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.
Corrosion resistance of straight and C-clasp stainless steel wrought wires in artificial saliva
Background: Stainless steel wires are commonly used in removable partial dentures, but their corrosion resistance may be affected by intraoral pH changes and mechanical deformation, such as bending into C-clasps. Objective: To evaluate the corrosion resistance of straight and C-clasp stainless steel wires in artificial saliva (pH 5.5 and 7.0) and to assess the influence of bending on corrosion behavior. Materials and methods: An in vitro experimental study was conducted using four groups of stainless steel wires: straight pH 5.5, C-clasp pH 5.5, straight pH 7.0, and C-clasp pH 7.0. The samples were immersed for 4 weeks, with weekly weight measurements and corrosion rate calculations performed. Data were analyzed using repeated measures analysis of variance (ANOVA) or the Friedman test and two-way ANOVA for intergroup comparisons. Results: Two-way ANOVA revealed a significant effect of pH on corrosion behavior (p < 0.001), whereas wire configuration had no significant effect (p > 0.05). Acidic conditions (pH 5.5) resulted in significantly greater weight loss in both straight and C-clasp wires than neutral conditions, indicating increased corrosion in acidic environments. At pH 7.0, the corrosion rates were minimal or slightly negative, suggesting limited corrosion or minor weight changes. Conclusion: Environmental pH plays a central role in corrosion behavior, with acidic conditions accelerating degradation. No significant effect of bending into a C-clasp on corrosion susceptibility was observed under the present conditions. Maintaining an optimal oral pH may help preserve the integrity of stainless steel components in removable partial dentures.
Copyright (c) 2026 Eri Hendra Jubhari, Baiq Zalfa Zahira Aurellia Nityasari, Rifaat Nurrahma https://creativecommons.org/licenses/by/4.0
Propolis–xenograft scaffolds: comparing delivery methods for tibial bone regeneration in rats
Background: Alveolar bone loss after tooth extraction may compromise implant placement and often requires regenerative treatment. Propolis, a natural compound with osteogenic and anti-inflammatory properties, may enhance bone regeneration, particularly when combined with xenograft biomaterials. This study evaluated the effects of oral and topical propolis, alone and in combination with xenograft, on bone healing in a rat tibial defect model. Materials and methods: Sixty male Wistar rats were randomly assigned to six groups (n = 10): control, oral propolis, topical propolis, xenograft, oral propolis with xenograft, and topical propolis with xenograft. Standardized tibial defects (5 × 2 × 2 mm) were created and treated accordingly. After 4 weeks, radiographic, histological, and histomorphometric analyses were performed. Outcomes included relative bone density, new bone area, and osteoblast and osteoclast counts. Data were analyzed using one-way ANOVA with Tukey post hoc test (p < 0.05). Results: Relative bone density increased from 19% in the control group to 81% in the topical propolis with xenograft group (p < 0.05). This group also showed the largest new bone area (434,196 ± 153,911 µm² vs. 89,408 ± 42,376 µm²; p < 0.001), higher osteoblast counts (178.4 ± 44.2 vs. 49.4 ± 15.2), and lower osteoclast counts compared with single-treatment groups (p < 0.001). Combination treatments, particularly topical propolis with xenograft, consistently yielded superior outcomes (p < 0.01). Conclusion: Propolis enhances bone regeneration, especially when applied topically in combination with xenograft. This approach promotes bone formation and balanced remodeling, supporting its potential for clinical application in bone regenerative therapy.
Copyright (c) 2026 Yunia Dwi Rakhmatia, Lisda Damayanti, Rasmi Rikmasari, Nuroh Najmi, Sri Tjahajawati, Eriska Riyanti https://creativecommons.org/licenses/by/4.0
Shear bond strength of three composite resins for orthodontic bracket bonding on enamel and ceramic surfaces: an in vitro study after accelerated aging
Objective: To evaluate and compare the shear bond strength (SBS) of three composite resins, Z250 (3M), Transbond XT (3M), and Brace Paste (AO), used for orthodontic bracket bonding on human enamel and ceramic surfaces, after undergoing accelerated aging. Materials and Methods: An in vitro experimental design was conducted using 30 enamel specimens (human premolars) and 30 ceramic specimens (Brava Block, FGM), divided into three subgroups per substrate (n = 10 each). All specimens were etched (37% phosphoric acid for enamel, 9.6% hydrofluoric acid for ceramic), treated with silane (ceramics), and bonded using the designated composite resins. Specimens were subjected to an autoclave aging protocol. SBS was measured using a universal testing machine, and statistical analysis included Analysis of Variance (ANOVA), t tests, and chi-square tests (α = 0.05). Results: Transbond XT exhibited the highest mean SBS on ceramic surfaces (10.4 ± 5.2 MPa), while Brace Paste showed the highest SBS on enamel (7.3 ± 2.4 MPa). However, no statistically significant differences were observed among the composite resins in either substrate (p > 0.05). All materials demonstrated SBS values within or close to the clinically acceptable range for orthodontic bonding (approximately 6–8 MPa). Conclusion: Although numerical differences were found, all three composite resins demonstrated comparable performance. When appropriate surface conditioning protocols are applied, any of the tested materials can be considered reliable for bracket bonding to both enamel and ceramic substrates. Further in vivo studies are recommended to validate long-term durability.
Copyright (c) 2026 Melina Nohemi Atarihuana Diaz, Mauricio Aguirre Balseca, Marjory Elizabeth Vaca Zapata, Karina Maria Salvatore Freitas, Krisnaya Muñoz https://creativecommons.org/licenses/by/4.0
Pull-off bond strength of orthodontic molar bands cemented to enamel with novel calcium silicate, glass ionomer, and zinc phosphate cement
Aim: This in vitro study compared the pull‑off bond strength of orthodontic molar bands cemented to enamel using a novel fast‑setting and bioactive calcium silicate cement (CSC), a glass ionomer cement (GIC), and a zinc phosphate cement after 1 month of storage in phosphate‑buffered saline (PBS). Materials and Methods: Ninety extracted human molars were randomly allocated to three groups and fitted with orthodontic molar bands. Bands were cemented using a novel fast‑setting CSC (Protooth), a GIC (Orthocem B), or a zinc phosphate cement (DeTrey Zinc) according to manufacturers’ instructions. After storage in PBS for 28 days, band debonding was performed using a universal testing machine in a wire‑loop pull‑off configuration at a cross‑head speed of 1 mm/min. The maximum load at failure was divided by the band surface area to calculate pull‑off bond strength (MPa). Data were analyzed using the Kruskal–Wallis test followed by pairwise Mann–Whitney U tests with Holm–Bonferroni correction (α = 0.05). Results: The median pull‑off bond strength of the CSC was 1.22 MPa (interquartile range [IQR]: 0.93–1.34 MPa), which was significantly higher than that of the GIC 0.50 MPa (IQR: 0.33–0.79 MPa; p < 0.05). No statistically significant difference was observed between the CSC and zinc phosphate cement 0.92 MPa (IQR: 0.61–1.23 MPa; p ≥ 0.05). All specimens exhibited similar failure modes, with less than 30 % cement remaining on enamel following debonding. Conclusions: Within the limitations of this in vitro study, the novel fast‑setting CSC demonstrated pull‑off bond strength similar to zinc phosphate cement and significantly higher than GIC after 1 month of storage in PBS. Further studies are required to evaluate the clinical performance and long‑term behavior of this material.
Copyright (c) 2026 Mariantonietta Leo, Ishan El Khadery, Michel Dalstra, Dirk Leonhardt, Bahram Ranjkesh, Henrik Løvschall https://creativecommons.org/licenses/by/4.0
Effect of food-simulating liquids on flexural strength, Vickers microhardness, and surface roughness of IPS e.max Press and CEREC Tessera
Background: Lithium disilicate ceramics are widely used for indirect restorations, yet their mechanical performance may be influenced by fabrication route and chemical challenge from foods and beverages. Objective: To compare the effects of food-simulating liquids (FSLs) on flexural strength, Vickers microhardness, and surface roughness of pressed lithium disilicate (IPS e.max Press) and Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) advanced lithium disilicate (CEREC Tessera). Materials and methods: One hundred fifty rectangular specimens were prepared using IPS e.max Press and CEREC Tessera (n = 75 each) and allocated into five groups per material (n = 15): one unconditioned control group, artificial saliva (7 days at 37°C), 0.02% citric acid, 20% ethanol, or 50% ethanol. Citric acid and ethanol groups underwent three 5-minute challenge cycles followed by re-storage in artificial saliva. Flexural strength was assessed by three-point bending. Microhardness (Vickers HV1/10) and surface roughness (Ra) were measured on independent specimens. Data were analysed using two-way analysis of variance with Tukey’s post hoc test for flexural strength and surface roughness. For microhardness, factorial analysis was limited to the comparable shared conditions because ethanol-exposed IPS e.max Press specimens did not yield reliable Vickers measurements. Results: CEREC Tessera showed higher flexural strength than IPS e.max Press across conditions (control: 362.6 ± 15.4 vs 331.0 ± 8.5 MPa). Ethanol reduced strength in both materials, with the greatest reduction in 50% ethanol (238.0 ± 9.6 vs 147.4 ± 7.5 MPa). Across comparable conditions, CEREC Tessera also showed higher microhardness, while reliable Vickers measurements could not be obtained for ethanol-exposed IPS e.max Press specimens. Surface roughness increased after acidic and alcoholic exposure in both materials, although CEREC Tessera remained smoother overall (control: 0.06 ± 0.02 vs 0.67 ± 0.36 µm). Conclusion: CEREC Tessera demonstrated superior flexural strength, microhardness, and surface integrity compared with IPS e.max Press after exposure to FSLs, suggesting that fabrication route influences laboratory performance under chemical challenge.
Copyright (c) 2026 Asmaa Abdeewi, Seham A. Elsawaay, Ahmed A. Mhanni, Abubaker Qutieshat https://creativecommons.org/licenses/by/4.0
Evaluation of non-carious cervical restorations with different cavity configurations: a microscopy and OCT analysis
The aim of this in vitro study was to assess marginal and internal gap formation in simulated non-­carious cervical lesions (NCCLs) of different cavity configurations and restored with either bulk-fill or nanofilled resin composite, before and after thermocycling. NCCLs with 2.3 mm diameter and approximately 3.5 mm3 volume were prepared in 40 human molars in two cavity configurations (n = 20): saucer (1.3 mm depth) or wedge (1.9 mm depth) shape. The adhesive Clearfil SE Bond was used in all groups. These cavities were randomly divided according to the resin composite used (n = 10): Filtek Z350 XT or Filtek One Bulk Fill Restorative. The marginal and internal adaptation of the composite at cavity margins was assessed before and after thermal aging (TA) (5000 cycles between 5 and 55°C) using a plane light microscope and optical coherence tomography (OCT), respectively. The 3D images captured by OCT were analyzed by obtaining 16 B-scans per specimen using a custom-made script for software MATLAB R2019a, Update 3. Data were analyzed by two-way analysis of variance and paired t-tests (α = 0.05). Regarding the marginal gap, there was no statistically significant difference between the saucer and wedge cavity configurations, before or after TA, nor between cavities restored with bulk-fill or nanofilled composite (p > 0.05). Likewise, for the internal gap, no significant differences were found for the cavity configuration nor the resin composite (p > 0.05). Restorations placed in saucer or wedge cavity configurations showed similar marginal and internal adaptation, regardless of the type of resin composite, and gap formation was not aggravated by thermocycling.
Copyright (c) 2026 Ayla Macyelle de Oliveira Correia, Peter Hamilton Tomlins, Robert William Read, Taciana Marco Ferraz Caneppele, Eduardo Bresciani, Ana Raquel Benetti https://creativecommons.org/licenses/by/4.0
Influence of repetitive diamond bur use on the trueness and surface roughness of subtractively manufactured PICN restorations
Objectives: Progressive diamond bur degradation during the subtractive manufacturing (SM) of polymer-infiltrated ceramic networks (PICNs) compromises restorative clinical quality. To evaluate the degradation extent across two SM systems and investigate its effects on the trueness and surface roughness of PICN crowns. Materials and Methods: A total of 121 premolar crowns were fabricated from PICN blocks (Vita Enamic) using two SM machines (PrograMill PM7 and inLab MC X5). Crown trueness was quantified by superimposing crown scans onto the original digital design using three-dimensional inspection software (Geomagic Control X) and reported as the root-mean-square (RMS) ± standard deviation (µm). Surface roughness (Ra, Sa, Sq) was measured using confocal microscopy. Bur degradation was assessed after every five crown fabrications using machine-reported lifespan, surface roughness, and color deviation maps. Diamond bur tips, before and after use, were examined using scanning electron microscopy to characterize wear patterns. Statistical comparisons were performed both between and within machines using Welch’s Analysis of Variance (ANOVA) (p < 0.05). Results: Significant differences were observed in regional trueness (p < 0.0001): the PM7 yielded more accurate intaglio (inner) surfaces (22.21 ± 4.31 µm), while the MC X5 achieved higher external surface trueness (17.89 ± 2.76 µm). Bur degradation led to distinct error modes – whereas the PM7 exhibited a significant increase in negative deviations (overmilling), the MC X5 predominantly resulted in under-milled surfaces but with less impact from bur degradation. Crown surface roughness also differed between the two SM systems. While a consistent decreasing trend in surface roughness was observed in the MC X5 with repetitive milling cycles, the PM7 showed an initial decline followed by an accelerated increase after the 55th crown. Conclusions: The rate and extent of bur degradation varied by systems, causing distinct impacts on crown quality. Degradation in the PM7 predominantly resulted in adverse over-milling errors, whereas the MC X5 was more likely to cause inadequate material removal. System-specific degradation mechanisms substantially affect the ultimate quality of restorations. Surface roughness initially decreased in both SM systems; however, the systems followed divergent late-stage trajectories – one maintained a downward trend while the other exhibited a U-shaped recovery.
Copyright (c) 2026 Xiaoyun Liu, Andrew B. Cameron, Ketil Hegerstrøm Haugli, Adriane Andersen Mougios, Nicholas C. K. Heng, Joanne Jung Eun Choi https://creativecommons.org/licenses/by/4.0
Evaluation of physicomechanical and optical properties of bioactive glass (BAG)-filled resin composites: an in vitro study
Objective: To evaluate the behavior of bioactive glass (BAG)-filled resin composites (Beautifil II / Shofu—BR and Beautifil Flow Plus / Shofu—BF) compared with conventional resin composites (Filtek Z350 XT / Solventum—ZR and Filtek Supreme Flowable Restorative / Solventum—FS) by means of microhardness, sorption, solubility, and color stability tests. Materials and methods: For these analyses, ten specimens were fabricated per group using a split metal mold (15 mm in diameter × 1 mm thickness). Microhardness (n = 10) was measured using a digital microhardness tester, based on the mean of three indentations per specimen under a 2.94 N load for 15 s. For the sorption and solubility tests, five out of the 10 specimens used in the microhardness assays were randomly selected (n = 5), and ISO 4049/2019 recommendations were followed. Color stability was assessed using a digital spectrophotometer by comparing specimens immersed in coffee (using the five specimens not selected for the sorption and solubility tests / n = 5) and distilled water (control, using the same specimens from the sorption and solubility tests), with measurements obtained at baseline, after 1 day, and after 1 week of immersion. Color change (ΔE) was calculated using CIELAB parameters. Results: For microhardness, the high-viscosity resin composites (ZR and BR) showed significantly higher mean values than their low-viscosity versions (p < 0.001). Although sorption differed significantly among groups (p = 0.001), all resin composites exhibited values within the limits established by ISO 4049/2019. No statistically significant differences were observed for solubility. Regarding color stability, after 7 days in coffee, BR and ZR exhibited the greatest color changes (ΔE). Despite the observed statistical differences, the changes remained within acceptable clinical limits. Conclusion: BAG-filled resin composites exhibit properties comparable to those of conventional resin composites. The ZR resin composite showed higher microhardness; however, for the other evaluated parameters (sorption, solubility, and color stability in coffee), the tested resin composites exhibited values within the limits recommended by ISO 4049:2019 and were comparable to those of the reference conventional high- or low-viscosity resin composite.
Copyright (c) 2026 Yan Victor Silva de Santana, Emanuel Ewerton Mendonça Vasconcelos, Gabriela Queiroz de Melo Monteiro, Agna Roberta Xavier Bezerra, Luis Felipe Espíndola-Castro https://creativecommons.org/licenses/by/4.0
Hazard assessment of resin-based dental monomers: directions for greener dental material development
Introduction: The increasing use of resin-based dental materials has prompted questions about their environmental footprint. During clinical procedures, small amounts of unpolymerized monomers may enter wastewater systems, and their possible effects on aquatic invertebrates remain insufficiently explored. We hypothesized that commonly used resin-based dental monomers could exert developmental and cellular effects in an aquatic invertebrate model. Materials and Methods: The acute and sublethal effects of five monomers associated with dental composites, namely – BPA (bisphenol A), Bis-DMA (bisphenol A dimethacrylate), Bis-GMA (bisphenol A-glycidyl methacrylate), Bis-EMA (bisphenol A ethoxylate dimethacrylate), and TEG-DMA (triethylene glycol dimethacrylate) – were evaluated in Artemia salina at both cyst and naupliar stages. The effects on naupliar survival, body length, and Lactate dehydrogenase (LDH) activity were measured to assess compound-specific biological responses. Results: Bis-GMA, Bis-DMA, and BPA significantly reduced survival, while Bis-EMA caused modest mortality, and TEG-DMA had no effect. Despite these differences in survival, most monomers affected naupliar growth, with greater developmental sensitivity observed following cyst-stage exposure. However, growth responses were compound specific and not uniformly dose-dependent across all monomers. LDH responses were monomer specific: Bis-GMA and Bis-DMA increased LDH activity, although Bis-DMA showed no consistent effect on growth, whereas BPA and TEG-DMA showed reductions in LDH activity, despite observed growth inhibition, and Bis-EMA showed no significant change. Conclusion: Taken together, our findings show that dental resin monomers differ in their developmental and metabolic impacts, highlighting the importance of considering safety alongside clinical performance when designing and selecting dental biomaterials. As the concentrations used were for hazard screening, these results indicate possible biological effects under controlled conditions but do not necessarily reflect environmental exposure scenarios or ecological risk. Additional studies at environmentally relevant exposure levels are needed to better evaluate ecological safety and support the development of more sustainable dental materials.
Copyright (c) 2026 Mahmoud Abdelrahman Alatteili, Hamzeh ‘Ayed El-Amin’ Hassan Abid, Mohammad Talat Elsharkawy, Abdulmalik Saqer Mohammad Salti, Esraa Esam Mowafaq Shammamah, Rawan Yassin Nimir, Homa Darmani https://creativecommons.org/licenses/by/4.0
Influence of expanded graphene on physical and chemical properties, and in vitro toxicity of glass ionomer cements for luting
Objective: To evaluate physical and chemical properties and in vitro toxicity of six luting glass ionomer cements (GICs) – Vidrion, Vitro Cem, Meron, Gold Label (GCGL), GC Fuji Plus (GCFP), and Riva Luting – incorporated with expanded graphene to correct the GICs’ deficiencies. Methodology: Expanded graphene was incorporated into GICs at concentrations of 0.25%, 0.5%, and 1%. Disc-shaped specimens (4 × 2 mm) were fabricated and submitted to an erosive challenge (EC) by immersion in 30 mL of lactic acid/lactate solution (pH 2.74) for 24 h at 37°C. Thickness, surface roughness (Ra), and microhardness were evaluated before and after EC. Fluoride release was measured in the acid solution. Radiopacity was evaluated in specimens (15 ± 1 mm; n = 3), and gray values were analyzed with ImageJ. Cytotoxicity was assessed by the neutral red uptake assay using L929 fibroblasts exposed to DMEM extracts. Results: No microhardness loss after EC was observed in Vitro Cem 0.25% (p = 0.056) and 0.5% (p = 0.457) or Meron 0.5% (p = 0.167), while Vidrion 0.5% showed increased hardness (p < 0.001). Surface roughness remained unchanged in Meron, GCGL, and Riva Luting. Riva Luting containing 0.25% (p < 0.01) and 1% rGO (p < 0.01) released more fluoride compared with the control. GCGL showed improved cell viability at all expanded graphene concentrations. Vidrion demonstrated greater radiopacity with expanded graphene addition, and Meron exhibited enhanced radiopacity at all concentrations. Worsening effects were observed, including reduced fluoride release in GCFP 1% (p < 0.05), decreased cell viability in GCFP (45% reduction), Meron, and Vitro Cem at all percentages, and increased microhardness loss in Vitro Cem 1%, Meron 0.5%, and GCFP at all concentrations. Conclusion: Expanded graphene incorporation produced positive, neutral, and negative effects depending on the GIC and concentration.
Copyright (c) 2026 Sarah Pereira Martins, Carolina Mara Geraldino Monteiro, Renan Rocha da Silva, Andrea Vaz Braga Pintor, Marcela Baraúna Magno, Maria Augusta Visconti, Maria Teresa Villela Romanos, Livia Rodrigues de Menezes, Lucianne Cople Maia, Matheus Melo Pithon https://creativecommons.org/licenses/by/4.0
Biomechanical behavior of fiber-reinforced and bulk-fill composites in extensive class II restorations: a three-dimensional finite element analysis
Introduction: Owing to the complexity of dental architecture and the ongoing development of restorative materials, the biomechanical behavior within restored dental structures is not yet fully understood. Objective: This study aimed to evaluate and compare the stress distribution in extensive Class II restorations reinforced with different composite systems using 3D-Finite Element Analysis (FEA). Materials and Methods: A sound human mandibular first molar was digitized to generate a 3D solid model. Five experimental groups with mesio-occluso-distal (MOD) restorations were simulated: G1, bulk-fill composite core; G2, short fiber–reinforced composite (SFRC) core; G3, ultra-high molecular weight polyethylene (UHMWPE) fiber–reinforced core; C−, conventional nanohybrid composite; and C+, intact sound tooth. All restored groups received an occlusal and proximal veneering layer of conventional nanohybrid resin. A vertical load of 600 N was applied, and von Mises and maximum principal stresses were calculated. Results: The UHMWPE group exhibited the most favorable stress distribution, demonstrating the lowest stress concentrations in the coronal tooth structure (353.5 MPa) and the adhesive interface (11.10 MPa). Conversely, the SFRC group presented the highest stress values in the remaining tooth structure (359.9 MPa), while the bulk-fill group recorded elevated stress peaks within the veneering material (21.29 MPa). Notably, the polyethylene core absorbed the highest internal stress (13.31 MPa) compared to the other experimental groups. Conclusions: The type of structural reinforcement significantly dictates the biomechanics of Class II restorations. A core reinforced with polyethylene fibers (Ribbond THM) demonstrates a superior capacity to manage stress in high-load areas compared to SFRC (EverX Posterior) and bulk-fill composite (Tetric N-Ceram bulk fill).
Copyright (c) 2026 Luisfelipe Carlos Alarco-Jurado, Luis Felipe Alarco-La Rosa, Fredy Hugo Cruzado-Oliva https://creativecommons.org/licenses/by/4.0
Effect of fluoride toothpastes on surface roughness of nickel–titanium wires: an in vitro study
Objective: The main objective of this in vitro study was to determine the effect of toothbrushing with fluoride and natural fluoride-free toothpastes on surface roughness changes of nickel-titanium (NiTi) wires as an indirect indicator of corrosion-related surface degradation. Materials and Methods: Thirty rectangular superelastic NiTi wires (0.019 × 0.025”, 20 mm length; Orthometric) were randomly assigned to three groups (n = 10 each): Group 1 – fluoride toothpaste with brushing; Group 2 – fluoride toothpaste without brushing; Group 3 – fluoride-free toothpaste with brushing. Brushing was simulated with an electric toothbrush twice daily for 1 min over 28 days (cumulative 1 h). Initial and final surface roughness (Rz, µm) was measured using a portable roughness tester. Data were analyzed using paired Student’s t-test and ANOVA with Tukey post hoc comparisons (p < 0.05). Results: Significant increases in surface roughness were observed in Group 1 (0.717 ± 0.085 to 2.440 ± 0.225 µm; p < 0.001) and Group 2 (0.791 ± 0.082 to 1.904 ± 0.247 µm; p < 0.001). In contrast, Group 3 showed only a slight and non-significant increase in surface roughness (p = 0.167). Intergroup analysis revealed significant post-treatment differences (p < 0.001), with Tukey’s test distinguishing three subsets: Group 1 > Group 2 > Group 3. Conclusions: Fluoride-containing toothpaste, particularly when combined with brushing, significantly increased surface roughness of NiTi wires, likely due to fluoride-induced degradation of the protective titanium oxide layer, which increases susceptibility to surface deterioration. Clinically, these findings suggest that fluoride-free formulations may represent a safer alternative for orthodontic patients requiring prolonged use of NiTi wires.
Copyright (c) 2026 Karen Lisette Vega Bravo, Marjory Elizabeth Vaca Zapata, Mauricio Aguirre Balseca, Karina Maria Salvatore Freitas, Yalil Rodríguez https://creativecommons.org/licenses/by/4.0
Evaluation of an orthodontic adhesive containing 2 wt% nano-hydroxyapatite synthesized from a biogenic calcium precursor: antibacterial activity, calcium ion concentration, and enamel demineralization
Objective: Enamel demineralization and white spot lesions remain common adverse effects during fixed orthodontic treatment, primarily due to plaque accumulation around brackets and the limited functionality of conventional orthodontic adhesives. This study aimed to evaluate the effect of incorporating 2 wt% nano-hydroxyapatite (nHAp), synthesized using a biogenic calcium precursor derived from Asian moon scallop (Amusium pleuronectes) shells, on antibacterial activity, calcium ion concentration, and enamel demineralization. Materials and Methods: nHAp powder was synthesized from scallop shell-derived calcium carbonate via calcination and precipitation methods and incorporated into a commercial orthodontic adhesive under controlled conditions. Antibacterial activity against Streptococcus mutans was assessed using a disc diffusion assay. Calcium ion concentration in the immersion medium was measured using UV-Vis spectrophotometry (λ = 515 nm) with a murexide indicator. Enamel demineralization adjacent to bracket interfaces was evaluated using a standardized scoring system. Statistical analysis was performed using appropriate parametric and non-parametric tests with significance set at p < 0.05. Results: The nHAp-modified adhesive showed significantly greater antibacterial activity compared with the control group (p < 0.05). The experimental group demonstrated higher calcium ion concentration in the immersion medium than the control group. Enamel demineralization scores were significantly lower in the experimental group. Conclusion: Within the limitations of this in vitro study, incorporation of 2 wt% nano-hydroxyapatite synthesized using a biogenic calcium precursor was associated with increased antibacterial activity, higher calcium ion concentration in the surrounding medium, and reduced enamel demineralization. Further studies are required to evaluate mechanical properties and clinical applicability
Copyright (c) 2026 Gufa Bagus Pamungkas, Eddy Heriyanto Habar, Maria Tanumihardja, Rasmidar Samad, Stang, Eka Erwansyah, Nurlindah Hamrun https://creativecommons.org/licenses/by/4.0
Comparison of physico-mechanical properties of 3D-printed resins used as permanent indirect restoration materials
Objective: To compare the physico-mechanical properties (microhardness, surface roughness, and flexural strength) of permanent 3D-printed dental resins with those of a resin nanoceramic computer-aided design and computer-aided manufacturing (CAD/CAM) block and a composite resin. Methods: Four groups were tested: composite resin (Clearfil Majesty Esthetic), resin nanoceramic CAD/CAM block (Cerasmart), and two 3D-printed resins (Saremco Crowntec, VarseoSmile Crown Plus). Disk- and bar-shaped specimens were prepared according to ISO standards. Microhardness (Vickers test), surface roughness (profilometer), and flexural strength (three-point bending test) were evaluated. Data were analyzed using analysis of variance and Tukey post hoc tests (p < 0.05). Results: Cerasmart showed the highest microhardness (85.53 ± 3.97) and flexural strength (184.45 ± 9.42), while Saremco Crowntec exhibited the lowest microhardness (38.63 ± 2.14). Clearfil Majesty had the highest surface roughness (1.24 ± 0.35). Although the measured flexural strength values of 3D-printed resins exceeded the ISO 4049 minimum threshold, several samples were close to or below the limit. Conclusions: Within the limitations of this in vitro study, 3D-printed permanent resins exhibited mechanical properties comparable to conventional restorative materials in certain parameters, although inferior hardness values were observed compared to CAD/CAM blocks. Nevertheless, the present findings should be interpreted with caution, and further long-term clinical investigations are necessary before translating these results into clinical practice.
Copyright (c) 2026 Merve Arıkan, Serdar Akarsu https://creativecommons.org/licenses/by/4.0
Preliminary evaluation of a lemongrass-based nanoparticle gel for antibacterial control of Enterococcus faecalis: an in vitro study
Background: The search for biocompatible antimicrobial agents in endodontics has driven interest in phytotherapeutic compounds, including Cymbopogon citratus (lemongrass). This study aimed to perform a preliminary evaluation of the antibacterial potential of a lemongrass-based nanoparticle gel against Enterococcus faecalis. Materials and methods: Lemongrass leaves were collected, authenticated, and processed using different extraction methods. The most effective extract was selected for green synthesis of silver nanoparticles and incorporated into a 1% hydroxyethyl cellulose gel. Antibacterial activity against E. faecalis (ATCC 29212) was assessed by colony-forming unit (CFU/mL) quantification, agar well diffusion, and minimum inhibitory concentration (MIC) determination using resazurin. A 2.5% sodium hypochlorite (NaOCl) gel and 2% chlorhexidine (CHX) digluconate gel were used as positive controls, and a vehicle gel served as the negative control. Data were analyzed using Student’s t-test and the Wilcoxon test (α = 0.05). Results: The nanoparticulate lemongrass gel demonstrated significantly greater antibacterial activity than the non-nanoparticulated extract (p < 0.05), showing higher CFU/mL reduction and larger inhibition zones. The nanoparticle formulation maintained inhibitory activity at lower concentrations (MIC 50%) compared with the natural extract. Antibacterial performance of the nanoparticulate gel was comparable to CHX and superior to NaOCl in CFU reduction, while inhibition zones were similar to both controls. Conclusions: Nanoparticle incorporation significantly enhances the antibacterial efficacy of C. citratus against E. faecalis. The lemongrass-based nanoparticulate gel represents a promising alternative for use as a chemical auxiliary substance in endodontic treatment.
Copyright (c) 2026 Luedyna Rayane Rodrigues Leite, Maria Olívia da Costa, Álvaro de Souza Wanderley, Giovana Soriano Neiva, Carolina de Albuquerque Lima Duarte, Pedro Henrique Sette-de-Souza, Marlos Barbosa-Ribeiro https://creativecommons.org/licenses/by/4.0
Cytotoxicity evaluation of different clear aligner systems on human primary gingival fibroblasts: an in vitro study
Background: Clear aligners, widely adopted in modern orthodontics, are designed to stay in constant contact with the oral mucosa for extended durations. Persistent concerns exist about the possible leaching of cytotoxic agents like bisphenol-A from these materials, which have heightened the need for rigorous biocompatibility evaluation. Among various assays, the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide) assay is a reliable in vitro method, which assesses metabolic activity and cell viability, making it a gold standard for cytotoxicity screening. Objective: The objective was to assess and contrast the potential cell-damaging effects of three different clear aligner brands – Invisalign®, Smile® Aligners, and Illusion® Aligners using the MTT assay on human gingival fibroblasts (HGFs). Methods: Aligner pellets were immersed in normal saline for 30 days at 37°C. Eluents were diluted to 5, 10, and 20% concentrations. HGFs were exposed to these eluents for 48 hours, and cytotoxicity was assessed via MTT assay. To assess the survival rate of the cells, light absorbance was recorded at a wavelength of 570 nanometers. Results: Invisalign® showed the highest biocompatibility (97–98% viability across concentrations), followed by Smile® Aligners (94–99%). Illusion® Aligners exhibited significant cytotoxicity (80–92% viability), with a dose-dependent decline (p < 0.05). Conclusion: Material composition critically influences cytotoxicity. Invisalign® and Smile® Aligners are a safe options, while Illusion® Aligners require further refinement for clinical safety. These results highlight the need for transparency in material composition and standardization in manufacturing protocols for all aligner systems to ensure patient safety.
Copyright (c) 2026 Rituparna Pronajit Das, Parag Vishnu Gangurde, Alok Ranjan, Shashank Sharad Gaikwad, Hitesh Ramdas Sawant, Manav Karia https://creativecommons.org/licenses/by/4.0
Impact of red propolis addition on the color stability and surface roughness of glass ionomer cements
Objective: The present study aimed to evaluate the surface roughness (SR) and color stability of ­conventional restorative glass ionomer cements (GICs) modified with the addition of red propolis ethanolic extract (RPEE) as an antimicrobial agent. Methodology: Four GICs (Riva, Maxxion, Vidrion, and Ketac) were used with the addition of RPEE at ­concentrations of 11% and 20%. For the control groups, the GICs were manipulated according to the manufacturers’ instructions. SR was assessed using a surface profilometer. For the color variation analysis, the specimens’ colors were measured in the CIE Lab* color space using a spectrophotometer. The Kruskal–Wallis test, followed by Dunn’s test, was used to evaluate statistical significance. Results: The addition of RPEE did not negatively affect the SR of Riva, Maxxion, and Ketac GICs (p = 0.796, p = 0.111, and p = 0.858, respectively). By contrast, a significant reduction in SR was observed in Vidrion GIC with the addition of RPEE (p = 0.009). When comparing the different GIC brands, Riva and Ketac exhibited the lowest SR, with significant differences relative to Vidrion (p = 0.008) and Maxxion (p = 0.006). Both RPEE concentrations (11% and 20%) caused major color changes in all GICs tested, with no statistical differences between the two concentrations (p = 1.000), nor among the different GIC brands (p = 0.071). Conclusion: The incorporation of RPEE into conventional GIC did not increase SR, though in the case of Vidrion cement, it resulted in a significant reduction of this parameter. Conversely, the addition of red propolis at both 11% and 20% concentrations caused significant and clinically unacceptable color changes in all tested cements, regardless of brand or concentration.
Copyright (c) 2026 Giovanna Kelly Melo de Lima Sampaio, Pedro Henrique Sette-de-Souza, Basílio Rodrigues Vieira, Geisa Aiane de Morais Sampaio https://creativecommons.org/licenses/by/4.0
Effect of output intensity of light curing unit on coronal tooth discoloration induced by silicate calcium-based materials: an ex vivo study
Objective: Clinicians have various curing options due to new light-cure devices with different intensities. The present study aimed to evaluate the effect of two light-curing intensities (1,200 mW/cm² vs. 3,000 mW/cm²) on coronal discoloration induced by two calcium silicate-based cements (OrthoMTA and RetroMTA) in an endodontically treated bovine tooth model. Materials and Methods: Forty single-rooted bovine incisors were prepared, and their canals were filled with blood-soaked foam to the cemento-enamel junction. The samples were randomly divided into four groups (n = 10 per group) based on the cement used (OrthoMTA or RetroMTA) and the subsequent light-curing intensity. For all groups, a 2-mm layer of the assigned cement was placed. This was covered by 1 mm of resin-modified glass ionomer (RMGI), a bonding agent, and 2 mm of composite. In two groups, all light-curing steps (RMGI, bonding agent, composite) were performed at 1,200 mW/cm². In the other two groups, curing was performed at 3,000 mW/cm². All samples underwent 5,000 cycles of thermocycling. Color was assessed with a spectrophotometer immediately after composite placement and after aging. Color change (ΔE) and lightness change (ΔL) were calculated. Results: All groups exhibited ΔE values exceeding the clinically acceptable threshold (ΔE > 3.3) and demonstrated a decrease in ΔL after aging. Statistical analysis (two-way ANOVA, α = 0.05) revealed no significant difference in ΔE or ΔL between samples cured with high-intensity (3,000 mW/cm²) or low-intensity (1,200 mW/cm²) light, regardless of the cement type used (p > 0.05). Conclusions: Within the limitations of this study, the same amount of energy produced by high- or low-intensity light-cures (1,200 or 3,000 mW/cm²), when delivering the same total energy, did not result in a statistically significant difference in coronal discoloration caused by OrthoMTA or RetroMTA.
Copyright (c) 2026 Fatemeh Farshad, Noushin Shokouhinejad, Parham Pedram, Mohammad Javad KharaziFard, Elham Ahmadi https://creativecommons.org/licenses/by/4.0
Comparative evaluation of Calotropis gigantea latex and sodium hypochlorite as tissue-dissolving agents – an in vitro study on concentration and time-dependent proficiency
Background: Complete removal of organic tissue and microorganisms from the root canal system is essential for successful endodontic therapy. Sodium hypochlorite (NaOCl) remains the gold standard irrigant for its tissue-dissolving and antimicrobial properties, but its cytotoxicity and adverse effects have encouraged exploration of safer herbal alternatives. Calotropis gigantea (milkweed) latex contains proteolytic enzymes such as calotropin and calotoxin, which may offer effective organic tissue dissolution with improved biocompatibility. Aim: To evaluate and compare the tissue-dissolving potential of C. gigantea latex at two concentrations (5 and 10%) with 5.25% NaOCl at different exposure times. Methodology: An in vitro experimental study was conducted on pulp tissues extracted from freshly removed human teeth (n = 30). Samples were equally divided into three groups: 5% C. gigantea latex, 10% C. gigantea latex, and 5.25% NaOCl. Tissue samples were immersed for 10 minutes and 15 minutes, and weight reduction was measured using an analytical balance. Data were analysed using one-way analysis of variance and Tukey’s post hoc test with a significance level of p < 0.05. Results: The mean initial tissue weights were comparable among groups (p = 0.656). After 10 minutes, significant differences in weight reduction were observed (p < 0.001). Tukey’s post hoc test showed that 10% C. gigantea latex dissolved significantly more tissue than both 5% latex and NaOCl (p < 0.001). After 15 minutes, this difference persisted (p < 0.001). The 10% latex achieved the highest mean weight loss at both intervals, while no significant difference was observed between 5% latex and NaOCl. Conclusion: The 10% C. gigantea latex solution showed higher tissue-dissolving ability compared to 5.25% NaOCl under static in vitro conditions. Clinical applicability requires further evaluation of activation methods, cytotoxicity, dentin interaction, and antimicrobial efficacy.
Copyright (c) 2026 Megavarnan Ravi, Praveena Annadurai, Ramlakhan Gupta https://creativecommons.org/licenses/by/4.0
Surface roughness and microhardness of 3D printed denture base resins when printed with different printers
Objective: This study aimed to investigate the influence of using different printers on surface roughness and hardness of different 3D printed dentures. Methods: Three denture base resins (ASIGA, NextDent, and FormLabs) were printed with one of two printers: ASIGA or NextDent. Surface roughness was measured with a non-contact profilometer, while a surface hardness tester was used to measure Vicker’s hardness values. One-way and Two-way analysis of variance (ANOVA), and t-test were used to compare means with a significance level set at 0.05. Results: FormLabs and NextDent specimens showed different hardness values when different printers were used (p < 0.001), while ASIGA specimens had no difference (p = 0.072). Roughness values were similar with NextDent specimens printed with different printers (p = 0.053), while ASIGA and FormLabs specimens’ roughness values were significantly influenced by the printer used (p < 0.001). When printed with ASIGA, ASIGA and NextDent specimens had similar hardness values, which were higher than FormLabs specimens. When NextDent printer was used, ASIGA specimens showed superior hardness values compared to NextDent and FormLabs. When comparing surface roughness of different resin specimens printed with the same printer, differences were observed among all specimens (p < 0.001). Conclusions: The type and brand of the printer used can affect surface properties of printed dentures. When the same printer was used, surface roughness and hardness were significantly different among all resin materials. The choice of resin material and printer combination affects both surface roughness and microhardness. Clinical Significance: The choice of resin material and printer type may significantly impact the microhardness and surface roughness of 3D printed dentures. Careful material and printer selection is essential to ensure optimal clinical performance and longevity of prostheses.
Copyright (c) 2026 Faisal D. Al-Qarni 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 to dentin
This study evaluated the impact of different surface treatments – cold atmospheric plasma (CAP), airborne particle abrasion (APA), hydrofluoric acid (HF), and their combinations – on the bond strength of two zirconia types (3Y-TZP, 5YSZ) to dentin using self-adhesive resin cement, with or without primer. Two hundred zirconia and dentin specimens underwent surface treatment, cementation, thermocyclic aging, and shear bond strength (SBS) testing. Results showed APA and CAP significantly enhanced SBS (P < 0.001), while HF had no effect. Combined treatments (APA+CAP, CAP+HF) slightly reduced SBS. Primer application improved SBS across all groups. APA or CAP with a 10-MDP primer achieved the highest SBS values. CAP is a viable alternative to APA, though APA remains cost effective. HF is not recommended for surface treatment of zirconia. CAP exhibited a slightly higher, yet statistically comparable, SBS between zirconia and dentin when compared with APA. Nonetheless, APA may still represent the simplest and most cost-effective technique available to date. The combination of APA and CAP might not be recommended, as it showed a slight reduction in SBS of the tested specimens and inefficiency in terms of time and energy. Hydrofluoric acid showed no impact on SBS when combined with CAP. Both 3Y-TZP and 5YSZ can provide adequate clinical bond strength with the proper surface treatment and adhesive protocol.
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, Muhammad Sohail Zafar 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
Eggshell sourced hydroxyapatite as a bone regenerative material in dentistry – a narrative review
Although bone is a dynamic connective tissue with inherent regenerating potential, grafting materials are frequently needed to recuperate shape and function in cases of bone defects. Eggshell-derived hydroxyapatite (EHA) and its nano-form (EnHA) have become viable alternatives because of their availability, affordability, osteoconductivity, biocompatibility, and environmental friendliness. Human studies evaluating the clinical potential of EHA/EnHA in bone regeneration that were published between 2014 and 2024 were reviewed. A total of seven trials with 112 patients and 88 intervention locations were included in this narrative review. EHA showed promising results in improving bone density, volume, and healing time across a variety of motives including socket preservation, intrabony defects, apicoectomy, and cystic lesions. When paired with platelet-rich fibrin, EnHA consistently demonstrated better healing than ungrafted areas and equivalent outcomes to conventional grafts, such as demineralised freeze-dried bone allograft and synthetic hydroxyapatite. Significant improvements in bone density and the production of new trabecular bone were confirmed by radiographic and histomorphometric investigations. The therapeutic viability of materials generated from eggshells is further supported by their high calcium content, non-cytotoxic profile, and efficient high-temperature sterilising. However, there are drawbacks, such as inconsistent resorption rates, a dearth of long-term randomised controlled studies, and a lack of established preparation procedures. Large multi-centre studies, long-term result validation, and manufacturing process optimisation should be the main areas of future study. However, with the existing literature, EHA and EnHA are found to be affordable, biocompatible, and sustainable substitutes for conventional graft materials in bone repair and regeneration in dentistry.
Copyright (c) 2026 Konathala SV Ramesh, Mopati Nishanth Reddy Gokul, Penmetsa S Gautami, Naga Venkata SG Sruthima, Pasupuleti Mohan Kumar, Kanakamedala Anil Kumar, Mathala Venkata Lakshmi https://creativecommons.org/licenses/by/4.0
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
Influence of abutment materials on peri-implant tissues health—a systematic review
Background: Abutment materials play a critical role in maintaining peri-implant tissue health, influencing both biological responses and aesthetic outcomes in implant-supported restorations. With the introduction of newer materials and digital fabrication techniques, an updated evaluation of their clinical performance is warranted. Objective: This systematic review aimed to evaluate the influence of different abutment materials—­titanium, zirconia, and polyether ether ketone (PEEK)—on peri-implant tissue health based on contemporary clinical evidence. Materials and Methods: A systematic literature search was conducted in PubMed and Scopus databases in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Clinical studies published between 2019 and 2026 were included to reflect current advancements in implant prosthodontics. Eligible human studies assessing the impact of abutment materials on peri-implant tissue health were selected based on predefined criteria. Risk of bias was assessed using the ROBINS-I tool. Due to heterogeneity in study design, outcome measures, and follow-up duration, a meta-analysis was not feasible, and a qualitative synthesis was performed. Results: A total of 13 studies were included. Titanium abutments demonstrated consistent performance, with stable marginal bone levels, low inflammatory response and high long-term predictability. Zirconia abutments showed comparable biological outcomes, with superior soft tissue response and aesthetic integration, particularly in anterior regions. Evidence regarding PEEK abutments was limited; however, preliminary findings suggest reduced inflammatory response and favorable biocompatibility. The included studies exhibited substantial heterogeneity in methodology and outcome reporting, limiting direct comparisons. Conclusions: Titanium remains the most reliable abutment material due to its well-established clinical performance and mechanical stability. Zirconia represents a suitable alternative in aesthetically demanding situations, offering favorable soft tissue outcomes. PEEK demonstrates promising biological potential but lacks sufficient long-term clinical evidence to support routine use. Future research should focus on well-designed, long-term comparative studies with standardized outcome measures to strengthen the evidence base and guide clinical decision-making.
Copyright (c) 2026 Waad Kheder, Renita Rego, Marwan Mansoor Mohammed, Zaid Hamdoon, Waseem Jerjes https://creativecommons.org/licenses/by/4.0
Comparison of microleakage in restorative materials used for deep cervical margin elevation: a systematic review
The present study aims to evaluate and compare the rate of microleakage (ML) in deep margin elevation (DME) of posterior teeth with subgingival margins using different materials and techniques. Methodology: An electronic search was conducted between May and August 2025 across three databases, PubMed/Medline, Scopus, and Web of Science, using the following keywords: “deep marginal elevation” OR “proximal box elevation” OR “Cervical margin relocation” OR “coronal margin relocation” OR “open sandwich technique” AND “microleakage.” A secondary search was conducted in PubMed using the same terms without quotation marks. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied, and the search was restricted to full-text, in vitro studies published in English between 2014 and 2025 that evaluated ML in DME. Methodological quality was assessed using the Quality Assessment Tool for In Vitro Studies (QUIN) tool by two independent reviewers. Results: A total of 53 articles were screened, and 18 were included. The most frequently compared material among the studies was resin composite, particularly bulk-fill flowable resin composite (BF-FRC) composites, while various types of glass ionomers were less commonly evaluated. Lower ML was observed with the snowplow and centripetal techniques. The type of adhesive was found to influence the marginal integrity of restorations. Conclusion: The evidence highlights the superiority of BF-FRC composites in reducing ML rates in DME when used with self-etch adhesives. Nevertheless, clinicians should remain cautious considering the limitations of the existing evidence. Regarding the technique employed, current evidence is insufficient to determine which approach more effectively reduces ML due to methodological heterogeneity and the lack of direct comparisons.
Copyright (c) 2026 Shalonny Brithany Garzón Idrovo, Jaqueline Michelle Naula Farez, Martha Alejandra Cornejo Cordova, Maria de Lourdes Leon Vintimilla 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
Mineralization effect of ion-releasing fiber-reinforced composite in teeth with molar–incisor hypomineralization
Objective: To evaluate the long-term mineralizing effects of an experimental ion-releasing, short fiber-reinforced flowable composite (SFC-active) applied to human teeth with molar–incisor hypomineralization (MIH). Methods: A total of 16 first permanent molars, extracted due to MIH, received two occlusal restorations each. All cavities were acid-etched for 15 seconds before applying the restorative materials. One of the cavities in each tooth was restored with a commercial conventional particulate-filled composite (PFC; G-aenial Universal Injectable) after placement of the SFC-active liner. The other cavities were restored without the liner, using PFC alone (n = 8) or resin-modified glass ionomer cement (RMGIC; Fuji II LC) alone (n = 8). The teeth were stored in simulated body fluid at 37°C for 30 months. The mineralization effect was assessed at three regions (coronal, middle, and apical) under the restorations using micro-computed tomography (CT) (dentin density), micro-indentation (dentin hardness) and scanning electron microscopy/energy-dispersive spectroscopy (microstructure and calcium-to-phosphorus [Ca/P] ratio) analyses. Results: Micro-CT analyses revealed no statistically significant differences (p > 0.05) in dentin mineral density between the restorative materials at any of the three regions beneath the restorations. At the coronal region of interface, dentin hardness was higher with SFC-active than with PFC, but lower than with RMGIC (p < 0.05). The Ca/P ratios of dentin varied beneath the different restorations, ranging from 1.49 to 1.60, with the highest ratios observed at the coronal region of the interface with SFC-active. Strontium and fluorine were detected in the dentin adjacent to the RMGIC restorations. Conclusion: SFC-active demonstrated a positive mineralizing effect on dentin, reflected by higher hardness and Ca/P ratios at the coronal region of the interface. These findings indicate that SFC-active is a promising restorative material for the management of MIH-affected teeth.
Copyright (c) 2026 Lippo Lassila, Battsetseg Tseveenjav, Janna Waltimo-Sirén, Pekka Vallittu, Sufyan Garoushi 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