Journal of Clinical and Experimental Dentistry最新文献

Background: To assess the ability of nano propolis and nano curcumin as direct pulp capping agents in forming dentin bridge in permanent teeth using the CBCT.

Material and methods: For the present investigation, fifty-four teeth were selected and randomly divided into three groups (18 teeth per group) based on the pulp capping agent utilized: Group I (control group): teeth were directly pulp capped with MTA. Group II: they were directly pulp capped with propolis nanoparticles. Group III: they were directly pulp capped with curcumin nanoparticles. Cone-beam computed tomography (CBCT) scans were performed on all teeth following pulp capping therapy and six months later to assess the establishment of reparative dentin bridges. In order to detect reparative dentin bridges on the multi-planar reconstruction picture, the CBCT scan was examined. A statistical analysis was conducted.

Results: reparative dentin bridges were formed in all teeth across all patient groups. Group III (Nano-curcumin) had the greatest mean value, followed by group II (Nano-propolis), while Group I (MTA) had the lowest value.

Conclusions: When applied as a direct pulp capping agent, Nano curcumin and Nano propolis induce the production of reparative dentin and apex closure in permanent teeth. Key words:MTA, Nano-propolis, nano-curcumin, young permanent teeth, direct pulp capping, CBCT.

Background: This study aimed to evaluate bond strength of self-etching adhesive to dentin following chemomechanical dentin or burs carious removal.

Material and methods: Twenty-two sound molars were sectioned transversely to achieve complete exposure of dentin, followed by the induction of artificial caries. The teeth were randomly divided into two groups: Brix-carious dentin removal with papain-based gel (Brix 3000), and Burs-carious dentin removal with drills. A morphological analysis of prepared dentin was performed on two samples from each experimental group using scanning electron microscopy. Teeth were restored using a self-etch adhesive system (Clearfil SE Bond, Kuraray) and composite resin (Filtek Z350 XT, 3M Oral Care). For the microtensile bond strength μTBS test, beams were tested under tensile stress after 24 hours of storage in distilled water. Fractographic failure mode was performed using a stereomicroscope and two beams from each group were analyzed using scanning electron microscopy (SEM). The data were analyzed using an independent samples t-test with a significance level of α=0.05.

Results: The μTBS ranged from 23.84 ± 5.77 MPa for the Brix group to 28.91 ± 4.82 MPa for the burs group. There was no statistical difference between the groups (p = 0.06). The adhesive failure was the most prevalent in both groups.

Conclusions: The chemomechanical carious dentin removal using papain gel formulation Brix3000® did not affect bond strength compared to bur removal method. Key words:Dental caries, Tensile strength, Dental adhesive.

Background: Degenerative diseases of the temporomandibular joint (TMJ) represent a frequent subtype of temporomandibular disorders (TMDs), particularly prevalent among individuals over the age of 40. Although cone-beam computed tomography (CBCT) is recognized as the diagnostic gold standard for evaluating bony alterations of the TMJ, panoramic radiography remains widely utilized in clinical practice due to its accessibility and lower radiation exposure.

Material and methods: A retrospective observational pilot study was conducted at the Dental Clinic of the University Fernando Pessoa Canarias. A simple random sample of 60 panoramic radiographs from patients over 40 years of age was selected from a database comprising 323 records collected between April and October 2024. Bilateral assessment of the TMJs was performed by two independent observers according to established diagnostic criteria for degenerative alterations. Inter-observer agreement was measured using Cohen's Kappa statistics. Associations between degenerative and indeterminate findings and demographic variables were evaluated using the Chi-square (χ²) test. Descriptive statistics for age were reported as means and interquartile ranges.

Results: Among the 120 TMJs evaluated, osteophyte formation was the only degenerative finding detected (30%). Condylar flattening, considered an indeterminate sign, was observed in 85% of cases. Osteophytes were more frequently identified in males (33.33%); however, no statistically significant association was found between osteophyte presence and sex (p = 0.655). A significant association was observed between the presence of osteophytes and condylar flattening (χ² = 4.73, p = 0.030). Inter-observer agreement was moderate for degenerative signs (κ = 0.68) and minimal for indeterminate signs (κ = 0.37).

Conclusions: Osteophyte formation was the sole radiographic indicator of TMJ degeneration identified in this sample, frequently co-occurring with condylar flattening. Although panoramic radiography serves as a valuable screening modality, its diagnostic limitations underscore the need for CBCT in cases with suspected or advanced degenerative joint changes. Key words:Temporomandibular joint, Osteoarthritis, Degenerative joint disease, Panoramic radiography, Osteophyte.

Background: This study aimed to determine the prevalence of cervical and apical root resorption in maxillary central incisors of Peruvian adults without a history of orthodontic treatment, using cone beam computed tomography (CBCT).

Material and methods: This was an observational, descriptive, and cross-sectional study. The sample included 103 CBCT scans from adult individuals in a Peruvian population, comprising 71 women and 32 men (mean age: 34 ± 32 years). DICOM files were analyzed using RayScan Expert 3D software. The presence of cervical and apical root resorption in permanent maxillary central incisors was assessed by examining coronal, sagittal, and axial sections. Demographic characteristics were also recorded. Fisher's exact test and binary logistic regression were used to evaluate associations, with a significance level set at p > 0.05.

Results: The overall prevalence of root resorption was 5.8%, with cervical root resorption accounting for 1.0% and apical root resorption for 4.9%. No significant association was found between sex and the presence of root resorption (p = 0.173). Neither sex nor age had a direct influence on the occurrence of root resorption.

Conclusions: The prevalence of cervical and apical root resorption in maxillary central incisors of untreated Peruvian adults was low. Nevertheless, this condition should be considered by orthodontists during diagnosis and treatment planning. Key words:Cone-Beam Computed Tomography, Incisor, Root Resorption.

Background: The recent advent of universal resin cements provides clinicians with a versatile material that can function either as a self-adhesive or as an adhesive resin cement, depending on the specific clinical requirements. This investigation aimed to assess the shear bond strength of a contemporary self-adhesive universal resin cement (Panavia SA Cement Universal, Kuraray) when applied to enamel or dentin. For comparative analysis, its performance was benchmarked against an established control adhesive resin cement (NX3 Nexus, Kerr), both with and without the supplementary application of an adhesive bonding agent (Clearfil Universal Bond Quick, Kuraray).

Material and methods: Human molars were mounted using PVC pipes. Coronal tooth structure was removed to expose enamel or dentin. A bonding agent was applied to half of the specimens per cement and light cured. The specimens were placed in a jig and secured beneath a 2.4mm diameter mold. The resin cements were mixed according to the manufacturer's instructions, applied into the mold, and light cured (n=12). Prior to shear bond strength testing and failure mode analysis, all specimens underwent thermocycling. The resulting shear bond strength data for both enamel or dentin were statistically analyzed using one-way ANOVA and Tukey's post hoc tests (α=0.05).

Results: Our findings indicated that the universal resin cement's bond strength to enamel was not significantly influenced by the presence or absence of a bonding agent. Furthermore, its performance on enamel was comparable to that of the adhesive resin cement when a bonding agent was utilized. We observed a similar distribution of cohesive and mixed failures for the universal resin cement, regardless of whether a bonding agent was used, and for the adhesive resin cement combined with a bonding agent. Conversely, for dentin, the universal resin cement demonstrated significantly greater bond strength when a bonding agent was incorporated. However, even with a bonding agent, both universal resin cement applications (with and without bonding agent) yielded significantly lower bond strengths compared to the adhesive resin cement used with a bonding agent. Notably, a higher incidence of adhesive failures was recorded for both the adhesive and universal resin cements on dentin when no bonding agent was employed.

Conclusions: While the versatility of the novel universal resin cement (Panavia SA Cement Universal) allows for both adhesive and self-adhesive applications, our findings indicate that the adhesive resin cement (NX3 Nexus), when used with a bonding agent, consistently delivered the highest shear bond strength to dentin. However, its bond strength to enamel was comparable across the tested materials. Key words:Universal Resin Cement, Bonding Agent, Enamel, Dentin.

Background: This study aimed to evaluate the accuracy of guided endodontic access and fiberglass post removal, comparing stabilization methods such as metal sleeves and fixation pins.

Material and methods: Sixty-four extracted human teeth (32 mandibular molars and 32 single-rooted teeth) were divided into groups based on the use or non-use of fixation pins and metal sleeves. Precision was assessed using pre- and post-procedure CBCT scans to analyze deviations in bur positioning.

Results: For guided endodontic access, significant differences in angular deviation were found between the group using fixation and no sleeves (2.64°) and the group without fixation and sleeves (1.37°) (P<0.05). No other significant differences were found in either access or post removal procedures (P>0.05). Mean deviations in post removal ranged from 1.98° to 2.15°.

Conclusions: Guided endodontic techniques are highly reliable, with metal sleeves and fixation pins offering no significant improvement in precision. Key words:Guided Endodontics, Dental Post Removal, CBCT Analysis, Endodontic Guide Precision, Endodontic Access Deviation.

Background: The calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial odontogenic neoplasm. Some cases of CEOT may undergo malignant transformation, whose characteristics are still poorly known. This study aimed to perform a systematic review of CEOT cases with malignant transformation.

Material and methods: This systematic review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and was registered with PROSPERO (CRD42021285981). Searches for full-text articles on histopathologically confirmed CEOT cases with malignant transformation were performed in different databases (PubMed/ MEDLINE, Embase, Scopus, Web of Science, LILACS, SciELO, Google Scholar, Open Grey, and CAPES Dissertation and Thesis Catalog) without year of publication or language restrictions. A qualitative descriptive and risk of bias analysis were performed.

Results: Nine cases were included, with a mean age of 59.44 (±17.07) years and a slightly higher frequency in males (55.6%). The mandible (88.9%) was the most affected site, with predominance of the mixed imaging pattern (77.8%). Histopathologically, the clear cell variant, intense mitotic activity, presence of cellular atypia, and high Ki-67 immunoexpression were the predominant findings. Isolated surgery (44.4%) was the most common treatment and recurrence of CEOT before malignant transformation was observed in five cases (55.6%). CEOT with malignant transformation recurred in three cases (33.3%). Most cases had a positive outcome (77.8%), with remission of the disease.

Conclusions: This systematic review determined the clinicopathological profile of histopathologically confirmed cases of CEOT with malignant transformation and synthesized some characteristics that can assist in the diagnosis and appropriate therapeutic approach of this rare neoplasm. Key words:Systematic review, Odontogenic tumors, Clinicopathologic features, Treatment, Prognosis.

Background: The regeneration of the dentin-pulp complex represents a pivotal challenge in endodontics, requiring a delicate balance between microbial eradication and tissue repair. This scoping review, conducted in accordance with PRISMA-ScR guidelines, synthesizes current evidence on microbiological and pharmacological factors influencing regenerative outcomes.

Material and methods: A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library identified 242 studies, with 15 meeting inclusion criteria after screening.

Results: The review highlights the dominance of anaerobic biofilm-forming pathogens (Enterococcus faecalis, Porphyromonas gingivalis ) in periapical lesions, their virulence mechanisms (e.g., proteolytic enzymes, immune evasion), and the rising threat of antibiotic resistance driven by β-lactamases and efflux pumps. Pharmacologically, while triple/double antibiotic pastes promote dentin thickening, their cytotoxicity at high concentrations and disruption of commensal microbiota underscore the need for optimized dosing. Emerging alternatives-such as antimicrobial peptides, calcium hypochlorite, and immunomodulatory biomolecules-demonstrate superior biocompatibility and dual action against pathogens while supporting stem cell viability.

Conclusions: Future directions emphasize microbiome-targeted therapies, advanced biomaterials, and personalized approaches leveraging metagenomics. This review underscores the imperative to integrate selective antimicrobial strategies with regenerative biology to advance endodontic outcomes. Key words:Dentin-pulp regeneration, endodontic infections, biofilm, antimicrobial resistance, regenerative endodontics.

Background: We conducted a clinical trial using a modified split-mouth, double-blind, randomized approach to clinically assess template-assisted monochromatic structural colored versus universal multishade direct composite veneers over a 36-month period.Materials and Methods: A total of 88 direct composite veneers from 20 participants were included per the inclusion criteria. Each patient received at least one pair of the two types of direct veneers in two equal groups (n = 44): (group I): monochromatic structural colored veneer (OMNICHROMA) with palfique adhesive and (group II): universal multishade veneer (Ceram.x spectra) with Prime & Bond adhesive using U-veneer templates. Window-type veneer preparations were performed on the labial surface of anterior teeth (depth: 0.3-0.5 mm). Clinical assessment was conducted per modified United States Public Health Service (USPHS) criteria. The marginal integrity criterion was evaluated by scanning electron microscopy of an inverse replica of 32 randomly selected veneer restorations.

Results: The Friedman and Wilcoxon signed-rank tests revealed significant differences between group I and group II in marginal adaptation, marginal discoloration, surface texture, and color match (p <0.05). However, there no significant differences in fracture type or anatomical form existed between the two groups (p >0.05). The Mann‒Whitney U test indicated no significant differences between the groups across USPHS criteria (p >0.05). No secondary caries or hypersensitivity cases were reported during any evaluation period. The unpaired t test revealed no significant difference in the mean gap width between the two groups (p = 0.218 and 0.236, respectively). Spearman's correlation test, conducted on the related criteria in groups I and II after 12, 18, and 36 months of follow-up, revealed a positive relationship between the evaluated criteria.

Conclusions: Monochromatic structurally colored and universal multishade direct composite resin veneers demonstrated comparable satisfactory clinical performance by the end of the study period. Key words:Composite, Monochromatic, Multishade, Veneers, USPHS criteria.

Background: The objective of this study was to assess the push-out bond strength (PBS) of conventional prefabricated, universal 2-piece, and CAD/CAM-milled fiber posts cemented in root canals using a self-adhesive resin cement, as well as the Vickers microhardness (VHN) of the resin cement.

Material and methods: Thirty human uniradicular premolars roots were endodontically treated and divided into three groups (n = 10): conventional prefabricated fiber posts (PFPs), universal fiber posts (UFPs), and CAD/CAM-milled fiber posts (MFPs). After luting procedures using RelyX U200 (Solventum), six specimens were obtained of each root (two slices from each root third: cervical, middle, and apical). The first slices of each root region were subjected to PBS, and the second slices were subjected to VHN analysis. Data from the PBS and VHN tests were analyzed using two-way analysis of variance (ANOVA; post type vs. root region) and Tukey's test (α = 0.05).

Results: Regarding the PBS, MFPs and UFPs demonstrated statistically superior performance than PFPs (p < 0.001). Among the root regions, the cervical third exhibited the highest values, whereas the apical third showed the lowest (p < 0.001). Regarding VHN, PFPs and UFPs exhibited statistically superior values compared with MFPs (p < 0.001). The cervical third of the root displayed the highest VHN values, whereas the apical third presented the lowest (p < 0.001).

Conclusions: CAD/CAM-milled and universal 2-piece fiber posts may be a better alternative for restoring widened root canals. Key words:Resin Cements, CAD-CAM, Post and Core Technique, Hardness Tests, Root Canal Preparation.