Dental Research Journal最新文献

Background: The aim of this study was to evaluate the diagnostic potential of periapical radiograph, panoramic radiograph, and cone-beam computed tomography (CBCT) in detecting implant-related perforation of the inferior alveolar canals.

Materials and methods: In this ex vivo study, a total of 45 dental implants were placed in 15 sheep hemimandibles simulating two types of injuries to the inferior alveolar canal: pilot drill injury and implant penetration into the canal. Fifteen implants were placed as the control group with 1 mm distance from the inferior alveolar nerve (IAN) canal roof. An imaging phantom was prepared by placing implant-containing blocks in the posterior mandibular area on both sides of an artificial model of the cranium. Panoramic and periapical radiographs as well as CBCT scans were obtained from the imaging phantom. Two independent observers repeated image analysis over two sessions. The area under the receiver operating characteristic curve (AUC) was used to determine diagnostic accuracy. Interobserver and intraobserver agreements were obtained using Cohen's kappa (α = 0.05).

Results: For detection of pilot drill injuries by observer 1, CBCT (AUC = 1) and periapical radiograph (AUC = 0.889) were significantly better than using panoramic radiographs (AUC = 0.694) (P < 0.001 and P = 0.014, respectively). For observer 2, CBCT (AUC = 0.897) was also superior to panoramic radiography (AUC = 0.683) for this purpose (P = 0.018). For detection of penetrative injuries to the IAN canal, periapical radiography had an AUC of 0.995 and 0.986 for observers 1 and 2, respectively, while the AUC for panoramic radiography was 0.990 and 0.948 for observers 1 and 2, respectively. The corresponding values using CBCT were 1.000 and 0.995, respectively. No significant difference was observed between the three modalities for detection of penetrative injuries (P > 0.05).

Conclusion: CBCT was better in detecting pilot drill injuries to the IAN canal compared to panoramic radiograph. Therefore, in cases where clinical presentations suggest IAN disturbances, CBCT scan should be preferred. However, the diagnostic potential of periapical radiograph, panoramic radiograph, and CBCT was not significantly different for detection of penetrative injuries to the IAN canal.

Objectives: The objective of the study was to evaluate caries development and retention rate of resin-based hydrophilic and hydrophobic fissure sealants based on the randomized clinical trials in which the investigators have studied this subject.

Materials and methods: A literature screen was conducted in some databases, including PubMed, Scopus, Embase, ISI Web of Science, and Cochrane Library, to select randomized clinical trials that compared the caries development/retention rate of resin-based hydrophilic and hydrophobic fissure sealants until March 2025. The risk of bias of the included studies was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2), and the meta-analysis was performed using a random-effect model. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Results: A total of 20,945 articles were initially retrieved for screening, and fourteen studies were identified as eligible for inclusion in the quantitative analysis. The RoB assessment showed a high risk of bias in 5 studies, some concerns in 5, and low risk in 4. Caries development was reported in 11 studies, and retention rate in 14. The meta-analysis results showed a statistically significant difference for caries development (odds ratio [OR]: 0.490, 95% confidence interval [CI]: 0.277-0.867; P = 0.014), whereas the retention rate (OR: 0.859, 95% CI: 0.596-1.237; P = 0.414) indicated no statistically significant differences. The quality of evidence for both outcomes was rated as very low according to the GRADE system.

Conclusion: It could be concluded that hydrophilic and hydrophobic resin-based fissure sealants are approximately equal in caries development and retention rate, with very low quality of evidence.

Clinical relevance: In clinical practice, resin-based hydrophilic fissure sealants could be applied on susceptible tooth surfaces; in case of difficult isolation, with an almost equal clinical success for hydrophobic fissure sealants.

Background: The aim of the study was to evaluate the dimensional changes of the alveolar ridge in postextraction sockets filled with 1.2% atorvastatin (ATV) gel covered with a collagen membrane.

Materials and methods: This study is a split-mouth randomized clinical trial. A total of 30 postextraction sockets of single-root teeth of 15 patients were randomly allocated into two groups: (a) socket filling with 1.2% ATV gel and covered with an absorbable collagen membrane (n = 15) and (b) socket covered with a collagen membrane (n = 15). Four clinical indices - the width and height of sockets and the width and thickness of keratinized gingiva - were measured at baseline and 2 months after the intervention. Two histological parameters, namely the percentage of osteogenesis and the thickness of bone trabeculae, were also measured 2 months after the intervention. Data were analyzed by Mann-Whitney and Wilcoxon tests using SPSS software (P ≤ 0.05).

Results: Two months after extraction, dimensional changes in height (P = 0.07), width of the alveolar socket (P = 0.381), and keratinized gingival thickness (P = 1) showed no significant difference between the two groups. In both the groups, the keratinized gingival width increased significantly, but there was no significant difference between the two groups (P = 0.347). The percentage of lamellar bone formation in the test group was about 28% higher than that of the control group (P = 0.098), and the thickness of trabeculae in both the groups was similar (P = 0.78).

Conclusion: Although 1.2% ATV gel increased lamellar bone formation and reduced dimensional changes in postextraction sockets, the differences were not significant compared with the control group.

Background: Achieving durable bonding for all ceramic restorations will affect its long-term survival in the oral cavity. Dentists may use resin cement after its shelf lifetime, especially in low socioeconomic conditions, which may affect the success and longevity of restorations. The purpose of this in vitro study was to evaluate how the duration of shelf life impacts the shear bond strength (SBS) of lithium disilicate ceramics using light-cured resin cement.

Materials and methods: An in vitro comparative study investigated the impact of resin cement expiry on the SBS of pressed lithium disilicate ceramics. Twenty-four IPS e.max Press discs (4 mm × 2 mm) were randomly divided into two groups: Group I used unexpired light-cured resin cement, and Group II used expired cement. Each disc was bonded to enamel surfaces from sectioned maxillary incisors to create test specimens. Following thermocycling, samples were subjected to a shear force using a universal testing machine until debonding occurred, and the failure load was recorded. Data normality was confirmed with the Shapiro-Wilk test, mean SBS values were compared through independent t-test, and failure modes were assessed using the Chi-square test with Monte Carlo correction at a significance level of P < 0.05.

Results: Group I exhibited a higher SBS with a mean value of 24.98 ± 4.01 MPa compared to Group II with a mean value of 20.39 ± 2.72 MPa, with a mean P = 0.008.

Conclusion: Expiry date affected the SBS of light-cured resin cement to lithium disilicate ceramic materials. But still the recorded value is higher than the recommended clinical accepted value.

Background: Cleft lip and/or palate (CL/P) is a prevalent congenital craniofacial anomaly that affects facial esthetics, function, and psychosocial well-being. Oral health-related quality of life (OHRQoL) is a critical measure reflecting the impact of oral health on daily functioning and overall life quality. Despite extensive treatment, adults with CL/P may continue to face challenges affecting their OHRQoL.

Objective: To systematically evaluate and synthesize the existing evidence on OHRQoL in adults (≥18 years) with CL/P.

Materials and methods: A systematic search was conducted across Scopus, Embase, Web of Science, and PubMed until March 2025. Eligible studies included those assessing OHRQoL in adults with CL/P, using validated questionnaires such as Oral Health Impact Profile-14 (OHIP-14) and Oral Impacts on Daily Performances. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and the protocol was registered in PROSPERO. Risk of bias was assessed using a modified Newcastle-Ottawa Scale for cross-sectional studies and the National Heart, Lung, and Blood Institute Quality Assessment Tool for pre-post studies. Due to heterogeneity in methodologies, a narrative synthesis approach was adopted.

Results: From 407 identified records, 9 studies met the inclusion criteria. The majority were cross-sectional (n = 7), with 2 pre-post intervention studies. Most used the OHIP-14 questionnaire. Findings consistently showed that adults with CL/P report diminished OHRQoL, particularly in physical and psychological domains. Interventions like orthognathic surgery and prosthetic rehabilitation improved specific outcomes, but did not fully resolve functional or psychosocial challenges. Factors such as female gender, low income, limited social support, and the extent of dental decay were associated with worse outcomes.

Conclusion: Despite receiving specialized, multidisciplinary treatment, adults with CL/P continue to experience impaired OHRQoL. These findings underscore the need for a more holistic, patient-centered care approach that includes psychological support and long-term follow-up. Future research should focus on longitudinal studies and explore strategies to address persistent psychosocial impacts in adulthood.

Background: Dental caries is one of the most prevalent chronic diseases among children worldwide. Conventional caries management methods such as fluoride sealants and varnishes are widely used; however, newer noninvasive therapies like silver diamine fluoride (SDF) have gained attention. SDF has been proposed as a topical treatment for pediatric carious lesions, with advantages including arresting caries progression, reducing pain, and promoting remineralization with minimal intervention.

Materials and methods: This review summarizes available evidence on the effectiveness of SDF as a caries prevention and arrest agent in primary teeth. It is based on a comprehensive analysis of current clinical studies and trials, focusing on biochemical mechanisms of action (including antimicrobial effects and increased dentin hardness), alongside practical considerations such as safety, application ease, and cost-effectiveness.

Results: Across reviewed clinical studies and trials, SDF demonstrates effectiveness in preventing and arresting caries in primary teeth. Evidence supports underlying mechanisms including antimicrobial activity and enhancement of dentin hardness. The review also highlights practical strengths (safety profile, ease of application, and cost-effectiveness) and limitations, particularly esthetic concerns and staining. It also notes potential usefulness in pediatric populations with limited access to dental care or special healthcare needs.

Conclusion: SDF can be applied safely, effectively, and cost-effectively as a caries-preventive and caries-arresting approach for young primary teeth.

Background: Composite restorations are prone to hybrid structure degradation and microleakage over time, which causes destruction and discoloration of the restoration's margins, caries recurrence, postrestoration sensitivity, and pulp irritation. New fiber-reinforced restorations may reduce some of the disadvantages of conventional composite restorations. This study aimed to compare microleakage of fiber-reinforced and conventional composite restorations.

Materials and ethods: In this in vitro experimental study, 40 healthy extracted permanent premolars were included. The teeth were randomly divided into two groups: the first group consisted of teeth restored with fiber-reinforced composite and the second group consisted of teeth restored with conventional composite. In the teeth of both groups, two class II cavities were prepared, and then, according to the grouping, they were restored with composite or composite and fiber. Each cavity had a mesiodistal length of 2 mm, a buccopalatal width of 4 mm, and a depth of 5 mm, with proximal locations in the premolars. In the next step, the apex of all samples was sealed with adhesive wax, and the tooth surfaces were covered with two layers of nail polish and placed in 0.5% Fuchsin solution at room temperature for 24 h. Finally, the teeth were cut in half, and the extent of dye penetration was determined with a stereomicroscope equipped with a digital camera. The Mann-Whitney test was used to compare microleakage between groups. P ≤ 0.05 was considered statistically significant.

Results: The median of microleakage score was 1 (interquartile range [IQR] = 2) in the intervention group and 2 (IQR = 1) in the control group. The difference between groups was statistically significant (P = 0.012).

Conclusion: This study revealed significantly lower microleakage with fiber-reinforced composite compared to conventional composite.

Background: The current endodontic disinfection techniques may be supplemented with photodynamic therapy (PDT), which is believed to eliminate intracanal bacteria more efficiently. This in vitro study aimed to assess the antimicrobial effectiveness of PDT using various photosensitizers, in conjunction with a near-infrared diode laser (810 nm wavelength), in the root canals of teeth infected with Enterococcus faecalis. This research is crucial for determining the optimal PDT method for eliminating E. faecalis, thereby enhancing the effectiveness of endodontic disinfection techniques.

Materials and ethods: This in vitro experimental study was conducted on 50 intact human maxillary first molars, which were decoronated, and palatal roots were instrumented to ISO size X5. After autoclaving, roots were inoculated with E. faecalis (ATCC 29212; 10⁸ CFU/mL) and incubated anaerobically for 72 h. The roots were randomly divided into five experimental groups: control (C), laser alone (L), PDT with indocyanine green (ICG), PDT with methylene blue (MB), and PDT with cetrimide (CT) 2%. Root canals were flushed with phosphate-buffered saline, and serial dilutions were plated on agar. Colony-forming units were counted after 48-h incubation. Data were analyzed using one-way analysis of variance followed by Tukey's post hoc test for pairwise comparisons. A significance level of P < 0.05 was considered.

Results: PDT with ICG resulted in complete eradication of E. faecalis (0 CFU/mL), whereas PDT with MB and CT produced significant reductions (5.08 ± 0.2 and 5.55 ± 0.1 log₁₀ CFU/mL, respectively; P < 0.05). Laser alone reduced CFU/mL to 5.94 ± 0.07.

Conclusion: PDT with ICG and an 810 nm diode laser achieved complete eradication of E. faecalis, outperforming MB, CT, and laser alone. These results advocate for ICG-PDT as a potent adjunct in endodontic disinfection protocols.

Background: Dental impressions are a known potential vector for cross-contamination between patients and the dental laboratory. Effective disinfection is, therefore, a critical step in infection control protocols. This in vitro study aimed to evaluate and compare the antibacterial efficacy of ultraviolet (UV) radiation and 0.525% sodium hypochlorite solution for disinfecting two common impression materials: condensation silicone and alginate.

Materials and methods: This in vitro study employed a comparative experimental design to evaluate disinfection efficacy. A total of 195 samples were utilized, comprising 90 discs each of condensation silicone and alginate, alongside positive and negative controls (n = 9 and n = 6, respectively). All samples were experimentally contaminated with standardized suspensions of three pathogenic species: Streptococcus pyogenes (beta-hemolytic Group A), Pseudomonas aeruginosa, and Staphylococcus aureus. The disinfection protocols consisted of either exposure to 0.525% sodium hypochlorite spray for 10 min or treatment with UV radiation using a dedicated device ("Fast Steril"). Antibacterial efficacy was quantitatively assessed by enumerating the mean colony-forming units (CFUs) postdisinfection. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U-tests, with the significance level defined at α = 0.05.

Results: The analysis revealed a statistically significant difference in bacterial reduction based on the microbial species (P < 0.001). UV radiation demonstrated superior efficacy compared to sodium hypochlorite in disinfecting condensation silicone impressions (P < 0.05). Conversely, no significant difference was observed between the two disinfection methods for alginate impressions. Regarding bacterial susceptibility, the mean reduction in CFUs for S. pyogenes was significantly greater than for S. aureus and P. aeruginosa (P < 0.001), between which no significant difference was found (P = 1.0).

Conclusion: Within the limitations of this study, UV radiation proved to be a more effective disinfection method for condensation silicone impressions than sodium hypochlorite spray. For alginate impressions, both methods were equally effective. Given its efficacy and the superior dimensional stability of UV-treated impressions reported in the literature, the adoption of UV radiation is recommended as a viable and efficient method for disinfecting both condensation silicone and alginate impressions, thereby mitigating the risk of cross-infection in dental practice.

Background: Dental implants face challenges such as bacterial infiltration and peri-implantitis, emphasizing the need for a robust mucosal seal to ensure long-term success. This study aimed to evaluate the impact of polishing and glazing zirconia on the adhesion and survival of human gingival fibroblasts, which are critical for establishing this protective barrier.

Materials and methods: In this in vitro experimental study, 18 zirconia discs (2.5 mm thickness) were prepared, sintered, and divided into three groups: polishing, glaze, and simple. The polishing group underwent sequential polishing, whereas the glaze group was coated with glaze paste and heated in a vacuum oven; the simple group remained unaltered. Cell survival was assessed using direct and indirect 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, and cell adhesion was analyzed through fluorescence microscopy and quantitative fluorometry. Data analysis was performed using SPSS version 26, employing the Kolmogorov-Smirnov test for normality and one-way ANOVA (P < 0.05).

Results: Cell adhesion was significantly greater in the polished group compared to the simple group (P = 0.001) and the glazed group (P = 0.002). Cell survival did not significantly differ between the polished and plain groups (P = 0.111). However, the glazed group showed significantly higher cell survival compared to both the simple (P < 0.001) and polished groups (P = 0.004).

Conclusion: Within the limitations of this in vitro study, it can be concluded that polished zirconia surfaces promote greater gingival fibroblast adhesion. However, fibroblast cell viability was higher on glazed zirconia discs. These findings underscore the importance of zirconia surface treatments in improving gingival integration.