Saudi Dental Journal最新文献

This article aims to comprehensively review the clinical indications for esthetic crown lengthening (CL) and to propose a decision-making framework that incorporates key yet often overlooked factors influencing treatment planning. To gain a deeper understanding of the various clinical scenarios in which esthetic CL may be indicated, individual conditions are examined in detail, each accompanied by an appropriate treatment approach. Based on this analysis, we introduce a decision-making framework designed to guide clinicians in selecting the optimal treatment modality by accurately identifying the underlying esthetic concerns. The majority of published clinical guidelines for esthetic CL focus predominantly on cases with excessive gingival display. However, patients presenting without gingival display who may still benefit from esthetic CL are frequently neglected in the literature. Additionally, the influence of the smile arc and its relationship to incisal edge positioning remains underrepresented in current discussions. Our proposed decision-making framework integrates these critical factors to support more individualized and comprehensive treatment planning. Clinicians must possess a thorough understanding of all relevant esthetic and functional parameters when evaluating candidates for esthetic CL. Moreover, early and coordinated consultation with the prosthodontist is essential to define the appropriate balance between surgical and restorative interventions prior to surgical execution.

This research assessed the effect of acidic surface treatment in two different approaches involving airborne-particle abrasion (APA) surface treatment, relative to APA by itself, on the shear bond strength (SBS) of composite cement adhered to zirconia. Sixty cubes of 5 mol% yttria-stabilized zirconia (10 × 10 × 8 mm) were created and categorized into three groups (n = 20 each): APA Group, treated with 50 µm Al₂O₃ APA; APA + ZE 30 Group, underwent the same treatment as APA Group, followed by a 30 min ultrasonic application of Zircos-E etchant (ZE); and APA + ZE 120 Group, which received the same treatment as APA Group, followed by ZE for 120 min. SEM analyses were performed on three samples for each surface treatment. Each group was subdivided (n = 10 each) to receive either self-adhesive composite cement (RelyX U200) or MDP-containing primer (G-Multi primer) combined with BisGMA-based composite cement (G-CEM LinkForce). Composite cement cylinders were cast onto zirconia samples utilizing a mold (Ø4 × 3 mm). Samples were kept in an incubator at 37ºC with purified water for 24 h. An SBS test was subsequently performed using a universal testing machine (0.5 mm/min crosshead speed). Both ZE treatment groups demonstrated a significant level of difference compared to APA (p < 0.001), while there was no notable variation between the ZE treatment groups (p = 0.841). Moreover, there was no meaningful difference observed between the two varieties of composite cements (p > 0.05). Ultimately, SEM examinations of both ZE groups showed pits and porosities. Using acidic surface etchant is promising as an additional to APA for increasing SBS of composite cement to zirconia.

Background: Seventy-two percent of 12-year-old children in Indonesia experience dental caries, among 10-14-year-olds is 73%, and in 15-year-olds is 68.5%. Islamic boarding schools (pesantren) are one of the educational institutions in Indonesia, and dental caries status among the school students is moderate to severe. A preventive approach according to ecological balance has been proposed to prevent oral cavity disorders, especially dental caries.

Objectives: This study aimed to investigate the correlation of Lactobacillus reuteri probiotic consumption with plaque index, salivary pH, and Streptococcus mutans quantification.

Method: This research has been done at the Ibnu Hajar boarding school. A total of 40 research subjects aged 12-15 years were allocated into two groups (treatment and control), each consist of 20 subjects. Children in the treatment group took one Lactobacillus reuteri probiotic lozenge daily. Saliva samples of the subjects were taken at baseline and 7th days. Plaque index, salivary pH, and Streptococcus mutans quantification measurements were done before and after consumption of the Lactobacillus reuteri probiotic. Statistical analyses used the T-test and Spearman correlation test.

Results: There was a significant difference in plaque index, saliva pH, and an insignificant difference in Streptococcus mutans quantification after consuming the probiotics. The correlation coefficient between Lactobacillus reuteri probiotics consumption and plaque index is 0.672, between probiotic consumption and salivary pH is r = 0.433 (p < 0,05), while between probiotic consumption and Streptococcus mutans quantification is 0.162 (p > 0,05).

Conclusion: A significant correlation between Lactobacillus reuteri probiotic consumption with plaque index and salivary pH was found, but the correlation with Streptococcus mutans quantification was found insignificant.

Chronic periodontitis (CP) is associated with subgingival microbial dysbiosis and demonstrates specific microbial patterns, though definitive causal connections with microbiomes in distinct anatomical regions remain undetermined. Genome-wide association datasets for CP and oral microbial communities were sourced from a large European cohort and China National GeneBank DataBase (CNGBdb), respectively. Employing single-nucleotide polymorphisms (SNPs) as genetic instruments, Mendelian randomization (MR) analyses were conducted through the inverse-variance weighted (IVW) approach. Analysis methods were implemented through the 'TwoSampleMR' package (v0.6.4) in R software. Sensitivity analyses were performed to validate the robustness of the findings and mitigate the occurrence of horizontal pleiotropy. The MR analyses revealed three salivary bacterial taxa, Neisseria meningitidis (OR = 0.67, 95% CI, 0.49-0.98), Streptococcus vestibularis (OR = 0.74, 95% CI, 0.56-0.98), and Lancefieldella unclassified (OR = 0.68, 95% CI, 0.52-0.91) to be significantly associated with a reduced risk of CP (p < 0.05). In contrast, tongue microbial taxa Solobacterium unclassified (OR = 1.45, 95% CI, 1.04-2.04), Fusobacterium sp000235465 (OR = 1.40, 95% CI, 1.02-1.94), and Haemophilus parainfluenzae (OR = 1.56, 95% CI, 1.12-2.18) were associated with an increased CP risk (p < 0.05). No evidence of heterogeneity and directional pleiotropy was noted for these associations. This study highlights the association between specific salivary and tongue microbial taxa and CP, providing mechanistic linkages into the plausible relationship. It also suggests that some microbial taxa may be further explored as indicators for risk-stratified preventive measures and novel targets for precision prebiotics and therapies.

The current study investigated the relationship between the first central deciduous tooth eruption time and serum levels of maternal alpha-fetoprotein and related multiple of the median (MoM). The cross-sectional study was performed on a convenient sample of children aged 12 to 27 months in Isfahan City, Iran. Data regarding pediatrics' gender, gestational age, delivery mode, maternal age, serum levels of alpha-fetoprotein at weeks 15-20 of pregnancy, and the age of the first central deciduous tooth eruption were collected using a researcher-made standard checklist. The generalized linear model was used to investigate the link between eruption timing of the first central deciduous tooth and maternal alpha-fetoprotein/MoM. In total, 151 children were included in the study. The mean age of the first central primary tooth eruption was significantly lower in full-term compared to preterm children (8.01 ± 2.06 vs. 9.77 ± 3.15 months; P = 0.02). An inverse linear association was observed between maternal alpha-fetoprotein expressed as MoM and eruption timing in preterm infants (β = -4.27; 95% CI: -7.72 to -0.83; P = 0.01). In full-term infants, the association also approached statistical significance (β = -0.93; 95% CI: -1.86 to 0.01; P = 0.05). For maternal alpha-fetoprotein levels (ng/ml), marginal associations with eruption timing were noted in both full-term (P = 0.08) and preterm infants (P = 0.05). The findings of this study suggest a potential inverse relationship between maternal alpha-fetoprotein levels and the timing of first primary tooth eruption, particularly among preterm infants. Further prospective studies with larger, more diverse populations are required to validate and expand upon these preliminary observations.

This study combined in-silico molecular docking with in-vitro cytocompatibility testing to evaluate the safety of cyanoacrylate adhesives. Molecular docking was performed for four cyanoacrylate monomers (ethyl, n-butyl, isoamyl, and 2-octyl) against key proteins associated with inflammation (IL-1β, IL-6, TNF-α, CRP), bone metabolism (BMP4), and tissue repair (NOTCH2, fibronectin). Docking scores and binding residues were analyzed using PyRx and BIOVIA Discovery Studio. Degradation products (formaldehyde, ethyl-2-cyanoacetate) were also evaluated. In-vitro cytocompatibility of isoamyl 2-cyanoacrylate was assessed on 3T3-L1 fibroblasts using MTT and LDH assays at concentrations of 25-200 μg/mL over 24 and 48 h. Docking scores ranged from -4 to -6 kcal/mol, suggesting weak to moderate binding and low likelihood of interference with protein function. Longer-chain cyanoacrylates showed weaker binding compared to ethyl cyanoacrylate, indicating more favorable stability and lower toxicity. Degradation products demonstrated reduced binding, though ethyl-2-cyanoacetate showed comparatively higher affinities than formaldehyde. In-vitro assays revealed cell viabilities above the ISO 10993-5 threshold at clinically relevant concentrations, with mild cytotoxicity only at higher concentrations and longer exposures. The combined findings provide a molecular and cellular basis for their clinical use, suggesting that longer-chain cyanoacrylates are likely safer adhesives for denture applications.

Intracanal medication is critical for regenerative endodontic procedures (REPs). The purpose of this study was to examine the effects of modified triple antibiotic paste (mTAP) on the migration, proliferation, and osteogenic/cementogenic differentiation of human periodontal ligament stem cells (hPDLSCs) as well as its antibacterial effectiveness against Enterococcus faecalis (E. faecalis). hPDLSCs were treated with mTAP across various concentration gradients. hPDLSCs were treated with mTAP across concentration gradients. Cell Counting Kit-8, wound-healing assay, alizarin red staining, real-time quantitative polymerase chain reaction, and western blot were used to evaluate cell functions. The antibacterial efficacy was evaluated using microdilution assays and static biofilm models. The results demonstrated concentration-dependent effects on hPDLSCs functionality. At low and medium concentrations (3.9, 15.6, and 62.5 μg/mL), mTAP had no significant effect or slightly promoted hPDLSCs migration and proliferation, whereas high concentrations (≥ 250.0 μg/mL) inhibited these functions. With increasing mTAP concentration, mineralized nodule formation and osteogenic differentiation expression first increased and then decreased, whereas cementoblastic differentiation expression gradually increased. Against E. faecalis, mTAP exhibited a minimum inhibitory concentration (MIC) of 1 μg/mL and a minimum bactericidal concentration (MBC) of 128 μg/mL. mTAP inhibited 76.33 ± 0.89% early-stage biofilm formation at 32 μg/mL and eradicated ≥ 72.53 ± 1.15% 14-day mature biofilms at concentrations ≥ 125 μg/mL. Balancing biocompatibility and antibacterial efficacy, the optimal concentration range of mTAP during REPs was 128-250 μg/mL, which provides a robust basis for the future clinical application and formulation of safe and effective intracanal medications.

Desensitizing toothpastes are considered an effective treatment option for managing dentin hypersensitivity (DH). This review evaluated existing systematic reviews and meta-analyses to determine the effectiveness of toothpastes containing calcium sodium phosphosilicate (CSPS) in managing DH. A comprehensive search was conducted in PubMed, Embase, Scopus, Cochrane, and Web of Science databases. Two reviewers performed study selection, data extraction, methodological quality assessment (using the AMSTAR 2 tool) and risk of bias (RoB; using the ROBIS tool) evaluation. The primary randomized clinical trials overlap was assessed using a citation matrix and calculating the overlap percentage, covered area (CA), and corrected covered area (CCA). A total of 5681 studies were identified and the full text of 85 studies were assessed. Finally, nine reviews were included in the umbrella review. A very high overlap was observed across primary studies. Eight studies had a low or critically low quality. Two reviews demonstrated a low RoB across all domains. CSPS-containing toothpastes were found to be more effective in relieving DH than placebo and negative controls. CSPS-containing toothpastes may be effective in relieving the pain associated with DH. However, the considerable heterogeneity and generally low methodological quality of the available evidence warrant cautious interpretation.

Artificial intelligence (AI) has recently gained significant interest in orthodontics due to its ability to enhance diagnostic accuracy, guide treatment planning, and improve therapeutic outcomes. This review aimed to explore the relevance and applications of AI across various aspects of orthodontics. A comprehensive literature search was performed from January 2010 to 1 March 2025 in databases including PubMed, EMBASE, Web of Science, Scopus, and Cochrane. Letters to the editor, case reports, systematic reviews, and animal studies were excluded. Artificial intelligence models, especially those using deep learning, have been integrated into multiple orthodontic fields, including landmark identification, malocclusion classification, treatment planning, growth prediction, and risk assessment. They have also achieved notable success in segmenting two-dimensional and three-dimensional anatomical structures, aligner therapy, evaluating facial asymmetry, localizing impacted canines, and identifying clefts. While several investigations highlight the high accuracy of AI models, others emphasize the need for clinician oversight, recommending that these tools serve as a supportive tool rather than a replacement for clinical judgment. AI-based algorithms may enhance treatment quality, decrease procedural time and operator variability, and reduce human error. However, further clinical trials are needed to validate and optimize the accuracy and reliability of these models in orthodontics.

To evaluate the effect of bioactive varnish application on the shear bond strength (SBS) of orthodontic brackets bonded to demineralized enamel. Bovine incisors were selected and randomly assigned to four groups based on enamel treatment: Group 1 - sound enamel, no treatment (positive control); Group 2 - enamel subjected to a pH-cycling demineralization protocol (negative control); Group 3 - demineralized enamel treated with bioactive varnish (PRG Barrier Coat®, Shofu) and stored in distilled water for 24 h; and Group 4 - demineralized enamel treated with the same varnish and stored in distilled water for 28 days. For SBS and Adhesive Remnant Index (ARI) tests (n = 15 per group), orthodontic brackets (Roth Max® slot 22, Morelli) were bonded to the enamel using the Transbond XT® adhesive system (3 M Solventum). Samples underwent thermocycling (500 cycles between 5 °C and 55 °C), followed by SBS testing using a universal testing machine (0.5 mm/min) and ARI evaluation using stereomicroscopy. Enamel surfaces from each group (n = 3 per group) were also examined using scanning electron microscopy (SEM). SBS data were analyzed using the Kruskal-Wallis test, followed by Dunn's post hoc test. ARI scores were analyzed using Fisher's exact test, with significance set at 5%. The positive control group showed significantly higher SBS values compared to Groups 3 and 4 (p < 0.001). The negative control group showed intermediate values, with no significant differences from the other groups. A significant association was found between groups and ARI scores: in the positive control group, 53.3% of samples had ARI = 0 and 33.3% had ARI = 3; in the negative control group, 93.3% had ARI = 0. In Groups 3 and 4, 100% of the samples showed ARI = 0. SEM analysis revealed an intact surface in the positive control group, a porous surface in the negative control, and a varnish-covered surface in Groups 3 and 4, with Group 3 exhibiting a more homogeneous coating than Group 4. Conclusion: The application of bioactive varnish to demineralized enamel significantly reduced bracket bond strength and resulted in predominantly adhesive failures at the enamel interface. Clinically, this suggests that bonding orthodontic brackets directly to enamel treated with this bioactive varnish may compromise bond integrity, regardless of the waiting period after application.