Search Results (75)

Dental enamel discoloration, extrinsic staining, and periodontal biofilms remain persistent challenges in oral health. This study explores the in vitro, dual-functional potential of Magnolia figo flower extract (FMO), a sesquiterpene-rich botanical active phytochemical ingredient (API), for aesthetic and antimicrobial oral applications. FTIR identified characteristic terpenoid and long-chain fatty acid functional groups, including β-elemene, γ-elemene, and caryophyllene oxide. Whitening efficacy on coffee-stained bovine enamel was quantified using CIELAB colorimetry. The 0.5% FMO treatment achieved ΔE* = 8.49, which was within the clinical perceptibility threshold and the optimal biocompatibility balance. SEM confirmed no demineralization on the enamel surface after immersion in 3.0% FMO for 12 h. Antimicrobial assays demonstrated inhibition of Porphyromonas gingivalis, with MIC and MBC values of 0.25% and 0.5%, respectively. Biofilm formation was reduced by over 50% at a 0.148% concentration. Cytocompatibility assays using HGF-1 cells with various concentrations of FMO showed reduced cell viability at higher concentrations. When exposed for 5 min (simulating daily oral care) or 2 h, 0.5% FMO exhibited greater biocompatibility with L929 cells compared to toothpaste and peroxide-based agents. These findings suggest that FMO may serve as a natural candidate for dual-function oral care; however, further in vivo and clinical investigations are needed to validate its potential use within oral care treatments. Full article

Biomimetic restorative dentistry aims to preserve tooth structure and achieve optimal aesthetic harmony with surrounding dentition. The principles and protocols associated with biomimetic restorative dentistry are designed to enhance the longevity of the restoration. The use of flowable CRs is increasingly common; however, the effect of viscosity on the discoloration has not been clearly established. This in vitro study aimed to assess the color stability of flowable CRs with varying viscosities following immersion in common staining solutions and subsequent repolishing. A total of 250 disc-shaped specimens (8 mm × 2 mm) were prepared from five CRs with different viscosity profiles: high-viscosity (Spectra STHV, Dentsply, Milford, DE, USA), medium-viscosity (Estelite Universal Flow Medium, Tokuyama Dental Co., Tokyo, Japan), bulk-fill (Estelite Bulk-Fill Flow, Tokuyama Dental Co., Tokyo, Japan; SDR Plus, Dentsply, Milford, DE, USA), and packable (Estelite Posterior, Tokuyama Dental Co., Tokyo, Japan). After polymerization and baseline color measurements, specimens were immersed in coffee, tea, cola, red wine, or distilled water for 144 h. Color values were recorded before and after staining, and again following repolishing. Color changes (ΔE₁, ΔE₂, ΔE₃) were calculated using the CIE Lab system and statistically analyzed via two-way ANOVA and Tukey HSD (α = 0.05). Both the CR type and the staining solution substantially affected the color change. SDR Plus exhibited the highest ΔE values. Red wine caused the most discoloration. Repolishing enhanced color in selected groups. Full article

Background: The phenomenon of pink teeth represents a notable observation in forensic science, although its interpretation remains complex and not directly attributable to a specific cause of death. Methods: This systematic review provides an updated and comprehensive overview of the morphological and histological mechanisms associated with this finding, with a focus on hemoglobin diffusion and pigment accumulation during putrefaction rather than on detailed biochemical pathways. Results: Environmental conditions, especially high humidity and moderate temperatures, are identified as key facilitators. The synthesis of the available evidence, including case reports, observational series, and experimental studies, confirms that pink discoloration is primarily linked to postmortem hemoglobin diffusion following erythrocyte breakdown and release of heme groups into dentinal structures. This process occurs more frequently under conditions that preserve hemoglobin and facilitate its migration into dental tissues. Importantly, pink teeth have been documented across a wide spectrum of postmortem scenarios, such as hanging, drowning, carbon monoxide poisoning, and prolonged exposure to humid environments, indicating that their presence is neither pathognomonic nor exclusively associated with a specific cause of death. Assessment methods include semi-quantitative visual scoring systems (e.g., SPTC and SPTR), spectrophotometric assays, and histochemical analyses for hemoglobin derivatives. Recent advances in digital forensics, particularly micro-computed tomography and artificial intelligence–based segmentation, may further support the objective evaluation of chromatic dental changes. Conclusions: This review underscores the need for standardized approaches to the identification, classification, and analysis, both qualitative and quantitative, of pink teeth in medico-legal practice. Although not diagnostic in isolation, their systematic study enhances our understanding of decomposition processes and contributes supplementary interpretive data in forensic investigations. Full article

This study evaluated the effects of conventional cigarette smoke compared to aerosol from a heat-non-burn tobacco product on the color stability of two UDMA-based dental composite resins, namely a monochromatic (Omnichroma) and a polychromatic (Vittra APS) resin. Twenty disc-shaped specimens were prepared, divided into two groups of ten, and exposed to 105 cigarettes or 105 aerosol tobacco sticks via a custom-made smoking chamber. Puff duration was 2 s, with a 60 s interval between puffs in which smoke saturated the chamber for 30 s; then, clean air was introduced into the chamber for 30 s. Six puffs and six intervals were simulated. Color parameters were measured before and after exposure and following brushing of each specimen with 15 strokes. Color differences were determined based on the CIEDE2000 formula. Significant color change was found in all specimens exposed to cigarette and tobacco aerosol. The highest color-change mean value was obtained from composite resin exposed to cigarette smoke. Although both cigarette and thermal heating systems cause discoloration, the aerosol causes reduced composite resin discoloration, which compromises aesthetics and increases patient dissatisfaction, impacting the overall dental care. Color stability is the hallmark of success, as it is the main reason for replacing dental restorations. Full article

Background: Early childhood dental decay remains a pervasive chronic condition, and environmental toxicants—particularly lead—may exacerbate its development. This systematic review was designed to synthesize evidence on how lead exposure correlates with both the occurrence of carious lesions and aesthetic alterations in children’s primary teeth. Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science through April 2025, selecting observational investigations that assessed the link between lead levels and primary-tooth decay in pediatric cohorts. Thirteen eligible studies, encompassing 44,846 participants aged 2–19 years, were included for qualitative synthesis. Aesthetics were screened using author-defined enamel-defect or discoloration endpoints; however, only three studies reported compatible metrics, precluding quantitative pooling. Heterogeneity in exposure matrices likewise ruled out meta-analysis. Results: Most studies reported a statistically significant association between higher lead burden and greater prevalence or severity of caries in primary teeth. Blood lead concentrations across studies ranged from means of 1.53 μg/dL to geometric means of 7.2 μg/dL. Notably, elevated lead was linked to increased decayed, missing, or filled surfaces—with an adjusted risk ratio of 1.14 (95% CI: 1.02–1.27) at levels below 5 μg/dL—and adjusted mean ratios of up to 2.14 for decayed or filled teeth when blood lead reached 5–10 μg/dL. Conclusions: Current evidence suggests that children’s exposure to lead may heighten the risk of caries and detract from the aesthetic quality of primary teeth. However, variability in study design, lead quantification methods, and confounder adjustment limit the consistency of findings. Mitigating lead exposure in early life could represent a valuable preventive strategy against dental decay in susceptible pediatric populations. Full article

Smoking is a major risk factor for a variety of oral diseases. In particular, smoking-induced dental stains have been shown to be more refractory than those in non-smokers. Hydroxyapatite (HAP) is a biomimetic material that has been shown to be helpful in many oral health applications; however, its efficacy in stain removal in smokers and non-smokers is uncertain. To compare the effects of HAP toothpaste on the removal/control of extrinsic tooth discoloration in smokers and non-smokers. The secondary goal was to compare smokers and non-smokers in terms of staining extent and response to HAP. A total of 100 adults (50 smokers, 50 non-smokers) who met the inclusion and exclusion criteria were invited to participate in the study. At baseline and 2 weeks after the intervention, the same examiner performed clinical observations, including measurements of anterior tooth stain using the approximal plaque index (API) and the Lobene stain index. Adverse events and any changes in general health conditions of the patients were monitored. Comparisons of indices at baseline and post-intervention yielded statistically significant differences. In non-smokers, the median API (IQR) at baseline was 32.5 (19.0, 63.0) which decreased to 16.5 (7.0, 42.0) after the intervention (p < 0.001). The median Lobene stain index (extension) at baseline and after the intervention was 0.9 (0.5, 1.3) and 0.3 (0.2, 0.7), respectively (p < 0.001). In smokers, the median API at baseline (IQR) was 46.0 (30.0, 86.0), which decreased to 23.0 (7.0, 43.0) (p < 0.001) post-intervention. Lobene stain indices were lower after intervention in all groups than at baseline (all, p < 0.001), and the magnitude of reduction was more prominent in the smoker group. This study demonstrates that 2-week use of a toothpaste containing HAP can effectively reduce extrinsic tooth stains in smokers and non-smokers. Full article

Background/Objectives: Smoking remains a major public health concern, and healthcare professionals (HCPs) play a crucial role in smoking cessation efforts. This study aimed to assess the awareness, knowledge, and smoking behaviors of Italian students and graduates in dental hygiene from different regional areas (Group A) and students in health disciplines at a single university (Group B). Methods: Two separate surveys were conducted using a specifically designed online questionnaire administered to voluntary participants between February and April 2024. The questionnaire collected data on smoking habits, awareness of smoke-free products, sources of information, and perceptions of health effects. Results: A total of 878 questionnaires were completed. While 49.8% of participants had never smoked, 16.3% were regular smokers and 14% were occasional users of either traditional cigarettes or alternative smoke-free products. Awareness of non-combustion products was high, with social circles (74%) and social media (47.9%) being primary sources of information. Users of smoke-free products reported subjective improvements in halitosis, dental discoloration, cough, exercise capacity, and sense of taste. Despite 78% of participants receiving specific training on smoking-related diseases, gaps in knowledge persisted, particularly regarding the toxicological nature of smoking and the role of nicotine in smoking-related diseases. Conclusions: These findings highlight the need for continued education and training on smoking cessation and tobacco harm reduction among future HCPs. Strengthening evidence-based knowledge could enhance their ability to manage smoking-related diseases and promote effective cessation strategies. Full article

Background: Prophylactic polishing pastes (PPPs) are widely used to clean teeth and dental restorations; however, their effects on restorative materials are crucial for clinical outcomes. This study investigates the impact of PPPs on the susceptibility of CAD/CAM restorative materials to staining and the relationship between surface roughness and discoloration. Methods: Samples of tested materials (resin nanoceramic, hybrid ceramic, feldspathic ceramic, and lithium disilicate-reinforced glass ceramic) were treated with various PPPs (Cleanic, CleanJoy, Detartrine, Proxyt). Surface roughness and color parameters were recorded before and after the PPP application and following coffee immersion for 12 days. Initial measurements of surface roughness (Ra1) and color were taken. The specimens were divided into groups based on the PPP applied. After PPP application, secondary roughness (Ra2) and color values were measured. Changes in roughness (ΔRa), color (ΔE*ab, ΔE00), and whiteness index (ΔWID) were calculated post-application and after coffee immersion. Data normality was tested with the Shapiro–Wilks test. Two-way ANOVA evaluated the effects of material type and PPP on ΔE, ΔWID, and ΔRa. One-way ANOVA, Tukey HDS test, and Pearson correlation were used for further analysis, with significance set at p < 0.05. Results: The Vita Enamic–Detartrine group showed the highest ΔEab 1 and ΔE001 values, while Cerasmart–control showed the lowest. The Vita Enamic–Proxyt group had the lowest ΔWID1, and Vita Enamic–Cleanjoy exhibited the highest values of ΔEab 2, ΔE002, and ΔWID2. The E.MAX–control group had the lowest values for these metrics. No significant correlation was found between ΔRa and color changes (ΔE*ab 2, ΔE002, ΔWID2); however, a moderate positive correlation was found between values of ΔE1 and ΔE2. Conclusions: These findings indicate that PPPs significantly affect the discoloration and surface features of CAD/CAM materials, with both types of PPPs and materials. Full article

Vital pulp therapy (VPT) preserves dental pulp and its functions, offering a minimally invasive alternative to root canal therapy. However, the impact of patient-related factors on success remains unclear. This study aimed to estimate the sample size for a multivariate model predicting VPT success for assessing capping material, age, sex, and pulp conditions. A prospective cohort study was conducted with the inclusion of twenty-seven adult patients with carious pulp exposure in mature permanent teeth. Treatment comprised direct pulp capping, partial pulpotomy, or complete pulpotomy with Mineral Trioxide Aggregate Plus (MTA+) or Biodentine. Success rates were evaluated at 6 months through clinical and radiographic examinations. Statistical analysis included Pearson’s Chi-square tests and logistic regression. The success rates were 64% in the Biodentine group and 92% in the MTA+ group (OR: 0.15; p = 0.108). Sex and age had no significant effect. Success declined with increasing pulp condition severity and treatment invasiveness. MTA+ had a higher incidence of discoloration, while Biodentine showed none. Sample size calculations suggested 140 participants would be needed to detect a significant effect of pulp condition. Both materials were effective, though MTA+ showed higher success based on the strict success criteria. More severe pulpitis correlated with lower success, but a larger study is needed for predictive models. Full article

Background/Objectives: The Agenesis of maxillary lateral incisors occurs with a variable prevalence in different ethnic groups, and there is a need for a temporary replacement until maturity has been reached in patients for whom the replacement solution has been chosen. This study aims to analyze the scientific evidence available to date concerning the use of mini-screw implant (MSI)-supported pontics for the transitional management of permanent maxillary lateral incisors’ agenesis in developmental age subjects. Methods: Electronic research was conducted using four databases: PubMed, Clarivate Analytics/Web of Science Core Collection, Scopus, and the Wiley/Cochrane Library. Six studies were included in the final review. Data were extracted based on the first and second author, year of publication, study design, sample characteristics, mini-screw implant (MSI) characteristics, MSI insertion and loading protocol, characteristics of the prosthetic component, and outcomes during the follow-up time. Results: Clinical outcomes were proven positive in all studies. In only one study did MSIs show mobility and consequent failure after one month. Discoloration of the prosthetic part proved to be the main complication. Conclusions: The comparison with conventional removable prostheses and fixed dental prostheses revealed that MSI-supported pontics are a viable alternative and a promising temporary solution until the end of growth. Further studies to standardize protocols and assess long-term outcomes are needed. Full article

Objectives: Among modern metal-free materials, zirconia, a high-performance ceramic material that can only be manufactured through CAM procedures, has certainly exponentially gained popularity thanks to its mechanical strength, biocompatibility, esthetic, and versatility. However, one of the main debates that has been raised in relation to zirconia is its usage as an adhesive material. The present case report describes the clinical outcome of a multidisciplinary case finalized with adhesive minimally invasive zirconia veneers for the treatment of discolored teeth after a 24-month follow-up. Methods: A 19-year-old female patient with discolored upper frontal teeth (first premolar to first premolar) negatively affecting her self-esteem and social life was visited by a prosthodontic specialist. The treatment plan included orthodontic treatment, soft and hard tissue management through surgical procedures, and, lastly, minimally invasive adhesive zirconia veneers. The zirconia veneers bonding was performed under a rubber dam by conditioning the dental substrate by sandblasting the enamel with 40-micron aluminum oxide, etching with orthophosphoric acid 37%, and using a proper adhesive system. Monolithic zirconia restorations were sandblasted with 70-micron aluminum oxide at 0.2 MPa, then cleaned with a specific cleaner, and treated with a primer. Results: At the last follow-up (24 months), neither biological nor mechanical complications were observed. The patient anecdotally reported being very satisfied with the functional and esthetic results obtained. Therefore, the case was considered successful. Conclusions: Within the limitations of the present case report, the reported case on the use of minimally invasive resin-bonded zirconia veneers for the treatment of discolored teeth showed excellent outcomes after a 24-month follow-up. The use of zirconia as an adhesive material seems to be emerging. However, more clinical studies are required to validate the procedure. Full article

Newly developed 3D-printed polymer materials are used for denture base fabrication. The aim of the present study was to evaluate the color stability of two new 3D-printed resins, a hard PPMA-based and a soft Urethane-based resin, in relation to a traditional heat-polymerized PMMA resin, which was used for comparison purposes. Specimens of the materials were immersed in five solutions (distilled water, red wine, black tea, coffee, and Coke^®) for definite periods of time (one day, one week, and one month). The color measurements were carried out utilizing a spectrometer supported by a microscope and using special software. Color changes between immersion periods were calculated and statistically compared. The results showed that all types of resins were influenced during immersion periods. The heat-polymerized resin was influenced less than the others but with no significant difference to the 3D-printed hard PMMA resin. In respect to the materials compared, the discoloration effect for the 1 month immersion time was significantly more intense for the soft 3D-printed resin. In respect to the solutions’ staining effects, black tea and red wine significantly discolored all materials regardless of immersion periods. The new 3D-printed materials need further improvements for dental use. Full article

Background/Objectives: Electronic cigarettes (e-cigarettes) are commonly used by former smokers as an alternative product to conventional cigarettes and also by young adults and adolescents to deliver nicotine. E-cigarettes are thought to be a less harmful and more socially acceptable alternative to tobacco smoking; however, their long-term effects on health, including oral health, are currently unknown. Methods: A literature search for relevant papers indexed in the literature from 2016 to 2023 was conducted using the PubMed, Scopus, and Google Scholar databases. In our paper, we included clinical trials and both in vivo and in vitro research concerning the impact of e-cigarettes on oral health. Results: E-cigarettes impact the oral cavity, which is directly exposed to inhaled chemicals present in e-cigarette aerosols. The use of e-cigarettes has been linked to teeth discoloration and dental caries, promoting the development of periodontal diseases and causing oral mucosa lesions, including oral cancer. E-cigarette aerosols might also negatively affect the oral microbiome by suppressing the growth of commensal bacteria and increasing the population of bacteria responsible for developing numerous oral disorders. E-cigarettes also impact saliva composition and its properties, including reducing saliva’s antibacterial and antioxidant properties, which may subsequently lead to the promotion of oral diseases. Conclusions: The outcomes suggest that e-cigarette usage may cause the development of oral diseases, however further longitudinal studies of a larger and homogenous group of e-cigarette users are required. Full article

Background: Little has been written in the literature about the clinical comparison between the single use of chlorhexidine (CHX) and its combination with cetylpyridinium chloride (CPC). The purpose of this study is to compare the clinical effectiveness of two at-home antiseptic regimens. Methods: Healthy subjects scheduled for dental surgery were enrolled. After the surgery, patients were randomly allocated to the first group (group A), which received a manual ultrasoft toothbrush (Mentadent Professional^®), an antiseptic toothpaste with 0.12% CHX and Vitamin B3 (Mentadent Professional Azione Intensiva Gengive^®), and an antiseptic mouthwash with 0.12% CHX and 0.07% CPC. The second group (group B) solely received an antiseptic mouthwash with 0.2% CHX in conjunction with an anti-discoloration system (Curasept ADS/DNA^®) and were encouraged to use their usual toothbrush and toothpaste. Patients were instructed to use the products twice a day and to rinse for 30 s. On day 7, patients were examined for the early healing score (EHS), visual plaque index (VPI) of the sutures, numerical rating scale (NRS), and mouthwash taste. Results: Group A showed a statistically significant level of EHS and taste satisfaction. VPI and NRS were different but not significant among the studied groups. Conclusions: The regimen based on CHX used in conjunction with vitamin B3 in the toothpaste and CPC in the mouthwash resulted in superior clinical outcomes and satisfaction compared to CHX alone. Full article

Background/Objectives: Tooth whitening is a cosmetic dental treatment that improves the color of natural teeth, making them whiter and brighter; this review aimed to evaluate the greater effectiveness of in-office, at-home, and combined bleaching with hydrogen or carbamide peroxide, also in relation to possible relapses and side effects (tooth sensitivity). Methods: A literature search has been carried out through electronic databases, PubMed/MEDLINE, and Cochrane Library, focused on the use of the effectiveness of in-office, at-home, and combined dental bleaching. This review has been registered on PROSPERO (ID613248). Results: 30 articles have been included. Most of the studies did not find any more effective treatment than the proposed treatments; all types of bleaching have been shown to be effective in changing color; in the studies that have compared in-office and at-home bleaching, there was a lower recurrence of treatment with the use of the at-home trays with carbamide peroxide gel. There were no clear positions regarding tooth sensitivity, which would appear to be higher in professional in-office and combined dental bleaching. Conclusions: Bleaching is an effective treatment for the change of color of the tooth regardless of the type used (concentrations, type of gel, and duration of sessions), although, at home, it would seem to be more effective over time. It is, however, a clinical feature that may give a risk of tooth sensitivity after treatment. Full article