Background and aim Treatment of mandibular edentulous ridge with all-on-four treatment concept is a reliable choice. However, the framework material may affect the stresses transmitted to the implant and bone. The aim of the study was to compare stresses transferred to implant–bone interface on using glass fiber-reinforced composite (GFRC), zirconia (Zr), titanium (Ti) and poly-ether-ether-ketone (PEEK) as framework materials. Patients and methods Three-dimensional finite element model of completely edentulous mandible restored with four implants (two axial anterior implants and two posterior implants 30° distally tilted) connected with a framework of different materials (Zr, Ti, GFRC, and PEEK) was constructed. A unilateral axial load of 250 N was applied at the distal end of the cantilever and the resultant von Mises stresses at implant–bone interface were calculated. Results The lowest von Mises stresses at implant/crestal bone area was recorded with Zr framework followed by Ti then GFRC while the highest von Mises stresses were recorded with PEEK framework. Conclusions Within the limitations of this study, it could be concluded that the stiffer framework material transmits more stresses to the implants. The stress distribution of GFRC, as a framework material, is better than PEEK.

Objective To comparatively evaluate fracture resistance of different techniques for the reattachment of fractured maxillary central incisors. Materials and Methods Sixty intact freshly extracted permanent maxillary central incisors were selected and randomly divided into four groups of 15 each one of control (I) and three experimental groups (II, III, IV) according to the technique of reattachment. The incisal third of the experimental groups were sectioned horizontally. Group I: the teeth were kept intact without sectioning. Group II: an internal dentinal groove (1 mm deep and 1 mm wide). Group III: a pinhole (1.5 mm depth and 1.5 mm diameter). Fractured fragments in group II and group III were reattached using composite resin. Group IV: two vertical grooves (1 mm deep, 1 mm wide, and 4 mm length) with fiber-reinforced composite post (Everstick, GC America). After 24 h of restoration, all samples in each group were then subjected to thermocycling at 5±1 and 55±1°C for 500 cycles each cycle. All the samples were mounted on the universal testing machine (instron). The force was then applied at an angle of 45° of each tooth in a labial to palatal direction at a cross-head speed of 1 mm/min until fractured occurred and the obtained values were subjected to statistical analysis. Results The results showed that the mean fracture resistance of group I was the highest followed by group III, group IV, and group II the least (group II < group IV < group III < group I). Comparing the mean fracture resistance of four groups, analysis of variance showed significantly different fracture resistance among the groups (F = 22.93, P < 0.001). Conclusion No material and technique can restore the strength of intact tooth. However, reattachment techniques can be considered as an alternate method, when the fractured fragment is available with adequate size and appropriately preserved margins.

Aim This in-vitro study aimed to evaluate the translucency and color stability of bleached veneer shades with different resin cement. Material and Methods Forty-two IPS E-max CAD discs with bleached shades BL1 and BL3 milled by CAD/CAM, each disc was 0.5 mm in thickness, 10 mm in diameter. Each sample had been formed by cementation of IPS E-max CAD discover a PMMA disc 1 mm in thickness 10 mm in diameter with shade A2 by two different shades of resin cement from Variolink NLC shades clear and +2. This cementation done by using standardized mold 1.6 mm in thickness, with cement layer 0.1 mm. Translucency and color of each sample had been measured by Spectrophotometer. Transparent parameter and color difference △E had been calculated and analyzed by one-way analysis of variance then multiple comparison Tukey's test (α = 0.05). Results Using clear shade cement under both shade of IPS E-max showed lower than △E with cement shade +2. P value was highly significant in all samples (ρ> 0.000), while in BL3 disc before cementation and after cementation with clear cement showed nonsignificant result (ρ> 0.227). Transparent parameter was higher before cementation and the lowest value obtained with shade + 2 cement which is opaquer (10.59) with BL3 and (11.69) with BL1. Conclusion The final color and translucency of bleached veneers is influenced by the shade of resin cement.

Aim The aim of this study was to compare the effects of two different cleansing materials on the hardness and surface roughness of conventional and three-dimensional (3D) printed denture base materials. Materials and methods A total of 140 specimens were tested for surface hardness and surface roughness. The samples of each denture base type (n = 70) were randomly divided into seven subgroups each of them = 10 samples. The first subgroup was stored in distilled water. Second, third, and fourth subgroups were immersed for 18, 36, and 54 days in Corega denture cleanser, respectively. Fifth, sixth, and seventh subgroups were immersed for 18, 36, and 54 days in Aloe vera, respectively. Results The roughness of the 3D printed denture base material was significantly lower than that of the conventional denture base material. While the hardness of the 3D printed denture base material was significantly higher than that of the conventional denture base material. For the two types of cleaning agents used, there was a nonsignificant difference in hardness of 3D printed and conventional denture base materials immersed in Corega or Aloe vera. There was a significant difference in the surface roughness of 3D printed and conventional denture base materials immersed in Corega and Aloe vera. Conclusion Within the limitations of this in vitro study, it was concluded that 3D printed denture base material exhibited significantly more favorable surface roughness and hardness compared to the conventional denture base material. Disinfection by immersion using Corega produced higher surface roughness values than using Aloe vera. While Corega and Aloe vera caused nonsignificant damage to the hardness of the conventional and 3D printed denture base materials. Clinical implications Aloe vera gel for disinfecting 3D printed and conventional denture base materials is suggested to maintain a smooth surface of the denture base. Printing denture bases is recommended because of its high hardness and low roughness could be achieved.

Purpose Evaluation of trueness and tissue surface adaptation of digital versus conventional mandibular implant-assisted complete overdenture (IACO). Materials and methods Two implants were installed in the inter foraminal region of an epoxy resin model, which was scanned and saved as a Standard Tessellation Language (STL) file. The reference model with the implants was duplicated into 20-stone models. All models were scanned and the STL files were saved for digitally designed 20 IACOs. Half of them were fabricated by three-dimensional (3D) printing technology and considered as group I (the digital group). The other half were fabricated by the conventional pack and press technique and considered as group II (the conventional group). To evaluate the trueness, all IACOs were scanned and superimposed to the STL files of the original design by digital software. By using the same software, the gap between the intaglio surface of the scanned IACOs and the reference model was measured to evaluate the tissue surface adaptation. Results The statistical analysis by using t test revealed a highly significant difference between the two groups with less mean deviation value of the digital group with a P value less than 0.001. There is a significant difference between the two groups with P value of 0.035 at the implant region in the digital group. The overall adaptation between the two groups showed a significant difference with less mean deviation value of the digital group with a P value of 0.041. Conclusion The digital group has better trueness and adaptation than the conventional group. Despite the gap in the implant area in the digital group, the overall fit of the digital group is better. Clinical implications Three-dimensional printing technology can achieve an acceptable fit and good retention. Digital technology and implant dentistry provide great hope for complete edentulism, especially in those with a completely edentulous mandibular arch. Digital implant-assisted complete overdentures showed better fit than conventional ones.

Aim/Objectives The aim of this study was conducted to evaluate the effect of NaOH alkaline treatment on wettability and bioactivity of some commercial dental implants. Background The surface of titanium dental implants plays an important role in their success. Wettability is one of the crucial surface characteristics for osseointegration. Methods In this study, three commercial titanium dental implants are grouped by their types into 3 groups (n=10). Each group is divided into 2 subgroups (n=5) according to alkaline treatment. Each experimental specimen is immersed in 5 mL of 5M NaOH solution for 24h at 60°C, then put in an incubator for 24 h to dry at 40°C. All specimens are subjected to surface wettability test through measuring static contact angle (CA) by sessile drop technique and in vitro bioactivity test through immersion into a simulated body fluid (SBF) at 37°C and 7.4p H for 7 days. Then characterized by Scanning Electron Microscope and Energy Dispersive X-ray. Student t-test is used for pair-wise comparisons. The significance level is set at P≤0.05. Results/Conclusions The alkaline surface treatment of Ti dental implants significantly enhances their surface wettability and bioactivity by formation of a porous network structure at a nano scale from sodium titanate hydrogel layer on the surface.

Purpose This study was planned to compare between polyetheretherketone patient-specific implant and prebent titanium mesh in orbital floor reconstruction. Patients and methods Twelve patients with unilateral orbital floor fracture indicated for reconstruction divided in two equal groups according to the type of implant used. Postoperative evaluation was done for 6 months. Patients of both groups were examined clinically for hypoglobus, enophthalmos, ocular motility and diplopia and radiographically for orbital volume measurement preoperatively and postoperatively. A comparative analysis of the treatment outcomes was performed. Results Significant improvement in the external appearance of the eye including hypoglobus, enophthalmos, and ocular motility and diplopia although group II showed one (16.7%) patient with persistent hypoglobus, one (16.7%) patient measured as grade 3 enophthalmos (>2 mm), one (16.7%) patient with marked limitation of ocular motility (grade 3) and diplopia. There was significant improvement in the orbital volume of the affected side in both groups with no significant difference postoperatively between both groups during different follow up periods. There was significant difference between the orbital volume of the affected and nonaffected sides preoperatively and the difference between them was 3.91 ± 0.92 cm³ for group I and 3.64 ± 1.29 cm³ for group II which markedly decreased postoperatively was 0.50 ± 0.72 cm³ for group I and 1.35 ± 0.86 cm³ for group II with no significant difference between affected and nonaffected eyes. Conclusion The results of this study showed that polyetheretherketone patient-specific implant is precise, predictable, and demonstrated higher clinical efficacy in comparison to prebent titanium mesh in orbital floor reconstruction. Preformed prebent titanium mesh is not preferred in large defects.

Aim This study aims to evaluate the prevalence of dental anomalies and the tendency of dental anomalies among the teeth in Turkey. Patients and methods This retrospective study was designed on panoramic radiographs of randomly selected 4105 patients that applied to Zonguldak Bulent Ecevit University, Faculty of Dentistry. In the study, nine types of dental anomalies were analyzed statistically on the panoramic radiography images of the patients, including one supernumerary teeth, odontoma, congenitally missing teeth, ectopic eruption, rotation, impacted teeth, fusion, dilaceration, and morphological defects. Results The prevalence of a dental anomaly among all evaluated patients was 26.7%. The most common anomaly was found to be congenital missing teeth with a prevalence of 14.2%. Odontoma was found to be the least common anomaly with a prevalence of 01%. Congenital missing teeth were most frequently observed in the mandibular second premolar. Conclusion The prevalence of dental anomalies in the study population was very high. Nine different anomalies were detected and congenitally missing teeth are the most common developmental dental anomaly in the study. The prevalence of dental anomalies may vary and early diagnosis of dental anomalies is important for treatment planning and success.

Background Early childhood caries (ECC) is considered one of the most prevalent diseases in young children. It is a public health problem with oral and general consequences that adversely affects the quality of child life. This study aimed to determine the prevalence of ECC among preschool aged children in Gharbia Governorate and its related risk factors. Patients and methods A cross-sectional study conducted among 2700 Egyptian children 3–6 years old, a stratified cluster sampling methods was utilized to choose the enrolled children, a consent and a self-administered questionnaire about sociodemographic characteristics, dental service, dietary and oral hygiene behaviors applied to parents before the dental examination. The study approved by Research Ethics Committee at Faculty of Dentistry, Tanta University. Results The prevalence of ECC among preschool aged children in Gharbia Governorate was (68.5%), it was higher in older children and in rural areas. Data revealed associations between prevalence of ECC and sex, mother education and family income. As well using bottle at bed time and drinking soda or juice were significant factors. Brushing frequency especially at bed time, parent believes about the important of brushing their children teeth also were significant factors. Conclusions This study showed high prevalence of ECC in the study population. ECC prevalence was associated with age, sex, family socioeconomic status, drinking soda or juice, night bottle feeding and teeth brushing. Results reveal the need for new preventive strategies to increase awareness about ECC, promoting good oral hygiene practices and enhancing mothers' knowledge of oral health.

For successful clinical outcomes in endodontics, a thorough knowledge of root canal morphology, adequate clinical and radiographic assessment, and the use of newer diagnostic aids are required. This case report describes the diagnosis and endodontic management of a three-rooted left maxillary first molar which had three roots and seven canals (MB1, MB2, MB3, DB1, DB2, MP, and DP). This unusual morphology of the maxillary first molar was confirmed using a cone-beam computed tomography scan. This article discusses the morphology of the maxillary first molar and how to successfully diagnose and negotiate the extra canals using the most up-to-date techniques.

Cone-beam computed tomography (CBCT), a modern technology in three-dimensional imaging has gained wide acceptance in the field of endodontics. Treatment strategies and surgical guidance have both benefited from this strategy. By the use of conventional periapical radiographs sometime the intraoral localization of root apex is found to be difficult and it is inescapable to prevent significant amount of bone removal. Moreover, the duration of retraction of gingival flap increases and more amount of alveolar bone removal are usually required, leading to prolonged time of surgery. The more intraoperative time, the higher are the chances of postoperative pain, discomfort and even leads to increase risk of infection. The combination of intraoral or extraoral scan and CBCT provides favorable treatment outcomes. Leveraging CBCT, computer-aided design, and three-dimensional printing technology, this case report discusses a method of periapical surgery using a surgical template for guided osteotomy and root resection of the maxillary central incisor.

Oral submucous fibrosis (OSMF) is a potentially malignant condition mainly found in people of Indian subcontinent. Although, mainly adults affected with OSMF have been seen in literature, but its incidence is increasing in pediatric population in recent years. The increased trend of habit of chewing the areca nut in children has been associated with this condition. There is paucity of published literature regarding OSMF in pediatric age group. Hence, the current article presents a case report of OSMF in an 8.5-year-old boy having chronic habit of chewing flavored supari (areca-nut) five to seven packets per day in the last 3 years. Patient was managed by counseling, medicinal treatment and oral physiotherapy. Follow-up evaluation of patient showed the significant reduction in signs and symptoms of OSMF.