European Journal of Dentistry最新文献

Objectives:  This study aimed to compare the clinical effectiveness of four aligning archwires: Superelastic Nickel-Titanium (Superelastic-NiTi), SmartArch, Copper-Nickel-Titanium (Cu-NiTi), and Speed Tubular coaxial-Nickel-Titanium (Tubular coaxial-NiTi), regarding the alignment efficiency, associated perception of pain, and possibility of inducing root resorption.

Materials and methods:  This study includes two randomized clinical trials run in parallel. Patients with 5 to 9 mm of mandibular anterior teeth crowding according to Little's irregularity index (LII) who needed fixed orthodontic appliances without extraction were randomly assigned to four groups of aligning archwires (each trial with two groups): 0.014-inch, 0.018-inch Superelastic-NiTi; 0.016-inch SmartArch; 0.014-inch, 0.018-inch Cu-NiTi; and 0.016-inch, 0.018-inch Tubular coaxial-NiTi. LII was measured pretreatment and every 4 weeks for the next 16 weeks. Pain perception was assessed using a visual analogue scale in the first 7 days after the placement of each archwire. Periapical radiographs for mandibular central incisors were taken pretreatment and after 16 weeks to assess root resorption. The alignment efficiency was tested using a repeated measures analysis of variance test with mixed factorial design (between and within-subject effect), while pain perception and root resorption were tested using the Kruskal-Wallis test and Wilcoxon signed-rank test.

Results:  A total of 73 patients were recruited from different centers. The analysis included 64 patients who completed the trials. Neither clinical nor statistical significance was found between the groups regarding the alignment. Similarly, there was no significant difference between the four groups regarding pain perception and root resorption. However, root resorption was slightly more in the Superelastic-NiTi group than in the other groups.

Limitations:  The short time that root resorption was reported.

Conclusions:  The four types of archwires performed comparably regarding the alignment efficiency, associated perception of pain, and the possibility of inducing root resorption.

Registration:  The trials included in this study were registered with ClinicalTrials.gov on May 26, 2022 (Registration number: NCT05391542) and August 18, 2022 (Registration number: NCT05510206).

Objectives:  The objective of this study was to evaluate the bonding performance and the interfacial ultramorphology of an innovative self-curing restorative system compared with a conventional light-curing resin composite applied on dentin in etch-and-rinse (ER) or self-etch (SE) mode.

Materials and methods:  Twenty cavities (class I) were prepared in sound dentin and restored using two materials: (1) CERAM (n = 10; CERAM.X ONE, Dentsply Sirona) in combination with a universal adhesive system (PBU [Prime & Bond Universal]), or (2) STELA (n = 10; Stela Automix, SDI) in combination with its adhesive primer. Half of the specimens from each group were bonded in ER or SE mode. Specimens underwent microtensile bond strength testing after 24 hours of storage in artificial saliva. Failure mode was determined using a stereomicroscope, and fractographic analysis was performed using scanning electron microscopy. The interfacial ultramorphology/nanoleakage of the resin-dentin slabs was analyzed through dye-assisted confocal microscopy.

Statistical analysis:  For quantitative analysis, bond strength values (in MPa) were assessed for normality and variance using Kolmogorov-Smirnov and Levene's tests, followed by ANOVA based on restorative material and adhesive bonding protocol, with Fisher's least significant difference post hoc test (α = 5%).

Results:  SE groups exhibited significantly lower bond strength (17.4 MPa for CERAM; 26.2 MPa for STELA) compared with ER groups (35.8 MPa for CERAM; 33.6 MPa for STELA) (p < 0.05). CERAM applied in SE mode showed significantly lower bond strength compared with STELA applied in SE mode. Furthermore, CERAM applied in SE mode was the only group presenting a pre-test failure rate (27%). The failure mode was predominantly mixed in ER groups and adhesive in SE groups. Nanoleakage was observed clearly in the CERAM groups applied in both ER and SE modes but was less evident in the STELA groups.

Conclusion:  The new self-curing material (STELA) used in SE or ER may represent a promising clinical option to provide adequate interfacial adaptation and strong bonding to dentin when restoring deep class I cavities. The use of conventional adhesives in deep class I cavities may generate resin-dentin interfaces characterized by gaps and leakages.

This research studies the fracture resistance of a non-ferrule endodontically treated tooth restored with two types of resin matrix ceramic (Enamic and Cerasmart) post and core compared with the conventional prefabricated fiber-reinforced composite (FRC) post and core.Thirty single-root-canal premolars were sectioned to 13 mm root length and then all the roots were filled, using a crown-down technique for root canal preparation and one cone technique for root canal obturation, All the roots were randomly divided into three groups (n = 10) according to post and core material; (1) Enamic group (EN), (2) Cerasmart group (CM), and (3) prefabricated fiber post group (FRC). Three groups of specimens were tested using a universal testing machine (EZ Test Series, Shimadzu, Japan). Specimen blocks were fixed into a holder with an inclination of 45 degrees. The force was loaded to a palatal incline of buccal cusp at a crosshead speed of 0.5 mm/minute until there was split or fracture of the tooth. The maximum braking force was recorded in Newton (N), and the mode of failure was observed by a stereomicroscope.The dependent variable was fracture resistance (maximum breaking force) and the data were analyzed using one-way analysis of variance and then multiple comparison Tukey's tests were used, aiming to find means that are significantly different among the groups. Moreover, the failure mode was analyzed using the chi-square test.A significant difference was recorded. Teeth restored with prefabricated FRC had the most fracture resistance 342.19 ± 79.34 N (p = 0.007), followed by the resin matrix ceramic group (265.10 ± 48.58 N: Cerasmart) and Enamic group (260.98 ± 43.96 N: Enamic). No significant difference between the Enamic and Cerasmart groups was noted. Additionally, no significant difference in the mode of failure was recorded among the three groups.The fracture resistance of a non-ferrule endodontically treated tooth restored with the conventional prefabricated FRC post and core is greater than that restored with either type of resin matrix ceramic (Enamic and Cerasmart). This explains the higher failure rate resulting from the use of resin matrix ceramics.

Interprofessional education (IPE) and interprofessional collaborative practice are widely recognized for improving health care education and patient outcomes, especially in dentistry. Due to the strong link between oral and overall health, integrating IPE into dental curricula is essential for preparing practitioners to deliver collaborative, patient-centered care. A robust IPE curriculum for dental students requires well-defined learning outcomes aligned with other health professions and a focus on skills like patient care, communication, and teamwork. This review examines IPE curriculum design, implementation, and its impact on dental students, evaluating both short- and long-term effects on skills and career preparedness. By analyzing current IPE practices, this review seeks to illuminate effective strategies and future directions for integrating interprofessional collaboration into dental training.

Objectives:  This article evaluates the marginal and internal gap, interfacial volume, and fatigue behavior in computer-aided design-computer-aided manufacturing (CAD-CAM) restorations with different designs (crowns or endocrowns) made from lithium disilicate-based ceramic (LD, IPS e.max CAD, Ivoclar AG) or resin composite (RC, Tetric CAD, Ivoclar AG).

Materials and methods:  Simplified LD and RC crowns (-C) and endocrowns (-E) were produced (n = 10) using CAD-CAM technology, through scanning (CEREC Primescan, Dentsply Sirona) and milling (CEREC MC XL, Dentsply Sirona), and then adhesively bonded to fiberglass-reinforced epoxy resin. Computed microtomography was used to assess the marginal and internal gap and interfacial volume. A cyclic fatigue test (20 Hz, initial load = 100 N/5,000 cycles; step-size = 50 N/10,000 cycles until 1,500 N, if specimens survived, the step-size = 100 N/10,000 cycles until failure) was performed. Topography, finite element analysis (FEA), and fractography were also executed.

Statistical analysis:  Two-way analysis of variance and Tukey's post hoc tests were employed (α = 0.05) for marginal and internal gap and interfacial volume. Survival analysis based on Kaplan-Meier and Mantel-Cox tests (α = 0.05) was used for fatigue data.

Results:  RC crowns demonstrated the smallest marginal gap, LD crowns the largest. Endocrowns presented intermediary marginal gap values. Internal gaps were all above the planned 120 µm space. The lowest gap was seen at the cervical-axial angle at crowns, regardless of material. At the axio-occlusal angle, LD crowns presented a lower gap than RC; meanwhile, there was no difference among endocrowns. When comparing occlusal/pulpal space, LD crowns showed the lowest values, and RC-C, LD-E, and RC-E were statistically similar. Fatigue testing revealed superior behavior for RC restorations, withstanding higher loads and more cycles before failure compared to LD. FEA indicated that the crowns required higher stress concentration to unleash their failure than endocrowns. Fractographic features confirm failure origin at surface defects located at the restoration/cement intaglio surface, where it concentrated the highest maximum principal stress.

Conclusion:  RC crowns and endocrowns presented lower marginal gaps than LD ones. Differences in other internal gap outcomes exist but within a nonclinically relevant threshold. The restoration fatigue behavior was influenced by the CAD-CAM material, but not by its design.

Objective:  Bone grafts derived from natural hydroxyapatite (HA) are increasingly being explored because they are more economical in terms of production costs compared with commercial HA. HA can be obtained from local cattle slaughter waste in Aceh, Indonesia, which has not been widely studied for its potential for dental applications. This study examines the synthesis and characterization of bovine HA (BHA) derived from Aceh cattle femur through calcination for applications in dentistry.

Materials and methods:  This research began with the cleaning of fresh bones by boiling and soaking them in acetone for 2 hours before 3-hour calcination at varying temperatures. The BHA samples were characterized using Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction, scanning electron microscopy with energy dispersive X-ray (SEM-EDX), and particle size analyzer (PSA).

Statistical analysis:  Data were analyzed using SPSS with a one-way analysis of variance to assess the impact of calcination temperature on the yield and particle size of BHA.

Results:  BHA obtained from calcination at 900°C and 1,000°C showed the highest crystallinity, with values above 84%, and uniform particle distribution. PSA and SEM analysis showed that BHA particles were spherical in submicron size, which became smaller and more uniform but agglomeration did not occur significantly between each increase in calcination temperature. FTIR analysis showed the presence of phosphate, carbonate, and hydroxyl functional groups. Elemental composition analysis using EDX confirmed that essential elements such as calcium and phosphorus were distributed consistently at all temperatures with a Ca/P ratio of 1.7 to 2.3.

Discussion:  Based on the characteristics of crystallinity, particle size, and chemical composition of the obtained BHA, it is considered optimal for bioactivity, which allows stimulation of new bone tissue formation and promotes osseointegration while balancing structural stability. This makes BHA derived from Aceh cattle bones a suitable bone filler candidate for treating alveolar bone defects in hard tissue regeneration. These findings highlight the potential use of cattle bone waste as a sustainable source of HA in dental applications.

Conclusion:  These findings suggest that Aceh bovine bones are a viable source for producing quality BHA, potentially contributing to more sustainable and ecofriendly biomaterials for dental applications.

Objectives:  This study aims to explore the beliefs and attitudes related to the adoption of teledentistry among Pakistani dental professionals, focusing on data security, practice enhancement, and patient benefits.

Material and methods:  A cross-sectional study on a 5-point Likert scale assessed four domains of teledentistry: data security and patient consent, practice improvement capabilities, usefulness for dental practice, and patient benefits, among dental professionals through electronic forms. Demographic data and items from four domains were analyzed by descriptive statistics, analysis of variance and Pearson's correlation tests, respectively, using SPSS, with a p-value of < 0.05 set as statistically significant.

Results:  A large percentage (59.8%) of the 408 dental professionals raised issues related to data security with 52% showing concerns about securing patient consent. Most professionals (61.8%) acknowledged the potential of teledentistry in reducing waiting times. Gender, age, qualifications, and work experience were found to be associated with individual perceptions of teledentistry. Females were more skeptical on teledentistry capabilities (p < 0.000) while younger, more than the older professionals had heightened worries about data security (p < 0.000). Specialists viewed teledentistry favorably compared with other professionals (p < 0.000). Professionals with more than 5 years of experience expressed optimism, on how teledentistry could improve practice efficiency and patient outcomes (p < 0.000).

Conclusion:  This report on the views and attitudes of Pakistani dental professionals toward teledentistry indicates their positive perception of teledentistry, citing its potential to enhance practice and benefit patients. Overcoming data security concerns and improving education on teledentistry benefits could foster broader acceptance and utilization of this technology.

Objective:  Regenerative periodontal surgical approaches require scaffolds in a form that can fill narrow and irregular defects. Each scaffold must be specially designed to conform to the shape of the specific defect. The aim of this study was to fabricate nanohydroxyapatite chitosan-gelatin (nHA/KG) pastes with different composition percentages and to analyze the differences in physical, chemical, and biological characteristics in response to periodontal tissue regeneration in vitro.

Materials and methods:  The nHA/KG paste was prepared at three different concentrations of inorganic and organic contents (70/30; 75/25; and 80/20) by mixing nHA powder, chitosan flakes, and gelatin powder. The ratio of chitosan and gelatin on all nHA/KG pastes is 1:1. The three nHA/KG pastes were tested for the following rheology and bioactivity properties in simulated body fluid (SBF): pH value, swelling, degradability, surface morphology, and cell attachment by scanning electron microscopy and chemical structure by Fourier transform infrared (FTIR). Osteoblasts and fibroblasts were analyzed for proliferation using the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay and for cell proliferation by reverse transcription quantitative real-time polymerase chain reaction of COL1, alkaline phosphatase (ALP), osteocalcin (OCN), and RUNX2.

Statistical analysis:  Analysis of variance followed by Tukey's post hoc, Kruskal-Wallis, Wilcoxon, and paired sample t-tests were performed according to each data type.

Results:  The nHA/KG paste showed gel-like physical characteristics. The pH value after SBF immersion was stable at pH ± 7.0, although the pH of the nHA/KG 80/20 paste decreased to pH 6.3 on day 14. The three paste preparations showed significant differences in swelling (p < 0.05) on days 1 and 14 and in the degradability ratio on days 1, 2, and 7 (p < 0.05). The three-dimensional scaffold surface morphology differed depending on the immersion time. The FTIR test showed the presence of PO₄ ^3-, CO₃ ^2-, -OH, amide I, and amide II functional groups in all paste variants. The nHA/KG 75/25 paste had the most stable structure during the immersion period. Biological tests showed a viability ratio of osteoblasts and fibroblasts ≥ 70%. The paste could stimulate the messenger ribonucleic acid expression of the COL1, ALP, OCN, and RUNX2.

Conclusion:  The nHA/KG bone graft paste showed good potential as an injectable scaffold, with the nHA/KG 75/25 paste being the best of the three pastes tested here.

The increasing recognition of network meta-analyses (NMAs) in dentistry, particularly in periodontology and implantology, lacks assessed reporting quality. To address this, our study will undertake a systematic review of previously reported NMAs. Researchers conducted an electronic search in Web of Science and Scopus to identify NMAs across all dentistry journals. Two independent investigators selected studies, extracted data, and assessed reporting quality using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for NMA (PRISMA-NMA) checklist with 32 items. Each "yes" response earned 1 point, and "no" responses received 0 points, yielding an overall reporting quality score. In total, 39 NMAs were included in this study. The NMAs were published between 2010 and October 2024, with most of them published in 2022 (25%). Most of the NMAs employed the PRISMA-NMA guidelines (47%) and have been published in the Journal of Clinical Periodontology (53%). The overall reporting quality of the included NMAs ranged between 87.5 and 100% (i.e., high quality of reporting [≥ 75th %]), with 5 NMAs reporting all 27 items of the PRISMA-NMA statement. The limitations, presentation of network structure (results), funding, and objectives (methods) were reported in 97, 94, 81, and 78% of the NMAs, respectively. The least reported items were the protocol registration and the summary of network geometry, which were reported in 53% of the NMAs. All the remaining items were reported in all 39 NMAs. The reporting quality of the NMAs published related to periodontology and implantology was high. However, some deficiencies were revealed associated with the reporting quality of the PRISMA-NMA items, including protocol registration, formulation of the research question based on the PICO (Population, Intervention, Comparison, Outcome) format, and summarization of the network geometry.

Objective:  The search for an ideal obturating material has taken precedence due to the revolution of the materials used in pediatric endodontics. With zinc oxide, calcium hydroxide, and metronidazole as its core constituents, an unique obturating material was developed. To aid in the healing process, the material should be biocompatible and most importantly it should not have any negative consequences. Thus, using embryonic toxicology, brine shrimp lethality, and methylthiazol tetrazolium (MTT) assay, the current investigation sought to determine the cytotoxicity of the newly developed obturating material, which contained calcium hydroxide, zinc oxide, and metronidazole at 2% 60-40 concentrations.

Materials and methods:  In zebrafish embryonic toxicology method and brine shrimp lethality assay, five distinct concentrations of the new obturating material was tested and compared with the control in a 24-well plate containing fertilized zebrafish eggs and in 6-well plate containing nauplii, respectively. The hatching and the viability rate of the zebrafish embryos and survival rate of nauplii were calculated. In MTT assay, the percentage of fibroblast cell viability and the cell morphology was documented. A statistical analysis was performed on all of the collected data.

Results:  The hatching and the viability rate of the zebrafish embryos falls as the concentration of the new obturating material rises. The survival rate of the nauplii also falls with rise in the concentration of the obturating material. No cytotoxic effect was demonstrated by the novel obturating material on the human gingival fibroblasts up to 200 μg/mL concentration.

Conclusion:  The novel obturating material exhibits minimal cytotoxic effects even at increased concentrations.