Purpose: To compare the clinical efficacy of self-adhesive Bulk-fill resin composite and traditionally bonded Bulk-fill resin composite in the restoration of proximal lesions during the course of 18 months. Materials and methods: In a parallel study design, 40 participants with carious proximal lesions were assigned at random to the intervention (Surefil-one) and comparison (Bulk-fill) groups. Two blinded assessors evaluated restorations at initial screening (1 week), 6, 12, and 18 months using modified United States Public Health Service (USPHS) criteria measuring (marginal adaptation, marginal discoloration, surface roughness, anatomic form, postoperative sensitivity, recurrent caries, color match, and retention analysis). Categorical data were described as frequency and percentage. Intergroup and intragroup comparisons were done using the Chi-squared test. Results: Intergroup comparisons of both materials after 18 months revealed no differences of statistical significance in marginal adaptation (p = 0.0952), recurrent caries (p = 0.8728), postoperative sensitivity (p = 0.5936), retention analysis (p = 0.3173), and proximal contact (p = 0.9707). There was a difference of statistical significance between both materials for marginal discoloration (p = 0.0235), color match (p = 0.007), anatomic form (p = 0.0023) after 18 months, and surface roughness after 12 and 18 months (p = 0.0013 and 0.0001, respectively). Conclusion: Over an 18-month test time frame, a self-adhesive Bulk-fill resin composite hybrid (Surefil one) revealed clinically less satisfying performance when compared to traditionally bonded Bulk-fill resin composite. Surefil one can be employed as a clinical alternative in intermediate short-term restoration of proximal lesions.

Purpose: The purpose of this prospective split-mouth study was to compare crestal bone loss (CBL) and interleukin-1β (IL-1β) and C-terminal telopeptide (CTX) levels in peri-implant sulcus fluid (PISF) between implants restored with platform matched (PM) and platform switched (PS) abutments. Materials and methods: A total of 50 single tooth implants of 4.6 mm diameter were placed crestally in 25 patients (two implants in each patient) in the molar region. After 3 months, each of the two implant sites in each patient was randomly restored with a PM and a PS abutment (3.8 mm), and prostheses were given. The bone loss was calculated using a digital radiograph after abutment placement (baseline), 6 months, 1 year, and 2 years of loading. During each interval, PISF was collected around the implant and IL-1β and CTX were estimated using an enzyme-linked immune sorbent assay. The mean difference in bone loss and IL-1β levels within and between the two groups were compared using one-way analysis of variance (ANOVA) and independent t-tests. About 80% of PISF samples at baseline and 90% of samples of subsequent visits developed very negligible or no color and thus were considered negative for CTX. Results: The bone loss found at baseline was 0.82 ± 0.54 mm in the PM group and 0.69 ± 0.47 mm in the PS group (p = 0.376). At 6 months, the total bone loss was 1.05 ± 0.62 mm in the PM group and 0.97 ± 0.58 mm in the PS group, and increased to 1.11 ± 0.60 and 1.03 ± 0.64 mm, respectively in 2 years of follow-up. IL-1β levels were 4.52 ± 5.24 and 5.30 ± 6.38 ng/mL in the PM and PS groups, respectively (p = 0.175) at baseline. The levels decreased to 0.73 ± 0.83 ng/mL and 0.59 ± 0.54 ng/mL in the two groups, respectively, at 2-year follow-up. An insignificant difference was found in bone loss and IL-1β levels of both groups during the follow-up. Conclusion: Within the limitation of the study, the extent of bone loss and PISF IL-1β levels were insignificantly different when PM and PS abutments were used with the same implant system. IL-1β levels reflected the extent of inflammation associated with the implant site, which decreased with time.

Purpose: To evaluate the surface roughness of six composites polished with four different polishing systems. Materials and methods: Cylindrical resin specimens were prepared for each different composite group of nanohybrid (Clearfil Majestic Esthetic®, G-aenial ACHORD®, and Simplishade®) and microhybrid (Amaris®, Herculite®, and APX®), resulting in a total of ninety-six resin cylinders. Each cylinder was drilled to create five wells of 3 mm diameter and 2 mm depth. Each composite group size was 80 and was divided into four subgroups. The first subgroup was polished with the Sof Lex® system, the second subgroup with the Diapol Twist® system, the third subgroup with the Diacomp Plus® system, and the fourth subgroup with the Identoflex Ceramic Polish® system. Half of the samples from each subgroup (n = 10) would undergo an additional polishing step using a diamond paste. The results were analyzed using analysis of variance (ANOVA) and Tukey's test. Results: Amaris® composite had significantly higher roughness than the other composites, both with and without polishing paste (PP) (p < 0.05). There was no significant difference in roughness (p = 0.660) for both nanohybrid and microhybrid composites, indicating that their average roughness values were similar. Both types of composite and the finishing/polishing system were significant (p < 0.001) factors influencing roughness. Conclusion: Diamond particle polishers yield better polishing results on composites than aluminum oxide (Al₂O₃) particle polishers. There is no significant difference in roughness between micro- and nanohybrid composites. Therefore, clinicians should focus on polishing systems instead of composite types. The use of PP slightly improves surface roughness.

Purpose: The purpose of the study was to evaluate and compare the masticatory performance and bite force of conventional and hollow dentures in highly resorbed, completely edentulous ridge cases. Materials and methods: Around 20 highly resorbed, completely edentulous subjects between 45 and 60 years were included. Subjects with ≥15 mm of maxillary and mandibular restorative space from the soft tissue crest of the residual edentulous ridge to the proposed occlusal plane were only included. For each patient, conventional dentures followed by hollow dentures were given at 3-month intervals, with 2 weeks of washout period. Patient satisfaction, masticatory performance and bite force were evaluated for each subject. The weight of the dentures and masticatory performance were analyzed using a paired t-test, and bite force was measured using the Wilcoxon signed-rank test. Results: The satisfaction level of subjects was evaluated using a questionnaire in which 100% satisfaction was obtained for the comfort and appearance of hollow dentures. The mean value of masticatory performance for conventional and hollow dentures with peanuts was 34.43 and 44.07% with carrots, was 33.85 and 43.73%, respectively. There was a statistically significant difference in masticatory performance between conventional and hollow dentures (p < 0.05). The mean bite force for conventional and hollow dentures was 11.34 and 11.69 N in the right premolar region, and the difference was insignificant. Conclusion: Hollow dentures showed more patient satisfaction and better masticatory performance compared to conventional dentures. Hence, hollow dentures can be recommended for patients with highly resorbed edentulous ridges.

Purpose: To evaluate how plant-based nanoparticles, specifically titanium, zirconium, and hydroxyapatite, influenced the wettability and surface roughness of glass ionomer cement (GIC). Materials and methods: The research involved 48 samples divided into four groups (n = 12 for each group)—GIC modified with green-mediated chitosan, titanium, zirconium, and hydroxyapatite (Ch-Ti-Zr-HAP) nanocomposite at concentrations of 3% (group I), 5% (group II), 10% (group III), and a control group of conventional GIC (group IV). Toothbrushing simulation was carried out using the ZM-3.8 SD Mechatronik toothbrush simulator with 30,000 brushing cycles. Atomic force microscopy (AFM), contact angle analysis, and scanning electron microscopy (SEM) were employed for nanoscale surface imaging, wettability assessment, and high-resolution surface examination, respectively. Statistical analysis included one-way analysis of variance (ANOVA), Tukey's post hoc analysis, and paired t-test. Results: The study revealed significant differences (p = 0.001) in contact angle values, with the 10 and 5% concentration groups showing the least contact angle postsimulation. Surface roughness analysis indicated that the 5% concentration group consistently had the lowest roughness parameters [arithmetic mean roughness (Ra), root mean square roughness (Rq), and average surface roughness (Sa)] (p = 0.001). SEM analysis illustrated that higher concentrations of nanomodifiers led to a denser and more uniformly distributed arrangement of nanoparticles on the GIC surface. Conclusion: Within the limitations of the study, green-mediated nanomodification of GIC with plant-based nanoparticles demonstrated promising outcomes in improving wettability and reducing surface roughness. The study highlights the potential of environmentally sustainable modifications to enhance the properties of dental restorative materials.

Purpose: To compare the surface hardness of monochrome (single shade) and conventional composite resins after exposure to food-simulating liquids. Materials and methods: A total of 50 disk-shaped specimens of composite resin (n = 25 estelite alpha and n = 25 omnichroma) were fabricated in split teflon mold (15 mm diameter, 2 mm thickness). The specimens were divided into subgroups (n = 5/subgroup). The first subgroup acted as the control and incubated dry at 37 ± 0.5°C in darkness for 1 week. Each specimen of the other four subgroups was immersed separately into a tightly closed glass test tube with 2 mL of each solution of the four different food-simulating liquids (artificial saliva, citric acid 0.02%, heptane 50%, and 50% ethanol) and incubated at 37± 0.5°C in darkness, with daily manual agitation for 1 week. Vickers hardness number (VHN) was then measured for each specimen under a load of 0.49N and a dwell time of 15 seconds. The unpaired t-test was used to compare the two groups, while comparisons between >2 groups were performed using analysis of variance (ANOVA) with multiple comparisons post hoc Tukey test. Results: Omnichroma showed significantly higher Vickers hardness values in each storage condition than estelite alpha. Both omnichroma and estelilte alpha showed a reduction in the Vickers microhardness values in different solutions when compared to the dry condition. One-way ANOVA showed a significant difference (p < 0.001) between the subgroups of both composites. Estelilte alpha showed the greatest reduction in the Vickers microhardness values in the dry condition (21.94 ± 0.54 kgf/mm²) and the least value (15.92 ± 0.65 kgf/mm²) when immersed in 50% ethanol. Omnichroma also showed the greatest Vickers microhardness values in the dry condition (28.04 ± 0.99 kgf/mm²) and the least after immersion in 50% ethanol (21.90 ± 0.63 kgf/mm²). Conclusion: The 50% ethanol was the most critical food-simulating liquid, causing degradation in both composites. The resin formulation of urethane dimethacrylate/triethylene glycol dimethacrylate (UDMA/TEGDMA) of monochromatic composite showed better stability in surface hardness properties after exposure to different food-simulating liquids. The inclusion of prepolymerized filler in the nanohybrid composite had a negative impact on the surface hardness.

Purpose: To evaluate stress on bone and prosthetic screws as influenced by varying implant positions in a six-implant supported mandibular hybrid prosthesis using finite element method (FEM). Materials and methods: Three-dimensional (3D) models of the human mandible were generated. Three different models were created with 4.2 × 11.5 mm implants placed in different regions bilaterally (model 1: first premolar, second premolar, first molar region; model 2: central incisor, canine, first molar region; model 3: central incisor, second premolar, first molar region). A structural steel framework of 6 mm width to which the abutments were connected was also simulated. To carry out dynamic loading, all the models were subjected to a load of 150 N at 75° on the canine region and first molar region over 3,000,000 cycles, which simulated a clinical usage of 10 years. Stress analysis was carried out under dynamic loading using finite element software (ANSYS Inc.). Results: In model 1, maximum stress was induced on the prosthetic screw over the implant placed in the first premolar region, which fractures within 2,100,000 cycles (representing a clinical usage of 7 years). In model 3, the maximum stress was induced on the prosthetic screw over the implant placed in the central incisor region, which fractures within 2,400,000 cycles (representing a clinical usage of 8 years). No significant deleterious stress was seen to be induced on the bone. Conclusion: The screws fracture within a period of 7–8 years when the implants are placed in a less-than-ideal position, but owing to the prudent variation in a patient's mouth, it can be concluded that prosthetic screws in a full arch prosthesis should be changed within a period of 3–5 years, irrespective of the number of implants. Even though our results suggested that not much impact is induced in the bone, in a clinical scenario, this may vary where bone can increase and decrease in density in order to react and adapt to stress; thus, further clinical studies need to be carried out for the same.

Purpose: To compare the effect of in-office bleaching agent application times on tooth sensitivity and degree of color change. Materials and methods: PubMed, Web of Science, EBSCO, Scopus, Cochrane Library, DOAJ, LILAC, gray literature, and manual search. Randomized clinical trials or clinical studies that recruited patients aged 18 years or above for in-office tooth bleaching were included. The focused question was, “Do application times of in-office bleaching agents affect tooth sensitivity and degree of color change”? The risk of bias (RoBs) and meta-analysis were analyzed using review-manager software. Results: The database search identified 159 citations and 13 citations through manual search. After removing duplicates, the abstracts of 93 studies were assessed. Around 10 full-text articles were studied, and finally, four articles were included for qualitative analysis. The RoBs in the four included studies was considered to be low. Conclusion: Systematic review and meta-analyses showed that single prolonged bleaching has significantly reduced postbleaching tooth sensitivity compared to the multiple application times of the bleaching agent. The color change seemed the same with both application times of the bleaching agent.

Purpose: This systematic review and meta-analysis was conducted to evaluate the efficiency of the osseodensification protocol over the conventional drilling protocol. Materials and methods: A systematic search was conducted using PubMed and Google Scholar for English language literature. The focused question was, “is there any effect of osseodensification drilling protocol on the implant stability for dental implants placed in the low-density bone, based on clinical and histologic evaluation?” The selection of articles was done according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of Bias assessment for animal studies was done using the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) tool, and quality assessment for animal studies was done using Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. Quality assessment for human studies was done using modified ARRIVE guidelines. Meta-analysis was done using Statistical Package for the Social Sciences (SPSS) software for parameters such as bone-implant contact (BIC)%, bone area fraction occupancy (BAFO)%, insertion torque value (ITV), implant stability quotient (ISQ), bone volume (BV)%, and removal torque value (RTV). Results: The systematic search identified a total of 339 studies, out of which 15 articles were selected on the basis of inclusion criteria. These 15 articles included 11 animal studies, one clinical trial, two prospective studies, and one retrospective study. It was found that mean values of BIC, BAFO, ITV, ISQ, BV, and RTV were higher for the osseodensification protocol. Significant ridge width expansion was found with the osseodensification process. Conclusion: The osseodensification drilling protocol showed higher primary implant stability, secondary implant stability, and ridge width expansion in low-density bone and thin alveolar ridges than the conventional drilling protocol. However, to determine the long-term clinical success of this technique, more studies should be conducted.