BDJ Open最新文献

Objective: To evaluate the clinical performance of nitric acid associated with a mineral-enriched adhesive system compared to the conventional approach of phosphoric acid and a universal adhesive in cervical carious lesion restorations.

Materials and methods: Twenty-six individuals with 44 cervical anterior carious lesions were randomized into two equal parallel groups. The intervention group received a nitric acid etch (Clean and Boost dentin enamel cleanser, Vista Apex, USA) in conjunction with a mineral-enriched adhesive and a flowable composite liner (RE-GEN, Vista Apex, USA). Control group treated with phosphoric acid (Scotchbond Universal Etchant, 3 M ESPE), a universal adhesive (Single Bond Universal Adhesive, 3 M ESPE), and a standard liner (Filtek Supreme, 3 M ESPE). All cavities were restored using nanohybrid resin composite (Filtek Z350XT, 3 M ESPE). Postoperative sensitivity was assessed both qualitatively, using the modified USPHS criteria, and quantitatively, using a visual analog scale (VAS), as the primary outcome. In addition, clinical performance regarding marginal discoloration, adaptation, secondary caries, and retention was evaluated as secondary outcomes using modified USPHS criteria. Outcomes were assessed at 24 h, 6, 12, and 18 months. The data was statistically analyzed using intention-to-treat analysis. Intergroup comparisons were performed using the Chi-Squared test with a significance level (p ≤ 0.05), and intragroup comparisons were analyzed using Cochran's Q test with a confidence level of 95% and a study power of 80%. Relative risk was used to assess clinical significance. The survival rate was analyzed using the Kaplan-Meier and Log-rank tests. The study was conducted following the CONSORT 2025 guidelines.

Results: Both groups demonstrated similar performance in terms of postoperative sensitivity, retention, secondary caries, and marginal adaptation, as assessed using modified USPHS criteria. However, there was a significant increase in marginal discoloration within the phosphoric acid groups after 18 months. There was 50% less risk of sensitivity with nitric acid compared to phosphoric acid using the VAS scale (CI (0.2512 to 0.9953); p = 0.0485). The tested groups showed an equal survival rate (p = 0.3771).

Conclusion: Combining nitric acid with a mineral-enriched system is a promising approach for restoring cervical carious lesions.

Objectives: This study aimed to evaluate the effectiveness of using a flowable resin composite compared to periodontal pack in reducing postoperative morbidity after free gingival graft (FGG) harvesting.

Materials and methods: In this randomized controlled clinical trial, 34 patients requiring FGG were allocated into two equal groups. The intervention group received a flowable resin composite dressing over the palatal wound, while the control group received Coe-Pak. Postoperative pain was assessed using a Visual Analogue Scale (VAS) and mean analgesic consumption over 14 days. Secondary outcomes included wound size and color match of the healing site assessed at weeks 1, 2, 3, and 6.

Results: The control group reported significantly higher VAS pain scores than the intervention group on days 1-4 and 10 (p < 0.05), and highly significant differences on days 5, 6, 8, and 9 (p < 0.001). Analgesic use decreased significantly in both groups (p < 0.001), with no intergroup differences. Wound size and color match improvements were comparable between groups.

Conclusion: The application of flowable resin composite significantly reduces early postoperative pain following FGG harvesting without compromising healing outcomes. Its ease of application, patient comfort, and comparable clinical performance make it a promising alternative to traditional dressings. However, further investigations are warranted to confirm the biocompatibility of flowable resin composites and their impact on soft tissue healing.

Objectives: New tools aid in the diagnosis of diseases and thus help in advancing patient care. "Fractal Analysis" is a versatile method of applying nontraditional mathematics to patterns that are beyond understanding with traditional Euclidean concepts. This analysis can be used on radiographic and non-radiographic images in dentistry. In this review we aim to identify the usefulness of fractal analysis in dentistry in radiographic images, its applications and future scope.

Materials and methods: Articles published between 1992 and 2024 were retrieved through an electronic search of Medline via PubMed, Scopus, and Google Scholar databases. The search, which was limited to articles published in English, aimed to identify relevant studies by employing the following keywords: "fractal analysis," "dental radiographs," "mandibular," "panoramic radiographs," and "radiography." Ultimately, 76 articles that addressed the application of fractal analysis in dental radiographs were selected.

Results: Fractal analysis can reveal alterations in bone and in images of morphologically altered tissue, however no set values exist which could be used as a standard for diagnosing various conditions.

Conclusion: Fractal Analysis can potentially be used as an adjunct to diagnostic tests as it is shown to identify alterations in bony and trabeculae patterns.

Introduction: This study aimed to compare two different approaches for palatal wound healing following free gingival graft (FGG) harvesting: one involving Nano Bio-Fusion (NBF) gingival gel used in conjunction with a palatal stent, and the other using a palatal stent alone. Outcomes were assessed in terms of wound healing, post-operative pain, and patient satisfaction.

Methods: This parallel-grouped, two-arm, single-blinded, randomized controlled trial (RCT) included twenty-six patients with mucogingival defects that required harvesting an epithelialized free gingival graft (FGG). Patients were randomly allocated into either test group (NBF gingival gel and palatal stent; n = 13) or control group (palatal stent only; n = 13). Wound healing, the primary outcome, was evaluated over a 30-day period, while secondary outcomes included post-operative pain-measured using the Visual Analog Scale (VAS) and analgesic consumption-and patient satisfaction.

Results: In the test group, wound healing showed statistically significant higher healing index score than control group after 3 days (P = 0.017), then no statistical significance was noted. Regarding post-operative pain, the test group showed statistically significantly lower pain scores (VAS) than control group in the first week, followed by no statistical significance in the second week. In the third day, the test group showed statistically significant lower analgesic consumption dose (P = 0.024) with overall statistically significant higher satisfaction score than control group (P = 0.002).

Conclusion: Within the limitations of this study, the results suggest that NBF gingival gel may promote early-stage palatal wound healing, reduce postoperative pain and analgesic consumption during the first week, and enhance overall patient satisfaction.

Clinical trial registration: (NCT05442359 | | https://www.

Clinicaltrials: gov/ 30-June-2022).

Background: Lichen planus (LP) is a chronic inflammatory disease. Oral lichen planus (OLP) is a chronic inflammatory disease that affects the oral mucosa. Different clinical types of oral lichen planus can be diagnosed based on clinical presentation and histopathological features.

Aim: The present study aimed to assess the potential of salivary and serum leptin in the diagnosis of OLP.

Materials & methods: The study was conducted on 78 cases (i.e., 39 cases per group) with OLP. The subjects were systematically free. Salivary and serum leptin concentrations from patients exhibiting a classic OLP and from healthy controls were assessed.

Results: Salivary and serum leptin levels are higher in the OLP group. The participants in the study are older than those in the control group; therefore, the age difference between the two groups does not affect the study's results.

Conclusion: Salivary and serum leptin levels in OLP patients were higher than in healthy control subjects, suggesting a possible role in the process of OLP pathogenesis.

Background: White spot lesions (WSLs) is a caries lesion distinguished by white opacity due to subsurface enamel demineralization. These lesions resulting from a disparity between detrimental and protective factors and can continue to demineralize if untreated. Early diagnosis and remineralization can reverse WSLs, supporting minimally invasive dental care.

Aim: To compare and assess the color of WSLs through spectrophotometer after application of Self-assembling peptide P11-4, 2% Arginine Enriched Sodium Fluoride varnish and Functionalized Tri Calcium Phosphate Fluoride varnish.

Methods: This randomized controlled triple-blind clinical trial enrolled pediatric participants (ages 8-12 years) presenting with moderate caries risk as defined by CAMBRA (Caries Management By Risk Assessment) criteria, with visible white spot lesions (WSLs) on the labial surfaces of maxillary permanent anterior teeth, classified as ICDAS scores 1 or 2. A total of 39 WSLs were incorporated into the study and randomly allocated into one of the three groups 13/each. Group I: Self-assembling peptide P11-4 varnish (study group), Group II: Arginine-enriched Sodium Fluoride varnish (study group) and Group III: Tri Calcium Phosphate Fluoride varnish (positive control group). The color change ΔE of each WSL was quantified using a spectrophotometer at the baseline. Dimensions of WSLs were assessed by digital photography, remineralizing agents were applied then patients were recalled for further applications after 3 and 6 months and for WSLs assessment after 3, 6 and 9 months.

Results: All groups demonstrated progressive color improvement over time. At 3 months, Group I showed the least improvement (ΔE = 16.39 ± 3.04), followed by Group III (14.80 ± 3.11) and Group II (14.06 ± 4.46). By 9 months, Group II achieved (ΔE = 9.37 ± 3.79), and Group III (9.15 ± 2.74) surpassing Group I (12.21 ± 3.03). so both Group II and III ultimately outperformed Group I in color correction by the study's end. Group II achieved significantly greater WSL reduction (14.98 ± 7.55%) compared to both Group I (27.93 ± 8.98%) and Group III (22.32 ± 8.61%), with no significant difference observed between Groups I and III.

Conclusions: Although all the three tested materials demonstrated an enhancement in the color and dimension of WSLs, 2% of Arginine Enriched Sodium Fluoride showed the best results followed by Functionalized Tri Calcium Phosphate Fluoride varnish, while self-assembling peptide P11-4 showed the lowest results.

Objectives: Sodium hypochlorite (NaOCl) gel is an effective additive for white mineral trioxide aggregate (WMTA) that enhances its chemical and physical characteristics and significantly reduces setting time while maintaining biocompatibility. The study sought to compare the outcomes of pulpotomies performed in primary teeth using WMTA mixed with 2.25% NaOCl gel or WMTA mixed with distilled water (DW).

Materials and methods: It was a randomized, triple-blinded, split-mouth, controlled clinical trial. Forty primary second molars from cooperative children aged 5-10 who required pulpotomy were randomly assigned to the control group-WMTA  + DW or experimental group-WMTA + NaOCl gel for clinical and radiographic assessments at 3, 6, and 12 months of follow-up. The clinical evaluation involved checking for spontaneous pain, pain on percussion, tooth mobility, abscesses, sinus tracts, and the exfoliation of the treated tooth. The periapical radiographic evaluation identified whether there was furcal radiolucency, internal or external root resorption, and widening of the periodontal ligament. Canal obliteration was not considered a failure.

Results: The WMTA + NaOCl gel group showed a 90% and 95% clinical and radiographical success rate, respectively, at 3, 6, and 12 months of follow-up. In the control group, the clinical success rate was 90% after 3, 6, and 12 months, whereas the radiographical success rate was 100% at 3 months and decreased to 95% after 6 and to 85% after 12 months. No statistically significant difference was detected between the two groups (p > 0.05).

Conclusions: The present research validated WMTA + NaOCl gel as a potentially effective material for pulpotomy in primary molars.

Objective: Influenza, a respiratory infection caused by the influenza virus, has been associated with good oral hygiene, which correlates with a reduced incidence of the disease. Saliva possesses inherent antiviral properties against the influenza virus. However, the relationship between toothbrushing, a common oral hygiene practice, and the antiviral activity of saliva remains poorly understood. This study aimed to evaluate the effect of toothbrushing on the anti-influenza virus activity of saliva.

Materials and methods: Sixteen adults without oral disease participated in this open-label, single-arm study. Resting saliva and mouth-rinsed water samples were collected before toothbrushing. Participants then brushed their teeth with a toothbrush and toothpaste for five minutes, after which additional saliva and mouth-rinsed water samples were collected at five minutes and one-hour post-brushing. The total bacterial amount in the mouth-rinsed water was measured by qPCR. The anti-influenza virus activity of saliva was determined using the TCID₅₀ method.

Results: Saliva's anti-influenza virus activity increased significantly five minutes after toothbrushing compared to pre-brushing levels, but no significant difference was observed at 1 h, as follows [Δlog, median (min-max)]: Before brushing: 0.625 (-0.25-1.75), at 5 min: 1.25 (0.5-2), and at 1 h: 0.75 (0.5-2). A correlation analysis between total bacterial amount and antiviral activity revealed a negative correlation.

Conclusions: Improving the oral environment through toothbrushing enhances salivary antiviral activity. Maintaining oral hygiene may help prevent influenza virus infection.

Aim: To assess the impact of 980 nm diode laser-activated irrigation with or without EDTA on the adaptability of root canal filling in oval-shaped canals using a scanning electron microscope.

Methodology: Forty-five single-rooted mandibular premolars were assigned into three groups (n = 15) based on the final irrigation protocol: Conventional irrigation without activation; 980 nm diode laser without EDTA; 980 nm diode laser with EDTA. The marginal gap width (μm) and surface area (μm²) between the obturating material and the root canal were measured in the coronal, middle, and apical thirds using SEM software (ImageJ software version 1.53 t). The data was analyzed using Two-way ANOVA and Bonferroni's post hoc tests.

Results: All groups demonstrated statistically significant differences in mean gap width and surface area (p < 0.001) at the coronal, middle and apical root sections. Diode laser with EDTA group had the lowest gap values, followed by the diode laser group, while the conventional group recorded the highest values. Diode laser group exhibited the highest gap value in the coronal section. Additionally, significant differences in mean gap width and surface area were observed at different root levels within each group (p < 0.001). The highest mean gap value observed in the apical section, whereas the lowest value was found in the middle section for both the diode laser with EDTA and diode laser groups. In contrast, the conventional group had its lowest value in the coronal section.

Conclusion: Activation of the 2.6% NaOCl and 17% EDTA using 980 nm diode laser improves the adaptation of the root canal filling to the canal walls.