Faculty Of Dentistry Research Paper

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CLASEG: advanced multiclassification and segmentation for differential diagnosis of oral lesions using deep learning
(Nature Research, 2025-06-02) Afnan Al-Ali; Ali Hamdi; Mohamed Elshrif; Keivin Isufaj; Khaled Shaban; Peter Chauvin; Sreenath Madathil; Ammar Daer; FalehTamimi; Raidan Ba-Hattab
Oral cancer has a high mortality rate primarily due to delayed diagnoses, highlighting the need for early detection of oral lesions. This study presents a novel deep learning framework for multi-class classification-based segmentation, enabling accurate differential diagnosis of 14 common oral lesions—benign, pre-malignant, and malignant—across various mouth locations using photographic images. A dataset of 2,072 clinical images was used to train and validate the model. The proposed framework integrates EfficientNet-B3 for classification and ResNet-101-based Mask R-CNN for segmentation, achieving a classification accuracy of 74.49% and segmentation performance with an average precision (AP50) of 72.18. The gradient-weighted class activation map technique was applied to the model outputs to enable visualization of the specific areas that were most influential for predictive decisions made by the model. This significantly improves upon the state-of-the-art, where previous models achieved lower segmentation accuracy (AP50<50%). The framework not only classifies the lesion type but also delineates the lesion boundaries with high precision, which is critical for early detection and differential diagnosis in clinical practice.
Knowledge, perception, and attitude of Egyptian dental students toward the role of robotics and artificial intelligence in dental practices - a cross-sectional study
(BioMed Central Ltd, 2025-05-21) Naglaa Ezzeldin; Aya A. Salama; Karim A. Shehab
Background Rapid technological progress has made robotics (R) and artificial intelligence (AI) essential components of our everyday existence. In addition, robots designed for dental applications have been created. This study aimed to assess Egyptian dental students’ Knowledge, perception, and attitude toward the role of robotics and AI in dental practices. Methods A cross-sectional questionnaire-based study was conducted involving 204 Egyptian students from the Faculty of Dentistry at October University for Modern Sciences and Arts. The electronic link to the questionnaire was created using Google Forms and distributed to the students via email. The questionnaire included 26 questions that assessed the students’ knowledge, perception, and attitude toward the role of R and AI in Dentistry. Results A total of 85.8% of students were familiar with the concepts of R and AI. Among them, 66.2% demonstrated a good understanding of the applications of R and AI in dentistry, while 59.3% showed a positive attitude towards these technologies. Dental students perceived the use of R and AI favorably, particularly in dental implants and CAD/CAM technologies, with 80.6% and 82.3% expressing approval, respectively. However, 66.9% opposed the idea of replacing dentists with these technologies. Additionally, 75% expressed a desire to learn more about R and AI in the future. Conclusions Dental students possess a good understanding of and positive attitudes toward the use of R and AI in diagnosis and interpretation. They believe that AI can play an active role in various aspects of dental practice. However, they express uncertainty about the possibility of AI and robotics replacing dentists
Oral health status of Egyptian mothers and their preschool children: association of mother’s oral health literacy and marital satisfaction‑ a cross‑sectional study
(BioMed Central Ltd, 2025-05-22) Naglaa El‑Wakeel; Naglaa Ezzeldein; Amel A. Ramadan
Background Oral health literacy (OHL) and marital satisfaction (MS) are known to afect the overall health and qual‑ ity of life of parents and their children. A possible relation between MS and oral health has never been studied before. We aimed to; frst; assess levels of OHL and MS of Egyptian mothers, and second; investigate a possible relation between these levels and the oral health status of the mothers and their preschool children. Methods A cross-sectional study was conducted on 130 preschool-aged children and their mothers utilizing a structured, questionnaire consisting of three sections; 1- demographic and oral health-related data; 2- seven ques‑ tions of ENRICH Marital Satisfaction (EMS) Scale of mothers, and 3-A modifed Arabic Rapid Estimate of Adult Literacy in Dentistry (A-REALD-30) to measure the mother’s ability to read 30 commonly used dental terms. Clinical examina‑ tion of the participants was conducted afterwards to evaluate the oral health status using the Decay, missed flled teeth (DMFT), dmft, plaque, and gingival indices (PI and GI). Results The mean (SD) of DMF, PI, and GI for mothers were 5.07(3.41), 1.29(0.45), and 1.13(0.52) respectively. Children’s mean (SD) dmft was 5.42(3.27), the mean (SD) of total EMS and A-REALD-30 scores were 23.41(6.79) and 21.65(6.02) respectively. There was a positive correlation between the EMS score and A-REALD-30, p-value=0.44, and r=0.068, a negative correlation between EMS score and DMFT, dmft, PI, and GI, p-value=0.0043, 0.032, 0.956, and 0.730, and r=0.253, 0.188, 0.005, and 0.031, respectively. Whereas A-REALD-30 showed a positive correlation with the DMFT and dmft, and a negative correlation with PI and GI p-value=0.549, 0.412, 0.158, and 0.670, and r=0.053, 0.073, 0.125, and 0.038, respectively. Conclusions Within our limitations, this work showed for the frst time that there is a possible association between MS and oral health status of mothers and their preschool children. Further, this work unexpectedly showed a positive relation between A REALD-30 and DMFTs implying that REALD-30 alone would not be enough and is sug‑ gested to be used with other tools to assess OHL levels. Further long-term studies are needed to clarify how literacy and marital status afect oral health.
Influence of different endodontic treatment protocols on tooth survival: A retrospective cohort study with multistate analysis and group balancing
(Wiley-Blackwell Publishing Ltd, 2025-06-13) Ahmed Elmaasarawi; Mohamed Mekhemar; Andreas Bartols
Aim: This study aimed to assess how three different treatment protocols affect the survival of teeth and the survival of teeth without further interventions after root canal treatment (RCT), while also considering additional factors that could potentially influence the treatment outcome. Methodology: Data were collected from an outpatient clinic database from July 1999 to January 2024 and 14 233 treated teeth could be included in a retrospective cohort study. Treatment protocols incorporated hand files (Protocol 1), multiple-file rotary NiTi systems added with passive ultrasonic irrigation (PUI), citric acid and occasionally chlorhexidine (Protocol 2) and reciprocating instruments added with PUI, EDTA, warm vertical compaction and calcium silicate-based sealer (Protocol 3). Survival analysis coupled with Cox proportional hazard regression and Kaplan– Meier curves took into account several variables including treatment, patient demographics and experience of the treatment provider. Confounding was addressed by entropy balancing and gradient boosted logistic regression. Multistate analysis was conducted to evaluate the influence of treatment protocols on the transition between various intervention states. Results: Survival analysis revealed that Protocol 3 significantly enhanced survival rates and survival rates without further interventions by 30%–40% compared to both other protocols. Additionally, higher patient age was identified as a negative predictor of treatment outcomes. Supportive periodontal treatments were a positive predictor. Factors such as tooth type, vitality, number of visits, experienced treatment provider, calcium silicate-based sealer and patient gender did not significantly affect outcomes in the adjusted models. Multistate analysis confirmed that Protocol 3 was associated with significantly reduced incidences of retreatment and extraction. Conclusion: Protocol 3 significantly enhanced survival and survival without further interventions compared to both other protocols. Patient age and supportive periodontal treatments were significant predictors of outcomes throughout all calculated models.
Fit assessment of different sintering speeds of multilayer zirconia using micro-CT
(Elsevier Inc, 2025-06-02) Khaled A. Elbanna; Hetaf S. Redwan; Sarah M. Nassief; Shereen M. Elsayed; Rayan B. Yaghmoor; Ahmed Z. Zidan
Statement of problem Data on the marginal and internal fits of speed-sintered zirconia crowns is lacking. Purpose The aim of this in vitro study was to assess the marginal and internal fit of multilayer zirconia implant crowns when sintered with 3 different sintering cycles: a standard cycle (SC), a speed cycle (SP), and a superspeed cycle (SS). Material and methods A total of 30 zirconia implant crowns were fabricated and divided into 3 groups based on the speed of the sintering cycle (n=10). Microcomputed tomography was used to scan all specimens, and the marginal and internal gaps were measured. The Kruskal–Wallis and Friedman tests were used to compare the marginal and internal gaps among the groups (α=.05). Results A statistically significant difference was detected between the SC group and the other groups (P<.05). A statistical difference was found among all groups in terms of internal gaps (P<.05). The SC group showed the lowest marginal and internal gaps, with mean values of 47.4 µm and 90.8 µm, respectively. The mean values for marginal and internal gaps were higher in the SS group (54.3 µm and 117.5 µm) and highest in the SP group (68 µm and 128.9 µm). Conclusions All groups had marginal and internal gaps within a clinically acceptable range.
Influence of the use of a denture adhesive on salivary cells and candidal activity: A randomized clinical trial
(Elsevier Inc, 2025-05-17) Ahmed N. Elsherbini; Zeinab A. Elshereef; Tasneem M. Soliman
Statement of problem: Complete denture movement is inevitable and leads to mechanical irritation. Additional retention such as with adhesives can reduce mechanical irritation by reducing the denture movement but may be a chemical irritant. Whether these irritations can have an adverse effect on the salivary cells and oral infections is unclear. Purpose: The purpose of this randomized clinical trial was to evaluate the effect of complete denture retention, with or without a denture adhesive, on salivary cellular changes and Candida albicans activity Material and methods: Forty healthy, nonanemic, completely edentulous, male and female participants, between 40 and 60 years old were enrolled and randomly allocated into 2 equal groups. In one group, participants received conventional complete dentures without an adhesive. In the other group, participants received conventional complete dentures with an adhesive (Corega Super; GlaxoSmithKline). Saliva samples were collected in sterile containers for both groups before denture insertion, 1 month after insertion, and 3 months after insertion. Exfoliated squamous cells were examined regarding nuclear size (nuclear/cytoplasmic (N/C) ratio), chromatin distribution, regularity of nuclear membrane, prominent nucleolus, nuclear bi- or multinucleation, and Candida albicans count. Results: After 1 month and after 3 months in the group without an adhesive, no change was seen in the histological composition. However, in the group with an adhesive at 1 month after insertion, superficial and intermediate squamous cells were seen, with occasional reactive nuclear changes, showing enlarged nuclei and moderate inflammation polymorph nuclear leukocytes (PNLs). At 3 months after insertion, superficial and intermediate squamous cells were seen, with remarkable reactive nuclear changes, showing enlarged nuclei, binucleation, prominent nucleoli, and marked inflammation (PNLs). Conclusions: Provision of a complete denture did not alter the salivary cells; however, the use of a denture adhesive can lead to inflammatory responses of the salivary cells. © 2025 Editorial Council for The Journal of Prosthetic Dentistry
Cinnamic acid Attenuates Cisplatin-Induced Hepatotoxicity and Nephrotoxicity
(National Academy of science, 2016-01-06) Amany A. Tohamy; Ahmed M. Aref; Ahmed E. Abdel Moneim; Romissaa H. Sayed
We investigated the effects of cinnamic acid (CA, 20 mg/kg body weight) on cisplatin (CP)-induced hepto and nephrotoxicity in mice. CP (5 mg/kg bwt) was injected intraperitoneally and CA was given by gastric gavage for 5 days pre- and post-CP injection. After 5 days of CP injection, CP-induced injuries of the hepatic and renal tissues which were evidenced (i) histopathological damage of the hepatic and renal tissues, (ii) as increases in liver and kidney function parameters, (iii) as increases in lipid peroxidation and nitric oxide, and (iv) as decrease in glutathione content. In contrast, the oral administration of CA concurrently to CP intoxicated mice brought back lipid peroxidation, nitric oxide, glutathione levels to near normalcy. Moreover, the histological observations evidenced that CA effectively rescues the liver and kidney from CP mediated oxidative damage. Therefore, cinnamic acid can be considered a potential candidate for protection of hepato-and nephrotoxicity induced by cisplatin.
Therapeutic Effect of Melatonin and/or Adipose-Derived Mesenchymal Stem Cells Against Doxorubicin-Induced Renal Toxicity in Wister Rats
(Institute of Advanced Studies, 2024-07-22) Romisaa Hussein Sayed; Emad M. El Zayat; Sherein S. Abdelgayed3; Jehane I. Eid; Mohamed Hosney
Doxorubicin (DOX) is highly effective against cancer, but its use is limited due to significant toxicity, particularly in the liver and kidneys. This toxicity is primarily caused by oxidative stress, which results in biochemical, histological, and genetic abnormalities, and disrupts the body's antioxidant defenses. Adipose-derived mesenchymal stem cells (ADMSCs) show promise in cell therapy applications against DOX toxicity Similarly, melatonin supplementation has demonstrated therapeutic potential in mitigating DOX-induced liver and kidney damage by reducing oxidative stress. Understanding and harnessing these therapeutic effects could lead to improved treatments for DOXinduced organ damage. Aims: This study focused on evaluating how melatonin and adipose-derived mesenchymal stem cells (ADMSCs) could mitigate renal toxicity induced by doxorubicin (DOX), a potent anthracycline chemotherapeutic drug known for its severe side effects. The research aimed to explore whether the antioxidant properties of melatonin and the regenerative capabilities of ADMSCs could synergistically alleviate the adverse effects of DOX on renal function in Wistar rats. Methods: The study included two main groups: a control group receiving saline and a DOX group receiving six doses of doxorubicin to induce renal toxicity. Subsequently, rats from both groups were assigned to receive treatments of saline, ADMSCs, melatonin, or a combination of ADMSCs and melatonin. Rats were euthanized at different time points post-treatment, and blood and kidney tissue samples were collected. The analysis included assessment of oxidative stress biomarkers, DNA damage, gene expression profiles, histopathological changes, and cell homing in the kidney tissues. Results: DOX induces oxidative stress, inflammation, and genotoxicity in kidneys while reducing antioxidant enzyme activity. Melatonin and/or ADMSC treatments effectively mitigate these effects by decreasing oxidative stress, inflammation, and DNA damage. The protective mechanisms involve modulation of apoptosis pathways, evidenced by changes in p53 and Bcl2 expression levels, as well as assessment of double-strand breaks using the neutral comet assay, and also the improvement of the inflammatory markers IL-6 & IL- 10 evidenced by the histopathological results. Conclusion: Melatonin and ADMSCs demonstrate protective effects against DOX-induced renal toxicity, potentially enhancing chemotherapy safety by reducing renal damage. The synergistic benefits of combining melatonin and ADMSC therapy in improving chemotherapy tolerability warrant further investigation in preclinical models to optimize treatment strategies and validate efficacy before clinical application.
Durability of resin bonding to translucent zirconia materials: An in vitro study
(Elsevier Inc, 2025-04-11) Abdulaziz Samran; Shurouk Ali; Shadi El Bahra; Ahmed Wagdy Hashem; Mohamed Elbeshri; Sebastian Wille; Matthias Kern
Statement of problem: How the yttria content (3Y-PSZ, 4Y-PSZ and 5Y-PSZ) affects the tensile bond strength of luting resin to translucent zirconia ceramics is unclear. Purpose: The purpose of this in vitro study was to evaluate whether the bond strength of resin to translucent zirconia ceramics and its durability are influenced by the yttria content (3Y-PSZ, 4Y-PSZ and 5Y-PSZ). Material and methods: Sixty-four disk-shaped specimens of zirconia ceramics were randomly allocated to 4 groups (n=16) with respect to the yttria concentration: GHT: 3 mol% yttria-partially stabilized zirconia 3Y-PSZ; GHTML: 3 mol% yttria-partially stabilized multilayered zirconia 3Y-PSZ; GSTML: 4 mol% yttria-partially stabilized zirconia 4Y-PSZ; and GUTML: 5 mol% yttria-partially stabilized zirconia 5Y-PSZ. For bonding, acrylic resin tubes were filled with composite resin and bonded to the zirconia disks using adhesive luting resin by following manufacturer's instructions. Half of each main group (n=8) was stored in water for 3 days at 37 °C. The other half was stored in water for 150 days with 37 500 thermocycles (5 to 55 °C). The tensile bond strength test was determined with a universal testing machine at a crosshead speed of 2 mm/minute using a chain loop for alignment. Results: The tensile bond strength was not significantly affected by the yttria concentration of different zirconia materials (3Y-PSZ, 4Y-PSZ, and 5Y-PSZ, P=.17). The mean ±standard deviation failure loads for groups ranged from 24.1 ±2.6 MPa for the ultratranslucent multilayered zirconia (with thermocycling) to 52.7 ±5.4 MPa for the high translucent multilayered zirconia (without thermocycling). However, artificial aging adversely affected the tensile bond strength values for all tested zirconia systems (P<.001). Scanning electron microscope evaluation showed that cohesive fracture was the predominant failure mode, while few specimens exhibited adhesive failure at the interface. Conclusions: The yttria concentration (3Y-PSZ, 4Y-PSZ, and 5Y-PSZ) had no significant effect on the bond strength of different zirconia ceramics (P=.17), whereas the artificial aging procedures led to a statistically significant decrease in tensile bond strength (P<.001). © 2025 The Authors
Effect of archwire size on the rate of canine retraction in adult women: A randomized clinical trial
(Urban und Vogel, 2025-03-25) Aml Saeed Mohamed Abdelkader; Mohamed Abd El-Ghafour; Heba Mohamed Dehis; Fouad Aly El Sharaby; Amr H. Labib
Introduction: The purpose of the present study was to investigate the rate of upper canine retraction utilizing three different sizes of archwires. Materials and methods: In all, 36 upper canines of 18 adult females (21 ± 5 years) were allocated into three-arm parallel groups where canine retraction was attempted. In the first group (G16) 0.016–0.022-inch stainless steel wires (SS) were applied, in the second group (G17) 0.017–0.025-inch SS, and in the third group (G19) 0.019–0.025-inch SS, respectively. The eligibility criteria included patients with maxillary dentoalveolar protrusion that required extraction of first premolars as part of their treatment, mild crowding (< 5 mm), and full permanent dentition. Patients with active periodontal disease, systemic disease, medications or habits that would affect tooth movement were excluded. Randomization was performed using computer-generated numbers and the participants were allocated to each group according to their number in the randomization sheet. Canines were retracted using a closed nickel–titanium coil spring applying 1.5 N retraction force. The primary outcome of the study was the rate of canine retraction measured on three-dimensional (3D) digital models. Secondary outcomes were changes in canine tipping and root length that were assessed with CBCT scans, and the amount of first molar anchorage loss measured on the 3D digital models. The study was double blinded in which both the participants and the outcome assessor were blinded. Data were analyzed using ANOVA for the three groups. Paired sample t-test was used within each group. Results: A total of 32 canines were analyzed: 12 in G16, 10 in G17, and 10 in G19. The average distance moved by the canines per month was 0.9 ± 0.89, 0.68 ± 0.81, and 0.76 ± 0.98 mm in G16, G17, and G19, respectively, with no statistically significant difference between the three groups (P = 0.2). A statistically significant root resorption was observed in G19 compared to the other two groups (P = 0.024). Additionally, anchorage loss was greater in G17 and G19 compared to G16. A nonsignificant difference was detected between the three groups regarding the change in canine tipping. No harms were reported during the trial. Conclusions: Archwire sizes utilized in the current study showed no significant effect on the rate of canine retraction or tipping. However, wires with large sizes had more adverse effects with respect to root resorption and anchorage loss. Trial registration: The trial was registered at Clinicaltrials.gov with ID: NCT04020952. © The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2025.
In vitro evaluation of human enamel remineralization after treatment with Ginger, Ashwaganda and Maca herbal dentifrices versus commercially available fluoride containing dentifrice
(Springer International Publishing, 2025-03-03) Ghada Ahmed Elzayat; Fagr Hassan Elmergawy; Aya Abd ElFattah Mohammed Nemt Allah
Background: Compare the remineralization efficiency of Ginger, Ashwaghanda and Maca dentifrices versus commercially fluoride containing dentifrice. Methods: Ginger, Ashwaghanda and Maca extracts were prepared by solvent extraction methodology and were characterized using transmission electron microscope, dynamic light scattering, and inductively coupled plasma optical emission spectrometer. The pH of the dentifrices was evaluated by pH meter. Eighty teeth were collected and divided into five groups according to the treatment protocol. Enamel morphology was carried out by scanning electron microscope with energy dispersive X-Ray spectroscopy for the analysis of calcium, phosphorus, Ca/P ratio and carbon. Surface microhardness was evaluated by Vickers micro-hardness tester. Data were analyzed using One-way ANOVA followed by Tukey’s post hoc test (p ≤ 0.05). Results: Characterization results showed the highest calcium, phosphorus and fluoride ion release were associated to Maca, Ashwaganda and Ginger respectively. The pH results revealed that Ginger dentifrice exhibited the most alkaline pH, whereas Ashwaganda dentifrice exhibited the most acidic pH. Morphological analysis revealed that Ashwaganda showed lower remineralization ability compared to the other treated groups. Maca showed significant higher Ca/P ratio compared to other groups (p < 0.001) and Ginger showed significant higher surface microhardness recovery compared to Ashwaganda (p < 0.001). Conclusion: Ginger and Maca are promising remineralizing agents.
In vitro evaluation of shear bond strength of polymethyl methacrylate/montmorillonite modified Biodentine with dental resin composite
(Istanbul University Press, 2025-01-09) Fagr Hassan Elmergawy; Ola M. Elborady; Dina M. Wahied
Purpose The aim of this study was to evaluate the bond strength between Biodentine, modified with polymethyl methacrylate/Montmorillonite nanoclay, and resin composite at different stages of Biodentine's setting time. Materials and Methods Nanoclay was prepared and organo-modified with polymethyl methacrylate. The characterization of polymethyl methacrylate/Montmorillonite nanoclay, Biodentine, and modified Biodentine was assessed by X-ray diffraction analysis, Fourier-transform infrared spectroscopy, and scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy. A total of sixty acrylic molds were constructed; thirty specimens were filled with Biodentine, and the other thirty with nanoclay-modified Biodentine. Each group was subdivided according to different stages of Biodentine's setting time: 12 minutes, 2 hours, and 2 weeks. Universal adhesive, followed by flowable resin composite, was applied. The microshear bond strength was tested using a universal testing machine. Data were analyzed using one-way ANOVA followed by Tukey’s post hoc test, in addition to two-way ANOVA. The significance level was set at p ≤ 0.05. Results The characterization results revealed the successful preparation of polymethyl methacrylate/Montmorillonite nanoclay and modified Biodentine. The micro-shear bond strength results showed that modified Biodentine had significantly higher micro-shear bond strength than unmodified Biodentine at 12 minutes. However, no statistically significant difference was found between the unmodified and modified Biodentine groups at 2 hours and 2 weeks. Conclusion The incorporation of 10% modified nanoclay by weight into Biodentine could enhance the bond strength with resin composite when placed after 12 minutes of Biodentine's setting time
Evaluation of the Effect of Low-Level Laser Therapy Versus Photodynamic Therapy on the Level of Serum IL-17 and Salivary IL-4 in Patients Suffering from Erosive/Atrophic Oral Lichen Planus: A Case Control Study
(National Information and Documentation Centre, 2024-12-15) M. A. Sabry; M. E. Gheith; A. A. Hussine; A. M. Elsayed; S. H. Elkady; D. M. Abd El- Aziz
Background: One of the most common treatment modalities of oral lichen planus (OLP) is topical corticosteroids (TCS). However, it has several side effects which are harmful to the patients. One such promising treatment modality is low level laser therapy (LLLT) as well as photodynamic therapy (PDT) which are considered safe and reliable in reducing the painful symptoms of the disease with minimal side effects. The inflammatory mediators; cytokines as (IL- 4 & IL- 17) were found to play a crucial role in the pathogenesis of atrophic/erosive OLP. Objective: The aim of this study is to investigate and compare the effect of PDT, LLLT & TCS by measuring the pain scale VAS, IL- 4 in saliva and IL- 17 in serum to detect the response of OLP patients to these different modalities. Methods: The study was conducted on 30 patients divided into 3 groups. Each group received either of 3 treatments; PDT, LLLT or TCS, then VAS, salivary IL-4 and serum IL-17 were measured by ELISA at base line, immediately after the first session, at 2 and 4 months from base line to detect the efficiency of each type of treatment. Results: The use of PDT and LLLT were effective and superior to TCS in treatment of OLP in adult patients. Cytokines were reduced in the 3 groups and VAS was markedly reduced by LLLT. No correlation was found between any of the used parameters, this shows that each one of the parameters was efficient on its own in monitoring the effectiveness of the three treatment modalities used. Conclusions: the use of LLLT and PDT was effective in treatment of OLP in adult patients.
Micro CT evaluation of marginal discrepancies of endocrown restored molars with different intrapulpal depths and materials of fabrication. (in-vitro study)
(BioMed Central Ltd, 2025-01-27) Mohamed Aly Mohamed Badr Elagwany; Amina Mohamed Hamdy; Maged Mohamed Zohdy; Aliaa Mahrous; Ahmed Tawfik; Soha Osama Nabih
Objective The purpose of this study was to evaluate the effect of different preparation depths (0, 2 and 4 mm) of different restoration designs (classic endocrown design versus overlay design) on marginal adaptation of restorations fabricated of two different restorative materials (lithium disilicate and PEEK). Materials and methods Sixty mandibular natural molars were collected as abutments for the restorations of this study, and grouped in three main groups of different cavity depths (0, 2 and 4). Each group was divided into two subgroups according to material of fabrication to (L) for lithium disilicate (IPS emax CAD, Ivoclar vivadent, Switzarland) and (P) for PEEK (Bio-hpp, Bredent, Germany). CAD/CAM milling technology was used for fabrication of restorations. After cementation of restorations over abutments, hydrothermal aging was performed, and then marginal adaptation was evaluated via micro CT technology. Results Regarding cavity depths, there was a significant difference between different groups (p<0.001). The highest value was found in samples with 4 mm extension (84.35±18.16), followed by samples with 2 mm extension (66.52±21.86), while the lowest value was found in samples without pulpal extension (59.41±22.16). Post hoc pairwise comparisons showed samples with 4 mm extension to have a significantly higher value than samples without extension (p<0.001). Regarding materials of fabrication, PEEK (85.32±12.37) had a significantly higher value than Emax (54.86±20.86) (p<0.001). Conclusions Increasing intrapulpal cavity depths increases vertical marginal gap of lithium disilicate or PEEK restorations. Endocrowns fabricated of lithium disilicate show less marginal discrepancies than that of endocrowns fabricated of PEEK.
Revealing the diagnostic value of cerebrospinal fluid presepsin (sCD14) as a new biomarker for postneurosurgical and nosocomial central nervous system infections: A systematic review and meta-analysis of diagnostic test accuracy studies
(Elsevier B.V., 2025-01-29) Hazem E. Mohammed; Mohamed Nasser; Moaz Elsayed Abouelmagd; Mohamed E. Haseeb; Mohamed Khalafalla Darwish; Mohamed Salem Abdelqader; Ahmed Tawfik; Rania Elsayed Mahmoud Abdel-Mawla; Mahmoud Diaa Hindawi
Background: Central nervous system (CNS) infections represent life-threatening conditions. Emerging evidence suggests cerebrospinal fluid (CSF) presepsin (sCD14) as a promising biomarker for these infections. However, its diagnostic accuracy remains controversial. This study aimed to systematically evaluate the reliability of CSF presepsin in diagnosing CNS infections through a comprehensive meta-analysis. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted up to November 2024. Five prospective studies involving 384 participants were included. CSF presepsin levels were compared between infected and non-infected patients. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive predictive value (PPV), and negative predictive value (NPV) were calculated using a random-effects model. Publication bias and clinical utility were assessed through Deek’s funnel plot and Fagan’s nomogram, respectively. Results: Infected patients exhibited significantly higher CSF presepsin levels (mean difference: 760.16 pg/mL; 95 % confidence interval (CI): 426.26–1094.05, p < 0.01). Pooled sensitivity and specificity were 87 % (95 % CI: 82–91 %) and 67 % (95 % CI: 60–74 %), respectively, with a DOR of 13.04 (95 % CI: 7.51–22.64). The pooled PPV and NPV were 79 % (95 % CI: 73–84 %) and 79 % (95 % CI: 71–85 %), respectively. The area under the curve of the summary receiver operating characteristic curve was 86 %, emphasizing high diagnostic accuracy. No statistically significant publication bias was detected (P = 0.12). Conclusion: CSF presepsin demonstrated potential as a diagnostic biomarker for CNS infections, demonstrating high sensitivity and moderate specificity. Further large-scale studies are needed to refine its clinical applicability and establish standardized thresholds.
Beverage-Induced Surface Changes in Biomimetic Dental Resin Composite: AFM and Bacterial Analysis
(Georg Thieme Verlag, 2024-12-30) Rasha R. Basheer; Nermeen K. Hamza
Objective Continuous advancements in composite resin materials have revolutionized and expanded its clinical use, improving its physical and mechanical properties. Attaining and retaining surface texture and gloss are crucial for the long-term durability of the composite resin material. This study investigated the supra-nanospherical filler composite material compared with different composite resin materials immersed in different beverages. The study evaluated their surface roughness and subsequent adhesion of bacteria. Materials and methods A total of 144 specimens were made, using Teflon mold from different composite materials. Eighty-four specimens were used for surface roughness testing, using four different resin composite materials, Tetric N-Ceram (Ivoclar Vivadent, Schaan, Liechtenstein), Multichrome (Harvard Dental, Germany), Filtek Z350 XT (3M ESPE, Minnesota, United States), and Palfique LX5 (Tokuyama Dental Corporation, Taitō-Ku, Tokyo, Japan; n ¼ 21). They were further subdivided into three subgroups according to the immersion solution (n ¼ 7) for Monster, Gatorade, and deionized water, which served as the control group. Surface roughness values were tested via atomic force microscopy (AFM). Then, for biofilm testing the bacterial count was performed on the remaining 60 composite specimens from the four tested composite materials (n ¼ 15), that were subdivided randomly based on the immersion solutions into three subgroups (n ¼ 5). Statistical analysis Data were collected and statistically analyzed using the Kruskal– Wallis test followed by Dunn’s post hoc test with Bonferroni’s correction (p 0.05). The intergroup comparison showed a significant difference among different composite materials (p < 0.05), with the Multichrome showing the highest roughness values. Also, there was a significant difference between all composite materials with different beverages, with Palfique LX5 showing the lowest average roughness (Ra) values. All studied materials’ average surface roughness, however, remained below the crucial Ra value of 0.2 μm. For the bacterial count, there was a significant difference between different materials in different beverages (p < 0.05), with Z350 XT and Palfique LX5 showing the lowest bacterial count. Conclusion Supra-nanospherical composite (Palfique LX5) exhibited better resistance to different beverage challenges regarding surface roughness, while nanohybrid composite (Z350) showed the least bacterial adherence.
Sodium hypochlorite accident—complications, management and potential prevention: a report of three cases
(AME Publishing Company, 2025-01-07) Ayat Gamal-AbdelNaser; Alaa Elnaggar; Menna Mekawy; Gerges Boshra; Neveen Ghareeb
Background: Sodium hypochlorite (NaOCl) is a powerful irrigant for endodontic treatment. But, when extruded beyond the root apex, it becomes cytotoxic to patient’s tissues causing NaOCl accidents. The complications include ulceration to the soft tissues and irritation of nerves causing long term symptoms. Being under- or poorly-reported, this report presents cases for complications of NaOCl accident. Complying to the suggested criteria for well-reported NaOCl accidents, the report aims to help—with others—in clarifying the full picture of the situation Accordingly, a standardized plan for its prevention and management would be possible. Case Description: The current report presents three cases of females with post-NaOCl accident symptoms after performing endodontic treatment for a maxillary anterior tooth. The three patients presented after days of the accident with a deep ulcer in the buccal vestibule related to the treated tooth. Each case suffered from a further different complication in the form of: paresthesia of the infraorbital nerve in the first case, transient partial facial palsy beside the sensory deficit in the second case, and necrosis and deepening of the oral ulcer in the third patient. The cases received roughly the same treatment of oral ulcer debridement and dressing application, followed by antibiotic and analgesic prescription. Vitamin B12 supplements were prescribed in case of neural deficits and warm fomentations were advised in case of extraoral swelling. In all cases, post-operative instructions included strict hygiene of the intraoral lesion and daily repeated saline irrigation. The oral ulcers healed within 8 weeks while the neurological deficits were improving by the fourth month. Conclusions: This report emphasizes on the importance of using packs, complying to strict hygiene and prescribing vitamin B12 supplements in improving and accelerating healing of prolonged post-NaOCl accident symptoms. The report may also help anticipate the prognosis of NaOCl accidents with different severities and presentations. Showing the severity of the complications, the report further highlights on the importance of the accident’s prevention, so that all these sequelae would be avoided.
Survival beneft of cancer‑directed surgery and the role of adjuvant therapy in malignant major salivary gland cancers: a propensity score matched retrospective analysis
(W.B. Saundersw, 2025-01-09) Ahmed Elkoumi; Omar Elkoumi; Mohamed Hamouda Elkasaby; Huzifa Khitiy; Mariam Khaled Elbairy; Ahmed Tawfk; Omar K. Habib; Abeer Shaalan
Background The primary objective of this study was to assess the beneft of cancer-directed surgery (CDS) on both overall survival (OS) and cancer-specifc survival (CSS) of patients with malignant major salivary gland cancers (MMSGCs). The secondary objective was to explore the benefts of adjuvant therapy on the survival outcomes of these patients. Methods Patients diagnosed with MMSGC were extracted from the SEER database and subsequently categorized into two cohorts: CDS and non-CDS. Propensity score matching (PSM) was used to mitigate confounding variables. The survival beneft associated with CDS was evaluated using Kaplan–Meier analysis, log-rank tests, and Cox proportional hazard models. Furthermore, the impact of adjuvant radiotherapy and chemotherapy was explored within the CDS subgroup. Results A total of 7,029 patients with MMSGC were included. PSM was performed and resulted in a matched cohort between both groups, including 595 patients in each group. Multivariable Cox proportional hazard indicated that patients who received CDS had better OS (HR: 0.45, 95% CI [0.39 to 0.52], P<0.001) and CSS (HR: 0.46, 95% CI [0.40 to 0.52], P<0.001). The 5- and 10-year OS for the CDS group was 42% (95% CI, 38 −46%), and 25% (95% CI, 21 −29%) consecutively, while the 5- and 10-year OS for the non-CDS group was 20% (95% CI, 17 −24%), and 12% (95% CI, 9.7 −16%) consecutively. Moreover, patients with younger age, localized tumors, and lower TNM stage could beneft more from CDS. Radiotherapy as adjuvant therapy was found to be benefcial (HR: 0.69, 95% CI [0.55–0.85], p<0.001), while chemotherapy could not signifcantly beneft these patients. Conclusion CDS improved the OS and CSS survival in MMSGC patients. Specifc patient subgroups seemed to have a superior beneft from CDS. Adjuvant radiotherapy could help enhance the survival outcomes of these patients while chemotherapy could not.
THE EFFECT OF POLY (N-ISOPROPYLACRYLAMIDE) BASED MICROGEL APPLICATION ON THE MICROTENSILE BOND STRENGTH TO DENTIN: AN IN VITRO STUDY
(EGYPTIAN DENTAL JOURNAL, 2024-07-10) Mona Mohamed Fadel; Dina Mohamed Wahied; Reham Mohsen; Aliaa Mohamed Abdel Rahman El Wakeel
Objective: This study was carried out to determine the effect of polyNIPAM microgel particles on the microtensile bond strength (µTBS) of universal adhesive to dentin before and after thermocycling. Materials and methods: Superficial dentin discs were prepared from young human upper premolars. Specimens were divided into three groups GI: All-Bond Universal adhesive was applied directly to etched dentin. G2: 2% polyNIPAM microgel was added to the adhesive before being applied to etched dentin. G3: 2% polyNIPAM microgel was applied on etched dentin before application of the adhesive. In all groups, after light activation of the adhesive, resin composite (Filtek Z350 XT), was applied incrementally on the treated dentin specimens. A total of 120 beams were prepared. Half of these beams were subjected to 5000 cycles of 5°C to 55°C using a PCR thermocycler. Microtensile bond strength testing was performed on all specimens. The fractured dentin side of all specimens was inspected using a scanning electron microscope (SEM) at 200X magnification. Three sticks from each group were gold sputter coated and examined with SEM at 2000X. Results: The statistical analysis showed that before thermocycling, there was a statistically significant difference in the mean µTBS values of all the tested groups p <0.001. G1T0 showed the highest statistically significant mean µTBS values. After thermocycling, G1T1 showed the lowest statistically significant mean µTBS values p= 0.001. Failure mode analysis and SEM analysis confirmed and explained the µTBS results. Conclusion: The addition of polyNIPAM microgel to etched dentin preserved the bond durability, particularly after thermocycling.
INFLUENCE OF CERAMIC MATERIALS AND PREPARATION DESIGNS ON THE MARGINAL ADAPTATION OF INLAYS AND ONLAYS AFTER THERMOCYCLING
(Quintessence Publishing Company, 2024-09-27) Mahmoud Attia; Aya A Salama
INFLUENCE O F CERAMIC MATERIALS AND PREPARATION DESIGNS ON THE MARGINAL ADAPTATION OF INLAYS AND ONLAYS AFTER THERMOCYCLIN By (Attia, Mahmoud) ; (Salama, Aya A.) (provided by Clarivate) Source INTERNATIONAL JOURNAL OF PROSTHODONTICS Volume37Issue5Pagee200-e210 DOI10.11607/ijp.8504 Published SEP-OCT 2024 Indexed 2024-11-03 Document Type Article Abstract Purpose:To evaluate inlay and onlay marginal adapta2on of two different ceramic materials using two intracoronal prepara2on designs. Materials and Methods: An examina2on of the marginal adap2on of two materials-lithium disilicate (LD; IPS e.max CAD) and polymer infiltrated ceramic network material (PICN; Vita Enamic)-and two prepara2on designs, where D1 represents MOD inlay prepara2on with no cusp reduc2on and for D2, in addi2on to the basic MOD prepara2on, the buccal cusps (func2onal cusps) were reduced by 1.5 mm. Four sub-groups (LD-D1, LD-D2, PICN-D1, PICN-D2) were conducted. In total, 40 (n = 40) mandibular molars were used. A stereomicroscope was used to assess the marginal gap before, aWer cementa2on and aWer thermocycling. Values were calculated for the mean, median, SD, minimum, maximum, and 95% CI. Pairwise comparisons using Tukey post-hoc test were performed following an ANOVA significance of P <= .05. Results: The results revealed that lithium disilicate showed sta2s2cally significantly higher mean gap distance than PICN material (61 mu m to 99 mu m). Pairwise comparisons showed that D2 design has sta2s2cally significant higher mean gap values than D1. Conclusions: Both LD and PICN material provided marginal adapta2on within clinical accepted range. PICN material restora2ons provided better it than lithium disilicate restora2ons. Cusp coverage has a greater marginal gap compared toconven2onal prepara2on.

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