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August 2025 Abstracts
Evaluation of deep
learning systems in detection of dental caries
Hatice
Biltekin, dds, Gediz Geduk, dds, Aytaç Altan, phd & Seçkin Karasu, phd
Abstract: Purpose: To evaluate the effectiveness of
the deep convolutional neural network model for the detection of dental caries
on panoramic radiographs. Methods: A total of 2660 images of healthy and
decayed labeled teeth were obtained from 101 panoramic radiographs. A total of
5,000 data sets were created by obtaining 2,340 synthetic data from real data.
The total dataset is randomly divided as 80% training data and 20% test data. A
deep learning model was created using the ResNet50 deep convolutional neural
network architecture and model performance was measured after the model
training. All data was evaluated and diagnostic accuracy, sensitivity,
specificity, PPV (positive predictive value), NPV (negative predictive value),
ROC (receiver operator characteristics) curve and AUC (area under the curve)
were calculated for the detection and diagnostic performance of the deep
learning method with ResNet50. Results: The deep learning model
classified 500 healthy and 500 decayed tooth data at a rate of 82%. The deep
learning model's PPV value was 75.8%, NPV value was 92%, sensitivity 94% and specificity 70%. The AUC value was found to be 82%. (Am J
Dent 2025;38:163-168).
Clinical significance: The deep learning model used for the detection of
caries in panoramic radiography is promising for use as an auxiliary tool for
dentists in clinical practice.
Mail: Dr. Hatice Biltekin,
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University
of Bursa Uludag, Bursa, Turkey. E-mail:
dthaticebiltekin@gmail.com; haticebiltekin@uludag.edu.tr
Acute
periapical abscesses may be a risk factor for medication-related
Joseph Katz, dmd & Ilan Rotstein, dds
Abstract: Purpose: To explore the potential
association between acute periapical abscesses (PAs) and medication-related
osteonecrosis of the jaw (MRONJ). The study assessed the risk for MRONJ in
patients seeking emergency dental treatment for acute PAs in a large medical
facility in the United States. Methods: Data aggregated from 1,799,122
patients visiting a large medical center were recorded. Data from the
corresponding diagnosis codes for MRONJ and acute PAs was retrieved by
searching the appropriate query in the database. The odd ratio of acute PAs and
their association with MRONJ were calculated and analyzed statistically. Results: Patients with PAs showed significantly more MRONJ cases. The odds ratio (OR) of
patients receiving all types of bisphosphonates (BPs) was 6.21 and was
statistically significant (P< 0.0001). The OR of patients receiving
alendronate was 5.33 and was statistically significant (P= 0.0001). Following
adjustment for diabetes co-morbidity, the OR for MRONJ patients with acute PAs
was 5.33. The difference in prevalence compared to the total hospital patient
population was statistically significant (P= 0.0001). Following adjustment for
smoking co-morbidity, the OR for MRONJ in patients with acute PAs was 4.44. The
difference in prevalence as compared to the total hospital patient population
was statistically significant (P= 0.001). (Am J Dent 2025;38:169-172).
Clinical significance: Oral healthcare providers should be aware of the
possible association between MRONJ and the higher occurrence of acute
periapical abscesses. Enhanced oral hygiene and frequent dental visits are
recommended to diagnose and treat dental pathoses promptly in MRONJ patients.
Mail: Dr. Ilan Rotstein, 2929
Westminster Ave. #3666, Seal Beach, CA 90740-9998,
USA. E-mail: ilan@usc.edu
Clinical
study to evaluate the efficacy and safety of an herbal toothpaste
Ashwin Prabhu, bds, mds, Aparna Damle, msc, Trusha Dnyaneshwar, bams, md,
Abstract: Purpose: To assess the efficacy and safety
of Glister multi-action toothpaste Herbals (GHT) on gingivitis in diabetic subjects. Methods: A total of 72
diabetic subjects were enrolled and 61 subjects
completed the open label single arm clinical study for a period of 30 days.
Subjects were evaluated on Day 10 (visit 3), Day 20 (visit 4), and Day 30
(visit 5) for reduction in gingivitis, plaque, gingival bleeding, pocket depth, S. mutans count, hypersensitivity, teeth whiteness, extrinsic stains,
malodor, product tolerance, product sensory experience and product perception. Results: Modified Gingival Index mean (SD) score was 1.91 (0.82) at screening, reduced
to 1.5 (0.9) at Day 10, 1.4 (0.8) at Day 20 and 1.2 (0.6) at Day 30,
respectively. The P-value was highly significant (P< 0.0001) on Days 10, 20
and 30 when compared to screening as well as from Day 10 to Day 20, and Day 20
to Day 30.The Modified Plaque Index mean (SD) score was 1.6 (0.7) on screening
day which reduced to 1.3 (0.7) on Day 10, 1.1 (0.7) on Day 20 and 1.0 (0.6) on
Day 30, respectively from screening. Significant reduction (P< 0.0001) in
plaque was observed in as early as 10 days of regular usage. Similarly,
gingival bleeding reduced significantly (P< 0.0001) from screening day value
86.5 (16.1) to Day 10 value of 66.9 (19.8), and on Day 20 to 47.5 (15.5) and
Day 30 to 33.0 (12.8), respectively. The S. mutans mean (SD) count from
the screening day count of 43,259.7 (10,455.63) CFU/ml was reduced after the
use of GHT on Day 10 to 38,662.3 (10,501.81), on Day 20 to 33,019.7 (9,803.31)
and on Day 30 to 28,344.3 (9,404.42) CFU/ml respectively. At the screenin+g visit, the malodor mean (SD) score was 2.2
(1.2), which was reduced to 1.8 (1.1) on visit 3, to 1.4 (1.0) on visit 4 and
to 1.0 (0.8) on visit 5 respectively with statistical significance of P<
0.0001 on Day 10 compared to baseline, Day 20 compared to baseline and Day 10
and also on Day 30 as compared to other two intervals. (Am J Dent 2025;38:173-177).
Clinical significance: In the current study, Glister Multi-action Toothpaste
Herbals demonstrated a clinically significant improvement in diabetic subjects
as measured by gingival index, bleeding index, plaque index, malodor and S.
mutans count. The toothpaste was well accepted by the subjects without any
adverse effects. Thus, this toothpaste may be beneficial in improving gum
health among those with diabetes.
Mail: Dr. Ashwin Prabhu, Department
of Periodontology, Dayananda Sagar College of Dental Sciences, Bengaluru,
Karnataka, India. E-mail: ashwinprabhu@dscds.edu.in
Influence
of the cut-out-rescan procedure and rubber dam color
Ayşe Aslı Şenol, dds, Bengü Doğu Kaya, dds, Ece Bal, dds, Hatice Berra Cengiz, dds, Bora Korkut, dds, phd
Abstract: Purpose: To evaluate the laboratory effect of
the cut-out-rescan procedure and the rubber dam color on the trueness of two
intraoral scanners (IOS). Methods: An onlay preparation was performed on a typodont
maxillary left 1st molar. The left hemi-arch of the maxilla was
scanned using two IOS (Trios 3, 3Shape; n=20). These digital scans were defined
as references and exported. The prepared tooth and 1 mm proximal surfaces were
cut-out using the IOS’ software tools. Following the rubber dam (blue-color)
isolation, the cut-out area was rescanned and recorded. Reference and rescan
data in .STL were uploaded to the software programs
and superimposed. The deviations were obtained selectively for the teeth. Also,
additional hemi-arc rescans with different rubber dam
sheet colors (blue, purple, and black) were obtained and superimposed with
reference scan without cut-out procedure. Trueness was evaluated using root
mean square (RMS) error by Geomagic Control X and
mean distance (Md) by Oracheck. Data were analyzed using ANOVA, Shapiro-Wilk, and Independent
Samples (P< 0.05). Results: The Md values by the Trios 3 were
significantly higher than Omnicam for the 1st premolar and 1st molar (P< 0.05). Omnicam’s RMS and Md values for the 2nd molar were significantly higher than 1st premolar and 1st molar (P< 0.001). Trios’s RMS values were significantly higher for the 2nd molar than the 1st molar (P< 0.001). A lower deviation in Md values was obtained for black rubber
dam color compared to the blue and purple in Omnicam and the purple in Trios (P< 0.005). (Am
J Dent 2025;38:178-184).
Clinical significance: The cut-out-rescan procedure may influence the
scanning trueness depending on the IOS and location of the cut-out area. The
use of the cut-out-rescan procedure will be optimized by considering the
technology and software of the IOS. The black rubber dam was considered the optimal
choice when using the rescan procedure.
Mail: Dr. Ayşe
Aslı Şenol, Department of Restorative Dentistry, Faculty of
Dentistry, Marmara University, Başıbüyük Sağlık Yerleşkesi, Başıbüyük Yolu 9/3 34854, Maltepe, Istanbul,
(Türkiye) Turkey. E-mail: asli.tuncer@marmara.edu.tr
Effects
of whitening mouthwashes on color change of a resin composite
Pinar Naiboğlu, dds & Zeynep Pinar Keleş Yücel, dds, phd
Abstract: Purpose: To evaluate the effect of
whitening mouthwashes with different active ingredients on the color change
(ΔE00) of a stained resin composite. Methods: A total of
70 resin composite samples (G-aenial Anterior) with
dimensions of 8 х 2 mm were prepared. The samples were immersed in coffee
for 14 days to simulate time-dependent color change, then randomly assigned
into seven groups (n=10). Listerine Advanced White (LAW), Splat White Plus
(SWP), Colgate Optic White (COW), Colgate Plax White + Charcoal (CPC), Global
White Charcoal Extra Whitening Mouthwash (GWE), R.O.C.S Black Edition Whitening
Mouthwash (ROC), and distilled water (DW) were used over a 12-month period.
Color measurements were performed at baseline, after staining, and after 1
month, 3 months, 6 months, and 12 months of use. Results: Resin
composite exhibited discoloration exceeding the 50:50% acceptability threshold
(AT) (ΔE00: 1.8) after 14 days of coffee immersion. Group,
immersion period, and their interaction significantly affected the ΔE00 values (P< 0.001). All whitening mouthwashes except SWP reduced the color
change on resin composite below the AT, while COW achieved this level after 1
month of use, LAW and CPC after 3 months of use, and GWE and ROC after 12
months of use. The effectiveness of whitening mouthwashes in improving the
color of stained resin composite varies depending on the formulation of the
whitening mouthwash and immersion time. All whitening mouthwashes except SWP
were effective in improving the color of resin composite. (Am J Dent 2025;38:185-190).
Clinical significance: The color improvement effect of whitening mouthwashes
on resin composite may be affected by the specific formulation and duration of
use of whitening mouthwash.
Mail: Dr. Pinar Naiboğlu, Department of Restorative Dentistry, Faculty
of Dentistry, Giresun University, Giresun, Turkey. E-mail: pinar.naiboglu@hotmail.com
Disinfectant
effect of hydrogen peroxide on impression materials
Makbule
Heval Şahan, dds, phd, Serter Mert Selamet, dds, msc, Ece Halat, phd, Guven Ozdemir, phd
Abstract: Purpose: To evaluate the efficacy of hydrogen peroxide, sodium
hypochlorite, and glutaraldehyde in disinfecting dental impression materials;
alginate, polyether, condensation silicone and polyvinyl siloxane. The
objectives include comparing the microbial reduction (Log R values) and
assessing the interaction between microorganisms and disinfectants on these
materials. Methods: Common dental pathogens (Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus hirae,
and Streptococcus mutans) were used to contaminate the
impression materials. Each contaminated sample was disinfected using
hydrogen peroxide, sodium hypochlorite, or glutaraldehyde. Microbial reduction
was measured as Log R values. Statistical analyses included Kruskal-Wallis
tests and Bonferroni post hoc analyses. Results: Significant differences
in Log R values were observed among the impression materials and disinfectants.
Alginate exhibited lower Log R values (4.63 ± 1.56) compared to polyether and
polyvinyl siloxane. Sodium hypochlorite showed superior microbial reduction
(5.38 ± 0.84) compared to hydrogen peroxide (4.84 ± 1.44). Pseudomonas
aeruginosa and Streptococcus mutans had higher Log R values,
indicating greater susceptibility to the disinfectants. Glutaraldehyde
demonstrated effective microbial reduction (5.51 ± 0.69), with Log R values
comparable to sodium hypochlorite (5.38 ± 0.84), making it a potent
disinfectant for dental impression materials. (Am J Dent 2025;38:191-195).
Clinical significance: The study demonstrates that sodium hypochlorite and
glutaraldehyde are highly effective in reducing microbial load on dental
impression materials. While sodium hypochlorite and glutaraldehyde are
recommended for their higher efficacy, hydrogen peroxide offers a safer, less
toxic alternative, making it a viable option in specific clinical situations.
Mail: Dr. Makbule Heval Şahan,
Department of Prosthodontics, School of Dentistry, Ege University, 35100, Bornova, Izmir, Turkey. E-mail: heval.sahan@ege.edu.tr
Comparison
of accuracy of three intraoral scanners for different
Jung-Won Park, msd, Young-Jun Lim, dds, msd, phd, Bum-Soon Lim, msd, phd & Yeon-Wha Baek, dds, msd, phd
Purpose: To evaluate the laboratory accuracy
of three intraoral scanners (IOSs) across three types of tooth preparations,
using a laboratory scanner as the reference. Methods: Models of three
types of tooth preparations (inlay, onlay, and
three-unit fixed partial denture) were designed with CAD software and
fabricated using a 3D printer. Reference data were obtained by scanning these
models with a desktop laser scanner (Identica Hybrid,
Medit Co). Each model was scanned five times using three IOSs: TRIOS4 (3Shape),
I500 (Medit Co), and COMFORT+ (DDS), resulting in 45 scans across nine groups.
Scan files were exported in STL format and analyzed with Geomagic 3D inspection software. Accuracy was assessed using best-fit alignment and 3D
comparison functions. Results: Trueness did not significantly differ
among the IOSs within each tooth preparation group (P> 0.05). However, all
three IOSs showed significantly lower trueness for the
three-unit fixed partial denture compared to the inlay and onlay groups (P< 0.05). Precision significantly varied among the IOSs within the
tooth preparation groups (P< 0.05). Specifically, the I500 demonstrated
higher precision for inlays, while TRIOS4 and I500 exhibited better precision
for onlays and three-unit
fixed partial dentures. (Am J Dent 2025;38:196-200).
Clinical significance: All three tested intraoral scanners (TRIOS, I500, and
COMFORT+) demonstrated clinically acceptable accuracy for prostheses
fabrication, confirming their suitability for applications ranging from inlays
to crowns and bridges.
Mail: Dr. Yeon-Wha Baek, Department
of Prosthodontics, Gwanak Center, Seoul National
University Dental Hospital, 1, Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea. E-mail: obero7@snu.ac.kr
Efficacy and
effects on enamel of low and high-concentrated bleaching gels
Victor Cavallaro Bottesini, dds, msc, Douglas Ferreira da Silva, dds, msc,
Abstract: Purpose: To evaluate the efficacy of low
and high-concentrated bleaching gels in both at-home and in-office techniques and their effects on enamel properties. Methods: Bovine enamel/dentin specimens were randomly allocated to five groups (n=12):
deionized water (negative control - DW), 6% hydrogen peroxide (6HP), 40%
hydrogen peroxide (40HP), 10% carbamide peroxide (10CP), and 45% carbamide
peroxide (45CP). For 6HP and 40HP, the gel was applied 3×20 minutes in 1 day.
For 10CP and 45CP, the bleaching gels were applied 1×/day for 8 hours and 1×/day
for 30 minutes over 7 days, respectively. Before and after bleaching treatment,
color (CIE L*a*b*), surface microhardness (SMH), roughness (Ra), and gloss (GU)
were assessed. Alterations in color (DE00 and DWID), SMH (%SMHalt),
Ra (%Raalt) and GU (%GUalt) were calculated. Data were analyzed by one-way
ANOVA and Tukey’s test (α= 0.05). Results: Significant differences
were found for color alteration (P< 0.05). The group 10CP showed the highest
color difference. The groups 40HP, 10CP, and 45CP exhibited similar values of
ΔWID. No alteration in enamel microhardness and roughness was
found (P˃ 0.05). Although significant differences were found for %GUalt
between the groups (P< 0.05), they were not different from the negative
control. The 10% carbamide peroxide resulted in the highest color alteration,
while all tested bleaching gels were effective in producing color change that
exceeded the acceptability threshold without causing damage to the enamel
surface. (Am J Dent 2025;38:201-207).
Clinical significance: All bleaching gels can be considered safe in the
tested protocol, and the greatest color difference was promoted by 10%
carbamide peroxide overnight.
Mail: Dr.
Mariane Cintra Mailart, Avenida Engenheiro Francisco
José Longo, 777, Jardim São Dimas, São José dos
Campos - SP, ZIP code: 12245-000, Brazil. E-mail: mariane.cintra-mailart@unesp.br
Enhancing
resin-zirconia bonding: Influence of decontamination
Secil Ozkan Ata, phd & Rumeysa Okur
Abstract: Purpose: To evaluate the effect of
different decontamination protocols on the bonding strength of MDP-containing
resin cement to saliva-contaminated zirconia ceramic. Methods:144
zirconia samples (12 mm×12 mm×1.2 mm) were prepared from 4Y-TZP and 6Y-TZP blocks,
sandblasted with 50 μm Al₂O₃,
and contaminated with artificial saliva. Samples were divided into six groups
(n=24) based on decontamination method: sintered (CON), Rocatec-treated
(ROC), Al₂O₃ abraded (AL), water-cleaned
(HO), Ivoclean-treated (IVO), and 37%
H₃PO₄-cleaned (PH). Pre-prepared resin cylinders (2.0 mm diameter,
3.0 mm height) were bonded to zirconia using MDP-containing resin cement
(Panavia SA) and light-cured. All bonded samples underwent thermocycling (5°C-55°C,
10,000 cycles for 1 week, 50,000 cycles for 6 months, and 100,000 cycles for 12
months) to simulate intraoral aging. Shear bond strength was assessed at 1 week, 6 months, and 12 months using a universal testing
machine. Surface roughness parameters (Rq, Ra) were
measured with a digital profilometer, and adhesive failures were analyzed via
scanning electron microscopy (SEM). Data were evaluated using one-way ANOVA and
Tukey’s post hoc test (α= 0.05). Weibull analysis was performed to assess
the reliability and probability of bond strength failure. Additionally,
Kaplan-Meier survival analysis was conducted to evaluate the long-term
durability of resin–zirconia bonds over time. Results: For 4Y-TZP, Ivoclean (1768±32 MPa) and Al₂O₃
abrasion (1541±36 MPa) achieved the highest shear bond strengths at 1 week. In
contrast, 6Y-TZP exhibited lower bond strengths, with sintered and Rocatec-treated groups performing moderately. Surface
roughness analysis showed that sintered and Ivoclean-treated
4Y-TZP had lower roughness (Rq ~14.8, Ra ~0.5), while
6Y-TZP had higher values, particularly after H₃PO₄ treatment (Rq 61.6, Ra 119.7). (Am J Dent 2025;38:208-216).
Clinical significance: Selecting appropriate decontamination methods such as Ivoclean application or airborne-particle abrasion
with Al₂O₃-based on the zirconia type is
essential to achieve durable resin bonding and ensure the long-term success of
high-translucency zirconia restorations.
Mail: Dr. Secil Ozkan Ata, Department
of Prosthodontics, Faculty of Dentistry, Osmangazi University, Eskisehir, Turkey. E-mail: secilozkanata@gmail.com
