Albina de Fátima Fanni Santos, Carolina Dutra Degli Esposti, Ana Paula Santana Coelho Almeida
Objective: To identify the factors associated with the resolution of endodontic treatments in Brazilian municipalities with Brazilian Dental Specialty Centers (CEO). Material and Methods: Ecological study with 684 municipalities participating in the second cycle of the National Program for Improving Access and Quality of Specialty Dental Centers (PMAQ‑CEO) in 2018. Data were obtained from the health information systems of the Brazilian Unified Health System (SUS), the PMAQ-CEO, and additional sources. The dependent variable, resolution, was the ratio of completed endodontic treatments to endodontic access procedures. For the bivariate analysis, Pearson's chi-square test was applied, considering contextual and health system-related municipal factors as independent variables. These included the Municipal Human Development Index (MHDI), resident population size, national macro-region, dental insurance coverage, oral health team coverage, number of dentists affiliated with the SUS, coverage of initial dental consultations, existence of an Urgent Care Center, number of CEO, and PMAQ-CEO certification. Multivariate analysis was performed using ordinal logistic regression, adopting a two-level hierarchical model. Results: The median of the dependent variable was 0.33; that is, for every 10 teeth opened for pain relief due to deep dental caries, approximately 3 teeth had completed endodontic treatment. The adjusted analysis showed greater chance of resolution in municipalities with the following characteristics: Northeastern region (OR=1.9; 1.1-3.4); medium population size (OR=2.0; 104-2.9); second HDI-M quartile (OR=2.5; 1.6-4.0); lower dental plan coverage (OR=2.4; 1.5-4.0); classified as good, very good or excellent in the PMAQ-CEO certification (OR=1.4; 1.1-1.9). Conclusion: There was low resolution in endodontic treatments performed in SUS. Municipalities of both small and large sizes demonstrate greater fragility in care continuity, as reflected in a low proportion of completed endodontic treatments within the SUS.
Clóvis Lamartine de Moraes Melo Neto, Marcelo Coelho Goiato, Daniela Micheline dos Santos
et al.
The objective was to evaluate the influence of two tongue cleaning methods (copper tongue scraper and toothbrush) on morning halitosis in dental students. Thirteen dental students were included. After training, the first participant took the halimeter home and used it for 6 days. On the first three days, halitosis was measured immediately after the participant woke up in the morning. The night before each of these first three days, before going to sleep, the participant cleaned their mouth with dental floss and a soft-bristled toothbrush. The individual’s same soft-bristled toothbrush was also used to brush his tongue. Only one halitosis measurement was taken per day and the value was recorded each day (toothbrush group). On the fourth, fifth and sixth day, the same process was carried out, but the night before measuring halitosis, a copper tongue scraper was used to clean the participants’ tongue. Only one halitosis measurement was taken per day and the value was recorded each day (tongue scraper group). Subsequently, for each participant, the highest halitosis value of the first three days (toothbrush group) was chosen, as well as the highest halitosis value of the last three days (tongue scraper group). The Wilcoxon test was used to compare the two groups (P<0.05). The halitosis value (median) in the toothbrush group was significantly higher than that in the tongue scraper group. Only the tongue scraper group showed a clinically acceptable halitosis value (imperceptible odour). Therefore, the copper tongue scraper is more recommended for cleaning the tongue.
Three-dimensional (3D) printing has emerged as a transformative technology in dental splint fabrication, offering significant advancements in customization, production speed, material efficiency, and patient comfort. This comprehensive review synthesizes the current literature on the clinical use, benefits, limitations, and future directions of 3D-printed dental splints across various disciplines, including prosthodontics, orthodontics, oral surgery, and restorative dentistry. Key 3D printing technologies such as stereolithography (SLA), digital light processing (DLP), and material jetting are discussed, along with the properties of contemporary photopolymer resins used in splint fabrication. Evidence indicates that while 3D-printed splints generally meet ISO standards for flexural strength and wear resistance, their mechanical properties are often 15–30% lower than those of heat-cured PMMA in head-to-head tests (flexural strength range 50–100 MPa vs. PMMA 100–130 MPa), and study-to-study variability is high. Some reports even show significantly reduced hardness and fatigue resistance in certain resins, underscoring material-specific heterogeneity. Clinical applications reviewed include occlusal stabilization for bruxism and temporomandibular disorders, surgical wafers for orthognathic procedures, orthodontic retainers, and endodontic guides. While current limitations include material aging, post-processing complexity, and variability in long-term outcomes, ongoing innovations—such as flexible resins, multi-material printing, and AI-driven design—hold promise for broader adoption. The review concludes with evidence-based clinical recommendations and identifies critical research gaps, particularly regarding long-term durability, pediatric applications, and quality control standards. This review supports the growing role of 3D printing as an efficient and versatile tool for delivering high-quality splint therapy in modern dental practice.
Multilayer monolithic zirconia, which incorporates polychromatic layers that mimic natural tooth gradients, offers enhanced aesthetics and functionality while reducing debonding risks and improving fabrication efficiency. However, uncertainties remain regarding the fracture characteristics of multilayer monolithic zirconia crowns under occlusal loading, whether composed of uniform or combined yttria levels. The current study investigated how variations in yttria levels and thicknesses affected the optical properties and fracture loads of multilayer monolithic zirconia. Samples of multilayer monolithic zirconia in the Vita A1 shade were used, while employing 3Y (SZ) and 4Y + 5Y (AZ) yttria levels. The optical properties, including the color difference (Δ<i>E<sub>WS</sub></i>) and translucency parameters (<i>TP</i><sub>00</sub>), were measured using a digital colorimeter. The fracture loads were analyzed using a universal testing machine, and fractured surfaces were examined under a stereomicroscope. Statistical analyses assessed the impacts of the yttria levels and sample thicknesses on the optical properties. The Δ<i>E<sub>WS</sub></i> values of SZ ranged 3.6 to 4.0, while for AZ, Δ<i>E<sub>WS</sub></i> at 0.5 mm was 3.9 and <2.6 for other thicknesses. The <i>TP</i><sub>00</sub> values decreased with an increased thickness, with AZ generally exhibiting greater translucency than SZ. In the fracture load investigations, SZ (>1600 N) generally exceeded AZ (>1260 N), with fracture loads notably increasing with thickness, particularly for premolars (SZ > 3270 N, AZ > 2257 N). SZ predominantly exhibited partial and complete fractures, whereas AZ showed fewer non-fracture categorizations. Complete fractures began with dense, irregular cracks that extended outward to reveal smooth surfaces, while premolars subjected to higher loads exhibited concentric ripple-like structures. Partial fractures revealed radial textures indicative of areas of stress concentration. In summary, higher yttria levels were correlated with increased translucency, while variations in the fracture loads primarily stemmed from differences in the tooth position or thickness. Overall, multilayer monolithic zirconia incorporating combined yttria levels of 4Y + 5Y (AZ) offered high translucency, precise color matching, and substantial fracture resistance, rendering it highly suitable for aesthetic and functional dental applications.
María del Cisne Centeno Dávila, Paola Orellana Bravo, Carlos Andrade Tacuri
et al.
Introducción: Cuando existe un desequilibrio en el huésped, se ha demostrado que hay microorganismos que contribuyen
a la formación de distintas periodontopatías, siendo considerados como principales microorganismos los del complejo rojo
de Socransky: Porphyromonas gingivalis, Tannerella forsythia y Treponema denticola. En estudios recientes se consideran
también como posibles patógenos de enfermedad periodontal: Staphylococcus aureus, Candida albicans y Enterococcus
faecalis. Objetivo: Analizar los microorganismos presentes en la enfermedad periodontal, mediante una revisión
bibliográfica. Métodos: Se recurre a una investigación documental descriptiva. Se realiza mediante una revisión
bibliográfica narrativa, se realizó mediante la búsqueda de artículos científicos en bases de datos como Scielo, PubMed,
Elsevier, Ovid, Scopus y Google Academic; considerando 47 literaturas que se ajustan a los criterios de inclusión.
Conclusiones: Se confirmó que las bacterias pertenecientes al complejo rojo: Porphyromonas gingivalis, Tannerella forsythia
y Treponema denticola son principales causantes de la Enfermedad Periodontal. Mientras que, en diferentes estudios, se
demostró la presencia de microorganismos como: Staphylococcus aureus, Candida albicans y Enterococcus faecalis
asociando sus factores de virulencia y fisiopatología con las Enfermedad Periodontal, estos microorganismos son
considerados como periodontopatógenos oportunistas, sin embargo, no se logró demostrar que sean precursores de la
misma.
Clarissa Teles RODRIGUES, Reinhilde JACOBS, Mostafa EZELDEEN
et al.
Abstract The aim of this study was to compare the quantification of hard-tissue debris by using micro-computed tomography (micro-CT) and nano-focus computed tomography (nano-CT) after root canal instrumentation. Ten mandibular molars containing an isthmus in the mesial root were scanned in a SkyScan 1172 micro-CT device with a voxel size of 12.8 µm and in a NanoTom nano-CT device with 5.5 µm. The mesial root canals were irrigated with 5 mL of saline solution at the orifice level, instrumented with Reciproc R25 files and a second scanning was performed by micro-CT and nano-CT devices for post-instrumentation images. DataViewer software was used for registering the pre- and post-operative micro-CT and nano-CT images. The root canal and the debris were segmented for quantitative analysis of the volume of the canal and volume of debris using CTAn software. Statistical analysis was performed using the T test for comparison between volume of the canal after instrumentation and volume of debris in both image modalities. The level of significance was set at p < 0.05. Nano-CT images showed higher values of debris when compared with micro-CT (p < 0.05) after root canal instrumentation. No difference was observed between the volume of the root canal after instrumentation in the two imaging methods used (p > 0.05). Nano-CT technology can be recommended as a more precise method for quantitative analysis of hard-tissue debris. Moreover, in Endodontic research it is a promising method, as it is capable of providing higher spatial and contrast resolution, faster scanning and higher image quality.
Ali Abdulhussain Fadhil, Qasim Khlaif Kadhim, Abdullah Shakir
et al.
Background: Lung cancer is one of the most prevalent types of cancer and one of the world's leading causes of death. The purpose of the current study is to evaluate how well acceptance and commitment therapy (ACT) treats distress tolerance and death anxiety in patients with lung cancer.
Methods: The current research was practical in terms of purpose and quasi-experimental in terms of method with a pre-test, post-test, and follow-up design with a control group. The statistical population consisted of 317 patients with lung cancer referred to the King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia, in 2021. Simple random sampling was utilized to select 70 patients from the group. The participants were separated randomly into experimental and control groups (35 in each group). In order to collect information, questionnaires of distress tolerance and death anxiety were used. The SPSS software was used to perform repeated measures analysis of variance (ANOVA).
Results: The experimental and control groups differed in the post-test death anxiety measures and distress tolerance components (P < 0.001). In addition, the outcomes remained constant across the follow-up period (P < 0.001).
Conclusion: This study showed that in patients with lung cancer, ACT raised distress tolerance and decreased anxiety about death. In addition to medical programs to lessen and manage discomfort and death anxiety, educational and psychological programs must be offered to patients with lung cancer in order to improve their mental health.
Restorative materials such as conventional glass ionomer cement (CGIC), resin-modified glass ionomer cement (RMGIC), polyacid-modified composite resin (compomer), and giomer have the properties of fluoride release and refill, which may prevent or slow down the progression of caries. The caries resistance of these materials was evaluated according to the following criteria: fluorine-releasing ability, antibacterial activity, mechanical properties and anti-aging properties. The anti-caries effect of these materials mainly depends on the effect of fluoride ions on mineralization. However, materials with strong fluorine release ability, such as CGIC, are mainly used in pediatric dentistry and temporary restoration due to their poor mechanical properties. It is difficult to achieve both fluoride ion release potential and mechanical strength, and there are few materials that can provide ideal mechanical strength while maintaining a high standard of fluoride release. The fluoride releasing and recharging capacity of CGIC, RMGIC, compomer and giomer decrease successively. The trend of material modification, to a certain extent, tends to sacrifice the fluoride release capacity of materials to maintain the ideal mechanical strength. In recent years, scholars have tried to add a variety of fillers to further enhance the anti-cracking ability of materials and add antibacterial agents to compensate for the anti-caries effect to reduce the loss of fluoride release.
Marian O. Pacho, Dylan Deeney, Emily A. Johnson
et al.
There has been profound growth in the use of 3D printed materials in dentistry in general, including orthodontics. The opportunity to impart antimicrobial properties to 3D printed parts from existing resins requires the capability of forming a stable colloid incorporating antimicrobial fillers. The objective of this research was to characterize a colloid consisting of a 3D printable resin mixed with Ag-ion releasing zeolites and fumed silica to create 3D printed parts with antiviral properties. The final composite was tested for antiviral properties against SARS-CoV-2 and HIV-1. Antiviral activity was measured in terms of the half-life of SARS-CoV-2 and HIV-1 on the composite surface. The inclusion of the zeolite did not interfere with the kinetics measured on the surface of the ATR crystal. While the depth of cure, measured following ISO4049 guidelines, was reduced from 3.8 mm to 1.4 mm in 5 s, this greatly exceeded the resolution required for 3D printing. The colloid was stable for at least 6 months and the rheological behavior was dependent upon the fumed silica loading. The inclusion of zeolites and fumed silica significantly increased the flexural strength of the composite as measured by a 3 point bend test. The composite released approximately 2500 μg/L of silver ion per gram of composite as determined by potentiometry. There was a significant reduction of the average half-life of SARS-CoV-2 (1.9 fold) and HIV-1 (2.7 fold) on the surface of the composite. The inclusion of Ag-ion releasing zeolites into 3D-printable resin can result in stable colloids that generate composites with improved mechanical properties and antiviral properties.
Douglas Deporter, Maziar Ebrahimi Dastgurdi, Azadeh Rahmati
et al.
Background. This study used CBCT images to evaluate the suitability of maxillary first and second molar sites to receive immediate implants. Buccopalatal and mesiodistal widths of maxillary molar inter-radicular septum were evaluated at three different levels (crestal, middle, and apical), in addition to assessments of the root apex and furcation proximities to the sinus floor and comparisons of these measurements between the first and second upper molar sites before extraction.Methods. A total of 427 dental sites from 223 patients were used to measure the buccopalatal and mesiodistal widths of inter-septal/furcal (IRS) bone of maxillary first and second molars and vertical distances from the furcation and from all the root apices to the sinus floor (SF).Results. Mean coronal-most buccopalatal/mesiodistal IRS widths were 7.33/6.52 mm for the first and 6.86/5.85 mm for the second molars (P=0.008). Corresponding mean FSD (furcation-sinus floor) values were 9.69 mm (range: 2.02-24.68 mm) and 8.84 mm (range: 1.48-25.09 mm). Mean distances from all the root apices to SF were <3 mm. The palatal roots of the first molars had higher sinus intrusion rates (28.85%) than their buccal counterparts, while for the second molars, the mesiobuccal roots showed the highest sinus intrusion (37.65%).Conclusion. In the current patient sample, 61.7% of the first and 34% of the second molars had a sufficiently broad IRS to encase a 5-mm-diameter IMI (immediate molar implant) completely. The mean FSD of 9 mm for both molars indicated that some sinus floor elevation would likely be needed unless short implants were used.
Figen ÖNGÖZ DEDE, Şeyma BOZKURT DOĞAN, Umut BALLI
et al.
Abstract Objective This study aims to evaluate the effect of ellagic acid (EA) by measuring the levels of alveolar bone resorption and inflammatory and oxidative stress markers in the periodontal tissues and serum on the periodontal repair process related to experimental periodontitis in rats. Methodology Forty Wistar rats were divided into four study groups as follows: Group 1=healthy control (n=10); Group 2=EA control (15 mg/kg)(n=10); Group 3=periodontitis (n=10); Group 4=periodontitis+EA (15 mg/kg) (n=10). The periodontitis model was established by ligating bilateral mandibular first molars for 14 days. Then, rats were given normal saline or EA for another 14 days by gavage administration. Serum and gingiva myeloperoxidase (MPO) activity, 8-hydroxydeoxyguanosine(8-OHdG), and glutathione (GSH) levels were analyzed by ELISA. İmmunohistochemical analysis was used to detect Interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha (TNF-α) immunoreactivities in the periodontal tissues. Alveolar bone loss (ABL) and attachment loss (AL) was evaluated by histomorphometry analysis. Results ABL and AL were statistically higher in group 3 than in groups 1, 2 and 4 and in group 4 than in groups 1 and 2 (p<0.05). MPO activities in gingival tissue and serum were significantly increased in group 3 compared to groups 1 and 2 (p<0.05). Significantly higher serum GSH levels, lower gingiva, and serum 8-OHdG levels, and MPO activity were observed in group 4 compared to group 3 (p<0.05). Rats with periodontitis (group 3) expressed significantly higher immunoreactivities of IL-6 and TNF-α and lower IL-10 immunoreactivity compared to those other groups (p<0.05). IL-6 and TNF-α immunoreactivities significantly decreased and IL-10 immunoreactivity increased in group 4 after the use of EA compared to group 3 (p<0.001). Conclusions Our findings showed that EA provides significant improvements on gingival oxidative stress and inflammatory markers and alveolar bone resorption in the repair process associated with experimental periodontitis. Therefore, EA may have a therapeutic potential on periodontitis.
Avita Rath, Chong Junning, Priyadarshini HR
et al.
AIM:To compare the effects of a plaque disclosing toothpaste with a regular fluoridated toothpaste for supragingival biofilm reduction in patients with chronic gingivitis.
MATERIALS AND METHODS:This study was a randomized controlled trial with a parallel design. Forty patients, both males and females aged 18-25 years with chronic generalized gingivitis (N=40) were randomly allocated to two groups of twenty each (n=20), using lottery method. Participants in the experimental group brushed with a plaque disclosing toothpaste, while participants in the control group brushed with regular fluoridated toothpaste. Clinically, biofilm was measured using Silness & Loe Plaque Index, both at baseline and at follow up visits by two assessors who were blinded to group allocation. Adjunctly, intraoral photographs were taken for Digital Plaque Image Analysis of the remaining dental biofilm in the upper and lower anterior labial tooth surfaces, and calculated based on the area of stained pixels. Data was analyzed using SPSS version 22. Mean plaque scores between the groups were compared using independent sample t-test and p<0.05 was considered significant.
RESULTS:Data of all the 40 participants were analyzed as they were no drop outs. No significant differences were found in the mean plaque scores between the two groups (p=0.059) at the end of the study. Similarly, Digital Plaque Image Analysis showed no significant difference in the mean plaque scores between the groups (p= 0.93).
CONCLUSION:This study showed that there are no additional benefits of using a plaque disclosing toothpaste, in enhancing the removal of the supragingival dental biofilm during routine oral hygiene maintenance.
To clarify the effects of a local orthodontic force on alveolar bone by analysing bone remodelling in different regions of the maxilla during orthodontic tooth movement (OTM).
William Carlos Silva Barbosa, Américo Bortolazzo Correr, Diego Patrik Alves Carneiro
et al.
Aim: The aim of this study was to verify the frictional force during sliding mechanics in orthodontic tooth movement, using conventional metal brackets of the active and passive self-ligating types with stainless steel and copper nickel titanium archwires. Methods: This experimental in vitro study was conducted with conventional metal (Morelli, Sorocaba, SP, Brazil) brackets, active self-ligated (SLI Morelli, Sorocaba, SP, Brazil) and passive self-ligated (SLP Morelli, Sorocaba, SP, Brazil), with slot 0.022 x 0.028 inches and Roth prescription. The brackets were tested with rectangular section 0.019 x 0.025 inch copper nickel titanium and stainless steel archwires. For each type of bracket, 10 sets of plate/bracket/archwire segment (n=10) were fabricated. Non-parametric Kruskal Wallis and Dunn tests were used for comparison between types of brackets and Wilcoxon tests for comparison between types of archwires. Results: The results showed that the frictional force values were higher with copper nickel titanium than with stainless steel archwires (p<0.05). When copper nickel titanium archwires were used, the active self-ligating brackets showed higher frictional force values than the other types, followed by the conventional brackets. Lower frictional force values were observed with passive self-ligating brackets. For stainless steel archwires, no difference was observed between conventional and active self-ligating brackets, the passive self-ligating type presented lower frictional force values than the others. Conclusion: It was concluded that the higher frictional force was observed when active self-ligating brackets were associated with copper nickel titanium archwires. Lower frictional force was verified between passive self-ligating brackets combined with stainless steel archwires.