Postoperative sensitivity of composites using novel Bacillus subtilis nanofortified adhesives: a triple-blind study.

NANOTECHNOLOGY: is the art and science of dealing with nanoscale particles. This has transformed contemporary dental practices through myriad contributions to biomaterial science. Titanium dioxide nanoparticles procured from Bacillus subtilis, an eco-friendly and biogenic source, can significantly magnify the physiochemical attributes of dental materials. However, postoperative sensitivity is a major drawback of composite restorations. The incorporation of these nanoparticles into dental adhesives can greatly benefit clinical dentistry by resolving this issue. This trial aimed to evaluate the effectiveness of a novel titanium dioxide nanofortified adhesive on the postoperative sensitivity of composite restorations. METHODS: This triple-blind, parallel-group randomized controlled trial was conducted at the Department of Operative Dentistry and Endodontics, School of Dentistry, Islamabad, from May 15, 2023, to November 25, 2023. Participants (n = 60) with Class I and II primary carious lesions with a minimum cavity depth of 3-5 mm were randomly assigned to two groups (n = 30). After obtaining informed consent, the restorative procedure was accomplished using a minimally invasive approach and etch-and-rinse adhesive strategy. In group A, a nanofortified adhesive was used for composite restoration, whereas in group B, an adhesive without nanoparticles was used. Postoperative sensitivity was evaluated using the Visual Analog Scale (VAS) score at follow-up periods: of one day, one week, two weeks and one month. A Chi-square test was used to compare postoperative sensitivity between the two groups. The level of significance was set at p < 0.05. RESULTS: A noteworthy association was observed between sensitivity and the group variable at all four evaluation periods: after one day (p = 0.002), 1 week (p = 0.002), 2 weeks (p = 0.007) and one month. In conclusion, participants who underwent restorative intervention using titanium dioxide nanoreinforced adhesives reported a notable reduction in sensitivity at all time intervals. Hence, the occurrence and severity of postoperative sensitivity are significantly reduced using Bacillus subtilis-procured nanofortified adhesives as compared to conventional adhesives without nanoparticles. TRIAL REGISTRATION: This trial was retrospectively registered at ClinicalTrials.gov (ID: NCT06242184) on 03/02/2024. All procedures involving human participants were performed in conformance with this protocol.

Awareness of possible complications associated with direct composite restorations: A multinational survey among dentists from 13 countries with meta-analysis.

OBJECTIVES: Resin-based composites (RBCs) evolved into favoured materials for teeth restorations, marking a significant change in dental practice. Despite many advantages, RBCs exhibit various limitations in their physical and chemical properties. Therefore, we assessed the dentists' awareness of possible complications after direct composite restorations and their opinions about this material. METHODS: The online questionnaire was created in English in May 2023. A 16-item survey was dedicated to general dentists and specialists. The first section included four questions related to demographic characteristics. The second section comprised twelve questions and focused on awareness of potential side effects of composite restorations, the most crucial advantages and disadvantages of composite resins, and the frequency of experienced clinical complications after the application of composite materials. RESULTS: A total of 1830 dentists from 13 countries took part in the survey. Dentists most often declared awareness of low adhesion to the dentine (77.5 %) and, most rarely, solubility in oral fluids (42.6 %). Aesthetics was identified as the main advantage of composite fillings (79 %), followed by the possibility of repair (59 %) and adhesion to enamel (57 %). Polymerisation shrinkage was a major disadvantage for most countries (70 % overall). Analysing the declared potential clinical complications for all countries, statistically significant findings were obtained for marginal discolouration (OR=2.982, 95 % CI: 1.321-6.730, p-value=0.009) and borderline significance for secondary caries (OR=1.814, 95 % CI: 0.964-3.415, p-value=0.065). CONCLUSIONS: Dentists value aesthetics and repairability but are aware of shrinkage and experience discolouration. The issue of toxicity and solubility seems to be the least known to dentists. CLINICAL SIGNIFICANCE: Dentists should use RBCs with critical caution due to possible side effects. Despite the undoubted aesthetics of direct composite restorations, it is necessary to remember potential clinical complications such as marginal discolouration or secondary caries.

Novel microbial synthesis of titania nanoparticles using probiotic Bacillus coagulans and its role in enhancing the microhardness of glass ionomer restorative materials.

Dental caries is a commonly occurring non-communicable disease throughout the world that might compromise the quality of any individual's life. Glass ionomer cements (GIC) are the most acceptable restorative materials due to their ease of manipulation, minimal tooth loss and least invasive strategy; however, they lack mechanical stability that has become a point of concern. Nanoparticles (NPs) are an outstanding option for modifying and enhancing the properties of dental materials. The focus of this study was to prepare novel, biocompatible titania dioxide (TiO2) NPs as a dental-restorative material using an efficient probiotic Bacillus coagulans. The prepared NPs were incorporated into glass ionomer restorative material at varying concentrations and investigated for cell viability percentage, microhardness and surface morphology. Results indicated that pure 100% anatase phase TiO2 NPs with particle size of 21.84 nm arranged in smooth, spherical agglomerates and clusters forms. These NPs depicted cell viability > 90%, thus confirming their non-cytotoxic behavior. GIC restorative materials reinforced by 5% titania (TiO2) NPs demonstrated the highest microhardness in comparison to the control group and other experimental groups of the study. Surface morphology analysis revealed a reduction in cracks in this novel dental-restorative material supporting its compatible biological nature with better hardness strength and negligible crack propagation. Overall, these results indicated that TiO2 NPs produced using a biological approach could be easily used as restorative materials in dental applications.

Evaluation of accuracy of deep learning and conventional neural network algorithms in detection of dental implant type using intraoral radiographic images: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: With the growing importance of implant brand detection in clinical practice, the accuracy of machine learning algorithms in implant brand detection has become a subject of research interest. Recent studies have shown promising results for the use of machine learning in implant brand detection. However, despite these promising findings, a comprehensive evaluation of the accuracy of machine learning in implant brand detection is needed. PURPOSE: The purpose of this systematic review and meta-analysis was to assess the accuracy, sensitivity, and specificity of deep learning algorithms in implant brand detection using 2-dimensional images such as from periapical or panoramic radiographs. MATERIAL AND METHODS: Electronic searches were conducted in PubMed, Embase, Scopus, Scopus Secondary, and Web of Science databases. Studies that met the inclusion criteria were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Meta-analyses were performed using the random-effects model to estimate the pooled performance measures and the 95% confidence intervals (CIs) using STATA v.17. RESULTS: Thirteen studies were selected for the systematic review, and 3 were used in the meta-analysis. The meta-analysis of the studies found that the overall accuracy of CNN algorithms in detecting dental implants in radiographic images was 95.63%, with a sensitivity of 94.55% and a specificity of 97.91%. The highest reported accuracy was 99.08% for CNN Multitask ResNet152 algorithm, and sensitivity and specificity were 100.00% and 98.70% respectively for the deep CNN (Neuro-T version 2.0.1) algorithm with the Straumann SLActive BLT implant brand. All studies had a low risk of bias. CONCLUSIONS: The highest accuracy and sensitivity were reported in studies using CNN Multitask ResNet152 and deep CNN (Neuro-T version 2.0.1) algorithms.

Effects of endodontic irrigation solutions on structural, chemical, and mechanical properties of coronal dentin: A scoping review.

OBJECTIVE: This review aims to assess structural, chemical, and mechanical properties of coronal dentin after endodontic irrigation. MATERIALS AND METHODS: Reporting followed the PRISMA extension for scoping reviews. An electronic search was carried out in PubMed, Embase, and Cochrane Library. Records filtered by language and published up to November 4, 2022 were independently screened by two researchers. Studies evaluating structural, chemical, or mechanical properties of human permanent coronal dentin after irrigation within the scope of nonsurgical root canal treatment were included. Data were extracted regarding study type, sample description and size, experimental groups, outcome, evaluation method, and main findings. RESULTS: From the initial 1916 studies, and by adding 2 cross-references, 11 in vitro studies were included. Seven studies provide ultrastructural and/or chemical characterization, and six assessed microhardness and/or flexural strength. One percent to 8% sodium hypochlorite (NaOCl) and 1%-17% ethylenediaminetetraacetic acid (EDTA) were the most commonly tested solutions, with contact times of 2-240 min (NaOCl) and 1-1440 min (EDTA) being evaluated. CONCLUSIONS: Overall, the literature is consensual regarding the inevitable impact of NaOCl and chelating agents on coronal dentin, with both deproteinizing and decalcifying effects being concentration- and time-dependent. The alteration of mechanical parameters further confirmed the surface and subsurface ultrastructural and chemical changes. CLINICAL SIGNIFICANCE: Endodontic treatment success highly depends on restorative sealing. Understanding the result of exposing coronal dentin, the main substrate for bonding, to irrigants' action is crucial. The deproteinizing and decalcifying effects of NaOCl and chelating agents are both concentration- and time-dependent, causing surface and subsurface ultrastructural, chemical, and mechanical alterations.

Update on the M-pox virus and safety measures taken against it globally.

Globally, more than 50 countries have been affected by Monkey pox virus after COVID-19 has subsided. WHO declared "public health emergency of international concern" in year 2022 because of virus affecting 60,000 people in just one month that belonged to clade-IIb. Previously, it had been transmitted by body fluids, lesions and touching items, but fresh transmission is via sexual activity among bisexuals and man to man sex (MSM). New outbreaks reported compromised health status of confirmed cases with rectal pain, bleeding, tenesmus, pus or blood in stool, vomiting, proctitis and abdominal pain, which became alarming for entire world because of complications leading to bacterial skin infections, sepsis, encephalitis, hemorrhagic disease, blindness and pneumonia eventually. This virus has been further deteriorating unstable and unsustainable economy that requires dire attention. Strict preventive measures in terms of personal hygiene, pet and livestock health care, hospital contaminant disposal, good surveillance record, pre and post exposure vaccination, waste and water management could be only possible strategies to eliminate devastatingly dangerous M-pox outbreaks in this epic.

Advances in the design of amino acid and peptide synthesized gold nanoparticles for their applications.

The field of therapeutics and diagnostics is advanced by nanotechnology-based approaches including the spatial-temporal release of drugs, targeted delivery, enhanced accumulation of drugs, immunomodulation, antimicrobial action, and high-resolution bioimaging, sensors and detection. Various compositions of nanoparticles (NPs) have been developed for biomedical applications; however, gold NPs (Au NPs) have attracted tremendous attention due to their biocompatibility, easy surface functionalization and quantification. Amino acids and peptides have natural biological activities as such, their activities enhance several folds in combination with NPs. Although peptides are extensively used to produce various functionalities of Au NPs, amino acids have also gained similar interests in producing amino acid-capped Au NPs due to the availability of amine, carboxyl and thiol functional groups. Henceforth, a comprehensive review is needed to timely bridge the synthesis and the applications of amino acid and peptide-capped Au NPs. This review aims to describe the synthesis mechanism of Au NPs using amino acids and peptides along with their applications in antimicrobial, bio/chemo-sensors, bioimaging, cancer therapy, catalysis, and skin regeneration. Moreover, the mechanisms of various activities of amino acid and peptide capped-Au NPs are presented. We believe this review will motivate researchers to better understand the interactions and long-term activities of amino acid and peptide-capped Au NPs for their success in various applications.

Assessment of the Prevalence of Radix Entomolaris and Distolingual Canal in Mandibular First Molars in 15 Countries: A Multinational Cross-sectional Study with Meta-analysis.

AIM: The aim of this study was two-folded: i) to assess the prevalence of Distolingual Canal (DLC) and Radix Entomolaris (RE) in Mandibular First Molars (M1Ms), using Cone Beam Computed Tomography (CBCT) images and ii) to assess the impact of sociodemographic factors on the prevalence of these conditions worldwide. METHODS: CBCT images were scanned retrospectively and the ones including bilateral M1Ms were included in the study. The evaluation was performed by 1 researcher in each country, trained with CBCT technology. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating axial sections from coronal to apical. The presence of DLC and RE in M1Ms (yes/no) was identified and recorded. RESULTS: Six thousand three hundred four CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries regarding the prevalence of both RE and DLC (P < .05). The prevalence of DLC ranged from 3% to 50%, and the overall prevalence was 22% (95% CI: 15%-29%). RE prevalence ranged from 0% to 12%, and the overall prevalence was 3% (95% CI: 2%-5%). There were no significant differences between left and right M1Ms or between genders for either DLC or RE (P > .05). CONCLUSION: The overall prevalence of RE and DLC in M1Ms was 3% and 22%. Additionally, both RE and DLC showed substantial bilaterally. These variations should be considered by endodontic clinicians during endodontic procedures in order to avoid potential complications.

Attitude and practice of regenerative endodontic procedures among endodontists and paediatric dentists: A multinational survey from 13 countries.

BACKGROUND: Regenerative endodontics (RET) refers to biologically based procedures that aim to restore damaged tooth structures and reinstate the pulp-dentine complex to its normal physiological state. AIM: The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET. DESIGN: A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period. RESULTS: Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%-3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period. CONCLUSION: According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes.

Factors Affecting the Decision-making of Direct Pulp Capping Procedures among Dental Practitioners: A Multinational Survey from 16 Countries with Meta-analysis.

INTRODUCTION: Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had 3 purposes: (1) to investigate the factors that affect clinicians' decisions in DPC cases, (2) to determine which method of caries removal is preferred, and (3) to evaluate the preferred capping material for DPC. METHODS: The questionnaire comprised 3 sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure, and patients' age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. RESULTS: A tendency toward more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR = 2.86, 95% CI: 2.46, 2.32; P < .001) as opposed to the clinical scenario with 2 pulp exposures (RR = 1.38, 95% CI: 1.24, 1.53; P < .001). Complete caries removal was significantly preferred to selective caries removal (RR = 4.59, 95% CI: 3.70, 5.69; P < .001). Among the capping materials, calcium silicate-based materials were preferred over calcium hydroxide-based materials (RR = 0.58, 95% CI: 0.44, 0.76; P < .05). CONCLUSIONS: While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of calcium silicate-based materials appears to have replaced calcium hydroxide-based materials.