Can a dentin bonding agent prevent color change in regenerative endodontic procedures? An in vitro evaluation.

This in vitro study aimed to determine the efficacy of dentin bonding agents in preventing color changes following Regenerative Endodontic Procedures. One hundred twenty bovine incisors were endodontically prepared and randomly assigned to a two main factors design: application of a dentin bonding agent (Scotchbond Adper, 3M ESPE, St Paul, MN, USA) in the pulp chamber (Group 1, n=60) versus no bonding intervention (Group 2, n=60), and five levels of intracanal medication (n=12/subgroup): Triple antibiotic paste (TAP), double antibiotic paste (DAB), calcium hydroxide (CH), modified triple antibiotic paste (TAPM), and Control (CTL). Color changes were measured over 28 days at multiple time points (1, 3, 7, 14, 21, and 28 days) using the CIEDE2000 formula to calculate the color difference (ΔE00) from baseline (T0). The ΔE00 quantifies the perceptible color difference between the initial and final tooth color, with lower values indicating less discoloration. The results were analyzed using repeated measures ANOVA-2 and post-hoc Holm-Sidak tests. The TAP subgroups, both with and without the bonding agent, exhibited the highest color variation. However, a pulp chamber seal with a bonding agent showed a protective effect against discoloration compared to no seal, even though complete prevention was not achieved. All groups demonstrated ΔE00 values beyond acceptable interpretation thresholds for clinical application, primarily driven by a reduction in lightness (L*) and a decrease in redness (a* value, shifting towards green). In conclusion, while the pulp chamber seal with a bonding agent mitigated TAP-induced discoloration, it did not eliminate it.

Detection of caries around restorations on bitewings using deep learning.

OBJECTIVE: Secondary caries lesions adjacent to restorations, a leading cause of restoration failure, require accurate diagnostic methods to ensure an optimal treatment outcome. Traditional diagnostic strategies rely on visual inspection complemented by radiographs. Recent advancements in artificial intelligence (AI), particularly deep learning, provide potential improvements in caries detection. This study aimed to develop a convolutional neural network (CNN)-based algorithm for detecting primary caries and secondary caries around restorations using bitewings. METHODS: Clinical data from 7 general dental practices in the Netherlands, comprising 425 bitewings of 383 patients, were utilized. The study used the Mask-RCNN architecture, for instance, segmentation, supported by the Swin Transformer backbone. After data augmentation, model training was performed through a ten-fold cross-validation. The diagnostic accuracy of the algorithm was evaluated by calculating the area under the Free-Response Receiver Operating Characteristics curve, sensitivity, precision, and F1 scores. RESULTS: The model achieved areas under FROC curves of 0.806 and 0.804, and F1-scores of 0.689 and 0.719 for primary and secondary caries detection, respectively. CONCLUSION: An accurate CNN-based automated system was developed to detect primary and secondary caries lesions on bitewings, highlighting a significant advancement in automated caries diagnostics. CLINICAL SIGNIFICANCE: An accurate algorithm that integrates the detection of both primary and secondary caries will permit the development of automated systems to aid clinicians in their daily clinical practice.

Exploring the relationship between SARS-CoV-2 infection and headache: comprehensive systematic review / Explorando a relação entre infecção por SARS-CoV-2 e cefaleia: revisão sistemática abrangente

ABSTRACT BACKGROUND AND OBJECTIVES: Addressing secondary headaches in SARS-CoV-2 infection is crucial for effective management and care optimization. This review aims to synthesize data on headache characteristics and the impact of pre-existing headache conditions on these symptoms in SARS-CoV-2 infection. CONTENTS: A systematic search was conducted across multiple databases, including PubMed/Medline, Cochrane Collaboration, Web of Science, Scopus, LILACS, Embase, Open Grey, and Google Scholar, to identify studies on headache characteristics associated with SARS-CoV-2. The search focused on headache symptoms, characteristics, onset, duration, and response to treatment during and post-infection. Twenty-three studies met the inclusion criteria. Approximately 42.1% of individuals with SARS-CoV-2 reported headaches, resembling tension-type headaches and migraines. These headaches often manifested within the first three days of infection and could persist for up to four months. The data suggest that trigeminovascular activation and pro-inflammatory mediators play a significant role in headache pathogenesis, with pre-existing headache conditions exacerbating the symptoms. The importance of effective pain management strategies must be emphasized. CONCLUSION: Headache is a prevalent symptom among SARS-CoV-2 infected individuals, with significant implications for patient care. The findings emphasize the importance of recognizing headache characteristics in SARS-CoV-2 management and suggest that tailored clinical approaches are essential for effective symptom relief.

RESUMO JUSTIFICATIVA E OBJETIVOS: A abordagem das cefaleias secundárias na infecção pela SARS-CoV-2 é crucial para um manejo adequado e otimização do cuidado. Esta revisão tem como objetivo sintetizar os dados sobre as características da cefaleia e o impacto das condições pré-existentes de cefaleia sobre esses sintomas na infecção pela SARS-CoV-2. CONTEÚDO: Uma pesquisa sistemática foi realizada em vários bancos de dados, incluindo: Pubmed/Medline, Cochrane Collaboration, Web of Science, Scopus, LILACS, Embase, Open Grey e Google Scholar, com o objetivo de identificar estudos sobre as características da cefaleia associadas à SARS-CoV-2. A pesquisa se concentrou nos sintomas, nas características, no início, na duração e na resposta ao tratamento da cefaleia durante e após a infecção. Vinte e três estudos atenderam aos critérios de inclusão. Aproximadamente 42,1% dos indivíduos com SARS-CoV-2 relataram dores de cabeça, semelhantes a dores de cabeça do tipo tensional e enxaquecas. Essas cefaleias geralmente se manifestavam nos primeiros três dias de infecção e podiam persistir por até quatro meses. Os dados sugerem que a ativação trigeminovascular e os mediadores pró-inflamatórios desempenham um papel importante na patogênese da cefaleia, com condições preexistentes de cefaleia exacerbando os sintomas. A importância de estratégias eficazes de controle da dor deve ser enfatizada. CONCLUSÃO: A cefaleia é um sintoma prevalente entre os indivíduos infectados pela SARS-CoV-2, com significativas implicações no atendimento ao paciente. Os achados deste estudo enfatizam a importância do reconhecimento das características da cefaleia no manejo da SARS-CoV-2 e sugerem que abordagens clínicas personalizadas são essenciais para o alívio eficaz dos sintomas.

Can a dentin bonding agent prevent color change in regenerative endodontic procedures? An in vitro evaluation

Abstract This in vitro study aimed to determine the efficacy of dentin bonding agents in preventing color changes following Regenerative Endodontic Procedures. One hundred twenty bovine incisors were endodontically prepared and randomly assigned to a two main factors design: application of a dentin bonding agent (Scotchbond Adper, 3M ESPE, St Paul, MN, USA) in the pulp chamber (Group 1, n=60) versus no bonding intervention (Group 2, n=60), and five levels of intracanal medication (n=12/subgroup): Triple antibiotic paste (TAP), double antibiotic paste (DAB), calcium hydroxide (CH), modified triple antibiotic paste (TAPM), and Control (CTL). Color changes were measured over 28 days at multiple time points (1, 3, 7, 14, 21, and 28 days) using the CIEDE2000 formula to calculate the color difference (ΔE00) from baseline (T0). The ΔE00 quantifies the perceptible color difference between the initial and final tooth color, with lower values indicating less discoloration. The results were analyzed using repeated measures ANOVA-2 and post-hoc Holm-Sidak tests. The TAP subgroups, both with and without the bonding agent, exhibited the highest color variation. However, a pulp chamber seal with a bonding agent showed a protective effect against discoloration compared to no seal, even though complete prevention was not achieved. All groups demonstrated ΔE00 values beyond acceptable interpretation thresholds for clinical application, primarily driven by a reduction in lightness (L*) and a decrease in redness (a* value, shifting towards green). In conclusion, while the pulp chamber seal with a bonding agent mitigated TAP-induced discoloration, it did not eliminate it.

Resumo Este estudo in vitro avaliou adesivos dentinários na prevenção de alterações de cor após procedimentos endodônticos regenerativos. Cento e vinte incisivos bovinos foram preparados endodonticamente e aleatoriamente designados para um desenho com dois fatores principais: aplicação de agente adesivo (Scotchbond Adper, 3M ESPE, St Paul, MN, EUA) na câmara pulpar (Grupo 1, n=60) versus não intervenção adesiva (Grupo 2, n=60), e cinco níveis de medicação intracanal (n=12/subgrupo): pasta de triantibiótica (TAP), pasta diantibiótica (DAB), hidróxido de cálcio (CH), pasta triantibiótica modificada (TAPM) e Controle (CTL). Alterações cromáticas foram monitoradas por 28 dias em intervalos (1, 3, 7, 14, 21, e 28 dias), usando CIEDE2000 para calcular a diferença de cor (ΔE00) em relação a cor inicial. O ΔE00 quantifica a diferença entre a cor inicial e final do dente, com valores menores indicando menos descoloração. Os resultados foram analisados usando ANOVA-2 de medidas repetidas e teste posthoc de Holm-Sidak. Os grupos utilizando medicação TAP, com ou sem adesivo, possuíram as maiores variações cromática. Contudo, o uso do adesivo na câmara pulpar mostrou um efeito protetor contra descoloração, em comparação com a ausência do selamento adesivo, embora a prevenção completa não tenha sido alcançada. Todos os grupos demonstraram valores de ΔE00 além dos limiares aceitáveis para aplicação clínica, principalmente devido à redução na luminosidade (L*) e redução no vermelho (a*, deslocando-se em direção ao verde). Em conclusão, enquanto o selamento da câmara pulpar com um agente adesivo mitigou a descoloração induzida pelo TAP, mas não a eliminou completamente.

Full analysis of the effects of modeler liquids on the properties of direct resin-based composites: a meta-analysis review of in vitro studies.

OBJECTIVES: This study systematically revised the literature to answer the following question: do modeler liquids (MLs) affect the properties of direct resin-based composites (RBCs)? MATERIALS AND METHODS: The review followed the PRISMA statement, and the search was conducted in PubMed, Scopus, Web of Science, Embase, and Lilacs databases. Studies were included if they investigated the properties of RBCs prepared using the restorative dental modeling insertion technique (RDMIT). The risk of bias was performed with the RoBDEMAT tool. Statistical analyses were conducted using Review Manager, and heterogeneity was assessed with the Cochran Q test and I2 statistics. RESULTS: From 309 studies identified, 25 met the eligibility criteria, and 23 were meta-analyzed. In total, 27 MLs and 23 RBCs were evaluated. Modeled and non-modeled RBCs showed similar results in terms of cohesive strength, flexural strength, load-to-fracture, modulus of elasticity, work of fracture, degree of conversion, solubility, weight change, microhardness, and color change. Sorption and roughness benefited from the use of MLs, whereas translucency and whitening index were more adequate in the non-modeled RBCs. Aging affected similarly the modeled and non-modeled RBCs. Most studies showed a moderate risk of bias. CONCLUSIONS: Modeled and non-modeled RBCs performed similarly in most of the properties, and the use of non-solvated lubricants offered beneficial effects in some cases. CLINICAL RELEVANCE: When a balance has to be made between the RDMIT and the conventional technique, our review supports the safe application of modeler liquids for the handling of composite increments during the sculpting fabrication of direct resin-based restorations.

Surface Treatments and Adhesives Used to Increase the Bond Strength Between Polyetheretherketone and Resin-based Dental Materials: A Scoping Review.

PURPOSE: To identify and discuss the available surface treatments and adhesives for polyetheretherketone (PEEK) to increase its bond strength to resin-based materials used in dentistry. MATERIALS AND METHODS: The reporting of this scoping review was based on PRISMA. The study protocol was made available at: https://osf.io/4nur9/. Studies which evaluated PEEK surface treatments and its bond strength to resin-based materials were selected. The search was performed in PubMed, Scopus, Web of Sciences and Cochrane databases. The screening was undertaken by 3 independent researchers using the Rayyan program. A descriptive analysis was performed considering study characteristics and main findings (title, data of publication, authors, PEEK characteristics, surface treatments, control group, bonded set, luting agent, specimen geometry, storage, thermocycling, pre-test failures, test geometry, failure analysis, main findings, and compliance with normative guidelines). RESULTS: The initial search yielded 1965 articles, of which 32 were included for descriptive analysis. The review showed that the use of surface treatments and adhesives are important to promote bond strength to PEEK. Up until now, various surface treatments have been explored for bond improvement to PEEK. Sulfuric acid etching is commonly reported as promoting the highest bond strength, followed by alumina-particle air abrasion. Regarding adhesives, the use of a specific adhesive containing MMA, PETIA (pentaerythritol triacrylate), and dimethacrylates yields the best adhesive performance. CONCLUSION: Sulfuric acid etching and alumina particle air abrasion followed by application of bonding agents containing MMA, PETIA and dimethacrylates are the most effective choices to increase resin-based materials' adhesion to PEEK.