Journal of Contemporary Dental Practice最新文献

Aim: This study aimed to assess the effects of blood and saliva contamination on tensile bond strength (TBS) of two cements used for cementation of stainless-steel crowns (SSCs) of primary molar teeth.

Materials and methods: This in vitro, experimental study was conducted on 60 extracted primary mandibular first molars that received SSC preparation. After selection of appropriately sized SSCs, a piece of metal wire was soldered to their mesial and distal surfaces to create a handle for TBS testing. The teeth were then randomly divided into two groups (n = 30) for cementation with glass ionomer cement (GIC) and zinc polycarboxylate (ZPC) cement, each with three subgroups (n = 10) of saliva contamination, blood contamination, and no contamination (control). After cementation and incubation at 37°C for 24 hours, the TBS was measured in a universal testing machine. The groups were compared by two-way ANOVA and Tukey's test (alpha = 0.05).

Results: A significant difference existed in the mean TBS among the three contamination groups (p < 0.05). The mean TBS of the blood group was significantly lower than that of the control group (p < 0.05). Other differences were not significant (p > 0.05). Cement type had no significant effect on TBS (p > 0.05).

Conclusion: Blood contamination significantly decreased the TBS of both GIC and ZPC used for cementation of SSCs of primary mandibular molars. Cement type had no significant effect on TBS.

Clinical significance: Glass ionomer cement and ZPC have various applications in cementing stainless steel crowns. Since there is a possibility of bleeding from the gums during crown preparation and in situations where the child does not cooperate adequately, achieving isolation becomes challenging. Therefore, the effect of blood and saliva contamination on the bond strength of the cements is of great importance. How to cite this article: Taravati S, Basir L, Khoshnevisan M. Effects of Blood and Saliva Contamination on Tensile Bond Strength of Two Cements Used for Cementation of Stainless-steel Crowns of Primary Molar Teeth. J Contemp Dent Pract 2025;26(6):592-597.

Aim: This study aimed to assess oral hygiene practices, dental conditions, and access to dental care among children with autism spectrum disorder (ASD) in Tunisia.

Materials and methods: This descriptive cross-sectional study included 48 children diagnosed with ASD. Data were obtained through a structured questionnaire completed by caregivers and a clinical oral examination. The questionnaire comprised 25 items divided into three domains: (1) Knowledge (awareness of oral hygiene importance, fluoride use, recognition of dental caries, and regular dental checkups); (2) Attitude (motivation for oral care, caregiver perception of dental visits, and beliefs about prevention); (3) Practices (tooth brushing frequency, technique, use of toothpaste, dental attendance, and dietary habits). The clinical examination assessed oral hygiene status, presence of untreated caries, gingival condition, and parafunctional oral habits. Descriptive statistics were used to analyze the data.

Results: Of the 48 children included in the study, 23% (n = 11) were classified at the severe end of the autism spectrum, while the remaining 77% (n = 37) presented with mild to moderate forms of ASD. Poor oral hygiene was observed in 46.6% (n = 14) of the children, untreated dental caries were present in 36.6% (n = 11), and 60% (n = 18) had never visited a dentist. Additionally, 33.3% (n = 10) of the children did not brush their teeth regularly. The presence of gingival inflammation and parafunctional habits was also noted but varied across severity levels of ASD.

Conclusion: The study reveals considerable challenges regarding oral hygiene behaviors, dental health status, and access to dental care among children with ASD in Tunisia. These findings underscore the necessity for targeted oral health education programs and enhanced caregiver involvement to improve oral health outcomes in this population.

Clinical significance: A better understanding of the specific oral health needs of children with ASD is essential for tailoring dental care protocols. Focused caregiver training and adapted dental approaches are recommended to promote improved oral hygiene practices and overall oral health in children with ASD. How to cite this article: Ben Hadj Khalfa A, Boukhris H, Ayari G, et al. Oral Health Challenges and Hygiene Practices in Children with Autism Spectrum Disorder: A Cross-sectional Study from Tunisia. J Contemp Dent Pract 2025;26(6):581-586.

Aim: To assess the accuracy of facebow transfer in three articulators facebow systems by comparing the occlusal plane orientation of the mounted maxillary cast with lateral cephalograms.

Materials and methods: Thirty dentate individuals were selected. For all the subjects, cephalograms were done and maxillary impressions were made. The casts obtained were oriented on three semi-adjustable articulator - facebow systems: Hanau Wide Vue, Corident CSA 400, and Bioart 4000-S. Mean angles of the occlusal plane inclination from the horizontal reference plane were obtained for all three systems and the cephalograms. The data were tabulated and statistically analyzed.

Results: It was found that the mean occlusal plane inclination for lateral cephalogram, Hanau Wide Vue, Bioart 4000-S, and Corident CSA 400 was 8.40, 8.23, 12.33, and 10.87. Thus, the observed occlusal plane inclination was most accurate for Hanau Wide Vue, followed by the Corident CSA 400 articulator.

Conclusion: This in vivo study provides evidence supporting the superior accuracy of Hanau Wide Vue when compared to the Corident CSA 400 and Bioart 4000-S articulator in transferring the occlusal plane inclination.

Clinical significance: Accurate transfer of the occlusal plane to the articulator is critical for obtaining stability, normal function, and esthetics in dental prosthetics. The occlusal plane inclination directly impacts the smile line of the prosthesis, stability, and phonetics. Correct occlusal plane is vital for harmonious function of cheek, tongue, and muscles, which ensures denture stability and efficient mastication. How to cite this article: Shrivastava SP, Sinha N, Singh S, et al. Evaluating the Accuracy of Maxillary Occlusal Plane Transfer by Using Three Semi-adjustable Articulator - Facebow Systems: An In Vivo Study. J Contemp Dent Pract 2025;26(6):587-591.

Aim: This in vitro study aims to evaluate fracture strength and fractographic analysis of implant crown fabricated as monolithic cement-retained (MCV), monolithic screw retrievable-cement retained (MSV), and bilayer system monolithic (BSV), all bonded to Ti-base abutment.

Materials and methods: A total of 30 specimens were included, with sample size calculated based on an alpha level of 0.05 and statistical power of 80%. The specimens were equally distributed into three groups: control (MCV, n = 10) and test groups (MSV, n = 10, and BSV, n = 10). All specimens underwent thermal aging and were subjected to fracture strength testing. Data normality was assessed using the Shapiro-Wilk test. As the data were not normally distributed, group comparisons were analyzed using the Kruskal-Walli's test. Post-hoc pairwise comparisons (MCV vs MSV, MCV vs BSV, and MSV vs BSV) were performed using the Mann-Whitney U-test with Bonferroni correction. Fracture modes were further analyzed by scanning electron microscopy (SEM) and categorized based on the percentage of remaining crown material.

Results: The MCV crowns demonstrated the highest fracture strength (2955.84 ± 310.93 N), followed by MSV (2846.11 ± 370.59 N) and BSV (1994.70 ± 95.44 N). Statistically significant differences in fracture strength were observed among the groups (p < 0.001). Post-hoc analysis showed that BSV had significantly lower fracture resistance than both MCV and MSV (p < 0.001), while no significant difference was found between MCV and MSV (p = 1.000). Regarding fracture mode, half of MCV specimens had >75% crown remaining, BSV exhibited 50-75% remaining, and MSV had <50% remaining. The SEM analysis revealed catastrophic fracture patterns for both MCV and MSV, whereas BSV exhibited complex failure patterns.

Conclusion: Implant crown design significantly impacts fracture resistance and failure modes. The MCV crowns exhibited superior strength, whereas BSV crowns, despite lower fracture strength, maintained intact zirconia abutment, offering repairability of the superstructure.

Clinical significance: Monolithic cemented crowns may be preferred in high-load areas for their superior strength, while bilayer designs with intact zirconia abutments offer retrievability and repair potential, making them suitable for lower-load regions. How to cite this article: Affendi NHK, Hakim AYA, Ahmad R, et al. The Effect of Crown Design on Fracture Strength and Mode of Implant-supported Molar Crown Bonded to Titanium-based Abutment. J Contemp Dent Pract 2025;26(6):565-672.

Aim: The aim of the current investigation was to assess the shear bond strength of two distinct intraoral porcelain repair systems in porcelain fused to metal restoration.

Materials and methods: The nickel-chrome metal alloy was used to prepare 60 samples, each measuring 10 mm in diameter and 3 mm in thickness. And a layer of feldspathic porcelain, 1.8 mm thick, was placed on top of the metal disc. All 60 samples were randomly divided into two intraoral porcelain repair systems (30 samples in each group) as follows: Group A: Samples treated with the ceramic repair system; group B: Samples treated with Clearfil porcelain repair system. All samples were stored for 24 hours at 37°C prior to the thermal cycle procedure. The samples underwent 1,000 cycles of 30 second intervals of thermal cycling at 5-55°C. A universal test machine was used to determine the shear bond strength after the aging processes. Data was recorded and statistically analyzed.

Results: The maximum shear bond strength was found in the Clearfil porcelain repair system (34.12 ± 1.88) followed by the ceramic repair system group (30.82 ± 2.36). A significant difference was found between the ceramic repair system and Clearfil porcelain repair system groups.

Conclusion: On conclusion, the shear bond strength of the Clearfil porcelain repair system group showed the highest shear bond strength mean value as compared to Ceramic repair system group.

Clinical significance: Metal ceramic restorative fractures can be fixed intraorally in order to avoid the need for a remake. A rapid, easy, and very patient-acceptable technique, the intraoral chairside porcelain repair method doesn't need removing the restoration or creating a new one. There are so many different ceramic repair materials available, but the most crucial factor in determining how well the repair systems will work is the bond strength. How to cite this article: Liya NB, Kumar H, Chakraborty S, et al. Assessment of the Shear Bond Strength of Two Different Intraoral Porcelain Repair Systems in Porcelain Fused to Metal Restoration. J Contemp Dent Pract 2025;26(6):561-564.

Aim: This retrospective study was designed to investigate the 12-month clinical performance of zirconia-lithium disilicate crowns among Yemenis using the modified United States Public Health Service (USPHS) criteria and patient satisfaction via the visual analog scale (VAS). Participants and methodology: This retrospective clinical study analyzed data from eight Yemeni patients who received a total of 103 single full-coverage crowns. All crowns had a zirconia core veneered with lithium disilicate. The crowns were fabricated using CAD/CAM technology and placed on anterior and posterior teeth in both the maxillary and mandibular arches. United States Public Health Service (USPHS) criteria were utilized to assess parameters such as marginal adaptation, color match, and retention. Meanwhile, VAS was used to measure patient satisfaction. Clinical evaluations were recorded at baseline (within one-week post-cementation), 3-, 9-, and 12-month post-cementation. Following data collection, the data were analyzed using the Statistical Package for Social Sciences with Chi-square and McNemar tests.

Results: The survival and success rates were 100% and 97.1%, respectively. Significant degradation occurred in marginal adaptation (11.6% Bravo scores at 12 months) and color match (14.6% Bravo), particularly in posterior teeth and left-side restorations. Non-vital abutments had higher failure, with 2.9% Charlie/Delta scores. Patient satisfaction remained high, with mostly "very satisfied" scores. However, the marginal and color scores declined slightly. Moreover, khat chewing correlated with color changes but lacked statistical significance.

Conclusion: The findings of this study highlight that zirconia cores veneered with lithium demonstrated excellent retention and biological performance. However, they exhibited gradual degradation in marginal adaptation, restoration integrity, and color match.

Clinical significance: Clinicians are advised to weigh the esthetic and durable benefits of zirconia-lithium disilicate crowns against potential marginal degradation and discoloration in patients with high occlusal stress or social habits such as khat chewing. How to cite this article: Al-Hamzi MA, Al-Badani ITH, Al Kbous EHM, et al. Twelve-month Clinical Outcomes of Zirconia Cores Veneered with Lithium Disilicate Crowns: A Retrospective Study. J Contemp Dent Pract 2025;26(6):540-550.

Aim: This randomized controlled trial (RCT) aimed to evaluate the patient-reported outcome measures (PROMs) when treated with the bone-anchored intermaxillary traction (BAIMT) associated with rapid maxillary expansion (RME) and the removable mandibular retractor (RMR) associated with slow maxillary expansion (SME).

Materials and methods: This was a single-center 2-arm RCT accomplished between September 2021 and September 2023 involving patients aged between 12 and 15 years and diagnosed with skeletal class III (SCIII) and maxillary constriction. The patients were randomly divided into the BAIMT/RME group and the RMR/SME group. The levels of pain, discomfort, and functional impairment were evaluated by a standardized questionnaire at five assessment times: (T1) after a day, (T2) after a week (T3) after 4 weeks, (T4) after 3 months, and (T5) after 6 months following treatment onset.

Results: Twenty-four patients (13 males and 11 females) were included without any dropouts. No statistically significant differences were found between both groups in any of the assessment time points regarding the studied variables (p > 0.01). High levels of patients' confidence were reported in both groups without any significant difference (p > 0.01).

Conclusion: Treatment of class III malocclusion in growing patients by both appliances did not negatively affect PROMs. Moreover, the application of both appliances was associated with a gradual improvement in the levels of pain and functional impairments until they were almost nonexistent after 6 months.

Clinical significance: Application of both the BAIMT/RME and RMR/SME in adolescents with SCIII patients is associated with comparable and acceptable levels of pain, discomfort, functional impairment, and shame.

Trial registration: This study was registered in ClinicalTrials.gov (ID: NCT06877780). How to cite this article: Zakaria AS, Hassan R, Baharin F, et al. Evaluation of Patient-reported Outcome Measures during the Correction of Skeletal Class III Malocclusion with Maxillary Constriction in Early Adolescence. J Contemp Dent Pract 2025;26(6):598-607.

Aim: To compare the tensile bond strength of 3-unit fixed dental bridges using four different first premolar retainer designs: Full coverage on a sound abutment, full coverage on a post and core build-up, endocrown, and Sharonlay (SL).

Materials and methods: Forty human mandibular teeth (20 first premolars and 20 first molars) were used to fabricate 23-unit fixed dental bridges replacing the second premolar. Teeth were mounted in epoxy resin blocks, with each bridge supported by one premolar and one molar, resulting in a total of 20 specimens. These were evenly assigned to 4 main groups (n = 5 per group) according to first premolar retainer designs: Full coverage on a sound tooth (FC), full coverage on a fiber post and composite core build-up (PC), endocrown with 2.5 mm intraradicular extension (EC), and SL with 5 mm intraradicular extension. All teeth were scanned using the Medit i700 intraoral scanner, and zirconia bridges were digitally designed, milled, and cemented using dual-cure resin cement under a 5-kg load. Tensile bond strength was tested using a universal testing machine with a constant crosshead speed; then data were collected for appropriate statistical analysis.

Results: The highest mean tensile bond strength was recorded in the FC group (431.82 ± 18.90), followed by the PC group (212.93 ± 5.84), endocrown (EC) group (181.97 ± 12.06), and SL group (156.92 ± 10.75). Statistical analysis showed a significant difference among the groups (p < 0.001).

Conclusions: Within the limitations of this in vitro study, the full coverage retainer demonstrated the highest tensile bond strength among the evaluated designs, while the SL showed the lowest. Retainer design significantly affects the bonding performance of three-unit fixed dental bridges.

Clinical significance: This study demonstrates that retainer design significantly impacts the tensile bond strength of three-unit fixed dental bridges. Full coverage retainers provide superior bond strength; therefore, it is recommended that clinicians prioritize full coverage designs to enhance the longevity and stability of dental prostheses. How to cite this article: Abd-Elghany NF, Mohsen CA. Effect of First Premolar Retainer Design on Tensile Bond Strength in Three-unit Fixed Partial Dentures: An In Vitro Study. J Contemp Dent Pract 2025;26(6):555-560.

Aim: The study aimed to evaluate the potential of salivary caspase-3 levels as a noninvasive biomarker for the early detection and monitoring of peri-implantitis (PI) in type 2 diabetic patients with full-arch implant-supported prostheses.

Materials and methods: A total of 42 participants were included, divided into three groups (n = 14 each) based on glycemic status (HbA1c ≥ 6.5% for diabetics) and presence of PI (probing depth ≥ 6 mm and radiographic bone loss exceeding one thread). Group A included patients with PI with presence of diabetes mellitus (DM + PI), group B with PI but absence of diabetes mellitus (NDM + PI), and group C periodontally healthy and absence of diabetes mellitus (NDM + PH). Unstimulated whole saliva (10 mL) was collected over 5 minutes in sterile polypropylene tubes. Samples were centrifuged at 3000-10000 rpm for 10 minutes; the supernatant was stored at -80°C. Salivary caspase-3 levels were quantified using a commercially available Human Caspase-3 enzyme-linked immunosorbent assay kit following the manufacturer's protocol. Data were analyzed using nonparametric tests (Kruskal-Wallis and Mann-Whitney U) with significance set at p < 0.05.

Results: The salivary caspase-3 levels were significantly higher in diabetic patients with PI (80.36 ± 0.35 pmol/L) compared with nondiabetic patients with PI (58.10 ± 0.26 pmol/L) and healthy controls (41.30 ± 0.11 pmol/L), with a statistically significant difference among the groups (χ² = 37.865, p < 0.001).

Conclusion: Elevated salivary caspase-3 levels were associated with PI, especially in patients with type 2 diabetes mellitus. This suggests that caspase-3 could serve as a noninvasive salivary biomarker for early detection and monitoring of PI inflammation in high-risk populations.

Clinical significance: The identification of a salivary molecular marker linked to inflammation and PI tissue breakdown offers clinicians a valuable diagnostic adjunct, enabling earlier detection, personalized intervention, and improved long-term outcomes of implant therapy in systemically compromised patients. How to cite this article: Fathima F, Rajaraman V, Suresh N, et al. Evaluation of Salivary Caspase-3 as a Biomarker for Peri-implantitis in Type 2 Diabetic Patients with Full-arch Implant-supported Prostheses: A Cross-sectional Study. J Contemp Dent Pract 2025;26(6):551-554.

Aim: This systematic review aims to assess the effectiveness of regenerative approaches in promoting periapical healing and restoring pulp vitality.

Background: Periapical lesions of endodontic origin (LIPOE) are a common clinical issue that can compromise the prognosis of the affected tooth. While conventional treatment focuses on infection control and periapical healing, regenerative endodontics has emerged as a promising alternative.

Results: The review protocol followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and was registered on PROSPERO (ID: CRD420251046339). A comprehensive electronic and manual search was conducted in three databases-MEDLINE via PubMed, Web of Science, and Cochrane-using keywords such as "periapical lesion," "regenerative endodontics," "platelet-rich fibrin," and "endodontic periapical lesion," focusing exclusively on randomized controlled trials (RCTs). Out of 135 initially retrieved articles, 10 RCTs met the inclusion criteria. Treatment outcomes were assessed through radiographic and clinical evaluations. Revascularization was the most commonly applied technique. The studies demonstrated a significant reduction in periapical lesion size, improved pulp vitality responses, and progressive tissue healing. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and all included studies were found to have a low risk of bias.

Conclusion: The selected studies highlight the effectiveness of regenerative endodontic techniques in the treatment of LIPOE. While the overall results are encouraging, complete pulp regeneration remains limited.

Clinical significance: This review provides evidence-based information on the effectiveness of regenerative endodontic procedures (REPs) for the treatment of periapical lesions. It underscores the potential of these techniques in promoting periapical healing and partial pulp tissue regeneration, making it a valuable resource for clinicians and researchers in the field of endodontics. How to cite this article: Kawthar BS, Fatma B, Hanen B, et al. Regenerative Endodontics in the Treatment of Periapical Lesions of Endodontic Origin: A Systematic Review of Randomized Controlled Trials. J Contemp Dent Pract 2025;26(6):623-631.