Saudi Dental Journal最新文献

This study investigated the color stability and surface roughness of three novel single-shade universal composites after exposure to common staining solutions. A total of 120 specimens (n = 40 per composite) were fabricated from Transcend Universal Composite (TRA), Ecosite One (ECO), and Clearfil Majesty ES-2 Universal (CLA). Specimens were stored at 37 °C in four different staining solutions (artificial saliva, coffee, red wine, matcha tea). Color changes (ΔE₀₀) were assessed at five time points using the eLAB system, and surface roughness (Sa, Sz) was analyzed via 3D laser scanning microscopy. Statistical analysis was performed using a linear mixed model and post-hoc test (Tukey) (p < 0.05). Composite type, staining solution, and exposure duration significantly affected discoloration (p < 0.001). Red wine induced the most pronounced color change (ECO: ΔE₀₀ = 38.9 ± 1.56), while coffee and matcha tea caused similar discoloration (p = 0.164). TRA showed the greatest surface roughness increase; no correlation with color change was observed. The color stability of single-shade composites is influenced by resin matrix composition and staining agent exposure. Tri-modal or nanohybrid composites showed greater color stability than the micro hybrid composite. Surface roughness did not impact discoloration susceptibility.

One clinical complication oral surgeons encounter is oroantral communication (OAC) with progressive formation of oroantral fistula (OAF). Among bone grafting materials, autogenous bone is still considered the gold standard in grafting oral and maxillofacial regions. To evaluate clinically and radiographically the efficacy of Calcium phosphate (Vital-Os) bone cement in stabilizing an autogenous bone graft in repairing an oroantral fistula. The study recruited 20 patients with an oroantral fistula ranging from 4-10 mm diameter. Ten patients were treated by grafting the defect with bone graft harvested from the chin area and closure of oroantral by buccal advancement flap and Vital-Os Bone cement (Study group), and ten patients were treated without Vital-Os Bone cement (Control group). All patients came for postoperative follow-up at the 1st, 3rd, and 6th months. Visual Analogue Scale (VAS) in the study group was significantly lower than the control group one week and one month postoperatively (p = .007, .004; respectively). Failure of the oroantral fistula closure was significantly lower in the study group (p = .025). The closure of an oroantral fistula is recommended through the use of an autogenous bone graft harvested from the chin region, supplemented by the application of injectable VitalOs bone cement to secure the graft at the recipient site.

This study evaluates the antimicrobial efficacy of gold nanogel as an endodontic medicament against Enterococcus faecalis in persistent root canal infections. It investigates whether gold nanogel can serve as an effective and biocompatible alternative to conventional medicaments in eliminating E. faecalis. Gold nanoparticles (< 100 nm) were tested against E. faecalis using the agar diffusion method. Extracted teeth inoculated with E. faecalis were treated with gold nanogel (1000 µg/mL), chlorhexidine gluconate (2%), calcium hydroxide, or saline for seven days. Antimicrobial efficacy was assessed on days 1, 3, and 7 using agar diffusion and colony-forming unit (CFU) assays. Gold nanogel significantly reduced E. faecalis biofilm viability, showing greater efficacy than calcium hydroxide and comparable results to 2% chlorhexidine. Chlorhexidine eradicated E. faecalis by day 7, while gold nanogel exhibited sustained antibacterial action with minimal CFUs remaining. Gold nanogel demonstrated superior efficacy over calcium hydroxide and comparable effectiveness to chlorhexidine gluconate (2%) against E. faecalis. Further studies are recommended to evaluate its clinical applications and long-term biocompatibility.

The study conducted to assess the frequency of radiographic retakes during endodontic procedures among undergraduate dental students and to identify common imaging errors, intending to propose strategies to increase radiographic accuracy and minimize unnecessary exposure. A retrospective analysis conducted using data from 4786 intraoperative periapical radiographs taken by fourth-year students during root canal treatment. The incidence and reasons behind repeating radiographs were examined on the basis of tooth type and treatment step. The imaging errors were categorized, then chi-square tests and one-way analysis of variance were performed. The overall repeat rate was 37.2%, with the highest frequency occurring during the master cone selection (54.6%) and working length determination (47.4%). The most prevalent error leading to repetition was missing the apical area (38%), which was significantly associated with radiographic repetition (p = 0.0001). Other common errors included incorrect working length adjustment (9.6%) and master apical cone positioning (20%). There was no significant difference in overall repeat rates between maxillary and mandibular teeth (p > 0.05). The high radiographic repetition rate highlights the need for enhanced radiographic training, improved faculty supervision, and greater reliance on electronic apex locators (EALs) with the radiographs to reduce unnecessary imaging. Implementing structured radiographic education and promoting the use of parallel devices can increase students' diagnostic accuracy. Clinically, reducing radiographic repetition minimizes radiation exposure and improves procedural efficiency.

This study aimed to evaluate the fracture resistance of maxillary veneers with feather edge, butt-joint and palatal chamfer and traditional full coverage crowns fabricated out of chairside CAD/CAM advanced lithium disilicate and virgilite. Fifty-two restorations for maxillary right canine were fabricated (n = 13 per group) as follows: veneers with feather edge, veneers with butt-joint, veneers with palatal chamfer and full coverage crowns out of chairside CAD/CAM lithium disilicate and virgilite (Cerec Tessera). The restorations were bonded to 3D printed resin dies with resin cement (Variolink Esthetic LC). The cemented restorations were subjected to 10,000 thermocycles at 5 to 55 °C with a dwell time of 30 s. The specimens were loaded until fracture using a universal testing machine and the resistance was recorded in Newtons. Two-way ANOVA was used to assess the fracture resistance among veneers with different incisal edge designs and between veneers and crowns. Scanning electron microscope (SEM) images of the fractured specimens were taken and descriptive analysis was carried out. Full coverage crowns displayed higher fracture resistance (1496 ± 41 N) than any type of veneers. Veneers with palatal chamfer showed the highest value (842 ± 28 N) among veneers followed by butt joint veneers (661 ± 22 N). Feather edge veneers provided the lowest fracture resistance values (464 ± 23 N). The fracture resistance of CAD/CAM advanced lithium disilicate maxillary veneers are significantly influenced by the incisal edge design. Palatal chamfer veneers displayed higher fracture resistance than feather edge and butt joint veneers. Full coverage crowns offered higher fracture resistance than any type of veneer.

Recognizing the characteristics of the zygomatic process of the maxilla (ZPM) has several applications in implant dentistry and orthodontics. The present study evaluated the relationship between ZPM morphology, as obtained from panoramic images, and sinus pneumatization within the ZPM, according to cone-beam computed tomography (CBCT). CBCT and panoramic images of 300 patients were obtained, and the patients were divided into three age groups: Group I (15-34 years), Group II (35-55 years), and Group III (≥ 55 years). ZPM morphology was classified into J-shaped and non-J-shaped types based on panoramic images. The ZPM volume, maxillary sinus volume, and extent of sinus pneumatization within the ZPM were measured using CBCT scans, and their relationship to ZPM morphology classification was evaluated. Statistical analyses were performed using the Shapiro-Wilk test, one-way ANOVA, independent sample t-test, Mann-Whitney U test, Kruskal-Wallis test, and chi-square test (α = 0.05). Participants ranged in age from 17 to 82 years, and 67% were female. Most ZPMs were J-shaped (75%). J-shaped ZPMs had significantly greater sinus volume (1.83 ± 0.81 cm³), sinus pneumatization (53.56 ± 12.60%), and ZPM volume (3.50 ± 0.98 cm³) compared to non-J-shaped ZPMs (P < 0.05). Male participants had significantly larger ZPM volumes than females (P = 0.039). Sinus pneumatization and maxillary sinus volume were comparable across age groups and between gender. The presence of a non-J-shaped ZPM might be associated with less sinus pneumatization than J-shaped ZPMs, regardless of the patient's age or gender. Therefore, non-J-shaped ZPMs might offer more bone availability for various applications in dentistry.

Bone turnover biomarker levels serve as valid tools for assessing bone resorption and formation. While the standard retention protocol consists of using fixed retainers, removable retainers, or both, attempts have been made to explore alternative approaches using biological agents. Psidium guajava fruit is reported to possess osteoanabolic properties. These properties might be useful in preventing orthodontic treatment relapse. To assess the effect of orally administered Psidium guajava fruit suspension on alkaline phosphatase (ALP) and osteocalcin (OC) levels in the gingival crevicular fluid (GCF) of Wistar rats using enzyme-linked immunosorbent assay (ELISA). Fourteen rats underwent orthodontic tooth movement of the left maxillary first molar. Subsequently, the appliance was removed, then retention phase was initiated by placing composite resin in the created space between the left maxillary first and second molars. The intervention group received 250 mg/kg of P. guajava fruit suspension daily, while the control group received normal saline for 35 days. When retention ended, the left maxillary first molars were allowed to relapse for 7 days. At the end of the relapse phase, GCF samples were collected from the distal side of the left maxillary first molars using a PerioPaper and analyzed by ELISA. The mean concentration of ALP in the control and intervention groups was 0.074 ± 0.012 pg/mL and 0.075 ± 0.005 pg/mL, respectively (P = 0.704), while that of OC was 0.696 ± 0.003 pg/mL and 0.692 ± 0.011 pg/mL, respectively (P = 0.391). Oral supplementation of P. guajava fruit suspension did not have a positive impact on GCF bone turnover biomarkers (ALP and OC) in Wistar rats.

Deep Margin Elevation (DME) is a restorative technique that lifts deep proximal cavities, allowing for better restoration margins. The effect of DME materials on the fracture resistance of premolar endocrowns is not well understood. This study compared the fracture resistance of premolar endocrown employing two DME materials, SDR flowable composite and resin-modified glass ionomer (RMGI), after thermocycling. 54 endodontically treated premolars were assigned into three groups (n = 18) and prepared to receive polymer infiltrated ceramic (PIC) endocrowns. The cervical margins of the control group (E1) were set 2 mm below the cemento-enamel junction (CEJ) and restored directly with Endocrown. Group E2: Endocrown was used to reconstruct the teeth after a deep margin was raised to a height of 1 mm above the CEJ using flowable composite. Group E3: teeth were rebuilt as in the E2 group, and a deep margin was raised with RMGI. Following cementation, the samples underwent 10,000 cycles in two water baths with varying temperatures (5-55). Next, Standardized testing procedures were used to evaluate the fracture resistance. After thermocycling, Group E2 displayed the greatest mean fracture load value (621 to 833N). The group E3 values were found to be between (577 and 728 N), which was not significantly different from the values of group E1. SDR-based restorations would show improved durability compared to RMGI-based restoration. When isolation is possible, endocrowns made with the combination of SDR and PIC endocrowns may offer promising results without turning to more surgical treatment procedures.

To evaluate the (i) incidence of post-operative pain after RCT at 24 h, 48 h and 7 days, (ii) factors affecting the incidence of post-operative pain and (iii) patients' post-operative quality of life (PoQoL) at 24 h, 48 h and 7 days. One hundred and sixty two (n = 162) patients underwent either single-visit or multiple-visit RCT or retreatment at the Restorative Department. Post-operative pain was assessed via phone calls at 24 h, 48 h and 7 days via the Numeric Rating Scale (NRS) and Modified Verbal Rating Scale (MVRS) pain assessment tools. The PoQoL was assessed at the same three time points based on an adopted questionnaire which assessed pain on chewing, speaking, sleeping, ability to perform daily activities and social relations as well as the effects of pain on the overall QoL. The incidence of pain and the effects on the PoQoL were evaluated using descriptive analysis while the prognostic factors were evaluated using ordinal logistic regression analysis. Patients who felt pain after instrumentation had mild (24 h n = 24, 48 h n = 23) to moderate pain (24 h n = 13, 48 h n = 13) that decreased after 7 days. Post-obturation discomfort was highest at 24 h (n = 41), reduced at 48 h (n = 31) and 7 days (n = 11).The majority of patients who felt pain after treatment needed analgesics only at 24 and 48 h for pain control. Post-instrumentation and post-obturation pain did not affect patients' overall PoQoL, although many complained of chewing difficulty within 24 to 48 h. Only pre-operative pain within 24 h before treatment was a positive predictive factor for post-instrumentation pain in the simple ordinal logistic regression model. As for the post-obturation pain, molar tooth was associated with 2.5 times higher likelihood of post-obturation pain. Post-operative pain after RCT was common within 24 to 48 h but reduced at 7 days, with a likelihood of chewing difficulty following treatment. The pain felt was mainly mild to moderate, well controlled by analgesics and did not significantly affect the PoQoL. Clinical Trial Registration: ClinicalTrials.gov ID NCT06412263, protocol ID 295316.

There are numerous factors that can impact both the correction of jaw deficiencies and the success of a particular grafting material, including the histology and density of both the maxillary and mandibular bones and the grafting material itself. This study compares the clinical outcomes of grafted augmentations of the horizontal alveolar ridge of the anterior maxilla using mandibular symphysis onlay bone that was admixed with either injectable platelet-rich fibrin (i-PRF) or xenografts. Twelve adult patients with horizontal maxillary alveolar ridge deficiency were randomly divided into two groups of six patients each. Group I received mandibular symphysis onlay bone grafts mixed with i-PRF, while Group II received mandibular symphysis onlay bone grafts admixed with xenografts (InterOss anorganic cancellous granules). CBCT scans were used to measure alveolar ridge width and bone density both preoperatively and at 6-month follow-up. Both groups showed improvements in alveolar ridge width and bone density. The increase in measured bone width and density after 6 months in Group II was significantly greater than that in Group I (p = 0.040). Horizontal alveolar ridge augmentation using an onlay chin graft in combination with xenografts was successful and offered adequate bone quantity and quality.