Alkasite restorative material for endodontically treated teeth: a randomized controlled pilot study.

Objectives: This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment. Materials and Methods: The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05). Results: After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05). Conclusions: The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period. Trial Registration: Brazilian Registry of Clinical Trials (ReBEC) Identifier: RBR-97kx5jv.

Effect of the calcium silicate and sodium phosphate remineralizing products on bleached enamel.

Context and Aims: This study evaluated the effect of calcium silicate and sodium phosphate (CSSP) dentifrice and serum on the surface of enamel bleached with hydrogen peroxide (H2O2). Materials and Methods: A total of 160 bovine enamel slabs were bleached with 35% H2O2 and treated with sodium fluoride (NaF) dentifrice-GI, CSSP dentifrice-GII; CSSP dentifrice + CSSP serum-GIII, or NaF dentifrice + NaF gel-GIV. The dentifrices were applied using a brushing machine three times daily for 7 days. After brushing, sodium phosphate gel and CSSP serum were applied. The microhardness (KNH, n = 14), surface roughness (Ra, n = 14), energy dispersive spectroscopy (n = 6), and scanning electron microscopy (n = 6) were assessed at t0 (before bleaching), t1 (after bleaching), and t2 (after postbleaching treatments). Statistical Analysis Used: The data were subjected to a two-way analysis of variance and Bonferroni's test. Results: The KNH decreased at t1 (P < 0.001) but recovered at t2 for all treatments, although only GII showed restored baseline values (P = 0.0109). The surface roughness increased at t1 (P < 0.001) and reduced at t2 (P < 0.001) for all groups, with no significant differences among groups. Enamel composition and morphology did not differ after the treatments, except for silicon accumulation in GIII. Conclusions: Postbleaching treatment with CSSP dentifrice and serum yielded superior remineralizing effects on bleached enamel.

Efficiency of the photodynamic therapy on viability of Streptococcus mutans in the oral cavity using chitosan nanoparticles: an in vitro study.

PURPOSE: This study aimed to investigate the efficiency of antimicrobial photodynamic therapy (aPDT) on Streptococcus mutans biofilm in the oral cavity using the photosensitizer chloroaluminum phthalocyanine encapsulated in chitosan nanoparticles (ClAlPc/Ch) at three preirradiation times. METHODS: Biofilms of Streptococcus mutans strains (ATCC 25,175) were cultivated on bovine tooth blocks and exposed to a 10% sucrose solution three times a day for 1 min over three consecutive days. The samples were randomly distributed into five treatment groups (n = 5): (I) aPDT with ClAlPc/Ch with a preirradiation time of 5 min (F5), (II) aPDT with ClAlPc/Ch with a preirradiation time of 15 min (F15), (III) aPDT with ClAlPc/Ch with a preirradiation time of 30 min (F30), (IV) 0.12% chlorhexidine digluconate (CHX), and (V) 0.9% saline solution (NaCl). After treatment, the S. mutans biofilms formed on each specimen were collected to determine the number of viable bacteria (colony-forming units (CFU)/mL). Data were analyzed for normality using the Shapiro-Wilk test and the analysis of variance (ANOVA) and Tukey HSD tests to analyze the number of viable bacteria (α = 0.05). RESULTS: The one-way ANOVA showed a difference between the groups (p = 0.0003), and the Tukey HSD posttest showed that CHX had the highest microbial reduction of S. mutans, not statistically different from the F5 and F15 groups, whereas the NaCl group had the lowest microbial reduction statistically similar to the F30 group. CONCLUSION: The results demonstrate that aPDT mediated by ClAlPc/Ch when used at preirradiation times of 5-15 min can be an effective approach in controlling cariogenic biofilm of S. mutans, being an alternative to 0.12% CHX.

Longevity of composite restorations in posterior teeth placed by dental students: a 12-year retrospective study.

OBJECTIVES: To evaluate the longevity of resin composite restorations placed in posterior teeth by dental students, using data from electronic records from 2008 to 2019. MATERIALS AND METHODS: Demographic (gender and age) and clinical variables (dental group, position in dental arch, and the number of restored surfaces) were evaluated. The 5-year follow-up was assessed according to the day the restoration was placed. Kaplan-Meier curves were generated to calculate the annual failure rate. Data were analyzed by Chi-Square, Kruskal-Wallis, and Mann-Whitney tests (α = 0.05). RESULTS: In total, 3.883 records relative to return periodicity were analyzed. The final sample consisted of 900 restorations from 479 patients. The majority were females, aged between 31 and 60. In total, 256 failures were reported (success rate = 78%), showing an annual failure rate of 2.05%. The main reasons for failures were restoration replacement (55.5%), endodontics (21.9%), prosthetics (14.5%) and extraction (8.2%). There was a higher risk of failure in restorations involving three or more surfaces (p = 0.000) and in patients over 60 years (p < 0.001). In females (p = 0.030), molars (p = 0.044), and maxillary teeth (p = 0.038) failed in a shorter time. CONCLUSIONS: Resin composite restorations placed in permanent posterior teeth by dental students had high survival rates. The main reason for failure was the replacement of restorations. The age group and the number of restored surfaces significantly affected the success of the restorations. CLINICAL RELEVANCE: The electronic health records over 12 years showed that 78% of the resin restorations in posterior teeth placed by dental students were successful for a minimum of five years.

Pomegranate extract on eroded dentin: antioxidant action, bond strength and morphology of the adhesive interface after aging.

Objectives: This study aimed to evaluate the effect of pomegranate solution (Punica granatum) on eroded dentin through antioxidant action, shear bond strength (SBS) and interface morphology. Materials and Methods: The 10% pomegranate peel extract was prepared by the lyophilization method. Punicalagin polyphenol was confirmed by high-performance liquid chromatography. Antioxidant activity was evaluated by capturing the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical. For the SBS, 48 dentin fragments were divided into sound or eroded, and subdivided according to the pretreatment (n = 12): water or P. granatum. The surfaces were restored with self-etch adhesive and a bulk-fill resin (Ecosite; DMG). The SBS was done immediately (24 hours) and after thermal cycling + water storage (12 months). For scanning electron microscopy, 48 dentin fragments (24 sound and 24 eroded) received the same treatments as for SBS (n = 6), and they were analyzed after 24 hours and 12 months. Results: The P. granatum had antioxidant action similar (p = 0.246) to the phenolic standard antioxidants. After 24 hours, eroded dentin had lower SBS than sound dentin (p < 0.001), regardless of the pretreatment. After 12 months, P. granatum maintained the SBS of sound dentin (13.46 ± 3.42 MPa) and eroded dentin (10.96 ± 1.90 MPa) statistically similar. The lowest values were found on eroded dentin treated with water (5.75 ± 1.65 MPa) (p < 0.001). P. granatum on eroded dentin caused peritubular demineralization and hybrid layer with resin tags. Conclusions: The pomegranate extract had antioxidant action and preserved the adhesive interface of the eroded dentin.

Influence of Intravascular Laser Irradiation of Blood (ILIB) on inflammatory cytokines and nitric oxide in vivo: a systematic review.

The use of Intravascular Laser Irradiation of Blood (ILIB) as a treatment or adjunct tool has been used around the world since the 1980s. So that more professionals can deliver benefits to their patients in different areas of health, it is necessary to understand in depth the mechanisms of laser action at the molecular level, for correct indication and success in the treatment. To analyze works that evaluated the influence of ILIB on inflammatory cytokines and nitric oxide (NO) in animals and humans. The literature search was carried out between February and April 2023 in Pubmed, Medline, Web of Science, SciELO, Lilacs database. The risk of bias was assessed using the bias table where the authors performed the analyzes of all articles with the risk of bias domains. The methodology was defined following the PRISMA guidelines (Preferred Systematic Reviews and MetaAnalysis Report). The search retrieved 135 possibly relevant articles. After removing duplicates, according to the eligibility criteria, evaluation of titles and review of abstracts, in the end, 6 articles were included. An increase in anti-inflammatory cytokines, a decrease in pro-inflammatory cytokines and an increase in NO can be observed. The wavelengths used ranged from 660 to 808 nm when using a low intensity laser and when using a VIP light source 480-3400 nm, they also differed in terms of the light emission pattern. ILIB may be a complementary treatment option for patients who have comorbidities that lead to systemic inflammation.

Physicochemical and mechanical properties of preheated composite resins for luting ceramic laminates.

This study analyzed and compared the physicochemical and mechanical properties of preheated resin composite with light-cured resin cement for luting indirect restorations. 210 specimens of resin cement/resin composite were prepared according to preheating treatment heated (Htd) or not (NHtd). Light-cured resin cement (Variolink Veneer, Ivoclar), and resin composite (Microhybrid-Z100, 3 M; Nanohybrid-Empress direct, Ivoclar; and Bulk fill-Filtek One, 3 M) were used (n = 10). Resin cement specimens were not preheated. The response variables were (n = 10): film thickness, microhardness, liquid sorption and solubility. Data were analyzed by 2-way ANOVA and Tukey HSD post-test (α = 0.05). Bulk fill NHtd resin had the highest film thickness values (p < 0.001). Microhybrid and nanohybrid Htd resins had the smallest thicknesses and did not differ from the cement (p > 0.05). The highest microhardness values were found for Bulk fill NHtd and Bulk fill Htd resins. The nanohybrid and microhybrid Htd resins showed the lowest microhardness values, with no difference in cement (p > 0.05). For liquid sorption, there was no significant difference between the groups (p = 0.1941). The microhybrid Htd resin showed higher solubility values than the other materials (p = 0.0023), but it did not differ statistically from resin cement (p > 0.05). Preheating composite resins reduced the film thickness. After heating, nanohybrid and Bulk fill resins retained stable microhardness, sorption, and solubility values.

Laser acupuncture to reduce temporomandibular disorder (TMD) symptoms: systematic review and meta-analysis.

The application of low-level laser therapy (LLLT) to acupuncture points may produce effects similar to that of needle stimulation in patients with temporomandibular disorders (TMD). This systematic review was conducted according to the Cochrane Collaboration guidelines and aimed to address clinical questions using the following strategy: Patient/Problem, Intervention, Comparison, and Outcome (PICO). A comprehensive literature search was performed upto April 26, 2023, across nine electronic databases (BVS, PubMed, Scopus, Embase, Web of Science, ScienceDirect, Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), and Google Scholar) supplemented with gray literature. The risk of bias in randomized and nonrandomized clinical trials was assessed using two tools: risk-of-bias (RoB) 2 and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I). Meta-analysis involved the extraction of mean and standard deviation values for spontaneous pain and mouth opening levels. Seven studies were included in this review, all of which used LLLT. The applied wavelengths ranged from 690 to 810 nm without significant variations in light emission patterns. LLLT demonstrated a significant reduction in instantaneous pain levels (standard mean difference [SMD] = 3.85; 95% confidence interval [CI] = 2.09, 5.62; p < 0.003) and an improvement in instantaneous mouth opening ability (mean difference [SMD] = -7.15; 95% CI = -11.73, -2.58; p < 0.002), with low certainty of evidence. LLLT may alleviate symptoms in patients with TMD; however, caution should be exercised when interpreting the results because of protocol variations among studies and the limited number of studies included in the meta-analysis.

Chitosan nanoparticles loaded with epigallocatechin-3-gallate: synthesis, characterisation, and effects against Streptococcus mutans biofilmEpigallocatechin-loaded chitosan nanoparticles: effects against Streptococcus mutans biofilm.

This study evaluated the effects of chitosan nanoparticles loaded with epigallocatechin-3-gallate (EGCG) against Streptococcus mutans biofilm. EGCG-loaded chitosan (Nchi + EGCG) nanoparticles and Chitosan (Nchi) nanoparticles were prepared by ion gelation process and characterised regarding particle size, polydispersion index, zeta potential, and accelerated stability. S mutans biofilms were treated twice daily with NaCl 0.9% (negative control), Nchi, Nchi + EGCG, and chlorhexidine (CHX) 0.12% (positive control). After 67 h, the biofilms were evaluated for acidogenesis, bacterial viability and dry weight. Biofilm morphology and structure were analysed by scanning electron microscopy. The nanoformulations presented medium to short-term stability, size of 500 nm, and polydispersion index around 0.400. Treatments affected cell morphology and biofilm structure. However, no effects on microbial viability, biofilm dry weight, and acidogenesis were observed. Thus, the nanoformulations disassembled the biofilm matrix without affecting microbial viability, which makes them promising candidates for the development of dental caries preventive and therapeutic agents.

Do erbium lasers promote changes in the tooth enamel during debonding of ceramic laminate veneers? A systematic review.

The longevity of ceramic laminate veneers can be influenced by several factors, which can result in the need for a removal process. Laser removal has emerged as a good alternative to facilitate the procedure, and its repercussions on tooth enamel have been investigated. We aimed to evaluate the efficacy of erbium lasers for debonding ceramic laminate veneers without damaging the tooth enamel. This systematic review based on the PICOS model adhered to the PRISMA statement. The PubMed/MEDLINE, Web of Science, Embase, and Scopus databases were systematically searched until December 1, 2022, and 2902 studies were retrieved. After screening, four in vitro studies that analyzed the dental morphology using scanning electron microscopy, optical analysis, stereomicroscopy, or x-ray dispersion spectroscopy were included. The risk of bias was assessed using the Cochrane Collaboration tool. Our findings suggest that erbium lasers are useful for ceramic laminate veneer removal without damaging the tooth enamel. However, the removal is influenced by the type and thickness of ceramic and type of cement used. It could be concluded that the application of Erbium laser did not promote superficial changes in the dental enamel. This effect was observed in all analysis performed.

Er:YAG laser in selective caries removal and dentin treatment with chitosan: a randomized clinical trial in primary molars.

This study evaluated the effect of chitosan on dentin treatment after selective removal of caries lesions with Er:YAG laser in reducing Streptococcus mutans, as well as its effect on the performed restorations. The sample consisted of children (aged 7 to 9 years) with active carious lesions and dentin cavitation located on the occlusal surface of deciduous molars. Eighty teeth were randomly distributed into 4 groups according to the caries removal method: Er:YAG laser (250 mJ/4 Hz) or bur and dentin surface treatment: 2.5% chitosan solution or distilled water. The bacterial load of caries-affected dentin was quantified by counting CFU/mg (n = 10). The teeth were restored and evaluated at 7 days, 6 months, and 12 months using modified USPHS criteria (n = 20). Microbiological data was analyzed by Mann-Whitney and clinical analyses were done using Kruskal-Wallis and Dunn test (α = 0.05). The results showed that the Er:YAG laser significantly reduced the amount of Streptococcus mutans (p = 0.0068). After dentin treatment with chitosan, there was a significant reduction in the amount of Streptococcus mutans for both removal methods (p = 0.0424). For the retention and secondary caries criteria, no significant differences were observed along the evaluated time (p > 0.05). The laser-treated group was rated "bravo" for discoloration (p = 0.0089) and marginal adaptation (p = 0.0003) after 6 and 12 months compared to baseline. The Er:YAG laser reduced the amount of Streptococcus mutans and the chitosan showed an additional antibacterial effect. After 1 year, the Er:YAG laser-prepared teeth, regardless of the dentin treatment, showed greater discoloration and marginal adaptation of the restorations.

Antibiofilm and antimicrobial activity of temporary filling materials on root canals: an in situ acid challenge.

The present study evaluated the antibiofilm and antimicrobial effects of temporary restorative materials on root canals after an intra-oral challenge. Seventy roots were endodontically treated and divided into 5 groups: high-viscosity glass ionomer (HV-GIC), light-activated glass ionomer (RM-GIC), zinc-oxide cement without eugenol (ZO), zinc-oxide cement with eugenol (ZOE), and unsealed roots (negative control). For 28 days, 14 participants used intra-oral devices with five roots, and drops of sucrose were applied onto them. The amount of biofilm and the bacterial counts were analyzed by Kruskal-Wallis and Dunn, and by two-way ANOVA and Tukey (α = 0.05). HV-GIC and RM-GIC better inhibit biofilm, followed by ZO and ZOE. Unsealed roots had the largest biofilm accumulation (p = 0.002) and higher bacterial penetration than restored roots (p = 0.023). A low amount of Streptococcus was found in RM-GIC and ZOE-restored roots without difference from HV-GIC (p = 0.021). The low amount of Enterococcus (p = 0.003) was found in the ZOE-restored roots, without difference from GICs.

Patients´ satisfaction concerning direct anterior dental restoration.

The objective of this study was to observe patients' satisfaction with their in-service direct anterior dental restorations and to compare it with clinical evaluation using FDI (Federation Dental International) criteria. Patients scored their own anterior dental restorations regarding satisfaction (satisfactory /dissatisfactory). If dissatisfaction was mentioned, then, they would be interviewed about the complaint. In the same session, the dental restorations were clinically evaluated by two dentists using FDI criteria (1-5 score) concerning esthetic, functional, and biological domains. Descriptive statistics were used for frequencies of scores attributed by patients and clinicians. In order to compare patients' to clinicians' frequencies, the Chi-square test was applied (p ≤ 0.05). A total of 106 restorations were evaluated by patients and clinicians. Patients reported 52.8% of restorations satisfactory and 47.8% dissatisfactory. Overall, clinicians reported the same restorations as 82,3% satisfactory and 17,6% dissatisfactory. Patients' most frequent complaints referred to color, followed by anatomical form, fracture of material and retention, and approximal anatomical form. Comparing patients' satisfaction and dissatisfaction rates to clinicians' evaluation per criteria, there was no difference regarding esthetics. The frequency of dissatisfactory restorations by clinicians was significantly lower when functional and biological properties were compared with patients' opinions. Direct anterior dental restorations were more frequently reported as satisfactory by patients and clinicians, being the main complaints related to esthetic issues. When clinicians and patients' evaluations were compared, it was observed that the frequencies of satisfactory restoration by patients and clinicians were similar regarding esthetic properties, and significantly different regarding functional and biological properties.

Epigallocatechin-3-gallate prior to composite resin in abfraction lesions: a split-mouth randomized clinical trial.

Objectives: Natural extracts have been investigated as a biomimetic strategy to mechanically strengthen the collagen network and control the biodegradation of extracellular matrix. This study evaluated the effect of epigallocatechin-3-gallate (EGCG) on abfraction lesions prior to the composite resin. Materials and Methods: The sample consisted of 30 patients (aged between 28 and 60 years) with abfraction lesions located in 2 homologous premolars. The teeth were randomly assigned according to dentin treatment: 0.02% EGCG solution or distilled water (control). After enamel acid etching, the solutions were applied immediately for 1 minute. The teeth were restored with Universal Adhesive (3M) and Filtek Z350 XT (3M). Analyzes were done by 2 independent examiners using modified USPHS (retention, secondary caries, marginal adaptation, and postoperative sensitivity) and photographic (color, marginal pigmentation, and anatomical form) criteria at baseline (7 days) and final (18 months). The data analysis used Friedman and Wilcoxon signed-rank tests (α = 0.05). Results: At baseline, all restorations were evaluated as alpha for all criteria. After 18 months, restorations were evaluated as alpha for secondary caries, color, and marginal pigmentation. There was significant difference between baseline and 18 months (p = 0.009) for marginal adaptation and postoperative sensitivity (p = 0.029), but no significant difference were verified between treatments (p = 0.433). The EGCG group had a restoration retention rate of 93.3%, while the control group had 96.7%. Conclusions: The application of EGCG solution on abfraction lesions did not significantly influence the survival of the restorations based on clinical and photographic criteria.

Patients´ satisfaction concerning direct anterior dental restoration

Abstract The objective of this study was to observe patients' satisfaction with their in-service direct anterior dental restorations and to compare it with clinical evaluation using FDI (Federation Dental International) criteria. Patients scored their own anterior dental restorations regarding satisfaction (satisfactory /dissatisfactory). If dissatisfaction was mentioned, then, they would be interviewed about the complaint. In the same session, the dental restorations were clinically evaluated by two dentists using FDI criteria (1-5 score) concerning esthetic, functional, and biological domains. Descriptive statistics were used for frequencies of scores attributed by patients and clinicians. In order to compare patients' to clinicians' frequencies, the Chi-square test was applied (p ≤ 0.05). A total of 106 restorations were evaluated by patients and clinicians. Patients reported 52.8% of restorations satisfactory and 47.8% dissatisfactory. Overall, clinicians reported the same restorations as 82,3% satisfactory and 17,6% dissatisfactory. Patients' most frequent complaints referred to color, followed by anatomical form, fracture of material and retention, and approximal anatomical form. Comparing patients' satisfaction and dissatisfaction rates to clinicians' evaluation per criteria, there was no difference regarding esthetics. The frequency of dissatisfactory restorations by clinicians was significantly lower when functional and biological properties were compared with patients' opinions. Direct anterior dental restorations were more frequently reported as satisfactory by patients and clinicians, being the main complaints related to esthetic issues. When clinicians and patients' evaluations were compared, it was observed that the frequencies of satisfactory restoration by patients and clinicians were similar regarding esthetic properties, and significantly different regarding functional and biological properties.

Resumo O objetivo deste estudo foi observar a satisfação dos pacientes com suas restaurações dentárias anteriores diretas e compará-las com a avaliação clínica do dentista usando os critérios FDI (Federation Dental International). Os pacientes pontuaram suas restaurações dentárias (n=106) anteriores em relação à satisfação (satisfatória / insatisfatória). Quando insatisfatória, ele foi entrevistado sobre a queixa. Na mesma sessão, as restaurações dentárias foram avaliadas clinicamente por dois dentistas utilizando os critérios FDI (escore 1-5) quanto aos aspectos estéticos, funcionais e biológicos. Estatística descritiva foi usada para frequências de escores atribuídos por pacientes e clínicos. Para comparar as frequências dos pacientes e dos clínicos, foi aplicado o teste Qui-quadrado (p ≤ 0,05). Os pacientes relataram suas restaurações como 52,8% satisfatórias e 47,8% insatisfatórias. Os clínicos reportaram as mesmas restaurações, 82,3% satisfatória e 17,6% insatisfatória. As queixas mais frequentes dos pacientes referiam-se à cor, seguida da forma anatômica, fratura e retenção do material e forma anatômica proximal. Comparando os índices de satisfação e insatisfação dos pacientes com os clínicos, não houve diferença em relação à estética. A frequência de restaurações insatisfatórias por dentistas foi significativamente menor quando as propriedades funcionais e biológicas foram comparadas com as opiniões dos pacientes. As restaurações foram mais frequentemente relatadas como satisfatórias pelos pacientes, sendo as principais queixas relacionadas a questões estéticas. Quando as avaliações dos clínicos e dos pacientes foram comparadas, observou-se que as frequências de restaurações satisfatórias por pacientes e clínicos foram semelhantes em relação às propriedades estéticas e significativamente diferentes em relação às propriedades funcionais e biológicas.

Laser acupuncture in the treatment of neuropathies in dentistry: a systematic review.

Laser acupuncture can be used to treat neurosensory alterations and motor disorders caused by dental treatments. This study aimed to review the existing literature on the effects of laser acupuncture on neuropathies in the context of dentistry and to search for treatment modalities in which this technique is used. This systematic review was conducted in accordance with the Cochrane Collaboration guidelines and the PICOS strategy. Randomized clinical trials that evaluated laser acupuncture as a primary intervention for facial neuropathy were included. We searched the database for relevant studies and manually searched the gray literature until April 2022, and finally included four studies. The study was considered eligible if it included patients with paresthesia, facial paralysis, or neuralgia, neuropathies within dentistry, and referred to the application of laser acupuncture as a treatment method. The risk of bias was assessed using the RoB 2 tool. It was observed that the recommended wavelengths ranged from 790 nm to 810 nm, with a frequency of at least two applications per week, and to a greater or lesser degree, all evaluated studies obtained an improvement in sensory or motor recovery of the facial nerves. The use of laser acupuncture presented itself as a viable alternative in dentistry for the treatment of paresthesia and facial paralysis due to its therapeutic potential in neuropathic treatment (CRD42022344339).

In vitro antibacterial activity of green tea-loaded chitosan nanoparticles on caries-related microorganisms and dentin after Er:YAG laser caries removal.

This study aimed to determine the inhibitory effects of green tea (Gt), EGCG, and nanoformulations containing chitosan (Nchi) and chitosan+green tea (Nchi+Gt) against Streptococcus mutans and Lactobacillus casei. In addition, the antibacterial effect of nanoformulations was evaluated directly on dentin after the selective removal of carious lesion. At first, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against S. mutans and L. casei isolates were investigated. In parallel, dentin specimens were exposed to S. mutans to induce carious lesions. Soft dentin was selectively removed by Er:YAG laser (n=33) or bur (n=33). Remaining dentin was biomodified with Nchi (n=11) or Gt+Nchi (n=11). Control group (n=11) did not receive any treatment. Dentin scraps were collected at three time points. Microbiological analyses were conducted and evaluated by agar plate counts. Gt at 1:32 dilution inhibited S. mutans growth while 1:16 was efficient against L. casei. EGCG at 1:4 dilution completely inhibited S. mutans and L. casei growth. Independently of the association with Gt, Nchi completely inhibited S. mutans at 1:4 dilution. For L. casei, different concentrations of Nchi (1:32) and Nchi+Gt (1:8) were required to inhibit cell growth. After selective carious removal, viability of S. mutans decreased (p<0.001), without difference between bur and Er:YAG laser (p>0.05). Treatment with Nchi and Nchi+Gt did not influence the microbial load of S. mutans on dentin (p>0.05). Although variations in concentrations were noticed, all compounds showed antibacterial activity against S. mutans and L. casei. Both bur and Er:YAG laser have effectively removed soft dentin and reduced S. mutans counts. Nanoformulations did not promote any additional antibacterial effect in the remaining dentin.

Effect of low-level laser stimulation of acupuncture points in pediatric dentistry: a systematic review.

The biomodulatory potential of low-level laser therapy (LLLT) has prompted investigations of different outcomes in health. One line of research is the stimulation of acupuncture points for the relief of different signs and symptoms related to the stomatognathic system. In dentistry, some studies in pediatric dentistry have demonstrated the benefit of LLLT therapies in the management of dental anxiety in children. This systematic review aimed to analyze previous clinical studies on the application of LLLT at acupoints among pediatric dental patients. This systematic review was conducted according to the Cochrane Collaboration guidelines and the population, intervention, comparison, and outcome strategy. A broad literature search up to June 17, 2022, was performed using four electronic databases (PubMed, Scopus, Embase, and Google Scholar). The risk of bias in randomized clinical trials was assessed using the RoB 2 tool. A total of four studies using LLLT for photobiomodulation were included (n = 4). The most common wavelengths used were in the infrared range (variation between 716 nm and 980 nm). There were little variations in the application time (14 s to 1 min) and exposure dose (1 to 5 joules). LLLT acted positively on different acupuncture points. LLLT provided various benefits and optimized dental practice by reducing the gag reflex during radiography and impression taking, preanesthetic pain, and symptoms of sleep bruxism in the pediatric dental population. Only one of the evaluated studies had a high risk of bias. The LLLT at acupuncture points is associated with positive results on sleep bruxism, preanesthetic pain, and gag reflex in pediatric dentistry. Future research studies should prioritize standardization of the study design and the methods of analysis.

Longitudinal analyses of composite resin restoration on erosive lesions: effect of dentin treatment with a chitosan nanoformulation containing green tea

Aim To evaluate the influence of the biomodification of erosive lesions with a chitosan nanoformulation containing green tea (NanoCsQ) on the clinical performance of a composite resin. Methods The study was performed in a split-mouth, randomized and double-blinded model with 20 patients with 40 erosive lesions. The patient's teeth were randomized into two groups (n=20) according to the surface treatment: 1) Without biomodification (control), and 2) Biomodification with NanoCsQ solution (experimental). The lesions were restored with adhesive (Tetric N-bond, Ivoclar) and composite resin (IPS Empress Direct, Ivoclar). The restorations were polished and 7 days (baseline), 6 months, and 12 months later were evaluated according to the United States Public Health Service (USPHS) modified criteria, using clinical exam and photographics. Data were analyzed by Friedman's and Wilcoxon signed-rank tests. Results No significant differences were found between the control and experimental groups (p=0.423), and also among the follow-up periods (baseline, six months, and 12 months) (p=0.50). Regarding the retention criteria, 90% of the restoration had an alpha score in the control group. Only 10% of the restorations without biomodification (control) had a score charlie at the 12-month follow-up. None of the patients reported post-operatory sensitivity. Conclusion The NanoCsQ solution did not negatively affect the performance of the composite resin restorations after 12 months.