group 8: microwave, and Group 9: ultraviolet (UV) light. The effects of the disinfection methods on acrylic resins were examined by analyzing the surface roughness measurement of acrylic resins using a profilometer and the flexural strength values. The Kolmogorov-Smirnov and Levene tests were used to control the normal distribution of the data and the homogeneity of the variances, respectively. The surface roughness and flexural strength values were analyzed using one-way analysis of variance and post hoc Tukey's test. Results: There was an increase in surface roughness values in all the groups except the control and UV groups (p>0.05). Decreased flexural strength was found in all the groups except the control, 50% white vinegar solution, and UV groups (p>0.05). Conclusion: Only UV sanitizer caused the least negative effect among other disinfection methods in terms of surface roughness and flexural strength.

Dental anksiyete, hem hastanın tedaviden kaçınmasına neden olması, hem de mevcut tedavi sürecini olumsuz etkilediğinden dental tedavi sürecini hekim ve hasta açısından oldukça zorlaştırmaktadır. Bu çalışmada hastaların yaşı, eğitim düzeyi, cinsiyeti ve hastalarda dental anksiyete varlığının OHIP-14 ile ilişkisini değerlendirmek amaçlanmıştır. Çalışma Kırıkkale Üniversitesi ve Biruni Üniversitesi’ne tedavi görmek amacıyla başvuran 500 gönüllü ile gerçekleştirildi. Gönüllülere rutin planlanmış olan tedavi öncesi ve sonrasında MDAS, DKS ve OHIP-14 anketlerindeki sorular yöneltildi. Alınan cevaplarla edinilen veriler bir istatistiksel yazılım programı aracılığıyla analiz edildi. İstatistiksel analizlere göre yaş, cinsiyet ve eğitim durumunun dental anksiyete ve dental korku skalasi ile OHIP-14 arasinda pozitif ilişki olduğu sonucuna varıldı.

PURPOSE To compare the effect of thermomechanical aging on implant abutment color change when using different abutment backgrounds. MATERIALS AND METHODS In this study, three separate experimental groups (n = 10) with different implant abutment materials were used: zirconia, modified polyether ether ketone (MPEEK), and polyether ketone ketone (PEKK). Equal-sized glass-ceramic incisor crowns were cemented to the abutments using transparent dual-curing resin cement. The specimens were then subjected to the thermomechanical aging process for the clinical equivalent of 5 years of use. The color values of each specimen in the middle third and the incisal third were recorded by a digital spectrophotometer in the CIE L*a*b* color coordinates both before and after the aging process. Color differences between groups were compared using one-way analysis of variance (ANOVA), while Tukey test was used to compare differences within the groups (P = .05). RESULTS In terms of color change (ΔE00) values, the zirconia group was found to show statistically more color changes only in the middle third (P < .000), but there was no significant difference between the the MPEEK and PEKK groups. In all groups, the ΔE00 value was clinically acceptable (ΔE00 < 1.8). CONCLUSION After the aging process, high-performance polymer abutments caused less color change than zirconia. Therefore, esthetically satisfying results can be obtained in the anterior region, especially when highly translucent crown materials are used.

PURPOSE To evaluate the factors that could influence the fracture resistance of implant-supported posterior monolithic zirconia crowns. MATERIALS AND METHODS Sixty zirconia molar crowns with three different occlusal thicknesses of 0.5, 1.0, and 1.5 mm (20 samples per group) were prepared for implant abutments using a CAD/CAM system. In each group, 10 crowns were luted on the abutment with resin cement (Panavia F), and the other 10 crowns were luted with resin-modified glass-ionomer cement (Ketac Cem Plus). Dynamic loading (1.2 × 106 cycles; 70 N) and thermal cycling were applied to the samples using a chewing simulator before evaluating their fracture resistance with a universal testing machine and examining their fracture type using a stereomicroscope. One-way analysis of variance (ANOVA), the Duncan test, and two-way ANOVA were used for data evaluation (α = .05). RESULTS The occlusal thickness (P < .001) and cement type (P < .01) affected the fracture load of the monolithic zirconia crowns. The highest fracture resistance was found in 1.5-mm-thick crowns luted with resin cement (4,212 ± 501 N), and the lowest fracture resistance was found in 0.5-mm and 1-mmthick crowns luted with resin-modified glass-ionomer cement (1,198 ± 116 N and 1,197 ± 66 N). A significant difference was not found in the mean maximum fracture load between the 1.5-mm-thick crowns cemented with resin cement and glass-ionomer resin cement. CONCLUSION Both the occlusal thickness and cement type remarkably affected the fracture resistance of the crowns, but occlusal thickness was more significant. Implant-supported posterior zirconia crowns can withstand physiologic occlusal forces even with a thickness as low as 0.5 mm. Resin luting cement is recommended for implant-supported posterior zirconia crowns with reduced occlusal thickness.

Statement of problem Durable titanium-porcelain bonding is challenging because of the formation of a thick oxide layer on the surface during porcelain firing. Purpose The purpose of this in vitro study was to evaluate how atomic layer deposition (ALD) of different oxide coatings affected titanium-porcelain bonding and failure types. Material and methods Forty-four airborne-particle abraded Type-2 titanium specimens were coated by ALD with either SiO2, TiO2, or ZrO2 (n=11) at a thickness of 30 nm, whereas control specimens were left uncoated (n=11) (airborne-particle abraded only). The surface roughness of the specimens was analyzed with a profilometer before applying porcelain (Vita Titankeramic). Titanium-porcelain bonding was analyzed by using a 3-point bend test. Surface properties and titanium-porcelain interfaces were examined under scanning electron microscopy combined with energy-dispersive spectroscopy, and failure types were evaluated by using a stereomicroscope. Surface roughness and bond strength data were analyzed by 1-way ANOVA and Tukey HSD tests. Failure type data were analyzed by the Fisher-Freeman-Halton exact test (α=.05). Results All nanocoatings increased surface roughness values, but only TiO2 and ZrO2 coatings showed statistically significant higher roughness than the control surfaces (P<.001). Specimens coated with SiO2 (28.59 ±4.37 MPa) and TiO2 (26.86 ±3.66 MPa) presented significantly higher bonding strength than control (22.04 ±4.59 MPa) specimens (P<.01). Fracture types of different groups were not statistically different (P>.05). Conclusions Nanocoating titanium surfaces with SiO2 and TiO2 by using the ALD technique significantly improved titanium-porcelain bonding.

Aim: The purpose of this study was to investigate the length of the styloid process (SP) in different skeletal patterns and stages of skeletal maturation. Materials and Methods: Radiographs involving SP (n = 158; 77 female and 81 male, age with a mean value of 12.84 ± 1.94 years) were evaluated retrospectively. Class I group included 52 subjects (0 ≤ ANB ≤4), Class II group included 57 subjects (ANB>4), and Class III group included 49 subjects (ANB <0). The length of the SP was measured in Photoshop CS5 software (Adobe Systems Inc., San Jose, CA, USA). Skeletal maturation stages were determined by the evaluation of hand-wrist radiographs and lateral cephalometric radiographs. The data were analyzed using Student's t-test and one-way ANOVA. Results: Statistically significant difference in the length of the SP was found between Class I and Class II group (P ≤≤≤05). The mean length of the SP was 30.68 ± 9.69 mm in Class I group and 34.63 ± 5.87 mm in Class II group. No statistically significant difference was found in between skeletal maturation stages of the groups neither in the bilateral length of the SP between genders. Conclusion: The risk of Eagle syndrome in skeletal Class II malocclusion might be higher. In addition, when a patient is referred with pain in the temporomandibular area with skeletal Class II anomaly, SP elongation should be considered besides the joint problems.