Vladlena Doroshina

Background: Continuous chelation with etidronic acid (1-Hydroxyethylidene-1,1-diphosphonic acid, HEDP) has been proposed as a less aggressive alternative to sequential irrigation with ethylenediaminetetraacetic acid (EDTA) in endodontics. This systematic review and meta-analysis aimed to compare the effects of these two protocols on the mechanical properties and structure of root dentin. Methods: PubMed, Scopus, and Cochrane Central databases were searched up to June 2026 for in vitro studies comparing continuous chelation (NaOCl + HEDP mixture) with sequential irrigation (NaOCl and EDTA) on root dentin of permanent teeth. Studies on coronal dentin and those not using NaOCl + HEDP as a mixture were excluded. Risk of bias was assessed using the QUIN tool. Meta-analyses were performed for fracture resistance using a random-effects model. This review was registered in PROSPERO (CRD420250630663). Results: Twenty studies with a total of 572 specimens were included. Six studies had a low risk of bias and thirteen had a medium risk. The qualitative synthesis showed that HEDP generally resulted in similar or lower levels of erosion, microhardness reduction, demineralization, and collagen degradation compared to EDTA. The meta-analysis revealed no significant difference in fracture resistance (5 studies; SMD = 0.28; 95% CI: −0.37 to 0.92; p = 0.40); however, substantial heterogeneity was observed (I² = 66.7%). Conclusions: The evidence was limited by substantial heterogeneity and mainly medium risk of bias. Within the limitations, in vitro evidence suggests that continuous chelation with HEDP is comparable to EDTA in terms of root dentin mechanical properties and composition, supporting its use as a chelating agent in endodontic practice. This research received no external funding.

The study aimed to assess the effect of two etidronate-containing irrigants and EDTA on the ability of sodium hypochlorite (NaOCl) to remove the smear layer and dissolve organic tissues. This study evaluated the following solutions: distilled water, 3% NaOCl, 3% NaOCl + EDTA, and 3% NaOCl mixed with etidronate powder from two manufacturers [Dual Rinse, (DR); IsraDent, (ID)] to obtain 9%, 15%, and 18% solutions. To assess the proteolytic activity, bovine muscle tissue samples (56.1 ± 5.4 mg; n = 10 per group) were immersed in the tested solutions for 15 min. Absolute weight changes and percentages of weight changes (wt%) were calculated. To assess smear layer removal, the root canals of human wisdom teeth were instrumented, irrigated with the tested solutions (n = 10 per group), and evaluated using SEM. Statistical analysis employed an ANOVA with a post-hoc Tukey test and paired t-test, the Kruskal–Wallis test with a pairwise Wilcoxon rank sum test, and the Friedman test with a pairwise Wilcoxon signed-rank test. The mean weight loss in the NaOCl group comprised 17.3 mg (32 wt%). Sequential use of NaOCl and EDTA resulted in a significant increase in proteolytic activity of the former (57 wt%), while mixing these solutions led to a reduction of proteolytic activity (17 wt%). All NaOCl/DR groups exhibited a significantly greater dissolution activity than that of NaOCl alone, with the mean weight loss ranging from 23.3 mg (40 wt%) to 24 mg (41 wt%). ID9% and ID15% significantly decreased the proteolytic activity of NaOCl. In most groups, the apical thirds of the root canals demonstrated a significantly heavier smear layer compared to the middle and coronal thirds. The most effective smear layer removal was observed after irrigation with NaOCl combined with EDTA or DR (all concentrations); however, in the NaOCl + EDTA and DR18% groups, it was accompanied by moderate to severe erosion. Irrigation with ID did not result in smear layer removal or dentin erosion. In conclusion, the smear layer removal and pulp dissolving effects of continuous chelation using etidronate were manufacturer/composition-dependent. DR9% combined with NaOCl demonstrated the most promising results.

Soft drinks may have a deleterious effect on dental health due to a high titratable acidity and a low pH that could be sufficient to induce tooth demineralization. The use of oral care products immediately after acidic challenge may diminish the erosive potential of soft drinks. We assessed the effect of oral care foams and a spray on salivary pH changes after exposure to Coca-Cola^® in young adults. Thirty-three consenting eligible patients were recruited in this double-blind, randomized, crossover study performed in six visits. Baseline examination included unstimulated salivary flow rate, stimulated salivary buffer capacity, and the simplified oral hygiene index (OHI-S) assessment. Salivary pH and time for pH recovery were registered after exposure to Coca-Cola^® alone or that followed by the application of each of the studied products (an oral foam containing hydroxyapatite and probiotics, an oral foam containing amino fluoride, an alkaline oral spray, and tap water). Thirty-two patients completed the entire study protocol and were included in the final analysis. The mean minimum salivary pH and the mean oral clearance rate after rinsing with Coca-Cola^® were 6.3 and 27 min, respectively. Further rinsing with any one of the tested solutions, including tap water, resulted in a significant improvement in these parameters. When the pH curves were plotted, the oral care products demonstrated a lower area under the curve that differed significantly from the area under the curve for Coca-Cola^®; tap water did not differ significantly from Coca-Cola^® and oral care products. Minimum salivary pH correlated positively with salivary buffer capacity and salivation rate, while salivary clearance correlated with OHI-S plaque scores. In conclusion, the effect of oral care foams and a spray on minimum salivary pH and salivary clearance after exposure to Coca-Cola^® did not differ significantly among the tested products and tap water. Trial registration NCT06148662. Funding: none.

We aimed to assess the effect of oral probiotic containing the Streptococcus salivarius M18 strain on gingival inflammation, bleeding on probing, and oral biofilm. Sixty-one consenting participants aged between 18 and 25 with gingivitis were recruited in this double-blind, parallel-group study and randomly divided into the probiotic group (n = 31) and the placebo group (n = 30). Fifty-seven participants completed the entire study protocol, 27 in the probiotic group and 30 in the placebo group. The outcomes were assessed after 4 weeks of intervention and 4 weeks of follow-up. There was a significant decrease in the Gingival Index, with the effect size of 0.58 [95%CI 0.05–1.10], and Turesky modification of the Quigley and Hein Plaque Index, with the effect size of 0.55 [95%CI: 0.02–1.07], in the probiotic group after the intervention. However, after a 4-week follow-up, the only significant treatment outcome was improved gingival condition according to the Gingival Index. The Gingival Bleeding Index also decreased significantly in the probiotic group after the intervention period; after the follow-up, this parameter did not differ significantly in both groups from the baseline values. In the placebo group, there were no significant improvements in the assessed parameters throughout this study. No serious side effects were registered. Within the limitations of this study, we conclude that the use of oral probiotic containing the Streptococcus salivarius M18 strain resulted in a significant improvement in gingival condition and oral hygiene level in young adults with gingivitis. Trial registration NCT05727436. Funding: none.

Gingivitis is a widespread disease commonly associated with dentin hypersensitivity, that, in turn, may complicate routine dental care, leading to plaque accumulation. We aimed to assess the antigingivitis, desensitizing, and antiplaque effects of a fluoride-containing (TWF) alkaline toothpaste and a fluoride-free (TW) alkaline toothpaste. Eighty-four consenting patients aged 20–25 years with diagnosed gingivitis and dentin hypersensitivity (DH) were recruited in this double-blind, parallel-group study and randomly divided into two groups (each n = 42). Eighty-two patients completed the entire study protocol. The outcomes were assessed after 4 weeks of intervention. A significant improvement in gingival condition was found according to the modified gingival index, with effect sizes of 0.99 [CI95%: 0.52–1.46] and 1.71 [CI95%: 1.18–2.24], and the gingival bleeding index, with effect sizes of 3.17 [CI95%: 2.39–3.94] and 2.64 [CI95%: 1.96–3.32] in the TW and TWF groups, respectively. DH also decreased in both groups, with a significantly greater reduction in the TWF group (effect sizes of 3.28 [CI95%: 2.51–4.04] and 3.10 [CI95%: 2.40–3.80] according to the visual analog scale and Schiff scale, respectively). No side effects were registered. In conclusion, the use of alkaline toothpaste provided a significant reduction in gingival inflammation and bleeding, DH, and oral hygiene after 4 weeks of daily use in young adults. Trial Registration: NCT0562376. Funding: none.

We aimed to assess the influence of professional dental prophylaxis on the translucency and color stability of a novel simplified shade nanohybrid composite material. Sixty composite disks (5 mm in diameter and 2 mm thick) of light (n = 30) and dark (n = 30) shades were prepared. The specimens were randomly divided into the following three groups (n = 10) according to the prophylaxis procedure used: ultrasonic scaling, air-powder polishing with sodium bicarbonate, and controls. The specimens were submitted to translucency and color analysis based on the CIELab system. Two measurements were performed before and after 48-h storage in coffee. Translucency values of untreated light and dark specimens were 9.15 ± 0.38 and 5.28 ± 1.10, respectively. Air-powder polishing decreased the translucency of the light composite specimens. Storage in coffee resulted in color changes (∆E) ranging between 2.69 and 12.05 and a mean translucency decrease ranging between −0.88 and −6.91. The samples in the light group tended to exhibit greater staining; the treatment method had no effect on ∆E. It can be concluded that light-shade composite restorations are more prone to translucency and color changes resulting from air-powder polishing and contact with staining media. However, further research using other composites and powders is required.

We aimed to assess the effects of ultrasonic scaling and air-powder polishing on the roughness of enamel, three nanocomposites (Premise, Herculite Ultra, Harmonize), and composite/enamel and composite/cementum interfaces. Class V cavities were restored in 99 extracted third molars with one of the three nanocomposites and treated with ultrasonic scaler or air-powder polishing device (calcium carbonate or sodium bicarbonate powders). The roughness (Ra) of the investigated surfaces was measured with contact profilometer before and after treatment. The data were analyzed using repeated measures ANOVA. Specimens’ Ra values before instrumentation were near the clinically acceptable 0.2 μm threshold. All techniques increased the roughness of the tested surfaces; however, the enamel was slightly affected. The mean Ra values after prophylaxis for composite, composite/cementum and composite/enamel surfaces were 0.32–0.55, 1.33–1.73, and 1.25–1.36, respectively. The extent of composite surface damage was material dependent. Premise surface was not altered by ultrasonic scaling significantly. Air-powder polishing with both powders produced a greater increase in surface roughness of composite resin and restorations margins than ultrasonic scaling. The Ra values after both types of air polishing for Herculite Ultra and Harmonize were approximately 1.5 and 2 times higher, respectively, than those after ultrasonic scaling (p < 0.05).

The purpose of this study was to investigate the effect of final surface treatment and dental composite type on the roughness of the composite surface, composite/enamel interface, and composite/cementum interface, as well as on the polishing time. Class V cavities prepared in extracted teeth (n = 126) were restored using one of the three nanohybrid composites with different filler sizes. The specimens were randomly assigned to three different finishing and polishing sequences. The roughness (Ra) of the investigated surfaces was measured using the contact profilometer. The time required to achieve visible gloss was documented. The data were analyzed using ANOVA with Tukey’s post hoc test (p < 0.05). There was no significant influence of the composite type on the restoration surface roughness (p = 0.088), while the polishing method had a significant impact (p < 0.001). The Ra of the composites ranged between 0.08 µm and 0.29 µm, with the lowest values (0.09 µm ± 0.05 µm) found in the aluminum oxide disc group (p < 0.001). The time to achieve a visible composite gloss was influenced by the polishing method, composite type, and interactions between these factors (p < 0.001). The interface roughness was significantly greater than that of the composite surface (p < 0.001), and depended on the composite type and polishing system employed.