Search Results (378)

Background/Objectives: Gingival recession poses significant challenges in periodontal therapy, particularly in procedures aimed at achieving predictable root coverage and long-term stability of grafts. Conditioning of the root surface plays a crucial role in improving biomaterial adhesion and facilitating periodontal regeneration. This in vitro study aimed to evaluate the morphological and microroughness alterations of root cementum following different mechanical and chemical conditioning protocols commonly used in mucogingival surgery. Methods: Forty extracted human single-rooted teeth were randomly allocated into eight groups: untreated control, mechanical scaling alone, and scaling combined with ethylenediaminetetraacetic acid (EDTA), citric acid, phosphoric acid, tetracycline, doxycycline, or saline. Surface roughness was measured using contact profilometry, while structural modifications were analyzed via scanning electron microscopy. Results: Statistically significant intergroup differences (p < 0.05) were observed. Baneocin treatment produced the most conservative changes, with limited surface roughness and minimal structural alteration, whereas phosphoric acid, tetracycline, and EDTA caused pronounced demineralization and surface porosity. Citric acid and doxycycline induced moderate alterations, with partial preservation of cementum integrity. The null hypothesis assuming no surface or morphological changes was rejected. Conclusions: These findings indicate that low-aggressiveness agents may achieve an optimal balance between surface decontamination and cementum preservation, which is critical for enhancing graft integration and improving clinical outcomes in root coverage surgery. 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

Background: Radial shock wave therapy (RSWT) has increasingly been integrated into treatment protocols for adhesive capsulitis. While associations with diabetes and other systemic disorders are well documented, the role of obesity remains underexplored, particularly in relation to RSWT outcomes. Methods: Forty patients with adhesive capsulitis completed a 10-day treatment protocol combining RSWT with conventional physiotherapy. Pain (VAS), disability (SPADI), and range of motion (ROM) were assessed at baseline and immediately after treatment. At one-month follow-up, VAS and SPADI were reassessed alongside the Patient Global Impression of Change (PGIC). Correlations between body mass index (BMI) and clinical outcomes were analyzed, and potential confounding effects of comorbidities and affected-side dominance were examined. Clinical relevance was assessed using minimal clinically important differences (MCID) and effect sizes (Cohen’s d). Results: All clinical outcomes improved significantly post-treatment and at follow-up, with most changes exceeding MCID thresholds and showing large effect sizes. Higher BMI was significantly correlated with greater improvements in SPADI, VAS, shoulder extension, and internal rotation. Most comorbidities were negatively associated with outcomes, except neurologic conditions, which supported mobility improvement. Conclusions: RSWT appears effective in alleviating symptoms of adhesive capsulitis. The observed association between higher BMI and greater mobility improvement suggests potential benefits in overweight and obese patients. These findings warrant further investigation. Full article

This study investigates rapid-setting, phosphate-based, chemically bonded phosphate ceramic (CBPC) composites for emergency pothole repair through a two-phase experimental approach. Phase I involved fundamental mix design experiments that systematically examined the effects of water-to-binder ratio (20–40%), filler content (10–50%), and phosphate powder fineness (570–3640 cm²/g) on setting and mechanical performance. Based on Phase I results, Phase II evaluated field-applicable mixes optimized for concrete and asphalt pavement conditions in terms of rapid strength development: compressive strength exceeding 24 MPa within 30 min, flexural strength surpassing 3.4 MPa within 1 h, and adhesive strength reaching up to 1.62 MPa (concrete) and 0.68 MPa (asphalt) within 4 h. Additional performance evaluations included Marshall stability (49,848 N), water-immersion residual stability (100% under the test protocol), length change (small magnitude over 28 days), and self-filling behavior (complete filling in 17 s in the specified setup). These rapid early-age results met or surpassed relevant domestic specifications used for emergency repair materials. Based on these data, mix designs for field application are proposed, and practical implications and limitations for early-age performance are discussed. 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

The adhesion of endodontic sealers to dentin may be influenced both by the chemical composition of the sealer and the final irrigation protocol. The aim of this study was to examine the push-out bond strength of three differently formulated bioceramic sealers to root canal dentin, after different irrigation protocols. Four cavities were prepared in dentine discs obtained from middle thirds of third molars with fused roots. Discs were randomly divided into three groups (n = 8). Group 1: specimens were immersed in 2.5% NaOCl; group 2: in 2.5% NaOCl followed by 17% EDTA; and group 3: in a solution of 2.5% NaOCl with 9% etidronic acid (HEDP). The cavities on each disk were filled with four tested sealers: AH Plus Bioceramic, Bio C Angelus, BioRoot RCS, and AH Plus (n = 8 per sealer). The push-out bond strength test was performed after 7 days. The data were statistically analyzed using two-way analysis of variance with the Bonferroni post hoc test (α = 0.05). Irrigation with NaOCl resulted in significantly lower bond strength values of the sealers in comparison to NaOCl/EDTA and NaOCl/HEDP groups. In the NaOCl and NaOCl/HEDP groups, BioRoot RCS showed similar push-out bond strength compared to AH Plus and significantly higher compared to Bio-C and AH Plus Bioceramic. In the NaOCl/EDTA group, bioceramic sealers achieved a significantly weaker bond strength compared to AH Plus. The bond strength of BioRoot RCS was significantly higher compared to Bio-C and AH Plus Bioceramic. The irrigation protocols and the chemical composition of the sealers significantly influenced their bond strength to dentin. Epoxy resin-based sealer achieved the strongest bond strength, while within bioceramic sealers, the highest values were obtained for BioRoot RCS and the lowest for AH Plus Bioceramic. 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

Periprosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery that is difficult to both diagnose and treat. Misdiagnosing a prosthetic infection has terrible consequences for both the patient and healthcare system. No currently used diagnostic test fulfills the requirements to be considered a gold standard. This shortcoming has been overcome through the implementation of multi-criteria diagnostic protocols elaborated by societies including the Infectious Diseases Society of America, International Consensus Meeting and European Bone and Joint Infection Society, using a combination of clinical, paraclinical and molecular findings in order to achieve the best accuracy in diagnosing PJI. This review aims to survey the current state of the techniques and technologies used for the diagnosis of PJI, investigating the accuracies of serum biomarkers (e.g., C-reactive protein, Interleukin-6, procalcitonin, D-dimers, Serum Intercellular Adhesion Molecule-1), synovial biomarkers (e.g., Antimicrobial peptides, lipocalin-2, leukocyte esterase, calprotectin), tissue biomarkers (e.g., Toll-like receptors, CD15) and advanced molecular techniques (e.g., Polymerase chain reaction, Metagenomic next-generation sequencing), as well as describing their ongoing limitations. In the search for an accurate, inexpensive and fast diagnostic test for PJI, we conclude that the accuracies of the currently studied biomarkers could be further enhanced through the development of novel detection technologies. Full article

Positron emission tomography (PET) has become a powerful tool in Alzheimer’s disease (AD) research by enabling in vivo visualization of pathological biomarkers. Recent efforts have aimed to integrate PET-derived imaging phenotypes with genome-wide association studies (GWASs) to better elucidate the genetic architecture underlying AD. This systematic review examines studies that leverage PET imaging in the context of GWASs (PET-GWASs) to identify genetic variants associated with disease risk, progression, and brain region-specific pathology. A comprehensive search of PubMed and Embase databases was performed on 18 February 2025, yielding 210 articles, of which 10 met pre-defined inclusion criteria and were included in the final synthesis. Studies were eligible if they included AD populations, employed PET imaging alongside GWASs, and reported original full-text findings in English. No formal protocol was registered, and the risk of bias was not independently assessed. The included studies consistently identified APOE as the strongest genetic determinant of amyloid burden, while revealing additional significant loci including ABCA7 (involved in lipid metabolism and amyloid clearance), FERMT2 (cell adhesion), CR1 (immune response), TOMM40 (mitochondrial function), and FGL2 (protective against amyloid deposition in Korean populations). The included studies suggest that PET-GWAS approaches can uncover genetic loci involved in processes such as lipid metabolism, immune response, and synaptic regulation. Despite limitations including modest cohort sizes and methodological variability, this integrated approach offers valuable insight into the biological pathways driving AD pathology. Expanding PET-genomic datasets, improving study power, and applying advanced computational tools may further clarify genetic mechanisms and contribute to precision medicine efforts in AD. Full article

Background/Objectives: Self-adhesive flowable resins (SAFR) entered the market, eliminating the adhesive system application due to their self-adhesive technology. Guided by the PICO framework (Population, Intervention, Comparison, Outcome), the aim was to conduct a systematic review of clinical studies to compare the clinical performance of Self Adhesive Flowable Resin (SAFRs) with conventional flowable resins used for direct restorations. Methods: The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (CRD42023394297) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Five databases (PubMed, Embase, Web of Science, Scopus, and Cochrane Library) were searched from inception to July 2025. Nine randomized clinical trials were included, totaling 493 restorations in 232 patients. Clinical performance was assessed using USPHS or FDI criteria, with follow-up periods ranging from 6 months to 5 years. Data were pooled using a random-effects meta-analysis to calculate risk differences (RD) and 95% confidence intervals (CI) for marginal adaptation, retention, marginal staining, post-operative sensitivity, color stability, surface roughness, secondary caries, and anatomical form. Results: Meta-analysis showed no significant differences between SAFRs and CFRCs for in terms of: marginal adaptation (RD = 0.01; 95% CI: −0.02 to 0.04; p = 0.53; I² = 0%), retention (RD = 0.00; 95% CI: −0.02 to 0.03; p = 0.81; I² = 0%), marginal staining (RD = 0.01; 95% CI: −0.01 to 0.02; p = 0.51; I² = 0%), and post-operative sensitivity (RD = −0.01; 95% CI: −0.03 to 0.02; p = 0.62; I² = 0%). The certainty of the evidence for all outcomes was rated as moderate to high according to the GRADE assessment. Conclusions: SAFR restorations demonstrated comparable clinical performance to conventional resins; however, heterogeneity in follow-up duration and the scarcity of long-term data (>5 years) warrant caution. Full article

Modern, small-diameter endoscopic instruments, such as resectoscopes (e.g., the GUBBINI System) and mini-hysteroscopes, are widely used in clinical practice. These tools allow endoscopic procedures to be conducted without cervical dilation, often in an outpatient setting, and under local anesthesia alone. Background/Objectives: The present retrospective study aimed to analyze the perioperative and delayed complications of hysteroscopy performed under local anesthesia. This study also assessed the pain experienced during hysteroscopy under local anesthesia, depending on the type of procedure performed. Methods: A retrospective analysis was conducted in 1945 patients who underwent hysteroscopy under local anesthesia at the Center for Hysteroscopy, Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital, Karol Marcinkowski Medical University, Poznań, Poland, between January 2021 and December 2023. Hysteroscopic procedures were performed with the GUBBINI Mini Hystero-Resectoscope through a paracervical block using lignocaine. Results: The procedure was discontinued in 46 patients, accounting for 2.36% of all hysteroscopies. The most common reasons for procedure discontinuation were severe pain and uterine perforation, accounting for 52.8% and 13% of discontinued procedures, respectively. The complication rates were low: uterine perforation occurred in 0.3% of cases (n = 6), and late complications requiring readmission occurred in 0.2% (n = 3). The average pain intensity score for all the patients was 2 points (2.8 ± 2.14). Conclusions: Our study confirmed that hysteroscopy performed under local anesthesia is a safe and effective diagnostic and therapeutic method for selected uterine pathologies, noting increased risks in cases such as extensive intrauterine adhesions. The low complication rates in both the perioperative and postoperative stages indicate the high safety profile of this procedure, particularly when performed by experienced personnel using standardized, validated protocols. Full article

This study presents the development and the mechanical and clinical characterization of a flexible biodegradable chitosan–glycerol–graphite composite strain sensor for real-time respiratory monitoring, where the main material, chitosan, is derived and extracted from Tenebrio Molitor larvae shells. Chitosan was extracted using a sustainable, low-impact protocol and processed into a stretchable and flexible film through glycerol plasticization and graphite integration, forming a conductive biocomposite. The sensor, fabricated in a straight-line geometry to ensure uniform strain distribution and signal stability, was evaluated for its mechanical and electrical performance under cyclic loading. Results demonstrate linearity, repeatability, and responsiveness to strain variations in the stain sensor during mechanical characterization and performance, ranging from 1 to 15%, with minimal hysteresis and fast recovery times. The device reliably captured respiratory cycles during normal breathing across three different areas of measurement: the sternum, lower ribs, and diaphragm. The strain sensor also identified distinct breathing patterns, including eupnea, tachypnea, bradypnea, apnea, and Kussmaul respiration, showing the capability to sense respiratory cycles during pathological situations. Compared to conventional monitoring systems, the sensor offers superior skin conformity, better adhesion, comfort, and improved signal quality without the need for invasive procedures or complex instrumentation. Its low-cost, biocompatible design holds strong potential for wearable healthcare applications, particularly in continuous respiratory tracking, sleep disorder diagnostics, and home-based patient monitoring. Future work will focus on wireless integration, environmental durability, and clinical validation. Full article

The aim of this work is to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) against oral MDR (multi-drug-resistant) Candida spp. infections related to orthodontic treatment with palatal expanders through in vitro study. Methods: PDT protocol: Curcumin + H₂O₂ was used as a photosensitizer activated by a 460 nm diode LED lamp, with an 8 mm blunt tip for 2 min in each spot of interest. In vitro simulation: A palatal expander sterile device was inserted into a custom-designed orthodontic bioreactor, realized with 10 mL of Sabouraud dextrose broth plus 10% human saliva and infected with an MDR C. albicans clinical isolate CA95 strain to reproduce an oral palatal expander infection. After 48 h of incubation at 37 °C, the device was treated with the PDT protocol. Two samples before and 5 min after the PDT process were taken and used to contaminate a Petri dish with a Sabouraud field to evaluate Candida spp. CFUs (colony-forming units). Results: A nearly 99% reduction in C. albicans colonies in the palatal expander biofilm was found after PDT. Conclusion: The data showed the effectiveness of using aPDT to treat palatal infection; however, specific patient oral micro-environment reproduction (Ph values, salivary flow, mucosal adhesion of photosensitizer) must be further analyzed. Full article

Biofilms, structured communities of microorganisms encased in an extracellular matrix, are a major cause of persistent infections, particularly when formed on medical devices. This study investigated the kinetics of biofilm formation by Escherichia coli and Pseudomonas aeruginosa, two clinically significant pathogens, on two medical-grade polymers: polyether ether ketone (PEEK) and polyamide 12 (PA12). Using a modified crystal violet staining method and spectrophotometric quantification, we evaluated biofilm development over time on polymer granules and catheter segments composed of these materials. Results revealed that PEEK surfaces supported significantly more biofilm formation than PA12, with peak accumulation observed at 24 h for both pathogens. Conversely, PA12 demonstrated reduced bacterial adhesion and lower biofilm biomass, suggesting surface characteristics less conducive to microbial colonization. Additionally, the study validated a reproducible protocol for assessing biofilm formation, providing a foundation for evaluating anti-biofilm strategies. While the assays were performed under static in vitro conditions, the findings highlight the importance of material selection and early prevention strategies in the design of infection-resistant medical devices. This work contributes to the understanding of how surface properties affect microbial adhesion and underscores the critical need for innovative surface modifications or coatings to mitigate biofilm-related healthcare risks. Full article

Electroless nickel deposition (ELD) is an autocatalytic technique extensively used to impart conductive, protective, and mechanical functionalities to inherently non-conductive synthetic substrates. This review systematically explores the fundamental mechanisms of electroless nickel deposition, emphasising recent advancements in surface activation methods, solvent systems, and microstructural control. Critical analysis reveals that bio-inspired activation methods, such as polydopamine (PDA) and tannic acid (TA), significantly enhance coating adhesion and durability compared to traditional chemical etching and plasma treatments. Additionally, solvent engineering, particularly using polar aprotic solvents like dimethyl sulfoxide (DMSO) and ethanol-based systems, emerges as a key strategy for achieving uniform, dense, and flexible coatings, overcoming limitations associated with traditional aqueous baths. The review also highlights that microstructural tailoring, specifically the development of amorphous-nanocrystalline hybrid nickel coatings, effectively balances mechanical robustness (hardness exceeding 800 HV), flexibility, and corrosion resistance, making these coatings particularly suitable for wearable electronic textiles and smart materials. Furthermore, commercial examples demonstrate the real-world applicability and market readiness of nickel-coated synthetic fibres. Despite significant progress, persistent challenges remain, including reliable long-term adhesion, internal stress management, and environmental sustainability. Future research should prioritise environmentally benign plating baths, standardised surface activation protocols, and scalable deposition processes to fully realise the industrial potential of electroless nickel coatings. Full article