A randomized
controlled trial evaluating a novel oscillating-rotating
Ralf Adam, phd, Julie Grender, phd, Hans
Timm, phd, Jimmy
Qaqish, bsc & C. Ram Goyal, dds
Abstract: Purpose: To assess the relative efficacy of
a new entry-tier oscillating-rotating (OR) electric toothbrush versus a sonic
electric toothbrush over 4 weeks of use for plaque and gingivitis reduction. Methods: This single-center, examiner-blind, two-treatment, parallel-group, randomized
clinical study enrolled adult participants who had evidence of gingivitis and
plaque at baseline. Participants were randomly assigned to use either an
entry-tier OR toothbrush (Oral-B iO2) with the Ultimate Clean brush head in
Daily Clean mode or an advanced sonic toothbrush (usmile Marble-Art) used with the usmile Advanced Whitening
brush head in Clean mode (and at the high-intensity
level). Both groups brushed with a standard sodium fluoride dentifrice.
Participants were assessed for gingivitis (Modified Gingival Index and the
Gingival Bleeding Index) and plaque (Rustogi Modification of the Navy Plaque Index) at baseline and after 4 weeks of
twice-daily use. Plaque was also assessed after a single use at baseline. Results: Both toothbrushes statistically significantly reduced gingivitis after 4 weeks
of use and plaque after a single use and after 4 weeks (P< 0.001 for all).
The OR toothbrush, relative to the sonic toothbrush, demonstrated a
statistically significantly greater reduction in Modified Gingival Index score
and number of bleeding sites (P< 0.001) and was associated with a
significantly greater number of users transitioning from gingivitis to a state
of gingival health (i.e., < 10% bleeding sites; P= 0.038) by the end of the
study. The OR toothbrush likewise demonstrated greater efficacy with respect to
plaque reduction after a single use (whole mouth, interproximal, and gingival
margin; P< 0.001 for all) and after 4 weeks of use (whole mouth and
interproximal; P< 0.001 for both). (Am J Dent 2025;38:3-8).
Clinical
significance: The novel entry-tier OR toothbrush
offers significantly greater plaque control and gingivitis reduction relative
to the advanced sonic toothbrush model.
Mail: Dr. Ralf
Adam, Procter & Gamble German Innovation Center, Frankfurter Straße 145,
61476 Kronberg, Germany. E-mail: adam.r@pg.com
Effect
of remineralization product on the microhardness
Dilan Kopuz, dds, Özlem Erçin, dds, Dilek Tağtekin, dds, phd & Funda Yanikoğlu, dds, phd
Abstract: Purpose: To evaluate the effect of toothpaste containing sodium fluoride, a commercially
available remineralization product, on the microhardness and roughness of
enamel after whitening with two different
concentrations of hydrogen peroxide. Methods: 32 premolar teeth
extracted for orthodontic reasons were collected. Initial microhardness and
roughness values were measured. All samples were immersed in a coffee solution
for 1 week to simulate coloration in the oral environment and ensure
standardization. Then, the second microhardness and roughness measurements were
obtained. Two samples were separated, and the remaining ones were divided into
three groups; Group 1: Samples treated with Whiteness HP (hydrogen peroxide)
35% bleaching agent; Group 2: Samples treated with Beka HP 30% bleaching agent;
Group 3: Samples kept in distilled water. For Groups 1 and 2, the bleaching
procedure was applied in three sessions of 15 minutes each, following the
manufacturer's instructions. Afterward, measurements of all samples were
repeated. To examine the reversibility of surface changes following the
bleaching process, a demineralization-remineralization (pH) cycle was applied.
Subsequently, microhardness and roughness measurements were repeated, and two
samples from each group were set aside for FE-SEM Field emission scanning electron
microscope analysis. A total of eight samples underwent FE-SEM analysis at ×1,000
and ×5,000 magnifications. Data were analyzed using two-way
ANOVA and Kruskal-Wallis tests. Results: Initial microhardness values of
all samples were the highest values, with a decrease observed after the
bleaching procedure. Even though the microhardness of the samples increased in
Groups 1 and 2 after the pH cycle, there was no significant difference (P< 0.05).
While the roughness values of the samples decreased after the discoloration (P>
0.05), they increased after the pH cycle and there were significant differences
between the 4th measurement and the other measurements (P< 0.05). (Am J
Dent 2025;38:9-14).
Clinical significance: The bleaching agent causes changes in the structure of the enamel and reduces
microhardness and roughness values. However, remineralizing agents applied during the pH cycle may have a positive effect on microhardness.
Mail:
Dr. Dilan Kopuz, Department of Restorative Dentistry, Faculty of Dentistry, Istanbul
Kent University, Istanbul, Turkey. E-mail: dilan.kopuz@kent.edu.tr
Bond
strength evaluation of universal adhesives applied
Anh Duc Nguyen, dds, Sina Broscheit, dds, Dirk
Vordermark, dr med, dmd, phd, Kerstin Bitter, dr med Dent, dds, phd
Abstract: Purpose: To evaluate the laboratory microtensile bond strength (µTBS) of universal adhesives
applied in etch-and-rinse mode on irradiated and sound human dentin. Methods: Dentin specimens of 135 freshly extracted human third molars were divided in three superordinate groups. Each tooth received either no
irradiation (control group), 5 Gy (2 Gy/2 Gy/1 Gy in 3 consecutive days) or the
high-level therapeutic dose of 60 Gy (test groups) applied fractionally (2
Gy/day, 5 days/week, 6 weeks). Samples from each group were randomly divided
into three subgroups assigned to three established universal adhesives (Futurabond U, AdheSE Universal,
Xeno Select) in just the etch-and-rinse application mode (n= 15). Bond strength
was assessed with a universal testing machine 15 minutes after application and
light curing of the adhesive materials. Statistical analysis was performed
using a two-way ANOVA (P< 0.01) and Tukey's test (P< 0.05). Results: Regarding all experimental groups ANOVA showed significant effects on µTBS of
dentin irradiation and the used adhesives (P< 0.01, ANOVA). In nearly all
groups, a decrease of µTBS was observed when used on highly irradiated dentin.
However, comparing the different groups, no significant influence of high-level
radiation on the microtensile bond strength of the
three universal adhesives assessed in etch-and-rinse application mode could be
determined (P> 0.05, Tukey's test). (Am J Dent 2025:38:15-21).
Clinical
significance: Within the limitations of this
laboratory study, no significant effects of low- and high-level tumor
irradiation on the bond strength of universal adhesives can be detected after
application in etch-and-rinse mode. Consequently, this mode of application may
be considered a viable option for patients who have undergone radiation therapy
when using universal adhesive systems for luting restorative materials.
Mail: Prof. Dr. Christian Ralf
Gernhardt, University Outpatient Clinic for Conservative Dentistry and
Periodontology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 16, 06112 Halle, Germany. E-mail:
Christian.Gernhardt@uk-halle.de
Efficacy
of calculus removal with hand and ultrasonic instruments
Maggie Elise Eslinger, bs, Vrushali Abhyankar, bds, mds, ms, Brian R. Morrow, bs, ms,
Abstract: Purpose: To evaluate the impact of different instruments on dental implants on titanium
discs and simultaneously test how effective they were in removing calculus. Methods: Artificial calculus was applied on 36 rectangular areas demarcated on titanium
discs. Surface roughness was measured using a stylus profilometer. Calculus was
then removed using six different hand or power-driven ultrasonic instruments.
Surface roughness measurements D-Ra and D-Rz were then re-calculated. Cleaned
distance was divided by total calculus to yield a cleaning ratio and the number
of cleaning strokes required to remove the calculus was calculated. All
measurements were statistically analyzed independently (two-way ANOVA, Holm-Sidak
roughness and cleaning ratios Kruskal-Wallis one-way ANOVA on ranks, and
Student-Newman-Keuls, α< 0.05). Results: Ultrasonic magnetostrictive instruments were most efficient in
calculus removal and demonstrated a statistically high cleaning ratio
percentage (P< 0.001) and required the least number of strokes compared to
all the other groups. The resin curettes were the least effective in
calculus removal and required the greatest number of strokes. When surface
roughness values (D-Ra) were compared between different instruments,
statistically significant differences were noted between the resin curettes and
ultrasonic magnetostrictive groups, with the resin
curette group showing lower values and the Ultrasonic magnetostrictive group showing greater values. (Am J Dent 2025;38:22-26).
Clinical significance: Current research on significance of titanium particles and their possible role
in causing periimplantitis emphasizes the importance of using instruments that
do not damage the implant surface. Instrumentation causing the least amount of
surface roughness should be considered since the risk of damaging the surface
outweighs the benefit.
Mail:
Dr. Pooja AjitSankardas, Department of
Periodontology, Room C530, College of Dentistry, University of Tennessee Health
Science Center, 875 Union Avenue, Memphis, TN 38103, USA. E-mail: pajitsan@uthsc.edu
Effect of brushing
on the surface properties of modified
Semsettin
Yildiz, dds, phd & Bahar Tekin, dds
Abstract: Purpose: To evaluate the surface roughness
(SR) and surface topography (ST) of mechanical brushing with pure-unfilled PEEK
(U-PEEK) and PEEK materials with different contents [titanium-containing PEEK
(T-PEEK), ceramic-modified PEEK (C-PEEK) and glass fiber-reinforced PEEK
(G-PEEK). Methods: A total of 40 disc-shaped samples (10 mm × 2 mm) were
obtained (n= 10) from each group (U-PEEK, T-PEEK, C-PEEK, G-PEEK). After
sanding and polishing, a profilometer was used to analyze all discs' surface
roughness (Ra). Qualitative analysis (QA) was performed on random samples with
the help of a scanning electron microscope (SEM). Brushing was done with a
custom-made brushing simulator, and the analyses were repeated. Statistical
analysis was performed (P< 0.05). Results: A statistically
significant difference was found between the PEEK groups before and after
brushing (P< 0.05). In the measurements before and after brushing, the
lowest measurement value was seen in the C-PEEK and T-PEEK groups. While there
was no significant difference between T-PEEK and C-PEEK measurements, both
measurements found the highest measurement value in the G-PEEK group. In
addition, in all groups, the average roughness values after brushing were
statistically significantly higher than those before brushing. All groups
except G-PEEK are below the clinically acceptable SR value (0.2 µm) before and
after brushing. T-PEEK and C-PEEK show better SR values. (Am J Dent 2025;38:27-32).
Clinical
significance: With this study, knowing the
effect of mechanical brushing on the SR of modified PEEK materials which may
become widely used in dentistry, will be a guide for clinicians.
Mail: Dr. Bahar Tekin, Department
of Periodontology, Faculty of Dentistry, Firat University, Elazig, Postal Code: 23119, Turkey. E-mail: dtbahartekin@gmail.com
Bond strength of
different resin-based cements to 3D-printed
Engin Kariper, phd & Aylin Cilingir, phd
Abstract: Purpose: To
investigate the shear bond strength of different primers with adhesive cements to 3D printed restorations. Methods: 72
3D-printed restorations (Formlabs permanent crown
resin) and nano-hybrid composite (Tetric EvoCeram) resin cylinders prepared and assigned to two
groups, according to G-Multi Primer (GMP) with G-Cem One (GCO) and Clearfil ceramic primer plus (CCP) with Panavia F2.0 (PF)
cements and three subgroups (n=9) were created for each cement: (1) control
group, (2) 5,000 thermal cycles, (3) 10,000 thermal cycles. 3D-printed
restorations were embedded in Teflon molds and cemented with nano-hybrid
composite resin cylinders and a shear bond strength test was performed
according to group. Failure modes were observed with stereomicroscope (30×),
and surface morphology was evaluated with SEM analysis (100× and 2,000×).
Statistical analysis was performed using Kolmogorov-Smirnov and Shapiro Wilks
tests, and for evaluating the study data, 2-way ANOVA test and post hoc Tukey
HSD test were used. Results: The GCO groups exhibited significantly
higher SBS values than the PF groups in the bonding of the tested 3D-printed
restorations. There was no statistically significant difference in the bond
strengths of tested GCO cement groups. A control group of PF cement showed
significantly higher SBS values than the 5,000 and 10,000 cycling of PF groups.
However, there was no statistically significant difference in the 5,000 and 10,000 cycling PF groups. The bonding performance was superior
for the GCO group. (Am J Dent 2025;38:39-45).
Clinical significance: Silane
coupling agent application allows chemical bonding and improves the bond
strength of the self-adhesive resin cement types. In the cementation of
3D-printed resin restorations, G-Cem One has demonstrated superior bond values,
even under aging conditions, and is a viable alternative to Panavia, the gold
standard adhesive cement, when applied with Clearfil ceramic primer plus.
Mail: Dr. Aylin Cilingir,
Department of Restorative Dentistry, Trakya University, Faculty of Dentistry.
22030 Edirne, Turkey. E-mail: aylincilingir@trakya.edu.tr.
Synthesis of amino
acid-based carbon dots: Effect on oral cancer cells
So-Young
Park, dds, phd, Wooil Kim, phd, Ae-Ri
Pyo, ms, Yong Hoon Kwon, phd
Abstract: Purpose: To
assess if amino acid-based carbon dots (CDs) eliminate in vitro cancer cells. Methods: CDs were synthesized using
cysteine as a precursor and metal and photosensitizer as modifiers. In vitro cell viability tests were
performed using cancer and normal cells without and with H2O2 and laser irradiation. Methylene blue (MB)
solution was used to evaluate the production of ROS by CDs via observing
absorbance differences before and after treatments. Extracellular oxygen
production was measured in real-time using a probe. The generation of singlet
oxygen was spectroscopically evaluated using RNO-ID assay. Results: Within the test conditions, CDs fn-Cei-Ce6 achieved significantly low in vitro cancer cell viability (near
to 26% of initial cell count) at 20 ppm concentration, high absorbance difference (Δ) in all wavelengths, oxygen production approximately
to 1.2 mg/L, and high absorbance decrease of RNO-ID assay solution all with 100 μM H2O2 and laser irradiation
conditions. (Am J Dent 2025;38:46-50).
Clinical
significance: Amino acid-based carbon dots (CDs) eliminated cancer cells in vitro with near to 74% of initial cancer cells under 100 μM H2O2 and laser irradiation conditions. The
results may be extended to the clinical potential of fn-Cei-Ce6 in treating
tumors in the oral cavity.
Mail: Dr. Franklin Garcia-Godoy,
Department of Bioscience Research, College of Dentistry, University of
Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA. E-mail:
fgarciagodoy@gmail.com
Color
improvement and surface integrity: Charcoal-based
Pinar Naiboğlu, dds & Zeynep Pinar Keleş Yücel, dds, phd
Abstract: Purpose: To determine the effect of charcoal-based toothpaste used alone or in
combination with charcoal-based mouthwash on color change (ΔE00)
and surface roughness (Ra) of a stained resin composite. Methods: Disc-shaped (8 × 2 mm) resin composite samples (Filtek Z250) were prepared. Then, the samples were immersed in coffee for 12 days. The
samples were randomly assigned into four groups (n= 12). Distilled water (DW),
Colgate Total 12 (CT), Colgate Optic White (COW), and Colgate Optic White +
Colgate Plax White Charcoal (COW + CPWC) were used over a 3-month period. Color
measurements were performed at baseline, after staining, after 1 and 3 months use. Ra analysis and surface topography by
scanning electron microscopy (SEM) were evaluated after staining, after 1- and
3 months use. Results: Color changes occurring on resin composite
samples immersed in coffee for 12 days exceeded the 50:50% acceptability
threshold (AT) (ΔE00:1.8). CT, COW, and COW + CPWC reduced the
color change on composite samples below to the AT after 3 months of use. CT and
COW + CPWC showed a significant increase in Ra after both time intervals and
caused changes in surface morphology of resin composite. The present findings
suggest that charcoal-based toothpaste used alone may be effective in improving
the color of resin composite without inducing surface damage. Moreover, when
used with charcoal-based mouthwash, the similar effect
in color improvement may be accompanied by increased surface roughness. (Am
J Dent 2025;38:51-56).
Clinical significance: This is the
first study evaluating the effect of charcoal-based mouthwash when used with
charcoal-based toothpaste on color change and surface roughness of a stained
resin composite. Both toothpastes tested were effective in improving the color
of the resin composite samples. While conventional toothpaste caused increased
surface roughness, the charcoal-based toothpaste maintained surface integrity. However, charcoal-based toothpaste did not provide further
color improvement when used in combination with the charcoal-based mouthwash
and specifically led to increased surface roughness, highlighting potential
implications for clinical practice.
Mail: Dr. Pinar Naiboğlu,
Department of Restorative Dentistry, Faculty of Dentistry, Giresun University,
Giresun, Turkey. E-mail: pinar.naiboglu@hotmail.com
_______________________________________________________________________________________________________________________
Review
Article
_______________________________________________________________________________________________________________________
Effect of
bisphosphonates on periodontal diseases in menopausal
Linlin Qin, ms, Xinyue Wu, ms, Kunshuang Wu, ms, Hanyue Mai,
bs & Ping Wang, phd
Abstract: Purpose: To systematically evaluate the
effect of bisphosphonates on periodontal diseases in menopausal and
postmenopausal women. Methods: Databases (PubMed, Embase, Web of
Science, Cochrane Library databases, Chinese Scientific and Technological
Journal database, Wan Fang Data, China Biomedical Literature Database, and
Chinese National Knowledge Infrastructure) were searched from inception to July
2024, languages are Chinese and English. Randomized controlled trials (RCTs)
reporting the effect of bisphosphonates in menopausal and postmenopausal women
with periodontitis were included. The risk of bias was performed using the
Cochrane collaboration tool. The primary outcome was clinical attachment loss
(CAL), and the secondary outcomes were probing depth (PD) and gingival index
(GI). The analysis of the data was performed using Rev Man 5.3 and Stata 16.0. Results: The meta-analysis incorporated four studies that fulfilled the inclusion
criteria. In evaluating the efficacy of bisphosphonates against control treatments,
there was high heterogeneity observed in CAL (P = 0.0002; I2 = 85%) and
PD (P< 0.00001; I2 = 93%) within the study groups. Meta-analysis showed a significant improvement
in CAL gain (MD = - 0.57 mm; 95% CI = -1.04 to -0.11 mm; P< 0.05), PD
reduction (MD = - 0.50 mm; 95% CI = -0.96 to -0.05 mm; P< 0.05), and GI
reduction (MD = -1.11; 95% CI = -1.22 to -1.01; P< 0.00001) for
bisphosphonate treatment vs. bisphosphonate-naïve therapy. (Am J Dent 2025;38:33-38).
Clinical
significance: Bisphosphonate treatment seems to
be beneficial for managing periodontitis in menopausal and postmenopausal
women.
Mail: Dr. Ping Wang, Department of
Stomatology, The First Affiliated Hospital of Chongqing Medical University,
Chongqing, 400016, China. E-mail:
cqykdxwp@126.com