Journal of Contemporary Dental Practice最新文献

Aim: The aim of the study was to evaluate the effect of feather-edge finish line and deep chamfer finish line on gingival position and marginal adaptation.

Methods: Thirty patients requiring restoration of a posterior tooth received zirconia crowns (BruxZir shaded 200). Fifteen patients received subgingival featheredge finish line preparations (intervention group), and the other 15 patients received subgingival deep chamfer finish line preparations (comparator group). CAD/CAM milled zirconia crowns were cemented with resin cement. Position of crown margin (gingival recession) and marginal adaptation measurements were taken at baseline, 6 months, and 1 year. Results were tabulated, and statistical analysis was performed.

Results: The results of gingival recession and marginal adaptation showed no significant difference between featheredge and deep chamfer designs at baseline, 6 months, and 1 year.

Conclusions: Monolithic zirconia crowns with subgingival restorative margin designs can be used with deep chamfer and featheredge margin designs, as both designs showed clinically acceptable results regarding gingival recession and marginal adaptation. Both margin designs behaved similarly after 1 year of clinical service, so special attention should be given to the position of the finish line and conservation in the choice of design.

Clinical significance: Both margin designs behave comparatively regarding gingival recession and marginal adaptation with zirconia crowns. To favor the more conservative approach that would preserve tooth structure, the featheredge margin design would be preferred, if not otherwise needed. The clinical trial was registered with the Clinical Trial Registry of clinicaltrials.gov (NCT04729569). How to cite this article: El-Khayat H, Anwar EM, Nabil O, et al. Gingival Recession and Marginal Adaptation of Zirconia Crowns with Two Subgingival Margin Designs: A Randomized Clinical Trial. J Contemp Dent Pract 2025;26(8):767-775.

Aim: The study aimed to evaluate marginal and internal adaptation of endocrowns fabricated from Nano-ceramic Hybrid and Lithium disilicate ceramic materials.

Materials and methods: A total of 22 endocrowns were fabricated for restoring endodontically treated posterior teeth. The patients were divided into two equal groups according to the type of ceramic material used: Lithium disilicate IPS e.max CAD endocrown (control group) and Grandio nano-ceramic hybrid endocrown (intervention group). Before cementation, marginal and internal adaptation of both groups was measured by using the silicon replica technique and a digital microscope. Statistical analysis was performed by using an independent t-test, while comparison between different surfaces was performed by using One Way ANOVA test followed by Tukey's post hoc test for multiple comparisons.

Results: Marginal and internal gap results showed that the Grandio nano-ceramic hybrid group was statistically significantly higher than the lithium disilicate IPS e.max CAD group with p-value, p = 0.0001, p = 0.0002, respectively.

Conclusions: Marginal adaptation of lithium disilicate IPS e.max CAD restorations is considered clinically acceptable, whereas that of Grandio nanoceramic hybrid exceeds the clinically acceptable limit. Both lithium disilicate IPS e.max CAD and Grandio nanoceramic hybrid restorations scored an acceptable internal adaptation value.

Clinical significance: Upon consideration of restoring non-vital posterior teeth with endocrowns, lithium disilicate IPS e.max CAD is the material of choice, while Grandio nano ceramic hybrid is less recommended. How to cite this article: Salah El-Din M, Adel S, Naguib A, et al. Evaluation of Marginal and Internal Adaptation of Endocrowns Fabricated from Nano-ceramic Hybrid and Lithium Disilicate Ceramic Materials: A Randomized Controlled Clinical Trial. J Contemp Dent Pract 2025;26(8):795-805.

Aim: The current study calculated and compared the percentage of remnant volume (PRV) after reinstrumentation using Reciproc Blue files and assessed the effect of ultrasonic activation.

Materials and methods: A total 40 palatal roots of maxillary first molars randomly assigned to four groups of 10. The samples were sectioned to a consistent 12 mm length and prepared using ProTaper Next (PTN) file system, then obturated with gutta-percha (GP) and sealer (MTA FILLAPEX or One-Fil BC). Reinstrumentation was performed using a reciprocation program with Reciproc Blue files. Irrigation time was standard, and samples were divided based on whether Ultra-X activation of the irrigant was used. A Planmeca ProMax CBCT machine was used to acquire images both before and after canal reinstrumentation. The volume of the primary obturation and the remnants after reinstrumentation were calculated by using Mimics and 3-Matic Medical program. The PRV was made for the entire canal as well as for the coronal, middle, and apical thirds independently. The Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis, with a significance threshold of p < 0.05.

Results: There was statistically significant difference between MTA and BC, with BC materials showing significantly more remnants than MTA, particularly when using the needle irrigation technique (p < 0.05). The Ultra-X groups showed statistically significant difference than the needle groups, especially in the apical and middle thirds for both BC and MTA.

Conclusion: Apical sections retained the highest amount of remnants across all groups, and BC materials resulted in significantly more remnants than MTA. Ultra-X activation was more effective overall than the needle method, especially in reducing the apical and middle remnants for both BC and MTA.

Clinical significance: The removal of sealer is essential for the success of endodontic retreatment procedure. This study assesses two types of sealer removability and also the effect of ultrasonic activation during the reinstrumentation. How to cite this article: Dawod KM, Al-Hashimi RA. Assessing Volume of Two Sealers' Remnants after Reinstrumentation Using 3D Imaging Technology: An In Vitro Comparative Study. J Contemp Dent Pract 2025;26(8):743-751.

Aim: The aim was to determine the prevalence and morphometric characteristics of the Canalis sinuosus (CS) and its accessory canals (ACs) in Latin American individuals using cone-beam computed tomography (CBCT).

Materials and methods: A retrospective, cross-sectional study was conducted using a sample of 136 tomographic volumes obtained from reference radiology centers in Chile (n = 47), Colombia (n = 43), and El Salvador (n = 46). The equipment used included EAGLE 3D, J. Morita, and Orthophos SL 3D (Dentsply Sirona). The study evaluated the presence or absence of the CS and its anatomical variations, including whether they were unilateral or bilateral. Furthermore, the study evaluated the terminal diameter of the CS and the position of its opening. Pearson's Chi-square test, Mann-Whitney U test, and binary logistic regression were applied.

Results: A 100% prevalence of the CS was found in 272 maxillary sides, with ACs present in 62.1% of samples. No significant differences were observed in terms of sex or age. The CS commonly terminated anterior to the incisive canal (38.7%) and at the maxillary central incisor (25.1%). Binary logistic regression showed no significant associations between sex or age and the presence of ACs. In female patients, the average sagittal diameter of the CS was 1.27 mm, and the coronal diameter was 1.28 mm (p > 0.05). Additionally, the location of the CS termination showed no significant relation to the sex of the evaluated patients (p = 0.873).

Conclusion: The Canalis sinuosus and its ACs should be regarded as typical anatomical structures due to their high frequency, irrespective of sex or age.

Clinical significance: Oral and maxillofacial radiologists need to understand the anatomical structure of the CS, mainly due to the frequency of surgical procedures performed in the anterior maxilla, to minimize the risk of complications. How to cite this article: Gonzales-Campbell V, Reyes-Veliz B, Llaguno-Rubio JM, et al. Prevalence and Morphometric Study of the Canalis Sinuosus in Latin American Individuals Using Cone-beam Computed Tomography. J Contemp Dent Pract 2025;26(8):727-731.

Aim: The aim of this research was to assess the microleakage of three different implant-abutment interface designs.

Materials and methods: A total of 60 implants were used in this investigation. These were divided into three groups. i.e., 20 samples in each group as follows: group I-conical hex implant and abutment interface, group II-internal hexagon and abutment interface, and group III-Morse taper implant and abutment interface. Staphylococcus aureus was cultivated and incubated for 24 hours at 37°C to create a bacterial suspension in brain-heart infusion broth. The assembly was taken out after 2 weeks of S. aureus culture broth submersion and allowed to remain submerged in 70% alcohol for 3 minutes. Microbial evaluation was conducted to assess the microleakage of all the samples, and scanning electron microscope with a ×1,000 magnification was used to evaluate and record the microgaps. All data were recorded and statistically analyzed.

Results: The least microleakage was found in conical hex implant and abutment interface group, i.e., 6.80 ± 2.58 followed by internal hexagon and abutment interface group (8.56 ± 3.14) and 10.24 ± 2.10 with Morse taper implant and abutment interface group. Statistically significant difference was obtained between different implant-abutment interface designs. The maximum gap was found in Morse taper implant and abutment interface group with a mean of 9.18 ± 1.62 followed by internal hexagon and abutment interface with a mean value of 7.98 ± 2.08 and conical hex implant and abutment interface group with a mean value of 7.30 ± 1.26. Statistically significant difference was obtained between different implant-abutment interface designs.

Conclusion: In conclusion, the implant abutment connection is susceptible to microleakage despite the connection design. But, implants with conical hex connections demonstrated less microleakage and microgaps than those with internal hexagon and Morse taper connection design implants.

Clinical significance: A microgap within the implant and abutment interface might be a source of microorganisms, affect clinical and histological parameters, cause inflammation, and potentially jeopardize osseointegration. As a result, knowing the components that work well together helps overcome treatment planning issues. By altering implant designs, implant-abutment connections, and procedures, several inventions are produced to reduce marginal bone loss. How to cite this article: Mondal U, Bhargava A, Roy AK, et al. Comparative Evaluation of the Microleakage of Various Implant-Abutment Interface Designs: An In Vitro Study. J Contemp Dent Pract 2025;26(8):776-779.

Aim: To assess and compare the soft tissue profile and dentoalveolar changes associated with bimaxillary distalization to those associated with first premolar extraction.

Methods: This was an ambidirectional, cohort study comprising of 40 subjects between 18 and 30 years of age of either gender, with well-aligned arches and incisor proclination. They were divided equally into two groups - group A underwent fixed orthodontic treatment with bimaxillary distalization and group B were treated by first premolar extraction with moderate anchorage. Changes in ANB, incisor inclination, molar distalization, and extrusion, as well as nasolabial angle and lip retraction, were assessed using pre- and posttreatment lateral cephalograms. Intra and intergroup comparisons were carried out by paired and independent tests, respectively. The threshold for statistical significance was set at p < 0.05.

Results: Both groups showed significant improvements in the soft tissue profile and dentoalveolar values posttreatment. In group A, favorable changes in incisor inclination, lip retraction, and the nasolabial angle were observed, which were found to be statistically significant. Similar changes were observed in group B, in addition to a change in the ANB angle. On comparing treatment outcomes between the groups, statistically significant differences were seen in the mandibular plane angle, upper and lower incisor inclinations, and upper lip retraction (p = 0.005).

Conclusion: The changes produced by both treatment modalities were favorable with significant improvements. Although the changes seen in group A were slightly lesser than those seen in group B, they were comparable.

Clinical significance: To extract or not to extract has always been a dilemma orthodontists face, especially in borderline cases. The advent of extraradicular screws has largely simplified this problem since full arch distalization is now possible. This approach is particularly beneficial for patients hesitant about extractions or when extractions might undesirably flatten the facial profile. Considering the dearth of evidence, this study was taken up to compare treatment outcomes of a conventional premolar extraction approach vs a non-extraction approach with full arch distalization. The findings offer valuable insights for practitioners to make evidence-based treatment decisions. How to cite this article: Sanman R, Desai A, Natarajan S, et al. An Ambidirectional Cohort Evaluation of Soft Tissue and Dentoalveolar Changes after Orthodontic Treatment with Bimaxillary Distalization vs First Premolar Extraction. J Contemp Dent Pract 2025;26(7):699-704.

Aim: This case report aims to highlight the application of a computed tomography (CT)-guided, digitally designed workflow for implant-retained auricular prosthetic rehabilitation in a patient with traumatic ear loss.

Background: Implant-retained auricular prostheses require highly precise implant positioning for optimal retention and esthetics. Advances in virtual surgical planning, combined with radiographic imaging and implant planning software, now enable a prosthetically driven, patient-specific approach.

Case description: A 45-year-old male with right auricular loss from childhood trauma reported dissatisfaction with an adhesive-retained prosthesis due to poor retention and skin irritation. Clinical evaluation confirmed adequate bone and healthy surrounding tissue, thus planned for implant-retained prosthetic rehabilitation. A CT-guided digital workflow was employed, using a custom 3D-printed surgical guide with intraoral occlusal support and an external auditory canal plug for accurate implant placement in the mastoid region. Peri-implant soft tissue was managed through debulking, split-thickness skin grafting, and a stent-supported healing protocol. A CAD-designed, stereolithography-printed three-piece negative mold was used to fabricate a wax pattern and a color-matched silicone prosthesis secured to a custom metal bar. The patient was instructed on hygiene maintenance to preserve soft tissue health. Patient acceptance of the prosthesis was found to be favorable, with positive feedback regarding both esthetic integration and functional comfort, which further supports the efficacy of implant-supported facial prostheses in restoring quality of life following orofacial rehabilitation.

Conclusion: This case highlights the effectiveness of a CT-based digital workflow in improving the precision and clinical outcomes of implant-retained auricular prostheses. The integration of a modified 3D surgical guide and custom negative mold offers a patient-specific, accurate, and reproducible approach for complex auricular rehabilitation, significantly enhancing prosthesis retention, esthetics, and patient satisfaction.

Clinical significance: This case underscores the value of a CT-based digital workflow and customized 3D-printed tools in achieving precise implant placement and superior prosthetic outcomes in auricular reconstruction. By integrating anatomical references like the external auditory canal into the surgical guide and employing a custom negative mold for prosthesis fabrication, clinicians can enhance retention, soft tissue health, and esthetic results. How to cite this article: Ajay Y, Vijayamohan M, Krishnadas A, et al. Digital Workflow for Implant-retained Auricular Prosthesis Using Modified 3D Surgical Guide and Negative Mold: A Case Report. J Contemp Dent Pract 2025;26(7):710-715.

Aim: To evaluate and compare the shear bond strength (SBS) and adhesive remnant index (ARI) scores of four different orthodontic bracket system bonded to fluorosed enamel surfaces using two color-changing adhesive materials.

Materials and methodology: The sample consisted of 48 extracted human premolar teeth with fluorosis, intended for orthodontic purposes. These were divided into two groups: group I and group II, each comprising 24 samples. Group I samples were bonded with Ormco Grengloo, while group II samples were bonded with 3M Transbond XT Plus. Each group was further subdivided into four subgroups of six samples each, based on the type of brackets used: subgroup A - metal conventional brackets (CBs), subgroup B - metal self-ligating brackets (SLBs), subgroup C - ceramic CBs, and subgroup D - ceramic SLBs. Prior to bonding, all teeth were thermocycled 500 times. The brackets were then debonded using a universal testing machine at a crosshead speed of 1 mm/min. The debonding force was applied in the occlusogingival direction and recorded in Newtons. Statistical comparison of the bond strengths among subgroups was carried out using the ANOVA test.

Results: The analysis revealed a material- and bracket-type-dependent variations in SBS. In group I, subgroup B exhibited the highest SBS, while subgroup C showed the lowest. In group II, subgroup D demonstrated the highest SBS, whereas subgroup A had the lowest. These differences were statistically analyzed using ANOVA, confirming significant variation based on both adhesive type and bracket configuration.

Conclusion: These findings suggest that SLBs, both metal and ceramic, generally provide stronger bonds compared to CBs, regardless of the adhesive used. Ormco Grengloo adhesive appears to be more effective for bonding metal CBs and metal SLBs, while Transbond XT Plus excels in bonding ceramic CBs and ceramic SLBs.

Clinical significance: This study helps orthodontists choose the best bracket-adhesive combinations for fluorosed teeth, improving bond strength, reducing treatment delays, and making bonding easier with color-changing adhesives. It supports personalized treatment, better bracket retention, and fewer bond failures in patients with enamel fluorosis, making orthodontic care more effective and efficient. How to cite this article: Goswami M, Wadhawan A, Nagar S, et al. Evaluation of Shear Bond Strength of Orthodontic Brackets with Color-changing Adhesives on Fluorosed Teeth: A Randomized Clinical Trial. J Contemp Dent Pract 2025;26(7):652-657.

Aim: To evaluate dentinal defect development, this study compared three rotary systems used for root canal preparation, namely ProTaper Next (PTN), 2Shape, and Reciproc.

Materials and methods: Sixty first mandibular molars with two separated canals were selected and included in this study. The samples were divided into four groups (n = 15): Control, PTN, 2Shape, and Reciproc. The control group was left unprepared, and the remaining 45 samples were prepared using these three systems. The samples were sectioned perpendicular to the long axis at 3, 6, and 9 mm from the apex. Each slice was examined under a stereomicroscope at 20× magnification to evaluate the presence of dentinal defects. The images were analyzed using ImageJ software, and the data were assessed statistically using the Chi-square and Fisher's exact tests.

Results: No cracks were observed in the control group. ProTaper Next, 2Shape, and Reciproc groups caused cracks development in 24, 11, and 40% of the samples, respectively. Reciproc system caused significantly more cracks at 3 mm level (p < 0.05). No statistically significant difference was observed among groups at the 6 and 9 mm levels (p > 0.05).

Conclusion: All three rotary file systems examined produced dentinal cracks, particularly at the apical third. ProTaper Next and 2Shape tend to produce fewer cracks compared to Reciproc.

Clinical significance: Although all motion kinematics tested in this study caused some degree of dentinal crack formation, the Reciproc system (R25) demonstrated a more destructive effect in the apical third of the root canal. In contrast, the PTN and 2Shape 25/0.06 systems were found to be safer options for root canal preparation in the mesial roots of first mandibular molars. How to cite this article: Nasiri K, Doychinova M, Wrbas KT. Comparative Evaluation of Dentinal Crack Formation Using Three Ni-Ti Rotary Systems after Root Canal Preparation: An In Vitro Study. J Contemp Dent Pract 2025;26(7):663-667.

Aim: This study aims to devise a comprehensive objective rubric to better facilitate radiographic skills assessment for students and enhance the assessment's impact on the performance, competency, and standards of clinical practice.

Materials and methods: The study population will include 10 clinical experts in dental radiography and 50, 4th year Bachelor of Dental Surgery students. Research will be carried out in multiple phases (11) and will include literature review, expert consultation, rubric construction, and pilot testing. The validation of the rubric will be analyzed using the modified Delphi technique and construct validity, inter-rater reliability, and students' acceptability of the rubric. Data will be analyzed using Statistical Package for Social Sciences software with a significance level of less than 5%. The analysis will involve determining the content validity index, the face validity index, exploratory factor analysis for construct validity, Cronbach's alpha for internal consistency, and inter-rater reliability using Cohens' kappa statistic and intraclass correlation coefficient.

Conclusion: This study explores rubric use in dental radiography education, aiming to standardize assessment, enhance feedback, improve student skills, and guide future research for better education and patient care outcomes.

Clinical significance: The need for this study arises from the lack of a standardized, objective, and comprehensive tool to assess dental radiography skills in undergraduate students. Current assessment methods are inconsistent and subjective, leading to variability in evaluating student competence. This study aims to establish a standardized, objective rubric to enhance accuracy and consistency in assessing dental radiography skills, ultimately improving student competence, feedback quality, and patient care outcomes. How to cite this article: Gondivkar SM, Panchbhai A, Gadbail AR, et al. Development of a Comprehensive Rubric for Assessing Dental Radiography Skills in Undergraduate Dental Students: Study Protocol. J Contemp Dent Pract 2025;26(7):658-662.