Automated Stabilization, Enhancement and Capillaries Segmentation in Videocapillaroscopy.

Oral capillaroscopy is a critical and non-invasive technique used to evaluate microcirculation. Its ability to observe small vessels in vivo has generated significant interest in the field. Capillaroscopy serves as an essential tool for diagnosing and prognosing various pathologies, with anatomic-pathological lesions playing a crucial role in their progression. Despite its importance, the utilization of videocapillaroscopy in the oral cavity encounters limitations due to the acquisition setup, encompassing spatial and temporal resolutions of the video camera, objective magnification, and physical probe dimensions. Moreover, the operator's influence during the acquisition process, particularly how the probe is maneuvered, further affects its effectiveness. This study aims to address these challenges and improve data reliability by developing a computerized support system for microcirculation analysis. The designed system performs stabilization, enhancement and automatic segmentation of capillaries in oral mucosal video sequences. The stabilization phase was performed by means of a method based on the coupling of seed points in a classification process. The enhancement process implemented was based on the temporal analysis of the capillaroscopic frames. Finally, an automatic segmentation phase of the capillaries was implemented with the additional objective of quantitatively assessing the signal improvement achieved through the developed techniques. Specifically, transfer learning of the renowned U-net deep network was implemented for this purpose. The proposed method underwent testing on a database with ground truth obtained from expert manual segmentation. The obtained results demonstrate an achieved Jaccard index of 90.1% and an accuracy of 96.2%, highlighting the effectiveness of the developed techniques in oral capillaroscopy. In conclusion, these promising outcomes encourage the utilization of this method to assist in the diagnosis and monitoring of conditions that impact microcirculation, such as rheumatologic or cardiovascular disorders.

Permanence of Modifications in Oral Microcirculation in Ex-Smokers.

BACKGROUND The aim of this study was to assess the long-term effects of smoking and to investigate the permanence of this damage to the oral microcirculation. MATERIAL AND METHODS We recruited 75 patients and divided them into 3 groups: group 1 was composed of 25 healthy non-smokers, group 2 was composed of 25 healthy current smokers, and group 3 was composed of 25 healthy ex-smokers. Video-capillaroscopic examination was performed on all patients. The video-capillaroscopic investigation was performed on patients in sitting position, always with the same light source, at the same room temperature (23°C), in the morning, with the same operator (GAS), and was repeated many times for every area under investigation. An enlargement of 200× allowed us to explore point-by-point all the morpho-structural characteristics of the capillaroscopic field. For non-parametric data, we evaluated the visibility of the loops and their position in relation to the surface of the mucosa. The evaluated parametric data were length of capillary loop, diameter of the loop, capillary tortuosity, and capillary density. RESULTS Our study clearly shows there was no remission of vascular damage, even 13 years after smoking cessation. CONCLUSIONS Our research shows that that the effects of smoking are still visible in ex-smokers, even at 13 years after cessation and also that ex-smokers are still subject to the risk of oral pathologies in the interval of time that we considered.

Diabetic Microagiopathy of Oral Mucosa Depends on Disease Duration and Therapy.

BACKGROUND Diabetes mellitus is a chronic degenerative systemic disease whose prevalence is increasing. This paper aims to evaluate the effects of diabetic microangiopathy, depending on its duration and the type of treatment administered, by using polarized light videocapillaroscopy of the oral mucosa. MATERIAL AND METHODS We enrolled 120 subjects: 60 healthy subjects and 60 patients with diabetes mellitus. In turn, patients were divided into 3 subgroups according to the type of diabetes, the duration of the disease, and the type of treatment administered. A videocapillaroscopic examination of the oral mucosa was carried out on the diabetic and healthy subjects. RESULTS Changes in microcirculation were detected in diabetic patients: at the level of the labial, buccal, and lingual mucosa, the density of the loops is on average reduced; there is an increase in the length and the total diameter of the loops, while the average density of the periodontal capillaries is much higher. The most significant changes were noted in patients who had had type 1 diabetes for more than 10 years and had received insulin therapy. CONCLUSIONS This study, performed using polarized light videocapillaroscopy, which for the first time was used to analyze the capillaries of the oral mucosa in patients with diabetes, confirms the presence of changes that are instrumentally "objectifiable" and "quantifiable" through the videocapillaroscopic technique. Videocapillaroscopy can be a reliable method in the study and monitoring of complications in patients with type 1 and 2 diabetes mellitus.

Changes of oral microcirculation in chemotherapy patients: A possible correlation with mucositis?

The aim of this investigation is to appraise labial oral microcirculation in chemotherapy patients to clarify the effects of cytotoxic agents on oral microvessels. Twenty-five patients with diagnosis of head and neck tumors were recruited in the study. All the patients were submitted to chemotherapy. Labial oral microcirculation was evaluated on labial mucosa using oral videocapillaroscopy. The statistical significance was checked with the Mann-Whitney U-test (P < 0.05). The analysis of videocapillaroscopic patterns showed statistically significant variations relative to the diameter of the incoming loop; the diameter of the outgoing loop; and loop tortuosity. This study shows that capillary alterations to patients who receive chemotherapy occur in labial oral microcirculation.

A simple method to identify implant sites in totally edentulous arches: a pilot study with thermo-printed templates used with cone beam computed tomography.

BACKGROUND: All dental implants must be placed following radiological, clinical and aesthetic indications in compliance with prosthetic principles avoiding iatrogenic damage to patients. In implantology, among the key choices, to obtain predictable results, it is essential to establish (by cone beam computed tomography [CBCT]) the sites where to insert the implants; these sites must be identified, during the surgical phase, in the oral cavity. Surgical guides represent a valid aid especially in complex cases that require multiple implants. For some clinical conditions, expert operators choose the free hand technique during which identifying the chosen implant sites on CBCT in the oral cavity is more difficult. METHODS: This experimental study is based on the use of thermo-molded mask as an alternative to surgical guides when the freehand technique is adopted in totally edentulous patients. These innovative masks, containing radiopaque references, are initially worn by patients during the execution of the CBCT, and later during surgery to identify the implant sites in the oral cavity. RESULTS: The procedure described proved to be very useful and able to increase the precision of the freehand technique even if it does not provide information on the inclination of the implants. The metal references help clinical identification of the implant site. CONCLUSIONS: Our thermo-molded masks, in particular clinical conditions, could represent a valid and economical alternative to the classic surgical guide. The described procedure does not increase costs for the patient and significantly increases the precision in inserting the implants during free-hand techniques.

Soldering in Dentistry: An Updated Technical Review.

INTRODUCTION: The need to permanently join two or more pieces of metal using heat is a frequent condition in various fields of medicine such as dentistry. Welding, brazing and soldering are permanent joining techniques between different metals that require in-depth background knowledge in order to obtain predictable results. AIM: This review examines the different methods of joining metals using heat and their fields of application. DISCUSSION: It is possible to create permanent metal joints in various phases of the creation of final products that will be used on the patient. In several cases, welds are also made directly by the manufacturer during industrial processing. In dentistry, dental laboratories perform complex welds mainly on dental prostheses and orthodontic appliances during the production process. It is also possible to obtain intraoral welding carried out by the clinician inside the patient's oral cavity. Welding can be carried out using combustible gases, electric current, infrared light and laser light through different technical procedures which must be chosen according to the specific needs and the metals to be joined. CONCLUSIONS: It is useful for the dentist and dental technician to know the different welding methods, including those carried out in the factory by the manufacturer, to better understand the physical properties and mechanical resistance of the components marketed for the construction of prostheses and orthodontic appliances. The enormous variety of conditions in which those who practice welding can find themselves therefore presupposes in-depth knowledge in this field in order to apply the most suitable technique.

Oral Squamous Cell Carcinoma: Features and Medico-Legal Implications of Diagnostic Omission.

Early diagnosis of oncologic pathologies has a crucial role to determine patient's prognosis and therapeutic path. Nonetheless, clinical errors and omissions that can occur during diagnostic, as well as detection of preneoplastic or neoplastic condition, may result in devasting consequences both for patients in terms of health and for professionals in terms of medico-legal responsibility. This study is aimed at examining in depth, through the presentation of a specific clinical case, the medico-legal aspects inherent to the diagnosis of oral cancer, analyzing the preventive, interceptive, and diagnostic strategies, the legal implications of clinical evaluation errors and diagnostic omission, and the type of medical damage produced and professional liability. The medico-legal landscape surrounding oral squamous cell carcinoma is multifaceted and characterized by diagnostic challenges, treatment complexities, and legal considerations. Health-care providers must remain vigilant in navigating these complexities to ensure optimal patient care while mitigating legal risks. By prioritizing high-quality medical records, fostering transparent communication with patients, and implementing preventive strategies, health-care institutions can strive to minimize the incidence of litigation and uphold standards of ethical practice in oral carcinoma cases. Additionally, continued research and education in forensic and legal medicine are essential in informing evidence-based practices and promoting patient safety in this evolving field.

Filter Masks during the Second Phase of SARS-CoV-2: Study on Population.

During the SARS-CoV-2 pandemic, the most common countermeasure are the use of masks, which are supposed to filter inhaled and exhaled air to reduce the spread of the virus. The masks, which are medical devices, must be used by providing appropriate instructions for correct use. This study, which examined the population during the advanced stage of the pandemic, highlighted a substantial improvement in the management and choice of masks, even though the information disseminated to the population probably should be even more detailed and precise in order to avoid incorrect behavior that could compromise the effectiveness of these devices; in fact a high percentage of subjects had behaviors that can facilitate the spread of the virus, such as the continuous attempts to correct the incorrect positioning of the mask on the face or the need to move it because it is annoying.

Palatal Rugae as a Discriminating Factor in Determining Sex: A New Method Applicable in Forensic Odontology?

The purpose of this study is a new method that can help to identify the sex through the study of palatal rugae, comparing sagittal sections of the hard palate using Cartesian coordinates and evaluating the assistance given by digital technology and its applicability in this method. In this study, 57 digital impressions were examined and divided in two groups based on sex. Results: 2223 impression sections were studied and 145 coordinates that were present with a frequency greater than 50% in one or both groups were obtained: 52 discriminating traits (DT) in the male group, 29 discriminating traits in the female group, and 64 common traits (CT). The DTs in the female group showed no statistically significant difference from the same coordinates in the male one (p = 0.832). Statistically significant differences were observed in the DTs in the male group compared to the same coordinates in the female group (p = 0.018). No statistically significant differences were observed in the frequency of DTs in both sexes (p = 0.056). Further research in forensic odontology is needed to determine its scientific certainty. It is certain that digital technology may one day be a valuable support for the forensic odontologist but to date the lack of dedicated and certified programs limits its reliability.

Roots and Root Canals Characterization of Permanent Mandibular Premolars Analyzed Using the Cone Beam and Micro Computed Tomography-A Systematic Review and Metanalysis.

This current paper aims to review the literature on the root canal configuration (RCC) and root structure of permanent mandibular premolars. To find the published scientific literature on the RCC of mandibular premolars up to July 2022, a systematic search of four electronic databases was performed. The studies were selected, rendering to a predetermined point of reference: "mandibular 2nd premolar", "root and canal system", "morphology of root and canal", "root and canal configuration", and "morphology", along with "anatomy" and "mandibular premolars". Cross-referencing along with screening through the bibliographies of the chosen articles resulted in the identification of further studies. In the current study, we examined 30 different articles, and we chose them based on the quality of research investigations. From 3471 retrieved studies, a total of 15981 mandibular 2nd premolars were observed in 30 studies. The mean JBI score for studies assessing the structure of the root, as well as the root canal of the mandibular 2nd premolar, was 7.78 ± 0.81. We have found a pooled prevalence of 91.82% for Vertucci class I root canal morphology and 78.63% pooled prevalence of single-rooted mandibular second premolar. A total of 8677 mandibular 1st premolars were observed in 22 studies. The mean JBI score for studies assessing the structure and anatomy of the root, as well as root canal of mandibular 1st premolar, was 7. 95 ± 0.85. We have found a pooled prevalence of 74.34% for Vertucci class I root canal morphology and 85.20% pooled prevalence of single-rooted mandibular 1st premolar. Mandibular first and second premolars were mostly single-rooted teeth (89.5-100%). The most frequently seen RCC is a 1-1-2-/2 (type V-Vertucci's), followed by 1-1-2-/1 (type IV- Vertucci's; type III-Weine's), and finally RCC 2-2-2-1 (type IV-Vertucci's; type III-Weine's). Presently, the imaging of CBCT is the most used research approach for studying Mn2Ps' structural characteristics.

Periodontal microcirculation in diabetics: an in vivo non-invasive analysis by means of videocapillaroscopy.

BACKGROUND: Diabetes mellitus is today considered a society-wide disease of a chronic/degenerative nature. Among the secondary effects of diabetes, the one that interests the dental surgeon most is diabetic parodontopathy. The aim of this study was to underline and objectify microcirculatory variations at a periodontal mucous level in type 2 diabetics. MATERIAL/METHODS: The study enrolled 80 subjects: 40 subjects with a diagnosis of diabetes mellitus type II (18 males and 22 females, between 44 and 85 years of age); and 40 healthy subjects (17 males and 23 females, between 44 and 78 years of age). All the subjects, both diabetic and healthy, were submitted to a videocapillaroscopic examination of the mucosa of the oral cavity. RESULTS: The measurements concerning the density (expressed in the number of loops/mm2) of the capillary loops presented differences between the healthy subjects and the diabetic subjects. The average periodontal capillary density (DC-P) was clearly superior in diabetic subjects (35.62 ± 10.40 n°loop/mm²) compared to healthy subjects (17.55 ± 3.88 n°loop/mm²). The statistical analysis was performed by means of the Mann Whitney test. The value of P (p=0.000000986), well below the level of significance, demonstrates the high significance of the results obtained. CONCLUSIONS: The increase in capillary density could suggest the presence of active inflammatory phenomena or, more probably, a tendency to a greater susceptibility to inflammatory phenomena. Ultimately, this study shows that there is some peripheral damage to microcirculation at the masticatory mucous level in diabetic subjects and that such alterations can be instrumentally objectified and quantified through the videocapillaroscopic method.

Oral microcirculation in post-menopause: a possible correlation with periodontitis.

OBJECTIVES: The reduction in the level of oestrogen, typical in menopause, has some effect on the health of the oral cavity. In fact, post-menopausal women present more severe periodontal disease than pre-menopausal women. Numerous factors can be held to be responsible for this increase, among which are the effects of oestrogens on the oral epithelium, on the salivary glands, on bone tissue and on the endothelium. Our double blind study aims to evaluate the possible variations in oral microcirculation in post-menopausal women. METHODS: Twenty-seven women in post-menopause (age: Mean ± SD: 57.3 ± 8.73) and 27 women in pre-menopause (age: Mean ± SD: 27.77 ± 3.56) were examined. Oral microcirculation was investigated using oral videocapillaroscopy. RESULTS: The study showed significant differences between cases and controls for the following parameters: decrease in diameter of loops (mean ± SD: 0.038 ± 0.008; 0.045 ± 0.005), increase in tortuosity (mean ± SD: 3.83 ± 1.13; 1.83 ± 1.06) in labial mucosa and decrease in density in periodontal mucosa (Mean ± SD: 28.86 ± 10.92; 89.62 ± 17.83). CONCLUSION: The decrease in periodontal density may compromise the epithelium tropism, making it prone to inflammation. The tortuosity may indicate a greater permanence of inflammatory factors, increased in post-menopausal women.

The Effects of Low-frequency Vibration on Aligner Treatment Duration: A Clinical Trial.

Objectives: The aim of this study was to investigate the effectiveness of an orthodontic tooth movement acceleration device (AcceleDent, OrthoAccel Technologies, Houston, Texas) when used during an aligner treatment. Materials and Methods: Adult patients who began an aligner treatment (Lineo, Micerium Lab, Avegno, Italy) were allocated to two treatment groups. The first one (Group A), with a 7-day aligner change regimen, used the AcceleDent device for 20 min per day, whereas the second one (Group B) changed the aligners every 14 days and did not use any device. The registered outcomes were the possibility of completing the treatment, the number of aligners needed and treatment duration in the two groups. Moreover, we assessed patients' perception of pain during the first week of treatment. Results: Twenty-four patients were allocated to Group A or B depending on the acceptance of AcceleDent use. Patients which used AcceleDent (Group A) completed the treatment using each aligner for fewer days than those belonging to Group B (9.0 ± 1.0 and 15.4 ± 1.2 days, respectively) (P < 0.001). As a secondary outcome, a significant difference was found in pain perception during the first week of treatment between the two groups (P < 0.05). Conclusions: This controlled clinical trial shows that is possible to apply a 7-day change regimen together with AcceleDent use and successfully complete an aligner treatment with a significant saving of time when compared to a standard 14-days change regimen. Finally, the use of this device allowed reduction in pain perception during the orthodontic treatment.

Home Oral Care Domiciliary Protocol for the Management of Dental Erosion in Rugby Players: A Randomized Clinical Trial.

People performing regular physical activity are at high risk of dental erosion especially in cases of high sport drinks intake. Biomimetic hydroxyapatite-based oral hygiene products, like toothpastes and mouthwashes, have been investigated in recent years for their remineralizing activity on the teeth. The aim of the present study was to evaluate the efficacy of two different oral hygiene protocols, respectively consisting of the combination of a hydroxyapatite-based toothpaste plus mouthwash (Trial group) or toothpaste alone (Control Group). At baseline (T0), as well as at 15 days (T1), 30 days (T2) and 90 days (T3), the following clinical indexes were assessed: Basic Erosive Wear Examination (BEWE), Schiff Air Index (SAI), Visual Analogue Scale (VAS), Plaque Index (PI) and Bleeding Index (BI). In general, for all the indexes assessed, a progressive intragroup reduction was noticed from the baseline to the subsequent timepoints, with no intergroup differences. Accordingly, the use of the hydroxyapatite-based toothpaste, alone or in combination with the mouthwash containing hydroxyapatite as well, is an effective method for the domiciliary management of dental erosion in physically active individuals like rugby players.

Comparison of Interactive Teaching in Online and Offline Platforms among Dental Undergraduates.

In recent years, the educational system has focused more on the holistic development of an individual. Modern technology has changed the educational environment to provide students with better academic opportunities. Along with the education system, teaching techniques and learning tools have also changed with digital evolution. This research was undertaken to assess the academic performance of interactive teaching methods in offline and online platforms in Periodontics among BDS undergraduates at a dental college in India. This prospective study was conducted among 49 students: Group I (n = 24, online class through Zoom) and Group II (n = 25, offline classes). The subject was divided into three modules and was covered in one week. The topics covered, teaching methods, lectures, and activities were similar for both groups. A formative assessment mark was obtained from written tests during the module, whereas the summative assessment mark was recorded from exams conducted towards the end of the module. In the results, a statistically significant difference was not observed in terms of formative assessment between Group I (77.88 ± 12.89) and Group II (77.80 ± 16.09) (p = 0.98). In addition, a statistically significant difference was not observed in terms of summative assessment between Group I (80.54 ± 8.39) and Group II (80.28 ± 11.57) (p = 0.93). Overall, this study suggests that interactive teaching methods in both offline and online platforms in Periodontics showed equivalent performance by the undergraduate dental students.

LinguAPP: An m-Health Application for Teledentistry Diagnostics.

An Android/iOS application for low-cost mobile devices to aid in dental diagnosis through questionnaire and photos is presented in this paper. The main purposes of our app lie in the ease of use even for nonexperienced users, in the limited hardware requirements that allow a wide diffusion, and in the possibility to modify the questionnaire for different pathologies. This tool was developed in about a month at the beginning of the COVID-19 (SARS-CoV-2) pandemic and is still in use in Italy to allow support to patients without going to the hospital, if not strictly necessary.

Herbal Medications in Endodontics and Its Application-A Review of Literature.

Herbal products are gaining popularity in dental and medical practice nowadays due to their biocompatibility, higher antimicrobial activity, antioxidant and anti-inflammatory properties. Herbal medicine has experienced rapid growth in recent years due to its beneficial properties, ease of availability, and lack of side effects. As pathogenic bacteria become more resistant to antibiotics and chemotherapeutic agents, researchers are becoming more interested in alternative products and treatment choices for oral diseases. As a result, natural phytochemicals separated from plants and utilized in traditional medicine are suitable substitutes for synthetic chemicals. The aim of this review article is to list and understand several herbal alternatives that are currently accessible for use as efficient endodontic medicaments. The herbal products used in endodontics have several advantages, including safety, ease of use, increased storability, low cost, and a lack of microbial tolerance. However, preclinical and clinical testing and interactions with other materials and adverse effects are required for these herbal products.

Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review.

This systematic review's objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci's classification system (n-16) and the four-digit system (n-6).

A Vaccine Construction against COVID-19-Associated Mucormycosis Contrived with Immunoinformatics-Based Scavenging of Potential Mucoralean Epitopes.

Mucormycosis is a group of infections, caused by multiple fungal species, which affect many human organs and is lethal in immunocompromised patients. During the COVID-19 pandemic, the current wave of mucormycosis is a challenge to medical professionals as its effects are multiplied because of the severity of COVID-19 infection. The variant of concern, Omicron, has been linked to fatal mucormycosis infections in the US and Asia. Consequently, current postdiagnostic treatments of mucormycosis have been rendered unsatisfactory. In this hour of need, a preinfection cure is needed that may prevent lethal infections in immunocompromised individuals. This study proposes a potential vaccine construct targeting mucor and rhizopus species responsible for mucormycosis infections, providing immunoprotection to immunocompromised patients. The vaccine construct, with an antigenicity score of 0.75 covering, on average, 92-98% of the world population, was designed using an immunoinformatics approach. Molecular interactions with major histocompatibility complex-1 (MHC-I), Toll-like receptors-2 (TLR2), and glucose-regulated protein 78 (GRP78), with scores of -896.0, -948.4, and -925.0, respectively, demonstrated its potential to bind with the human immune receptors. It elicited a strong predicted innate and adaptive immune response in the form of helper T (Th) cells, cytotoxic T (TC) cells, B cells, natural killer (NK) cells, and macrophages. The vaccine cloned in the pBR322 vector showed positive amplification, further solidifying its stability and potential. The proposed construct holds a promising approach as the first step towards an antimucormycosis vaccine and may contribute to minimizing postdiagnostic burdens and failures.

Evaluation of Effects of Various Irrigating Solutions on Chemical Structure of Root Canal Dentin Using FTIR, SEM, and EDS: An In Vitro Study.

Background: Sequential chemical application for irrigating a root canal during chemomechanical debridement can affect the dentin microstructure. Understanding the effects of various irrigants on chemical properties of dentin can elucidate their effects on physical properties and thereby explain the higher incidence of structural failure in endodontically treated teeth. This in vitro research aimed to compare and evaluate the effects of three different irrigating solutions on the chemical structure of root canal dentin in extracted human teeth. Methods: Forty-eight extracted single-rooted mandibular premolar teeth were sectioned at the cemento−enamel junction by a diamond disc and were then randomly assigned to four groups of twelve samples each. The groups were irrigated using 5.25% NaOCl, ozonated olive oil, silver citrate, or distilled water. Dentin sections measuring 1.5 mm were obtained from the root portion and each section and were analyzed using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and electron-dispersive spectroscopy (EDS). FTIR and EDS values are reported as means ± standard deviations. Data were analyzed using an ANOVA and a post hoc Bonferroni test (p < 0.05). Results: A comparison of the FTIR and EDS values among the groups using ANOVA revealed statistically significant differences in the organic and inorganic peak values among the groups. An intergroup comparison between NaOCl with silver citrate and ozonated olive oil revealed significant reductions in the carbonate and phosphate peak values in the NaOCl group (p < 0.05). The EDS values tabulated for the carbon, oxygen, phosphorous, and calcium peak levels showed significant differences between the groups using an ANOVA. An SEM analysis was conducted under 1500× magnification, which revealed smear layer removal in the silver citrate group. Conclusions: The silver citrate solution and the ozonated olive oil caused less changes in the organic and mineral contents of dentin than sodium hypochlorite.