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Language Journal of Clinical and Experimental Dentistry. 2025. Vol. 17, no. 02
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- Influence of ultrasonic agitation on pH and antibiofilm activity of endodontic sealers: an in vitro study(Medicina Oral S.L., 2025) Viana, FL.; Sousa, CE.; Limoeiro, AG.; Alcalde, MP.; Vivan, RR.; Duarte, MA.; Pinheiro, ET.; Vasconcelos, BC.Background: The influence of ultrasonic agitation (UA) on the pH and antibiofilm activity of AH Plus Jet (AHP) and BioRoot RCS (BCS) sealers was evaluated. Subgroups were created based on the sealer/UA application. Material and Methods: The pH was measured at 30 min., 3, 24, 72, 168 h. Antibiofilm activity was determined by direct and indirect contact tests (DCT/ICT) on dual-species biofilms (Enterococcus faecalis and Streptococcus oralis). Bacterial survival was assessed by colony-forming unit (CFU) counting. The Mann-Whitney test was applied for th pH analysis whereas the Kruskall-Wallis and Dunn tests were employed for the DCT/ICT evaluations. Results: BCS presented the highest pH at all time points (p<0.05). Related to UA, it significantly reduced the pH at 30 min., 3, 24 and 72 h (p<0.05). In the DCT, a significant reduction in CFUs was observed in the BCS and BCS/ UA groups compared to the control and AHP/UA group. BCS also showed the best results in the ICT (p<0.05). Conclusions: It was concluded that UA reduced pH and did not improve the sealers’ antibiofilm activity. BCS showed the highest pH values and antibiofilm activity.
- Assessment of changes in optical and mechanical properties and adverse effects of over-the-counter bleaching agents: an in vitro study(Medicina Oral S.L., 2025) de Oliveira, MN.; Alves, HB.; Lerner, FE.; Campolina, MG.; Lins-Candeiro, CL.; Vieira, Wd.; Toniollo, MB.; da Silva, GR.; Paranhos, LR.Background: This in vitro study evaluated the impact of over-the-counter (OTC) products on the optical properties (color and gloss changes) and mechanical properties (shear bond strength) of tooth enamel subjected to a simulated orthodontic treatment. Material and Methods: 80 bovine teeth were selected and subjected to a staining protocol and initial color assessments. Then, orthodontic brackets were bonded on the center of the clinical crown of each sample, and teeth underwent the bleaching protocols. The samples were allocated to five groups (n=16): Conventional in-office bleaching 35% Hydrogen peroxide - positive control (HP35); Dentifrice with 2% HP (DHP); Mouthwash with 2.5% HP (MouHP); Paint-on with 6% HP (PON); Conventional dentifrice without HP - negative control (DWHP). After receiving the bleaching protocol, the samples underwent the shear bond strength test for orthodontic bracket removal. The remaining resin was then removed from the sample surfaces using multi-blade burs. Data was analyzed with Kruskal-Wallis test or one-way ANOVA, with 5% significance. Results: Regarding color change, multiple comparison analyses showed significant differences (p< 0.05). The HP35 and MouHP groups showed a significantly greater color change compared to the DWHP and DHP groups for both ΔE00 and ΔEab values, while the PON group did not differ significantly from the other groups. The statistical test did not detect a significant difference in post-bleaching gloss increase between the experimental groups (p=0.20). In addition, it did not detect a significant difference between the experimental groups for shear assessment (p=0.14).Conclusions: Except for dentifrices, the color change outcomes of the evaluated OTC bleaching treatments were as satisfactory as in-office bleaching, without differences between groups for gloss change. The study suggests that the evaluated OTC products did not influence the bond strength of orthodontic brackets to teeth.
- Compressive strength evaluation of two composites with and without fiber reinforcement used as restorative material in incisal edge: an In-vitro study(Medicina Oral S.L., 2025) Sagala, PV.; Vemuri, S.; Guptha, AB.; Garlapati, R.; Ravali, TK.; Krishna, MV.Background: To evaluate compressive strength of two composites with and without fiber reinforcement used as restorative material in incisal edge. Material and Methods: Sixty extracted human maxillary incisors were collected and divided into four groups (n=15). In group 1and 3: fracture line is beveled circumferentially, etched with 37% phosphoric acid gel for 15 seconds, bonding agent applied, and the lost tooth structure was incrementally built with nano-composites. In group 2 and 4: grooves are prepared for placing fibers. Fracture line is beveled circumferentially, fiber is placed into the flowable composite in the prepared groove area and remaining portion built incrementally with nano-composite. All samples were subjected to universal testing machine to evaluate compressive strength and observed in stereomicroscope to analyze mode of failure. The obtained data is analyzed using one-way ANOVA and Tukey’s Post-hoc tests. Results: Group 2 and 4 showed significantly higher fracture resistance. No significant difference is observed between group 1 and 3, group 2 and 4. More mixed failure were seen in group 1 and 3 and cohesive failures in group 2 and 4. Conclusions: Fiber reinforced composites have higher compressive strength which can be used as an treatment option for incisal edge fractures.
- Prevalence and morphology of lower second molars with C-Shaped canals: a CBCT analysis(Medicina Oral S.L., 2025) Mingo, E.; Noguera, M.; Jiménez, F.; Ballester, ML.; Berástegui, E.Background: This study aimed to assess the prevalence and morphology of lower second molars with C-shaped configuration among patients at the University of Barcelona Dental Hospital using cone beam computed tomography (CBCT). Material and Methods: CBCT images of 408 patients, comprising 792 lower second molars, were examined to identify C-shaped canals and evaluate their anatomical characteristics. Inclusion criteria required patients to have both lower second molars present. The configuration of C-shaped canals was categorised at three axial root levels. The variables of symmetry, position, gender and age were analysed. Results: Out of the 792 lower second molars analysed, a total of 65 molars with C-shaped canals were identified in 42 patients, representing a prevalence of 10.2%. The prevalence in females (12.6%) was significantly higher than in males (6.5%). Bilaterality was observed in 54.76% of individuals with C-shaped molars. The C1 configuration was most frequently observed in the coronal third (56%), while the C2 configuration was equally distributed between the coronal and middle thirds (44.1%). The C3 configuration was most prevalent in the middle third (41.4%), and the C4 configuration was predominantly observed in the apical third (96%). Variations in configurations along the root were observed in 70.8% of the molars. The longitudinal groove was predominantly located on the lingual surface of the roots (83.1%). Conclusions: CBCT is a useful tool to analyse the morphology of the root canal system
- Can charcoal-based dentifrices change the color stability and roughness of bleached tooth enamel and resin composites?(Medicina Oral S.L., 2025) Campolina, MG.; de Souza, PA.; Dietrich, L.; Soares, CJ.; Carvalho, CN.; Carlo, HL.; Silva, GR.Background: Given the increasing prevalence of individuals using charcoal-based dentifrices over extended periods without professional oversight, concerns have emerged regarding their potential effects. This study aimed to investigate the influence of different charcoal-based products on color change (ΔE00), gloss stability, and surface roughness of dental enamel (Intact or bleached) and resin composites subjected to 12-month simulated brushing. Material and Methods: 132 bovine crowns were randomly allocated and restored with either SS-single-shade or conventional multi-shade, NH-nanohybrid, NF- nano-filled, or BF- bulk-fill composite. A conventional toothpaste (Control), a charcoal-based toothpaste (DC) , and a charcoal-based toothpowder (PO) were evaluated corresponding to 1-, 2-, 6-, and 12-month simulated tooth brushing, respectively. Color (ΔE00) and surface roughness (Ra) were assessed at baseline and after each brushing (n=11). Gloss (GU) was assessed before and after brushing. The brushing products, as well as the enamel and composite surfaces, were analyzed using scanning electron microscopy. Color change, gloss stability, and surface roughness were analyzed by a three-way repeated-measures analysis of variance followed by Tukey’s test (α=0.05). Results: Significant differences were found for composite color change (ΔE00) based on brushing product (P<0.001), brushing time (P<0.001), and their interaction (P<0.001), with similar changes across charcoal-based and conventional toothpaste. After 12 months of brushing with toothpowder (PO), all composites exceeded the acceptable ΔE00 threshold. Gloss values decreased significantly (P<0.001), with greater losses in NF and NH resins. Roughness (Ra) also increased more with PO than with toothpaste. Both PO and DC significantly reduced enamel gloss, especially on bleached enamel. Conclusions: Charcoal-based toothpaste alters the morphology, roughness, gloss, and color of enamel and resin composite, similar to regular toothpaste. Toothpowder creates surface irregularities, decreasing the gloss and increasing the color change and roughness, more strongly impacting bleached enamel and composites after 12-month simulated tooth brushing.
- Impact of probable bruxism on the oral health-related quality of life among police officers and their relatives(Medicina Oral S.L., 2025) Atuncar-Salazar, JT.; Huertas-Mogollón, GA.; Vidigal, EA.; López-Ramos, RP.Background: Bruxism is a global oral disorder that can negatively affect oral health-related quality of life (OHRQoL). Nonetheless, there are few studies regarding police officers. The aim of this study was to determine the impact of probable bruxism on quality of life among police officers and their relatives. Materials and methods: This cross-sectional study included 243 police officers, and their relatives aged 18-70 years who attended the dental service of a Peruvian National Police Hospital. They were evaluated through a questionnaire of probable bruxism, including a clinical oral examination. The Oral Health Impact Profile (OHIP-14) questionnaire was also used to determine the impact of OHRQoL. Univariate and bivariate statistical analyses were performed. In addition, multivariate analysis was performed via the statistical program STATA version 18. Results: The mean OHIP-14 score was 13.4 ± 8.0, and 48.6% of the participants had probable bruxism. Statistically significant differences were found in questionnaire domains such as physical pain (p=0.001), psychological distress (p=0.012), social disability (p=0.002) and handicap (p=0.007). Multivariate analysis, adjusted for age in years, sex, type of insurance, level of education and degree of dental wear showed the mean OHIP-14 total score was 2.38 points higher in patients with probable bruxism (95% CI; 0.75, 4.71). Conclusions: Probable bruxism had a negative impact on the oral health-related quality of life of police officers and their relatives.
- Technical Note of a 3D Printed Stimulating Palatal Plate Prototype for Children with Trisomy 21(Medicina Oral S.L., 2025) do Nascimento, NF.; Warol, F.; Lima, P.; Amaral, LD.; dos Reis, DB.; Picciani, BL.Background: The stimulating palatal plate is an orthopedic device indicated for babies with Trisomy 21. A digital workflow should be implemented to enhance infant safety, starting by intraoral scanning and ending with device printing using a biocompatible material. Thus, the main objective of this technical note is to describe the digital workflow for fabrication of a palatal plate for therapy in T21 patients. Material and Methods: The fully digital linear workflow is presented below, as well as the effectiveness of use in a clinical case of an infant with T21. The maxilla was registered using the TRIOS3 intraoral scanner and the design process for the Stimulating Palatal Plate (SPP) aligns with similar parameters to craft an individual tray, using the Exocad software. After completion of the printing phase, the devices go through a crucial post-processing stage. Results: Upon placement, the SPP was perfectly adapted and the child with T21 presented immediate alteration of the tongue posture and lip sealing. Conclusions: The digital workflow from scanning to impression of the stimulating palatal plate is efficient and safe and should replace the conventional method, especially in patients with Trisomy 21. The printed plate presents excellent adaptation and acceptance by family members.
- Effect of energy drinks on the surface microhardness of bulk fill resins. In vitro study(Medicina Oral S.L., 2025) Loo-Valle, J.; Aguilar Gálvez, D.; Arriola-Guillén, LE.Background: The study aimed to compare the surface changes of Filtek Z350XT, Filtek Bulk Fill, and Opus Bulk Fill resins immersed in Maltin Power® and Volt® energy drinks using surface microhardness testing. Material and Methods: This experimental study evaluated two types of bulk fill resins and Filtek resin (control). Forty-eight resin discs measuring 4x4 mm were prepared and soaked in 20 ml of an energy drink for 10 minutes daily for 7 and 30 days. Surface microhardness was assessed using the Vickers microhardness method. Repeated samples were analyzed using the ANOVA test, and multiple comparisons were conducted using the Bonferroni test. Finally, the Kruskal-Wallis test also was applied (P < 0.05). Results: The decrease in surface microhardness of the three resins exposed to the two energy drinks was significant (P<0.05). After immersion in the Volt energy drink over 30 days, the Filtek Z350XT, Filtek Bulk Fill, and Opus Bulk Fill resins showed decreases in surface microhardness of 3.89±1.94; 7.74±4.66 and 5.86±3.17, respectively, while the respective decreases after immersion in the Maltin Power energy drink were 3.67±4.08, 5.70±0.99, and 3.23±1.76. Conclusions: Immersion in the energy drinks changed the surface microhardness of bulk fill resins after 7 and 30 days. Both clinicians and patients should consider these findings when determining the consumption frequency of these beverages.
- Tooth pain accompanying cluster headache in a middle-aged female: a case report(Medicina Oral S.L., 2025) Ohnuma, S.; Takizawa, K.; Ozasa, K.; Young, A.; Noma, N.Some orofacial pains (OFP) resemble primary headache disorders, but involve the trigeminal nerve V2 or V3 dermatome. The International Classification of Orofacial Pain (ICOP) distinguishes three types of such OFPs: Type 1 (facial pain in addition to headaches), Type 2 (facial pain replacing a previous primary headache), and Type 3 (OFP similar to primary headaches, without a history of headaches). This report describes a 46-year-old female patient with a chief complaint of toothache and severe pain radiating to the left orbital region, and with accompanying autonomic signs and symptoms. The pain persisted despite dental treatments, leading to a diagnosis of cluster headache. The OFP initially matched the Type 1 description, but later changed to match the Type 2 description. This case highlights the need to differentiate nonodontogenic from odontogenic pain for accurate diagnosis and treatment.
- E-cigarette: a safe tool or a risk factor for oral cancer? A systematic review(Medicina Oral S.L., 2025) Palaia, G.; Mohsen, M.; Pergolini, D.; Bartone, V.; Purrazzella, A.; Romeo, U.; Polimeni, A.Background: Electronic cigarettes (e-cigarettes) are considered relatively safe, thus tobacco and nicotine delivery products have become popular in the last few years. However, the safety of long-term use of these products on oral health is still questionable. E-cigarettes may have potential risks to oral health that can be demonstrated as cellular damage, genetic instability, and mucosal lesions. This review aims to observe the role of e-cigarettes as a risk factor for oral cancer development. Material and Methods: This systematic review was conducted following the PRISMA guidelines to provide reliable data on the role of electronic cigarettes as a risk factor for oral cancer development. The research was performed on Pubmed and Scopus by three reviewers from the Oral Pathology Department (Sapienza University of Rome) in May 2024. The search terms included: “e-cigarette”, “oral cancer”, and “risk factor” where 32 articles from PubMed and 75 from Scopus were collected. A total of 12 studies met the eligibility criteria: 6 clinical studies and 6 in vitro. All the included studies were subjected to quality assessment and data extraction processes. The risk of bias assessment of in vitro studies revealed low or unknown risk. None of the studies had any industrial sponsoring and almost all the papers (90%) had the same methods, 64% measured the cell vitality. The qualitative analysis was done for all the included clinical studies using the RoB assessment tool (MINORS). The range of the total RoB score in the comparative studies was between 12 and 23. Results: The clinical studies involved a total of 413 participants were also included. Most studies did not specify the age and gender of participants and patients were divided into three main groups based on specific criteria: nonsmokers, smokers, and e-cigarette users. These studies highlighted cases of mucosal lesions and genetic instability associated with e-cigarette use. Conclusions: However, the limited long-term data and conflicting results emphasize the need for a larger number of studies, such as randomized controlled trials and cohort studies, to acquire more data about the safety and risks associated with e-cigarettes.
- Barrier Effects of a poly (lactic acid/caprolactone) Bilayer Membrane for Guided Bone Regeneration on Skull without Periosteum of Adult-Senior Staged Rats(Medicina Oral S.L., 2025) Murata, M.; Kabir, MA.; Horie, N.; Yokozeki, K.; Shakya, M.; Kusano, K.Background: Vertical and horizontal bone augmentation is one of the most challenging techniques in bone engineering. The use of barrier membranes and scaffolds in guided bone regeneration (GBR) procedures is a common approach for the treatment of lost bone around teeth and dental implants. The aim of this study was to estimate the barrier effects of a synthetic poly (lactic acid/caprolactone) [P(LA/CL)] bilayer membrane for GBR, compared to a porcine collagen bilayer membrane, in the vertical augmentation model on 10–12-months old rat skull without periosteum. The hydroxyapatite (HAp) block (diameter: 4 mm, height: 3 mm, porosity:75%, average pore size:150 μm) was placed on the rat skull without a periosteum. The P(LA/CL) membrane (solid layer: 25 μm, porous layer: 175 μm) or the collagen membrane (solid layer, porous layer) was applied onto the HAp block. At 3, 6, and 12 weeks after the surgery, the incised tissues were fixed, de-calcified, and stained with hematoxylin and eosin for histological evaluation. The P(LA/CL) membrane remained until 12 weeks and could achieve barrier effects to inhibit cellular invasion from the repositioned soft tissues. Local bone formation occurred in the interconnected pores of HAp at 6 weeks. On the other hand, the collagen membrane did not inhibit cellular invasion for its expansion until 3 weeks, and was absorbed until 6 weeks. Histomorphometrically, bone in the P(LA/CL)/HAp at 6 and 12 weeks occupied 8.3 % and 10.0 %, respectively, while bone was not formed in the pores of the upper half area in the collagen/HAp. The results in the biomimetic model indicated that the P(LA/CL) membrane might be effective in GBR as an occlusive and absorbable membrane.
- Factors associated with indication of tooth whitening during orthodontic treatment(Medicina Oral S.L., 2025) Chinchay-Ruesta, S.; Ortiz-Pizarro, M.Background: Although teeth whitening is preferred after orthodontic treatment, aesthetic demands may generate a different indication. Aim: To determine the factors associated with indication of tooth whitening during orthodontic treatment. Material and Methods: A cross-sectional study was conducted using an online survey for participation of 200 dentists who frequently performed fixed orthodontic treatment. The validity and reliability of a 10 questions instrument was determined, content was entered into Survey Monkey software to generate delivery links. The instrument was sent through social networks with instant messaging and email. The bivariate analysis of associated factors was evaluated with Chi Square test and logistic regression was used to identify risk or protective factors for indication of tooth whitening. Results: In bivariate analysis, it was found that dentist’s specialization in orthodontics (p-value = 0.006), intensity of patient’s tooth staining (p-value = 0.001), patient’s staining habits (p-value = 0.001) and patient’s self-perceived aesthetic need (p-value = 0.001) were associated with indication of tooth whitening during orthodontic treatment. While professional experience (p-value = 0.525) and training in dental aesthetics (p-value = 0.936) were not associated. In adjusted analysis, differences were found between those who are specialists in orthodontics versus those who are not (p-value = 0.035), multiplying by 2.750 their decision to indicate tooth whitening (OR=2.750). Conclusions: The decision to indicate tooth whitening during orthodontic treatment is low. However, this initial decision could be affected by intensity of tooth staining, pigmentation habits and patient’s self-perceived need for dental aesthetics; but mainly by orthodontics specialization of dentist.
- Impact of different gutta-percha removal techniques on dentinal integrity: an in vitro analysis(Medicina Oral S.L., 2025) Guedes, OA.; Ferreira, HC.; Abreu, DM.; de Lima, KS.; Souza, EM.; de Freitas, YG.; Decurcio, Dd.; Estrela, C.Background: This study aimed to evaluate the impact of different gutta-percha removal (GPR) techniques on the occurrence of dentinal defects in bovine root canals. Material and Methods: One hundred and eight bovine incisors were selected and stored in distilled water. The crowns were removed, leaving roots approximately 17 mm in length. Twelve roots were left unprepared and served as control (G1), and the remaining 96 roots were instrumented with BioRace files up to size 40/.04 (BR5) and f illed with gutta-percha and Sealapex sealer using the lateral condensation technique. Twelve other roots were left f illed and received no retreatment procedure (G2). The remaining 84 roots underwent filling material removal with R-Endo (G3), D-Race (G4), WaveOne Gold (G5), ProTaper Retreatment (G6), Mtwo R (G7), Reciproc (G8) instruments or with R1-Clearsonic ultrasonic insert (G9). After GPR, final apical enlargement was achieved using a BR7 (#60/.02) instrument. Roots were sectioned 3, 6 and 9 mm from the apex and observed under a stereomicroscope at 25ᵡ magnification. The presence/absence of root fractures, microcracks, and craze lines were recorded. Chi-square tests compared the incidence of dentinal defects between the groups, with a significance level set at P<.05. Results: Defects occurred in 46.6% of the samples. No defects were observed in the unprepared canals (control, G1). Defects were detected in all other experimental groups (G2 to G9). Among retreatment techniques the R-Endo group (G3) presented significantly higher microcracks and craze lines (P<.05). Defects were more frequent in the coronal and middle thirds. Conclusions: All GPR methods were linked to dentinal defects. The R-Endo system significantly increased microcracks and craze lines.
- Effect of potassium nitrate on tooth sensitivity during in-office bleaching: a randomized clinical trial(Medicina Oral S.L., 2025) Somacal, DC.; do Rio, MC.; Bittencourt, HR.; Júnior, LH.; Spohr, AM.Background: The study is a triple-blind, split-mouth, randomized trial to evaluate and to compare the effect of different concentrations of potassium nitrate (PN) prior to in-office bleaching on tooth sensitivity (TS). Material and Methods: Sixty participants were randomly divided into groups (n=30): Group A: 5% PN (positive control) and 10% PN; and Group B: 5% PN (positive control) and 35% PN. Each concentration of PN was applied to a hemi-arch for 10 min, and then a 35% bleaching agent was applied. The participants underwent two sessions of bleaching with a one-week interval. TS was recorded using a questionnaire and a visual analog scale. Results: According to McNemar’s test, there was a significant reduction in the prevalence of TS in group A (p=0.013) and group B (p=0.000) across the time assessments. Fisher’s Exact Test showed no significant difference between the control and treatment sides (p>0.05). There was a significant reduction in TS intensity for both groups (p<0.05). Conclusions: The 10% and 35% PN were effective in reducing the prevalence and intensity of TS, as well as 5% PN, and the treatments did not affect color change.
- Evaluation of Remineralization of White Spot Lesions with Quercetin Nanoparticles:an in vitro Study(Medicina Oral S.L., 2025) Subramani, K.; Decker, B.; Chaudhry, K.; Subbiah, U.; Mota, EG.Background: This study explored the synthesis of quercetin nanoparticles (QNPs) and evaluated the remineralization effect of QNPs on artificial white spot lesions on extracted human teeth. Material and Methods: QNPs were successfully synthesized, and their size was measured. Seventy-six extracted human molars were divided into 4 groups of n=19 to undergo a 10-day pH cycling protocol: 1000 ppm fluoride solution as aqueous NaF (group 1), 6.5% w/v quercetin microparticle solution (group 2), 4000 ppm QNP (group 3) and deionized water (group 4). Vickers microhardness tester, scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDX) and atomic force microscopy (AFM) were used to measure the surface microhardness (SMH), Ca:P ratio and surface roughness (Ra), respectively. Results: After remineralization, the SMH values were significantly different among all the experimental groups (p<0.001). The fluoride and QNP groups had significantly greater SMH values than the quercetin group. The AFM data showed a significant decrease, but the differences were not significant. The Ca:P values were significantly greater than those of the control in all 3 experimental groups, but the QNP and fluoride concentrations were significantly greater than those of quercetin. There were no significant differences between QNPs and fluoride according to any test. Conclusions: It can be concluded from the results of this study that QNPs have similar remineralization potential to f luoride and are more effective than quercetin.
