The Impact of Repeated Steam Sterilization Cycles on the Efficacy of Chairside Adjustment Kits for Polishing Monolithic Multi-Layered Zirconia Dental Restoration Material.

BACKGROUND Before insertion, chairside adjustment kits are heat sterilized for positioning and polishing dental restorations. This study aimed to evaluate the effects of 2 steam sterilization cycles on the efficacy of polishing highly translucent monolithic zirconia (HTMLZ) dental restoration material. MATERIAL AND METHODS 100 HTMLZ disc-shaped specimens were adjusted (grinding, finishing, polishing) with EVE Diacera kit. Two steam sterilization techniques [standard (Gp S), immediate/flash (Gp (F)] of CAK were further subgrouped based on number of sterilization cycles [cycle 1 (control), cycle 5, 10, 15, and 20 (experimental)] (n=10 each). Each subgroup accordingly was evaluated for average surface roughness (Ra) and root mean square roughness (Rq) using a profilometer. Mean and standard deviation of 5 subgroups were statistically analyzed using one-way ANOVA/post hoc Tukey's test. Scanning electron microscopy complemented Ra, Rq measurements. Statistical differences of P≤0.05 were considered significant. RESULTS HTMLZ specimens in both groups showed increased (Ra/Rq) values after repeated sterilization of EVE Diacera kit, with Gp F showing lesser increase than Gp S (20 cycles). Gp F at 10 cycles and Gp S at 15 cycles showed clinically unacceptable roughness threshold (0.25 µm). Differences between subgroups for Ra and Rq values were significant (P≤0.05) with less differences within groups observed in early cycles (1, 10). Results validate the manufacturer's recommendations of using flash sterilization/10 cycles for EVE Diacera kit. CONCLUSIONS Repeated sterilization reduces efficacy of chairside adjustment kit to produce smooth surfaces on HTMLZ. This study recommends flash sterilization to a maximum of 10 times to get the clinically acceptable results of Ra and Rq.

Impact of Auxiliary Features on Retention of Short Dental Crowns: An In-Vitro Analysis of Box and Groove Preparations.

BACKGROUND Several auxiliary features have been proposed to achieve sustainable retention for short-prepared dental crowns; however, achieving retention is challenging. This study aimed to assess the impact of increased total occlusal convergence and auxiliary preparation factors like box and groove on the retention form of short tooth preparations. MATERIAL AND METHODS Eighty resin machine-milled dies with a height of 3 mm and a deep chamfer margin of 1 mm were prepared to mimic the short-prepared molar. Initially, 2 teeth were prepared following the guidelines, and the total occlusal convergence was kept at 10° and 20°, respectively. Auxiliary features such as the proximal box and buccal groove were prepared on separate 20° dies. Eighty dies were prepared with 10 samples each for 10°, 20°, 20° with proximal box and 20° with buccal groove for zirconia (n=40) and metal crowns (n=40). Cementation was done with glass ionomer luting cement, and a pull-off test was conducted. Data were analyzed using one-way analysis of variance and post hoc fisher least significant difference test (P<0.05). RESULTS The highest mean was observed in the proximal box group with the metal crown (14.59), and the lowest in the group with 20° zirconia crowns (9.12). Within groups, the highest retentive values were found for the 20° taper with proximal box preparation; the lowest was for the 20° taper group. CONCLUSIONS Within the study limitations, it could be concluded that incorporating a proximal box or buccal groove in short tooth preparations with an increased total occlusal convergence improved retentive values.

Comparative Accuracy of Intraoral and Extraoral Digital Workflows for Short Span Implant Supported Fixed Partial Denture Fabrication: An In Vitro Study.

BACKGROUND The advent of digital impressions using computer-aided design and manufacturing technology (CAD/CAM) has simplified and improved the fabrication of implant prostheses in dentistry. The conventional impression has several drawbacks, including tray selection, material type, impression technique, impression disinfection, and cast model storage. The inaccuracies caused by distortion and contraction of impression material can be minimized with digital impressions. This study aimed to compare digital dental impressions of 10 working casts made using the Pindex laser removable die system to fabricate parallel drill channels vs 10 working casts made using the Di-Lok plastic tray removable die system. MATERIAL AND METHODS An implant master die with 2 dental implant analogs was fabricated. Ten working casts using the Pindex laser removable die system with parallel drill channels and 10 working casts using the Di-Lok plastic tray removable die system were fabricated. The working casts were scanned using an extra-oral laboratory scanner and the implant master model was scanned with an intra-oral scanner. RESULTS The properties of the casts made using the 2 systems were evaluated and analyzed with ANOVA and post hoc Tukey test. The mean horizontal linear distances between A1B1 (P<0.021), A2B2 (P<0.018), C1D1 (P<0.026), C2D2 (P<0.03), B1C1 (P<0.01), and mean vertical distances between B1A2 (P<0.015), C1D2 (P<0.001), B1B2 (P<0.028), and C1C2 (P<0.001) were significantly different between the Pindex system and Di-Lok tray system as compared to intra-oral scans. CONCLUSIONS Complete digital workflow with intra-oral scans were more than the partial digital workflow with extra-oral scans for the Pindex system and Di-Lok tray systems.

Assessment of dimensional stability of novel VPES impression material at different time intervals with standard disinfectants.

BACKGROUND: Vinyl polyether silicone (VPES) is a novel impression biomaterial made of a combination of vinyl polysiloxane (VPS) and polyether (PE). Thus, it is significant to assess its properties and behaviour under varied disinfectant test conditions. This study aimed to assess the dimensional stability of novel VPES impression material after immersion in standard disinfectants for different time intervals. METHODS: Elastomeric impression material used -medium body regular set (Monophase) [Exa'lence GC America]. A total of 84 Specimens were fabricated using stainless steel die and ring (ADA specification 19). These samples were distributed into a control group (n=12) and a test group (n=72). The test group was divided into 3 groups, based on the type of disinfectant used - Group-A- 2% Glutaraldehyde, Group-B- 0. 5% Sodium hypochlorite and Group-C- 2% Chlorhexidine each test group was further divided into 2 subgroups (n=12/subgroup) based on time intervals for which each sample was immersed in the disinfectants - subgroup-1- 10 mins and Subgroup 2- 30 mins. After the impression material was set, it was removed from the ring and then it was washed in water for 15 seconds. Control group measurements were made immediately on a stereomicroscope and other samples were immersed in the three disinfection solutions for 10 mins and 30 mins to check the dimensional stability by measuring the distance between the lines generated by the stainless steel die on the samples using a stereomicroscope at x40 magnification. RESULTS: The distance measured in the control group was 4397.2078 µm and 4396.1571 µm; for the test group Group-A- 2% Glutaraldehyde was 4396.4075 µm and 4394.5992 µm; Group-B- 0. 5% Sodium hypochlorite was 4394.5453 µm and 4389.4711 µm Group-C- 2% Chlorhexidine was 4395.2953 µm and 4387.1703 µm respectively for 10 mins and 30 mins. Percentage dimensional change was in the range of 0.02 - 0.25 for all the groups for 10 mins and 30 mins. CONCLUSIONS: 2 % Glutaraldehyde is the most suitable disinfectant for VPES elastomeric impression material in terms of dimensional stability and shows minimum dimensional changes as compared to that of 2% Chlorhexidine and 0.5% Sodium hypochlorite.

Comparative Analysis of Properties in Chairside Silicone Denture Liners versus Heat-Cured Molloplast-B: An In-Depth In Vitro Evaluation.

BACKGROUND We investigated the bond strength, tensile strength, and water absorption properties of 4 widely used chairside silicone long-term denture soft lining materials and compared properties with those of heat-cured silicone material. MATERIAL AND METHODS Four chairside materials (GC Reline Soft, Mucopren Soft, Sofreliner Soft, and Elite Soft Relining) and a heat-cured silicone material (Molloplast B) were investigated. For tensile and shear bond strength and tensile strength, samples were prepared according to the manufacturers' instructions and the testing machine used. For water absorption, IOS 1567 was followed to prepare specimens. Bond strengths were measured using a Lloyd Instruments materials testing machine. Ten specimens for each test were prepared for each soft liner, except for water absorption and solubility tests, for which only 5 specimens were prepared. ANOVA, Bonferroni, and Kruskal-Wallis tests were used to compare values of materials and assess changes over time. RESULTS There was strong evidence of differences in the properties between materials. GC Reline Soft showed comparable tensile bond (1.4±0.6 MPa), shear bond (1.1±0.4 MPa), tensile strength (5.44±0.98), water absorption (0.92±0.2 µg/mm³), and solubility values (0.3±0.2 µg/mm3) to that of Molloplast B (1.4±0.4; 1.6±0.5; 4.53±0.9 MPa, 1.7±0.3, and 1.0±0.3 µg/mm³, respectively). The water solubility of Sofreliner Soft was significantly lower (1.5±0.8 µg/mm³) than that of Molloplast B. CONCLUSIONS There were significant differences between some properties of 4 chairside denture soft lining materials and that of Molloplast B, which had higher shear and tensile bond strength than chairside denture silicone soft lining materials but had the highest water solubility.

Online Questionnaire-Based Study to Evaluate the Attitudes and Use of Rubber Dental Dams by Saudi Dental Practitioners.

BACKGROUND A dental dam is a protective sheet with an aperture and is used to prevent the spread of infection during dental procedures. This study aimed to use a 2-part online questionnaire to evaluate the attitudes and use of rubber dental dams by 300 Saudi dental interns, general dental practitioners, residents, specialists, and consultants in prosthodontics, endodontics, and restorative dentistry. MATERIAL AND METHODS The 17-item validated questionnaire consisted of 5 questions on demographics, 2 on knowledge, 6 on attitudes, and 4 on perceptions. It was distributed through Google Forms. The chi-square test was used to determine the associations between the study variables and perception questions. RESULTS A total of 41.67% participants were specialists/consultants, among which 59.2% were in the prosthodontics specialty, 12.8% in endodontics, and 28% in restorative dentistry. Most participants (84.67%) stated the necessity of using rubber dams during post and core procedures. A total of 53.67% had received enough training for using rubber dams during their undergraduate/residency education. The majority of participants (41%) also preferred using rubber dams during the prefabricated post and core procedures, and 28.33% stated that the remaining tooth structure was one of the major reasons for not using rubber dams during the post and core procedures. CONCLUSIONS Workshops and hands-on training should be conducted among dental graduates to instill a positive attitude regarding the use of rubber dams.

Unlocking Endocrown Restoration Expertise Among Dentists: Insights from a Multi-Center Cross-Sectional Study.

BACKGROUND This study, employing an online questionnaire, aimed to assess and contrast the awareness, knowledge, and perceptions of dentists in Saudi Arabia (SA) regarding endocrowns (EC) as post-endodontic restorations with those of dentists educated in various other countries. MATERIAL AND METHODS We conducted a cross-sectional survey among dental interns and practicing dentists in government facilities, private dental centers, and dental colleges in SA, including participants of diverse nationalities. We disseminated validated, closed-ended questionnaires through WhatsApp via Google Forms. The Chi-square test was applied to assess associations between categorical variables, with a P-value of ≤0.05 indicating statistical significance. RESULTS The majority of participants (61.2%) indicated that EC restorations are best suited for molar teeth. Furthermore, 69.6% asserted that the primary objective of employing EC is to accomplish minimally invasive preparations while preserving the existing tooth structure. Among the responses, 68.3% pinpointed debonding of ECs as a significant cause of failure. Notably, substantial differences were observed in responses concerning the knowledge or practice of EC across various factors such as gender, educational attainment, country of graduation, and workplace. CONCLUSIONS The findings reveal a comparatively low adoption of ECs among the participants, irrespective of experience or country of education. This underscores the need for incorporating ECs into dental curricula through theoretical and clinical discussions or considering them as a subject for post-graduate continuing education programs.

Comparative Evaluation of Dimensional and Occlusal Accuracy of Non-Working Antagonist Casts: A Study on Different Impression Materials and 3D Printing.

BACKGROUND The aim of this study was to assess and compare the vertical/horizontal dimensions and occlusal accuracy of non-working/opposing casts obtained from three different impression materials and 3D print cast. MATERIAL AND METHODS Dentulous Master models simulating a case of a fixed dental prosthesis were mounted on an articulator (control group). Opposing mandibular casts obtained from three different impression materialsand 3-dimensional print constituted test groups , ,and , respectively. Three points, anterior vertical (AV), posterior vertical (PV), and anteroposterior (AP) were compared for dimensional accuracy among casts. Occlusal accuracy was analyzed on Medit Link software at 3 teeth (#13, #17, and #27). After calculating means for each group, the differences were calculated at probability value of P≤0.05 using the single-sample t test, ANOVA, and Tukey test. RESULTS The dimensions were significantly different from those of the mounted master models except in Gp AL(E) and Gp AL(F) at AV dimension and Gp AL(E) at AP dimension (P>0.05). A statistically significant difference of the error of means among the 4 tested groupswere detected only at 2 dimensions (AV and PV) between the Gp AL(E) and Gp 3D-C and between Gp AL(F) and Gp 3D-C groups. Other groups showed no significant differences. CONCLUSIONS The opposing casts obtained from the extended-pour alginate and alginate alternative impression materials showed higher occlusal accuracy compared to conventional alginate and 3D printed casts.

Influence of different surface treatment on bonding of metal and ceramic Orthodontic Brackets to CAD-CAM all ceramic materials.

BACKGROUND: Developing efficient bonding techniques for orthodontic brackets and all-ceramic materials continues to pose a clinical difficulty. This study aimed to evaluate the shear bond strengths (SBS) of metal and ceramic brackets to various all-ceramic CAD-CAM materials, such as lithium disilicate CAD (LDS-CAD), polymer-infiltrated ceramic (PIC), zirconia-reinforced lithium silicate glass ceramic (ZLS), and 5YTZP zirconia after different surface treatments and thermal cycling. MATERIALS AND METHODS: The samples were divided into two groups to be bonded with ceramic and metal lower incisor brackets. Each group was subdivided into a control group devoid of any surface treatment, 10% HF acid (HFA) etching, ceramic etch & prime (MEP), Al2O3 air abrasion, and medium grit diamond bur roughening. After surface treatment, brackets were bonded with composite resin cement, thermal cycled, and tested for shear bond strength. The failed surfaces were evaluated with a digital microscope to analyse the type of failure. The data were statistically analysed using a one-way ANOVA and Tukey HSD tests at p < 0.05. RESULTS: The highest mean bond strengths were found with HFA etching in LDS-CAD (13.17 ± 0.26 MPa) and ZLS (12.85 0.52 MPa). Diamond bur recorded the lowest mean bond strength roughening across all the ceramic groups. There were significant differences in mean shear bond values per surface treatment (p < 0.001) and ceramic materials. CONCLUSION: Among the surface treatment protocols evaluated, HFA etching and MEP surface treatment resulted in enhanced bond strength of both ceramic and metal brackets to CAD-CAM all ceramic materials.

Radiographic Evaluation of the Gap between Cemented Post and Remaining Gutta-Percha in Endodontically Treated Teeth Performed by Undergraduate Students: A Retrospective Cross-Sectional Study.

The coronal seal in root canal-treated teeth may be compromised depending on the accuracy of post space preparation and post cementation along with remaining gutta-percha. Root canal treatment can be compromised by endotoxins released by the coronal bacteria as a result of microleakage. The study was conducted by undergraduate students to measure the gap between the cemented post and residual gutta-percha. In total, 217 endodontically treated teeth were evaluated with intraoral peri-apical radiographs. Based on the intraoral periapical radiographic examination in the CS-R4 program, Group I had no gap, Group II had a gap of >0 to 2 mm, and Group III had a gap of more than 2 mm between the end of the cemented post and the remaining gutta-percha. In total, 40% (n = 87) of the teeth had no gap, 59% (127) had a gap of >0 to 2 mm, and 1% (n = 3) had a gap of more than 2 mm between the cemented post end and remaining gutta. Chi square test revealed a significant difference in the gap between the post and remaining gutta-percha between males and females students (p < 0.001). In terms of the gap between the cemented post end and the residual gutta-percha, the root canal treated teeth with post and core by undergraduates were clinically acceptable.

Effect of Miswak Derivatives on Color Changes and Mechanical Properties of Polymer-Based Computer-Aided Design and Computer-Aided Manufactured (CAD/CAM) Dental Ceramic Materials.

BACKGROUND Miswak is a form of chewing stick used to clean teeth in different parts of the world, including Saudi Arabia. We present a description of the effects of miswak derivatives, namely toothpaste, mouthwash, and brushing sticks, on the mean color changes (DE00), compressive fracture resistance values, and fracture modes of polymer-based computer-aided design (CAD) and computer-aided manufactured (CAM) prosthetic materials. MATERIAL AND METHODS Eighty-one rectangular-shaped samples were prepared from lithium disilicate glass-ceramic (IPS e.max CAD), zirconia-reinforced lithium silicate (Vita Suprinity), and monochromatic tooth-colored feldspar (Vitablocs Mark II) CAD/CAM ceramics. The color parameters were recorded using spectrophotometer before and after exposing the specimens to the different miswak oral hygiene derivatives for 15 days. Compressive fracture resistance values and fracture types were also assessed, and statistical analysis was performed. RESULTS Vita Suprinity and Vitablocs Mark II miswak sticks had the highest ΔE00 values. Moreover, miswak mouthwash had the lowest ΔE00 values, with significant differences among groups. IPS e.max CAD miswak sticks had the highest mean values of compressive fracture. Vitablocs Mark II had the lowest values for mouthwash and toothpaste. Significant differences were found within the IPS e.max CAD group. Reparable fractures were found in IPS e.max CAD, while semi-reparable fractures were seen in other groups. CONCLUSIONS Most ΔE00 values were within the acceptable clinical range, with IPS e.max CAD showing superior color stability. The mouthwash group showed minimal ΔE00. IPS e.max CAD had the highest mean compressive fracture resistance values with reparable fracture types.

Dimensional Stability of Light-Activated Urethane Dimethacrylate Denture Base Resins.

An accurate and dimensionally stable trial denture base is required for a successful denture. The aim of this in vitro study was to assess the dimensional stability of a light-activated urethane dimethacrylate (UDMA) visible light cure (VLC) denture base with three fabrication techniques and different curing cycles. Forty-five VLC denture base samples were divided evenly into three groups. Group A used a conventional fabrication technique with a curing cycle of 5 min. Group B used a modified fabrication technique with two 4-min curing cycles. Group C used a multi-step fabrication technique with three curing cycles (4 min, plus 4 min, plus 2 min). The samples were sectioned and observed under a stereomicroscope to measure the discrepancy between the sample and the master cast. The mean dimensional discrepancy (mm) at the molar region at mid-palate, after 24 h in Group A, B and C was 0.790 mm, 0.741 mm and 0.379 mm, respectively; at the right ridge crest, it was 0.567, 0.408 and 0.185, while at the left ridge crest it was 0.475, 0.331 and 0.125, respectively. Statistical analysis showed significantly different dimensional discrepancies among the groups at all three sites; right ridge crest (F = 93.54, p < 0.001), left ridge crest (F = 105.96, p < 0.001) and mid-palate (F = 125.53, p < 0.001). Within the limitations of this laboratory study, it can be concluded that the denture base using a multi-step fabrication technique with three curing cycles provides better adaptation than the conventional technique. The significance of the study is that clinicians should consider performing denture base fabrication using a multi-step technique to enhance adaptation and hence the stability of the dentures for patients.

Prevalence of burnout and practice-related risk factors among Saudi Board dental residents using the Copenhagen Burnout Inventory: A survey-based cross-sectional study.

Occupational burnout is a chronic psychological problem affecting professionals. The aim of this study was to assess the types and categories of burnout among Saudi Dental board residents at different levels of residency in different provinces of Saudi Arabia, using the Copenhagen Burnout Inventory. Questionnaires were sent to 170 Saudi Dental board residents via Email and WhatsApp. at various training centers in Saudi Arabia, in May 2022. A part of the questionnaire covered the socio-demographic characteristics of the participants such as gender, training level or center, number of working sessions or hours per week and day, dental speciality, and marital status. The second part consisted of the Copenhagen Burnout Inventory survey with 21 questions. Only 110 participants returned the answered questions. The overall significant type of burnout was present in 46.3% of the respondents while 53.7%, were for free or minimal burnout. Personal, work-related, and patient-related burnout recorded 62%/38%; 40% to 60%, and 60%:40% for free or minimal to significant burnout. The overall burnout types of values were equal in both gender as well as training levels with no significant differences and P-values ≤ .05. Burnout values were close to each other among the participants in different specialties, except for orthodontics residents which were the least. Analysis of variance, followed by chi-square tests showed a significant difference among participants in different specialties in type and categories of burnout with P-values between .002 to .029. Finally, the burnout value was higher among married participants. Overall burnout types were marginally similar between genders and training levels, while the significant was slightly higher in females, married, highest training level, restorative, and prosthodontic speciality participants.

Antibacterial Efficacy and Surface Characteristics of Boron Nitride Coated Dental Implant: An In-Vitro Study.

This in vitro study evaluated bacterial cell proliferation and biofilm adhesion on titanium discs with and without antibacterial surface treatment to reduce the chances of peri-implant infections. Hexagonal boron nitride with 99.5% purity was converted to hexagonal boron nitride nanosheets via the liquid phase exfoliation process. The spin coating method was used for uniform coating of h-BNNSs over titanium alloy (Ti6Al4V) discs. Two groups of titanium discs were formed: Group I (n = 10) BN-coated titanium discs and Group II (n = 10) uncoated titanium discs. Two bacterial strains, Streptococcus mutans (initial colonizers) and Fusobacterium nucleatum (secondary colonizers), were used. A zone of inhibition test, microbial colony forming units assay, and crystal violet staining assay were used to evaluate bacterial cell viability. Surface characteristics and antimicrobial efficacy were examined by scanning electron microscopy with energy dispersion X-ray spectroscopy. SPSS (Statistical Package for Social Sciences) version 21.0 was used to analyze the results. The data were analyzed for probability distribution using the Kolmogorov-Smirnov test, and a non-parametric test of significance was applied. An inter-group comparison was done using the Mann-Whitney U test. A statistically significant increase was observed in the bactericidal action of BN-coated discs compared to uncoated discs against S. mutans, but no statistically significant difference was found against F. nucleatum.

Effect of smokeless tobacco on color stability and surface roughness of CAD/CAM milled, 3D printed, and conventional provisional crown and fixed dental prosthesis materials: An in vitro study.

BACKGROUND: Provisional fixed dental prosthesis (FDP) plays an important role during fixed prosthodontic therapy till the definitive. Discoloration of materials used for provisional FDPs can cause patient dissatisfaction and may create doubt about the color stability of the definitive FDP. Surface roughness is the other major property to be taken into consideration for provisional FDP materials. Smokeless tobacco is reported to affect the color stability and surface roughness of different prosthetic materials. OBJECTIVE: The aim of the current study was to evaluate the effect of two types of smokeless tobacco (black and white) on color stability and surface roughness of 3D printed, CAD/CAM milled, and conventional provisional FDP resin materials. METHODS: A total of 144 disc-shaped specimens were fabricated using four techniques CAD/CAM subtractive technique (milling), CAD/CAM additive technique (3D Printing), and conventional technique using autopolymerized PMMA, and autopolymerized Bis-acrylic resins. Each group was subdivided into three subgroups of twelve specimens each, and were submerged into three solutions (artificial salivary substitute, black smokeless tobacco, white smokeless tobacco). The change in color and surface roughness was evaluated and the data collected were statistically analyzed. RESULTS: It was observed that black smokeless tobacco caused the maximum color change and the effect was highest in autopolymerized PMMA resin specimens (ΔE = 9.343 ± 0.489), followed by 3D printed (ΔE = 7.187 ± 0.391), autopolymerized Bis-acryl (ΔE = 6.464 ± 0.453) and milled (ΔE = 4.978 ± 0.227). White smokeless tobacco was found to cause a maximum change in surface roughness and the effect was highest in autopolymerized Bis-acryl specimens (ΔRa = 0.321 ± 0.015 µm), followed by autopolymerized PMMA (ΔRa = 0.297± 0.015 µm), 3D printed (ΔRa = 0.191 ± 0.019 µm), and milled (ΔRa = 0.168 ± 0.014 µm). Statistically significant (p-value < 0.05) differences were observed among all techniques and solutions. CONCLUSIONS: The change in color and surface roughness were maximum in the case of FDPs prepared using autopolymerizing resins, followed by 3D printed, and CAD/CAM milled reins.

Effects of Smokeless Tobacco on Color Stability and Surface Roughness of 3D-Printed, CAD/CAM-Milled, and Conventional Denture Base Materials: An In Vitro Study.

Tobacco consumption in its different forms can affect the optical and surface properties of dental materials that are used in the oral cavity. Thus, the present study was conducted to evaluate the effects of two commercially available smokeless tobacco products on the color stability and surface roughness of denture base resins that were fabricated using three different techniques (CAD/CAM milling, 3D printing, and conventional heat polymerization). A total of 126 denture base resin specimens were fabricated using the three different manufacturing techniques (n = 42 each). Specimens from each group were further subdivided into three subgroups (n = 14 each) and immersed in three different immersion media (a khaini suspension, a tabbaq suspension, and artificial saliva). The differences in color and surface roughness were assessed according to data that were collected and statistically analyzed using SPSS version 24.0. The tabbaq smokeless tobacco was found to cause greatest changes in color and surface roughness; the effect was observed to be highest in the 3D-printed specimens followed by the conventional heat-polymerized and CAD/CAM milled specimens. The mean changes in color and surface roughness were the highest for the tabbaq smokeless tobacco followed by the khaini smokeless tobacco and the artificial saliva. Statistically significant (p-value < 0.05) differences were observed among all techniques and suspensions. We concluded that the mean changes in color and surface roughness were significantly higher for the 3D-printed dentures compared to the conventional heat-polymerized and CAD/CAM-milled dentures. Thus, the results of the present study strengthened the concept that tobacco in any form can lead to changes in the color and surface roughness of denture base materials.

Assessment of PCL between dental implant prosthesis and natural teeth using a digital force analyzer.

BACKGROUND: The prime concern of an implant-supported prosthesis (ISP) is to maintain an optimal proximal contact tightness, which further maintains arch integrity, improves masticatory effectiveness, and minimizes peri-implantitis. OBJECTIVE: To investigate the loss of proximal contact tightness between single tooth implant-supported prosthesis and the adjacent natural teeth. METHODS: Forty patients treated by a single mandibular first molar ISP, aged between 18-50 years were selected. All were randomly allocated in Group I and Group II. Group I, 20 subjects who have received ISP without an insertion of Essix retainer, and Group II patients received an insertion with Essix retainer. The groups were subdivided into Subgroup A, B, and Subgroup C, D, in which A and C are control groups. To measure the tightness at proximal contact points, a digital force analyzer was used. Proximal contact tightness (PCT) was measured immediately after the placement of the prosthesis, 3 months, 6 months, and 1-year follow-up respectively, and the PCT values at end of 1 year were statistically evaluated. Statistical analysis was done, mean and standard deviation was calculated by independent sample t-test wit p< 0.05 as a statistically significant value. RESULTS: In Group I, towards the end of 1 year, 2.09 N (65.5%) and 1.50 N (53.1%) loss of PCT were found on mesial and distal contact areas respectively. In Group II, loss of PCT at mesial contact area was 0.87 N (28.9%) and at distal contact area was 1.77 N (53.3%), which is significantly less compared with the non-usage of Essix retainer (p< 0.05). CONCLUSION: The usage of Essix retainer, PCT increases especially on the mesial contact area. The frequency of contact loss was decreased. Thus, to minimize the loss of proximal contact the usage of Essix retainer is recommended.

Assessment of Conventionally and Digitally Fabricated Complete Dentures: A Comprehensive Review.

CAD/CAM technology is gaining popularity and replacing archaic conventional procedures for fabricating dentures. CAD/CAM supports using a digital workflow reduce the number of visits, chair time, and laboratory time, making it attractive to patients. This study aimed to provide a comparative review of complete dentures manufactured using CAD/CAM and conventional methods. The PubMed/Medline, Science Direct, Cochrane, and Google Scholar databases were searched for studies published in English within the last 11 years (from 2011 to 2021). The keywords used were "computer-engineered complete dentures", "CAD/CAM complete dentures", "computer-aided engineering complete dentures", and "digital complete dentures". The search yielded 102 articles. Eighteen relevant articles were included in this review. Overall, computer-engineered complete dentures have several advantages over conventional dentures. Patients reported greater satisfaction with computer-engineered complete dentures (CECDs) due to better fit, reduced chair time, shorter appointments, and fewer post-insertion visits. CAD/CAM allows for precision and reproducibility with fewer procedures compared to conventional dentures. Polymethyl methacrylate is used as the denture base material for conventional dentures. For CECDs, the resin can be modified and cross-linked to improve its mechanical properties. The advantages of CECDs include a reduced number of appointments, saving chairside time, a digital workflow allowing easy reproducibility and greater patient satisfaction with a better fit.

Evaluation of Micro-Tensile Bond Strength of Fibre Post with Titanium Dioxide Nanoparticles as Fillers in Experimental Dental Composite Resin.

BACKGROUND: The clinical success of post-core restorations is determined by the composite utilized and the strength of the post-core adhesion. The effectiveness of titanium dioxide nanoparticles (TiO2 NPs) as a multifunctional material with photo-induced activities and better mechanical characteristics are observed as particle size is reduced to under 50 nm. AIM: The purpose of this study is to determine the bond strength of fibre-reinforced composite (FRC) posts with TiO2 NP as fillers and to compare it with conventional composite resin core material. MATERIALS AND METHODS: 30 single-rooted mandibular premolars were selected and routine root canal procedures were done. A quantity of 5% TiO2 NPs were synthesized and added as silanized filler to the experimental composite resin. Post space was prepared and fibre-reinforced composite (FRC) post luting was performed. The specimens were then grouped into the following groups: Group I consisted of the experimental composite resin containing 5% TiO2 fillers, Group II consisted of core X flow, and Group III consisted of Multicore Flow. All test groups were submitted for thermocycling. After this, the samples were tested for micro tensile bond strength. A stereomicroscope with a magnification of 20× was used to examine the fractured surfaces. The data were analysed using one-way ANOVA and Tukey HSD tests. RESULTS: Statistical analysis revealed that Group I showed the highest mean bond strength value of 35.6180 Mpa. The results obtained with Group III showed the lowest mean bond strength value of 19.4690 Mpa. Adhesive failures were identified by stereomicroscopy of the fractured surfaces. CONCLUSION: The experimental composite resin comprising 5% TiO2 NP had a greater bond to the FRC post than other materials tested.

Comparison of Microleakage in Nanocomposite and Amalgam as a Crown Foundation Material Luted with Different Luting Cements under CAD-CAM Milled Metal Crowns: An In Vitro Microscopic Study.

Microleakage is a persistent problem despite advancement in materials and techniques in fixed prosthodontics. This leads to the importance of sound crown foundation material and luting agents used to maintain the marginal seal. The literature is deficient with studies, comparing microleakage under various crown foundation materials and luting agents, especially with CAD-CAM (computer-aided design and computer-aided manufacturing) metal crowns. This study was aimed to compare microleakage in a nanocomposite/dentinal bonding agent and amalgam/cavity varnish as crown foundation materials luted with two different luting cements: resin-reinforced glass ionomer cement and self-adhesive resin cement, under both dry and contaminated conditions. A hundred intact, caries-free human molars were prepared to receive crown foundation material and extra coronal restorations. Amalgams with cavity varnish and nanocomposites with dentinal bonding agent in both ideal and contaminated conditions were used as crown foundation materials. After restoration, each sample was cemented with a CAD-CAM milled metal crown using two different luting agents-resin-reinforced glass ionomer cement and self-adhesive resin cements both in ideal and contaminated conditions. Cementation was followed by thermocycling of samples, immersion in erythrosine B dye, embedding in clear auto polymerizing acrylic resin and sectioning to evaluate microleakage using stereomicroscope. The mean microleakage between different luting cements on the experimental side of the facial surface was 137.64 µm and 211.01 µm for resin-reinforced GIC and for self-adhesive resin cement was 119.78 µm and 150.42 µm, under ideal and contaminated condition, respectively. There was a significant difference in mean micro-leakage between different crown foundation material and cement groups used in the study. The composites and amalgam, both when used as crown foundation material and luted with use of technically advanced CAD-CAM metal crown with self-adhesive resin cement (in both ideal or contaminated condition), showed less microleakage than in resin-reinforced glass ionomer cement. Overall, the self-adhesive resin cement showed comparatively reduced microleakage in all combinations with different crown foundations. Thus, this combination can be used in daily clinical practice to provide better protection from further decay.