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.

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.

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.

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.

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.

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.

Radiation therapy in head and neck cancer.

This review summarizes the beginning of radiotherapy, techniques of modern radiation therapy with different types, toxicities induced by radiotherapy and their management. Head and neck radiation therapy is still improving for the better management and control of the cancer and induced radiotherapy toxicities.

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.

Antimicrobial capacity of photodynamic therapy on oral health-related quality of life and halitosis among elderly patients wearing removal dentures.

PURPOSE: The aim of the present clinical trial was to evaluate the efficacy of antimicrobial photodynamic therapy (PDT) for the treatment of halitosis in elderly patients wearing dentures. METHODS: Elderly patients (>60 years age) wearing complete dentures and diagnosed with halitosis (H2S levels >112 ppb) were divided into two groups: patients undergoing treatment with tongue scraper and full mouth disinfection (Group I) and patients undergoing treatment with tongue scraper, full mouth disinfection and single application of PDT (Group II). Oral health related quality of life (OHRQoL) was assessed using a 14-point Likert scale used in oral health impact profile (OHIP). The assessment of halitosis was done with the help of a device called Oral Chroma™. Microbial sampling for detection of Porphyromonas gingivalis (P. gingivalis) was performed from the dorsum of the tongue using a sterile swab at baseline and after treatment on day 5, 15 and 30 and quantified using polymerase chain reaction. RESULTS: Forty elderly patients with halitosis completed the trial. The mean age in Group I and Group II was estimated to be 66.42 years and 67.91 years, respectively. Group II participants also maintained good OHRQoL in the post-operative period that reported statistically significant difference when compared with the control group (p < 0.01). Group II showed significant improvement in H2S concentration values at final analysis compared to Group-I (p = 0.001). P. gingivalis showed statistically significant reduction on day 5 only with PDT in Group II (p < 0.05). CONCLUSION: Antimicrobial PDT helped in reducing H2S gas concentration and improving quality of life in elderly patients wearing dentures. A significant reduction of P. gingivalis occurred only in the short-term follow-up.

Review of surgical resection and reconstruction in head and neck cancer. Traditional versus current concepts.

This review summarizes the development of head and neck cancer resection and reconstruction. The developments in the treatment of cancer patients are reflected in their surgical outcomes, in addition to functional and aesthetic improvements. New technologies, such as surgical simulation and planning, minimally invasive surgery, and microsurgery have been added to the field to improve surgical resection of the tumor and reconstruction. The field is still growing to optimize the management of head and neck cancer.

Arab Societal Awareness of Dental Veneers.

AIM: The aim of this study is to assess the Arab society's knowledge, awareness, and attitudes toward dental veneers. MATERIALS AND METHODS: A cross-sectional study was performed by collecting data through an online questionnaire created using the Survey Monkey website and distributed among Middle Eastern societies through social media to ascertain participants' knowledge and awareness regarding dental veneers. The sample included Arab laypeople who were over 18 years old, to represent the awareness of the majority regarding dental veneers. RESULTS: The sample of this study included 1,332 subjects from different Middle Eastern nationalities, mainly Saudis, Kuwaitis, and Emiratis (15.6% of males and 84.4% of females). The results of this study showed that the total knowledge of dental veneers is 50.12%. The respondents with the highest level of knowledge acquired their information mainly from newspapers and magazines, followed by the Internet, then dentists, then social media, and, finally, friends and relatives. Cost was the only factor limiting 38.4% of subjects from receiving veneers, and 56% of the subjects would receive veneers if they were free of cost. In total, 72.6% of the respondents believed that veneers are currently overused. CONCLUSION: The knowledge and awareness of dental veneers were below a satisfactory level. Participants who relied on social media as a source of information had lower knowledge levels. CLINICAL SIGNIFICANCE: This study emphasized the need for continual societal education regarding dental veneers.

The Effect of Color Training of Dental Students' on Dental Shades Matching Quality.

OBJECTIVE: To assess the effect of color training on the dental shade matching quality of dental students of both gender and to study the need to include lectures and exercises about shade selection in the undergraduate dental curriculum. MATERIALS AND METHODS: One hundred and twenty junior dental students from the College of Dentistry at King Saud University participated in the present study and were distributed randomly into four testing groups. They were asked to match the color of four target shade tabs from the VITA Linearguide 3D-MASTER. Group 1 attended a brief lecture and a training exercise about dental shade matching, Group 2 only attended the lecture, and Group 3 only performed the training exercise. Group 4 did not participate in the lecture or the training exercise and served as a control. Exact matching rates were calculated and analyzed to determine the pre- and post-test matching values. Three way repeated measures analysis of variance, paired t test, and independent t-test were used to compare shade matching quality, with a significance level of p < 0.05. RESULTS: There was a significant difference between the pre- and post-test values for the students' dental shade matching qualities for all of the test groups. CONCLUSION: The effectiveness of the dental shade matching training about color and dental shade matching for improving the students' shade matching quality was proven for both genders. CLINICAL SIGNIFICANCE: Training can improve shade matching quality of dental students. (J Esthet Restor Dent 29:346-351, 2017).