Faculty Of Dentistry Research Paper

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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.
Double layer graft technique for horizontal alveolar ridge augmentation with staged implant placement: radiographic histological and implant stability analysis–a case report
(BioMed Central Ltd, 2024-06) Elraee, Leila ; Ibrahim, Suzan Seif Allah ; Adel-Khattab, Doaa
Introduction: Horizontal ridge augmentation of a deficient alveolar bone site is performed either simultaneously with implant placement or in a staged approach prior to implant insertion. There are several available strategies for the augmentation of alveolar ridge deficiencies, including guided bone regeneration (GBR) through the use of barrier membranes. The success of the GBR approach mainly depends on the exclusion of soft tissue cells during bone remodeling. Case presentation: A healthy 25-year-old male patient presented with a missing upper left central incisor after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the horizontal alveolar ridge augmentation using resorbable pericardium membrane with double layer graft technique (DLT) where autogenous bone placed as a first layer of the graft followed by xenograft as a second layer, the membrane was fixed with titanium pins. A cone beam computed tomography (CBCT) was performed before, immediately and 6 month following the surgery. After 6 months during implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation, with assessment of primary implant stability. The radiographic analysis showed a horizontal width gain of about 4 mm, at 6 month following implant placement, the implant was successfully osteointegrated with stability assessment also done after 6 months from placement. Conclusion: DLT was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.
Tomographic assessment of bone changes in atrophic maxilla treated by split-crest technique and dental implants with plateletrich fibrin and NanoBone® versus platelet-rich fibrin alone: Randomized controlled trial
(BioMed Central Ltd, 2024-06) Anis, Maged ; Abdelrahman, Ahmed Reda ; Attia, Rasha ; Zahran, Amr
Background: This study evaluated the clinical benefits of adding NanoBone® with split-crest technique and simultaneous implant placement covered with platelet-rich fibrin membrane in horizontally deficient maxillary ridges in terms of crestal and horizontal bone changes and patient morbidity. Methods: Forty patients indicated for maxillary ridge splitting and simultaneous implant placement were assigned randomly to the study groups: control group (Platelet Rich Fibrin membrane) and test group (Platelet Rich Fibrin membrane + Nanobone®). The Cone Beam Computed Tomography Fusion technique was utilized to assess crestal and horizontal bone changes after five months of the surgical procedure. Patient morbidity was recorded for one week post-surgical. Results: Five months post-surgical, buccal crestal bone resorption was 1.26 ± 0.58 mm for the control group and 1.14 ± 0.63 mm for the test group. Lingual crestal bone resorption was 1.40 ± 0.66 mm for the control group and 1.47 ± 0.68 mm for the test group. Horizontal bone width gain was 1.46 ± 0.44 mm for the control group and 1.29 ± 0.73 mm for the test group. There was no significant statistical difference between study groups regarding crestal and horizontal bone changes and patient morbidity. Conclusions: The tomographic assessment of NanoBone® addition in this study resulted in no statistically significant difference between study groups regarding crestal and horizontal bone changes and patient morbidity. More randomized controlled clinical trials on gap fill comparing different bone grafting materials versus no grafting should be conducted. Clinicaltrials.gov registration number: NCT02836678, 13th January 2017.
Evaluating flexure properties, hardness, roughness and microleakage of high-strength injectable dental composite: an in vitro study
(BioMed Central Ltd, 2024-05) Basheer, Rasha R; Hasanain, Fatin A; Abuelenain, Dalia A
Background Recently, a new generation of high-strength fowable dental composites has been introduced by manufacturers. The manufacturers claim that these materials have enhanced mechanical and physical properties and are suitable for use in a wide range of direct anterior and posterior restorations, even in high-stress bearing areas. Aim The objective of this study was to assess certain physical and mechanical properties of these recently introduced high-strength fowable composites in comparison to conventional multipurpose dental composites. Methods Four types of high-strength fowable composites (Genial Universal FLO, Gaenial Universal Injectable, Beautifl Injectable, and Beautifl Flow Plus) were tested in experimental groups, while a nanohybrid conventional composite (Filtek Z350 XT) was used as the control. For fexure properties, ten rectangular samples (2×2×25 mm) were prepared from each composite material and subjected to 5000 cycles of thermocycling. Samples were then subjected to fexural strength testing using the universal testing machine. Another twenty disc-shaped specimens of dimensions (5 mm diameter×2 mm thickness) were fabricated from each composite material for surface roughness (Ra) (n=10) and hardness (VHN) test (n=10). All samples underwent 5000 cycles of thermocycling before testing. Additionally, microleakage testing was conducted on 60 standardized class V cavities prepared on molar teeth and divided randomly into fve groups (n=12). Cavities were then flled with composite according to the manufacturer’s instructions and subjected to thermocycling for 1000 cycles before testing using methylene blue solution and a stereomicroscope. Results All tested materials were comparable to the control group in terms of fexural strength and surface roughness (p>0.05), with Gaenial Universal FLO exhibiting signifcantly higher fexural strength compared to the other fowable composite materials tested. However, all tested materials demonstrated signifcantly lower elastic modulus and surface hardness than the control group (p<0.05). The control group exhibited higher microleakage scores, while the lowest scores were observed in the Gaenial Universal FLO material (p<0.05) Conclusion The physical and mechanical behaviors of the diferent high-strength fowable composites investigated in this study varied. Some of these materials may serve as suitable alternatives to conventional composites in specifc applications, emphasizing the importance of dentists being familiar with material properties before making material selections.
Effect of Salvadora persica on resin-dentin bond stability
(BioMed Central Ltd, 2024-04) Abu-Nawareg, Manar M; Abouelseoud, Hanan K; Zidan, Ahmed Z
Background The stability of resin–dentin interfaces is still highly questionable. The aim of this study was to evaluate the effect of Salvadora persica on resin–dentin bond durability. Materials and methods Extracted human third molars were used to provide mid-coronal dentin, which was treated with 20% Salvadora persica extract for 1 min after acid-etching. Microtensile bond strength and interfacial nanoleakage were evaluated after 24 h and 6 months. A three-point flexure test was used to measure the stiffness of completely demineralized dentin sticks before and after treatment with Salvadora persica extract. The hydroxyproline release test was also used to measure collagen degradation by endogenous dentin proteases. Statistical analysis was performed using two-way ANOVA followed by post hoc Bonferroni test and unpaired t-test. P-values<0.05 were considered statistically significant. Results The use of Salvadora persica as an additional primer with etch-and-rinse adhesive did not affect the immediate bond strengths and nanoleakage (p>0.05). After 6 months, the bond strength of the control group decreased (p=0.007), and nanoleakage increased (p=0.006), while Salvadora persica group showed no significant difference in bond strength and nanoleakage compared to their 24 h groups (p>0.05). Salvadora persica increased dentin stiffness and decreased collagen degradation (p<0.001) compared to their controls. Conclusion Salvadora persica extract pretreatment of acid-etched dentin preserved resin–dentin bonded interface for 6 months. Clinical significance Durability of resin-dentin bonded interfaces is still highly questionable. Endogenous dentinal matrix metalloproteinases play an important role in degradation of dentinal collagen within such interfaces. Salvadora persica may preserve resin-dentin interfaces for longer periods of time contributing to greater clinical success and longevity of resin composite restorations.
Dental implant planning using artificial intelligence: A systematic review and meta-analysis
(Elsevier Inc, 2024-04) Alqutaibi, Ahmed Yaseen; Algabri, Radhwan; Ibrahim, Wafaa Ibrahim; Alhajj, Mohammed Nasser; Elawady, Dina
Statement of problem: Data on the role of artificial intelligence (AI) in dental implant planning is insufficient. Purpose: The purpose of this systematic review with meta-analysis was to analyze and evaluate articles that assess the effectiveness of AI algorithms in dental implant planning, specifically in detecting edentulous areas and evaluating bone dimensions. Material and methods: A systematic review was conducted across the MEDLINE/PubMed, Web of Science, Cochrane, and Scopus databases. In addition, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies that examined the accuracy of AI-based diagnostic tools on dental radiographs for dental implant planning. The most recent search was conducted in January 2024. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included articles. Results: Twelve articles met the inclusion criteria for this review and focused on the application of AI in dental implant planning using cone beam computed tomography (CBCT) images. The pooled data indicated an overall accuracy of 96% (95% CI=94% to 98%) for the mandible and 83% (95% CI=82% to 84%) for the maxilla in identifying edentulous areas for implant planning. Eight studies had a low risk of bias, 2 studies had some concern of bias, and 2 studies had a high risk of bias. Conclusions: AI models have the potential to identify edentulous areas and provide measurements of bone as part of dental implant planning using CBCT images. However, additional well-conducted research is needed to enhance the accuracy, generalizability, and applicability of AI-based approaches.
Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18-month follow-up prospective cohort study
(Wiley-Blackwell, 2024-02) ElNahass, Hani; Tawfik, Omnia K; Naiem, Suzy N; Zazou, Nada; Moussa, Mahmoud
Objectives: The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption. Materials: The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score. Results: Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results. Conclusion: Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long-term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes.
Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18-month follow-up prospective cohort study
(Wiley-Blackwell, 2024-02) ElNahass, Hani; Tawfik, Omnia K; Naiem, Suzy N; Zazou, Nada; Moussa, Mahmoud
Objectives: The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption. Materials: The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score. Results: Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results. Conclusion: Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long-term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes.

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