Search Results (246)

Implantable biomaterials are widely used in modern medicine, especially in orthopaedics, cardiovascular surgery, dentistry, and plastic and reconstructive surgery. The issue of the interaction of implants with body tissues and the risk of infection associated with them is one of the most studied and topical issues in medicine. It is very important to find a biomaterial that effectively combines both microbiology and tissue compatibility aspects. The aim of this research work was to determine the adhesion and colonization rates of Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans on smooth, microtextured, and macro-textured silicone biomaterials in an in vitro study. A total of 90 silicone biomaterial samples were used, 30 for each type of biomaterial. In each of the biomaterial groups, half of the samples (n = 15) were used to determine the adhesion intensity and the other half to determine the colonization intensity on the active surface of the biomaterial samples. The study found that Staphylococcus epidermidis and Pseudomonas aeruginosa had the highest adhesion intensity on the macro-textured implant, while Candida albicans adhered best to smooth. Among the microorganisms, Pseudomonas aeruginosa demonstrated the highest colonization rate, followed by Staphylococcus epidermidis and then Candida albicans. The most intensive colonization of microorganisms was on the macro-textured implant, then on the micro-textured, and then on the smooth. The smooth and micro-textured implants did not show statistically significant differences in the intensity of adhesion and colonization. The biomaterials did not show pro-oxidant or anti-oxidant properties, and no lipid peroxidation was induced by the biomaterials. Full article

Background and Objectives: Endocrowns have emerged as a minimally invasive restorative option in dentistry, aiming to preserve as much of the original tooth structure as possible. This scoping review investigates the success rates, biomechanical performance, and material efficacy of endocrowns for restoring molars, in comparison to conventional post-and-core crowns. Materials and Methods: A comprehensive literature review was conducted to identify relevant studies using PubMed and Scopus databases. The search covered publications up to March 2025. All study types focusing on molar restorations were included, except for case reports. Data extraction and screening were performed independently by two reviewers. Results: A total of 37 studies fulfilled the eligibility criteria. Eleven systematic reviews examined comparisons between endocrowns and post-and-core crowns, as well as differences in material selection, survival and success rates, and outcomes between molars and premolars. The remaining 26 studies addressed the clinical performance and longevity of endocrowns, with an emphasis on preparation design, adhesive protocols, and mechanical behavior related to material selection. Conclusions: Endocrown restorations present a conservative and predictable alternative to post-and-core crowns for molars with extensive coronal damage. However, due to variability in reported outcomes, high-quality randomized clinical trials are crucial for confirming their clinical effectiveness. The development of novel, standardized treatment guidelines would provide clinicians with adequate information to effectively restore endodontically treated teeth (ETT). Full article

Glass ionomers are utilized extensively within the domain of dentistry, for instance, as provisional restorations, liners, or bases, in addition to their application as pit and fissure sealers. It is imperative that this type of material exhibits favorable physico-chemical and biological properties. The primary objective of the presented study is to modify commercial resin-modified glass ionomer (Riva Light Cure, RMGIC) by doping it with copper particles (RMGIC + Cu) and to evaluate its properties in terms of potential beneficial clinical applications. Susceptibility to adhesion of microbial species and potential antimicrobial activity was evaluated against the Candida albicans, Streptococcus mutans, and Lactobacillus rhamnosus strains. Antiviral properties were evaluated against two viruses: Herpes simplex virus type 1 and human Adenovirus 5. Cytotoxicity of the materials was assessed using Balb/3T3 mouse fibroblast cell line. Temporal fluoride release up to 168 h in water and artificial saliva of different pH levels were also measured and assessed using statistical analysis. Samples were also subjected to Attenuated Total Reflectance Fourier-Transform Infrared Spectroscopy and Fourier-Transform Raman Spectroscopy. The findings of the present study demonstrate that RMGIC + Cu displays reduced biofilm formation against the tested strains when compared to non-modified material. The influence of the Cu presence on fluoride release is most pronounced in artificial saliva with a low pH (4.5), where the difference is significantly higher in samples with Cu than in samples without it. No reduction in herpes simplex 1 titers under the influence of either material was observed, whereas both materials exhibited virucidal properties against human adenovirus 5. Commercial glass ionomer presented no cytotoxicity, while the modified biomaterial caused changes in the fibroblast culture only under the sample (slight cytotoxicity, grade 1). Considering all the acquired results, doping glass ionomer with copper may be an interesting modification enhancing antimicrobial properties of the biomaterial, but it requires further evaluation in terms of long-term cytotoxicity before further in vivo studies. Full article

Objective: This systematic review and meta-analysis aimed to evaluate the effects of moisture control strategies (including wet-bonding techniques, universal adhesives, and etching type) on dentin bonding performance in restorative dentistry. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar, following PRISMA guidelines. Only in vitro and ex vivo studies comparing wet- and dry-bonding protocols, using human dentin substrates, and reporting microtensile bond strength (μTBS) were included. The data were synthesized using a random-effects meta-analysis and the methodological quality was assessed using the MINORS tool. Certainty of evidence was evaluated using the GRADE framework. Results: Nine studies met the inclusion criteria, eight of which were included in this meta-analysis. The moisture control strategies significantly influenced the bonding outcomes, with ethanol and acetone wet bonding yielding higher μTBS and enhanced hybrid layer morphology. The universal adhesives performed effectively under both moist and dry conditions, although their performance varied by the adhesive composition and solvent system. The meta-analysis revealed a statistically significant advantage for hydrated dentin (SMD = +1.20; 95% CI: 0.52 to 1.86; p < 0.001), with the moist and ethanol-treated substrates outperforming the dry and over-wet surfaces. The long-term durability was better preserved with ethanol and acetone pretreatments and the adjunctive use of chlorhexidine. Conclusions: Moisture conditions influence dentin bond strength, but modern universal adhesives show consistent bonding performance across different moisture conditions. Solvent-wet-bonding protocols, particularly with ethanol or acetone, enhance the immediate and long-term performance. While the current evidence is limited by the in vitro designs and heterogeneity, the findings demonstrate protocol flexibility and highlight strategies to optimize adhesion in clinical practice. Future clinical trials are necessary to validate these approaches under real-world conditions. Full article

This study aimed to evaluate the penetration and bonding performance of three restorative materials—high-viscosity glass ionomer cement (Riva Self Cure HV), resin-modified glass ionomer cement (Riva Light Cure) and a bioactive resin (Activa BioActive Restorative™)—in the healthy and carious dentine of permanent molars. Forty extracted human molars with sound or decayed dentine were restored following standardised protocols and subsequently divided into slices. So, twenty-four samples were used for each group (sound and carious dentine) for interface analysis using confocal laser scanning microscopy, field emission scanning electron microscopy and energy dispersive X-ray spectroscopy, and another eight simples were used for each group (sound and carious dentine) for Vickers microhardness testing. Results showed that both glass ionomer cements achieved consistent chemical bonding in healthy dentine and demonstrated better interfacial adaptation compared to carious dentine, where partially demineralised areas showed weaker bonding. The bioactive resin exhibited good adhesion in sound dentine due to the adhesive system but showed poorer interaction in decayed dentine with signs of interfacial separation. Elemental analysis revealed similar compositions among materials, with no significant differences in material concentrations among the ionomers, while there were significant differences with the other materials. On the other hand, some variations were observed in the sulphur, fluoride and strontium content depending on dentine condition. Microhardness values were higher in healthy dentine than in carious dentine for all materials (p < 0.001), except the high-viscosity glass ionomer, which maintained stable hardness in both substrates (36.33 ± 6.23 VHN vs. 34.56 ± 4.31 VHN; p = 0.605). These findings highlight the relevance of material selection and dentine condition in minimally invasive restorative dentistry. Full article

Background: Traditional visual-tactile methods, radiographic interpretation including CBCT imaging, clinical judgement and supplementary aids such as fluorescence-based devices are pivotal components of the restorative diagnostic process in detecting dental caries and defective or failed restorations. However, when evaluating the restorability of a tooth compromised by extensive and deep caries, whether associated with a failed restoration or not, the conventional approach may not provide sufficient diagnostic information to establish a definitive restorative diagnosis without first removing failing restoration, caries or both. Objective: This manuscript presents caries clearance management (CCM) as a novel comprehensive clinical diagnostic restorative procedure designed to assist dentists in making a final restorative diagnosis regarding the restorability of a tooth compromised by extensive caries, fractured tooth cusp(s) or a failed large direct/indirect restoration without caries or a combination of all of them. Practical implications: CCM involves removing the failed direct/indirect restorations and selective removal of carious tissue while preserving the greatest amount of sound tooth structure as possible. Following this clinical diagnostic procedure and an assessment of dental pulp and periodontium, the clinician proceeds through a decision-making process to determine the final restorative diagnosis. This allows the dentist to advise the patient on a suitable complex restorative treatment plan. Conclusions: The manuscript introduces caries clearance management (CCM) as a structured clinical diagnostic procedure, to assist dentists to determine the restorability of compromised teeth by extensive caries, fractured teeth or failed large direct or indirect restorations. Full article

Background: A major challenge in adhesive dentistry, often leading to restoration failure, is microleakage. This in vitro comparative study was designed to assess microleakage at the tooth–composite interface. The investigation aimed to compare the sealing efficacy of two commonly used adhesive systems. Methods: Standardized Class I cavities were prepared on 20 extracted human molars and randomly divided into two groups (n = 10 each). Group A was treated with a fifth-generation total-etch adhesive (OptiBond™ Solo Plus, Kerr Corporation, Orange, CA, USA), and Group B received a seventh-generation self-etch adhesive (Adhese® Universal VivaPen®, Ivoclar Vivadent AG, Schaan, Liechtenstein). All restorations were completed using Herculite XRV composite resin. Microleakage was evaluated using dye penetration analysis after immersion in 2% methylene blue for 10 days, followed by longitudinal sectioning and microscopic measurement at 500× magnification. Results: The fifth-generation adhesive group showed a mean microleakage of 0.2503 ± 0.1921 mm, while the seventh-generation group recorded 0.2484 ± 0.1764 mm. Statistical analysis using an independent t-test revealed no significant difference between the groups (p = 0.696). Conclusions: Both adhesive systems demonstrated comparable performance in minimizing microleakage under standardized conditions. Although the total-etch group exhibited slightly lower numerical values, the difference was not statistically significant. These findings suggest that both adhesive approaches can be clinically effective when applied appropriately. Full article

This study assessed and compared the shear bond strength of self-adhesive and self-etching resin cements for indirect aesthetic restorations to dentin. Four different materials, lithium disilicate ceramics, zirconia ceramics, polymethyl methacrylate (PMMA) composites, and hybrid materials, were used for indirect restorations cemented to dentin. The null hypothesis was that there would be no differences in shear bond strength between the investigated materials. Eighty extracted human molars were used. Eighty dentin specimens with a flat surface were prepared and randomly distributed in groups of 10 (n = 10). From each material (Cerasmart 270, Initial LiSi Blok, Katana ZR Noritake, and Crowntec Next Dent), 20 blocks were made and cemented to the dentin samples. Half of the blocks from each material were cemented to dentin using self-etching resin cement (Panavia V5), and the other half using self-adhesive resin cement (i-CEM). After the specimens were prepared, a laboratory test was conducted to evaluate the shear bond strength. The fracture type was determined using a light microscope, and SEM confirmed the results. The results were statistically analysed. All materials cemented with self-etching cements (Panavia V5) showed statistically higher shear strength values than those cemented with self-adhesive resin cement (i-CEM). In the specimen groups where self-adhesive cement (i-CEM) was used, Cerasmart 270 bonded statistically better. A statistical difference was found between all groups of materials cemented with self-etching cement. The Initial LiSi Block showed the strongest bond, followed by Katana Zr Noritake, Crowntec NextDent, and Cerasmart 270. Adhesion fracture to dentin was observed for all groups cemented with i-CEM. This study highlights the superior performance of self-etching cements in terms of shear bond strength. 10-Methacryloyloxydecyl dihydrogen phosphate (10-MDP), a functional monomer, was found to enhance adhesion strength significantly. However, using self-adhesive cements was associated with a weaker bond to dentin, highlighting the importance of the right cementing agent in restorative dentistry. Full article

Background: In adhesive dentistry, debonding-on-demand is attractive for situations where no permanent attachment is required. Due to its destructive nature, ultraviolet (UV) light may be of interest for attenuating bond forces. The aim of this study was to investigate the impact of UV light on the shear bond strength (SBS) of etch-and-rinse (n = 4) and universal adhesives (n = 3). Methods: Glass-ceramic samples were bonded to bovine enamel surfaces (n = 10/adhesive) and subjected to shear bond testing before and after exposure to UV light (320–390 nm, 126 Jcm⁻²). Data was statistically analyzed by Mann–Whitney U test. Results: Initial photopolymerized etch-and-rinse adhesives showed superior SBS compared to universal adhesives. Highest values were recorded for iBOND^® Total etch (15.48 MPa) and Syntac classic© (17.60 MPa). Lowest SBS was obtained for Ecosite Bond^® (2.63 MPa). Additional UV exposure caused a significant decrease in SBS among iBOND Total etch (5.24 MPa, p = 0.009) and Solobond M© (3.65 MPa, p = 0.005), while for Syntac classic©, an increase (24.12 MPa, p = 0.047) was recorded. Among all other tested adhesives, no significant changes were observed. Conclusions: UV radiation impacted SBS of etch-and-rinse adhesives only (decrease: iBOND Total Etch, Solobond M; enhancement: Syntac classic©). Further research should focus on introducing sufficient light-triggered debonding mechanisms. Full article

This study aimed to develop an innovative resin composite with anti-biofouling properties, tailored to prosthesis fabrication in dentistry using a digital light processing (DLP) 3D-printing technique. The resin composite was formulated using a blend of dental monomers, with the integration of 2-methacryloyloxylethyl phosphorylcholine (MPC) with anti-biofouling behavior and γ-MPS-treated silica-zirconia powder for simultaneous mechanical reinforcement. The overall characterization of the resin composite was carried out using various contents of MPC incorporated into the resin (0–7 wt%) for examining the rheological behavior, photopolymerization, flexural strength/modulus, microstructure and anti-biofouling efficiency. The resin composite demonstrated a significant reduction in bacterial adhesion (97.4% for E. coli and 86.5% for S. aureus) and protein adsorption (reduced OD value from 1.3 ± 0.4 to 0.8 ± 0.2) with 7 wt% of MPC incorporation, without interfering with photopolymerization to demonstrate potential suitability for 3D printing without issues (p < 0.01, and p < 0.05, respectively). The incorporation and optimization of γ-MPS-treated silica-zirconia powder (10–40 vol%) enhanced mechanical properties, leading to a reasonable flexural strength (103.4 ± 6.1 MPa) and a flexural modulus (4.3 ± 0.4 GPa) at 30 vol% (n = 6). However, a further increase to 40 vol% resulted in a reduction in flexural strength and modulus; nevertheless, the results were above ISO 10477 standards for dental materials. Full article

There is insufficient evidence regarding the cytotoxicity of restorative 3D-printing resins, used as part of the digital workflow in dentistry. This study presents a novel comparative evaluation of cell viability and adhesion using human Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs), a less commonly used but clinically relevant cell line in dental biomaterials research. The aim of this study was to evaluate the cell viability of WJ-MSCs seeded on 3D-printed resins intended for temporary restorations. Resin discs of three commercial 3D-printing resins (NextDent C&B, Leaf Dental C&B, and UNIZ Temp) and a conventional self-curing acrylic resin (NicTone) were used. WJ-MSCs were cultured on the specimens for 1, 4, and 10 days. Cell viability was assessed using the PrestoBlue assay, Live/Dead immunofluorescence staining, and 7AAD/Annexin V staining. Cell adhesion was evaluated using scanning electron microscopy. Direct exposure to the 3D-printed resins and the self-curing acrylic caused slight reductions in cell viability compared to the control group in both microscopic analyses. 7AAD/Annexin V showed the highest percentage of viable WBCs for the conventional acrylic (34%), followed by UNIZ (35%), NextDent (42%), and Leaf Dental (36%) (ANOVA p < 0.05 Tukey’s post-hoc test p < 0.05). These findings suggest that 3D-printed resins could be considered safe for use in temporary restorations. Full article

Introduction: Digital planning and evolution of technology is allowing dentistry to be more efficient in time than before. In orthodontics the main purpose is to obtain fewer patient visits and to reduce the bonding time. For that, indirect bonding planned with CAD-CAM softwares is used to obtain a shorter treatment period, in general, and less chair-time. This waste of chair-time should also be reduced in other fields of dentistry such as endodontics, surgery, prosthodontics, and aesthetics. Methods: A total of 504 teeth were embedded into epoxy resin models mounted as a dental arch. Customized lingual multibracket appliances were bonded by a current adhesion protocol. After that, they were debonded, the polishing of cement remnants was performed with three different burs and two drills. The polishing time of each group was recorded by an iPhone 14 chronometer. Results: Descriptive and comparative statistical analyses were performed with the different study groups. Statistical differences (p < 0.005) between diamond bur and tungsten carbide and white stone burs and turbine were obtained, with the first being the slowest of them. Discussion: Enamel roughness was widely studied in orthodontics polishing protocol as the main variable for protocols establishment. However, in lingual orthodontics, due the difficulty of the access to the enamel surfaces, the protocol is not clear and efficiency should be considered. It was observed that the tungsten carbide bur is the safest bur. It was also recommended that a two-step protocol of polishing by tungsten carbide bur be followed by polishers. Conclusions: A tungsten carbide bur mounted in a turbine was the most efficient protocol for polishing after lingual bracket debonding. Full article

Deep margin elevation (DME) is a widely adopted technique for managing subgingival cervical proximal margins by repositioning them to a supragingival location. This approach enhances access, visibility, and control in these anatomically challenging areas. This narrative review aimed to evaluate current evidence on the indications, materials, clinical protocols, and outcomes of DME. A structured search was conducted in PubMed, the Cochrane Library and Scopus up to February 2025, using keywords such as “deep margin elevation”, “proximal box elevation” and “subgingival margin.” Clinical studies, in vitro investigations, relevant reviews and reports in English were included. A total of 59 articles were selected based on eligibility criteria. The hypothesis was that DME can serve as a reliable alternative to surgical crown lengthening in appropriate cases. A variety of materials have been investigated for use as the intermediate layer, with composite resins of varying viscosities and filler compositions being preferred due to their favorable long-term mechanical properties. DME may reduce the need for surgical intervention while maintaining periodontal health; however further randomized clinical trials are needed to clarify the material selection, establish long-term outcomes, and standardize clinical protocols. Understanding the indications, limitations, and protocol of DME is critical for achieving biologically sound and predictably functional restorations. Full article

Background: Monolithic zirconia has attracted considerable interest in dentistry due to its favorable physical and mechanical properties, making it a promising alternative for crown fabrication. Nonetheless, a standardized finishing protocol for this material has yet to be established. Objective: This study aimed to evaluate the surface characteristics and in vitro biofilm formation of zirconia finished by either polishing or glazing. Methods: A total of 72 zirconia specimens were fabricated and divided into control, glazing, and polishing groups. Surface analysis included roughness, wettability, and surface free energy. Microbiological analysis included CFU (colony-forming units per mL) counts, microbial adhesion at 2, 4, 6, and 8 h, biofilm biovolume, and qualitative biofilm assessment via scanning electron microscopy (sEm). Results: The glazing group showed significantly greater roughness than the polishing (p = 0.006) and control (p = 0.016) groups, along with a lower contact angle (polishing—p = 0.002; control—p < 0.001) and higher surface energy (polishing—p = 0.005; control—p < 0.001). No significant differences were observed in CFU counts for the tested microorganisms (C. albicans, p = 0.158; L. casei, p = 0.610; S. mutans, p = 0.904). Regarding microbial adhesion, the polishing group showed a smaller biofilm-covered area compared to the control group for both total biofilm (p = 0.008) and viable biofilm (p = 0.005). no statistically significant difference was observed in biofilm biovolume (p = 0.082). Conclusions: These findings suggest that, despite the surface differences among the groups, biofilm formation was not significantly affected. Full article

Background and Objectives: Cyanoacrylate (CA) tissue adhesives have gained increasing attention as alternatives to sutures in oral surgery and periodontology. The objective of this scoping review is to assess their clinical applications and effectiveness in wound closure and postoperative management. Materials and Methods: The review was conducted following the JBI methodology and PRISMA-ScR guidelines. A comprehensive search was performed in PubMed, Scopus, and Web of Science to identify randomized controlled trials published between 2015 and 2025 evaluating the use of CAs in oral surgery and periodontal procedures. Results: A total of 19 studies were included. Cyanoacrylate adhesives demonstrated comparable or superior outcomes to other wound healing strategies in terms of operative time, postoperative pain reduction, and early wound healing. Their use was particularly beneficial in free gingival grafts and palatal donor site management. However, the findings across studies were not always consistent, and some trials did not report statistically significant differences. The use of long-chain CA formulations is associated with minimal toxicological risk, though these adhesives demonstrate intrinsic hemostatic and antimicrobial effects. Conclusions: Cyanoacrylate tissue adhesives represent a valid alternative to sutures in several dental surgical contexts, especially in procedures involving mucogingival grafts. Further high-quality clinical studies are needed to clarify their long-term outcomes and broaden their indications in dentistry. Full article