Faculty Of Dentistry Research Paper

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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.
Laser‑assisted Icon and clinpro for restoring white spot lesions: an in vitro comparative study
(Springer Japan, 2024-11-26) Yomna Said Mohamed; Mohamed Shamel; Sara El Banna
Managing white spot lesions (WSLs) remains a challenging issue that has yet to be fully resolved. WSLs are areas of demineralized enamel that most commonly occur following orthodontic treatments. They can potentially lead to enamel caries and are also esthetically undesirable. The current study investigated and analyzed the efects of Icon resin infltration (Icon) and Clinpro XT varnish (Clinpro), both alone and in combination with a diode laser, on the restoration of WSLs. Color change, microhardness, and scanning electron microscopy were used to evaluate the WSLs after the diferent treatment applications. Results showed that the combination of Icon and Clinpro, along with a diode laser, enhanced color stability and restoration of enamel hardness in white spot lesions. Utilizing a diode laser signifcantly improved the efcacy of both Icon and Clinpro therapies. SEM examination verifed that laser-assisted treatments resulted in almost total blockage of enamel rods, indicating enhanced efectiveness. Conclusions: Integrating diode laser treatment with Icon and Clinpro XT Varnish has signifcantly improved the esthetic outcomes and mechanical properties of treated enamel.
Acoustic signal intensity analysis in patients with dysphonia rehabilitated with two different designs for tongue prostheses: A cross-over study
(Elsevier Inc., 2024-11-19) Ahmed N. Elsherbini; Ashraf E. Eskandar
Statement of problem: Studies on the significance of intensity on speech production with a tongue prosthesis are lacking, despite this being an important criterion in speech production in patients with total glossectomy. Purpose: The purpose of this cross-over clinical study was to assess acoustic signal intensity and frequency in patients with total glossectomy rehabilitated with mandibular dentures with 2 different attachment designs for the tongue prosthesis. Material and methods: Seven participants initially received a mandibular denture with a tongue prosthesis attached using an acrylic resin plate. After a period of 3 months, the dentures were retrieved and modified by replacing the acrylic resin plate with a metal framework as an attachment to the tongue prosthesis to be used for another 3 months with no washout period. The intensity and acoustic energy frequency of acoustic signals were recorded and analyzed for both denture designs at insertion, after 1 month, and after 3 months using 2-way repeated ANOVA (α=.01). Patient satisfaction was evaluated at the end of the follow-up period using a questionnaire. Participants were asked about comfort, phonation, and deglutition ability. The McNemar test was used for all parameters (α=.01). Results: Intensity mean ±standard deviation values for the acrylic resin plate group were 21.56 ±0.54 at insertion, 19.23 ±0.25 at 1 month, and 15.46 ±0.21 at 3 months. For the metal framework group, they were 19.05 ±0.19 at insertion, 16.88 ±0.16 at 1 month, and 13.98 ±0.09 at 3 months. The differences were statistically significant (P<.01). Conclusions: The intensity of the sound (loudness) decreased in the metal framework group, which affects the ability to increase volume in a noisy environment. Participants showed higher satisfaction with the comfort of the metal framework design compared with the acrylic resin plate design. However, participants showed higher satisfaction with the deglutition ability while using the acrylic resin plate when compared with the metal framework
Effect of Access Design and Location on Stress Distribution Within Endodontically Treated Maxillary Incisors: A Three-Dimensional Finite Element Analysis
(University of Dicle, 2024-10-04) Manal M. Abdelhafeez
The optimal approach to access cavity preparation in anterior teeth requiring root canal treatment, especially those affected by traumatic injuries, remains contentious among endodontists. Minimally invasive techniques aim to preserve tooth structure while maintaining strength. The effect of different access cavity designs on stress concentration and distribution in necrotized anterior teeth needing root canal treatment is not well documented. This study aims to evaluate and compare the effect of various access cavity designs on stress distribution in anterior teeth using three-dimensional finite element analysis. Three-dimensional finite element models of maxillary central incisors were created. Three groups with different access cavity designs were analyzed: Group A (Cervical access), Group B (Middle access), and Group C (Incisal access). A load of 100 N was applied at a 45-degree angle to the tooth axis in each model, and stress distribution was analyzed. Maximum stress values (in MPa) were recorded for each design. Group A: Enamel (587.52), Dentin (163.97), Composite (65.11); Group B: Enamel (880.93), Dentin (132.32), Composite (81.27); Group C: Enamel (493.92), Dentin (126.99), Composite (42.39). The study found significant differences in stress distribution among different access cavity designs, with traditional middle access showing the highest stress concentration. These findings could inform clinical decisions to optimize outcomes in root canal treatments.
Glutathione Injection versus Laser in the Treatment of Gingival Hyperpigmentation
(AIN SHAMS DENTAL JOURNAL Official Publication of Ain Shams Dental School, 2024-09) Ahmed Mahmoud Ashry Muhammed; Ola Mohamed Ezzatt; Mahetab Mohamed Abdalwahab
Aim: To assess the effect of intra –mucosal injection glutathione and diode laser for treatment gingival hyperpigmentation concerning: Evaluate Clinical outcome and patient satisfaction. as a primary objective. Assess histological responses of gingival tissues as secondary objective. Materials and Methods: This research involved 10 individuals seeking treatment for gingival hyperpigmentation for an esthetic concern (10 quadrant per group). Patients were recruited between January 2022 to December 2023, and then were randomly and equally allocated to each of the tested group; Group I (Glutath.) was considered the study group, Group II (laser) was considered the control group. All patients were committed to treatment protocol, none of the cases reported serious side effects or adverse outcomes for the interventions used. Results: There was no improvement in the mean DOPI sore with the injectable GLU (Group I) while with laser (Group II), there was a significant reduction in the mean of DOPI from baseline (2.66±0.72) to (0.79±0.40) 3 months after treatment. The mean % of Surface Area decreased insignificantly from baseline (5.99±2.79) to 3 months (4.62±2.40) after treatment in Group I (GLU). While in Group II, there was a significant decrease from baseline (5.90±1.74) to 3 months (2.23±1.41) in Group II (LASER). There was a significant difference in MAF on comparing Group I & II to being (1.62±0.56) (0.73±0.30) respectively after a three-month follow up there was a higher percentage of reduction among Group II than Group I. There was also a reduction in MAF among Group I from baseline (1.76±0.43) to (1.62±0.56) after 3 months of treatment but it was non-significant. Conclusion: Intra-mucosal injection of 1ml Glutathione (repeated 3 times with 1-week intervals) had no detectable effect on gingival pigmentation score and surface area compared to rapid initial response and more patient satisfaction with Diode Laser gingival depigmentation. Histologically, Diode Laser treatment showed a greater and significant reduction in MAF of melanosomes after three months post-treatment than Glutathione.
Subcutaneous emphysema during surgical gingival depigmentation: a case report
(Journal of Medical Case Reports, 2024-10) Rasha Attia; Neveen Nabil; Maged Anis
Background Subcutaneous emphysema related to dental procedures is well documented in literature. It usually occurs during or within minutes to hours after dental treatment and can be easily diagnosed by the presence of crepitus on palpation. Although it is self-limiting, it can develop to potentially life-threatening complications. Case presentation To the authors knowledge, this is the first report documenting the development of subcutaneous emphysema in a 22-year-old Egyptian female during lower surgical gingival depigmentation using NSK high speed, air driven handpiece operated at 0.25 MPa. Sudden swelling developed involving the right side of the face and immediate diagnosis of subcutaneous emphysema was made on the basis of the presence of crepitus during palpation of the swollen area. Intraoral examination revealed small tissue laceration of the loosely attached alveolar mucosa through which the pressurized air might have passed into the fascial spaces. Complete resolution of the swelling occurred after 7 days without further complications. Conclusion Straightforward surgical procedures, such as gingival depigmentation, can be complicated by the development of subcutaneous emphysema. The crucial role of dentists is to be aware of its signs and to immediately diagnose and manage it to avoid further complication.
Palatal vault configuration and its influence on intraoral scan time and accuracy in completely edentulous arches: a prospective clinical study
(The Korean Academy of prosthodontics, 2024-08) Elawady, Dina Mohamed Ahmed; Ibrahim, Wafaa Ibrahim; Ghanem, Radwa Gamal; Osman, Reham Bassuni
PURPOSE. The aim of this prospective clinical study was to compare the influence of palatal vault forms on accuracy and speed of intraoral (IO) scans in completely edentulous cases. MATERIALS AND METHODS. Based on the palatal vault form, participants were divided into three equal groups (n = 10 each); Class I: moderate; Class II: deep; Class III: flat palatal vault. A reference model was created for each patient using polyvinylsiloxane impression material. The poured models were digitized using an extraoral scanner. The resultant data were imported as a solid CAD file into 3D analysis software (GOM Inspect 2018; Gom GmbH, Braunschweig, Germany) and aligned using the software’s coordinate system to determine its X, Y, and Z axes. Five digital impressions (DIs) of maxilla were captured for each patient using an intraoral scanner (TRIOS; 3Shape A/S, Copenhagen, Denmark) and the resultant Standard Tessellation Language (STL) scan files served as test models. Trueness was evaluated by calculating arithmetic mean deviation (AMD) of the vault area between reference and test files while precision was evaluated by calculating AMD between captured scans to measure repeatability of scan acquisition. The scan time taken for each participant was also recorded. RESULTS. There was no significant difference in trueness and precision among the groups (P =.806 and.950, respectively). Average scan time for Class I and III palatal vaults was 1 min 13 seconds and 1 min 37 seconds, respectively, while class II deep palatal vaults showed the highest scan time of 5 mins. CONCLUSION. Palatal vault form in edentulous cases has an influence on scan time. However, it does not have a substantial impact on the accuracy of the acquired scans.
Evaluation of clinical performance of additively manufactured and milled polyetheretherketone (PEEK) inlays compared with indirect composite resin inlays over a one-year follow-up: A randomized clinical trial
(Elsevier Inc, 2024-07) El-shafey, Donia M; Yehia, Dina; Ezz, Dina; Tawfik, Ahmed; Bills, Paul; El-Baz, Maha A
Statement of problem: Data on polymer materials, particularly polyetheretherketone (PEEK) used in restorative dentistry, are scarce, as is knowledge concerning the clinical efficacy of PEEK restorations produced through additive manufacturing when compared with existing indirect materials and techniques. Purpose: The purpose of this randomized clinical trial was to evaluate the clinical performance of additively manufactured and milled PEEK inlays compared with composite resin inlays according to modified United State Public Health Service (USPHS) criteria over a 1-year follow- up. Material and methods: Participants were allocated into 3 distinct categories based on the materials and techniques used: R1 denoting teeth restored with 3 dimensionally (3D) printed PEEK inlays (N=16), R2 representing teeth restored with milled PEEK inlays (N=16), and R3 indicating the comparator group comprising teeth restored with milled composite resin inlays (N=16). After the placement of inlay restorations, evaluations were conducted at 3 time points (T): baseline (T0), 6 months (T1), and 12 months (T2) by using the modified USPHS criteria for assessing anatomic form, color match, marginal discoloration, marginal adaptation, surface texture, secondary caries, retention, and postoperative sensitivity. Ordinal data were analyzed using the Kruskal-Wallis test, followed by the Dunn post hoc test for between group comparisons, as well as the Friedman test, followed by the Nemenyi post hoc test for within group comparisons (α=.05). Results: Across all parameters and intervals, most of the restorations within each group exhibited an alfa score, with no statistically significant differences noted (P>.05). However, concerning color match, all restorations within the PEEK groups received a bravo score, indicating a statistically significant difference in intergroup comparison between the milled composite resin groups and the PEEK group (P<.001). However, no significant variances were noted in the scores evaluated across different follow-up periods (P>.05). Conclusions: Subtractive and additive manufacturing techniques, as well as PEEK and composite resin materials together, offer clinically acceptable functioning restorations over 1 year. PEEK material can be used as a suitable alternative to commonly used indirect composite resin intracoronal restorations in posterior areas. Improvements in terms of surface texture and esthetics are required.
Applications of Finite Element Analysis in Endodontics: A Systematic Review and Meta-Analysis
(Wolters Kluwer Medknow Publications, 2024-07) Abdelhafeez, Manal M
Background: Endodontics increasingly uses finite element analysis (FEA) to evaluate stress distribution, fracture resistance, and temperature changes in treated teeth. FEA's endodontic uses, benefits, and drawbacks are examined in this systematic review and meta-analysis. Methods: A PubMed systematic search found relevant studies published up to January 2022. Original endodontic research articles utilizing FEA to quantify stress distribution, fracture resistance, or temperature changes in treated teeth were eligible. The systematic review comprised 30 publications, 15 of which were meta-analyzed. Data were extracted using a standard form, and the 'Newcastle-Ottawa Scale (NOS)' for observational studies and the Cochrane risk of bias tool for randomized controlled trials assessed quality. Random-effects models calculated pooled effect sizes and 95% confidence intervals in RevMan 5.4 meta-analysis. Results: Meta-analysis shows FEA-guided endodontic treatment improves stress distribution (P < 0.001) and fracture resistance (P < 0.05) compared to conventional treatments. The temperature did not vary significantly (P = 0.12). Stress distribution had an effect size of 0.75 (95% CI: 0.65-0.85), fracture resistance 0.42 (95%: 0.12-0.72), and temperature variations -0.18. Conclusion: In conclusion, FEA is a valuable technique in endodontics for stress distribution study and fracture resistance testing. FEA models' accuracy, dependability, and clinical applicability were questioned, underlining the need for more research and development to maximize their endodontics clinical use.
Prevalence and Pattern of Mandibular Condensing Osteitis Lesions in Saudi Population at Qassim Region
(Wolters Kluwer Medknow Publications, 2024-07) Abdelhafeez, Manal M; Alrasheed, Felwah M
Background: Condensing osteitis (CO) is a common radiopaque lesion observed in the jaws, often detected incidentally on panoramic radiographs. Understanding the prevalence and characteristics of CO is essential for early detection and appropriate management. Objective: To determine the prevalence and characteristics of condensing osteitis among the Saudi population in the Qassim region. Methods: A retrospective study was conducted using 876 digital panoramic radiographs. The presence of CO was identified based on specific radiographic features, and data were collected regarding gender, age, lesion localization, lesion shape, and associated dental status. Results: The prevalence of CO was found to be 2.3% (n = 20) in the study population, with a higher predilection in females (1.4%) compared to males (0.9%). The most commonly affected age group was 30-39 years for males and 10-19 and 30-39 years for females. The mandibular molar region was predominantly affected (90%), with a 'U' shape observed in 55% of the lesions. Root canal treatment was the most commonly associated dental status (75%), followed by deep caries (20%) and large restorations (5%). Conclusion: The study highlights a 2.3% prevalence of CO in the Saudi population of the Qassim region, with a higher predilection in females and a predominant localization in the mandibular molar region. Dental practitioners should be vigilant in identifying CO, especially in at-risk populations, to facilitate timely diagnosis and appropriate management.
The effect of different materials and cavity designs on fracture resistance of ceramic partial coverage
(Wiley-Blackwell, 2024-07) Attia, Mahmoud; Fahmy, Nadia; Shaker, Atef; Salah, Tarek
Background: Two intra-coronal preparation designs with varying extensions of cuspal coverage can perform differently regarding their fracture resistance against introral forces. Methods: Two materials (IPS e-max CAD [EX], VITA ENAMIC [EN]), and two different preparation designs (EX-D1), (EX-D2), (EN-D1), and (EN-D2) were investigated to compare their fracture resistance. A total of 40 (n = 40) caries free human mandibular molars were used. All the prepared samples were scanned using CEREC Omnicam scanner and the preparations were checked by the software for any sharpness and undercuts before restoration designing and fabrication. All restorations were milled using Cerec MCXL 4.4 milling machine. Duo-Link resin cement was used for cementation. After thermocycling and chewing simulation, all samples were loaded in the Universal testing machine in order to evaluate fracture resistance of all samples. Results: Fracture resistance testing revealed that e-max CAD (2134 N) showed statistically significantly higher mean fracture resistance values than Vita Enamic (1728 N). On the other hand, there was no statistically significant difference between mean fracture resistances between the two tested designs. Conclusions: Within the confines of this investigation, it can be said that although preparation design had no appreciable impact on fracture resistance, the CAD/CAM ceramic material utilized did. Clinical Significance: When restoring compound cavitties indirectly; a conservative defect oriented approach should be used. Glass Ceramic are prefered as restorative material.
Socket Preservation Using Platelet-Rich Fibrin and Free Gingival Grafts
(Elsevier Inc, 2024-07) Afifi, Haya Hesham Abdel-Latif; Nasr, Shaimaa Saieed; BinShabaib, Munerah Saleh; Alharthi, Shatha Subhi; Shoeib, Mona
Objective: The present randomised controlled trial is based on the null hypothesis that there is no difference in crestal bone levels (CBLs) following socket preservation (SP) using platelet-rich fibrin (PRF) and free gingival graft (FGG). The aim was to evaluate CBLs following SP using PRF and FGG. Methods: This study is a parallel-arm randomised controlled trial. Patients in the test and control groups underwent SP using PRF and FGG, respectively. Intraoral visual examination was performed to clinically assess signs of swelling, pus/abscess, and stability of sutures and graft. Self-rated postoperative pain was assessed after 1 week and 6 months using the visual analogue scale (VAS). At the 6-month follow-up, cone-beam computed tomography was performed to evaluate CBL in mesiodistal and buccolingual dimensions. The preoperative cone-beam computed tomographic images were superimposed with those taken at the 6-month follow-up to compare CBLs. Statistical comparisons were performed and level of significance was set at P < .05. Results: The test and control groups each comprised 13 individuals with comparable ages. All teeth included in the test and control groups were located in the maxillary aesthetic zone. At the 1-week follow-up, VAS scores were higher in the control than in the test group (P < .01). At the 6-month follow-up, none of the participants reported self-rated pain. The change in buccolingual dimension was greater in the control group than in the test group (P < .05). Conclusions: Both FGG and PRF are effective techniques for SP; however, the latter technique is more effcacious in maintaining buccolingual dimensions of the extraction socket.
The effect of aging on the translucency of contemporary zirconia generations: in-vitro study
(BioMed Central Ltd, 2024-06) Salama, Aya A; Shehab, Karim A; Bushra, Sherif Samir ; Hamza, Faisal Safwat
BACKGROUND: The translucency of different zirconia generations at each time point after thermocycling aging is still lacking. METHODS: Four zirconia materials were used with a total of 60 samples produced from monolithic third generation (5Y) 5 mol% yttria-stabilized zirconia polycrystalline ceramic and fourth generation zirconia (4Y) 4 mol% yttria-stabilized zirconia polycrystalline ceramic, represented by [group1:[CM-5Y] Ceramill Zolid fx (3rd generation zirconia) (Amann Girrbach, Koblach, Austria), group 2:[CM-4Y] Ceramill Zolid HT + (4th generation zirconia) (Amann Girrbach, Koblach, Austria), group 3:[CC-5Y] Cercon XT/ML (Dentsply Sirona, Germany) (3rd generation), and group 4:[CC-4Y] Cercon HT/ML (Dentsply Sirona, Germany) (4th generation)]. The L*a*b* figures were measured by using a spectrophotometer at baseline and after 10,000, 30,000, and 50,000 cycles of thermocycling. At each interval, the translucency of the samples was estimated by using the translucency formula CIEDE2000. The Scheffe post-hoc compared differences among each of the four materials. The Repeated measures ANOVA tested the differences between the materials at each of the different thermocycling intervals (p < .001). Data analyses were evaluated at a significance level of p < .05 (CI 95%). RESULTS: Two-way ANOVA revealed that at baseline the third and fourth generation's zirconia showed statistically significant differences in translucency (P < .001). Translucency values at baseline and after thermocycling exhibited statistically significant changes (p = .003). At each of the time interval; CM-4Y had the highest translucency values followed by CM-5Y, CC-4Y and CC-5Y had the least translucency values. CONCLUSIONS: The third and fourth generations of zirconia displayed different translucencies. Thermocycling affected the translucency of both third and fourth generations of zirconia. At each of the time intervals group 2:[CM-4Y] had the highest TP followed by group1:[CM-5Y], while, group 3:[CC-5Y] and group 4:[CC-4Y] had the least TP.
Erythropoietin Gel as an adjunct to Xenograft in the Surgical Management of Intrabony Periodontal Defects: A Randomized Controlled Clinical Study
(Ain Shams University, Faculty of Dentistry, 2024-06) Mostafa, Roaa; Amr, Ahmed Elsayed Hamed; Moussa, Mahmoud Hassan; Fouad, Yasmine Ahmed
Aim: The present trial aimed to compare the clinical as well as the radiographic efficacy of Erythropoietin (EPO) gel as an adjunct to xenograft versus xenograft alone in treating intrabony defects. materials and Methods: This research was conducted at the Faculty of Dentistry, Ain Shams University, in the Department of Oral Medicine, Periodontology, and Oral Diagnosis. It was a randomized, double-blind, and controlled study. Twenty-six (stage III) periodontitis patients, with (three-wall) intrabony defects, were randomly divided (Thirteen in each group) into test (EPO gel + xenograft) and control (xenograft alone) groups. The primary outcome was evaluating the changes in the periodontal parameters; the plaque index (PI), sulcular bleeding index (SBI), probing depth (PD), and clinical attachment level (CAL) and wound healing by the Early Healing Index (EHI). The secondary outcome was evaluating the changes in the radiographic parameters including the defect fill (DF) and alveolar crest changes. Results: After the first and second weeks, the test group demonstrated a significant EHI reduction than the control group. At six months, there was a significant gain in CAL and DF in both groups with a significantly lower CAL gain and DF in the test group compared to the control group. There was a significant PD reduction with no significant difference between both groups. Conclusion: EPO gel as an adjunct to xenograft may accelerate soft tissue healing after surgical management of intrabony defects. However, it does not enhance the xenograft regenerative outcomes.
Oral Papillary Squamous Cell Carcinoma and Oral Squamous Cell Carcinoma: A Histopathological and Immunohistochemical Comparative Study
(Springer, 2024-06) Mahmoud, Esraa Ashraf ; Abdellatif, Mohsen Kazem ; Mahmoud, Sarah Ahmed Mohammed
Purpose: The aim of the study is to investigate the immunohistochemical expression of both Alpha smooth muscle actin and Transforming Growth Factor beta and compare their expression in oral papillary squamous cell carcinoma with their expression in different histological grades of oral squamous cell carcinoma. A correlation between these immuno-histochemical expressions and histological findings will then be performed. The research question is “Do the percentages of α-SMA and TGF-β immune-expression in OPSCC differ from that in the conventional OSCC?”. Methods: This will be achieved by collecting archival blocks of oral papillary squamous cell carcinoma and different grades of oral squamous cell carcinoma, staining the specimens with Transforming Growth Factor beta and alpha smooth muscle actin, then measuring the mean staining index of expression in each group and the area percent of both markers. Results: Results revealed that transforming growth factor beta expression in the epithelium was high in all cases of well-differentiated squamous cell carcinoma, most oral papillary squamous cell carcinoma, and poorly differentiated oral squamous cell carcinoma. On the other hand, different grades of oral squamous cell carcinoma showed a high staining index of alpha smooth muscle actin expression in the stroma. While cases of oral papillary squamous cell carcinoma were either moderate or low-staining. Conclusions: Oral papillary squamous cell carcinoma has a favourable prognosis compared to different histological grades, and the prognosis does not depend only on histological grade but also on other prognostic factors.
Performance of two laser motion modes versus conventional orthodontic ceramic brackets debonding technique on enamel surface topography
(Springer London, 2024-06) Abdulaziz, Alarifi ; El-Kholy, Moataz Mohamed ; Bushra, Sherif Samir ; Ali, Sara Mohamed ; Shehab, Karim A
The risk of enamel deterioration that frequently coexists with debonding of orthodontic teeth brackets elevates the mandate for finding an optimum approach for debonding them without harmful effects. This in-vitro study is intended to compare the effects of two different laser modes (scanning and circular) and a conventional method on the enamel surface after debonding orthodontic brackets. 66 extracted premolars were assigned into 3 groups. After that, light-cure composite resin was used to attach the ceramic brackets to the teeth. Amongst the test groups, Group I: specimens that were debonded using conventional debonding using pliers; Group 2: specimens that were debonded using Er, Cr: YSGG laser applications using the circular motion method; and Group 3: specimens that were debonded using Er, Cr: YSGG laser applications using the scanning motion method. Adhesive Remnant Index (ARI) assessment, intra-pulpal temperature increase, enamel surface roughness after polishing, and assessment of the microstructure of enamel were carried out with scanning electron microscopy. The gathered information was examined statistically. The conventional debonding method had a significantly higher proportion of adhesive remnant index (ARI) scores of 2 and 3 in comparison to the circular (p <.004) and scanning laser groups (p <.001). There was no significant difference in ARI scores between the circular and scanning laser groups (p >.05). Moreover, the circular and scanning laser debonding methods resulted in a significantly higher proportion of Enamel Surface Roughness (ESR) scores of 0 and a lower proportion of ESR scores of 3 compared to the conventional technique group (p <.001). However, there was no significant difference in ESR scores between the circular and scanning laser methods (p =.945). Lastly, the average intra-pulpal temperature was significantly higher in the circular laser group (1.9 ± 0.5) compared to the scanning laser group (0.9 ± 0.2) with p <.001. Er, Cr: YSGG laser irradiation is a tool that shows promise for debonding ceramic brackets with minimal harm to the enamel surface. The scanning laser technique is more desirable due to the lower intra-pulpal temperature increase.

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