Biomaterial Investigations in Dentistry is an international, open-access, peer-reviewed journal dedicated to publishing high-quality, original research in the field of oral biomaterials science. Our editorial policy embraces submissions from researchers worldwide, encompassing both basic and clinical aspects of oral biomaterials science in dentistry. We prioritize analytical studies over descriptive ones, with a particular preference for articles presenting novel research that demonstrates cause-and-effect relationships in experimental studies and explanatory/associative relationships in observational studies. We strongly encourage hypothesis-driven research.
Antibiotic approaches to endodontic regeneration
Regenerative endodontics (REs) has redefined the management of immature permanent teeth with necrotic pulps by shifting the objective from simple disinfection to biologically driven root maturation and restoration of the dentine–pulp complex. A critical component of this process is the selection of intracanal medicaments that can effectively eliminate microbial infection while preserving the viability of stem cells required for regeneration. This narrative review evaluates the biological and antimicrobial performance of commonly used medicaments, particularly calcium hydroxide (Ca(OH)₂) and triple antibiotic paste (TAP), and discusses their role in RE procedures. A literature search was conducted using PubMed/MEDLINE, Scopus, and Web of Science for articles published between January 2000 and March 2025. Although Ca(OH)₂ remains widely used due to its antimicrobial properties and ability to promote hard tissue formation, concerns remain regarding its high alkalinity and potential adverse effects on stem cell survival. TAP, in contrast, appears to provide a more supportive environment for dental pulp stem cell proliferation and attachment but is associated with drawbacks such as tooth discoloration and antibiotic-related limitations. Emerging alternatives, including double antibiotic paste (DAP) and nano-modified calcium hydroxide formulations, aim to improve the balance between antimicrobial efficacy and biocompatibility. Overall, current evidence emphasizes the importance of optimizing medicament concentration and duration of application to enhance the predictability and long-term success of RE therapy.
Copyright (c) 2026 Samiya Riaz, Asmak Binti Abdul Samat, Muhammad Amber Fareed, Muhammad Sohail Zafar https://creativecommons.org/licenses/by/4.0
Comparison of post-treatment complications of conventional composites versus self-adhering composites: a review
Self-adhering composites (SACs) are designed to simplify dental procedures by eliminating the need for separate adhesive systems. These materials are indicated for small Class I and Class V cavities, noncarious cervical lesions, and as liners in Class I and II restorations. Despite their advantages, the long-term durability and clinical performance of these composites compared to conventional composites (CCs) is a question. This study aims to compare post-treatment complications, including marginal adaptation, postoperative sensitivity, marginal discoloration, marginal gap, and microleakage, between CCs and SACs. In February 2024, a comprehensive search was conducted using PubMed, Google Scholar, Scopus, and Web of Science databases. No filters were applied during the search. Keywords included ‘resin composite restoration’, ‘post-operative sensitivity’, ‘marginal adaptation’, ‘marginal gap’, and ‘microleakage’. Studies were selected based on inclusion criteria (clinical trials, English-language, focusing on SACs vs. CCs) and exclusion criteria (nonindexed studies, conference abstracts, editorials, case reports, review articles, or pre-2019 studies). From 361 articles, 148 remained after removing duplicates and title screening. Out of 148 records found in databases, six records were selected for this study. Data showed that SACs and CCs have comparable marginal adaptation, postoperative sensitivity, marginal discoloration, and retention in conservative restorations. SACs showed slightly higher microleakage in some cases. Overall, the clinical performance of SACs were comparable to that of CCs. Thus, SACs can be a practical alternative for simplifying restorative procedures. However, their potential for higher microleakage needs further investigation through long-term clinical studies.
Copyright (c) 2026 Fatemeh Farshad, Erfan Eskandari, Marzieh Rohaninasab https://creativecommons.org/licenses/by/4.0
A comprehensive narrative review on the significance of hyaluronic acid for dental implantology
Dental implants have significantly advanced the scope of oral health care and practices, providing a stable and durable solution for replacing missing teeth. Essential maintenance practices, including regular oral hygiene and professional monitoring, are imperative to prevent complications such as peri-implant diseases, which can compromise implant integrity. Supplementary agents, including hyaluronic acid (HA), have been shown to enhance healing and integration. HA is recognised for its moisture-retaining properties, its promotion of wound healing, its reduction of inflammation, and its facilitation of tissue integration. The extensive therapeutic applications of HA in dental implant therapy are due to its biocompatibility and regulatory influences on cellular behaviour, which render HA a valuable adjunct to implant success, particularly concerning soft and hard tissue integration around the implants. The present study aims to explore the potential applications of HA in dental implantology, including the modification of implant surfaces, the promotion of soft tissue healing around the implants, and the management of peri-implant diseases, such as mucositis and peri-implantitis. In addition, this study explores the role of HA in alveolar bone regeneration, particularly through alveolar ridge augmentation and preservation processes, as well as more advanced techniques such as tissue engineering, as the primary requirement for successful implant placement is sufficient bone width and depth. HA promotes osseointegration, increases osteogenesis, and helps treat peri-implant conditions such as mucositis and peri-implantitis. Implant biocompatibility, hydrophilicity, and bacterial adhesion resistance are all enhanced by HA coatings, which facilitate improved peri-implant bone and soft tissue healing. Stability and healing properties of HA can be increased by combining it with other biomaterials. Future studies should focus on enhancing HA’s mechanical properties, improving long-term bioactivity, and investigating synergistic biomaterial combinations; clinical trials are required to fully understand its potential in implant dentistry.
Copyright (c) 2026 Ahmed Yaseen Alqutaibi, Nazrah Maher, Anum Mahmood, Faiza Amin, Ghulam Irtiza Mustafa, Naresh Kumar, Muhammad Sohail Zafar https://creativecommons.org/licenses/by/4.0
Comparative success of platelet-rich fibrin and mineral trioxide aggregate in direct pulp capping and pulpotomy: a systematic review and meta-analysis
Purpose: This systematic review and meta-analysis aimed to compare the clinical success rates of Platelet-Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) when used in pulp-capping and pulpotomy. Materials and methods: A systematic search of PubMed, Scopus, Embase, and Web of Science was performed. Randomized and non-randomized clinical trials with a minimum 6-month follow-up were included. The risk of bias was assessed using RoB-2 and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE. Results: Nine studies were included in the qualitative and quantitative synthesis. The meta-analysis at 6 months (7 studies, 436 treated teeth) showed no significant difference between PRF and MTA (odds ratio [OR] 0.72, 95% confidence interval [CI]: 0.29–1.78; P= 0.4799). At 12 months (7 studies, 352 treated teeth), the results also indicated no statistically significant difference (OR 1.50, 95% CI: 0.93–2.43; P= 0.0962), though the point estimate favored PRF. Conclusion: Within the limitations of this study, PRF and MTA demonstrate broadly similar clinical success rates in pulp-capping and pulpotomy over 6 and 12 months. The low certainty of evidence underscores the need for well-designed, larger randomized controlled trials with extended follow-up to more definitively establish their comparative long-term efficacy.
Copyright (c) 2026 Malik Alkabazi, Ebtesam Aldieb https://creativecommons.org/licenses/by/4.0
Health and environmental hazards of shape memory polymer used in orthodontic aligners – a scoping review
Background: Shape memory polymers (SMPs) are gaining traction in orthodontics, particularly in clear aligners, due to their stimulus-responsive behavior and potential to improve treatment outcomes. However, their use in biomedical devices raises questions about biocompatibility and environmental sustainability. Objectives: This scoping review aims to map current evidence on the health and environmental risks of SMPs used in orthodontic aligners, identify knowledge gaps, and guide future research. Search methods: A systematic search of PubMed, Scopus, Web of Science, Embase, ProQuest, and Cochrane databases was conducted, focusing on studies from the past decade. Search terms included SMPs, orthodontic aligners, toxicity, biodegradability, and environmental impact. Selection criteria: Eligible studies involved original in vitro, in vivo, clinical, or environmental research related to SMPs in orthodontic applications. Data collection and analysis: Key information from each study was extracted using a standardized Excel spreadsheet by one reviewer (SA) and validated by another (MKN). Extracted data included study design, polymer type, health and environmental risks, and conclusions. Due to heterogeneity, results were synthesized narratively. Results: Sixteen studies met the inclusion criteria. Evidence on SMP biocompatibility is emerging but limited. Certain SMP formulations released residual monomers and degradation products with potential cytotoxic or systemic effects. Environmental concerns included low degradability, accumulation of polymer waste, and lack of recycling strategies. Notably, there was a lack of long-term clinical data and environmental life-cycle analyses. Conclusions: While SMPs offer promise in orthodontics, their safety and environmental impacts are insufficiently studied. Future research should focus on standardized toxicological testing, long-term evaluations, and sustainable material development. Registration and Conflicts: This scoping review was prospectively registered in PROSPERO (ID: CRD42022308725). The authors report no conflicts of interest.
Copyright (c) 2026 Sweety Agrawal, Mithun K. Naik, Dilshad Umar, Sandeep Shetty https://creativecommons.org/licenses/by/4.0
BioHPP in prosthetic dentistry: a narrative review of mechanical, biological, and clinical properties
Biocompatible high-performance polymer (BioHPP), a high-performance polymer derived from polyetheretherketone (PEEK) and reinforced with ceramic fillers, has emerged as a promising alternative to conventional metal and ceramic framework materials in prosthetic dentistry. With an elastic modulus (~4 GPa) comparable to that of cortical bone, BioHPP promotes physiological stress distribution and reduces stress shielding, thereby supporting peri-implant bone preservation. Its excellent chemical inertness and low bacterial affinity minimize mucosal inflammation and reduce the risk of peri-implant disease. However, the material’s low surface energy and hydrophobicity pose challenges to long-term adhesive stability, necessitating specific surface modification techniques and specialized adhesive systems. Clinically, BioHPP has been successfully applied in single crowns, fixed partial dentures, full-arch hybrid prostheses (e.g. All-on-Four), bar-retained overdentures, maxillofacial frameworks, customized abutments, and provisional restorations. Despite its favorable biomechanical and biological profile, limitations such as inherent opacity, restricted fracture toughness, and the scarcity of long-term clinical data highlight the need for further interdisciplinary research and material innovation. This narrative review comprehensively evaluates the mechanical, biological, and adhesive characteristics of BioHPP, compares its performance with traditional framework materials, and discusses its clinical applications and future perspectives in prosthetic rehabilitation.
Copyright (c) 2026 Aslı Bengisu Karayel, Ragibe Şenay Canay https://creativecommons.org/licenses/by/4.0
Evaluating the remineralisation potential and clinical evidence of emerging biocompatible materials in restorative dentistry: a systematic review
Background: Biocompatible materials with remineralising and regenerative properties are now being increasingly used in restorative dentistry as possible materials in place of conventional agents. This systematic review aimed to evaluate the laboratory remineralisation potential and available clinical evidence of emerging biocompatible, non-fluoridated materials used in restorative dentistry. Patient-reported outcomes were explored where reported. Materials and methods: A systematic review was performed on relevant databases as PubMed, Cochrane, EBSCOhost and Scopus. Results: A total of 8 in vivo and 23 in vitro studies were included. Self-assembling peptide P11–4 (SAP P11–4) and chitosan-based materials demonstrated consistent remineralisation benefits, predominantly in laboratory studies, with limited supporting clinical evidence. Risk of bias was moderate for in vitro studies and low-to-some concerns for in vivo studies. Conclusion: Self-assembling peptides and chitosan-based biomaterials show promising potential, though current evidence is largely laboratory-based and requires further clinical validation. Further well-designed clinical trials are warranted.
Copyright (c) 2026 Isaiselvi Duraiarasan, Indumathi Kariannan Partheeban, Sibyl Siluvai, Krishnaprakash Govindaraj https://creativecommons.org/licenses/by/4.0
Clinical efficacy of hyaluronic acid in peri-implantitis treatment: a systematic review of clinical, radiographic, and biological outcomes
Objective: This systematic review evaluated the impact of adjunctive hyaluronic acid (HA) on outcomes in the management of peri-implantitis, while characterizing the various protocols and formulations. Materials and methods: In accordance with the PRISMA 2020 guidelines, a search was conducted across five databases up to February 10, 2025 to identify randomized controlled trials (RCTs) and non-randomized clinical studies including controlled studies and case series. A dual-pass screening and data extraction process was employed to ensure data accuracy. The risk of bias was evaluated using Cochrane Risk of Bias 2, Risk of Bias in Non-Randomized Studies of Interventions-I, and Joanna Briggs Institute tools. The certainty of evidence for key outcomes was graded with the GRADE approach. Results: Six studies (four RCTs, one controlled pilot study with a split-mouth design, and one prospective case series) with 110 patients were included; sample sizes ranged from 5 to 63 participants, and follow-up periods ranged from 15 days to 12 months. The findings were heterogeneous; while some studies demonstrated statistically significant improvements in probing pocket depth (PPD) and bleeding on probing (BOP), other studies reported no significant difference compared to controls. Marginal bone loss (MBL) outcomes were inconsistent. HA demonstrated an anti-inflammatory effect by reducing interleukin-1 beta levels and showed some benefits against the peri-implantitis-associated bacterial community. Conclusion: Adjunctive HA is associated with favorable effects on PPD and BOP, but with a low certainty of evidence, and may have a benefit in decreasing the levels of early-colonizing bacteria. Significant improvement in MBL was associated only with surgical approaches but with a very low certainty of evidence. The high degree of heterogeneity in study design, HA formulations, and treatment protocols, coupled with a high risk of bias, makes it difficult to draw a definitive conclusion. Well-designed RCTs are required to establish the clinical role of HA in the management of peri-implantitis.
Copyright (c) 2026 Raid Khayat https://creativecommons.org/licenses/by/4.0
Impact of plant fiber reinforcement on mechanical properties of PMMA denture base resin: a systematic review
Introduction: To improve the clinical outcomes and long-term durability of polymethyl methacrylate (PMMA) denture-based resins, they have undergone several developments and changes in their chemical composition to enhance their mechanical properties, including reinforcing them with natural fibers. Aim: This systematic review aimed to explore the influence of plant fiber reinforcement on the mechanical characteristics of PMMA denture resins. Material and methods: For this purpose, the formulated focus question was ‘Does incorporating plant fibers in PMMA denture resins improve their mechanical strength?’ Using the PRISMA protocol, three electronic databases (Google Scholar, PubMed, and ScienceDirect) were searched using the specific search words: (plant fibers, natural fibers, and PMMA) denture base resins between 2014 and 2024. After evaluating the papers against the inclusion criteria, only those that met all requirements were included in the study. Additionally, all articles were screened for quality assessment, with particular attention to potential bias arising from experimental design and methodological reporting. Results: This review included eight experimental laboratory-based studies that met the inclusion criteria. All studies had low risk of bias, except one, which had moderate risk of bias. The evaluation of reinforced resins’ flexural strength was a noticeable trend observed in studies, with the maximum weight percentage utilized in the studies being 10 wt%. While flexural strength was primarily assessed by the majority of studies, other mechanical properties – including hardness, impact strength, tensile strength, and compressive strength – were also evaluated. Conclusions: The analysis revealed that the flexural strength and surface hardness of PMMA denture resins were significantly enhanced through the addition of plant fiber reinforcement. However, limited and inconclusive data are present for other mechanical properties (impact, compressive, and tensile strength). Extended experimental studies related to aging and various storage protocols, as well as clinical trials, are essential to determine its clinical relevance and longevity
Copyright (c) 2026 Muhammad Khawaja Hammad Uddin, Nazrah Mehar, Muhammad Ammar Khan, Muhammad Hassan Khoso, Bilquess Saba, Muneeb Ahmed Lone, Ayesha Akram, Syeda Mamoona Mateen, Muhammad Amber Fareed, Muhammad Sohail Zafar https://creativecommons.org/licenses/by/4.0
Tongue stabilisation during CT simulation in radiotherapy using a customised dental biomaterial appliance: a case report
Introduction: Precise tongue stabilisation is essential during radiotherapy (RT) planning to ensure accurate target delineation in patients with squamous cell carcinoma of the tongue. Conventional tongue- depressing techniques can be difficult to apply in completely edentulous patients due to the absence of dentition and limited tongue control. This report aims to present a simple prosthodontic solution for effective tongue stabilisation during RT planning in an edentulous patient. Patients: A 72-year-old completely edentulous woman diagnosed with stage III (T3N0M0) well-differentiated squamous cell carcinoma of the left side of the tongue was scheduled for definitive RT. Conventional tongue stabilisation methods failed during computed tomography (CT) simulation. A custom-designed clear acrylic resin intraoral appliance was fabricated to maintain a constant 1.5 cm distance between the tongue and the palate and to achieve reproducible tongue depression. Repeated CT simulations were performed to assess the consistency of tongue positioning. Results: The custom intraoral appliance provided stable and repeatable tongue positioning, allowing improved visualisation of the target volume and facilitating accurate RT planning. Consistent tongue depression was confirmed across repeated CT simulations. Conclusion: The proposed low-cost, custom-made prosthodontic appliance is an effective method for tongue stabilisation in edentulous patients undergoing head and neck RT. Its use can enhance treatment planning accuracy and may be beneficial in similar clinical situations.
Copyright (c) 2026 Khalida Kamarudin, Muhammad Syahir Mohd Suhaimi, Nur Sabrina Zainol Abidin, Wan Adwaa Afiq Wan Zainalam https://creativecommons.org/licenses/by/4.0
Clinical management of severe molar–incisor hypomineralisation using CAD/CAM fabricated PMMA crowns: a case report
Background: Molar-incisor hypomineralisation (MIH) is a well-documented developmental enamel ­disorder, typically involving first permanent molars (FPMs) and incisors. However, atypical presentations with extensive involvement of other permanent teeth remain uncommon and poorly understood leading to management challenges. Materials and methods: This case report describes a severe presentation of MIH in a 10-year-old male, with a significant medical history of high-grade fever and febrile seizures during infancy. The patient reported normal timing of permanent tooth eruption, followed by progressive post-eruptive breakdown, affecting all permanent teeth except the premolars and second permanent molars. Clinical and radiographic ­evaluations confirmed severe MIH with substantial loss of enamel structure, especially in FPMs and incisors, which led to severe aesthetic and functional concerns. A comprehensive treatment plan was devised. CAD/CAM technology was employed to fabricate and deliver polymethyl methacrylate (PMMA)-based crowns for the affected teeth to restore aesthetics and function. Discussion: The patient was monitored over 24 months, demonstrating satisfactory outcomes of PMMA crowns in terms of durability, mastication, appearance and psychological benefit, indicating a successful restorative outcome. This case highlights the severe presentation of MIH, possibly linked to early childhood systemic illnesses, and individualised management of MIH, particularly in young paediatric patients.
Copyright (c) 2026 Vignesh Ravi, Madhur Sharma https://creativecommons.org/licenses/by/4.0
Delayed endodontic management of traumatically exposed immature maxillary anterior teeth: a case series
Background: Traumatic dental injuries are a leading cause of pulpal exposure in immature permanent anterior teeth. Vital pulp therapy (VPT), particularly pulpotomy, has become the preferred treatment modality in such cases as it maintains pulp function, supports physiologic dentin deposition, and promotes long-term tooth retention. However, treatment delays may compromise clinical outcomes due to bacterial contamination and progressive pulpal inflammation. Mineral trioxide aggregate (MTA) and Biodentine™, both hydraulic calcium silicate cements, have demonstrated favorable biological responses in VPT. Aim: To evaluate clinical and radiographic outcomes of full pulpotomy using MTA and Biodentine™ in immature permanent teeth with complicated crown fractures and delayed treatment intervals of up to 10 days. Methods: This case series included eight immature maxillary central incisors in seven patients, aged 8.5–9.5 years, presenting with complicated crown fractures. Full pulpotomy was performed using either MTA or Biodentine™ following standardized clinical protocols, and teeth were restored in the same visit, with fragment reattachment performed when feasible. Clinical and radiographic follow-up was conducted at 1 week and at 1, 3, 6, 12, 18, and 24 months. Results: At 18–24 months, all treated teeth remained vital, demonstrated resolution of symptoms, and showed continued physiologic root development consistent with successful apexogenesis. A radiographic dentinal bridge was observed in three teeth. No cases exhibited pathological changes such as periapical radiolucency, swelling, or restoration failure, except for one case with crown discoloration. Conclusion: Full pulpotomy using MTA or Biodentine™ may represent a promising treatment option for traumatically exposed immature permanent teeth, even when initiated up to 10 days after injury; however, these findings should be interpreted cautiously in view of the limited sample size and follow-up duration.
Copyright (c) 2026 Vignesh Ravi, Ruchi Singhal, Madhur Sharma, Ritu Namdev https://creativecommons.org/licenses/by/4.0
Comparison of mineral precipitation, elemental release, pH change and cytotoxicity of calcium-silicate cements and an experimental resin-modified glass ionomer cement containing bioactive glass
Introduction: Resin-modified glass ionomer cements (RMGICs) exhibit lower remineralising potential than calcium-silicate (Ca-Si) cements. This study aimed to prepare an experimental RMGIC incorporating Sr/F-bioactive glass nanoparticles (EXP) to enhance remineralisation on demineralised dentine. The experimental material was compared with commercial Ca-Si cements (RetroMTA [MTA], Biodentine [BDT], Theracal LC [TC]) and a commercial RMGIC (Vitrebond [VB]). Materials and methods: Demineralised dentine specimens were attached to discs of each material and immersed in simulated body fluid for up to 4 weeks. Mineral precipitation was assessed using an Attenuated Total Reflection – Fourier Transform Infrared Spectroscopy (ATR-FTIR) and scanning electron microscopy-energy-dispersive X-ray spectroscopy analyses. Remineralisation was quantified as the mineral-to-collagen ratio, calculated from the phosphate FTIR peak height at 1024 cm-1 relative to the amide I peak at 1636 cm-1 (n = 5). Changes in pH and elemental release (Na, Al, Si, P, Ca and Sr) from materials immersed in deionised water over 4 weeks were also evaluated (n = 3). Indirect cytotoxicity of material extracts on human dental pulp stem cells was assessed using the 3-(4,5 dimethylthiazol-2-yl)-2,5-di-phenyltetrazolium bromide assay (MTT) assay (n=4). Statistical analysis was performed using one-way analysis of variance (ANOVA) followed by Tukey’s Honestly Significant Difference test. Results: The highest increase in the mineral-to-collagen ratio was observed with MTA (78%), which was significantly higher than that of VB (−28%) and EXP (−33%). Scanning electron microscopy analysis demonstrated mineral precipitation with MTA, BDT and TC but not with VB or EXP. Additionally, MTA, BDT and TC produced the highest alkalinisation of the storage solution (pH~12). EXP exhibited the release of multiple ions (Na, Al, Si, P, Ca and Sr). Although MTA showed the highest cell viability, all materials demonstrated cell viability exceeding 70%. Conclusion: The experimental RMGIC containing Sr/F-bioactive glass nanoparticles exhibited inferior remineralising potential compared with Ca-Si cements. However, it promoted the release of multiple essential ions.
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
Effect of long soaking in Kawa Daun beverage on discoloration of nanofilled composite resin
Objective: This study investigated the effect of prolonged soaking in the Kawa Daun beverage on the discoloration of nanofilled composite resin. Materials and methods: Thirty disk-shaped specimens (6 mm diameter, 2 mm thickness) of nanofilled composite resin were prepared and divided into six groups. The samples were soaked in Kawa Daun solution, Robusta coffee solution, and artificial saliva for 6 and 18 hours at 37°C. Color measurements were taken before and after soaking using a Colorflex EZ spectrophotometer, and ΔE values were calculated. Data were analyzed using repeated-measures analysis of variance and post-hoc tests (p < 0.05). Results: Significant color changes were observed among the groups (p < 0.001). Soaking in Kawa Daun and Robusta coffee solutions produced significantly greater discoloration than artificial saliva, with increased ΔE values corresponding to longer soaking times. Conclusion: Prolonged exposure to Kawa Daun beverage caused measurable discoloration of nanofilled composite resin, likely due to pigment and acid content that degrade the resin matrix. These findings highlight the importance of patient education regarding the esthetic effects of traditional acidic and pigmented beverages on dental restorations.
Copyright (c) 2026 Deli Mona, Syifa Mahdiyah https://creativecommons.org/licenses/by/4.0
Effect of maturation time and adhesive system on the shear bond strength and failure modes of Biodentine™ bonded with resin composite and glass ionomer cement
Objectives: This study aimed (1) to compare the shear bond strength (SBS) and failure modes of Biodentine™ (BD) specimens bonded with resin composite (RC) or high-viscosity glass ionomer cement (HVGIC) at different maturation times and (2) to compare the SBS of BD bonded with RC using different adhesive systems. Materials and Methods: Part I: A total of 120 BD specimens were bonded with either RC or HVGIC (n = 60 each), then divided into four groups (n = 15 each) based on BD maturation time: 12 min, 24 h, 48 h, and 1 week. Part 2: A total of 45 BD specimens matured for 24 h were bonded with RC using 3 adhesives (n = 15 each): (1) Single Bond Universal (SU) with self-etched technique (SU-SE), (2) Adper Single Bond 2 adhesive with etch and rinse technique (AS-ER), and (3) SU adhesive with etch-and-rinse technique (SU-ER). All specimens underwent pH cycling and thermocycling. SBS was measured using a universal testing machine, and failure modes were examined under a stereomicroscope. Results: BD bonded with RC showed significantly higher SBS than BD bonded with HVGIC at all BD maturation times (p < 0.05). No significant SBS differences were found within RC groups, except between the 24-h and 1-week. Cohesive failure predominated in RC specimens (70%), whereas adhesive failure prevailed in HVGIC specimens (71.7%). SU-ER had significantly higher SBS than SU-SE or AS-ER (p < 0.05). Conclusion: BD bonded with RC demonstrated higher SBS than BD bonded with HVGIC. The failure mode in the RC group was predominantly cohesive, whereas in the HVGIC group, it was primarily adhesive. These findings support the clinical applicability of immediate definitive RC placement over BD using a methacryloyloxydecyl dihydrogen phosphate-containing adhesive with an etch-and-rinse strategy.
Copyright (c) 2026 Wichida Chaweewannakorn, Kittichot Saeta, Achirawat Wattakul, Suprawee Ngamjantratip, Pathida Pornraksamanee, Nirada Dhanesuan, Narinee Chinajitphan, Kwanchanok Youcharoen https://creativecommons.org/licenses/by/4.0
Food dye staining of dental composites: material variability and mouthwash-induced staining reversibility
Objective: Food dyes, widely used in consumables, may interact with polymeric materials, yet their staining effects on resin based dental composites remain underexplored. This in vitro study investigates the staining potential of five common water-soluble food dyes on contemporary dental composites and evaluates the efficacy of Listerine Advanced White mouthwash in reversing discolouration, using both colour difference and whiteness-based analyses. Methods: Five synthetic dyes – Tartrazine, Sunset Yellow, Ponceau 4R, Carmoisine, and Brilliant Blue – were tested on six resin composites: Charisma Smart, Estelite ∑ Quick, Filtek One Bulkfill, RubyFlow, Spectra SphereTEC High Viscosity (STHV), and Filtek Ultimate. Sixty disk-shaped samples (7 mm × 2 mm) per composite (N = 360) were immersed in dye solutions (50 mg/L) or distilled water (control) for 7 days. Colour changes were evaluated using the CIEDE2000 colour difference formula (ΔE₀₀) and the dental whiteness index (WID), calculated from Commission Internationale de l’Eclairage L*a*b* color space (CIELAB) coordinates obtained with a spectrophotometer. Results: Brilliant Blue exhibited the highest staining potential, producing ΔE₀₀ values exceeding the clinically unacceptable threshold (1.8) in all composites except Spectra STHV, and was also associated with the greatest changes in WID values. Other dyes caused variable and generally less pronounced changes in both ΔE₀₀ and WID. The whitening mouthwash partially reversed discolouration, reflected by significant increases in WID and reductions in ΔE₀₀, with significant recovery observed in Estelite, RubyFlow, and Filtek One (p < 0.05). Analysis of variance revealed significant effects of dye type, composite material, and treatment on both ΔE₀₀ and WID outcomes (p < 0.001). Conclusion: The colour stability and whiteness of dental resin composites are affected by synthetic food dyes in a material- and dye-dependent manner. Whitening mouthwash can partially restore both colour difference and whiteness; however, complete recovery to baseline values is generally not achieved.
Copyright (c) 2026 Burçin Deniz, Osman Tolga Harorli https://creativecommons.org/licenses/by/4.0
Acrylic-based occlusal device materials – the influence of manufacturing techniques on material properties and the propensity for biofilm formation
Objective: The material composition, manufacturing system, and post-processing steps used to fabricate acrylic-based occlusal devices may affect their clinical performance. This study aims to assess how manufacturing techniques and post-processing treatments influence the material properties of acrylic-based occlusal devices and the propensity of Streptococcus mutans to form biofilms on the surfaces. Materials and methods: Based on applied manufacturing technique and post-processing treatment, disc‑shaped specimens were manufactured using four 3D printing workflows (Splint 2.0‑Asiga Flash/Otoflash (OF), and LT Clear‑Form Cure/OF), one milling workflow (Therapon), and one autopolymerization workflow (PalaXtreme). Water sorption and solubility, surface free energy (SFE), average ­surface roughness, and Vickers hardness were tested across these workflows. The ATCC 700610 Streptococcus mutans strain served as a model for biofilm formation on the material surfaces. Two biofilm methods were employed: a 24-hour bioreactor approach and a 72-hour culture plate approach. Biofilm was quantified as colony-forming units per cm2. Results and conclusion: The Therapon and PalaXtreme workflows exhibited the lowest solubility, ­suggesting that these materials have the lowest release of material components in water. The Splint 2.0 workflows exhibited the lowest water sorption, indicating enhanced material integrity in humid conditions. Therapon showed the highest Vickers hardness, followed by PalaXtreme. The lower hardness of the print materials may make them susceptible to wear, which may not be optimal for treating patients with bruxism. No significant differences in SFE were observed between workflows. Low roughness values across all workflows indicate good polishability, which can enhance resistance to bacterial adhesion. In the 72-hour biofilm experiment, the Therapon workflow exhibited the most biofilm formation on material surfaces while PalaXtreme showed the least (p < 0.05). No significant differences between workflow groups were shown in the 24-hour biofilm experiment. In summary, material properties are influenced by material chemistry, manufacturing method, and ­associated post-processing treatment.
Copyright (c) 2026 Ketil H. Haugli, Jan Tore Samuelsen, Vigdis Aas, Inger S. Dragland, Colin Charnock https://creativecommons.org/licenses/by/4.0
Impact of artificial aging on the color stability and translucency of ceramic laminate veneers using different glass and hybrid ceramic materials
Background: The color stability and translucency of contemporary Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) glass and hybrid ceramic materials used for minimally invasive laminate veneers remain a clinical concern, particularly after exposure to aging conditions simulating oral service. The purpose of this in vitro study was to investigate the influence of accelerated artificial aging on the color stability and translucency of ceramic laminate veneers fabricated from different glass and hybrid ceramic materials. Materials and methods: A total of 40 composite resin discs (A2 dentin shade, 8.0 mm diameter × 4.0 mm thickness) were fabricated to simulate the normal dentin substrate. They were randomly assigned to four groups (n = 10) according to the ceramic veneering material: (EC) IPS e.max CAD, (CT) Cerec Tessera, (VE) Vita Enamic, and (CS) Cerasmart. Then, 40 disc-shaped ceramic veneers (0.5 mm thickness) were fabricated and adhesively cemented to the substrates. Baseline color and translucency parameters were measured using a digital spectrophotometer. After artificial thermomechanical aging, color differences (ΔE00), using the CIEDE2000 formula and translucency parameter (TP) were calculated. The resulting data were statistically analysed using repeated-measures two-way analysis of variance (ANOVA) test (material × aging), followed by Post hoc Tukey test for multiple-group comparisons and Paired t-test for within-group comparisons, at p-value ≤ 0.05. Results: Artificial aging significantly affected color stability and translucency for all tested materials (p < 0.001). Glass ceramics (EC and CT) demonstrated lower ΔE₀₀ values within clinically acceptable limits, whereas hybrid ceramics (VE and CS), particularly CS, exhibited significantly higher color changes exceeding acceptability threshold. Translucency significantly decreased after aging for all materials (p < 0.001). Conclusions: Artificial thermomechanical aging adversely affected the optical properties of all tested ceramic laminate veneers. The hybrid ceramic materials, particularly CS, were the most affected by aging in terms of color stability, whereas the glass ceramic materials (EC and CT) exhibited superior color stability. A reduction in translucency was observed for all materials after aging.
Comparative evaluation of the remineralisation potential of biomimetic agents on phosphorylated dentine using SEM–EDX analysis: an in vitro study
Introduction: Dentine remineralisation remains a clinical challenge due to its higher critical pH and complex organic matrix. Biomimetic strategies that replicate the role of non-collagenous proteins through phosphorylation have shown promise in promoting intrafibrillar mineralisation. Sodium tripolyphosphate (STPP) has been proposed as a phosphorylating agent capable of enhancing dentine remineralisation. This in vitro study aimed to comparatively evaluate the remineralisation potential of different biomimetic agents on artificially demineralised dentine using scanning electron microscopy (SEM) and energy-­dispersive X-ray (EDX) analysis. Methodology: An in vitro study was conducted using 70 extracted human permanent teeth, which were sectioned to obtain coronal dentine discs. Baseline mineral content and surface morphology were assessed using SEM and EDX. Samples were subjected to pH cycling to induce demineralisation and randomly assigned to four groups: Group A – theobromine, Group B – Casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), Group C – Novamin and Group D – Artificial saliva. Each group was further subdivided based on STPP application (n = 10). Remineralisation protocols were carried out for 7 and 21 days, followed by SEM and EDX evaluation. Results: All specimens demonstrated significant mineral loss following demineralisation. Experimental groups showed progressive remineralisation over time compared to the control. STPP-treated subgroups exhibited greater mineral deposition and improved surface morphology. Among the tested agents, CPP-ACP combined with STPP demonstrated the highest calcium and phosphorus content, with EDX values exceeding baseline reference levels at 21 days. CPP-ACP + STPP showed significantly higher remineralisation compared to Novamin, theobromine, and the control groups at days 7 and 21 (p < 0.05). Conclusion: Phosphorylation of dentine using STPP enhances the remineralisation efficacy of biomimetic agents. CPP-ACP in combination with STPP showed superior remineralisation potential. These findings support the use of phosphorylating biomaterials as promising strategies for dentine remineralisation. However, the findings are limited by the in vitro design and require clinical validation.
TheraCal LC versus Mineral Trioxide Aggregate for full pulpotomy in cariously exposed mature permanent molars with symptomatic irreversible pulpitis: a randomized clinical trial
Introduction: Preserving pulp vitality is crucial for long-term tooth survival. Pulpotomy, which involves the removal of infected pulp while retaining healthy pulp, helps maintain tooth vitality and function. Although TheraCal LC has shown success as a pulp-capping agent, its use in pulpotomy remains unexplored. This study compared the clinical and radiographic success of TheraCal LC and mineral trioxide aggregate (MTA) in full pulpotomy of mature permanent molars in young patients with symptomatic irreversible pulpitis (SIP). Materials and methods: In this double-blinded, parallel, non-inferiority randomized controlled trial, 72 healthy children (aged 9–14, mean age = 11.72 ± 1.35 years) with cariously exposed mature permanent molars diagnosed with SIP were randomly assigned to receive either TheraCal LC or MTA (n = 36 each). Follow-ups were conducted up to 12 months. Data were analyzed using Mann-Whitney U, Chi-square, and Kaplan-Meier tests (α = 0.05). Results: At 12 months, MTA showed significantly higher success (ITT – Intention to Treat: 94.4%, PP – Per Protocol: 100%) compared to TheraCal LC (ITT: 75%, PP: 79.4%) (p < 0.05). Seven failures occurred in the TheraCal LC group; none in the MTA group. Two patients in each group were lost to follow-up. Pain scores were significantly lower in the MTA group on days 1, 3, and 5 (p < 0.05). Conclusions: MTA demonstrated superior outcomes over TheraCal LC for full pulpotomy in young, mature permanent molars with SIP. Statement of clinical relevance: The use of MTA in pulpotomy procedures for mature permanent molars with SIP results in enhanced clinical success rates when compared to TheraCal LC, offering valuable insight for evidence-based treatment planning.
Copyright (c) 2026 Vignesh Ravi, Ritu Namdev, Ruchi Singhal, Madhur Sharma, Charu Dayma, Asha Rani https://creativecommons.org/licenses/by/4.0
Shear bond strength of rebonded metal brackets using four light-curing resins: an in vitro study
Background: Rebonding of orthodontic brackets requires effective surface conditioning to restore adequate adhesive retention. Objective: To compare the shear bond strength (SBS) of rebonded metal brackets using four light-curing resins. Material and methods: Eighty premolars were allocated to two conditioning protocols (n = 40 per group): G1 – enamel etching with 37% phosphoric acid; G2 – sandblasting of bracket bases followed by enamel etching. Each group was subdivided according to the resin used (n = 10 per subgroup): Orthocem (FGM), Bracespace (3M), Transbond XT (3M), and Z250 (3M). Brackets were bonded, debonded, reconditioned, and rebonded. SBS was tested using a universal testing machine (0.5 mm/min). Data were analyzed using Kruskal–Wallis and Dunn’s post-hoc tests (α = 0.05). Results: In the acid‐etched group, there was no statistically significant difference in SBS among the four resins (Kruskal–Wallis, p = 0.097). In the sandblasting group, a significant intergroup difference was observed (p = 0.044). Dunn’s post-hoc test identified higher SBS for Bracespace (3M) and Transbond XT (3M) compared with Orthocem (FGM) and Z250 (3M). When comparing conditioning methods within each resin, sandblasting of the bracket bases resulted in significantly higher SBS only for Bracespace and Transbond XT, whereas Orthocem and Z250 showed no significant change. Conclusions: Rebonding of metal brackets showed comparable SBS among resins after acid etching. However, when the bracket bases were sandblasted, Bracespace and Transbond exhibited significantly higher bond strengths. Surface preparation of the bracket base is therefore a key factor influencing SBS in rebonding procedures.
Copyright (c) 2026 Verónica Estefanía Pozo, Mauricio Aguirre Balseca, Marjory Elizabeth Vaca Zapata, Karina Maria Salvatore Freitas, Johanna Elizabeth Fiallos Sanchez https://creativecommons.org/licenses/by/4.0
Incorporation of selenium nanoparticles into mineral trioxide aggregate used as a direct pulp capping material
Introduction: This study evaluated the histopathological response of the dental pulp following direct pulp capping (DPC) using Mineral Trioxide Aggregate Repair High Plasticity (MTA Repair HP) supplemented with green-synthesized selenium nanoparticles (SeNPs). The objective was to determine how SeNP concentration influences the biological behavior of MTA HP and to identify the dose that best supports pulp healing compared with MTA HP alone. Methods: Twelve male dogs with 132 teeth were included. Twelve teeth served as negative controls, while 120 teeth were assigned to five groups: MTA HP alone or MTA HP combined with 0.5%, 1%, 1.5%, or 2% (w/w) SeNPs (n = 24 per group). Standardized pulp exposures were created and treated according to group allocation. Samples were collected at 7, 14, 30, and 60 days (n = 6 per interval) for histopathological assessment of inflammation, necrosis, and reparative dentine formation. Results: The group treated with 1% SeNP had the best results. They displayed very little inflammation, no signs of tissue necrosis, and started forming reparative dentine as early as day 14. While inflammation diminished over time in all the groups, the statistical analysis showed that the different SeNP levels made a difference in how much inflammation occurred, how much tissue necrosis there was, and the quality of the new dentine. Conclusion: Adding SeNP to MTA HP depended on the amount used. The 1% version presented the best biocompatibility and assisted pulp tissue heal better. On the other hand, higher amounts triggered more inflammation. Overall, these results recommend that 1% SeNP-enhanced MTA HP could be a choice for direct pulp capping, offering better healing and clinical results.
Copyright (c) 2026 Njwan Fadhel Shehab, Hana Khaleel Ismail, Nadia H Hasan https://creativecommons.org/licenses/by/4.0
Evaluation of an Angio-Osseo Inductive Bone Ceramic versus demineralised freeze-dried bone allograft in the treatment of periodontal intrabony defects: a randomised controlled clinical trial
Introduction: Periodontal intrabony defects (IBDs) respond favourably to regenerative periodontal therapy. Various graft and non-graft materials have been used, with non-allogenic bone substitutes offering the potential to enhance clinical outcomes and radiographic defect resolution. Angio-Osseo Inductive Bone Ceramic (ABC), a novel ion-doped biphasic calcium phosphate graft, has shown promise due to its osteogenic and angiogenic potential. Aim: The study aimed to compare the clinical and radiographic outcomes of ABC and demineralised freeze-dried bone allograft (DFDBA) in the surgical management of periodontal IBDs. Materials & methods: A parallel-group, examiner- and statistician-blinded, randomised controlled clinical trial was conducted on 30 IBDs (one per patient), randomly assigned to ABC (test, n = 15) or DFDBA (control, n = 15). Clinical parameters, including Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD), and clinical attachment level (CAL), were recorded at baseline, 3 months, and 6 months. Radiographic bone fill was assessed at 3 and 6 months using standardised digital radiovisiography. Results: In both groups, mean IBD scores were significantly different at all time intervals (p < 0.05). Intergroup differences in PPD reduction and CAL gain were not statistically significant. Radiographic analysis demonstrated significantly greater bone fill in the test group (68.63%) compared with the control group (45.48%) at 6 months (p < 0.05). Conclusion: Both ABC and DFDBA were effective in the treatment of periodontal IBDs. However, ABC demonstrated statistically significant improvement in defect fill, supporting its potential as a novel alloplastic alternative to conventional allograft.
Copyright (c) 2026 Vidya Sagar S, Uday Kiran Roopavath, Navatha Sattar, Raja Babu P, Athmuri Durga Nandini, Neema Kumari, Subha Narayan Rath https://creativecommons.org/licenses/by/4.0
Effect of nano silver fluoride pre-treatment on the microtensile bond strength of a universal adhesive to dentin: an in vitro study
Objective: The study aims to evaluate the effect of Nano Silver Fluoride (NSF) pre-treatment at two concentrations on the microtensile bond strength (µTBS) of a universal adhesive to dentin. Methods: Flat deep coronal dentin surfaces from sound human molars were treated with NSF at 600 or 1500 ppm, or left untreated (control). A universal adhesive (Single Bond Universal; 3M ESPE/now Solventum) was applied in self-etch (SE) mode, followed by placement of a bulk-fill resin composite (Filtek Bulk Fill; 3M ESPE / now Solventum). Specimens were sectioned to obtain sticks (~1 mm2) and tested for µTBS using a universal testing machine (500 N load cell; 5 mm/min crosshead speed), considering the tooth as the experimental unit (n = 8). Group comparisons were performed using Welch’s one-way Analysis of Variance (ANOVA). Weibull analysis was conducted on stick-level data (n = 56 per group) to assess bond strength reliability. Failure modes were evaluated under stereomicroscopy, and dentin morphology and silver nanoparticle distribution were qualitatively assessed using Scanning Electron Microscopy (SEM). Results: No statistically significant differences were detected among groups (p = 0.074). Mean µTBS values were 33.0 ± 10.2 MPa (control), 35.6 ± 8.7 MPa (NSF 600), and 21.4 ± 11.7 MPa (NSF 1500). Effect size analysis indicated a large effect associated with NSF concentration. Weibull analysis showed lower characteristic strength and Weibull modulus for the NSF 1500 group, indicating reduced bond reliability. Adhesive failures predominated in all groups. Conclusion: Although no statistically significant differences were detected, higher NSF concentration (1500 ppm) was associated with lower bond strength reliability, whereas the lower concentration (600 ppm) maintained favorable bonding performance. Greater accumulation of silver nanoparticles on the dentin surface may interfere with resin infiltration and hybrid layer formation.
Copyright (c) 2026 Larissa Alexsandra dos Santos Silva, Anna Caroline Lima dos Santos, Luis Felipe Espíndola-Castro, Ana Luísa Cassiano Alves, Márcia de Almeida Durão, Maria Clara Müller de Andrade, André Galembeck, Gabriela Queiroz de Melo Monteiro https://creativecommons.org/licenses/by/4.0
Role of cold atmospheric plasma alone or combined with conventional surface treatments on shear bond strength of 3Y-TZP and 5YSZ ceramics bonded with composite resin
Objective: To evaluate the role of cold atmospheric plasma (CAP), alone or in combination with conventional surface treatments, on the shear bond strength (SBS) and failure mode of 3Y-TZP and 5YSZ ceramics bonded to composite resin using two adhesive protocols. Materials and methods: A total of 200 zirconia specimens (3Y-TZP and 5YSZ) were assigned to five surface-treatment groups: No treatment (control), airborne-particle abrasion (APA), CAP, APA + CAP, and hydrofluoric acid (HF) + CAP. Each group was further divided according to the use of a primer. The zirconia specimens were bonded to composite resin using a self-adhesive cement. After artificial aging, SBS testing and failure-mode analysis were performed. Data were analyzed using appropriate parametric tests (α = 0.05). Results: Compared with the control group, surface treatments significantly improved SBS (p < 0.001). Applying self-adhesive cement with surface primer further improved SBS (p < 0.001). Different yttria contents of zirconia materials did not impact SBS (p > 0.05). There was no benefit to combining APA and CAP or CAP and HF. Failure modes were predominantly adhesive in the control group and mixed on treated zirconia surfaces. Conclusions: CAP provides bond strength comparable to APA while potentially minimizing surface damage, supporting its use as a conservative surface-treatment option. Additional combined or aggressive surface treatments do not offer further clinical benefit for bonding zirconia restorations.
Copyright (c) 2026 Ahmad Abdulkareem Alnazzawi, Mohamed F Aldamaty, Mohammed H. AbdElaziz, Ahmed Yaseen Alqutaibi, Ahmed E. Farghal, Jamal Qernas Almarashi, Abdel-Aleam H. Mohamed, Mohamad Sohail Zafar https://creativecommons.org/licenses/by/4.0
Effects of HCl concentration and immersion time on physicochemical properties, BMP-2 detection, degradation, and osteoblast response of human demineralized tooth matrix
Objective: Human demineralized tooth matrix (hDTM) is a promising tooth-derived graft material; however, demineralization protocols vary widely and may alter matrix structure, degradation behavior, and growth factor detectability. This study investigates the combined effects of hydrochloric acid (HCl) concentration (0.5 vs 1.0M) and immersion time (10 vs 20 min) on the physicochemical characteristics, Bone Morphogenetic Protein-2 (BMP-2) detection, degradation behavior and osteoblast response of hDTM. Methods: Caries-free permanent teeth (particle size 500–1000 µm) were demineralized using four HCl protocols: 0.5M/10 min, 0.5M/20 min, 1M/10 min, and 1M/20 min. Morphology, crystallinity, and surface features were characterized by scanning electron microscopy (SEM), X-ray diffraction, X-ray fluorescence, and Brunauer-Emmett-Teller analysis. Total protein and BMP-2 were quantified using Bradford and enzyme-linked immunosorbent assay (ELISA) assays. In-vitro degradation was monitored for 60 days in simulated body fluid. MC3T3-E1 osteoblast adhesion and proliferation were evaluated using the SEM and PrestoBlue® assay. Two-way analysis of variance was performed to assess main and interaction effects of concentration and time. Results: Both HCl concentration and immersion time significantly influenced hDTM properties. Lower concentration enlarged dentinal tubules and collagen exposure, whereas higher concentration produced surface microcracking and reduced collagen exposure. Higher HCl concentration increased degradation (1M/20 min: 23.76 ± 3.23% vs. 0.5M/20 min: 9.02 ± 0.63%, p < 0.01), while longer immersion increased ELISA-detected BMP-2 levels (1M/20 min: 11.8 ± 1.9 ng/g; 0.5M/20 min: 5.3 ± 1.6 ng/g vs. control: 0.1 ng/g, p < 0.001). Significant independent and interactive effects of HCl concentration and immersion time were observed (p < 0.001). Among the test conditions, a 0.5M/20 min protocol demonstrated balanced collagen preservation, controlled degradation, and favorable osteoblast proliferation. Conclusion: HCl concentration and immersion time independently and interactively modulate hDTM properties. Within the test conditions, 0.5M HCl for 20 minutes provides a practical solution and balances collagen preservation, controlled degradation, and osteoblast proliferation, supporting its use as a feasible approach for fabricating tooth-derived bone graft materials.
Copyright (c) 2026 Anupong Jeerachaipansakul, Narit Leepong, Srisurang Suttapreaysri https://creativecommons.org/licenses/by/4.0
The efficacy of acetic acid and citric acid on calcium silicate based cement removal from root canals and their effect on dentine structure – an in vitro study
Objectives: This study evaluated the effectiveness of acids on calcium silicate cement surface hardness, perforation, and their impact on root dentine microstructure. Materials and methods: Root dentine discs were exposed to hydrochloric, acetic, and citric acids. Fourier transform infrared spectroscopy (FTIR) assessed dentine microstructure after exposure to these acids. Sixty discs of Biodentine and NeoPUTTY (n = 30 each) were treated with 2% acetic acid, 5% citric acid, or saline (control), then tested for surface microhardness (Vickers hardness number, VHN). Another 60 dentine discs filled with these cements were exposed to the acids or saline and mechanically perforated with a Peeso reamer; perforation time was recorded. Scanning electron microscopy (SEM) examined dentine and cement surfaces. Results: FTIR revealed that hydrochloric acid caused severe demineralization of dentine microstructure, whereas 2% acetic and 5% citric acids had no significant effect on dentine microstructure. Both acids (acetic and citric) significantly reduced VHN compared to controls (p < 0.001). Acid-treated groups were perforated faster, with citric acid showing the greatest time reduction (p < 0.001). NeoPUTTY required less perforation time than Biodentine (p < 0.001). SEM revealed surface cracks in Biodentine and round-shaped defects in NeoPUTTY after acid exposure; citric acid opened dentinal tubules more distinctly than acetic acid. Conclusions: Acetic and citric acids significantly reduced microhardness and facilitated mechanical perforation of calcium silicate cements, with citric acid exerting greater effect.
Copyright (c) 2026 Hanan Alzraikat, Ahmad S. Al-Hiyasat, Estabraq Sarya Jamous, Mohammad A. Alebrahim https://creativecommons.org/licenses/by/4.0
Effect of salivary pH variations on the adhesive performance of Transbond XT and Orthocem in orthodontic bracket bonding
Objective: This in vitro study aimed to evaluate the shear bond strength of orthodontic brackets bonded to acrylic resin specimens with two adhesive systems, Transbond XT and Orthocem, under different salivary pH levels (4, 5, 6, and 7). Materials and methods: A total of 120 acrylic resin specimens (Brava Block®, FGM) were prepared and randomly assigned to three groups: control bonded with Transbond XT and Orthocem with no salivary exposure (n = 24), Transbond XT (n = 48), and Orthocem (n = 48). Each adhesive group was subdivided and immersed in artificial saliva at pH 4, 5, 6, or 7 for 30 days. Metal premolar brackets (Vector+ Roth prescription, Aditek®) were bonded following manufacturers’ protocols and subjected to shear bond strength testing using a Universal Testing Machine, following ISO 4049 standards. Data were analyzed with Analysis of Variance (ANOVA), t-test, and Tukey tests at a significance level of p < 0.05. Results: Transbond XT consistently showed higher bond strength than Orthocem across all pH levels. Maximum resistance was observed at pH 7 (21.19 ± 5.06 MPa), followed by the control group (19.64 ± 5.28 MPa). Orthocem demonstrated significantly lower values, ranging from 9.51 ± 3.87 MPa (pH 5) to 4.94 ± 2.15 MPa (pH 6). Acidic conditions reduced the bond strength of both adhesives, but Transbond XT maintained clinically reliable values, while Orthocem was more susceptible to performance decline at moderately acidic levels. Conclusions: Salivary pH directly influenced adhesive performance. Transbond XT demonstrated superior resistance under all conditions, whereas Orthocem showed lower but still clinically acceptable shear bond strength values, except at pH 6, where a marked decrease was observed.
Copyright (c) 2026 Lismory Karina Leiton Narváez, Marjory Elizabeth Vaca Zapata, Mauricio Aguirre Balseca, Karina Maria Salvatore Freitas, Yalil Rodríguez https://creativecommons.org/licenses/by/4.0
The impact of biological properties of bioactive glasses on enamel during artificial erosive tooth wear
Objectives: The aim of this study was to evaluate the protective effect of air-abrasion with two bioactive glasses (BAGs) on enamel surface against erosion/abrasion challenge. Materials and methods: Thirty human third molars were collected, and enamel specimens were prepared and randomly assigned to three groups (n = 10): control group, where specimens received no treatment and BAG groups, where enamel was air-abraded once for 10 seconds with BioMinF® and ProSylc™, respectively. The operational parameters were: air pressure 20 psi, powder flow rate dial 1 g/min and nozzle-surface distance 5 mm. The samples were submerged in a 0.01 M HCl solution for 2 minutes and then placed in a remineralizing solution for 2 hours (five times daily). At the end of each day, the samples were stored in the remineralizing solution for 14 hours. Thirty minutes after the initial and final erosive challenges of the day, an abrasion challenge was conducted using an electric toothbrush. Erosive tooth wear (ETW) was evaluated by measuring enamel surface loss, while surface hardness and roughness were measured to provide an indirect assessment of ETW-related changes. Additional insights into the bioactivity of the treatments were obtained by analyzing alterations in enamel morphology and composition. The data were statistically analyzed using one-way Analysis of Variance (ANOVA). Results: BAG treatments significantly reduced surface loss (38.7–46.7%) and increased surface hardness (6.3–8.9%) and roughness in enamel (p < 0.05). No significant differences were observed between the two BAG treatments (p > 0.05). Alterations in enamel surface morphology and composition were detected in the BAG groups compared to the control. Conclusions: Air-abrasion treatment with BAGs can provide a protective effect against early ETW, particularly under conditions that simulate gastroesophageal reflux disease (GERD)–related defects. Clinically, this implies that BAG air-abrasion may serve as a minimally invasive preventive treatment for patients at high risk of ETW, such as those with GERD.
Copyright (c) 2026 Dimitrios Dionysopoulos, Petros Mourouzis, Avraam Konstantinidis, Lambrini Papadopoulou, Kosmas Tolidis, Robert G. Hill https://creativecommons.org/licenses/by/4.0
Temporal effects of restorative pretreatments on biodentine: an in-vitro study
Background: Biodentine is frequently exposed to various surface pretreatments, such as dentin conditioner (DC), glass ionomer liquid (GICL), acid etchant, and adhesives, during pulp capping procedures. However, the impact of these agents on Biodentine’s surface microstructure and chemical composition remains underexplored. Objective: This study qualitatively analyzes the effects of DC, type II GICL, acid etchant (AE), Clearfil SE (CFS, a two-step self-etch adhesive), and Single Bond Universal (SBU, a universal adhesive) on the surface microstructure and chemical composition of Biodentine (BD) at 5 min, 12 min, 24 h, and 7 days after manipulation. Materials and methods: BD samples were subjected to various pretreatments and qualitatively analyzed using scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX), micro-Raman spectroscopy, and X-ray diffraction (XRD). Results: SEM revealed distinct surface morphologies depending on the pretreatment and time interval, ranging from homogenous and grainy to smooth and polymer-coated surfaces. EDX showed significant variations in calcium-to-silicon ratios over time. Notably, AE caused pronounced surface disruption up to 24 h, while CFS and SBU resulted in minimal changes. DC, GICL, and DC+GICL did not adversely affect BD’s surface microstructure at any time point. XRD and micro-Raman analyses indicated no change in the chemical composition of BD across all groups and time intervals. Conclusion: Surface pretreatments influence BD differently depending on timing. AE compromised surface integrity until 24 h, whereas self-etch and universal adhesives produced only superficial alterations. Delaying aggressive pretreatments until 7 days minimizes disruption.
Copyright (c) 2026 Narendrakumar Akshaya, Hrudi Sundar Sahoo, Kurinji Amalavathy Ratnakaran, Adisree Ravichandran https://creativecommons.org/licenses/by/4.0
Effect of carbonate apatite nanoparticles on the physicochemical properties and cytocompatibility of an experimental dental adhesive
Objective: The study aimed to evaluate the effect of incorporating silanized and non-silanized carbonate apatite nanoparticles (CA5n) on the physicochemical properties and cytotoxicity of a hydrophilic experimental adhesive. Materials and methods: A dental adhesive composed of 70% bisphenol A diglycidyl ether dimethacrylate, 28.75% 2-hydroxyethyl methacrylate, 0.25% camphorquinone, and 1% ethyl N, N-dimethyl-4-aminobenzoate was used. CA5n, synthesized with a CO₃/PO₄ molar ratio of 5, was used in both silanized and non-silanized forms at concentrations of 0.5, 1, 2 or 4% (wt). The degree of conversion (DC) was measured using Fourier Transform Infrared spectroscopy (n = 5) immediately, 5 minutes, and 60 minutes after curing. Water sorption and solubility were evaluated over 28 days (n = 6). The cytotoxicity of 24-hour and 7-day extracts (n = 6) was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay in triplicate. DC data were statistically analyzed using a mixed model. Independent-samples t-tests and Wilcoxon tests were used, depending on data normality, to analyze water sorption, solubility, and cell viability results. Statistical significance was set at p < 0.05. Results: The addition of CA5n significantly increased the DC over time, regardless of the concentration or silanization status. All CA5n groups exhibited high water sorption and acceptable water solubility, unaffected by concentration or silanization. Water sorption increased significantly with higher CA5n concentrations compared to the control, except in the 0.5% non-silanized (NS) group. Water solubility remained below 7.5 µg/mm³ (ISO 4049 requirement), with no significant differences among groups. Cell viability decreased significantly across all experimental groups compared to the negative control, with similar effects observed in both 24-hour and 7-day extracts. Conclusion: Adding CA5n to an experimental adhesive increased the DC and the water sorption. According to ISO 10993-5, the experimental adhesive, with and without CA5n, demonstrated low cytotoxicity potential.
Copyright (c) 2026 Heba E. AbdelRazik, Jon E. Dahl, Simen E. Kopperud https://creativecommons.org/licenses/by/4.0
Colour stability of Siloczest LSR 120 against Cosmesil M511 maxillofacial silicones under simulated environmental ageing conditions
Background: Maxillofacial prostheses play a vital role in rehabilitating facial form and function, with long-term colour stability being a key determinant of patient satisfaction. These prostheses are routinely exposed to ultraviolet radiation, sweat, and cleaning agents, which may compromise their appearance over time. Aim: To compare the colour stability of two maxillofacial silicone elastomers, Siloczest LSR 120 and Cosmesil M511 under simulated ageing conditions replicating clinical exposures. Materials and methods: A total of 80 samples (40 per material) were fabricated and divided into four subgroups based on ageing conditions: sunlight, artificial sweat, immersion in neutral soap, and a combination of sunlight and sweat. Colour measurements were recorded before and after 6 months of ageing, except for neutral soap (30 hours) using the Commission Internationale de l’Eclairage Lab* ( CIE L*a*b*) system via a spectrophotometer, and ΔE values were calculated. Data were analysed using SPSS v28. Normality was assessed with Kolmogorov-Smirnov and Shapiro-Wilk tests. Independent t-test and one-way analysis of variance with Bonferroni correction were used for inter- and intra-group comparisons. Results: Both materials exhibited colour changes under all conditions. No statistically significant difference was observed between Siloczest LSR 120 and Cosmesil M511 under isolated sunlight or sweat exposure. However, Siloczest LSR 120 showed significantly higher discolouration under neutral soap (ΔE-1.48) and combined sunlight and sweat conditions (ΔE-6.68) against Cosmesil M511 (ΔE-0.68 & 3.82 respectively), (p < 0.05). The combination of sweat and sunlight caused the greatest colour degradation, particularly in Siloczest LSR 120. Conclusion: The results suggest that while Cosmesil M511 remains the more reliable option for long-term aesthetics, Silicozest LSR 120 demonstrates promising performance. Although its colour stability was comparatively poorer under neutral soap and combined exposure, the observed changes remained within clinically acceptable limits for darker skin tones (ΔE < 10.07), indicating that it can still be considered a viable material for clinical use in appropriate contexts.
Copyright (c) 2026 Anurag Jain, Pavankumar Koralakunte Ravi, Sunitha Naveen Shamnur, Nandeeshwar Doddabasavaiah Basvapura https://creativecommons.org/licenses/by/4.0
Antibiofilm and antibacterial effects of Nigella sativa extract against Streptococcus mutans predicting the role of fatty acids composition: in vitro, CLSM and in silico studies
Purpose: To investigate the antibiofilm and antibacterial properties of Nigella sativa seed aqueous extract (NSE) against Streptococcus (S.) mutans. Methods: Chemical analysis of aqueous extract powder of Nigella sativa seeds was carried out using gas chromatography–mass spectrometry (GC-MS). S. mutans biofilm removal by NSE and chlorhexidine (CHX) mouthwash was evaluated using crystal violet (CV) assay. Ten extracted human teeth were sectioned to obtain 12 enamel specimens. Enamel specimens were coated by artificial saliva with bovine serum albumin, and then inoculated by S. mutans for biofilm formation. Enamel specimens were divided into four groups [positive biofilm control (without treatment), negative biofilm control (without bacteria), NSE and CHX biofilm treatment groups]. Acridine orange/propidium iodide assay was used for vital/dead biofilm staining. Confocal laser scanning microscopy (CLSM) biofilm images were digitally analyzed to calculate vital/dead stains relative fluorescence (RF) and estimate biofilm thicknesses. Molecular docking (MD) of interaction between long chain fatty acids (FAs) of NSE and MurA enzyme (PDB: 1UAE) was performed. Results: GC-MS revealed high concentration of long chain FAs (linoleic, oleic and palmitic acids). NSE and CHX groups showed significantly the highest red (dead) RF. NSE caused the highest reduction in biofilm thickness. NSE and CHX presented the minimum absorbance in CV assay. MD predicted a high binding affinity between FAs ligands and MurA receptors (Arg371, Arg331, Asn23, Lys22), with maximum affinity to linoleic acid (–98.07 kcal/mol). Conclusion: NSE showed antibacterial effect against S. mutans biofilm comparable to that of CHX, with a higher biofilm removal effect. NSE is expected to have a MurA enzyme inhibitory effect.
Copyright (c) 2026 Sherif ELsayed, Khaled EL-Adl, Doaa M. Sadony, Haidy A. Gad, Abdullah Yousef, Ahmed A. Radwan https://creativecommons.org/licenses/by/4.0
Evaluation of two cementation protocols for lithium disilicate crowns on zirconia one-piece implants: a micro-CT analysis of cement thickness, porosity, and excess
Objective: To evaluate the influence of two cementation protocols on lithium disilicate crowns cemented to zirconia one-piece implants by analyzing cement thickness, porosity, and excess cement using micro-computed tomography (micro-CT). Materials and methods: Sixteen Computer-Aided Design (CAD)/Computer-Aided Manufacturing (CAM)-fabricated lithium disilicate crowns were cemented onto zirconia one-piece implants (WhiteSKY, Bredent) using two resin-based cements: an adhesive resin cement (ARC) and a self-adhesive resin cement (SARC) based on multifunctional phosphoric methacrylates. Each cement was applied with either a conventional apical-half (AH) or an abutment-assisted apical-half protocol (A-AH), creating four groups (n = 4). Samples were scanned with micro-CT for volumetric analysis of the cement. Data were analyzed using Analysis of Variance (ANOVA) with Dunnett’s post hoc test (α = 0.05). Results: The ARC showed lower porosity and more uniform cement layers than the SARC. The A-AH technique significantly reduced excess cement in both cements, particularly with the self-adhesive resin type. All groups exceeded the 50 µm digital cement space, with the self-adhesive A-AH group showing the highest thickness. Conical abutment geometry contributed to localized cement accumulations. Conclusions: Both the cement type and the application protocol appeared to influence the characteristics of the cement interface. In this study, the ARC tended to produce a more uniform and less porous cement layer, whereas the abutment-assisted protocol was associated with reduced amounts of excess cement. These findings suggest that modifications to the cementation protocol may help to optimize outcomes for zirconia one-piece implant restorations, particularly when using self-adhesive resin systems.
Copyright (c) 2026 Veranda Azizi Bunjaku, Ivica Pelivan, Rania Al-Mahdi, Blerina Azizi Veseli, Ying Xue https://creativecommons.org/licenses/by/4.0
Sealing ability of Biodentine, zirconia reinforced glass ionomer cement and Mineral Trioxide Aggregate as furcation perforation repair materials: an in vitro analysis
Aim: The present study aimed to evaluate and compare the sealing ability of Biodentine, zirconia reinforced glass ionomer cement (GIC), and Mineral Trioxide Aggregate (MTA) as furcation repair materials. Materials and methods: A total of 50 extracted permanent maxillary molars were collected and divided into three experimental groups and one control group. Group I – Biodentine (n = 15), Group II – zirconia reinforced GIC (n = 15), Group III – MTA Angelus (n = 15), and unrepaired, control group (n = 5). Crowns of teeth in experimental groups were sectioned 3 mm above the cementoenamel junction and roots 3 mm below the furcation. Standardised endodontic access openings were prepared, canal orifices and root ends were sealed with sticky wax. After coating with nail varnish, a 1 mm furcation perforation was created at a standardised location using a round carbide bur. Samples were flushed, dried, and incubated at 37°C for 24 h to simulate clinical conditions. All samples were subjected to orthograde and retrograde methylene blue dye challenge followed by dye extraction with a concentration of 65% nitric acid. Samples were then analysed using 550 ultraviolet-visible spectrophotometers. Statistical analysis: The results were analysed statistically by one-way analysis of variance (ANOVA) and Tukey’s multiple comparison tests. Result: No statistically significant difference in sealing ability was observed between Biodentine, zirconia reinforced GIC, and MTA when used as a furcation perforation repair material. Conclusion: Within the limitations of this study, it can be concluded that Biodentine, zirconia reinforced GIC, and MTA showed sealing ability comparable to each other.
Copyright (c) 2026 Sumita Panwar, Yajuvender Singh Hada https://creativecommons.org/licenses/by/4.0
In vitro effect of mouthwash containing chlorhexidine and chlorine dioxide against halitosis pathogens
Objective: This study evaluated the antibacterial efficacy of chlorhexidine-chlorine dioxide (CHX-CDO) mouthwash formulations against major halitosis-related pathogens: Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Prevotella intermedia (Pi), and Eikenella corrodens (Ec). Materials and methods: Five bacterial strains were cultured anaerobically. Experimental mouthwashes with varying concentrations of CHX (0.01–0.2%) and CDO (0.05–0.1%), labeled solution A–J, were tested. Agar diffusion assays measured inhibition zones. MICs were determined by broth microdilution with 24 h anaerobic incubation and OD600 measurement. The time-kill test quantified CFUs from serial dilutions at time points (0, 1, 3, 6, 12, and 24 h). Results: All CHX-CDO mouthwash combinations inhibited bacterial growth, with A (0.05% CHX + 0.05% CDO), C (0.2% CHX + 0.05% CDO), F (0.2% CHX + 0.1% CDO), and J (CHX 0.02/CDO 0.1) showing the largest inhibition zones and G (CHX 0.01/CDO 0.05) and H (CHX 0.02/CDO 0.05) exhibiting the most favorable MIC values. Time-kill assays confirmed sustained bactericidal effects for low concentration-CHX/0.05% CDO formulations. Significant differences in antibacterial activity were observed among the formulations (p < 0.05). Conclusion: Low-dose CHX combined with 0.05% CDO mouthwash maintains antibacterial efficacy against halitosis-associated pathogens, suggesting a promising CHX dose reduction while preserving effectiveness.
Copyright (c) 2026 Thao Thi Phuong Tran, Thuy Anh Vu Pham https://creativecommons.org/licenses/by/4.0