Revolutionising dental technologies: a qualitative study on dental technicians' perceptions of Artificial intelligence integration.

BACKGROUND: The integration of artificial intelligence (AI) in dentistry has the potential to revolutionise the field of dental technologies. However, dental technicians' views on the use of AI in dental technology are still sparse in the literature. This qualitative study aimed to explore the perceptions of dental technicians regarding the use of AI in their dental laboratory practice. METHODS: Twelve dental technicians with at least five years of professional experience and currently working in Malaysia agreed to participate in the one-to-one in-depth online interviews. Interviews were recorded, transcribed verbatim and translated. Thematic analysis was conducted to identify patterns, themes, and categories within the interview transcripts. RESULTS: The analysis revealed two key themes: "Perceived Benefits of AI" and "Concerns and Challenges". Dental technicians recognised the enhanced efficiency, productivity, accuracy, and precision that AI can bring to dental laboratories. They also acknowledged the streamlined workflow and improved communication facilitated by AI systems. However, concerns were raised regarding job security, professional identity, ethical considerations, and the need for adequate training and support. CONCLUSION: This research sheds light on the potential benefits and challenges associated with the integration of AI in dental laboratory practices. Understanding these perceptions and addressing the challenges can support the effective integration of AI in dental laboratories and contribute to the growing body of literature on AI in healthcare.

Evaluation of bacterial leakage and marginal adaptation of the bioceramics pulp dressing materials: an invitro study.

OBJECTIVE: To compare the sealing ability and marginal adaptation of three calcium silicate-based cement (Biodentine, Pro root MTA, MTA Angelus) using a bacterial leakage model and scanning electron microscope (SEM). METHODS: Recently extracted lower first premolars were randomly categorized into three experimental groups (n = 15 samples), positive control (n = 5 samples), and negative control group (n = 5 sample). Samples from the experimental groups and positive control group were subject to cavity Class I occlusal preparation followed by modified coronal pulpotomy. Different types of bioceramic dressing material were placed in 3 mm thickness accordingly, group 1 (Biodentine), group 2 (MTA Angelus), and group 3 (ProRoot MTA). No dressing material was placed in the positive control group (group 4). All samples were placed in the incubator for 24 h at 37℃, 100% humidity, for the materials to be completely set. The final restoration was placed using the Z350 resin composite. A double layer of nail varnish was applied over all the sample surfaces except the occlusal site. Whereas the samples' surfaces in the negative control, were completely covered. A 3 mm length was measured from the root apex of the samples from each group, before proceeding with the resection. The bacterial leakage test was performed using Enterococcus faecalis TCC 23,125, and a sample from each experimental group was randomly chosen for SEM. Data analysis was conducted under the One-way ANOVA test, completed by Tukey's post hoc test. RESULTS: There is a significant difference in sealing ability and marginal adaptation between the groups. (p < 0.05). The study showed that Pro Root MTA had the superior sealing ability and marginal adaptation compared to Biodentine and MTA Angelus. CONCLUSION: The ProRoot MTA as a coronal pulpotomy pulp dressing material, was found to have a better marginal adaptation and sealing ability compared to three other bioceramics materials. The material would be the better choice during clinical settings and procedures.

Comparative Evaluation of the Percentage of Gutta-percha Filled Areas in Canals Obturated with Different Obturation Techniques.

AIM: To evaluate the percentage of gutta-percha filled areas (PGFA) in canals obturated with guttacore system, single cone, and lateral compaction techniques. MATERIALS AND METHODS: A total of 60 single-rooted mandibular premolars were selected and randomly divided into three equal groups depending on the type of obturation technique used. After the obturation, the samples were marked at 2, 4, 6, and 8 mm distance from the apex and sectioned horizontally, and viewed under a stereomicroscope at 25×. The area of the canal and of the filling material was recorded, and the percentage of filling material on the canal wall was calculated. RESULTS: Guttacore showed the highest percentage of root-filled areas followed by single cone and lateral compaction techniques at 2, 4, 6, and 8 mm from the apex. CONCLUSION: None of the filling techniques used in the study was completely able to fill the root canals with gutta-percha and sealer. The guttacore system had a maximum area of root canals filled as compared to the single cone and lateral compaction system. CLINICAL SIGNIFICANCE: Root canals are mostly oval, elongated, or irregularly shaped rather than being completely round. Hence, the obturation technique that fills the maximum area of the root canal must be selected according to the given clinical circumstances.

Novel dental composite resin derived from rice husk natural biowaste: A systematic review and recommendation for future advancement.

OBJECTIVES: This review aimed to summarize contemporary evidence related to dental composite resin derived from rice husk biowaste and its potential future advancement. This review paper included the techniques for synthesis, characterization, and preparation of rice husk composite resin. Focus was also given to the flexural strength and modulus, compressive strength, wear rate, hardness, surface roughness, color stability, polymerization shrinkage, degree of conversion, and their application onto root canal treated teeth. MATERIAL AND METHODS: A search of English peer-reviewed literature (January 1960-February 2021) was conducted from electronic databases (PubMed Central, Cochrane, LILACS, Science Direct, Web of Science, SIGLE, EMBASE, EBSCO, Medline, and Google Scholar). RESULTS: 11 articles and a book section were finally selected for qualitative analysis. Studies concluded that the physicomechanical properties and the color stability of rice husk dental composites showed comparable results to conventional dental composites. Incorporation of zirconia nanopowder into rice husk dental composite increased the compressive strength and hardness values, associated with lower shrinkage, a high degree of conversion, and improved fracture strength when applied on root canal treated teeth. CONCLUSIONS: Due to its low cost, eco-friendliness, and acceptable clinical performances, rice husk dental composite resin can be considered as an alternative to conventional composites. CLINICAL SIGNIFICANCE: Dental composite resin derived from rice husk silica demonstrated excellent performance, which could potentially substitute currently available composite resins. This review will give new insight to clinicians and researchers on the usage of natural biowaste mass in the field of dental restorative materials.

New Experimental Zirconia-Reinforced Rice Husk Nanohybrid Composite and the Outcome of Its Surface Roughness and Microhardness in Comparison with Commercialized Nanofilled and Microhybrid Composite Resins.

BACKGROUND: An ideal composite resin should demonstrate smooth surface after polishing and high hardness value to provide long-term success. Thus, this study aimed to compare the surface roughness and microhardness of new experimental zirconia-reinforced rice husk nanohybrid composite (Zr-Hybrid) with commercialized nanofilled (Filtek-Z350-XT) and microhybrid composite (Zmack-Comp) resins before and after artificial ageing. METHODS: One hundred and eighty standardized disc samples were prepared, of which ninety samples each were used for surface roughness and microhardness test, respectively. They were divided equally into: Group 1 (Filtek-Z350-XT), Group 2 (Zmack-Comp), and Group 3 (Zr-Hybrid). For surface roughness test, all samples were polished with aluminium oxide discs and further subdivided into aged and unaged subgroups, in which composite samples in aged subgroups were subjected to 2500 thermal cycles. Next, all the samples were subjected to surface roughness test using a contact stylus profilometer. As for microhardness test, all the aged and unaged samples were tested using a Vickers hardness machine with a load of 300 kgf for 10 s and viewed under a digital microscope to obtain microhardness value. Data were analyzed using two-way ANOVA followed by post hoc Tukey's honestly significant difference and paired sample t-test with significance level set at P = 0.05. RESULTS: In both the aged and unaged groups, Zr-Hybrid showed statistically significantly lower surface roughness (P < 0.05) than Filtek-Z350-XT and Zmack-Comp, but no statistically significant difference was noted between Filtek-Z350-XT and Zmack-Comp (P > 0.05). A similar pattern was noted in microhardness test, whereby Zr-Hybrid showed the highest value (P < 0.05) followed by Filtek-Z350-XT and lastly Zmack-Comp. Besides, significant differences in surface roughness and microhardness were noted between the aged and unaged groups. CONCLUSION: Zr-Hybrid seems to demonstrate better surface roughness and microhardness value before and after artificial ageing.

The existence of butterfly effect and its impact on the dentinal microhardness and crack formation after root canal instrumentation.

To compare the microhardness and crack formation in root dentine presented with butterfly effect in lower premolars. Sixty mature lower premolars were selected and divided into the control and experimental groups. Teeth in the experimental group were instrumented up to size 30/.04. The roots were cut horizontally into twelve parts of 1-mm-thick cross-section and were numbered accordingly. They were divided into coronal, middle, and apical root sections. Sections were then viewed under a microscope to determine the presence of butterfly effect and subsequently scored. 8 teeth from both control and experimental groups with the highest and lowest score were selected. Crack formation was inspected and classified into four different types of cracks. Microhardness test was performed using a Vickers hardness test. Higher frequency of butterfly effect was found in the apical root section and root dentine with butterfly effect were harder mesiodistally. The middle and apical root sections with butterfly effect were harder than the coronal section. No significant difference of dentine hardness between the control and experimental groups. Cracks only occurred in the experimental group and presented in buccolingual direction with a higher rate of Type 1 and Type 2 cracks. Prevalence of butterfly effect in lower premolars increased from coronal to apical with increased hardness mesiodistally. More buccolingual cracks were found in radicular dentine with butterfly effect and most of them exhibited Type 1 and Type 2 cracks. Roots of lower premolar with butterfly effect may be susceptible to a higher rate of vertical root fracture in buccolingual direction, especially after root canal treatment. Thus, special attention should be given not to overload instruments during root canal preparation.

Success rates of coronal and partial pulpotomies in mature permanent molars: a systematic review and single-arm meta-analysis.

Objectives: This systematic review aimed to evaluate the clinical and radiographic outcomes of coronal and partial pulpotomies in mature permanent molars with cariously exposed vital pulp. Method and materials: The protocol of the current review was registered in the PROSPERO database (CRD 42020190785). Articles published between January 1980 and June 2020 were searched in eight different online databases and six textbooks according to PRISMA guidelines. Eleven studies were included in the analysis of 1-year success rates, whereas five studies were included in the analyses of 2-year and > 2-year success rates for coronal pulpotomy. Two studies were included in the analyses of the 1-year and 2-year success rates for partial pulpotomy. The clinical and radiographic success rates were estimated using the DerSimonian-Laird random effect method. The risks of bias were evaluated using Cochrane RoB 2, ROBINS-I, and Newcastle-Ottawa scale assessment tools. Evidence levels were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) recommendation tool. The success rates using different pulp capping medicaments and restorative materials were analyzed using meta-regression analysis. Results: The clinical and radiographic success rates of coronal pulpotomy ranged between 92.2% and 99.4%, whilst for partial pulpotomy, the success rates ranged between 78.2% and 80.6%. Different pulp capping medicaments and restorative materials showed no significant effect on the success rates of coronal pulpotomy, but the former significantly (P < .05) affected the success rates of partial pulpotomy. Conclusion: Coronal and partial pulpotomies demonstrated a high success rate in treating cariously exposed vital pulp of mature permanent molars. Further well-designed studies with longer follow-up periods are required to validate these findings.

Dislodgement resistance and adhesive pattern of different endodontic sealers to dentine wall after artificial ageing: an in-vitro study.

To compare the dislodgement resistance and the adhesive pattern of four different endodontic sealers to root dentine walls. Ninety lower premolars were assigned to five groups (n = 18), Group 1: no sealer (control); Group 2: EndoRez (ERZ); Group 3: Sealapex (SPX); Group 4: EndoSeal MTA (ESA) and Group 5: BioRoot RCS (BRS). They were instrumented up to size 30 taper 0.06 and obturated using single cone technique with matched-taper gutta-percha cones and one of the mentioned sealers. Six teeth from each group were then randomly subjected to 100, 1000 and 10,000 thermocycles, respectively. 1 mm slice of mid root region, measuring 6 mm from the apical foramen was prepared and subjected to push-out test under a Universal Testing Machine. Adhesive patterns of sealers were assessed using a stereomicroscope at 20 × magnification and classified using a new system. Statistical analyses were performed using two-way ANOVA, complemented by Tukey HSD and Chi-square tests. ESA and BRS showed significantly higher (p < 0.05) push-out bond strength, followed by SPX, ERZ and lastly the control, but no significant difference was noted between ESA and BRS (p > 0.05) at 100, 1000 and 10,000 thermocycles, respectively. Both ESA and BRS exhibited a significant higher rate (p < 0.05) of Type 3 and Type 4 adhesive patterns as the thermocycles increased. ESA and BRS demonstrated higher bond strength and better adhesive pattern to root dentine wall than SPX and ERZ, especially after artificial ageing.

The effect of accelerated aging on the color stability and translucency of novel zirconia reinforced rice husk dental composite resin in different infusion media / O efeito do envelhecimento acelerado na estabilidade de cor e translucidez de uma nova resina composta de casca de arroz reforçada com zircônia em diferentes meios de infusão

Objective: To compare the color stability and translucency of aged and unaged experimental zirconia reinforced rice husk nanohybrid composite resin (Zr-Hybrid) with a commercialized nanofilled and a microhybrid composite resin after immersion in four different infusion media. Material and Methods: Three groups of standardized disc-shaped composite resin with 80 samples per group were prepared as follow: Group 1 (Filtek-Z350-XT), Group 2 (Zmack-Comp), and Group 3 (Zr-Hybrid). Each group was further subdivided into aged (n=40) and unaged (n=40) groups. Initial color measurements were taken using a digital spectrophotometer based on CIE L*a*b* color system. Samples in aged subgroup were subjected to 2500 thermal cycles. Subsequently, all samples were immersed in four different types of infusion media (n=10): T1 - Distilled water, T2 - Soft drink, T3 - Tea and T4 - Coffee. After 15 days, color measurements of all samples were measured again. Data were analyzed using two-way ANOVA followed by Bonferroni and paired sample t-tests with a significance level set at P=0.05. Results: Unaged Zr-Hybrid showed comparable color change to Zmack-Comp and Filtek-Z350-XT (P=0.181), but aged Zr-Hybrid demonstrated the lowest color change (P<0.001). Zr-Hybrid exhibited the lowest translucency value (P<0.001), but no significant color and translucency changes (P=0.051 and P=0.069, respectively) were observed between unaged and aged Zr-Hybrid. Soft drink had the greatest effect (P<0.001) on color change, while coffee showed the greatest effect (P<0.001) on translucency. Conclusion: Although Zr-Hybrid showed greater opacity, it still retained its color stability and translucency after accelerated aging compared to commercialized microhybrid and nanofilled composite resins. All infusion media caused discoloration and affected the composite resins' translucency. (AU)

Objetivo: Comparar a estabilidade de cor e translucidez de uma resina composta nanohíbrida de casca de arroz reforçada com zircônia experimental envelhecida e não envelhecida (Zr-Hybrid) com uma resina composta comercial nanoparticulada e microhíbrida após a imersão em quatro meios de infusão diferentes. Material e Métodos: Três grupos de resina composta em forma de disco padronizado com 80 amostras por grupo foram preparados da seguinte forma: Grupo 1 (Filtek-Z350-XT), Grupo 2 (Zmack-Comp) e Grupo 3 (Zr-Hybrid). Cada grupo foi subdividido em grupos de envelhecimento (n = 40) e não envelhecimento (n = 40). As medições iniciais de cor foram feitas usando um espectrofotômetro digital baseado no sistema de cores CIE L * a * b *. As amostras do subgrupo envelhecido foram submetidas a 2500 ciclos térmicos. Posteriormente, todas as amostras foram imersas em quatro tipos diferentes de meios de infusão (n = 10): T1 - Água destilada, T2 - Refrigerante,T3 - Chá e T4 - Café. Após 15 dias, as medições de cor de todas as amostras foram medidas novamente. Os dados foram analisados usando ANOVA dois fatores seguido por Bonferroni e testes t pareados com nível de significância estabelecido em P = 0,05. Resultados: O grupo Zr-Hybrid não envelhecido mostrou uma mudança de cor comparável a Zmack-Comp e Filtek-Z350-XT (P = 0,181), mas o grupo Zr-Hybrid envelhecido demonstrou a menor mudança de cor (P <0,001). Zr-Hybrid exibiu o menor valor de translucidez (P <0,001), mas nenhuma mudança significativa de cor e translucidez (P = 0,051 e P = 0,069, respectivamente) foram observadas entre Zr-Hybrid não envelhecido e envelhecido. O refrigerante teve o maior efeito (P <0,001) na mudança de cor, enquanto o café apresentou o maior efeito (P <0,001) na translucidez. Conclusão: Apesar do grupo Zr-Hybrid tenha mostrado maior opacidade, ele ainda manteve sua estabilidade de cor e translucidez após envelhecimento acelerado em comparação com resinas compostas micro-híbridas e nanoparticuladas comercializadas. Todos os meios de infusão causaram descoloração e afetaram a translucidez das resinas compostas (AU)

Fracture strength of endodontically treated lateral incisors restored with new zirconia reinforced rice husk nanohybrid composite.

BACKGROUND: This study aimed to compare the fracture strength, fracture pattern and type of fracture of endodontically treated maxillary lateral incisors restored with new zirconia reinforced rice husk nanohybrid composite. MATERIAL AND METHODS: Eighty mature permanent maxillary lateral incisors from patients age range of 30-60 years with single canal were selected and randomly divided into: Group 1 - RCT + nanofilled composite (Filtek), Group 2 - RCT + microhybrid composite (Zmack), Group 3 - RCT + new nanohybrid composite (Zr-Hybrid) and Group 4 - Intact teeth (control). Standardized mesio-palatal-distal cavity was prepared, and endodontic treatment was carried out using crown-down technique until size 30, tapered 0.04. Obturation was completed using single cone technique with gutta-percha and AH plus sealer. Cavity access was restored with respective composite resins. Next, teeth were stored in incubator for 24 hours and subdivided into aged and unaged subgroups. Teeth in aged subgroups were subjected to 2500 thermal cycles for 5ºC, 37ºC and 55ºC with 30 seconds dwell time and 5 seconds transfer time. After that, root surfaces of teeth were covered with silicone-based material and placed in boxes filled with acrylic until the cemento-enamel-junction (CEJ) level. They were then tested under Universal Testing Machine until fracture occurred. Samples were then viewed under Leica microscope to determine the fracture pattern and type of fracture. Data analyzed using One-way ANOVA complimented by post hoc Tukey HSD and paired sample T test for fracture strength. Fracture pattern and type of fracture were analyzed using Chi-square test. Level of significance was set at p<0.05. RESULTS: Significant differences were observed (p<0.05) with Group 3 demonstrating the highest fracture strength followed by Group 4, Group 1 and lastly Group 2 in both aged and unaged subgroups respectively. A significant decreased in fracture strength was noted in Group 1 and Group 2 (p<0.05) as number of thermocycle increased but no significant differences were noted in Group 3 and Group 4 (p>0.05). Besides, Group 3 and Group 4 showed higher rate of favorable fracture pattern, followed by Group 1 and lastly Group 2. Most favorable fracture pattern was noted to exhibit horizontal fracture type (86.36%), whereas most unfavorable fracture pattern exhibited vertical fracture type (77.78%). CONCLUSIONS: Endodontically treated teeth restored with new zirconia reinforced rice husk nanohybrid composite (Zr-Hybrid) demonstrated higher fracture strength than commercialized composite resins especially after artificial ageing. Zr-Hybrid showed similar fracture pattern to those of intact teeth with higher rate of horizontal fracture type. Key words:Fracture strength, fracture pattern, composite resin, rice husk, Zirconia.