Journal of Contemporary Dental Practice最新文献

Aim: To compare fracture resistance (FR) of IPS e.max computer-aided design (CAD) and press endocrowns with different preparation depths (2 and 5 mm) and crowns retained by post and core.

Materials and methods: Thirty-six intact maxillary central incisors were utilized. Teeth were categorized into two primary groups (n = 18) according to the material fabrication technique; A: Computer-aided design/computer-aided manufacturing (CAD/CAM) technique and, B: Pressing technique, with each group then separated into three subgroups (n = 6); S1: Crown supported by post and core, S2: Long endocrown with a depth of 5 mm, and S3: Short endocrown with a depth of 2 mm. Restorations were luted using resin cement and subjected to thermocycling (5,000 cycles), followed by FR test. Data were gathered and subjected to statistical analysis utilizing a two-way analysis of variance test.

Results: Results indicated that IPS e.max CAD exhibits superior FR than IPS e.max press across all configurations. The FR variations among designs for each material individually indicated that, within the CAD group, FR increased gradually from S1 to S3 (S1: 473.8 ± 22 ≤ S2: 608.6 ± 38.7 ≤ S3: 713.3 ± 22.5). In the press group, a notable disparity was observed, however with a distinct pattern: S1 (418.9 ± 5.6) exhibited lesser FR than both S2 and S3 (437 ± 5.7 ≤ 477.1 ± 28.1, respectively).

Conclusion: All groups showed clinically accepted FR results. Restorations fabricated by CAD/CAM technique showed a higher FR than those fabricated by pressing technique. Endocrowns showed a higher FR than full-coverage crowns held by post and core.

Clinical significance: For clinicians, using IPS e.max CAD anterior endocrowns with short depth (2 mm) could present a practical treatment modality to the traditional crowns held by post and core for restoration of endodontically treated maxillary central incisors. How to cite this article: Ahmed DH, Amgad SW, Bakry AM. Effect of Preparation Depth on Fracture Resistance of Anterior Teeth Restored by Endocrowns and Post-retained Crowns - In Vitro Study. J Contemp Dent Pract 2025;26(5):504-511.

Background: The current investigation aimed to assess oral implant stability with/without platelet-rich fibrin (PRF) using resonance frequency analysis (RFA).

Materials and methods: A total of 40 patients, aged 25-55 years, were chosen and their eligibility was examined. There were two groups with 20 patients in each group, Group A: Implant with PRF placement and group B: Implant without PRF placement. Thirty minutes before surgery, the test group's PRF preparation started. After blood collection, for 10 minutes, the tube was centrifuged at 400g at 3,000 revolutions per minute. The PRF was separated and placed in the surgical site for the test group. The implant shoulder up to the interproximal alveolar bone crest served as the reference point. The distance between the implant shoulder and the first visible bone-implant contact was measured using radiography in millimeters to assess the mean marginal bone level changes. All data was collected at baseline, three months, and six months. The stability of the implant was evaluated using RFA. Data was collected and statistically analyzed.

Results: In an implant with PRF group mean marginal bone level was 12.88 ± 0.28 at baseline, reduced to 9.42 ± 0.12 at 3 months and 8.74 ± 0.06 at the sixth month. In an implant without PRF group mean marginal bone level was 13.02 ± 0.09 at baseline, reduced to 10.96 ± 0.18 at 3 months and 9.44 ± 0.04 at the sixth month. A statistical difference was found within both groups. The mean difference in implant stability was 88.6 ± 1.58 in the implant with PRF group and 72.8 ± 1.20 in the implant without PRF at the end of the sixth month. A statistically significant difference between the groups was noticed.

Conclusion: In conclusion, the current study showed that the use of PRF during implant surgery improved implant stability compared to the group without PRF.

Clinical significance: Clinicians and academics have shifted their focus to making treatment quicker and more comfortable for patients due to the rising success rates of dental implants. A natural concentration of autologous growth factors may be obtained by the preparation of PRF, a straightforward, inexpensive, and minimally invasive technique that is often utilized in several medical specialties to speed up the healing of both soft and hard tissues. How to cite this article: Jalaluddin M, Ramanna PK, Jasthi VC, et al. Comparative Assessment of the Oral Implant Stability with/without Platelet-rich Fibrin: An In Vivo Study. J Contemp Dent Pract 2025;26(5):500-503.

Aim: The present study evaluates the marginal adaptation, shade matching, and patient satisfaction of polychromatic feldspathic porcelain laminate veneers compared to hybrid ceramic multicolor laminate veneers.

Materials and methods: A total of 26 patients required one side veneer to restore discolored, fractured, or maligned anterior teeth. Patients were divided into two groups according to the type of restoration used. The Comparator group included patients receiving multicolor feldspathic (TriLuxe forte) laminate veneers Intervention group included patients receiving Multicolor hybrid ceramic laminate veneers (multicolored Vita Enamic). After final cementation, Marginal Adaptation, Shade matching, and Patient satisfaction were evaluated according to the modified USPHS criteria, after 3-, 6-, and 12-month follow-up intervals.

Results: Marginal adaptation and patient satisfaction showed a statistically insignificant difference (p > 0.05) between both tested groups at all intervals, whereas, color stability had a statistically insignificant difference (p > 0.05) between both tested at T0 and T1, but there was a statistically significant difference (p-value 0.05) between both tested groups at T1 and T2; however, that difference was clinically insignificant. Both groups showed acceptable marginal adaptation, suitable color matching, and color stability with high patient satisfaction.

Conclusion: After 1-year of follow-up, TriLuxe forte and multicolored Vita Enamic laminate veneers showed successful marginal adaptation, shade matching, and patient satisfaction. This indicates that both materials can be recommended to be used as anterior single or multiple veneer restorations in clinical situations for optimum esthetic outcome. How to cite this article: Naji KF, Al Ansary HE, Elnaggar GAE, et al. Marginal Adaptation, Shade Matching, and Patient Satisfaction of Polychromatic Feldspathic Porcelain vs Polychromatic Hybrid Ceramic Laminate Veneers. J Contemp Dent Pract 2025;26(5):433-447.

Aim: To assess the effect of marginal elevation in endodontically treated teeth repaired with CAD/CAM ceramic endocrowns on marginal adaptation.

Materials and methods: 20 sound mandibular first molars were treated endodontically and prepared for endocrowns with a butt-joint occlusal edge and mesial proximal box. They were divided into two groups (n = 10 each) based on ceramic type: Group H (hybrid ceramic) and group L [lithium disilicate ceramics (LDS) ceramic]. Each group was further divided into subgroups E (with marginal elevation) and N (without marginal elevation), with 5 specimens each. The endocrowns were cemented using dual-cured self-adhesive resin cement and exposed to 5000 thermal aging cycles (5-55°C). Marginal adaptation was evaluated using a stereo microscope at five mesial margin locations, and the mean gap measurement was calculated.

Results: The lowest marginal gap measurements were recorded by hybrid ceramic (Grandio) with deep marginal elevation (23.25 µm), which is significantly lower than all tested subgroups (p < 0.001). The highest marginal gap measurement was recorded by LDS (IPS e.max) CAD without deep marginal elevation (57.62 µm), which is significantly higher than all tested sub-groups.

Conclusion: Compared to LDS IPS e.max, hybrid ceramics with and without marginal elevation exhibit superior marginal adaptation.

Clinical significance: Marginal adaptation of endocrowns is critical for proper seal, preventing micro leakage and secondary caries, thus enhancing restoration longevity and patient outcomes for severely damaged teeth. How to cite this article: Ahmed OS, Amgad SW, Bakery AM. Impact of Marginal Elevation in Restored Endodontically Treated Teeth with CAD/CAM Ceramic Endocrowns on the Marginal Adaptation (In Vitro). J Contemp Dent Pract 2025;26(5):473-480.

Aim: This clinical case report describes the multidisciplinary treatment workflow for a complex rehabilitation case to correct skeletal class II malocclusion, bilateral congenitally missing premolars, and improve the esthetic smile in tetracycline-stained teeth.

Background: The anterior esthetic zone plays a crucial role in the overall appearance of a patient's smile. Tooth discoloration and congenitally missing premolars are frequently reported in young adults, affecting both esthetics and function. The tetracycline-stained teeth and visible absence of premolars can impact a patient's self-esteem by creating noticeable gaps in the smile. Missing premolars may also cause the remaining teeth to shift, impair the ability to chew effectively, which may lead to uneven wear or malocclusion. Treatment options require a multidisciplinary approach involving an orthodontist, an oral surgeon, and a prosthodontist.

Case description: A 34-year-old female presented to a private hospital with complaints of chewing difficulties due to bilateral congenitally missing premolars and was unsatisfied with her smile due to tetracycline-stained teeth. She had a history of taking tetracycline for respiratory infections over the past 30 years. This clinical case report describes the treatment workflow for this complex rehabilitation case, utilizing digital planning to correct skeletal class II malocclusion and create sufficient restorative space for the missing premolars (teeth 12, 13, 20, and 29 according to the universal numbering system) to allow for implant placement with clear aligners. The esthetic smile was enhanced using CAD/CAM technology to fabricate final lithium disilicate restorations. Follow-up over 18 months confirmed the success of the treatment, with the patient expressing satisfaction with both the functional and esthetic outcomes.

Conclusion: A multidisciplinary management for the treatment of a complex rehabilitation case involving orthodontic treatment before implant placement and subsequent restorative intervention resulted in predictable outcomes with minimal tooth reduction. This technique provided functional stability, improved esthetics, and increased patient satisfaction.

Clinical significance: With careful planning and precise execution, the gradual incorporation of digitally guided orthodontic-restorative planning, in conjunction with CAD/CAM technology, can simplify the treatment workflow, leading to accuracy and predictability in complex rehabilitation cases. How to cite this article: Tapananon A, Kamolroongwarakul P, Buranaprasertsuk P. Minimally Invasive Multidisciplinary Management of Tetracycline-stained and Congenitally Missing Teeth. J Contemp Dent Pract 2025;26(5):512-518.

Aim: To evaluate the effect of addition of 10% v/v and 20% v/v chitosan (CH), a biopolymer, into FUJI IX glass ionomer cement (GIC) on its compressive strength (CS), diametral tensile strength (DTS), and fluoride release (FR) at both 24 hours and 7 days after preparation of the cement mix.

Materials and methods: A total of 60 disc-shaped samples with dimensions 6 mm length and 4 mm diameter for CS (n = 30) evaluation and 3 mm height and 6 mm diameter for DTS (n = 30) evaluation were prepared using Teflon molds. All the samples were divided into three groups, group I: Consisting of FUJI IX GIC (n = 20.), i.e., control; group II: Consisting of 10% v/v CH GIC (n = 20), and group III: Consisting of 20% v/v CH GIC (n = 20). The concentration of cumulative fluoride ion released was determined as function of time using a fluoride ion-selective electrode (ORION) at 24 hours and 7 days. Analysis of variance (ANOVA) and the unpaired "t"-test were used to the mean values, and then, at a significance threshold of 5%, Tukey's honestly significant difference post-hoc analysis was performed.

Results: The highest CS was shown by group II, which being 178.14 ± 4.32 followed by group III with a mean of 154.26 ± 1.86 and 148.16 ± 2.95 for group I. The maximum mean value for DTS was shown by group II, i.e., 16.40 ± 2.29, followed by group III which showed 14.35 ± 1.69, and the least mean value was shown by group I, i.e., 9.12 ± 0.81. Group II showed the highest concentration of release of fluoride at both 24 hours and the 7th day of testing, with the values being 13.09 and 40.59 ppm, respectively. This was followed by group III which showed an FR of 10.61 and 31.13 ppm.

Conclusion: On conclusion, it is proven that 10% v/v CH GIC significantly enhanced the CS, DTS, and FR compared with 20% v/v CH GIC and FUJI IX GIC.

Clinical significance: The condensable GICs, which were created for atraumatic restorative treatment, need more advancement in their mechanical and anticariogenic qualities since they have greater occlusal wear rate and lower fracture strength and antibacterial qualities than other restorative materials. Bioadhesive CH-fluoride microparticles aid in enhanced fluoride availability and absorption, giving protection against caries. How to cite this article: Thenumkal E, Sahoo N, Chopra S, et al. Evaluation of the Mechanical Properties and Fluoride Release Profiles of a GIC and Chitosan-modified GIC. J Contemp Dent Pract 2025;26(5):468-472.

Aim: To evaluate and compare the gingival and periodontal health status in patients after using Matcha mouthrinse and 2% chlorhexidine (CHX) gluconate mouthwash and also evaluate the efficacy of Matcha extract on Porphyromonas gingivalis (P. gingivalis) and Streptococcus mutans (S. mutans).

Material and methodology: It is a randomized clinical trial study with 32 adult patients having mild-to-moderate gingivitis and periodontitis. They were divided into two groups, each with 16 patients. Group A was given Matcha extract, and group B was given 2% CHX gluconate. All participants were brought to baseline by oral prophylaxis. They were asked to use their particular group mouth rinse for rinsing twice a day for 1 minute. Indices were taken at baseline, 7, 14, and 28 days. Minimal inhibitory concentration (MIC) was checked for Matcha extract on both P. gingivalis and S. mutans bacteria, and gingival crevicular fluid (GCF) was taken at baseline and after 28 days to check colony-forming units (CFUs) of the samples.

Results: Matcha mouthrinse significantly reduced the inflammatory condition of gingivitis and periodontitis (p < 0.05) and is comparable with 2% CHX gluconate. In vitro evaluation of Matcha extract at various concentrations of MIC shows its effectiveness on P. gingivalis and S. mutans.

Conclusion: To conclude, Matcha mouthrinse may be recommended as an alternative mouthrinse for improving oral health status.

Clinical significance: The findings of this study suggest that Matcha mouthrinse, a natural and antioxidant-rich alternative, is effective in reducing gingival and periodontal inflammation, with outcomes comparable to the gold standard 2% CHX gluconate. Additionally, Matcha extract demonstrated antibacterial efficacy against key periodontal pathogens P. gingivalis and S. mutans. This highlights its potential as a safer, herbal-based adjunct in periodontal therapy, especially for patients seeking non-chemical or side-effect-free options for maintaining oral hygiene and preventing disease progression. How to cite this article: Gadekar AV, Dodamani AS, Vishwakarma PK, et al. Comparative Evaluation of Herbal Matcha Extract and 2% Chlorhexidine Gluconate on Periodontal Health Status: A Clinico-microbiological Study. J Contemp Dent Pract 2025;26(5):488-492.

Aim: The objective of the present study was to evaluate the dimensions of the superior, anterior, and posterior joint spaces of the temporomandibular joint (TMJ) of Ecuadorian skeletal class I and II individuals without clinical signs of joint dysfunction on cone-beam computed tomography (CBCT), using a reformatting tool and cubic interpolation of images to reduce the size of the tomography voxel.

Materials and methods: Forty-eight CBCT of TMJ of individuals of both sexes with no backgrounds of joint disorders were divided into two groups according to skeletal class: class I group consisting of 48 tomographic images of joints of 24 individuals with an A-point-nasion-B-point (ANB) angle (2 ± 2°), and class II group consisting of 48 tomographic images of joints of 24 individuals, with a Steiner ANB angle of more than 4°, were evaluated. The anterior joint space (AS), superior joint space (SS) and posterior joint spaces (PS) were measured by adapting the method used in a previous study. A t-student test and multiple regression analysis were applied.

Results: The comparison of joint spaces between groups only showed significant differences in the superior posterior joint space (SS) between skeletal class I and class II (p = 0.038). Multiple linear regression showed the influence of sex on the superior joint space (SS): in women the superior joint space is 0.039 mm shorter than in men.

Conclusions: There is a significant difference in posterior joint space between skeletal class I and class II, and females tend to have a shorter superior joint space than males. These considerations could have an impact on clinical activity. Additionally, the voxel size reduction tool of a CBCT could be a good resource for future research where high precision measurements on computed tomography scans are required.

Clinical significance: Identifying the condyle position in individuals with skeletal class II characteristics is crucial, as well as comparing it with class I individuals from the same and other populations. How to cite this article: Santillan-Rivera FJ, Arriola-Guillén LE, Vaca-Zapata ME, et al. Temporomandibular Joint Space in Skeletal Malocclusion Class II Ecuadorians: A Cone-beam Computed Tomography Study Using Image Reformatting and Interpolation. J Contemp Dent Pract 2025;26(5):448-452.

Aim: This study compared the shade matching, color difference, and patient satisfaction of lithium disilicate (IPS e.max CAD) and the new gradient technology zirconia (5Y-TZP3Y-TZP) (IPS e.max ZirCAD Prime) crowns in the esthetic zone.

Materials and methods: A total of 24 ceramic crowns were divided into two groups (n = 12), and patients were allocated randomly into group E (IPS e.max CAD) and group Z (IPS e.max ZirCAD Prime). After final cementation, shade matching to the reference tooth was evaluated by three experienced evaluators using Modified United States Public Health Service criteria. The color difference ΔE was measured using intraoral spectrophotometer and evaluated for each group. Patient satisfaction of the two groups was assessed using the visual analog scale. The follow-up was at 3, 6, 9, and 12 months.

Results: There was no statistically significant difference between group E and group Z (p-value = 1, effect size = 1.316) concerning the shade matching. There was no change by time in scores in each group. Color difference: IPS e.max CAD showed statistically significantly higher ΔE than IPS e.max ZirCAD Prime. Regarding each material, there was no statistically significant change in ΔE at different periods. There was no statistically significant difference concerning patient satisfaction between group E and group Z (p-value = 0.432, effect size = 0.298). There was no change by time in scores in each group.

Conclusions: Within the limitations of this study, both IPS e.max CAD and IPS e.max ZirCAD Prime crowns provide satisfactory esthetic outcomes. However, ZirCAD Prime exhibited a superior ability to replicate natural tooth shades.

Clinical significance: Shade matching is a critical skill for dental clinicians, playing an important role in achieving optimal esthetic outcomes and patient satisfaction. Accurate color selection ensures that restorations seamlessly blend with natural teeth, maintaining a harmonious smile. Precise shade matching contributes significantly to patient satisfaction by meeting their esthetic expectations and boosting their confidence. How to cite this article: Eid NK, Sherif RM, Rabie KA. Clinical Evaluation of Shade Matching and Patient Satisfaction of Gradient Zirconia vs Lithium Disilicate Crowns in the Esthetic Zone: Randomized Clinical Trial. J Contemp Dent Pract 2025;26(5):481-487.

Aim: To evaluate and compare the salivary pH and oral clearance rate following the use of four different commercially available antitussive lozenges, in order to assess their potential impact on oral health.

Materials and methodology: A total of 40 healthy young adults were randomly divided into four groups (n = 10 each): Group I - Strepsils, group II - Koflet, group III - TusQ, and group IV - Vicks. Baseline unstimulated saliva samples were collected 1 hour after breakfast. After lozenge consumption, stimulated saliva samples were collected at 5-minute intervals up to 30 minutes. Salivary pH was measured using a calibrated digital pH meter. Oral clearance time was determined based on the time required for the salivary pH to return to baseline. Data were recorded and statistically analyzed.

Results: All groups showed a salivary pH drop after lozenge use, with TusQ having the largest drop (3.73) and Koflet the smallest (5.74) at 5 minutes. pH levels gradually increased, with no significant differences between groups by 30 minutes. Koflet maintained higher pH at most times, while Strepsils had higher pH than TusQ at 10 and 15 minutes. Oral clearance time was shortest for Koflet (12.7 ± 2.34 minutes) and longest for Vicks (19.4 ± 2.67 minutes), with Koflet significantly different from the others.

Conclusion: The study concluded that different commercially available antitussive lozenges significantly influenced salivary pH and oral clearance time, highlighting their varying potential to impact oral health. Products with lower pH and prolonged clearance times may pose a higher risk for enamel erosion and caries, emphasizing the need for careful consideration when using such lozenges frequently.

Clinical significance: This study highlights the significance of evaluating the erosive potential and oral clearance time of commonly used over-the-counter lozenges. Lozenges with low pH, high acidity, and extended oral retention can increase the risk of dental erosion and caries, particularly in vulnerable populations. The findings emphasize the need for dental professionals to advise patients on safer alternatives and urge manufacturers to create more tooth-friendly products. How to cite this article: Wankhede SD, Vishwakarma PK, Dodamani AS, et al. pH Modulation and Salivary Clearance Rate of Different Antitussive Lozenges in Adults: A Randomized Clinical Trial. J Contemp Dent Pract 2025;26(5):458-461.