Saudi Dental Journal最新文献

This study aimed to evaluate the impact of acid erosion and mechanical abrasion-mimicking conditions associated with gastroesophageal reflux disease (GERD)-on the color stability and surface hardness of five commercially available dental composite resins, including four bulk-fill and one flowable composite. Standardized disc-shaped specimens were fabricated from Filtek Bulk Fill (FTB), SureFil SDR (SDR), Tetric N-Ceram (TNC), Beautifil Bulk Restorative (BBR), and Dynamic Flow (DYF). Specimens underwent 24-hour acidic storage (pH 2.8) and brushing simulation (5000 cycles) in acidic medium. Color changes (ΔE₀₀) were measured using a spectrophotometer, and surface microhardness (Vickers Hardness) was evaluated before and after treatment. Data were analyzed using one-way ANOVA, independent t-tests, and linear regression. All composites exhibited varying degrees of color change and hardness reduction, with BBR and SDR showing the most pronounced degradation, while FTB demonstrated the highest resistance. Composites with hydrophobic monomers (e.g., Bis-EMA) and high filler content exhibited improved resilience, whereas materials with hydrophilic matrices and lower filler loadings were more susceptible to deterioration Acid erosion and brushing significantly affect the aesthetic and mechanical properties of dental composites. Material composition-particularly polymer matrix type and filler matrix integration-plays a critical role in determining resistance to oral stressors. These findings underscore the importance of tailored material selection for patients with conditions like GERD and support the need for further development of durable restorative materials.

The all-on-four treatment concept is widely used to rehabilitate edentulous dental arches; however, its biomechanical effect on supporting jawbones requires careful evaluation. This study aims to optimize the all-on-four implant design to minimize cortical bone stress using finite-element analysis (FEA). A three-dimensional FEA model was developed based on the mean average dimensions of Japanese edentulous mandibles (Takahashi et al. 2010). Implants (length = 12-16 mm and diameter = 3-5 mm) were placed between the two mental foramina with two parallel anterior implants positioned at distances ranging from 9.6-15 degree from the mandibular midline. Posterior implants are angled from 1-45° with lengths varying between 12-18 mm. A rigid superstructure splints all implants and an occlusal load of 50 N was applied at distal ends. The maximum Von Mises stress on the cortical bone was measured. The adaptive optimization approach identified eight optimal design configurations. These designs results in a peak Von Mises stress of 2.26 MPa which demonstrate 32% reduction compared with previous findings by Takahashi et al. (2010). The optimized all-on-four configuration significantly reduces cortical bone stress while accommodating anatomical variability. This approach offers clinical insights into improving implant longevity and outcomes in edentulous patients.

This systematic review aims to evaluate the efficacy of probiotic interventions in the prevention of enamel demineralization, with a specific focus on randomized clinical trials (RCTs). A comprehensive literature search was conducted in the Cochrane Library, PubMed, Scopus, and Web of Science electronic databases, covering studies published until April 2025. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Article selection and data extraction were independently conducted, with methodological quality evaluated using the Jadad Score. A total of 34 RCTs were included, with 17 studies scoring 5 and 8 studies scoring 3 on the Jadad scale, indicating moderate to high methodological quality. The majority of the trials involved children aged 1 to 15 years, while eight studies focused on adult cohorts aged 18 to 65 years. Intervention durations varied from 6 days to 2 years. The most commonly used probiotic strains were Lactobacillus, Bifidobacterium, or a combination of both, delivered via dairy-based products, lozenges, mouth rinses, or probiotic tablets. Twenty-seven research studies demonstrated a significant reduction in the main cariogenic pathogen, Streptococcus mutans (p < 0.05 - p < 0.001), while findings on Lactobacillus reduction, plaque index, gingival status, salivary pH, and buffering capacity were inconsistent across studies. Long-term studies (≥ 6 months) showed more sustained effects, emphasizing the need for continuous probiotic intake to maintain oral health benefits. The findings suggest that probiotic interventions may represent a potential approach for preventing enamel demineralization, primarily through their ability to reduce cariogenic bacteria and increase salivary pH.

Dental erosion is mainly linked to consumption of acidic foods and drinks, potentially including fermented dairy products. The aims of this primary in vitro study were to determine the acidity of different fermented milk products commonly consumed in Saudi Arabia and to evaluate their potential erosive effects on dental enamel. Extracted bovine tooth crowns were embedded in resin with the enamel exposed and randomly divided into three groups (n = 3/group): laban (buttermilk), yogurt, and milk (control). Each specimen was immersed in the test product (60 min, 25 °C), then submitted to surface profile analysis using optical profilometry and confocal laser scanning microscopy. Further, pH and titratable acidity were evaluated for seven dairy products: laban, Activia laban, ayran laban, full-fat yogurt, fruited yogurt, plain Greek yogurt, and milk (control). All tested fermented dairy products were acidic and had significantly lower pH than the control (p < 0.0001), with ayran laban the lowest (pH 4.1 ± 0.02) and Greek yogurt the highest (pH 4.6 ± 0.01). Tested yogurt products exhibited significantly higher titratable acidity than laban products. The yogurt group had the highest enamel surface roughness, which was significantly different to the untreated surface on profilometric analysis (p < 0.0001). All characterized fermented dairy products were acidic with erosive potential. Yogurt and laban both increased enamel surface roughness, and the effect was more pronounced with yogurt. These findings underscore the need to moderate fermented milk product intake, to prevent dental erosion, and to include guidance on their consumption in oral health dietary recommendations.

Virtual articulators have emerged as promising digital tools for simulating jaw movements and occlusal contacts in dentistry. However, few studies have compared the performance of different virtual articulators and their impact on recording occlusal contacts. This study designed to evaluate the effects of various virtual articulators on occlusal contact distribution and morphology and identify the most accurate system. TRIOS 3Shape intraoral scans of lower and upper arches of five dentate patients with digital bite registration on both sides were performed and exported to dental CAD software (3Shape OrthoSystem). The occlusal plane was standardized using three points on 3Shape OrthoAnalyzer. Eight virtual articulators were evaluated during this study in motion: Ivoclar Vivadent, SHUFO Proarch IV, Kavo Protar, 3Shape Generic, Denar Marta 330, ACR (Atex compatible), SAM 2P, and BIO ART A7 Plus. Occlusal contacts were recorded during motions for left, right, retrusive, and protrusive movements. The result of occlusal map was recorded and analyzed by Python code written by the researcher (Ian Code) to capture the information for the number and regions of occlusal contact and convert it to numerical values for comparison. Significant differences were found between articulators in the number and area of occlusal contact distributions. The 3Shape Generic articulator showed the highest number of contact regions with a mean of 19.6 ± 6.8 regions, while the ACR (Atex compatible) articulator showed the lowest number with a mean of 15.8 ± 7.3 regions. The result of contact areas shows the highest area with mean of 32 ± 6.4 mm² in the Ivoclar Vivadent articulator and the lowest area with a mean of 26.6 ± 6.3 mm² in the BIO ART A7 Plus articulator. These findings suggest that the choice of a virtual articulator can significantly influence the representation of occlusal contact regions and area, with potential effects on its implications for planning and treatment outcomes. Dental laboratories and clinicians should be aware of the specific characteristics and limitations of their chosen virtual articulator system and consider these factors when interpreting the results and making decisions in treatment. Future researches consider on validating these findings in clinical application in dentistry by investigation the effect of dynamic and static virtual articulation, this may lead to developing a new virtual articulator that incorporates advanced algorithms and technologies that can improve the accuracy of occlusal contact simulations.

Gingival recession (GR) is a prevalent condition characterized by the apical migration of the gingival margin, leading to root exposure and aesthetic and functional challenges. While conventional surgical techniques like coronally advanced flaps and connective tissue grafts are considered the gold standard for root coverage, these methods are limited by patient morbidity and inconsistent long-term outcomes. Adjunctive strategies such as laser therapy, hyaluronic acid (HA), and nanomaterials have been introduced to improve clinical results. This narrative review explores the rationale and clinical relevance of these adjunctive therapies in root coverage procedures. This narrative review (2017-2025) critically examines laser therapy, hyaluronic acid, and nanomaterials as adjuncts in surgical root coverage. Human studies were prioritized, with preclinical data included for nanomaterials. Biological mechanisms, clinical efficacy, and limitations were analyzed to provide a comparative perspective and highlight future research directions in periodontal regeneration. The literature indicates that while these therapies offer distinct benefits, their clinical effectiveness remains inconclusive. Laser therapy aids tissue healing, HA offers regenerative effects, and nanomaterials facilitate bioactive delivery. However, clinical evidence on long-term efficacy, especially in achieving consistent root coverage, remains limited. Adjunctive therapies such as laser therapy, HA, and nanomaterials show promise in improving outcomes for gingival recession treatment. However, further high-quality clinical trials are needed to validate their efficacy, safety, and long-term results.

Purpose: Oral cancer is the sixteenth most common malignancy globally and is characterized by a 5-year survival rate of less than 40%. In recent years, innovative methods have been developed to facilitate its early diagnosis, including the GOCCLES® device. This study aimed to evaluate the diagnostic value of GOCCLES® in detecting dysplasia in oral potentially malignant disorders (OPMDs) and diagnosing oral squamous cell carcinoma (OSCC). Additionally, this study sought to compare the device's efficacy with toluidine blue (TB) staining and assess the value of combining both methods.

Methods: Patients clinically diagnosed with OPMDs or OSCC were included. Anamnesis, oral examination, inspection with GOCCLES®, and TB staining were performed. Finally, lesions were biopsied and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each technique were determined.

Results: Thirty-two patients were included in this study. The GOCCLES® device had a sensitivity of 33.3%, specificity of 40%, PPV of 25%, NPV of 50%, and accuracy of 37.5%. For TB staining, the sensitivity, specificity, PPV, NPV, and accuracy were 58.3%, 85%, 70%, 77.27%, and 75%, respectively. The respective values for the combined method were 44.4%, 77.78%, 66.67%, 58.33%, and 61.11%.

Conclusions: GOCCLES® and TB staining could help in the early diagnosis of OSCC and OPMDs, but a biopsy of the lesion remains essential for obtaining a definitive diagnosis.

As a biofilm-mediated disease, dental caries is primarily attributed to the activity of Streptococcus mutans and Streptococcus sobrinus, key contributors to enamel mineral loss under acidic conditions. Current broad-spectrum antimicrobials disrupt the oral microbiota and carry undesirable side effects, prompting interest in targeted, microbiome-friendly alternatives. This study evaluated the antimicrobial, anti-cariogenic, and cytotoxic properties of pomegranate (Punica granatum) derived compounds, corilagin, ellagic acid, gallocatechin, kaempferol-7-O-glucoside, punicalagin, punicalin, and rutin against cariogenic S. mutans and S. sobrinus, and the commensal S. gordonii. Antibacterial activity was assessed using disc diffusion, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) methods. Anti-virulence effects were evaluated through glycolytic pH drop and cell surface hydrophobicity assays. Cytotoxicity was determined using the brine shrimp lethality assay. Punicalagin, punicalin, and ellagic acid showed strong, selective bactericidal activity against S. mutans and S. sobrinus, with low MICs and MBC/MIC ratios, while sparing S. gordonii. These compounds significantly suppressed acid production, maintaining pH above the critical demineralisation threshold, and reduced surface hydrophobicity in cariogenic strains without affecting the commensal. Most compounds exhibited low toxicity (LC₅₀ > 500 µg/mL), indicating a favourable safety profile. Overall, punicalagin and punicalin demonstrated dual antimicrobial and anti-virulence activity with selective targeting of cariogenic pathogens. These findings support the potential inclusion of punicalagin and punicalin in oral care formulations aimed at preventing dental caries while preserving beneficial oral microbiota. As this is a preliminary screening study, the results should be interpreted cautiously, and further biofilm and host-cell assays are needed to confirm translational potential.

The objective of this research was to evaluate and compare the flexural strength and practical uses of provisional crown materials such as self-curing polymethylmethacrylate (PMMA), heat-curing PMMA, self-curing temporary acrylic resin (Tempron), fast-setting Bis-Acrylic self-cure (Structur 2 SC), and Bis-Acryl composite (Protemp-III Garant). Standardized specimens (25 mm x 10 mm x 2 mm) of each material were fabricated (n = 15 per group) and allowed to bench cure for 20 min under a constant load of 500N. Heat-activated PMMA specimens were polymerized at 90 °C for 2 h. Specimens were polymerized in normal saline at 37 °C for five days to simulate oral conditions. A universal testing machine (UTM) assessed their flexural strength and elastic modulus. Significant differences were observed among the materials (p < 0.05). Protemp III Garant showed the highest mean flexural strength, followed by Structure 2 SC and Tempron, while self-cure and heat-cure PMMA exhibited the lowest values. However, the elastic modulus values did not differ significantly among groups (p > 0.05. Within the limitations of this in vitro study, Protemp III and Structure 2 SC demonstrated superior flexural performance compared with other tested materials, suggesting their potential suitability as provisional crown materials. Further long-term in vivo studies are recommended to validate these findings.

The temporomandibular joint disorders (TMD) involve the mastication muscles, the temporomandibular joint (TMJ), and its related structures. To determine the role of Michigan oral splint aided by OTC drug versus removal of distoverted maxillary 3rd molars in the treatment of TMD. The randomized controlled clinical trial study enrolled 280 patients with confirmed TMD who attended different private/public dental centers, from November 2023 to August 2024. Patients had chief complaints of pain and clicking noise/sounds in their TMJ during mouth opening, chewing, muscle tension in the neck/face region, and pain in the head, neck, and pre-auricular/facial areas. Then, patients were randomly assigned to a control group (n = 140) and a study group (n = 140). Patients in the control group (Y1) underwent extraction of distoverted maxillary only, while patients in the study group (Y2) received Michigan oral splint aided by OTC drugs. Then, the Visual Analogue Pain Rating Scale was used to determine the intensity of pain among patients in both groups. Finally, patients were evaluated for treatment outcomes. Most patients were female (67.5%, n = 186) and had a mean age of 38 ± 8 years. Their pain intensity before treatment was 6.47 ± 1.49, and after treatment, it was 0.0 ± 0.0, indicating that the patients were completely healed after using the selected treatment. The results of the normality tests for pain scores before and after treatment showed strong evidence against the null hypothesis (p = 0.000). Additionally, a significant difference (p ≤ 0.05) between both groups suggests that the Michigan occlusal splint, aided by OTC drugs, had a positive effect on healing the patients. Consequently, the occlusal splint has a significant (p = 0.000) behavioural effect on increasing cognition related to mandibular position and function of the stomatognathic system. Michigan occlusal splint aided by OTC drugs was a superior modality than extraction of distoverted maxillary 3rd molars in treatment of TMD.