Assessing the effect of Artemisia sieberi extracts on surface roughness and candida growth of digitally processed denture acrylic materials.

BACKGROUND: Denture stomatitis, frequently encountered, is generally addressed symptomatically, with limited exploration of preventive approaches involving antifungal medicinal plants. OBJECTIVE: This study assessed the impact of Artemisia sieberi extracts on the candida growth of conventional and digitally processed acrylic materials. METHOD: Thirty acrylic resin discs (3 mm thickness × 10 mm diameter) were prepared by conventional or CAD/CAM technology (milling and 3D printing). The resin discs were exposed to simulated brushing, thermocycling, and immersion in Artemisia sieberi extract for 8 hours. The surface roughness of the discs was assessed at baseline and after immersion in Artemisia sieberi extract. Candida growth was quantified through colony-forming units (CFU/mL). Data was analyzed using SPSS v.22 (α⩽ 0.05). RESULTS: Irrespective of the material type, the post-immersion surface roughness was significantly higher compared to pre-immersion values (p< 0.05). Candida growth was significantly higher in conventional acrylic materials than digitally fabricated acrylics (p< 0.05). At × 3, Ra and CFU were found to be moderately positive and non-significantly correlated (R= 0.664, p= 0.149). At × 4, Ra and CFU were found to be weak positive and non-significantly correlated (R= 0.344, p= 0.503). CONCLUSION: Artemisia sieberi extracts had a notable impact on digitally fabricated denture acrylics, reducing candida albicans growth compared to conventional heat-cured acrylic. This suggests a potential role for these extracts in improving denture hygiene and preventing denture stomatitis, particularly in the context of digitally fabricated dentures.

Microhardness and Gloss of a New CAD/CAM Hybrid Material Following Accelerated Aging and Coffee Immersion.

PURPOSE: To evaluate and compare the effect of accelerated aging and coffee immersion on the microhardness and gloss of a new computer-aided design and computer-aided manufacturing (CAD/CAM) hybrid material (Crystal Ultra) to those of contemporary restorative materials. MATERIALS AND METHODS: A total of 160 specimens (12 × 14 × 1 mm ± 0.05 mm) were obtained from IPS e.max (IPS), VITA Enamic (VE), Crystal Ultra (CU), Lava Ultimate (LU), and CeraSmart (CS) high-translucency CAD/CAM blocks. The Vickers microhardness and gloss of the specimens were determined after thermocycling and coffee immersion. Data analysis was performed using SPSS (α = .05). RESULTS: IPS and CS specimens exhibited the highest (572.66 ± 11.30) and lowest (61.92 ± 3.91) microhardness, respectively. The highest gloss was observed with IPS specimens (3.31 ± 0.32), and LU specimens showed the lowest gloss (2.33 ± 0.06). A significant difference in gloss was observed between the materials at all measurement intervals (P < .01), except at T0 (P = .43). IPS specimens showed no significant changes in either group at any measurement interval. CONCLUSIONS: The microhardness and gloss of the new CU material were comparable to those of the tested contemporary hybrid restorative materials. Glass-ceramic showed superior hardness and gloss compared to hybrid restorative materials. Accelerated aging with thermocycling and staining significantly affected the microhardness and gloss of all tested CAD/CAM materials.

Effect of Adding Silver-Doped Carbon Nanotube Fillers to Heat-Cured Acrylic Denture Base on Impact Strength, Microhardness, and Antimicrobial Activity: A Preliminary Study.

Poly (methyl methacrylate) (PMMA), is an acrylic polymer substance that is mostly used for denture base applications. The purpose of this laboratory study was to investigate the effect of adding 0.05 wt.% Ag-doped carbon nanotubes (CNT) to PMMA-based (PMMA and MMA) denture base material on the impact strength, microhardness, and antimicrobial activity. A total of 60 heat-cured acrylic resin specimens were prepared. The specimens were randomly divided into two main groups (n = 30/group), according to the powder used: (a) control group, using heat-cured PMMA; (b) treatment group, using a powder prepared by blending 0.05 wt.% silver-doped CNT nanoparticles with heat-cured PMMA. The impact strength, microhardness and anticandidal activity for each group were assessed via the Charpy, Vickers and agar diffusion tests, respectively (n = 10/test for each subgroup). Data were analyzed using independent-sample t-tests (p ≤ 0.05). The results of the impact strength test revealed that the treated heat-cured PMMA-MMA with Ag-doped CNT (2.2 kJ/mm2) was significantly higher than that of the control heat-cured PMMA (1.6 kJ/mm2). Similarly, the Vickers microhardness of the treatment group (52.7 VHN) was significantly higher than that of the control group (19.4 VHN). Regarding the agar diffusion test, after 24 h of incubation, the treated heat-cured PMMA with the Ag-doped CNT exhibited significantly higher anticandidal activity than that of the control group. Therefore, Ag-doped carbon nanotubes could be considered as promising fillers for the dental heat-cured acrylic resin to improve the resistance of the resultant denture against sudden fractures, scratching, and candida invasion.

Release and MMP-9 Inhibition Assessment of Dental Adhesive Modified with EGCG-Encapsulated Halloysite Nanotubes.

Degradation of the collagen fibrils at the dentin-resin interface by the enzymatic activity of matrix metalloproteinases (MMPs) has been known to permit some dental restoration complications, such as microleakage, secondary caries, and, ultimately, restoration failures. This study aimed to evaluate a modified adhesive by adding an MMP inhibitor from green tea extract with and without nanotube encapsulation to sustain the drug release. Epigallocatechin-3-gallate (EGCG) and Halloysite nanotubes (HNTs) were prepared to produce three variant combinations of modified adhesive (EGCG, EGCG-encapsulated HNT, and EGCG-free HNT). The drug loading efficiency and EGCG release over time were evaluated using UV-vis spectrometry. MMP-mediated ß-casein (BCN) cleavage rate assays were used to determine the ability of the EGCG in eluates of the adhesive to inhibit MMP-9 activities. For up to 8 weeks, HNT encapsulation reduced release to a statistically significant level. MMP-mediated ß-casein cleavage rate assays showed a significant decrease for the EGCG groups compared to the non-EGCG adhesive groups. Furthermore, the use of HNT for EGCG encapsulation to modify a dental adhesive helped slow down the rate of EGCG release without impacting its MMP inhibitory capabilities, which may help to maintain the dentin-resin interface's integrity over the long term after dental restoration placement.

Efficacy of Denture Cleansers on Microbial Adherence and Surface Topography of Conventional and CAD/CAM-Processed Denture Base Resins.

This study assessed the efficacy of five denture cleansers on the microbial adherence and surface topography of conventional and CAD/CAM denture base resins. Acrylic resin discs were fabricated using conventional, milling, and 3D printing methods (N = 180). The discs were contaminated with dual species of Candida albicans and Streptococcus mutans biofilm for 72 h and then disinfected with either of the denture cleansers (Fittydent cleansing tablets, 2% Chlorhexidine gluconate, 0.2% Chlorhexidine gluconate, 0.5% sodium hypochlorite, and 1% sodium hypochlorite (n = 10). Distilled water served as the control group. The colony-forming units of the microorganisms were calculated, followed by post-treatment surface roughness. Data were statistically analyzed using one-way ANOVA, paired t-test, and post hoc Tukey HSD test (α = 0.05). Among the denture cleansers, 2% Chlorhexidine gluconate, 0.5% sodium hypochlorite, and 1% sodium hypochlorite had the best cleansing effect on the resin discs and demonstrated zero growth of colonies for both the species. Comparing the material groups, the 3D-processed discs showed higher colony-forming units followed by the conventional and CAD/CAM milled group. The highest surface roughness was demonstrated by the 3D-printed discs (0.690 ± 0.08 µm), followed by the conventional (0.493 ± 0.11 µm) and the milled groups (0.301 ± 0.08 µm). The tested chemical denture cleansers affected the Candida albicans and Streptococcus mutans adhesion compared to control discs immersed in distilled water. The clinician may recommend to their patient to use 2% chlorhexidine gluconate for the disinfection of CAD/CAM PMMA denture base materials.

Microhardness and gloss of a new CAD-CAM hybrid material following accelerated aging and coffee immersion.

PURPOSE: To evaluate and compare the effect of accelerated aging and coffee immersion on the microhardness and gloss of a new CAD/CAM hybrid material (Crystal Ultra) to those of contemporary restorative materials. MATERIALS AND METHODS: A total of 160 specimens (12 x 14 x 1 mm ± 0.05 mm) were obtained from (IPS e.max [IPS], VITA Enamic [VE], Crystal Ultra [CU], Lava Ultimate [LU], and CeraSmart [CS]) high-translucency CAD/CAM blocks. The Vickers microhardness and gloss of the specimens were determined following thermocycling and coffee immersion. Data analysis was performed using SPSS (α = .05). RESULTS: IPS and CS specimens exhibited the highest (572.66 ± 11.30) and lowest (61.92 ± 3.91) microhardness, respectively. The highest gloss was observed with IPS specimens (3.31 ± 0.32), and LU specimens showed the lowest gloss (2.33 ± 0.06). A significant difference in gloss was observed between the materials at all measurement intervals (P < .01), except at T0 (P = .43). IPS specimens showed no significant changes in either group at any measurement interval. CONCLUSION: The microhardness and gloss of the new CU material were comparable to those of the tested contemporary hybrid restorative materials. Glass-ceramic showed superior hardness and gloss compared to hybrid restorative materials. Accelerated aging by thermocycling and staining significantly affected the microhardness and gloss of all the tested CAD/CAM materials.

Influence of Acidic Environment on the Hardness, Surface Roughness and Wear Ability of CAD/CAM Resin-Matrix Ceramics.

This study aimed to measure the effect of storage environment on the hardness, surface roughness and wear ability of CAD/CAM resin-matrix ceramics. A total of 200 rectangular-shaped specimens were obtained by sectioning 5 CAD/CAM blocks; Crystal Ultra (CU), Vita Enamic (VE), Lava Ultimate (LU), Cerasmart (CS) and Vita blocks Mark II (MII). Microhardness and surface roughness were measured at baseline and after 7 days of immersion either in saliva or cola (n = 10). The wear ability of the CAD/CAM materials against steatite-ceramics antagonist was determined using a chewing simulator. The data were statistically analyzed using factorial ANOVA followed by post hoc Bonferroni multiple comparison tests (p < 0.05). The independent factors significantly influenced the microhardness and surface roughness (p < 0.05). The highest VHN was observed in MII at baseline (586.97 ± 13.95), while CU showed the lowest VHN after 7 days of immersion in cola (68.3 ± 1.89). On the contrary, the highest Ra was observed after 120,000 chewing cycles for the VE specimens (1.09 ± 0.43 µm) immersed in cola, while LU showed the lowest Ra at baseline (0.07 ± 0.01 µm). The highest % mass loss of the antagonist was observed with MII immersed in cola (1.801%), while CS demonstrated the lowest % mass loss of 0.004% and 0.007% in AS and cola, respectively. This study confirms that the surface properties of tested CAD/CAM materials are susceptible to degradation in an acidic environment except for hardness and wear of CS material.

Effect of Different Wax Pattern Manufacturing Techniques on the Marginal Fit of Lithium Disilicate Crowns.

Purpose: The present study evaluated the marginal gap of lithium disilicate crowns fabricated through three different wax pattern techniques; Conventional, Milling and 3D-printing. Materials and Methods: Thirty stone models were replicated from a stainless-steel model representing a prepared tooth; ten were sent to make conventional wax patterns while the remaining were sent to a digital dental scanner. The computer aided design was completed and STL (Standard Tessellation Language) files were sent to either milling or 3D-printing machines. All wax patterns (n = 30) were pressed, and a stabilizing instrument was used to secure the crowns on the master model. The marginal gap was measured at 18 points for each crown using a digital microscope (µm) (n = 540) and compared using One-way ANOVA (p ≤ 0.05). Results: There was a significant difference in the marginal gap value between all three groups (p < 0.01) where the milled group showed the least mean gap (28.87 ± 30.18 µm), followed by 3D printed (47.85 ± 27.44 µm), while the highest mean marginal gap was found in the conventional group (63.49 ± 28.05 µm). Conclusion: Milled and 3D-printed wax patterns produced better fitting crowns compared to conventional techniques.

Effects of background color and thickness on the optical properties of CAD-CAM resin-matrix ceramics.

STATEMENT OF PROBLEM: Information regarding the masking ability of computer-aided design and computer-aided manufacture (CAD-CAM) resin-matrix ceramic materials with different compositions is scarce. PURPOSE: The purpose of this in vitro study was to evaluate the effects of background color and thickness on the optical properties (color and translucency) of CAD-CAM resin-matrix ceramics. MATERIAL AND METHODS: Twelve rectangular specimens were fabricated at a different thickness (1, 1.5, and 2 mm) (n=12) from each of the resin-matrix ceramic materials: Shofu block (SB), Lava Ultimate (LU), CERASMART (CS), VITA ENAMIC (VE), Crystal Ultra (CU), and the VITABLOCS Mark II feldspathic ceramic (VB). The color of the specimens over amalgam, titanium, enamel, and dentin backgrounds was measured with a spectrophotometer, and the color differences (ΔE∗ab) were calculated by using the Commission Internationale de l'Eclairage (CIE) 76 formula. The difference in color of the specimen over the black and white backgrounds was used to calculate the translucency parameter (TP). ANOVA was used to statistically test whether material, background, and thicknesses influenced ΔE∗ab and TP values. Post hoc comparisons were performed to determine the significant difference among the groups (α=.05). RESULTS: The interaction with 2 between factors demonstrated that the material was a factor that significantly influenced ΔE∗ab (P<.001). The highest mean ±standard deviation of ΔE∗ab was recorded in the combination of VB material and 2-mm thickness (1.84 ±0.37), and the lowest with CS material with 1.5-mm thickness (0.47 ±0.24). The type of material and specimen thickness significantly influenced TP (P<.001). The highest and lowest mean ±standard deviation of TP were recorded for the 1-mm-thick CS (14.20 ±0.90) and 2-mm-thick SB (4.91 ±0.42) specimens, respectively. CONCLUSIONS: CERASMART resin-matrix ceramic and VITABLOCS Mark II feldspathic ceramic exhibited high and low masking abilities over the investigated background substrates, respectively. However, irrespective of the thickness, all study materials exhibited acceptable masking abilities.

Effect of aging and mechanical brushing on surface roughness of 3D printed denture resins: A profilometer and scanning electron microscopy analysis.

BACKGROUND: The use of 3D printed material in the dental field is gaining tremendous attention. However, studies related to 3D printed denture resins are scarce and need consideration before their inclusion in routine clinical practice. OBJECTIVE: This study aimed to assess the surface roughness (Ra) of 3D printed denture resins following aging and mechanical brushing. METHODS: Forty round samples (diameter, 10 mm and thickness, 3 mm) were fabricated from two 3D printed (DentaBASE and Denture 3D+) and one conventional polymethylmethacrylate (PMMA) denture materials. The samples were thermo-cycled, subjected to mechanical brushing, and later immersed in either artificial saliva (AS), coffee, cola, or lemon juice (n= 10) to simulate one and two years of oral use. Surface roughness (Ra) was determined using a non-contact profilometer and scanning electron microscope was used for qualitative analysis. The data was analyzed using SPSS v.20 (α= 0.05). RESULTS: Denture 3D+ demonstrated highest mean Ra (1.15 ± 0.28 µm), followed by PMMA (0.99 ± 0.50 µm) and DentaBASE (0.81 ± 24). The difference in mean Ra between the materials was statistically non-significant (P= 0.08). Amongst the different beverages used, the highest Ra was observed for samples immersed in lemon juice (1.06 ± 0.40 µm) followed by cola (1.04 ± 0.46 µm) and coffee (0.98 ± 0.40 µm), respectively. The lowest Ra was observed for samples immersed in AS (0.85 ± 0.24 µm). CONCLUSION: The surface roughness of 3D printed denture resins was comparable with that of conventional PMMA resins. Denture 3D+ demonstrated the highest mean roughness, followed by PMMA and DentaBASE.

Use of temporary abutment to assess implant osseointegration before final impression: A case report.

In implant dentistry, a temporary abutment, either plastic or metal, also called an implant cylinder, is used to construct a provisional restoration. This provisional restoration can be cemented on or integrated with a temporary abutment for a screw-retained prosthesis. It can be further used as a diagnostic tool to evaluate esthetics and promote tissue healing around implants. After achieving osseointegration of the implant with the adjacent bone and a proper soft tissue profile, both the temporary abutment and the prosthesis can be replaced with permanent ones. In the present case report, a simple technique using a temporary abutment was utilized for the assessment of implant osseointegration before making the final impression. In this study, we discuss the advantages of this method over other methods. It is impossible to verify the stability of the implant at all stages of implant placement; however, the clinical procedure explained in the case report is easy to apply and provides good results.

Influence of Toothbrush Abrasion and Surface Treatments on Roughness and Gloss of Polymer-Infiltrated Ceramics.

The aim of this study was to compare the surface roughness and gloss of polymer-infiltrated ceramics after simulated in vitro toothbrushing in different storage mediums. Four polymer- infiltrated ceramics were evaluated, Lava ultimate (LU), Vita enamic (EN), Shofu (SH), and Crystal ultra (CU). The control group was a feldspathic ceramic, Vita Mark II (VM). One hundred and twenty specimens (12 × 14 × 2.5 mm) were prepared using a precision saw. For each material (n = 24), the specimens were allocated into two groups, polished and stained. The specimens of each group were stored (for 7 days) in either citric acid (0.2N) or distilled water. Data for surface gloss (ΔE*SCE-SCI) and roughness (Ra) were evaluated before (baseline) and after simulated toothbrushing. For toothbrushing simulation, a toothpaste slurry containing a toothpaste of 100 relative dentin abrasion (RDA) and 0.3 ml distilled water was used for 3650 cycles (7300 strokes) for each specimen. Data were analyzed using t-test and ANOVA. A p-value of ≤ to 0.05 was considered significant. The highest mean value of surface gloss was identified in CU (stained-water) (4.3 (0.47)) (ΔE*) and EN (stained-acid) (4.3 (1.00)) (ΔE*) specimens, whereas the lowest mean value was shown by SH (stained-acid) (2.04 (0.42)) (ΔE*) samples. The highest mean value of surface roughness was observed in SH (0.40 (0.99)) Ra (stained-acid) whereas the lowest in VM (0.13 (0.039)) Ra (polished- water). A significant difference (p < 0.05) was observed in surface roughness and gloss between the materials with simulated toothbrushing, except in VM and LU, respectively. Therefore, it can be concluded that simulated toothbrushing impacts on surface roughness and gloss, irrespective of the storage medium.

Soft Denture Liner Adhesion to Conventional and CAD/CAM Processed Poly(Methyl Methacrylate) Acrylic Denture Resins-An In-Vitro Study.

This study aimed to evaluate the airborne-particle abrasion surface treatment effects on the tensile bond strength (TBS) between resilient denture liner and CAD/CAM or conventional heat polymerized poly (methyl methacrylate) (PMMA) acrylic denture resins. A total of 48 dumbbell-shaped specimens (70 mm in total length, and 12 mm and 7 mm in diameter at the thickest and thinnest section, respectively) were prepared from CAD/CAM and conventional acrylic resins. Before relining with denture liner, 12 specimens from each material were surface-treated by 110 µm Al2O3 airborne-particle abrasion, and the remaining specimens served as control (no treatment). Following relining, all the specimens were aged by thermal cycling (1000 cycles, 5-55 °C). The TBS of denture liner to acrylic denture resins was tested in a universal testing apparatus at a 5 mm/min crosshead speed. The debonded surfaces were visually examined for the failure modes. ANOVA and multiple comparisons posthoc analysis tests were applied to determine the significant difference in TBS between the study groups (α = 0.05). A significant difference in TBS was observed between the control and surface treated groups (p < 0.001) for both acrylic resins materials. However, there was no statistically significant difference in bond strength between the acrylic resins materials (p = 0.739). Surface treatment with airborne-particle abrasion demonstrated increased TBS of the soft denture liners to acrylic resins. The TBS of conventional and CAD/CAM acrylic resins to soft denture liners were not considerably different.

Evaluation of the Water Sorption and Solubility Behavior of Different Polymeric Luting Materials.

Objective: The study evaluated the water sorption (WSP) and water solubility (WSL) characteristics of different luting agents over a 180-day water storage period. Materials and Methods: Nine luting materials, i.e., conventional resin cement: Panavia F (PF), Rely X ARC (RA), self-adhesive resin cement: Rely X Unicem (RU), Breez (BZ), Maxcem Elite (MX), BisCem (BC) and resin-modified glass ionomer cement: FujiCem (FC), FujiPlus (FP) Rely X luting plus (RL) were assessed and fifty-two-disc specimens of each material were fabricated. All specimens were desiccated until a constant weight (W0) was reached. Thirteen specimens for each luting material were then randomly assigned to one of the four water immersion periods (7, 30, 90, and 180 days). After each period, the specimens were removed from the water and weighed to get W1. The samples were again desiccated for a second time and W2 was measured. Both WSP and WSL were determined by the following equations: WSP (%) = (W1 - W2) × 100/W0 and WSL (%) = (W0 - W2) × 100/W0. Assessments were performed following ISO standards. ANOVA was used to assess the effect of luting agent and time period on water sorption and solubility. Pair-wise comparisons were adjusted using Tukey's multiple comparison procedure. A significance level of 0.05 was used for all statistical tests. Results: The highest mean WSP and WSL (WSP/WSL) were demonstrated by resin-modified glass-ionomers (RL 18.32/3.25, FC 17.08/4.83, and FP 14.14/1.99), while resin luting agents showed lower WSP and WSL results (PF 1.6/0.67 and RA 1.76/0.46), respectively. The self-adhesive agents exhibited a wide range of WSP and WSL values (RU 1.86/0.13, BZ 4.66/0.93, and MX 3.68/1.11). Self-adhesive cement showed lower WSP and WSL compared with the resin-modified glass-ionomers (p < 0.05). All the materials reached equilibrium after 90-days. Conclusions: Resin-based luting materials have the lowest sorption and solubility. Rely X Unicem self-adhesive luting materials were comparable to resin luting materials for WSL and WSP. Resin-modified glass-ionomer showed the highest water sorption and solubility compared with both resin and self-adhesive materials.

Color stability of 3D-printed denture resins: effect of aging, mechanical brushing and immersion in staining medium.

PURPOSE: This in-vitro study evaluated and compared the color stability of 3D-printed and conventional heat-polymerized acrylic resins following aging, mechanical brushing, and immersion in staining medium. MATERIALS AND METHODS: Forty disc-shaped specimens (10 mm in diameter and 3 mm thick) were prepared from two 3D-printed [DentaBASE (DB) and Denture 3D+ (D3D)] and one conventional polymethylmethacrylate (PMMA) denture materials. The specimens were thermo-cycled, subjected to mechanical brushing, and were immersed in either coffee, lemon juice, coke, or artificial saliva (AS) to simulate one and two years of oral use. Color measurements of the specimens were recorded by a spectrophotometer at baseline (T0), and after one (T1) and two years (T2) of simulation. The color changes (∆E) were determined and also quantified according to the National Bureau of Standards (NBS) units. Descriptive statistics, followed by factorial ANOVA and Bonferroni post-hoc test (α=.05), were applied for data analysis. RESULTS: The independent factors, namely material, staining medium, and immersion time, and interaction among these factors significantly influenced ∆E (P<.009). Irrespective of the materials, treatments, and time, the highest and the lowest mean ∆Es were observed for PMMA in lemon juice (4.58 ± 1.30) and DB in AS (0.41 ± 0.18), respectively. Regarding the material type, PMMA demonstrated the highest mean ∆E (2.31 ± 1.37), followed by D3D (1.67 ± 0.66), and DB (0.85 ± 0.52), and the difference in ∆E between the materials were statistically significant (P<.001). All the specimens demonstrated a decreased color changes at T2 compared to T1, and this difference in mean ∆E was statistically significant (P<.001). CONCLUSION: The color changes of 3D-printed denture resins were low compared to conventional heat polymerized PMMA. All the tested materials, irrespective of the staining medium used, demonstrated a significant decrease in ∆E values over time.

Efficacy of Rose Bengal and Curcumin mediated photodynamic therapy for the treatment of denture stomatitis in patients with habitual cigarette smoking: A randomized controlled clinical trial.

BACKGROUND: Cigarette smoking in conjugation with bad oral hygiene is considered a typical predisposing factor for many oral diseases including denture stomatitis. This study investigated the effect of Rose Bengal (RB)-and Curcumin (CUR)-mediated photodynamic therapy (PDT) in comparison with nystatin therapy in the intervention of denture stomatitis in cigarette smokers. METHODS: Overall, 45 habitual cigarette smokers aged ~58 years having denture stomatitis were categorized into three groups: Group-I - RB-mediated PDT, Group-II - CUR-mediated PDT, and Group-III - Nystatin therapy. The primary outcome of the interest was: counts of Candida colony from denture surface and palatal mucosa, calculated as CFU/mL, whereas the prevalence of Candida species determined in 3 research groups comprised the secondary outcome. Oral swab specimens were gathered from the denture surfaces and palatal mucosa. All clinical assessments were performed at baseline, 6 weeks, and 12 weeks. RESULTS: C. albicans was the most prevalent yeast identified on both denture surfaces and palatal mucosa, followed by C. tropicalis and C. glabrata. A considerable decrease in the CFU/mL scores were observed in Group-I and Group-II at the end of the interventions and on the 12-week follow-up (p<0.05). Group-I, II, and III demonstrated clinical efficacy rates of 53%, 51%, and 49%, respectively. CONCLUSION: CUR-and RB-mediated PDT was found to be as effective as topical Nystatin therapy for the intervention of denture stomatitis among cigarette smokers.

Clinical, bacterial, and inflammatory outcomes of indocyanine green-mediated photodynamic therapy for treating periimplantitis among diabetic patients: A randomized controlled clinical trial.

Background This 6-months randomized controlled clinical trial aimed to assess the efficacy of indocyanine green mediated photodynamic therapy (ICG-PDT) as an adjunct to peri­implant manual debridement (PIMD) versus PIMD alone among Diabetes Mellitus (DM) patients in the treatment of peri­implantitis. Methods A total of 48 DM patients having 64 implants were treated with either ICG-PDT + PIMD (n = 35 implants) or PIMD alone (n = 29 implants). Clinical (probing depth [PD], bleeding on probing [BOP], and plaque index [PI]) and radiographic (peri­implant crestal bone loss [PCBL]) peri­implant variables were recorded. Bacterial species including Porphyromonas gingivalis and Treponema denticola were evaluated from peri­implant plaque biofilms. Levels of interleukin (IL)-1ß and IL-6 were assessed after the collection of peri­implant sulcular fluid. All the evaluations were carried out at baseline, 3- and 6-months. The significance level was set to p < 0.05. Results All clinical parameters significantly reduced within both treatment groups (P<0.05). Intra-group comparison indicates that there was statistically significant reduction in PD and suppuration for ICG-PDT group (P<0.05). There was a statistically significant difference in the BOP between ICG-PDT and PIMD groups at both follow-up periods (P<0.001). However, there was a significant difference for PD (P = 0.001), suppuration (P = 0.01), and PCBL (P = 0.04) on 6 months follow-up between ICG-PDT and PIMD groups, respectively. Only ICG-PDT showed a significant reduction in P. gingivalis and T. denticola on both 3 months and 6 months follow-up compared to baseline. PIMD showed a statistically significant reduction only on 3 months follow-up compared to baseline. This reduction was maintained for both the species when dental implants were treated with ICG-PDT. However, PIMD failed to maintain this reduction until 6 months. Only at 3 months assessment that both treatment groups showed statistically significant reduction in IL-1ß and IL-6 with no significant difference between the groups. Both biomarkers failed to maintain the reduction in both groups and significantly increased levels for IL-1ß was noted at 6 months follow up Conclusion Multiple application of indocyanine-green mediated photodynamic therapy resulted in improved clinical and microbial parameters among type 2 DM subjects in the treatment of peri­implantitis. This clinical trial was registered in the ClinicalTrials.gov Protocol Registration and Results System with registration record number: NCT04833569.

Fracture Load of CAD/CAM Fabricated Cantilever Implant-Supported Zirconia Framework: An In Vitro Study.

The fracture resistance of computer-aided designing and computer-aided manufacturing CAD/CAM fabricated implant-supported cantilever zirconia frameworks (ISCZFs) is affected by the size/dimension and the micro cracks produced from diamond burs during the milling process. The present in vitro study investigated the fracture load for different cross-sectional dimensions of connector sites of implant-supported cantilever zirconia frameworks (ISCZFs) with different cantilever lengths (load point). A total of 48 ISCZFs (Cercon, Degudent; Dentsply, Deutschland, Germany) were fabricated by CAD/CAM and divided into four groups based on cantilever length and reinforcement of distal-abutment: Group A: 9 mm cantilever; Group B: 9 mm cantilever with reinforced distal-abutment; Group C: 12 mm cantilever; Group D: 12 mm cantilever with reinforced distal-abutment (n = 12). The ISCZFs were loaded using a universal testing machine for recording the fracture load. Descriptive statistics, ANOVA, and Tukey's test were used for the statistical analysis (p < 0.05). Significant variations were found between the fracture loads of the four ISCZFs (p = 0.000); Group-C and B were found with the weakest and the strongest distal cantilever frameworks with fracture load of 670.39 ± 130.96 N and 1137.86 ± 127.85 N, respectively. The mean difference of the fracture load between groups A (810.49 + 137.579 N) and B (1137.86 ± 127.85 N) and between C (670.39 ± 130.96 N) and D (914.58 + 149.635 N) was statistically significant (p = 0.000). Significant variations in the fracture load between the ISCZFs with different cantilever lengths and thicknesses of the distal abutments were found. Increasing the thickness of the distal abutment only by 0.5 mm reinforces the distal abutments by significantly increasing the fracture load of the ISCZFs. Therefore, an increase in the thickness of the distal abutments is recommended in patients seeking implant-supported distal cantilever fixed prostheses.

Influence of toothbrush abrasion and surface treatments on the color and translucency of resin infiltrated hybrid ceramics.

PURPOSE: The study compared the color change, lightness, and translucency of hybrid resin ceramics exposed to toothbrush abrasion and surface treatment. MATERIALS AND METHODS: Four hybrid ceramics [Lava Ultimate (LU), Vita Enamic (EN), Shofu HC (SH), and Crystal Ultra (CU)] were compared with a glass-ceramic (Vita Mark II) control. One hundred and twenty specimen blocks were prepared using a precision saw machine. Specimens in each material were divided into four subgroups based on the surface treatment (polishing or staining) and a storage medium (water or citric acid). Simulated tooth brushing with a mixture of 100 RDA (radioactive abrasives) with 0.3 ml distilled water was used for 3650 cycles (7300 strokes) for each specimen. Measurements for the color change, lightness, and translucency were measured after toothbrushing using a spectrophotometer. Statistical analysis compared outcomes using paired t-test, ANOVA, and Tukey post hoc test. RESULTS: The maximum color change was identified in SH (stained acid) [1.44 (0.40)], whereas the lowest was identified in EN (polished water) [0.66 (0.16)] material. The maximum and minimum loss of surface translucency was observed in SH (polished water) [12.3 (0.52)] and EN (stained acid) [6.5 (0.55)] specimens, respectively. Lastly, loss of lightness was the highest in VM (polished acid) [69 (0.95)], whereas the lowest was observed in CU (stained water) [56.7 (0.86)]. CONCLUSION: The comparison presented a significant effect of toothbrush abrasion on translucency and lightness of the hybrid resin ceramics. Color change was not significantly influenced irrespective of the storage medium employed. Surface staining demonstrated the preservation and stability of color and optical properties under the influence of toothbrush abrasion and chemical trauma.

Role of antimicrobial photodynamic therapy in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with and without dental implants.

OBJECTIVE: The aim was to assess the impact of antimicrobial photodynamic therapy (aPDT) in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with dental implants. METHODS: Type-2 diabetic and self-reported non-diabetic patients were included. Participants were divided into the following groups: Group-1: Type-2 diabetic patients with dental implants; Group-2: Non-diabetic patients with dental implants; Group-3: Type-2 diabetic patients without dental prostheses; Group-4: Non-diabetic patients without dental prostheses. In each group, participants were subdivided into 2-sub-groups. In the test-subgroup, participants received routine oral hygiene maintenance instructions (OHMI) and underwent full mouth disinfection using aPDT; and in the control-group, participants received OHMI alone. Unstimulated whole saliva samples were collected, hemoglobin A1c levels were measured and yeast colonization was assessed at baseline and at 3-months' follow-up in all groups. Sample-size estimation was done and group-comparisons were done. P-values <0.01 were considered statistically significant. RESULTS: At baseline, the mean oral yeasts colonization was significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). At baseline and at 3-months of follow-up, the mean HbA1c levels and oral yeasts colonization were significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). CONCLUSION: In the short-term, routine OHMI with adjunct aPDT is more effective in reducing whole salivary oral yeasts counts than OHMI alone in patients with and without dental implants.