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Language Journal of Clinical and Experimental Dentistry. 2026. Vol. 18, no. 4
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- Comparison of the bond strength of silane-treated glass fiber posts at different solvent evaporation times: an in vitro study(Medicina Oral S.L., 2026) Ramos-Ramos, Valeria; Dextre-Herrera, Sergio; Ramírez-Vargas, Giovanna; Castro-Ramírez, Leonor; Turpo Claudio, Denisse Linda; Cervantes Ganoza, Luis; Cayo Rojas, César FélixSilane is used as a coupling agent on glass fiber posts to enhance chemical interaction at the post-resin cement interface. This in vitro study evaluated the bond strength of silane-treated glass fiber posts at different solvent evaporation times.This in vitro experimental study included forty single-rooted mandibular premolars assigned to four groups according to silane solvent evaporation time: G1 (control), G2 (60 s), G3 (120 s), and G4 (180 s). Specimens were stored in physiological saline at 37 °C. After endodontic treatment, root canals were prepared and glass fiber posts were cemented. In the experimental groups, silane was applied and allowed to evaporate for the allotted time. After cementation, the roots were sectioned into thirds (coronal, middle, and apical) and bond strength was determined using the push-out test on a universal testing machine. Welch's ANOVA with Games-Howell post hoc was used to compare groups. Statistical significance was set at p < 0.05.In the middle third, significant differences were observed between evaporation times (p < 0.001), with higher values for 180 s (13.94 ± 6.59 MPa) versus 60 s (3.86 ± 2.04 MPa; p = 0.004), 120 s (3.30 ± 1.85 MPa; p = 0.003) and control (4.69 ± 2.95 MPa; p = 0.007). In the coronal third (control: 7.09 ± 3.00 MPa; 60 s: 7.22 ± 3.16 MPa; 120 s: 4.81 ± 2.05 MPa; 180 s: 8.01 ± 4.34 MPa) and in the apical third (control: 6.49 ± 3.09 MPa; 60 s: 5.56 ± 1.96 MPa; 120 s: 5.19 ± 3.98 MPa; 180 s: 8.10 ± 3.40 MPa) no significant differences were detected between protocols (p = 0.164 and p = 0.196, respectively). When comparing root thirds within each protocol, only the 60 s group showed differences, with higher bond strength in the coronal third than in the middle third (p = 0.032).Evaporation of the silane solvent for 180 s improved the bond strength of the glass fiber posts in the middle root third, while no significant differences were detected in the coronal and apical thirds between the times evaluated. Within protocols, the 60 s group showed lower bond strength in the middle third than in the coronal third. Taken together, these findings suggest that prolonging evaporation to 180 s may be a useful operative adjustment to optimize bonding in the middle third, with no evidence of consistent benefit in the coronal and apical regions.
- Evaluation of treatment decision-making for teeth with post-treatment apical periodontitis among dental students, general dentists, and endodontists in chile(Medicina Oral S.L., 2026) Dufey, Nicolás; Vera, Ignacia; Peña Bengoa, Fernando; Bórquez, Giovanna; Cáceres, Carolina; Nagendrababu, Venkateshbabu; Dummer, Paul M. H.; Abella, Francesc; García Font, MarcThis study aimed to evaluate treatment decision-making processes when assessing periapical radiographs of teeth with post-treatment apical periodontitis (AP) among dental students (DS), general dental practitioners (GDP), and endodontists (E) within Chile, and to identify demographic and tooth-related factors associated with extraction decisions.A cross-sectional study was conducted between 2023 and 2024, involving 431 participants who assessed standardised periapical radiographs depicting clinical scenarios and selected one treatment option: root canal retreatment, apical surgery/intentional replantation, or extraction. A nested mixed logistic regression model and simple logistic regression analyses were performed to evaluate associations between treatment choices and clinician- or tooth-related variables (p < .05).Demographic factors significantly associated with extraction decisions included professional group, age, and workplace. GDP and DS were significantly more likely to recommend extraction (p < 0.001 for both), particularly among GDPs aged 36-45 years (p = 0.003) and those working in the public sector. All tooth-related variables significantly influenced decisions. Teeth with indirect restorations were associated with higher extraction rates, especially among GDP (p < 0.001). Inadequate root canal fillings significantly increased extraction decisions by GDPs (p < 0.001). GDPs also had a strong tendency to extract teeth with medium (p < 0.001) and large apical lesions (p = 0.001).Significant differences were observed across professional groups, with E demonstrating a greater tendency toward tooth preservation. Improving clinical decision-making in undergraduate and continuing dental education may help reduce unnecessary extractions and support evidence-based health planning in underserved areas with limited access to specialist care.
- Absence of the periodontal space in impacted third molars: a cross-sectional study using cone beam computed tomography(Medicina Oral S.L., 2026) Sancho Davila-Moreno, Cinthia Christhie; Mendez-Nava, Mary Isolina; Llaguno-Rubio, Jhoana Mercedes; Fiori-Chincaro, Gustavo Adolf; Arriola-Guillén, Luis-ErnestoThis study aimed to determine the frequency of tomographic signs indicating the absence of the periodontal space (APS) in impacted third molars using cone-beam computed tomography (CBCT) and to assess its association with demographic and anatomical variables, as well as the presence of replacement resorption (RR).A cross-sectional and retrospective observational study was conducted using 258 randomly selected tomographic volumes from a radiological center in Lima, Peru, in 2025. The study evaluated 457 impacted upper and lower third molars. Two trained and calibrated evaluators analyzed the impaction of the third molars using multiplanar CBCT reconstructions with a voxel size of 0.2 mm. The variables assessed included age, sex, dental arch, third molar position, affected root zone, angulation of the third molar (APS), and root resorption (RR). Chi-square tests and logistic regression analyses were performed, with p < 0.05 considered statistically significant.221 cases (48.35%) exhibited an absence of periodontal ligament spaces. The absence of the periodontal space was significantly associated with third molar position, being more frequent in horizontal (27.1%) and distoangular (23.1%) positions (p = 0.003). The apical third was the most commonly affected root zone (43.0%) (p < 0.001). Replacement resorption (RR) was observed exclusively in molars without a detectable periodontal space (3.6%) (p = 0.003). Age was identified as the only significant predictor; with each additional year, the risk of APS increased by a factor of 1.07 (p < 0.001).The absence of the periodontal ligament space in third molars is highly prevalent, especially in older patients, particularly those with horizontal or distoangular positions and when the apical region is involved.
- Vertebral cervical fusion in individuals with and without open bite: a comparative matched study(Medicina Oral S.L., 2026) Angeles-Estrella, Lucecita; Llaguno-Rubio, Jhoana Mercedes; Fiori-Chincaro, Gustavo Adolf; Arriola-Guillén, Luis-ErnestoThis study aims to evaluate the presence of cervical vertebral fusion in individuals with an open bite compared to those without, matched by skeletal relationship, age, and sex.This matched-comparative study analyzed 234 lateral head radiographs, dividing the subjects into two groups. The open-bite group consisted of 117 patients (69 women and 48 men; average age 24.05 ± 12.5 years), while the control group included an equal number of individuals with a similar gender ratio (average age 23.79 ± 11.95 years). Both groups were matched based on their skeletal relationship, specifically the ANB angle. A trained and calibrated radiologist conducted a visual assessment of the cervical spine using lateral cephalometric radiographs for each subject. The study evaluated the presence of simple fusion and block fusion. Statistical analyses were performed using the Chi-square test and binary logistic regression (p 0.05).There were no differences in the overall prevalence of cervical fusions between individuals with anterior open bite and those without. However, the finding that block fusions occurred exclusively in the open-bite group underscores the importance of evaluating the cervical spine, as it may affect the individual's head position.
- Comparative evaluation of nano-hydroxyapatite–silica modified glass ionomer cement as a luting agent for stainless steel crowns using the Hall technique: an in vitro study(Medicina Oral S.L., 2026) Baharin, Fadzlinda; Izzati Che Abdullah, Siti Nuramira; Ghani, Nik-Rozainah-Nik-Abdul; Kamarudin, AimiNano-hydroxyapatite and silica incorporation into glass ionomer cements (GICs) have been proposed to enhance their physical and biological properties. In paediatric dentistry, the Hall technique relies heavily on the sealing ability of luting cements used for stainless steel crown (SSC) placement. This study aimed to compare the microleakage of nano-hydroxyapatite-silica incorporated glass ionomer cement (nano-HA-silica GIC) with conventional GIC and resin-modified glass ionomer cement (RMGIC) when used as luting agents for SSCs placed using the Hall technique.Thirty extracted human primary molars were randomly allocated into three groups (n = 10). Stainless steel crowns were cemented using conventional GIC, nano-HA-silica GIC, or RMGIC following the Hall technique protocol. Specimens were immersed in 2% methylene blue dye, sectioned longitudinally, and evaluated under a digital microscope to assess dye penetration. Microleakage values were statistically analysed using one-way ANOVA followed by the Games-Howell post hoc test.Statistically significant differences in microleakage were observed among the three groups (p < 0.001). RMGIC demonstrated significantly lower microleakage compared with both conventional GIC (mean difference = 1.568) and nano-HA-silica GIC (mean difference = 2.290). No statistically significant difference was observed between conventional GIC and nano-HA-silica GIC (mean difference = 0.722).Nano-hydroxyapatite-silica incorporated GIC exhibited comparable sealing ability to conventional GIC; however, RMGIC demonstrated superior resistance to microleakage when used as a luting cement for SSCs placed using the Hall technique. Further studies are required to evaluate the long-term clinical performance of nano-HA-silica modified GIC.
- Cardiovascular effects of 4% articaine with 1:100,000 versus 1:200,000 epinephrine during inferior alveolar nerve block: a prospective randomized double-blind clinical study(Medicina Oral S.L., 2026) da Silva, Marcele Cruz; Rodrigues, Bruno-Teixeira-Gonçalves; de Carvalho, Estephani Martins Barcellos; de Sá Bahia, Thaís Pimentel; Ritto, Fábio-Gamboa; Medeiros, Paulo-José-D’AlbuquerqueLocal anesthetic solutions containing epinephrine are widely used in oral surgery to prolong anesthesia and improve hemostasis; however, their sympathomimetic effects may influence cardiovascular parameters. Evidence comparing different epinephrine concentrations in articaine during third-molar surgery remains limited. This randomized clinical trial compared the cardiovascular effects and clinical performance of 4% articaine with epinephrine 1:100,000 (A100) and 1:200,000 (A200) during mandibular third-molar extraction.A prospective, randomized, split-mouth, double-blind clinical trial was conducted in 40 healthy patients undergoing bilateral impacted mandibular third-molar extraction. Each participant received A100 on one side and A200 on the contralateral side in randomized order with a 15-day interval. Heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2) were recorded at baseline, immediately after injection, and at 5 and 15 minutes. Intraoperative bleeding, pain (VAS), and need for supplemental anesthesia were also assessed. Paired statistical tests were applied ( = 0.05).Eighty procedures were analyzed. Intraoperative bleeding incidence was similar between A100 (10%) and A200 (12.5%) (p = 1.000). Supplemental anesthesia was required in 3.8% of procedures, with no difference between concentrations (p = 1.000). HR increased with both formulations but was significantly higher with A100 at 5 and 15 minutes (p = 0.035 and p = 0.003). BP showed no significant differences at any time point. SpO2 remained within normal limits, with slightly higher values for A200 at intermediate times. Pain scores did not differ significantly.Both epinephrine concentrations in 4% articaine provided comparable anesthetic efficacy and hemostasis with minimal cardiovascular effects in healthy patients undergoing mandibular third-molar extraction. The 1:200,000 concentration produced a smaller heart-rate increase, suggesting a potential advantage in patients with cardiovascular risk, while 1:100,000 remains suitable when greater vasoconstriction is desired.
- Effect of total crown and veneer zirconia meso-structure designs on anterior implant-supported restorations: a 3d finite element analysis(Medicina Oral S.L., 2026) de Andrade, Guilherme -Schmidt; Formighieri, Luiz Alberto; Aragonez, Gabriela Carrão; Augusto, Marina Gullo; Tribst, João Paulo MendesUnfavorable implant positioning in esthetic zones may result in buccal or incisal emergence of the prosthetic screw access, requiring alternative restorative strategies. This study evaluated, by three-dimensional finite element analysis (FEA), the effect of total crown and laminated veneer zirconia meso-structure designs cemented onto a titanium base (Ti-base) on stress distribution and bone microstrain.Two zirconia meso-structure designs: total crown (TC) and laminated veneer (LV) were simulated on a Ti-base using previously validated models. A 20 Ncm screw torque and a 150 N oblique load at 30° were applied. Stress was analyzed using von Mises and maximum principal stress, and bone response by microstrain.Both designs showed similar stress distribution in the implant, Ti-base, and screw. Microstrain concentrated mainly in the peri-implant cortical bone, with slightly wider distribution in the LV model.TC and LV meso-structures exhibited comparable biomechanical behavior, suggesting that their selection may be guided primarily by restorative and esthetic considerations.
- Retention of fluoride in the oral cavity: a randomized clinical study with nanoencapsulated fluoride toothpaste(Medicina Oral S.L., 2026) Avelino de Paiva, Marcel Alves; Moura, Helene Soares; de Medeiros Souza, Matheus Barbosa; Júnior, Alexandre Almeida; de Oliveira, Andressa-Feitosa-Bezerra; Sampaio, Fábio CorreiaTo evaluate in vivo fluoride retention in saliva and dental biofilm after the use of experimental toothpaste containing nanoencapsulated fluoride (NanoF).A triple-blind randomized clinical study involving sixty-one residents from a municipality without fluoridated drinking water. The toothpastes used in the study were: Group 1 (1100 ppm, 100% NanoF); Group 2 (1100 ppm, 50% free NaF + 50% NanoF); and Group 3 (1100 ppm, 100% free NaF). During the use of the toothpaste, samples of dental biofilm and stimulated saliva were collected. Collection times were 1 and 2 hours (h) post-brushing for biofilm, and 1, 5, 10, 15, 20, 30, 45, 60 minutes, and 2h for saliva. The fluoride [F] concentrations in saliva and dental biofilm were analyzed using a specific electrode through the hexamethyldisiloxane (HMDS) facilitated diffusion technique. The data were analyzed using the Kruskal-Wallis, Friedman, and Wilcoxon tests (p G2 (84.73) > G1 (54.98). For dental biofilm, the highest fluoride [F] concentration was observed in G1 (35.26 mg/kg), followed by G3 (34.06 mg/kg) at the 1-hour mark; at 2 hours, the results were 24.88 mg/kg and 31.43 mg/kg, respectively, with a significant reduction in [F] observed only in G1 (p=0.02).The nanoencapsulated fluoride tested in this study exhibited a distinct pattern of fluoride release in saliva. However, in dental biofilm, the release pattern was similar to that of the free fluoride formulation (NaF).
- The management of calcified teeth with iatrogenic errors with static-guided and freehand endodontic technique(Medicina Oral S.L., 2026) Ali, Afzal; Ikhar, Anuja; Yıldız, Ezgi Doğanay; Arslan, HakanThe endodontic management of teeth with pulp canal calcification (PCC) is challenging and may result in iatrogenic errors in the form of excessive tooth structure loss and perforation. The present case reports aims to describe the management of calcified teeth with iatrogenic canal deviation using static-guided (SG) and conventional free hand endodontic technique.A 23-year-old male patient referred to the clinic with the chief complaint of pain over the upper incisor teeth region. Periapical radiography and CBCT scan revealed pulp canal calcification (PCC) of maxillary central incisors (#11 and #21), and periapical radiolucency in relation to #21 and #22. The patient was informed about the treatment options including SG endodontic approach and the course of treatment was determined based on the patients' decisions. The endodontic treatment of teeth #21 and #22 was initiated with conventional free hand technique. After a perforation on the labial root wall, the patient opted for saving the tooth (#21) using SG endodontic technique. With the help of CBCT, intra-oral Scanner and a 3D printer, a guide was fabricated. The root canal was negotiated and the endodontic treatment was completed. Similarly, the endodontic treatment of a 21-year-old female patient with iatrogenic apical deviation was performed using the same endodontic protocol, except for the use of a static-guide. Follow-up examination revealed clinically asymptomatic patients with the radiographic signs of periapical healing in both the cases.Tooth substance loss during access cavity preparation plays a vital role in determining the prognosis of the tooth. The teeth with PCC are categorized as cases with a high difficulty level which are often prone to iatrogenic errors. SG endodontic technique is a safe approach and provides predictable outcome in the management of cases with high difficulty level.
- Wide-thread implant macrogeometry and immediate implant placement: a systematic review of primary stability, marginal bone loss, and survival outcomes(Medicina Oral S.L., 2026) Hernández, Rubén JiménezWide-thread dental implants have been proposed to enhance primary stability and marginal bone preservation in immediate implant placement protocols, particularly in low-density bone. This systematic review aimed to evaluate the influence of wide-thread implant macrogeometry on primary stability, marginal bone loss, and survival outcomes in immediate implant placement.A systematic electronic search was performed in PubMed (MEDLINE), complemented by manual screening of reference lists and forward and backward citation tracking, to identify studies published between January 2007 and August 2025. Clinical studies, in vitro experiments, finite element analyses, and reviews assessing the effect of implant macrogeometry, especially wide-thread configurations, on insertion torque, implant stability quotient (ISQ), marginal bone loss (MBL), and survival in immediate placement were included. Studies without biomechanical relevance, non-English publications, case reports, and those lacking quantitative stability or bone data were excluded.A total of 36 records were initially identified, and 25 studies met the inclusion criteria. Increased thread depth, wider or more aggressive threads, and tapered implant bodies generally improved insertion torque and ISQ values, particularly in D3-D4 bone and post-extraction sockets. Clinical investigations reported high survival rates for immediately placed implants with optimized macrogeometry, while MBL typically remained within clinically acceptable limits when adequate primary stability and appropriate loading protocols were achieved. However, small sample sizes, short follow-up periods, heterogeneity among implant systems, and non-standardized outcome reporting limited the possibility of robust quantitative comparisons.Wide-thread implant macrogeometry appears to enhance primary stability in immediate placement and supports favorable short- to medium-term survival and marginal bone behavior when combined with careful case selection and controlled loading. Further well-designed prospective randomized studies with long-term follow-up are needed to determine whether these biomechanical advantages translate into superior long-term clinical outcomes.
- Approaches to preoperative assessment of elderly patients undergoing dental surgical interventions: a systematic review(Medicina Oral S.L., 2026) Shurdumov, Aslan Ramazanovich; Gusarov, Artem Maksimovich; Ivanov, Sergey Y.; Ivanova, Irina; Borozdkin, Leonid; Kamilov, Shamsulvara Taymaskhanovich; Kuznetsov, Alexey Mikhailovich; Sviridenko, Artem DmitrievichElderly patients represent a high-risk population for surgical dental interventions due to multimorbidity, frailty, and polypharmacy. Moreover, standard preoperative assessment protocols often fail to account for geriatric syndromes. Objective: To systematize and analyze contemporary approaches and tools for comprehensive preoperative assessment of elderly patients planning surgical dental procedures.A systematic review was conducted in accordance with the PRISMA 2020 guidelines. The review protocol was registered in the international PROSPERO registry (ID: CRD420251147418). Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Google Scholar, CyberLeninka, and eLibrary.ru up to January 31, 2025. Original studies including patients aged 60 years focused on preoperative assessment prior to dento-maxillofacial surgery were included. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using the ROBINS-I tool for observational studies.Of 312 identified records, 12 studies were included in the analysis. The most frequently evaluated domains were nutritional status (MNA, MNA-SF; 5 studies), cognitive function (Mini-Cog, MMSE; 5 studies), frailty (Fried Criteria, CFS; 6 studies), and oral health (CPI, PI, OHIP-14; 8 studies). Meta-analysis was not performed due to high clinical and methodological heterogeneity. Overall evidence quality, assessed using the GRADE system for key outcomes, was low, confirming methodological limitations in the current scientific literature in geriatric dentistry.Despite the availability of numerous geriatric assessment tools, a standardized preoperative protocol for dental surgery is lacking. The findings emphasize the need for development and validation of a dental-specific assessment algorithm based on comprehensive geriatric assessment (CGA). Limitations: The conclusions should be interpreted with caution due to methodological limitations of the included studies, their heterogeneity, and inclusion of general maxillofacial surgery data, which reduced specificity for dental practice. Risk of publication bias was not assessed.
- Polypharmacy, salivary function, and oral health outcomes in institutionalized older adults: a scoping review(Medicina Oral S.L., 2026) Espada-Salgado, Fernando Mauricio; Iuga, María Mihaela; Oprea, Bogdan; Capellino, Alex R. A.Polypharmacy is common in long-term care facilities (LTCFs) and may contribute to xerostomia, hyposalivation, and oral disease. However, evidence specific to LTCF populations has not been comprehensively mapped. Objective: To map the available evidence on the association between polypharmacy or medication burden and salivary dysfunction and oral health outcomes in institutionalized older adults.This scoping review was conducted in accordance with Joanna Briggs Institute guidance and reported following PRISMA-ScR. PubMed/MEDLINE, Embase, Scopus, Web of Science Core Collection, and LILACS via BVS were searched from 1 January 2005 to 23 January 2026. To identify potentially relevant grey literature, Google Scholar and ClinicalTrials.gov were also searched. Screening was performed in Rayyan, data were extracted using a piloted charting form, and findings were synthesized narratively.Eight studies published between 2010 and 2025 were included. Seven used a cross-sectional design and one was a randomized controlled trial, all conducted in LTCF settings in Europe and Asia. Polypharmacy, commonly defined as the use of five or more medications, was highly prevalent. Measures of xerogenic or anticholinergic burden identified associations with xerostomia or reduced salivary flow more consistently than medication count alone. Dry mouth was frequent, and where oral outcomes were assessed, substantial oral morbidity was also reported.In institutional care settings, salivary dysfunction and oral disease are common and appear to be more closely associated with xerogenic or anticholinergic burden than with medication number alone. Preventive oral care protocols integrated with xerogenic risk-informed medication review and standardized outcome assessment should be prioritized in future LTCF research and care.
- The effects of different implant crown restorative materials on the detection of proximal caries of adjacent teeth in cone-beam computed tomography (CBCT) scans using various machines, metal artifact-reduction (MAR) algorithm, and exposure protocols(Medicina Oral S.L., 2026) Morcos, Mina; Bartlett, Ben; Katkar, Rujuta A.; Maghsoodi, Taraneh; Geha, Hassem; Shinas, NikolaosThis study aimed to investigate how artifacts from different restorative materials affect the detection of approximal caries in CBCT scans, using various machines, artifact-reduction (AR) algorithms, and exposure protocols.Ten permanent teeth (5 molars, 5 premolars) were selected and categorized into 3 intact and 7 with artificial carious lesions. The teeth were arranged in a human mandible with an ingot of material in-between and in the following approximal surfaces configurations: intact-ingot-intact, caries-ingot-caries, and intact-ingot-caries/caries-ingot-intact. Three different ingot materials were used (3Y and 5Y Zirconia, and E-Max) and the setup was scanned using two CBCT systems (Planmeca Mid and Prexion) with varying exposure protocols, with and without AR algorithm, thus resulting in 90 scans. Three observers of different experience levels evaluated the images and P and Kappa values were calculated.Kappa and P values showed a significant positive association with the AR option, and a negative association without AR for zirconia 5Y. Zirconia 3Y had the highest positive association across all observers using both low and standard exposure settings on the Prexion®. The inter-observer agreement was insignificant, while intra-observer agreement was highly significant.The AR option improves the accuracy of approximal caries detection in CBCT scans for materials with higher yttria concentration but has no significant effect on lower yttria materials. The Prexion® scanner outperformed the Planmeca ProMax 3D Mid® in caries detection without AR.
- Shear bond strength and adhesive remnant index of metal brackets bonded after different post-bleaching waiting periods in enamel bleached with two bleaching agents: an in vitro study(Medicina Oral S.L., 2026) Miranda-Castro, Angelo; Ramírez-Tito, Danny; Castro-Ramírez, Leonor; Cervantes Ganoza, Luis; Garcia-Luna, Goretty; Ladera Castañeda, Marysela Irene; Cayo Rojas, César FélixSuccessful fixed orthodontic therapy using metal brackets depends on reliable bracket-to-enamel bonding. However, many patients undergo tooth bleaching before fixed orthodontics, which may alter enamel and compromise shear bond strength (SBS). The present in vitro study aimed to compare the SBS and the adhesive remnant index (ARI) of metal brackets bonded after different post-bleaching waiting periods to enamel bleached with two different agents.An in vitro experimental study was performed using eighty-four human premolars extracted for orthodontic reasons and randomly allocated to seven groups: an unbleached control group and six experimental groups bleached with 22% carbamide peroxide or 35% hydrogen peroxide and evaluated after three post-bleaching intervals (24 hours, 7 days, and 14 days). Brackets were bonded using Orthocem. SBS was tested in a universal testing machine, and failure mode was assessed using the adhesive remnant index (ARI) under stereomicroscopy. SBS was analyzed using robust one-way ANOVA with Games-Howell post hoc comparisons (p 0.05).The SBS of metal brackets depended on the type of bleaching agent and the time elapsed, suggesting that bleached enamel may behave variably during the immediate post-treatment period. In addition, after 14 days, a significant deterioration in adhesion was observed, especially with 22% carbamide peroxide, which could translate into a higher risk of detachment if cementation is performed at that time. On the other hand, the distribution of the IRA did not show significant changes over time, indicating that bleaching would mainly affect the magnitude of bond strength rather than the failure pattern. These findings support orthodontic planning that considers the bleaching agent used and the waiting time before cementation, although clinical studies are needed to confirm its applicability in patients.
- Histologic analysis of peri-implant soft tissue around external hexagon and morse taper implant connections(Medicina Oral S.L., 2026) de-Castro, Daniel Sartorelli Marques; de Matos, Jefferson-David-Melo; Lima, Jozely Francisca Mello; Lopes, Guilherme-da Rocha-Scalzer; Sinhoreti, Mario-Alexandre-Coelho; Queiroz, Daher Antonio; Dos Reis Pereira de Araujo, CarlosTwenty patients rehabilitated with screw-retained full-arch implant-supported prostheses functioning for at least one year were included.This clinical study included 20 patients rehabilitated with screw-retained full-arch implant-supported prostheses in function for at least 1 year. Participants were allocated into two groups according to the implant-abutment connection design: external hexagon (EH; n = 10) and Morse taper (MT; n = 10). One peri-implant soft tissue biopsy specimen was obtained from each patient and processed for hematoxylin-eosin staining. Histological evaluation assessed epithelial hyperplasia, epithelial organization, inflammatory infiltrate intensity, and connective tissue fibrosis. Data normality was assessed using the Shapiro-Wilk test. Intergroup comparisons were performed using the Mann-Whitney U test, with a significance level of = 0.05.Mean epithelial hyperplasia scores were 2.0 in the EH group and 1.6 in the MT group (P = 0.690). Mean fibrosis scores were 2.2 (EH) and 2.4 (MT) (P = 0.841). Inflammatory infiltrate scores were 0.4 in the EH group and 2.0 in the MT group (P = 0.095). No statistically significant differences were observed between groups for any evaluated parameter. The combined histologic score also showed no significant intergroup difference (P = 0.222).Within the limitations of this clinical study, peri-implant soft tissue architecture and inflammatory profiles were similar between external hexagon and Morse taper implant-abutment connections in full-arch rehabilitations following at least one year of functional loading.
- Impact of metallurgical and geometric characteristics on cyclic fatigue resistance of three thermally treated NiTi rotary instruments(Medicina Oral S.L., 2026) de Oliveira-Neto, Raimundo Sales; da Silva, Guilherme Ferreira; Nespeque Correa, Diego Rafael; Vivan, Rodrigo R.; Alcalde, Murilo-Priori; Duarte, Marco AntonioThis study aimed to evaluate the cyclic fatigue resistance and metallurgical characteristics of thermally treated NiTi rotary instruments: ProDesign Logic, Solla Purple, and Solla Colors.Cyclic fatigue testing was conducted at room temperature (20°C ± 1°C) and simulated body temperature (36°C ± 1°C) using a standardized artificial canal with a 60° curvature and 5 mm radius. Ten instruments per group (25.06) were tested at each temperature. Differential Scanning Calorimetry (DSC) and Scanning Electron Microscopy (SEM) were employed to assess phase transformation behavior and fracture topography, respectively.ProDesign Logic exhibited the highest cyclic fatigue resistance at room temperature compared to Solla systems (p0.05). ProDesign Logic had the highest austenite finish temperature (Af = 53.0°C). SEM confirmed typical fatigue fracture patterns in all groups.ProDesign Logic demonstrated greater cyclic fatigue resistance, attributed to its high Af temperature and cross-sectional design.
- Antifungal efficacy of chlorhexidine digluconate and silver nanoparticles incorporated into molloplast-b silicone soft liner against candida albicans: an in vitro study(Medicina Oral S.L., 2026) Soufiabadi, Samira; Khodaparast, Mahsa; Khodaparast, MohammadHossein; Khodaparast, Sahar; Attar, Hoda Shabani; Abedi, ReihanehDenture stomatitis is a common inflammatory condition among complete denture wearers and is primarily associated with Candida albicans colonization on denture base and soft lining materials. Conventional antifungal therapies often provide only temporary benefits due to limited patient compliance and rapid microbial recolonization. Therefore, intrinsic antifungal modification of silicone-based soft liners may represent a more effective preventive strategy.Standardized Molloplast-B silicone soft liner discs (6 mm × 1 mm; n = 10 per group) were modified with 1%, 2%, or 3% (w/w) chlorhexidine digluconate (CHX) or silver nanoparticles (AgNPs) using a solvent-assisted dissolution technique followed by heat polymerization. Unmodified Molloplast-B, solvent-processed Molloplast-B, pure CHX solution, and AgNP suspension served as control groups. Antifungal activity against Candida albicans ATCC 10231 was evaluated using an agar diffusion assay after 24-hour incubation at 37°C. Inhibition zones were measured by two blinded examiners. Data were analyzed using one-way ANOVA and Tukey's post-hoc test ( = 0.05).All modified groups demonstrated significantly greater antifungal activity compared with the negative and solvent controls (P < 0.001). CHX-modified specimens exhibited significantly larger inhibition zones than AgNP-modified specimens at all tested concentrations (P < 0.001). The highest antifungal activity was observed in the 3% CHX group (22.6 ± 1.8 mm), followed by the 3% AgNP group (16.0 ± 1.1 mm). A clear dose-dependent increase in antifungal efficacy was observed for both antimicrobial agents.Incorporation of 3% chlorhexidine digluconate into Molloplast-B silicone soft liner resulted in superior short-term antifungal efficacy against Candida albicans compared with silver nanoparticles. This intrinsic modification approach may be a promising strategy for reducing fungal colonization and preventing denture stomatitis; however, further long-term and clinical studies are required.
- Evaluation of the tunnelling technique for upper labial frenectomy using Er:YAG Laser(Medicina Oral S.L., 2026) Monteiro, Luis; Álvaro, Inês; Ferreira, Sara; Delgado, Maria Leonor; Vale, Teresa; Pacheco, José Júlio; Salazar, FilomenaAn abnormal upper labial frenum (ULF) can represent a potentially harmful gingival insertion located between the central incisors. Lasers, particularly the Er:YAG laser, have been described for ULF frenectomy and offer several promising advantages. The aim of this study was to evaluate the usefulness of Er:YAG laser frenectomy using the "tunnelization technique" for the elimination of an abnormal upper labial frenum.This cohort study evaluated ULF frenectomy using the tunnelling technique with an Er:YAG laser in a cohort of 20 patients treated between January 2011 and December 2024. The ULFs were morphologically and clinically characterized before and after the procedure.No intraoperative complications were observed during the frenectomy, apart from moderate intraoperative bleeding in 12 patients (60%), with no sutures required in any case. Postoperatively, analgesic medication was required by only 2 patients (10%) for mild pain. At the 3-month follow-up, a significant reduction was observed in both frenulum size (P<0.001) and interincisal diastema (P=0.008). All incisive papillae were preserved without any defects.Er:YAG laser frenectomy using the tunneling technique proved to be a suitable option, resulting in the immediate preservation of the incisive papilla and a reduction in ULF size and position, without significant associated complications.
