Objectives To investigate current practices in teaching removable partial dentures (RPDs) in dental schools in Indonesia, using a validated questionnaire. Materials and methods The survey questionnaire, originally designed to investigate instruction in RPDs in Oceania, was emailed to the Head of Restorative Dentistry, Prosthodontics, or RPD course coordinator at all 37 dental schools in Indonesian. The questionnaire sought information on preclinical and clinical teaching, including curriculum content, teaching methods, staff, facilities, techniques, clinical requirements, assessments, and challenges. Participants were given six weeks to respond, with reminders sent. Responses were compiled and analyzed using Excel. Results A total of 32 responses were received -a response rate of 84%. All participating schools reported offering a preclinical course on RPD design. Some schools (n=10,31%) began clinical training in RPDs in the fourth year of study. Regarding clinical case requirements before graduation, 31% of schools (n=10) required students to complete two cases, while 47% (n=15) mandated only one. The use of dental surveyors in clinical cases was compulsory in 59% (n=19) of the schools. The most frequently reported supervisor: student ratio was 1:5 (n=11,34%), though 20% (n=6) of the schools reported a higher ratio of 1:10. Approximately 47% of schools (n=15) relied on external commercial laboratories, often resulting in delays in treatment completion and limited student exposure to laboratory procedures. In contrast, 53% of the schools (n=17) had access to in-house laboratory facilities for the production of RPDs. Conclusion The teaching of RPDs is well integrated into the curricula in dental schools in Indonesia, but marked variation exists in teaching methods, supervision, clinical exposure, and assessment. Clinical case requirements in nearly 50% of schools are minimal. Harmonization of learning, teaching, instruction and assessment in RPDS could enhance graduate competence in RPD provision in Indonesia. Clinical significance As more patients requiring complex RPDs seek care from general dental practitioners, it is essential that undergraduate programs equip graduates with the skills and knowledge needed to manage these cases to a high standard.

AIMS AND OBJECTIVES:This study aimed to evaluate effects of calcium carbonate (CaCO3) and anhydrous strontium carbonate polyelectrolyte-cation complexes on dentin adhesive bonding, mechanical properties and intrafibrillar mineralization of dentinal collagen fibers. MATERIALS AND METHODS:Dentin discs were prepared from collected human premolars and treated with 1%SrF₂CaCO3, 0.5%SrF₂CaCO3, 2% SrF₂CaCO3 and distilled water for 15 days under controlled pH. Raman spectroscopy, transmission and scanning electron microscopy were performed to evaluate intrafibrillar mineralization and topographical changes. Diffusional coefficient and density functional theory were calculated. Resin-dentin bond specimens were prepared and microtensile bond strength was measured. Statistical analysis was performed using a one-way ANOVA with subsequent post-hoc comparisons, with significance of p < 0.05. RESULTS:Raman spectroscopy demonstrated a concentration-dependent increase in dentin mineralization, with enhanced phosphate and organic matrix signatures following SrF₂CaCO3 treatment. TEM and HRTEM confirmed organised intra- and extrafibrillar hydroxyapatite deposition, particularly in the 2% SrF₂CaCO3 group, showing aligned crystallites along the collagen axis and well-defined D-periodicity. SEM revealed progressive crystal elongation and surface densification with increasing concentration. Diffusion analysis indicated higher ionic mobility in modified groups, supported by DFT calculations showing increased Ca and P occupancy and crystallographic stability. µ-tensile testing demonstrated significantly improved bond strength in the 1% SrF₂CaCO3 and 2% SrF₂CaCO3 groups without compromising adhesive performance. CONCLUSION:The present study demonstrated the modification of dentinal surface using a range of concentrations of SrF₂CaCO3 as a multifunctional modifier indicating favourable bond strength and extensive crystallisation capability. The 2% SrF₂CaCO3 polyelectrolyte formulation has a significant potential for clinical application and offers a novel potential solution to address significant challenges in adhesive dentistry. CLINICAL SIGNIFICANCE:Strontium/fluoride/calcium carbonate polyelectrolyte complexes promote biomimetic dentin remineralization, enhance crystal organisation, and improve resin-dentin bond strength. This strategy offers a biologically guided approach to reinforce compromised dentin, potentially increasing the longevity and reliability of adhesive restorative procedures.

Objective To investigate the perception of dental students graduating from Malaysian dental schools about the teaching they received in implant dentistry, and to determine the need for curriculum review. Materials and methods A 31-item validated questionnaire including closed and open questions pertaining to students’ perceptions of the teaching of implant dentistry was distributed to all 13 dental schools in Malaysia. Responses were compiled on Excel and analysed. Results 272 responses were received. Nearly all respondents indicated that they had been made aware of implant dentistry (p<0.001) during training, with >65% of the students indicating that they are moderately well informed about implant dentistry (p<0.001). The vast majority of respondents strongly agreed that instruction in implant dentistry should be included in undergraduate curricula (p=0.047). Very few respondents indicated that implant dentistry was sufficiently covered in their curriculum (p=0.027), with >50% of the students planning to include implant dentistry in their future clinical practice (p=0.029). More than 95% of the students wished to gain experience on implant treatment planning (p=0.024), including digital workflow planning (p<0.001). Similarly, >95% students indicated that they wished to gain more experience in prosthodontics before providing embarking on implant dentistry (p=0.004). Conclusions Dental students in Malaysia consider themselves moderately wellinformed about implant dentistry, but ill-prepared to provide even simple forms of implant dentistry in clinical practice. There is a need to review undergraduate curricula in dental schools in at least Malaysia to include instruction in implant dentistry sufficient to enable new graduates to provide at least simple forms of implant dentistry. Clinical significance The study emphasises the preparedness of prospective Malaysian dentists in implant dentistry and indicates significant deficiencies in the curriculum. Comprehending students' perceptions can inform enhancements in pedagogy, guaranteeing that graduates possess clinical competence, confidence, and adherence to modern implant practice standards, thereby improving patient care and professional readiness in Malaysia.

Aims and Objectives The purpose of this paper is to report the outcome of an investigation of the teaching of repair rather than replacement in the management of defective composite restorations in dental schools in Indonesia. Materials and Methods The investigation is a cross-sectional study, using a validated questionnaire. The questionnaire sought information on both preclinical and clinical instruction, number and duration of modules, logistics of teaching, clinical requirements and teaching challenges. The data was collected and entered in an Excel spreadsheet. The results were collated and analysed. Results 34 of the 38 dental schools responded to the survey an 89.4% response. Most dental schools (n=22, 65%) did not provide instruction on restoration repair. 17 (50%) schools indicated poor experiences with composite repairs and lack of evidence as the principal reasons for their decision. Restoration defects considered appropriate for repair: marginal defects (n=25,74%), marginal discolouration (n=24,63%), partial loss of the restoration (n=23,68%), shade correction (n=20,53%), cervical discolouration (n=10,29%), discolouration of the labial or occlusal surfaces of restorations (n=8,24%), wear (n=10,29), and discolouration affecting multiple surfaces (n=7,21%). Most schools considered repair appropriate for management of fractures of anterior composite restorations (n=30,88%), specifically incisal fractures (n=20,59%), proximal fractures (n=21,62%) and proximal-incisal fractures (n=15,44%). Most dental schools (n=28,82%) reported teaching the bevelling of preparation margins. Conclusion Dental schools in Indonesia acknowledge the part repair, rather than replacement must play in the management of defective restorations of composite resin, but this is not reflected in the instructions provided to undergraduate dental student in many of the schools. There would be great benefit in the harmonization of instruction in the use of repairs across Indonesia and beyond.

Calcium silicate-based and glass ionomer cements are often used in caries-affected dentine. This study investigated the remineralising and physicochemical properties of two calcium silicates and a glass ionomer cement. Human molars with Class I cavities were subjected to pH cycling to simulate caries lesions. These were restored using two different calcium silicate cements (CTR-MTA or MTA-VOCO) or a glass ionomer cement (GIC). After storage in artificial saliva, Knoop microhardness (KHN) was measured within a 300-µm zone from the interface. Solubility, pH, calcium ion release, scanning electron microscopy (SEM)-energy-dispersive x-ray (EDX) and Fourier-transform infrared spectroscopy (FTIR) analyses were also conducted. Data were statistically analysed with statistical significance set at p < 0.05. Both MTAs promoted greater remineralisation (KHN) compared to GIC. GIC showed the lowest solubility, whereas CTR-MTA demonstrated the highest solubility, followed by MTA-VOCO; the latter had the highest calcium release. Apatite deposition was observed only in the MTA groups (SEM-EDX and FTIR). MTA-VOCO demonstrated superior calcium ion release and increased dentine microhardness, although some signs of collagen degradation were also visible. Clinical relevance: GIC and calcium silicate cements may enhance mineral deposition in caries-affected dentine, though the alkalinity of MTAs might compromise collagen integrity at the bonding interface.

Aims and objectives To evaluate two-year bond strength stability of a bioactive universal dentin adhesive modified with magnesium-doped hydroxyapatite (HAp/Mg2+) and to investigate its influence on intrafibrillar mineralization, dentin mechanical properties and individual collagen network. Materials and methods HAp doped with Mg2+ was prepared by the precipitation method. The experimental adhesives were formulated as an unmodified control, HAp only, Mg(2+)only, and HAp/Mg2+ combinations at 0.5%, 1%, and 2% concentrations They were applied to sectioned molars, which were subsequently stored for either 24 h or two years to be tested for microtensile bond strength (mu TBS). Degree of conversion (DC) was assessed using FTIR spectroscopy. The resin-dentin interface, collagen mineralization and dentin ultrastructure were evaluated using raman spectroscopy, atomic force microscopy, transmission electron microscopy, and nano-computed tomography. Mechanical properties of demineralized dentin were assessed using three-point bending tests. Results All groups demonstrated a significant reduction in mu TBS after two years (p < 0.001). However, the Ad (Hap Mg2+2%) exhibited higher long-term bond strength compared to other groups (p < 0.05). The DC did not differ significantly between the control group and the Mg(2+)and HAp-modified adhesive groups (p > 0.05). Microscopic and spectroscopic analyses demonstrated enhanced hybrid layer homogeneity, improved collagen encapsulation, increased nano-hardness, elastic modulus and superior dentin mechanical properties in HAp/Mg2+ groups. These effects were greatest at concentration of 2 wt%. Conclusion The study presents novel and clinically relevant findings on the use of HAp/Mg2+-modified bioactive adhesives and demonstrates improved long-term bond durability and collagen stability.

To evaluate novel functionalized graphene quantum dots (G-QDs) and determine their effects on dentin crystal orientation, mechanical properties, and adhesive bonding. Dentin blocks (4 mm × 4 mm × 3 mm) were used to create artificial caries-like lesions. Graphene-based treatment solutions were prepared at 0.1%, 0.2%, 0.3%, and 0.5% G-QDs (G-QDs0.1%, G-QDs0.2%, G-QDs0.3%, G-QDs0.5%.), with 0.9% saline serving as the vehicle control (controlG-QDs00). Molecular geometries were obtained from PubChem database and optimized with a semiempirical approach and atom labeling. Specimens were immersed in solutions for 1-month and then challenged with artificial saliva/collagenase cocktail for 3 days at 37°C. Treated dentin was characterized by TEM/XRD/O-PTIR/Raman spectroscopy/AFM-based mechanical testing, microtensile bond strength (μTBS), and glutamate quantification. Docking indicated higher affinity of G-CQD for collagen than for HAp. Quantum mechanical calculations suggested grafting of phenylalaninyl proline dipeptide groups to graphene oxide surface. Raman analysis showed concentration-dependent shifts at 1450, 1453, 1457, 1460, and 1462 cm−1 for control and G-QD groups, respectively. TEM demonstrated preserved collagen fibril organization in G-QDs0.5% specimens, with fibrillar collagen molecules having an estimated molecular length approximately 4.4 times the D-period. G-CQDs showed higher glutamate concentrations (p<0.05). O-PTIR ratio maps and indicated local matrix-to-mineral changes. XRD/Rietveld refinement showed increased crystallinity and altered atomic site occupancies, especially in G-QD groups who showed higher stiffness than control. μTBS decreased after aging in all groups except G-QDs0.5%. 0.5% G-QD modification improved dentin physicochemical and structural features and may contribute to a more stable adhesive-dentin interface.

BACKGROUND:Calcium phosphate biomaterials are widely used for bone regeneration, yet antibacterial and mechanical limitations persist. Brushite cements offer biodegradability and osteoconductivity but lack antimicrobial effects. Quaternary ammonium compounds (QACs), such as K21, provide potent antibacterial activity and tissue healing potential. This study developed and evaluated a novel K21-doped brushite cement with enhanced antibacterial and anti-inflammatory properties. METHODS:Brushite granules were synthesized from β-tricalcium phosphate and monocalcium phosphate monohydrate, followed by K21 drug loading (0.5 % and 1 % w/v). Material characterization used X-ray diffraction, Raman spectroscopy, and porosity analysis. In vitro tests included K21 release, antimicrobial efficacy against dual-species biofilms (P. aeruginosa, S. aureus), cytocompatibility with human gingival fibroblasts, and anti-inflammatory activity via protein denaturation assays. In vivo, mandibular critical-size defects were created in 24 rabbits (n = 8/group) and treated with control, 0.5 %, or 1 % K21-doped brushite cement. Bone regeneration and inflammatory response were assessed histologically at six weeks. RESULTS:K21 incorporation showed pH-sensitive release with higher drug content at increased concentrations. Both 0.5 % and 1 % K21 cements significantly reduced microbial viability, with 1 % showing stronger bacteriostatic effects. All groups exhibited good cytocompatibility. In vivo, 0.5 % K21-doped cement achieved the greatest new bone formation (∼95 %) and reduced inflammation. In contrast, 1 % formulations induced increased inflammation despite antibacterial efficacy. CONCLUSIONS:K21-doped brushite cements provide antibacterial, anti-inflammatory, and bone regenerative benefits. The 0.5 % formulation demonstrated optimal balance of safety and efficacy, making it a promising candidate for clinical use in craniofacial applications. CLINICAL SIGNIFICANCE:Bone graft failures are often linked to infection and inflammation. Incorporating K21 into brushite cement offers a dual-action material that not only supports bone regeneration but also reduces microbial risk and inflammatory complications, potentially improving outcomes in dental and maxillofacial defect repair.

Objectives: The objective of this study was to compare the peel bond strength and modes of failure of maxillofacial prostheses (MFP) adhered to simulated human skin using regular adhesive and hydrobond adhesive following exposure to tropical outdoor weather. Methods: Eighty MFP silicone specimens were constructed and adhered to simulated skin silicone using one of two maxillofacial prosthetic silicone adhesives (MFPSA): regular and hydrobond. For each adhesive, 20 samples were exposed to 4 h of tropical weather on five consecutive days (test group), and 20 samples were exposed to room temperature and dark room conditions for five consecutive days (control group). A T-peel test was conducted using a Universal Testing Machine and the samples were visually analyzed for mode of failure. Raman spectroscopic analysis was conducted with backscattering configuration. Results: There were no significant differences in MFPSA peel bond strength between regular adhesive and hydrobond adhesives following five days of exposure to tropical weather. Within the tropical weather (test) group, hydrobond adhesive demonstrated similar peel bond strengths compared with the regular adhesive; p = 1.00 (Table 2). Within the room temperature and dark room conditions (control) group, hydrobond adhesive showed peel bond strengths significantly greater than the regular adhesive (p = 0.16). The mixed mode of failure involving both adhesive and cohesive failure was observed in 80 % of specimens. Conclusions: The MFPSA peel bond strength was not affected by tropical weather conditions. Within the limitations of this in vitro study, the hydrobond adhesive demonstrated greater adhesive strength than the regular adhesive in room temperature and dark room conditions.

OBJECTIVE:This laboratory and in-silico study investigated the potential of carbon quantum dots (CQDs) to modulate the crystal orientation and mechanical properties of dentin hydroxyapatite (HAp), with a focus on the structurally critical c-axis. METHODS:Dentin specimens were treated with varying concentrations of functionalized CQDs (0.1 %-0.5 %) and subjected to artificial demineralization. Structural and mechanical changes were assessed using transmission electron microscopy (TEM), Raman spectroscopy, X-ray diffraction (XRD), nanoindentation, and density functional theory (DFT) simulations. Collagen organization and mineral crystallinity were evaluated through SAXS and NMR spectroscopy. Data were analyzed with one-way ANOVA and the Tukey Post hoc tests. RESULTS:CQD-treated groups, particularly at 0.3 % and 0.5 % concentrations, exhibited enhanced HAp crystallinity, improved alignment along the c-axis, and increased collagen fibril organization. Raman and XRD analyses confirmed higher mineral-to-matrix ratios and reduced lattice disorder. Mechanical testing revealed significant increases in hardness and elastic modulus. DFT simulations (p<0.05) supported the hypothesis of CQD-induced lattice stabilization via Ca-site substitution and spin-orbital coupling. CONCLUSION:Functionalized CQDs represent a novel strategy for reinforcing dentin by modulating and modifying HAp crystal orientation and collagen architecture through quantum-level interactions.

OBJECTIVE:To investigate the teaching of repair versus the replacement of defective direct composite resin restorations in undergraduate curricula in Malaysian dental schools. METHODS:A 24-item validated questionnaire, including closed and open questions regarding the teaching of repair versus the replacement of direct composite resin restorations (DCRs) was emailed to faculty members in all 13 dental schools in Malaysia. Responses were compiled in Excel and analysed. The questionnaire asked about the inclusion of DCR repair in the curriculum, the underlying reasons for its inclusion, the methods employed for teaching, the indications for repair, the operative techniques and materials used, the acceptability of repairs to patients, the anticipated longevity of repairs, and recall arrangements. RESULTS:All 13 dental schools completed and returned the questionnaire, reporting that composite repairs were taught as an alternative to the replacement of defective DCRs. All schools imparted theoretical and practical knowledge of repair within a clinical context. Twelve dental schools (92 %) agreed that the primary objective of teaching repair is the preservation of tooth structure. The principal reasons for repair were marginal defects (84 %), followed by marginal discoloration and partial loss of restoration (61 %). All 13 schools reported a high level of patient acceptance, which they regarded as a strong indicator. Eleven dental schools (84 %) reported recall arrangements to review repairs of DCRs. CONCLUSION:All undergraduate dental students in Malaysia are taught the use of repairs as an alternative to the replacement of defective DCRs. The advantages of this approach are considered in Malaysian dental schools to include, minimum intervention and preservation of tooth structure, with opportunity for time and cost savings. Further research should include the development of consensus criteria for the repair rather than replacement of defective DCRs and long-term clinical trials to further investigate the benefits of repair over the replacement of defective DCRs. CLINICAL SIGNIFICANCE:With all undergraduate dental students being taught the use of DCR repairs, the percentage of defective DCRs in Malaysia managed by means of a repair may be anticipated to increase in years to come. The cumulative effects of this increase may contribute to the conservation of teeth, with opportunity for cost savings.

AIMS AND OBJECTIVES:To analyse development of hydroxyapatite (HAp) crystals doped with glutamic acid and phosphorine residue (Ser-OPO3) having self-remineralization, biocompatible and optimum bonding properties MATERIALS AND METHODS: β-tri calcium phosphate, ammonium phosphate dibasic HAp was dissolved with strontium Flouride Glu or Ser-OPO3 components and utilised in two 0.1% TCPCa3(PO4)2 Str/FL and 0.2% TCPCa3(PO4)2 Str/FL groups. HAp formulation was evaluated for particle-size analysis, crystal size and indices using FTIR. Demineralized enamel specimens were treated and characterized using transmission electron microscopy (TEM), Xray diffraction (XRD), solid state NMR, and mechanical properties. MC3T3 mouse fibroblastic cells were evaluated for alkaline-phosphate activity (ALP). Human gingival fibroblasts (PGF) were evaluated for morphology. After modifying Universal adhesives, tensile force was assessed at 24 hr and 3 months. RESULT:Increasing concentrations of experimental solution exposure significantly affect mean diameter of HAp. The increasing FTIR intensity, were displayed; 0.2% TCPCa3(PO4)2 Str/FL > 0.1% TCPCa3(PO4)2 Str/FL> control. 0.2% TCPCa3(PO4)2 Str/FL revealed existence of distinct crystals, with planes orientated perpendicular to longer axis of tooth. XRD pattern indicated crystal growth with a rise in peak intensities in 0.2% TCPCa3(PO4)2 Str/FL group. The NMR spectra for Glu and Ser-OPO3 elucidated interactions between carbon atoms in amino acid and hydrogen atoms on HAp surfaces. Surface microhardness of 0.2% TCPCa3(PO4)2 Str/FL specimens showed significantly higher values on day 28 (p< 0.05). ALP density value of cells was significantly higher for 0.2% TCPCa3(PO4)2 Str/FL group on day 7 and 14. 0.1% TCPCa3(PO4)2 Str/FL and 0.2% TCPCa3(PO4)2 Str/FL enhanced migration of PGF cells in comparison to the control group (p<0.05). 0.1% TCPCa3(PO4)2 Str/FL and 0.2% TCPCa3(PO4)2 Str/FL groups showed significant differences in bond strength at different time points CONCLUSION: 0.1% TCPCa3(PO4)2 Str/FL and 0.2% TCPCa3(PO4)2 Str/FL were structurally integrated into the lattice demonstrating changes within the crystallite size and became conducive for adhesive bonding. CLINICAL SIGNIFICANCE:The new amino acid-based hydroxyapatite formulation is chemically stable due to the substitution of OH- with F- and is crucial in the rehardening of caries and adhesive bonding.

Aims and Objectives To examine if a novel antimicrobial silane K21 can alter macrophage polarisation and affect fibroblast proliferation by deciphering the molecular pathways for programmed healing using a combined in vitro and in vivo (animal) burn model. Materials and Methods An injectable silane-based antimicrobial aimed to modulate macrophage polarisation was manufactured. Experimental analysis included colorimetric cell migration assays on gingival fibroblasts, macrophage phagocytosis characterisation, immunofluorescence staining, triacylglycerol accumulation within macrophages by LCMS, cellular metabolic/proliferation assays, macrophage exposure quantification with morphology assessment using FE-SEM, Raman spectral analysis, RNA isolation for relative gene expression and animal study model to morphometrically and microscopically analyse partial thickness burn wound healing under QAS/K21. Results M1 and M2 polarisation both appeared exaggerated under QAS/K21 treatment. The wounds treated with K21 had depicted accelerated healing as compared to control (P < .05) in dorsal skin of rabbits. Relative gene expression results demonstrate reduced cytokine and anti-inflammatory response under the influence of K21. While M1 expression, TG accumulation, and associated characterisations demonstrate the programmed inflammatory potential of K21. Conclusion the antimicrobial and reparative efficacy of K21 silane aids in programmed inflammation for enhanced tissue healing and repair.

STATEMENT OF PROBLEM:Considerable variations exist in cavity preparation methods and approaches. Whether the extent and depth of cavity preparation because of the extent of caries affects the overall accuracy of training deep learning models remains unexplored. PURPOSE:The purpose of this study was to investigate the difference in 3-dimensionsal (3D) model cavity preparations after International Caries Detection and Assessment System (ICDAS) classification performed by different practitioners and the subsequent influence on the ability of a deep learning model to predict cavity classification. MATERIAL AND METHODS:Two operators prepared 56 restorative cavities on simulated mandibular first molars according to 4 ICDAS classifications, followed by 3D scanning and computer-aided design processing. The surface area, virtual volume, Hausdorff distance (HD), and Dice Similarity Coefficients were computed. Multivariate analysis of variance was used to assess cavity size and operator proficiency interactions, and 1-way ANOVA was used to evaluate HD differences across 4 cavity classifications (α=.05). The 3D convolutional neural network (CNN) predicted the ICDAS class, and Saliency Maps explained the decisions of the models. RESULTS:Operator 1 exhibited a cavity preparation surface area of 360.55 ±15.39 mm2, and operator 2 recorded 355.24 ±10.79 mm2. Volumetric differences showed operator 1 with 440.41 ±35.29 mm3 and operator 2 with 441.01 ±35.37 mm3. Significant interactions (F=2.31, P=.01) between cavity size and operator proficiency were observed. A minimal 0.13 ±0.097 mm variation was noted in overlapping preparations by the 2 operators. The 3D CNN model achieved an accuracy of 94.44% in classifying the ICDAS classes with a 66.67% accuracy when differentiating cavities prepared by the 2 operators. CONCLUSIONS:Operator performance discrepancies were evident in the occlusal cavity floor, primarily due to varying cavity depths. Deep learning effectively classified cavity depths from 3D intraoral scans and was less affected by preparation quality or operator skills.

This systematic review aims to assess the antibacterial efficacy of Quaternary Ammonium Compounds (QACs) against Enterococcus faecalis (E. faecalis) as a root canal irrigant for endodontic infections. A comprehensive literature search was conducted utilizing the databases PubMed, Scopus, Cochrane library and Google Scholar for papers from January 2000 up until January 2024. The research question was formulated using the PICO (Population, Intervention, Control and Outcomes) framework. This review focused on the efficacy of QACs (intervention) against E. faecalis (population) and compare it with NaOCl (comparator 1) and CHX (comparator 2) for antibacterial activity by using findings of colony forming unit (CFU) and confocal laser microscopy (CLSM) (outcomes). A methodological quality assessment was conducted using a scoring methodology provided by Quin tool to evaluate the studies, and the risk of bias was examined. A systematic screening of the selected publications was performed based on predefined inclusion criteria to identify studies eligible for meta-analysis. Nine research studies papers included varied in their design and had a low to medium risk of bias. The findings demonstrated a decrease in the number of E. faecalis bacteria following the inclusion of QACs, leading to improved disinfection and efficacy in combating root canal infections. Furthermore, the meta-analysis findings indicated that there was no statistically significant distinction (p > 0.05) in the efficacy of QACs [Quaternary ammonium silane (K21) and Benzalkonium chloride (BAK)] when compared to commercially available NaOCl, however these QACs showed high efficacy against E. faecalis. This review found QACs to be promising alternatives to NaOCl and CHX for E. faecalis elimination, though no significant difference was observed in meta-analysis due to study heterogeneity. Standardized in vivo studies are needed for validation. CRD42023389258. not applicable.

OBJECTIVE:To investigate the current and future teaching of posterior composite restorations in undergraduate curricula at dental schools in Canada. METHODS:A 23-item validated questionnaire including closed and open questions pertaining to the teaching of posterior composites was emailed to faculty members of all 10 dental schools in Canada. Responses were compiled on Excel and analysed. RESULTS:Nine dental schools responded to the survey, resulting in a response rate of 90 %. All respondent schools taught the use of posterior composites for two- and threesurface cavities in premolars and permanent molar teeth. The didactic teaching time devoted to composites was greater than for amalgam (38 % vs 29 %). Most schools were teaching to round internal angles (n = 9, 100 %), to make slot-type cavity preparations (n = 9, 100 %), and to avoid additional preparation for mechanical retention (n = 7, 78 %). All dental schools taught the use of rubber dam for moisture control, though 4 (44 %) said that it was not always mandatory. The most common contraindications to posterior composites reported were a history of adverse reaction to composites (n = 9), poor oral hygiene (n = 6), and inability to place a rubber dam (n = 5). CONCLUSION:The teaching of posterior composites in dental schools in Canada is wellestablished. Differences were observed in the teaching methods between dental schools in Canada and those in other countries and regions around the world. The diverse materials and techniques used across different regions may highlight a gap between clinical practice and research. Differences in the teaching between dental schools in Canada and the teaching in dental schools in other countries and regions of the world should be the subject of review. CLINICAL SIGNIFICANCE:Graduates from dental schools in Canada may be found to be well equipped with the knowledge and skills to perform posterior composite restorations in clinical practice. However, marked variation exists in the teaching between dental schools in Canada and teaching in other countries which should be the subject of review.

Polymethylmethacrylate is a commonly used biomaterial in dentistry. Although the material have been used for several years it has some limitations with respect to physical and mechanical properties. Researchers are exploring the potential of novel nanomaterials like nanographene oxide (nGO) and hexagonal boron nitride (hBN) to be used as a reinforcing agent. Therefore, the current investigation sought to evaluated physical, chemical, mechanical and antimicrobial potential of PMMA reinforced with nGO and hBN alone and synergistically as well. Four different groups were prepared including the control group (G1)0.2.5 wt

OBJECTIVES:As artificial atoms, quantum dots are widely used in quantum information research since their individual energy levels may be precisely controlled using gate voltages. The purpose of the study was to modify carbon quantum dots (CQDs) and evaluate its effects on the structure, crystal orientation and mechanical properties of the enamel substrate along with antibacterial properties of CQDs. MATERIALS AND METHODS:Enamel specimens of 4 mm × 4 mm × 3 mm were cut and CQD solution was dialyzed in deionized water mixed with urea solution and placed in microwave system (800 W) to obtain *CQD0.1 %-, **CQD0.2 %-, ***CQD0.3 %-, and *****CQD0.5 % for enamel blocks to be immersed for 2 weeks. X-ray diffraction analysis and density-functional theory (DFT) calculations were performed to determine degree of phase purity. Transmission electron microscopy (TEM) was used for imaging of CQDs and treated enamel, with zeta potential measured with Zetasizer. Raman spectra was acquired with spectral range of 400-2000 cm-1. Atomic force microscopy was performed with a peak force set at 200 nN. Lactobacillus biofilm was prepared on treated enamel substrates and analysed using confocal, scanning electron microscopy and TEM. RESULTS:DFT calculations summarised improved lattice parameters of HAp***CQD0.3 %- and HAp***CQD0.5 %-. Zeta potential is least for salineS and is maximum for *****CQD0.5 %- distributed system. The salineS, and *CQD0.1 %- groups had comparable v₁PO₄³⁻ value, indicating consistent phosphate intensities. TEM successfully verified carbon dots as spherical. Enamel crystals aligned their c-axis perpendicular to the electron beam within 1° with CQDs treated specimens exhibiting misoriented-crystals. *****CQD0.5 %- group had highest elastic modulus and nano hardness with maximum shear stress. Calculated bond length and angles using XRD show higher measures (p < 0.05) in all CQD groups. *****CQD0.5 %- exhibited a fibre texture pattern with an orientational distribution resembling an angle distortion. Most bacteria in the biofilms fluoresced red in CQD groups with no colony chain formations observed with *****CQD0.5 %- group. CQDs assemblies were observed to cause explosive lysis through loss of cell integrity. CONCLUSION:*****CQD0.5 %- modified enamel substrate displayed significant crystallite changes providing a novel option for fabrication of diverse functional CQDs aimed at modification of enamel tissue while possessing optimum antimicrobial properties.

This paper describes a promising candidate molecule, investigates the pattern of scaffold composition which arises and assesses the effect of the agent on its mechanical properties. Methods:Scaffold samples were fabricated using a commercial extrusion bioprinter equipped with a pneumatic printhead fitted with a 21G conical nozzle. The Pore Printability Index, and the area and perimeter of the pore within the grid patterns were quantified using ImageJ software (NIH, USA). Mechanical properties of scaffolds were assessed using atomic force microscopy. The phase composition and crystal structures were analyzed using X-ray diffraction and Raman mapping. Morphologies of human gingival fibroblastic cells were examined using scanning electron microscopy. Lactobacillus biofilms were generated for cytolysin peptide cleavage. A rabbit bone defect model with scaffold implantations was used to provide histologic specimens for measuring percentages of bone trabeculae, collagen fibers and inflammatory cells along with granulation tissue. The Primeway Total RNA Extraction Kit was used for RNA extraction. Results:All bioink formulations demonstrated successful printing of 3D grid and solid square patterned scaffolds achieving Pr values exceeding 0.9. 0.1 % K21 group showed the highest elastic modulus. XRD revealed a pattern producing around 90 % β-tricalcium phosphate displaying two peaks at 2θ angles. 0.1 % K21 and 0.1 % CHX did not alter scaffold's pore size and porosity. 0.1 % K21 group exhibited highest ratio (62.5 ± 6.1 θ), significantly surpassing control. Surface morphologies of cells were also well retained. TEM image shows a sequence of structural changes in fibroblastic cell structure when exposed to K21. 0.1 % K21 proved to be critical in completely eradicating the biofilm. 0.K21 group closed the openings of wound areas completely. Correlation coefficient of gene expression levels demonstrates sample variations and recurring instances among groupings. Conclusion:3D-printing technologies with 0.1 % K21 represent a significant advancement over conventional regenerative medicine techniques for bone-related treatments.