Effect of peroxide-free and peroxide-based in-office bleaching on the surface and mechanical properties of CAD/CAM esthetic restorative materials.

The study aimed to investigate the influence of H2O2-based and H2O2-free in-office bleaching on the surface and mechanical attributes of CAD/CAM composite blocks. CAD/CAM composite blocks from five different composite materials (CC1, CC2, CC3, CC4, and CC5) were randomly divided into two groups according to bleaching application (H2O2-based and H2O2-free). The surface topography, morphology, nanohardness, elastic modulus, flexural strength, and fracture toughness were measured. A paired and unpaired sample t-tests gauged the effect of pre- and post-bleaching on the substrates. The estimated mean differences (before-after bleaching) suggested an increase in surface roughness for two materials CC2 and CC4, and a significant decrease in nanohardness for material CC4 and in elastic modulus for materials CC2 and CC4 with H2O2-based bleaching, whereas H2O2-free bleaching resulted in changes compatible with no change in these properties. Flexural strength and fracture toughness showed no evidence of changes, irrespective of the bleaching gel used. Scanning electron microscopic analysis revealed erosive effects and micropore formation due to H2O2-based bleaching. H2O2-based bleaching deteriorates the surface of CAD/CAM composite materials while H2O2-free bleaching gel had an insignificant effect on both surface and bulk properties. The clinician should carefully evaluate the potential effects of H2O2-based bleaching on the surface properties of CAD/CAM composites.

Knowledge of the monkeypox 2022 outbreak among dental hygienists and students in Saudi Arabia: A cross-sectional study.

OBJECTIVE: This study aimed to assess the knowledge of monkeypox infection among dental hygiene professionals and students in Saudi Arabia. METHODS: A cross-sectional study was conducted among a convenience sample of dental hygiene professionals (n = 259). The questionnaire was developed based on previous literature, and descriptive analysis and a Chi-square test were performed. RESULTS: A total of 159 dental hygienists responded to the questionnaire. Results indicated that only 1.7% had good knowledge, 7.7% had moderate knowledge and 90.6% had low knowledge of the monkeypox outbreak. The mean knowledge scores varied among dental hygiene students, practitioners and faculty members. Significant group differences were observed for some questions (p < 0.05). CONCLUSION: Our study concludes that dental hygienists had moderate to low level of knowledge of the monkeypox infection and its implications for oral health and patient care, indicating a need for more education on the subject.

Clinical Evaluation of Single Versus Repeated Micro-Osteoperforations During Orthodontic Canine Retraction: A Randomized Clinical Trial.

INTRODUCTION: In the majority of orthodontic premolar extraction cases, the canine retraction phase is the most laborious procedure. This randomized clinical trial aimed to assess the effect of single versus repeated micro-osteoperforations (MOPs) during orthodontic canine retraction. METHODS: In this split-mouth study, two equal groups of 18 patients who required maxillary first premolar extractions and fixed orthodontic therapy were randomly assigned (n=9). In Group I, MOPs were only performed once on one site before retraction, whereas in Group II, MOPs were performed on one site repeatedly once a month for four months. In both groups, the contralateral control sites received no MOPs. The canines were retracted using mini-screws and closed-coil nickel-titanium springs. Using the patients' 3D models, the primary outcome measure at four months was the amount of orthodontic canine distal movement. The amount of anchorage loss (AL), degree of molar rotation (MR) and canine rotation (CR), and degree of canine tipping (CT) were measured as the secondary outcomes. The comparison of mean changes in the primary and secondary outcomes between the groups was done using the independent sample t-test (p<0.05). RESULTS: The rate of canine retraction, degree of CT, and rotation were not significantly different between the two groups (p>0.05). Additionally, there were no statistically significant variations in the maxillary first MR and the degree of AL (p>0.05). CONCLUSIONS: When maxillary canine retraction was performed with a single and repeated regimen of MOPs, comparable levels of distal CR and tipping were observed, along with an identical minimal degree of MR and AL.

Influence of aging process and restoration thickness on the fracture resistance of provisional crowns: A comparative study.

Background: The advancement of digital dentistry enhanced the fabrication of indirect provisional restorations utilizing durable materials, yet the performance of provisional crowns fabricated with various techniques, and different thickness remains unknown. Thus, this in-vitro study aimed to evaluate the influence of restoration thickness and aging on the fracture behavior of provisional crowns fabricated using different techniques. Methods: A dentiform maxillary first molar was prepared using a highly filled epoxy resin material to construct identical die replicas. Four groups of provisional crowns were fabricated: Group 1 was milled at 1.5 mm occlusal thickness; Group 2 was milled at 0.9 mm thickness; Group 3 was 3D-printed at 1.5 mm occlusal thickness; and Group 4 was 3D-printed at 0.9 mm occlusal thickness. Eight crowns from each group were subjected to a thermocycling process for 5000 cycles between baths held at 5 °C and 55 °C with a dwell time of 30 s and transfer time of 5 s. All crowns (aged and non-aged (control)) were loaded for fracturing using a universal testing machine at a 0.5 mm/min crosshead speed. Data were analyzed using a two-way analysis of variance and multiple comparisons at (α = 0.05). Results: The maximum mean force load was found in the non-aged milled group (M1.5) at 1706.36 ± 124.07 N; the minimum mean force load was recorded for the aged 3D-printed group (3D0.9) at 552.49 ± 173.46 N. A significant difference was observed before and after thermocycling (p < 0.01). Conclusion: Computer-aided design and manufacture of milled provisional crowns is superior to 3D-printed crowns for fracture resistance.

Stress Distribution of Monolithic and Veneered 3-unit Zirconia FDPs - Finite Element Analysis.

PURPOSE: To evaluate the effect of restoration design on fracture resistance and stress distribution of veneered and monolithic 3-unit zirconia fixed partial dentures (FDPs) using finite element analysis (FEA). MATERIALS AND METHODS: Identical epoxy resin replicas of mandibular second premolar and second molar (to serve as abutment for the 3-unit bridge) were divided into four groups (n = 10): monolithic zirconia (MZ) restorations; conventional layering veneering technique (ZL), heat-pressed technique (ZP), or CAD/CAM lithium disilicate glass ceramic (CAD-on). Specimens were subjected to compressive cyclic loading on the mesio-buccal cusp of the pontic (load range 50 to 600 N; aqueous environment; 500,000 cycles) in a universal testing machine. Data were statistically analyzed at 5% significance level with Fisher exact test and Kaplan-Meier survival analysis. 3D models were constructed in accordance with experimental groups. The stress distribution in each model was analyzed and evaluated according to the location and magnitude of the maximum principal stresses (MPS) using ANSYS software. RESULTS: Specimens from ZL and ZP groups failed at different stages of the 500,000 cycles fatigue, while CAD-on and MZ restorations survived fatigue test. Statistically, there was a significant difference between the groups (P < .001). The MPS were located under the mesial connector in both monolithic and bilayered 3-unit zirconia FDPs. These stresses were found to be higher in monolithic geometries compared to bilayered zirconia FDPs. CONCLUSION: Monolithic 3-unit zirconia and CAD-on zirconia frameworks resulted in superior fracture resistance. Restoration design significantly affected the stress distribution of 3-unit zirconia FDPs.

The Effect of Femtosecond Laser Surface Patterns on the Effectiveness of Resin Composite to Zirconia Bonding.

This laboratory study aimed to evaluate the effect of different surface patterns using femtosecond laser treatment on the enclosed mold shear bond strength (EM-SBS) of resin composite to zirconia (ZrO2) surfaces and to contrast it with the widely used tribochemical silica coating (TBC) surface conditioning method. A set of fifteen rectangular ZrO2 blocks were randomly divided into five groups according to surface pretreatment: Control G0-no treatment; G1-TBC with silane application; G2-femtosecond laser irradiation with horizontal lines 30 µm apart; G3-femtosecond laser irradiation with horizontal lines 15 µm apart; and G4-femtosecond laser irradiation with cross lines 30 µm apart. The pretreated surfaces were characterized by a surface profilometer, tensiometer and scanning electron microscope. The EM-SBS of resin composite stubs to ZrO2 was measured followed by fractographic analysis. The surface roughness and water contact angle were observed to be statistically higher among the femtosecond laser groups compared to the TBC and control groups. The G4 group exhibited the highest EM-SBS among all the groups, irrespective of the ageing conditions used. At the end of 5000 thermocycles, G4 exhibited EM-SBS of 14.05 ± 4.21 MPa compared to 13.80 ± 3.01 MPa in G1 and 5.47 ± 0.97 MPa in G0. The two-way ANOVA revealed a significant effect of both study groups and ageing conditions on the EM-SBS (p < 0.001). Utilization of femtosecond laser technology holds promise as a potential and alternative mechanical retention approach for enhancing the bonding strength of the resin composite to ZrO2.

Coffee Staining and Simulated Brushing Induced Color Changes and Surface Roughness of 3D-Printed Orthodontic Retainer Material.

This in vitro study evaluated the influence of combined coffee staining and simulated brushing-induced color changes and surface roughness on 3D-printed orthodontic retainers. Specimens measuring 10 × 10 × 0.75 mm3 were obtained either by conventional vacuum forming or 3D printing at four print angulations (0°, 15°, 30°, and 45°) (n = 10). The prepared specimens were immersed in a coffee beverage and then mechanically brushed using a simulating device. The specimen's color difference (ΔE) and surface roughness (Ra) were quantified using a spectrophotometer and a non-contact profilometer, respectively. The highest and lowest mean ΔE values were recorded for the 3D-printed-45° (4.68 ± 2.07) and conventional (2.18 ± 0.87) groups, respectively. The overall mean comparison of ΔE between the conventional and 3D-printed groups was statistically significant (p < 0.01). After simulated brushing, all groups showed a statistically significant increase in the Ra values (p < 0.01). The highest Ra was in the 3D-printed-45° (1.009 ± 0.13 µm) and conventional (0.743 ± 0.12 µm) groups, respectively. The overall ΔE of 3D-printed orthodontic retainers was not comparable to conventional VFRs. Among the different angulations used to print the retainers, 15° angulations were the most efficient in terms of color changes and surface roughness and were comparable to conventional VFRs.

Andersen health care utilization model: A survey on factors affecting the utilization of dental health services among school children.

BACKGROUND: Children's quality of life, academic performance, and future achievement can all be negatively affected by poor dental health. The present study aimed to assess the need for dental health services and the factors influencing their utilization using the Andersen health care utilization model among school children. METHODS: The current cross-sectional study was conducted among schoolchildren aged 13 to 15 in Bangalore, India (n = 1100). A questionnaire was developed using the concepts of the Andersen healthcare usage model. The parents of the children filled out the questionnaire. The factors were investigated using bivariate analysis and multivariate logistic regression analysis. RESULTS: About 78.1% of the children did not utilize dental health services. Regarding the reasons for not visiting a dentist, 65.8% said they did not have a dental problem, and 22.2% said they could not afford it. Bivariate analysis showed that age, gender, education level, occupation of the family's head of household, monthly family income, socioeconomic status, perceived oral health problems, accessibility of dental health facilities, and parental attitudes toward their children's oral health were significantly associated with using dental health services (p<0.05). Multiple regression analysis showed dental health service utilization was directly related to age (OR = 2.206), education, family size (OR = 1.33), and brushing frequency twice a day (OR = 1.575) with no significant relationship between distance to reach the dental facility, the number of dental visits, and socioeconomic status. CONCLUSION: Dental health service utilization was low in the past year. The age, number of family members, parent's education level, travel time to the dental facility, the child's oral health behaviors, and positive parental attitude all play a role in a children's utilization of dental health service.

Topographical changes and bactericidal efficacy of antimicrobial photodynamic therapy on titanium implant surface.

BACKGROUND: reExtensive rsearch has been done on various disinfection modalities used to achieve an aseptic implant surface. However, the bacterial efficacy and the topographical alterations resulting from the use of these techniques have never been compared. OBJECTIVE: This study aimed to evaluate and compare the disinfection efficacy and surface changes on a bacteria contaminated titanium block following application of various disinfectants. METHOD: Ultrasonically cleaned titanium blocks were contaminated with Porphyromonas gingivalis and Tannerella forsythia. The infected titanium implants were randomly divided into four experimental groups and decontaminated using antimicrobial photodynamic therapy (aPDT), laser therapy, chlorhexidine and hydrogen peroxide. Bacterial viability and surface changes following decontamination were analyzed. RESULT: Bacterial viability decreased in all the groups, with aPDT having the highest reduction. Surface roughness remained unchanged whereas the contact angle lessened in the aPDT group. CONCLUSION: aPDT could possibly be a suitable alternative to other disinfection regimen to treat periimplantitis.

Antimicrobial efficacy and topographical alterations of photodynamic therapy versus conventional antimicrobials on contaminated zirconia ceramic in vitro.

PURPOSE: The aim of this in vitro study was to assess the efficacy of antimicrobial photodynamic therapy (aPDT), neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, and two other disinfecting agents against P. gingivalis and T. forsythia that colonized over zirconia ceramics and to evaluate if the disinfecting protocols result in zirconia surface alteration. MATERIALS AND METHODS: The experiment was conducted on pre-sintered, commercially available Yttria Stabilized Zirconia (Y-TZP) ceramic blocks. The bacterial strains of P. gingivalis and T. forsythia were used to contaminate the zirconia specimens. The infected zirconia specimens were randomly divided into 4 groups (n=20/group): aPDT, Nd:YAG laser, hydrogen peroxide (H2O2), and chlorhexidine groups. The viability of bacteria was assayed using the MTT protocol. The surface roughness (Ra) of all zirconia specimens was estimated using a profilometer and a drop-shape analyzer was used to evaluate the contact angle using a special sessile drop method. RESULTS: A statistically significant reduction by the aPDT group is noticed for P. gingivalis and T. forsythia species compared to other disinfection methods (p<0.05). The second highest reduction was seen for chlorhexidine followed by Nd:YAG laser. The least reduction was demonstrated for the hydrogen peroxide group. Statistically, there was no significant difference in Ra scores between the four groups. However, the contact angles were significantly reduced from the zirconia specimens after the aPDT method which indicates a hydrophilicity increase compared to other groups. The SFE scores of all decontamination protocols from highest to lowest were aPDT (41.68), chlorhexidine (39.83), Nd:YAG (34.52), and H2O2 (29.88). CONCLUSIONS: Antimicrobial photodynamic therapy demonstrated a high antibacterial efficacy over zirconia ceramic surface without altering surface topography.