Aim: To assess the effect of mushrooms, ozone gas, and their combination as cavity disinfectants on the bonding strength of composite to dentin. Materials and methods: The study was conducted on 40 sound premolar teeth randomly divided into four groups. Group I: control group, Group II: mushroom group, Group III: Ozone group, and Group IV: mushroom + ozone gas (combination) group. After the pretreatment of dentin with the previous material the adhesive bonding agents and composite were applied and polymerized. The shear bond strength was measured using the universal testing machine. A sample from each group was evaluated blindly by scanning electron microscope (SEM) to see changes in dentin morphology after treatment. The data were statistically analyzed using one-way ANOVA for inter-group general comparisons while qualitative data were analyzed using the Chi-squared test. Results: The mean value of shear bond strength of the control group was 5.44 ± 1.45, the mushroom group was 7.55 ± 3.46, the ozone group was 10.42 ± 6.55 and the mushroom and ozone group was 7.45 ± 5.26. Comparison between the four groups regarding the shear bond strength indicated that there was a non-significant difference between the tested groups, with a p-value of 0.52. The SEM result showed a continuous hybrid layer in all groups with no gap formation in the combination group. Conclusion: It was concluded that ozone and mushrooms could be employed reliably as cavity disinfectants in permanent teeth without affecting bond strength negatively. The ozone group showed the highest bond strength. Clinical significance: Using antibacterial material before restoration is important to help in the prevention of recurrent caries and increase the longevity of restoration, and this should be performed without affecting bond strength.

Aim: This study aimed to evaluate the effectiveness of fenugreek as an adjuvant in managing oral potentially malignant disorders (OPMDs), specifically leukoplakia, lichen planus, and oral submucous fibrosis (OSMF). Materials and methods: Twenty-one participants prediagnosed with OPMDs were randomly divided into a study group (SG) and a control group (CG), with 10 participants in SG and 11 in CG, respectively. The SG received 2 gm of fenugreek as an adjuvant with standard systemic treatments tailored to the respective lesions: intralesional injection of vitamin A 1,00,000 IU (Aquasol A) and topical application of triamcinolone acetonide 0.1% (Kenacort) for 2 months for leukoplakia. Subjects with oral lichen planus were administered prednisolone 5 mg/day (Wysolone), chlorhexidine mouthwash 0.2% (Peridex), and Zincovit once daily for 8 weeks. For subjects with OSMF, one capsule of SM Fibro once daily for 12 weeks along with dexamethasone 1.5 mL (Decadron) was given, and hyaluronidase 1,500 IU (Hynidase) with 0.5 mL lignocaine HCL (Xylocaine) was injected intralesionally biweekly and mouth exercise was advised for 2 months; control group received only the standard treatment. Sociodemographic data were collected, and clinical assessments, evaluating size and shape for leukoplakia, erythema, and burning sensation for oral lichen planus, and mouth opening, cheek flexibility, and burning sensation for OSMF were assessed from baseline through 2 months. Data collected were organized in Excel and analyzed using Statistical Package for the Social Sciences version 21.0. Results: The SG and CG had 10 and 11 participants, with 4 in each group for leukoplakia, 2 participants in SG and 3 in CG for lichen planus, and 4 participants for OSMF in each group, respectively. Most participants presented with leukoplakia under 2 cm on the buccal mucosa bilaterally, with no significant changes in size or shape postintervention. For lichen planus, mild erythema and burning sensation were noted, but there were no significant differences within or between groups postintervention. A mild burning sensation, a statistically significant improvement in mouth opening was observed in SG (p < 0.051) when compared with CG after 8 weeks postintervention in OSMF. Also, significant improvement in cheek flexibility was noted from baseline to the fourth follow-up in SG post intervention. However, there were no differences between groups during the follow-up period. Conclusion: The findings from this trial suggest that SG showed significant improvement in OSMF than CG, whereas the improvements in leukoplakia and lichen planus remained same in both groups. Clinical significance: Fenugreek, being a cost-effective and affordable agent known for its anticancer, anti-inflammatory, antioxidant, and antiulcerative properties, could be used as an adjuvant for its management in OPMDs.

Aim: The aim of this in vitro study was to compare the surface roughness and color stability of polyetheretherketone (PEEK) with those of conventional interim prosthetic materials like polymethylmethacrylate, bis-acrylic composite, and rubberized diurethane dimethacrylate, following immersion in solutions of varying pH value. Materials and methods: A total of 320 circular discs with 10 mm diameter and 2 mm height were divided based on the fabrication (n = 80)—group A: polymethylmethacrylate; group B: bis-acrylic composite; group R: rubberized diurethane; and group P: hot-pressed PEEK—and were subjected to baseline measurement of roughness (n = 40) and color (n = 40) using 3D profilometer and UV-Vis spectrophotometer, respectively. Later, 10 samples from each group were immersed in distilled water, black coffee, green tea, and Pepsi, respectively, for 120 days, and measurements of roughness and color were repeated. The differences in roughness (ΔR^a) and color change(ΔE) were calculated and statistically analyzed with a significance level of p-value < 0.05. Result: Irrespective of the immersion solution, the highest mean difference in the roughness values was shown by rubberized diurethane specimens: ΔR^a = 3.574880 (0.0048350) in carbonated beverages, and lowest difference was shown by bis-acrylic composite: ΔR^a = 0.29004 (0.0017473) in distilled water. The greatest color stability was exhibited by PEEK. The type of interim material and immersion solution had a statistically significant effect on change in color and roughness values. Conclusion: The immersion in solutions of varying pH had a significant effect on surface roughness and color stability of all the tested materials. The R^a value of all specimens after immersion was still within the clinically acceptable range. Polyetheretherketone was the most color stable material in all solutions, except in green tea. Clinical significance: This study will provide guidance to dentists and patients regarding the selection of interim material for long-term use, depending on the effect of beverage consumption on its color stability and roughness.

Aim: The current study aimed to assess the oropharyngeal space using cone-beam computed tomography (CBCT) and its effect on airway volume both before and after denture placement. Materials and methods: For this investigation, a total of 15 individuals with fully edentulous upper and lower ridges, ranging in age from 40 to 70, were taken into consideration. A recording of the pulmonary function test was made both prior to and following full denture recovery. Prior to finishing denture therapy, the patient underwent a CBCT scan while standing erect and wearing a cephalostat. For one patient, two tomographs were recorded. The initial skull tomography was obtained prior to the rehabilitation of prosthetic limbs. After receiving prosthetic rehabilitation, the second tomograph was taken. On Demand 3D and CS 3D imaging software were used to take the measurements. The maxillary and mandibular complete dentures were fabricated using standardized techniques. Following prosthesis insertion, a CBCT scan of the skull was performed, and the results were recorded and analyzed. Results: The mean oropharyngeal space measurement before and after complete denture rehabilitation was 9.18 mm and 10.20 mm, respectively. It was discovered that there was a statistically significant difference (p = 0.001). The oropharynx's mean volume before complete denture rehabilitation was 5533.50 mm³, and it was 6562.39 mm³ after denture rehabilitation was finished. A statistically significant difference was discovered (p = 0.028). Conclusion: On conclusion, a statistically significant difference was found between the airway volume and oropharyngeal space prior to and following denture rehabilitation. Reducing apnea-hypopnea episodes can be achieved by minimizing pharyngeal collapsibility in patients by providing complete dentures that are created with acceptable and potentially improved vertical dimension of occlusion within the limits of permissible tissues. Clinical significance: The CBCT image enables it to be simple to distinguish between empty space and soft tissues. One benefit of wearing a denture while sleeping for edentulous patients with obstructive sleep apnea is that it helps decrease apnea-hypopnea episodes. This happens because wearing a denture causes changes to the soft tissue, pharyngeal airway space, jaw, and tongue positions.

Aim: The socket-shield technique arises from the efforts to stop the dimensional changes of the bone crest and gingival tissues. This technique consists of leaving a vestibular fragment of a naturally attached root with the purpose of keeping the crestal bone nourished through the periodontium. The aim of this research was to perform a scientometric analysis of the scientific production on the socket-shield technique in oral implantology. Materials and methods: A descriptive, observational study was carried out with a scientometric approach. A specialized search was performed, with variants of the keywords extracted from the Medical Subject Heading (MeSH) thesaurus of PubMed and the Embase thesaurus. For Web of Science (WOS) data, including only documents as original articles, reviews, and as sources corresponding to the subject. Production, trends, and impact indicators were performed. Results: During the study period 2000–2023, the scientific production of research increased in the last 3 years. The journal with the highest scientific production of research was “Clinical Oral Implant Research”, and the USA was found to be the dominant country in scientific production. Initially, the development of the research topic of interest was “tooth extraction and socket” between 2000 and 2015, and “dental implants and alveolar ridge preservation” between 2015 and 2023. Conclusion: The socket-shield technique in oral implantology is a growing field of research, with extensive international collaboration and significant impact in terms of citations. As this growth continues, we are likely to see even more advances and discoveries in this field. Clinical significance: The study on the socket-shield technique in oral implantology highlights its clinical importance by demonstrating that this technique can preserve crestal bone and gingival tissues, improving the stability, and esthetics of dental implants. In addition, its growing research and international collaboration underscore its relevance and potential for future innovations in the field.

Aim: The objective of the present study is to assess and compare the effectiveness of two different anesthetic agents, namely, 4% articaine and 2% lignocaine, in the extraction of primary molar teeth in children. Materials and methods: The study included 25 children requiring bilateral extractions of primary molar, with extraction performed on one side with 4% articaine and the contralateral side extraction with 2% lignocaine at two separate appointments. The anesthetic efficacy was evaluated objectively by assessing pain and the child's behavior at baseline, during injection and during extraction using the sound, eye, and motor (SEM) scale objectively, and subjectively using the faces pain rating scale (FPS). The data were then compiled and subjected to statistical analysis. Results: On statistical analysis, there was no statistically significant difference found between the two anesthetic agents during extraction of primary molar teeth, whereas a statistically significant difference was present between articaine and lignocaine during local anesthesia administration on the FPS scale. Also, there was no statistically significant difference found on SEM scale during the procedure between the two anesthetic agents. Conclusion: Articaine can effectively be used as an alternative to lignocaine and inferior alveolar nerve block (IANB) where a long-term procedure is required. Clinical significance: In pediatric dentistry, articaine and lignocaine play a very important roles as local anesthetic agents, offering clinicians effective tools to manage pain and discomfort during dental procedures for children.

Aim: This study aimed to analyze the upper airway dimensions in adult patients with different anteroposterior (sagittal) skeletal malocclusions (class I, II, and III) using cone beam computed tomography (CBCT) imaging. Materials and methods: This retrospective cross-sectional study involved 90 CBCT records from adult subjects who were categorized into three skeletal groups based on their ANB values: Class I (n = 30), class II (n = 30), and class III (n = 30) and were evaluated. The following upper airway measurements were considered: oropharyngeal airway volume, hypopharyngeal airway volume, pharyngeal airway volume, oropharyngeal airway length, hypopharyngeal airway length, pharyngeal airway length, the most constricted site of the pharyngeal airway, and the most constricted cross-sectional area (MIN-CSA) of the pharyngeal airway. Additionally, the volume of the intraoral airway was determined. Pearson's correlation test was employed to evaluate the relationship between age and upper airway dimensions. Results: Significant differences in upper airway volume were found among skeletal groups in the hypopharyngeal (p = 0.034) and pharyngeal (p = 0.004) regions, with class III patients showing larger volumes compared to class II. Oropharyngeal (p = 0.044) and pharyngeal (p = 0.011) lengths were shorter in class III than in class I. In contrast, the narrowest cross-sectional area of the pharyngeal airway was larger in class III compared to class II (p = 0.003) and class I (p = 0.032). Class III patients had a significantly greater intraoral space volume than class II patients (p = 0.036). Conclusions: The present study found significant differences in upper airway dimensions among adults with varying maxillomandibular sagittal relationships. Class III patients had larger hypopharyngeal and pharyngeal volumes, but shorter oropharyngeal and pharyngeal lengths compared to other classes. The narrowest pharyngeal area was larger in class III, with gender and age also influencing airway dimensions. Clinical significance: These findings underscore the need to consider skeletal relationships, gender, and age in airway assessments. Accordingly, these factors can help clinicians better understand the correlation between airway dimensions and jaw position for accurate diagnosis and treatment planning of orthodontic and surgical interventions.

Aim: The current in vivo investigation aimed to evaluate the accuracy of ultrasonography and color Doppler performed in the diagnosis of intraosseous jaw lesions. Materials and methods: A total of 30 patients with intraosseous jaw lesions between the ages of 12 and 60 were selected for the present study. For every jaw lesion, a preliminary diagnosis was done using preoperative conventional radiographs. A sonologist evaluated the preoperative ultrasound examination and color Doppler images to determine the lesion's content, vascular supply, and preliminary classification was made as either a cyst or a tumor. The tissue was curetted during the surgical procedure to facilitate the histological examination. Every measurement and result were compared, and a statistical analysis was performed. Results: On ultrasound and color Doppler examination out of 8 solid lesions, 2 (25%) were non-vascular and 6 (75%) were vascular.11 (64.7%) out of 17 cystic lesions were non-vascular and 6 (35.3%) were vascular. About 2 (66.7%) out of 3 complex lesions were non-vascular and 1 (33.3%) was vascular. And out of 2 Inconclusive lesions 1 (50%) was vascular and another 1 (50%) was non-vascular. There was a statistically significant difference found between color Doppler and ultrasound characteristics (0.001). Histopathological examination determined that 8 (100%) solids were diagnosed as the tumor. And 8 (47.1%) out of 17 cystic lesions were diagnosed as the tumor and 9 (52.9%) as cysts on histopathological examination. Out of 3 complex lesions 2 (66.7%) lesions were diagnosed as the tumor and 1(33.3%) as cysts. And 2 cases which were inconclusive were diagnosed as cysts and 1 tumor each. There was no statistically significant difference found between histopathological characteristics and ultrasound characteristics (p = 0.081). Conclusion: The current investigation came to the conclusion that ultrasound can reliably distinguish between a cyst and a tumor and provide correct information about the pathological nature of a jaw lesion. Clinical significance: Ultrasound has been a crucial diagnostic tool for numerous medical specialties. It is simple to use and can provide a detailed representation of soft tissues. Furthermore, it facilitates the accurate localization of samples when necessary and the evaluation of the solid and cystic components of lesions.

Aim: This study assessed the prevalence and etiological factors of maxillary midline diastema (MMD) in students attending different colleges and universities in Al-Hodeidah governorate, Yemen. Participants and methods: A total of 1,661 participants from different universities in Al-Hodeidah governorate were assessed, analyzed, and screened for the presence or absence of MMD. Only 246 had positive MMD and were divided five age-groups. Maxillary midline diastema width was assessed, and three groups were established: groups I (0.5–1 mm), II (1.1–2 mm), and III (over 2 mm). Associations of MMD with gender, family history, and etiology of MMD were documented. The data were recorded and statistically analyzed. Results: Out of the total students from different colleges, 1,107 were males (66.6%). The 19–20-year age-group was the largest (712; 42.9%), and 264 participants had positive MMD (15.9%). A significant difference in MMD was found between genders (p = 0.002), but no significant differences were found among different age-groups (p = 0.511). Highly attached labial frenum attachment was the most frequent cause of MMD. Males were larger in number and had higher percentages for all different causes, and a significant difference was observed between genders in terms of highly attached labial frenum and generalized spacing parameters (p = 0.004, 0.009). The Chi-squared test showed significant differences in family history and presence of MMD between genders (p = 0.016). Large MMD widths were recorded in groups I, II, and III (1.00, 1.5, and 2.1 mm, respectively), which were together 108 (83.1%), 60 (87.0%), and 16 (53.3%), respectively. Conclusion: The prevalence of MMD can be considered high in the participants and slightly higher in males. Among the causative factors of MMD, a highly attached labial frenum was the most common cause. Group II recorded the highest number of participants with large MMD widths, followed by group I. Clinical significance: Addressing the prevalence and causes of MMD can result in proper planning to minimize further esthetic appearances and functional complications.

Aim: This study aimed to investigate and compare the total and sectional bond strengths of three endodontic sealers when used with the single-cone obturation technique. Materials and methods: Forty-five human maxillary central incisors were prepared and divided into three groups according to the type of endodontic sealer: Group I (Gutta-percha/AH Plus Jet), group II (Gutta-percha/GuttaFlow 2), and group III (RealSeal/RealSeal SE). All canals were filled with the single-cone technique. Roots were sectioned and scanning electron microscope (SEM) analysis was performed on randomly selected samples from each group to assess the root canal filling interfaces. A root section from each root level was subjected to a push-out test. The sectional and total bond strengths were analyzed, then the failure modes were investigated. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey's test, and alpha was set at 0.05. Results: Significant differences in bond strength values were observed (p < 0.05), with RealSeal SE demonstrating the highest bond strength, particularly in the middle and apical root regions. On the contrary, GuttaFlow 2 exhibited the lowest bond strength. Cohesive failure modes were more common for AH Plus Jet and GuttaFlow 2, while RealSeal SE showed cohesive and adhesive failures. The SEM analysis revealed that each sealer exhibited different levels of adaptability to dentin and core material. Conclusion: RealSeal SE and AH Plus Jet showed superior bond strength compared to GuttaFlow 2 when the single-cone obturation technique was used. The apical root sections exhibited the highest bond strength for all sealers, except for AH Plus Jet, which showed a higher bond strength in the coronal root sections. Clinical significance: The current findings could guide dental professionals in choosing the most appropriate sealer for the single-cone obturation technique, potentially leading to more effective obturation procedures, especially for teeth requiring post and core restoration.

Aim: To assess hard as well as soft peri-implant tissues within cases having two lost adjacent anterior teeth treated through placing either two implants with two separate crowns or only an implant along with a crown with a cantilever, and evaluating the effect of polyetheretherketone (PEEK) restoration on cantilever design up to 18 months after functional loading. Materials and methods: Twenty-seven participants (15 males and 12 females; mean age, 38.6 years; range 20–50 years) with missing two adjacent anterior teeth were treated with implant system (Flotecno implant system, Italy). In the first group (implant–implant metal ceramic group), we treated nine participants utilizing two adjacent implants with two separate single metal ceramic crowns. In the second group (implant–cantilever metal ceramic group), we treated nine participants by placing single implant with cantilever metal ceramic fixed dental prosthesis (FDP). In the third group (implant–cantilever PEEK group), we treated nine cases utilizing single implant with a cantilever PEEK FDP framework. Clinical and radiographic examinations were recorded. Marginal bone level, implant stability, and prosthetic complications were assessed during an 18-month follow-up period. Results: Marginal bone loss (MBL) exhibited similar measurements among all groups. The clinical outcomes did not address significant variance among all groups as regards implant stability within the period of follow-up. We also observed minor prosthetic complications. Participants were very satisfied within all groups. Conclusion: Based on the limitations of our research, utilizing cantilever extensions has no influence on MBL as well as implant stability. Clinical significance: Mean marginal bone level exhibited a significant rise from baseline to 18 months for all groups, however, still within the clinically accepted range. Regarding implant stability, no significant variance was observed among all groups for 18 months. The cantilever FDP design facilitated prosthesis fabrication among those having laterals of narrow diameters. Further research is required to investigate such a particular concern due to a limited sample size in our research.

Aim: Tissue-invasive bacteria have been proposed to be a crucial factor in the etiopathogenesis of periodontitis, with the probable interaction of tissue-invasive bacteria with the innate immune response through inflammasomes, perpetuating periodontal attachment loss. This study aims to reveal the correlation between such tissue-invasive bacteria in upregulating inflammasomes and pro-inflammatory cytokines. Materials and methods: This study recruited a total of 10 patients with stage III/IV and grade C periodontitis based on the bone loss to age ratio. Patient sites were grouped into group I: healthy sites with no clinical attachment loss (CAL); group II (mild-to-moderate): 1–4 mm of CAL; group III: severe (≥ 5 mm of CAL). Tissue samples were collected in these sites during periodontal flap surgery and assessed for both the bacterial genomic DNA and assessed for the upregulation of pro-inflammatory markers NOD-like receptor – Pyrin domain containing protein 3 (NLRP3), Human AIM2, Human Pro-TNFα, Human Pro-IL-1β, Human Pro-IL 6 and Human glyceraldehyde-3-phosphate dehydrogenase (GAPDH) genes. Results: The levels of NLRP3, AIM2, and pro-inflammatory cytokine levels were all higher in the severe sites when compared with the other two sites. The tissue invasive bacterial phylotypes in these sites were thereafter compared with the levels of the pro-inflammatory markers in the various groups. The fold changes in the pro-inflammatory markers evaluated in this study all hovered around 1, indicating not much difference in the upregulation of these markers of inflammation. Statistically, significant correlation between bacterial phenotypes in the healthy sites group and the pro-interleukin-6 (IL-6) cytokine expression was observed (r = 0.68; p < 0.04). Conclusions: This study has highlighted the presence of tissue-invasive bacteria in sites with or without CAL. The fact that these healthy sites, after non-surgical therapy, have comparable levels of pro-inflammatory markers in the tissues may be explained by immune priming, by tissue- invasive periodontal pathogens. Clinical significance: Tissue-invasive bacteria are present in periodontally healthy sites too, and non-surgical periodontal therapy is inadequate to eliminate them. Greater importance should be given to the soft tissue walls of the periodontal pocket in clinical management of periodontitis.