Comparison of De-Torque and Failure Load Evaluation of Selective-Laser-Sintered CoCr, CAD-CAM ZrO, and Machined Implant Abutment/Restoration.

AIM: This study aimed to compare the torque loss, fracture load, compressive strength, and failure types of selective-laser-sintered cobalt chromium (SLM-Co-Cr), computer-aided design and computer-aided manufacturing zirconium oxide (CAD-CAM-ZrO), and machined titanium (Ti) implant abutments. METHODS: Thirty endosseous dental implants were vertically embedded with machined Ti (control group), CAD-CAM-ZrO, and SLM-Co-Cr abutments. Abutment fabrication involved CAD-CAM milling and SLM technology. The de-torque assessment included preload reverse torque values (RTVs), cyclic loading, and post-RTVs using a customized protocol. Fracture load assessment employed ISO-14801 standards, and statistical analysis was conducted using ANOVA and Tukey Post hoc tests (p < 0.05). RESULTS: In pre-load RTVs, SLM-Co-Cr showed the lowest mean torque loss (24.30 ± 2.13), followed by machined Ti (27.33 ± 2.74) and CAD-CAM-ZrO (22.07 ± 2.20). Post-load RTVs decreased for all groups. Fracture load and compressive strength were highest for SLM-Co-Cr, with significant differences among groups (p < 0.001). Fracture types included abutment failures in SLM-Co-Cr and machined Ti, while CAD-CAM-ZrO exhibited crown separation with deformation. CONCLUSION: SLM-Co-Cr-fabricated implant abutments exhibited superior stability and resistance to rotational forces, higher fracture loads, and greater compressive strength compared to CAD-CAM-ZrO and machined Ti.

The efficacy of iatrosedation and music listening techniques in attenuating dental anxiety in patients undergoing dental crown preparation: A randomized clinical trial.

Dental anxiety is a common problem encountered in dental clinics that affects both patients and dentists. Adequate management of dental anxiety is critical for optimal treatment outcomes for the patient. This study aims to assess the efficacy of two anxiety-reduction techniques (iatrosedation and music listening) for dental crown preparation in adult patients. In this clinical trial, 60 patients were randomly assigned to three groups: Group 1, iatrosedation; Group 2, music listening; and Group 3, control. Patients in all three groups underwent dental crown preparation. To measure the anxiety levels of the patients, heart rate was calculated using a pulse oximeter, and verbal rating scale scores were assessed. One-way analysis of variance, post hoc analysis, and Spearman's correlation were used to compare the mean values of the three groups. Significant differences were observed in the heart rate and verbal rating scale scores among individuals in the study groups. A more substantial reduction in anxiety levels was found in patients exposed to iatrosedation (Group 1), which was followed by music listening (Group 2). Recorded heart rate and verbal rating scores were the highest in the control group patients. The iatrosedation technique significantly reduced dental anxiety for patients undergoing dental crown treatment; however, music listening was less effective than iatrosedation. Educating patients regarding the dental care they are about to receive is vital for reducing their anxiety.

Clinical, Radiographic Peri-Implant Parameters and Patient Satisfaction with Splinted and Non-splinted Short Dental Implants in the Maxillary Premolar-Molar Region: A Long-Term Retrospective Clinical Study.

PURPOSE: The goal of this study was to assess the peri-implant condition, peri-implant bone loss (PBL), and complication rates of short dental implant-supported splinted crowns (SDI-SCs) and non-splinted crowns (SDI-NSCs) in the maxillary premolar-molar region. MATERIALS AND METHODS: Patients who had short implants placed near their maxillary sinuses were evaluated. Both patient satisfaction and presence of any technical complication, e.g. porcelain wear and chipping, loss of retention and loosening of the abutment, fixture or screw, were noted. The peri-implant plaque index (PIPI), probing depth (PIPD), bleeding on probing (PIBP), and peri-implant bone loss (PBL) were evaluated. To assess the impact of prosthesis type and SDI placement on technical problems, a log-rank test was computed. p < 0.05 was considered statistically significant. RESULTS: A total of 72 patients agreed to be followed-up, showing a mean follow-up time of 3.1 years. Ninty-five implants in total (55 SDI-SCs, and 40 SDI-NSCs) with moderately rough surfaces were evaluated. The average PBL score for implant and patients was 1.27 (0.02-3.97) and 1.25 (0.03-4.41), respectively. More technical complications were observed with single crowns than with splinted crowns. There were no statistically significant differences in the peri-implant parameters between SDI-SCs and SDI-NSCs (p > 0.05). PBL at molar sites was substantially higher than at premolar sites (p = 0.048). Sixty patients (83.3%) were satisfied with the appearance of the crowns, while 57 patients (79.1%) were satisfied with the crowns' performance. CONCLUSION: The peri-implant conditions, bone levels, technical complication rates and patient satisfaction were comparable between the SDI-SCs and SDI-NSCs. However, implants placed in the molar sites had statistically significantly greater bone loss in comparison to those at the premolar sites.

Anti-fungal efficacy of Miswak Extract (Salvadora Persica) and commercial cleaner against Candida albicans on heat cured polymethylmethacrylate denture base.

AIM: The aim of the study was to compare the antifungal efficacy between commercial cleaner (Corega) and Miswak extract (Salvadora persica) against Candida albicans on heat cured Polymethyl methacrylate (PMMA) acrylic denture base resin. MATERIALS AND METHODS: Forty-eight samples of heat cured PMMA acrylic denture base resin were fabircated in the study. The sterile acrylic resin specimens were immersed in standardized cell suspension of Candida albicans and incubated for 60 min at 370°C for cell adhesion and 2 h at 370°C for biofilm formation. After 24 h biofilm was evaluated by cell viability (CFUs) on SDA and cell counting of Candida albicans under light microscope at 400× magnification. The fungicidal effect of commercial cleaner and Miswak extract on Candida albicans biofilm was then evaluated by colony-forming units on SDA and cell counting under light microscope at 400× magnification. RESULTS: Screening test agar disk-diffusion assay showed mean inhibitory zone of 3 mm for commercial cleaner as compared to Miswak extract, which showed mean inhibitory zone of 2 and 1 mm for different concentrations. Broth microdilution method showed 31 mg/ml MIC and 62.5 mg/ml Minimal Fungicidal Concentration (MFC) values for commercial cleaner as compared to Miswak extract that showed 125 mg/ml MIC and 250 mg/ml MFC values against Candida albicans. A significant difference (p < 0.05) was observed between pre and post treatment of both commercial cleaner and Miswak extract, for CFUs and cell count for Candida albicans. CONCLUSION: Commercial denture cleaner (Corega) showed better antifungal (C albicans) activity than Miswak extract (Salvadora persica) on heat cured PMMA acrylic denture base resin.

Decontamination of lithium disilicate ceramics using various photosensitizers, herbal and chemical disinfectants, and the effect of surface conditioners on bond strength values.

AIM: To assess and compare the antimicrobial efficacy of disinfectants on lithium disilicate ceramic (LDC) used in dental applications and shear bond strength (SBS) of LDC after using different conditioners hydrofluoric acid (HF), self-etching ceramic primers (SECP) and Neodymium-doped yttrium orthovanadate (Nd: YVO4). MATERIALS AND METHODS: One hundred and twenty LDC discs were fabricated by auto-polymerizing acrylic resin using the lost wax technique. S. aureus, S. mutans, and C. albican were inoculated on thirty discs (n = 30 each). Each group was further divided into three subgroups based on different disinfecting agents used (n = 30) Group 1: Garlic extract, Group 2: Rose Bengal (RB) activated by PDT, and Group 3: Sodium hypochlorite (NaOCl). An assessment of the survival rate of microorganisms was performed. The remaining thirty samples were surface treated using three different LDC surface conditioners (n = 10) Group 1: HF + Silane (S), group 2: SECP, and Group 3: Nd: YVO4 laser+S. SBS and failure mode analysis were performed using a universal testing machine and stereomicroscope at 40x magnification, The statistical analysis was conducted using one-way ANOVA and Post Hoc Tukey test. RESULTS: Garlic extract, RB, and 2% NaOCl sample displayed comparable outcomes of antimicrobial potency against C. albicans, S aureus, and S. mutans (p > 0.05). Furthermore, SBS analysis showed HF+S, SECP, and Nd: YVO4+S exhibited comparable outcomes of bond strength (p > 0.05). CONCLUSION: Garlic extract and Rose bengal activated by PDT can be contemplated as alternatives to the chemical agent NaOCl used for LDC disinfection. Similarly, SECP and Nd: YVO4 possess the potential to be used for the surface conditioning of LDC to improve the bond integrity with resin cement.

Fiber post bonding with beta-tricalcium phosphate incorporated root dentin adhesive. SEM, EDX, FTIR, rheometric and bond strength study.

The aim was to formulate an experimental adhesive (EA) and added nanoparticles (NPs) of beta-tricalcium phosphate (ß-TCP) to see the impact on pushout bond strength (PBS) and other mechanical properties. Three adhesives were prepared, including EA (control, without ß-TCP NPs), 2.5%-ß-TCP NPs containing adhesive (2.5%-NPA), and 5% ß-TCP NPs containing adhesive (5%-NPA). For the characterization of the NPs, scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy was accomplished. For the adhesive's characterization, rheological assessment, and degree of conversion (DC) analysis were performed. PBS of these adhesives against resin fiber post to root dentin, interfacial failure categories, and resin dentin interface analysis were also assessed. The ß-TCP NPs were seen as agglomerated asymmetrical particles on SEM. These NPs were composed primarily of calcium (Ca), and phosphorus (P). Rheological evaluation of the adhesive's showed a drop in the viscosity of all adhesives at greater angular frequencies. The greatest DC was detected for the EA group (67.54 ± 7.9) followed by 2.5%-NPA group (45.32 ± 5.1), whereas the lowest DC values were seen for the 5%-NPA group (38.97 ± 6.5). Concerning PBS, the 2.5%-NPA revealed the highest values at the coronal (12.81 ± 3.0) and middle (8.50 ± 2.3) sections, whereas, for the apical section, the highest PBS values were seen for the 5%-NPA (4.9 ± 1.6). Most of the failures for all adhesive groups were seen at the adhesive-dentin interface (cohesive type failures) for all root segments (coronal, middle, and apical). The resin-dentin interface analysis verified hybrid layer and resin tag formation for all adhesives, but the presence of dispersed ß-TCP NPs was only seen in the two NP-reinforced adhesives. The adding of ß-TCP NPs in the adhesive could be beneficial as it could improve its PBS. Suitable rheological properties and dentin interaction were also observed for NP-reinforced adhesives. A reduced DC was seen for both ß-TCP NP-containing adhesives as compared to the EA. RESEARCH HIGHLIGHTS: Experimental adhesives were reinforced with beta-tricalcium phosphate (ß-TCP) nanocrystals. The ß-TCP NPs were seen as agglomerated asymmetrical particles on SEM. These NPs were composed primarily of calcium (Ca), and phosphorus (P). ß-TCP adhesives demonstrated superior pushout bond strength and a drop in the adhesive viscosity at greater angular frequencies compared to control adhesive. The greatest DC was detected for the EA group followed by 2.5%- ß-TCP group, whereas the lowest DC values were for the 5%- ß-TCP group.

Efficacy of surgical periodontal treatment with and without photobiomodulation in the treatment of severe periodontitis: An evaluation of periodontal, microbiological, and cytokine levels.

AIM: To compare the efficacy of surgical periodontal treatment (SPT) alone and PDT-assisted surgery in participants with severe periodontitis. MATERIAL AND METHODS: The present clinical trial was completed by 64 participants (n = 32 each). The selection was made according to predefined inclusion and exclusion criteria. Patients in group A were treated with SPT only and participants in group B were treated with SPT adjunct to PDT. Microbiological assessment of P.Gingivalis; T. Forsythia and T.Denticola were evaluated using cultural analysis and periodontal parameters plaque score (PSc), bleeding on probing (BoP) periodontal depth (PD), and clinical attachment loss (CAL) at baseline and post-treatment at 6 months and 12 months were performed. The gingival crevicular fluid (GCF) was collected for the estimation of IL-1ß and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay (ELISA). For intra-group comparison and post hoc correction, Student's t-test along with Bonferroni was used. For the difference between follow-ups, an analysis of variance (ANOVA) multiple rank tests were incorporated. RESULTS: The mean age of participants in the SPT group was 55.25±4.6yrs. Whereas, participants treated with PDT adjunct to SPT were 54.88±3.6yrs. Periodontal parameters (BoP, PD, PSc, CAL) showed no significant difference at baseline. At 6 months and 12 months follow-up, a significant difference in all parameters (BoP, PD, PSc, and CAL) was found in participants treated with SPT alone and PDT adjunct to SPT (p<0.05). Inflammatory biomarkers at 6-month and 12-month follow-ups, a statistically significant difference in the level of biomarkers (IL-1ß and TNF-α) were observed in both groups from baseline (p<0.05). However, at baseline, no significant difference was noted in both groups (p> 0.05). The microbiological assessment showed a significant drop in the bacterial count in participants treated with both regimes i.e., SPT alone and PDT adjunct to SPT. CONCLUSION: Photodynamic therapy (PDT) adjunct to surgical periodontal treatment (SPT) in severe periodontitis improves microbiological and periodontal parameters and lowers the level of proinflammatory cytokines.

Oral health related quality of life and the prevalence of ageusia and xerostomia in active and recovered COVID-19 Patients.

Background: Salivary disturbance is associated with patients who either have an active coronavirus disease 2019 (COVID-19) or have recovered from coronavirus infection along with loss of taste sensation. In addition, COVID-19 infection can drastically compromise quality of life of individuals. Objective: This study aimed to analyze xerostomia, ageusia and the oral health impact in coronavirus disease-19 patients utilizing the Xerostomia Inventory scale-(XI) and the Oral Health Impact Profile-14. Methods: In this cross-sectional survey-based study, data was collected from 301 patients who suffered and recovered from COVID-19. Using Google Forms, a questionnaire was developed and circulated amongst those who were infected and recovered from coronavirus infection. The Xerostomia Inventory (XI) and Oral Health Impact Profile-14 were used to assess the degree and quality of life. A paired T-test and Chi-square test were used to analyze the effect on xerostomia inventory scale-(XI) and OHIP-14 scale scores. A p-value of 0.05 was considered as statistically significant. Results: Among 301 participants, 54.8% were females. The prevalence of xerostomia in participants with active COVID-19 disease was 39.53% and after recovery 34.88%. The total OHIP-14 scores for patients in the active phase of infection was 12.09, while 12.68 in recovered patients. A significant difference was found between the mean scores of the xerostomia inventory scale-11 and OHIP-14 in active and recovered COVID patients. Conclusion: A higher prevalence of xerostomia was found in COVID-19 infected patients (39.53%) compared to recovered patients (34.88%). In addition, more than 70% reported aguesia. COVID-19 had a significantly higher compromising impact on oral function of active infected patients compared to recovered patients.

Influence of carbon and graphene oxide nanoparticle on the adhesive properties of dentin bonding polymer: A SEM, EDX, FTIR study.

OBJECTIVE: This study was aimed at including 2.5 wt.% of carbon nanoparticles (CNPs) and graphene oxide NPs (GNPs) in a control adhesive (CA) and then investigate the effect of this inclusion on their mechanical properties and its adhesion to root dentin. MATERIALS AND METHODS: Scanning electron microscopy and energy dispersive X-ray (SEM-EDX) mapping were conducted to investigate the structural features and elemental distribution of CNPs and GNPs, respectively. These NPs were further characterized by Raman spectroscopy. The adhesives were characterized by evaluating their push-out bond strength (PBS), rheological properties, degree of conversion (DC) investigation, and failure type analysis. RESULTS: The SEM micrographs revealed that the CNPs were irregular and hexagonal, whereas the GNPs were flake-shaped. EDX analysis showed that carbon (C), oxygen (O), and zirconia (Zr) were found in the CNPs, while the GNPs were composed of C and O. The Raman spectra for CNPs and GNPs revealed their characteristic bands (CNPs-D band: 1334 cm-1, GNPs-D band: 1341 cm-1, CNPs-G band: 1650 cm-1, and GNPs-G band: 1607 cm-1). The testing verified that the highest bond strength to root dentin were detected for GNP-reinforced adhesive (33.20 ± 3.55 MPa), trailed closely by CNP-reinforced adhesive (30.48 ± 3.10 MPa), while, the CA displayed lowest values (25.11 ± 3.60 MPa). The inter-group comparisons of the NP-reinforced adhesives with the CA revealed statistically significant results (p < 0.01). Failures of adhesive nature were most common in within the adhesives and root dentin. The rheological assessment results demonstrated a reduced viscosity for all the adhesives observed at advanced angular frequencies. All the adhesives verified suitable dentin interaction shown by hybrid layer and appropriate resin tag development. A reduced DC was perceived for both NP-reinforced adhesives, compared to the CA. CONCLUSION: The present study's findings have demonstrated that 2.5% GNP adhesive revealed the highest, suitable root dentin interaction, and acceptable rheological properties. Nevertheless, a reduced DC was observed (matched with the CA). Prospective studies probing the influence of diverse concentrations of filler NPs on the adhesive's mechanical properties to root dentin are recommended.

Effect on martens hardness and pushout bond strength of fiber post to canal dentin final irrigated with fotoenticine, chitosan, and ozone.

AIMS: To estimate the effect of contemporary final root canal irrigants (Ozonated water (OW), Chitosan, and Fotoenticine (FTC) on the bond scores of glass fiber post (GFP) and Martens hardness (MH) of root dentin. MATERIALS AND METHODS: Sixty extracted human premolars having a single straight canal that ends in a closed apex were included. Specimens were de-crowned till the cementoenamel junction preserving 12 mm of root length and were mounted vertically. Canal therapy was performed using a crown-down approach. Obturation was performed followed by post-space preparation. Samples were allocated into 4 groups based on chemical irrigations and photosensitizers used(n = 15). Group 1 (5.25% NaOCl + 17% EDTA), group 2 (5.25% NaOCl + FTC), group 3 (5.25% NaOCl + Chitosan), group 4 (5.25% NaOCl + OW). The ultra microhardness tester was put under a load of 5 mN at a speed of 1.5 mN/s for 1 s to assess the MH. The fiber post was luted with dual-cure cement and slices of 1 mm were prepared from each third of the tooth. PBS and failure mode analysis were performed using a universal testing machine (UTM) and stereomicroscope respectively. ANOVA and Tukey multiple comparisons t-tests for assessment of PBS and MH p > 0.05 RESULTS: Group 1 (5.25% NaOCl + 17% EDTA) exhibited the highest MH (0.19 ± 0.04 GPa). Whereas, group 2 (5.25% NaOCl + FTC) displayed the lowest MH (0.011 ± 0.14 GPa). The highest PBS was exhibited by the coronal third of group 1 (5.25% NaOCl + 17% EDTA) (7.11 ± 0.81 MPa). The apical section of group 3 specimens (5.25% NaOCl + Chitosan) (2.33 ± 0.26 MPa) unveiled the lowest PBS. Intergroup comparison analysis revealed that group 2 and group 3 displayed comparable outcomes of PBS. Group 1 and Group 4 also demonstrated no significant difference in the bond scores in all three sections. CONCLUSION: OW as a final irrigant can be used as an alternative to EDTA as it improves the bond strength with minimum impact on marten hardness.

Exploring the Most Effective Apical Seal for Contemporary Bioceramic and Conventional Endodontic Sealers Using Three Obturation Techniques.

Background and Objective: Despite a plethora of studies conducted to date, researchers continue to investigate the best sealer and obturation technique combinations. The aim of this study is to compare the apical seal provided by two bioceramic sealers (Endoseal and Endosequence) with that provided by a calcium hydroxide sealer (Sealapex), and to evaluate the effect of different obturation techniques (cold lateral condensation, continuous wave compaction and single cone) on the apical seal under a stereomicroscope. Materials and Methods: A total of 110 single-rooted mandibular premolar teeth were decoronated, cleaned and shaped using the Endosequence filing system to tip size 30/0.04 taper. Canals were irrigated with 5.25% NaOCl and 17% EDTA. The samples were randomly divided into 11 groups (9 experimental and 2 control groups) according to the designated sealer and technique. Samples were stored in an incubator for 7 days at 37 °C under 100% humidity. Samples were coated with nail varnish except for apical 2 mm and vertically placed in 0.2% rhodamine B dye solution for 48 h. Samples were split longitudinally and viewed under a stereomicroscope at 40× magnification. Results: Insignificant results were obtained between obturation techniques (p = 0.499) whereas statistically significant results were attained based on the type of endodontic sealer (p < 0.001). The overall lowest mean apical microleakage and best sealing ability was demonstrated by Sealapex (2.59 ± 1.20 mm) and amongst techniques by continuous wave compaction (3.90 ± 2.51 mm). Conclusions: Endosequence produced the best apical seal with the continuous wave compaction technique, whereas Endoseal did so with the bioceramic-coated single-cone technique. For the Sealapex sealer, the most effective apical seal was observed using cold lateral condensation. The quality and effectiveness of apical seal differed with the type of endodontic sealer and obturation technique used, and vice versa.

Dentin disinfection and adhesive bond strength using modified photoactivated carbon nanoparticles.

AIMS: The present study aimed to investigate the bond integrity and disinfection efficacy of Methylene blue(MB) alone, MB-PDT (Photodynamic therapy), MB@ carbon nanoparticles (CP)-PDT, and Cr, Cr: YSGG (ECL) against lactobacilli in Caries-affected dentin (CAD) MATERIAL AND METHODS: Methods consisted of Shear bond strength (SBS), Scanning electron microscopy (SEM), energy dispersive X-ray (EDX), methods of disinfection, and failure analysis. CAD samples were prepared and biofilm formed on the specimens randomly allocated into five groups based on disinfection. Group 1: CHX; Group 2: MB; Group 3: MB-PDT: group 4: MB@CP-PDT and group 5: ECL. After disinfection Colony forming units were measured and specimens were restored and positioned under a universal testing machine (UTM). Failure analysis was performed using a stereomicroscope. The difference in survival rate was assessed using the Kruskal-Walis test. Mean and standard deviation for bond values after different methods of disinfection was evaluated using analysis of variance (ANOVA) and Post Hoc Tukey. The significance level was p<0.05 RESULTS: Morphological analysis revealed that CPs under SEM are flat discs with edged irregular shapes. EDX analyses show a spike indicating carbon particles by more than 95%. MB@CP-PDT displayed the highest reduction in lactobacillus levels in comparison to the other disinfection methods. The highest SBS was exhibited by the CAD sample disinfected with ECL. The lowest SBS values in CAD specimens after cavity cleansing with MB alone. The predominant failure type in CAD disinfected with MB alone, ECL CHX, MB-PDT, and MB@CP-PDT was adhesive. CONCLUSION: The use of MB@CP-PDT showed high antibacterial potency against lactobacillus but demonstrated bond values similar to CHX. Use of Er, Cr: YSGG showed considerable effectiveness against lactobacillus along with the highest bond values.

Efficacy of indocyanine green and methylene blue mediated-photodynamic therapy on peri-implant outcomes among diabetics with peri-implant mucositis.

BACKGROUND: This study aimed to assess the efficacy of indocyanine green (ICG)-mediated versus methylene blue (MB)-mediated photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (MD) on the peri­implant clinical, radiographic, microbiological, and immunological outcomes among diabetics with peri­implant mucositis (pi-M). METHODS: For this 3-month follow-up study, diabetics having pi-M were randomly divided into 3 groups: group-I (n = 20) subjects received only MD; group-II (n = 20) participants received ICG-mediated adjunct PDT; and group-III (n = 20) subjects received MB-mediated adjunct PDT. Peri-implant clinical (i.e., plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]), microbiological (Fusobacterium nucleatum [F. nucleatum], Tannerella forsythia [T. forsythia], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans]), and immunological (interleukin [IL]-6, IL-1ß, tumor necrosis factor-alpha [TNF-α]) outcomes were assessed at baseline and 3-month follow-up. RESULTS: Mean changes between baseline and 3-month follow-up in peri­implant clinico-radiographic parameters were significantly different between control (PI: 12.42±21.80%; BOP: 12.10±19.30%; PD: 0.45±0.41 mm; CBL: 1.10±1.02 mm) and test groups (ICG-mediated PDT [PI: 26.55±25.80%; BOP: 28.77±29.24%; PD: 0.84±0.62 mm; CBL: 1.98±1.85 mm] and MB-mediated PDT [PI: 27.24±26.15%; BOP: 27.71±28.16%; PD: 0.85±0.63 mm; CBL: 1.95±1.80 mm]), however comparable differences were observed in peri­implant PI, BOP, PD, and CBL between group-II and group-III participants (p>0.05). The proportions of T. forsythia were significantly reduced in group-II (4.78 × 104 colony-forming unit per milliliter [CFU/mL]) and group-III (4.76 × 104 CFU/mL) as compared to group-I (-4.40 × 103 CFU/mL) at 3-month follow-up (p = 0.02). No statistically significant differences were observed between the study groups regarding the proportions of the other assessed target bacterial species. For IL-6 (group-I: 210±108; group-II: 298±165; group-III: 277±121 pg/mL; p = 0.03), IL-1ß (group-I: 101±95; group-II: 84±98; group-III: 86±74 pg/mL; p = 0.02), and TNF-α (group-I: 336±121; group-II: 385±210; group-III: 366±198 pg/mL; p = 0.03) peri­implant sulcular fluid [PISF] levels, all three study groups demonstrated statistically significant reduction at 3-month follow-up. CONCLUSIONS: ICG-mediated and MB-mediated adjunctive PDT showed statistically significant improvements in peri­implant clinical, radiographic, microbiological, and immunological parameters as compared to conventional MD alone at 3-month follow-up among diabetics with pi-M. However, comparable outcomes were demonstrated by ICG-mediated and MB-mediated adjunctive PDT regarding the assessed peri­implant parameters.

Comparison of the postoperative anti-inflammatory efficacy of chlorhexidine, saline rinses and herbal mouthwashes after mechanical debridement in patients with peri-implant mucositis: A randomized controlled trial.

AIM: The null hypothesis is that there is no difference in the post-operative anti-inflammatory efficacy of chlorhexidine (CHX), 2% saline rinses (SR) and a herbal mouthwash (MW) after non-surgical mechanical debridement (MD) for treatment of peri-implant mucositis (PiM). The aim was to compare the post-operative anti-inflammatory efficacy of CHX, 2% SR and a herbal oral rinse after non-surgical MD of PiM. MATERIALS AND METHODS: The present randomized controlled trial had a single-blinded parallel arm design. Patients diagnosed with PiM were enrolled. Demographic information was recorded. All patients underwent MD and were randomly divided into 4 groups: CHX-group: 0.12% non-alcoholic CHX; Sodium chloride (NaCl) group: 2% NaCl rinses; Herbal MW group: Herbal-based MW and H2 O group: distilled water with peppermint flavour. After MD, all the participants were advised to rinse twice daily (every 12 hrs) for 2 weeks with their respective MWs. In all groups, peri-implant modified plaque index (mPI), modified gingival index (mGI) and probing depth (PD) were measured at baseline and at 12 weeks of follow-up. Sample size was estimated using data from a pilot investigation; and group-comparisons were performed. Statistical significance was confirmed when P-values were below 0.01. RESULTS: Sixty individuals (15 patients/group) were included. At baseline, mPI, mGI and PD were comparable in all groups. At baseline, there was no significant difference in peri-implant mPI, mGI and PD in all groups. At 12-weeks' follow-up, there was a statistically significant reduction in peri-implant mPI (p < 0.01), mGI (p < 0.01) and PD (p < 0.01) in CHX, NaCl and herbal MW groups compared with H2 O group. There was no significant relation between implant location, duration for which, implants were functional, gender and peri-implant clinical parameters in all groups. CONCLUSION: After non-surgical MD, post-operative use of CHX and herbal and NaCl MWs is useful for the management of PiM in the short-term.

Interaction of zirconium oxide nanoparticle infiltrated resin adhesive with dentin conditioned by phosphoric acid and Er, Cr: YSGG laser.

The aim was to prepare experimental adhesive (EA) with ZrO2 nanoparticles (ZEA) and without it; and its interaction with dentin conditioned with photodynamic therapy (PDT), etch and rinse, and Er, Cr: YSGG laser (ECL). Methods consisted of the scanning electron microscope (SEM), energy dispersive X-ray (EDX), shear bond strength (SBS) failure mode, and rheological property analysis. The methods were employed to assess bond integrity; the shape of ZrO2 NPs and interfacial dentin and adhesive interaction. Ninety premolar teeth were collected and pre-bonding, conditioning of dentin was performed utilizing phosphoric acid (H3PO4), photodynamic therapy (PDT), and ER-CR-YSGG laser (ECL). The teeth were set to form bonded specimens using two adhesives EA and ZEA. The microscopic imagery of ZrO2 revealed irregular-shaped, non-edged particles. EDX analysis revealed Zr to be 75.7% whereas, O2 by weight was 25.3%. The highest SBS was demonstrated in dentin conditioned with etch and rinse and ZEA (19.05 ± 0.13 MPa). Whereas, the lowest SBS was observed in dentin surface treated with PDT and EA (12.25 ± 0.14 MPa). Most of the reported failure modes were adhesive. Rheological analysis revealed that with increasing frequencies the viscosities of adhesives were reduced. The presence of 10% ZrO by weight in adhesive improves SBS of restoration and this improvement in bond values is statistically significant compared to EA. Bond values may be influenced by surface treatment of dentin.

Clinical, Radiographic, and Inflammatory Peri-Implant Parameters around Narrow Diameter Implant Crowns among Prediabetic and Non-Diabetic Subjects.

Background and Objectives: To compare the clinical, radiographic, and inflammatory peri-implant parameters around narrow diameter implants (NDI) supported single and splinted crowns in non-diabetics and prediabetes. Materials and Methods: The clinical and radiographic parameters and the levels of IL-6 and TNF-α in the peri-implant crevicular fluid (PICF) of narrow diameter single (NDISCs) and splinted (NDISPs) crown implants were assessed both in non-diabetics and participants with prediabetes. The glycemic state of the patient was assessed using glycated hemoglobin (HbA1c) levels. The peri-implant soft tissue indices (Plaque index (PI), bleeding on probing (BoP), probing depth (PD)) and marginal bone loss were recorded and compared between the groups. Success of the prosthesis was assessed by the frequency of technical complications and patient satisfaction. Inter-group comparison was performed using ANOVA (one-way analysis of variance) while the normal distribution of dependent variables was calculated using Shapiro-Wilk. A p-value of less than 0.05 was considered to be statistically significant. Results: Sixty participants (30 non-diabetics and 30 with prediabetes) with a total of 178 (118 NDISCs and 60 NDISPs) platform-switched NDIs were a part of the study. Of the 118 NDISCs, 56 were placed in the non-diabetic individuals and 62 were placed in the prediabetes group whereas 30 NDISPs each were placed in both the study groups. The clinical parameters of PI, BoP and PD in the single crown and splinted crown groups showed comparable results. However, a statistically significant difference (p-value of less than 0.05) in PI, BoP and PD and in the values of IL-6 and TNF-α was found when a comparison was made between the non-diabetes and prediabetes group. A total of 91% of the patients were satisfied with the esthetics of the implants while 79% of the patients showed satisfaction with function. Conclusions: All the clinical and radiographic parameters were statistically similar in both single and splinted types of narrow diameter implants. However, the bone loss, probing depth, plaque index, and levels of inflammatory markers were statistically higher in prediabetes as compared to non-diabetes implying that a slight hyperglycemic state impacts peri-implant health.

Osteogenic Differentiation of Periodontal Ligament Stem Cells Seeded on Equine-Derived Xenograft in Osteogenic Growth Media.

Background and Objectives: The duration of bone turnover is critical, and different time points help in identifying the optimal endpoint of treatment duration. However, investigating the combination of xenograft and stem cells to allow tissue regeneration within an ideal time duration remains an under-investigated topic. The current study aimed to assess the impact of equine-derived xenograft bone blocks in assisting the human periodontal ligament stem cells (PDLSCs) to demonstrate osteogenic differentiation (collagen type 1 expression and calcium deposition) within an osteogenic growth media. Materials and Methods: Human PDLSCs were acquired commercially and seeded onto xenograft bone blocks. After the 14th and 21st day of culture, enzyme-linked immunoassay (ELISA) was utilized for the detection and quantification of levels of collagen type I, while the mineralization assessment (deposition of calcium) was conducted by staining the PDLSCs with Alizarin Red S (ARS). The statistical comparison between the means and standard deviations of study groups were evaluated using analysis of variance (ANOVA). Results: ELISA assessment revealed an upsurge in the expression of collagen type I for PDLSCs cultured with xenograft after 14 and 21 days compared to the controls (intergroup comparisons significant at p < 0.05). Similar findings were obtained for mineralization assessment and on ARS staining. PDLSCs cultured with xenograft bone blocks presented an increased deposition of calcium compared to their control counterparts (intergroup comparisons significant at p < 0.05). Conclusions: PDLSCs embedded in xenograft bone blocks inside an osteogenic growth medium demonstrated greater osteogenic differentiation potential after 14 and 21 days. This superior osteogenic differentiation capability was evident by increased collagen type I expression and more significant calcium deposition at the 14th and 21st days after culture.

Marginal Misfit of 3D-Printed (Selective Laser Sintered), CAD-CAM and Lost Wax Technique Cobalt Chromium Copings with Shoulder and Chamfer Finish Lines: An In-Vitro Study.

Background and Objectives: The aim was to compare the Misfit of 3D-Printed, Selective laser melting (SLM), milled (Computer aided design-Computer aided manufacture CAD-CAM) and Lost wax technique (LWT) fabricated Cobalt chromium (CoCr) alloy copings on shoulder (SH), radial shoulder (R-SH) and chamfer (CH) finish line configuration. Materials and Methods: Ninety resin, second maxillary premolar teeth were prepared for metal-ceramic crowns, equally divided into (n = 30) SH, R-SH and CH margin preparations. For each preparation design (SH, R-SH and CH), CoCr copings were prepared using SLM, CAD-CAM and LWT. This resulted in nine study groups with 10 CoCr copings each. The marginal misfit of specimens was assessed with a high-resolution digital microscope. Misfit was evaluated in vertical and horizontal dimensions in µm. Data were analyzed using ANOVA and a post hoc multiple comparisons test. Results: For vertical misfit, the highest was observed in SLM samples with chamfer margin (167.96 ± 24.1), and the least was shown by CAD-CAM samples with radial shoulder (58.8 ± 12.53). CAD-CAM and shoulder margins showed the least vertical misfit. For horizontal misfit, the maximum was observed in SLM samples with shoulder margin (137.94 ± 37.85) and the least by LWT samples with chamfer (89.38 ± 14.81). Chamfer margins and LWT samples showed the least horizontal misfit among the group samples. Fabrication technique and finish line design play a critical role in reducing the marginal misfit of CoCr copings. Conclusions: For vertical misfit, SLM copings showed poor outcomes compared to CAD-CAM specimens, however comparable outcomes to Cast specimens. SLM copings showed comparable horizontal misfit outcomes to CAD-CAM specimens and low misfit compared to Cast copings, respectively. Vertical misfit was low with shoulder margins, and horizontal misfit was better with chamfer marginal configuration.

Clinical Evaluation of Short Tuberosity Implants among Type 2 Diabetic and Non-Diabetic Patients: A 5 Year Follow-Up.

Aim: To assess clinical and radiographic parameters including bleeding on probing (BoP); probing depth (PD), plaque index (PI) and crestal bone loss (CBL) around short tuberosity implants (STI) supporting fixed partial dentures in patients with Type 2 diabetes mellitus (T2DM) and non-diabetics. Material and Methods: Participants with T2DM and without T2DM with at least one STI (6 mm) posteriorly restored with a fixed partial denture splinting premolar implant were included. A questionnaire collected demographic details including gender, age, duration of diabetes, habits of brushing, the total number of dental implants and location, implant loading after placement, restoration type, and family history of DM. Clinical and radiographic assessment of peri-implant parameters, i.e., bleeding on probing (BoP), probing depth (PD), plaque index (PI), and crestal bone loss (CBL) was performed. The restorative success of STI was determined by no sensation of the foreign body, lack of pain and dysesthesia, lack of infection, no radiolucency around the implant, and no mobility. The Kruskal-Wallis test was used for statistical analysis. A p-value of less than 0.05 was considered statistically significant. Results: Twenty-five T2DM (19 males and 6 females) and 25 non-diabetic (18 males and 7 females) participants were included. The number of STIs in T2DM was 41, whereas in non-diabetic it was 38. At 1 year follow-up, mean PI% in T2DM participants was 18.9% (19.2-21.4%) and in non-diabetics it was 17.6% (16.3-18.5%). The mean PD was recorded in diabetics (1.3 ± 5.0 mm) and non-diabetics (1.1 ± 3.2 mm). The BoP value in diabetics was 44.9% (39.8-46.4%) and 28.2% in non-diabetics (17.2-24.6%). At 5 years of follow-up, the mean PI% range in T2DM participants was 26.18% (25.4-29.1%) and 24.42% in non-diabetic (20.1-25.5%). The mean PD in millimeters around STI in T2DM was observed to be 2.3 ± 4.8 mm and 1.4 ± 3.4 mm in non-diabetics. In addition, BoP in diabetic participants was 39.54% (27.7-42.1%) and 24.42% in non-diabetics (20.1-25.5%). A total of six STIs failed, i.e., two in the non-diabetic and four in the T2DM group. Conclusions: Patients with T2DM have poor periodontal (BoP, PD, CBL) and restorative peri-implant parameters around STIs when compared to healthy (non-diabetic) participants at five years of follow-up. For long-term stability, glycemic control is pivotal along with following good plaque control.

Assessment of Caries-Affected Dentin Adhesive Interface Treated with Contemporary Conditioning Techniques.

Objective: The aim of this study was to assess shear bond strength (SBS) and failure analysis of adhesion of composite resin (CR) to caries-affected dentin (CAD) pretreated with the Er,Cr:YSGG (ECY) laser, photodynamic therapy (PDT), and etch and rinse (ER) used for cavity disinfection. Materials and methods: Methods used in this study included scanning electron microscopy (SEM), SBS analysis, failure analysis, and digital microscopy. The methods were adopted to assess bond integrity, CAD interface, smear layer, and hybridization. Thirty human third molars assessed clinically and having scores of 4 and 5 based on International Caries Detection and Assessment System (ICDAS) criteria were inspected. Infected dentin was removed. Dentin that was hard and stained pink was categorized as CAD. Ten samples were used in each group for pretreatment of CAD. Ten samples of healthy dentin [sound dentin (SD)] were collected separately and taken as controls. Samples were divided into the following groups: group 1: SD+ER; group 2: CAD+ER; group 3: CAD+ECY; and group 4: CAD+PDT after the pretreatment bonding agent was applied and the restorative procedure was performed using CR. Results: CAD conditioned with PDT before bonding to CR demonstrated the lowest SBS values (11.22 ± 0.77 MPa), whereas the highest SBS values were observed in the SD surface treated with ER (18.25 ± 1.22 MPa). In CAD and SD pretreated with ER, majority of failure modes were cohesive failure and admixed failure, whereas in CAD pretreated with PDT and the ECY laser, the adhesive failure mode was pertinent. Conclusions: The use of the ECY laser and PDT on CAD for cavity disinfection does not have potential for application in clinical settings as it decreases bond integrity of CR. Moreover, the ER pretreatment method for CAD and SD remains the gold standard.