Riccardo Monterubbianesi

The introduction of calcium-silicate-based sealers has renewed interest in simplified obturation protocols such as the single-cone technique, although warm techniques, including carrier-based obturation, are still considered the gold standard. The aim of this in vitro study was to compare the quality of root canal obturation achieved with single-cone and carrier-based techniques when used with the same calcium-silicate-based sealer. Thirty extracted mandibular molars were prepared using a standardized rotary instrumentation protocol and randomly assigned to two groups (n = 15 each): Group A was obturated using a carrier-based technique (Soft-Core obturators), while Group B was obturated with the single-cone technique. All canals were filled with the same calcium-silicate-based sealer (NeoSEALER Flo). Micro–computed tomography was used to evaluate the number and volume of voids of the obturation. Quantitative analysis showed that Group A exhibited a significantly lower number of voids (9.0 ± 5.0) and reduced total void volume (2.58 ± 0.8 mm³) compared with Group B (22.0 ± 10.1 voids; 4.71 ± 1.1 mm³; p = 0.00002 and p = 0.0026, respectively). Qualitative analysis confirmed that carrier-based obturation achieved a denser and more homogeneous filling, while the single-cone technique showed larger voids mainly in the coronal and middle thirds. Both techniques provided a reliable apical seal. Within the limitations of this in vitro study, carrier-based obturation demonstrated superior overall filling quality compared with the single-cone technique when used with a calcium-silicate-based sealer, particularly in the middle and coronal regions of the root canal.

Objective: This in vitro study quantitatively compared the time-dependent remineralization potential of three professional agents on artificially induced enamel lesions using Scanning Electron Microscopy (SEM) and energy-dispersive X-ray analysis (EDX). Methods: Sixty extracted sound molars were randomly assigned to three groups (number = 20): G_CPP-ACP, treated with casein phosphopeptide–amorphous calcium phosphate; G_Zn-HA, treated with zinc-hydroxyapatite; and G_F-ACP, treated with fluoridated amorphous calcium phosphate. The crown of each tooth was divided into three areas: one represented the control (CTRL, sound enamel), one underwent demineralization (DEMIN, demineralized enamel), and the third one was at first demineralized and then treated with a remineralizing agent, allowing intra-sample comparison. Artificial lesions were produced by immersion in 0.1 M lactic acid (72 h). Groups were subdivided according to remineralization time (7, 14, 21, and 28 days). Samples underwent daily treatment under a pH-cycling regimen. Surface morphology and Ca/P ratios were evaluated by SEM-EDX, and data were statistically analyzed (p < 0.05). Results: All agents promoted a progressive increase in Ca/P ratio over time, confirming a time-dependent remineralization effect. At day 7, G_Zn-HA showed higher Ca/P values, but from day 14 onward, G_F-ACP produced significantly greater mineral gain than the other groups (p < 0.05). By day 21, G_F-ACP reached Ca/P values approaching CTRL, while G_CPP-ACP and G_Zn-HA remained at lower levels, reaching a plateau respectively at 21 and 14 days. SEM observations supported these findings: G_CPP-ACP and G_Zn-HA showed partial surface recovery, whereas G_F-ACP exhibited a compact, homogeneous enamel-like structure at 28 days. Conclusions: All tested agents demonstrated time-dependent remineralization, enhanced with prolonged exposure, suggesting that the time of application represents a key factor for clinical success.

Objective: To evaluate the short-term clinical impact of daily use of calibrated interdental brushes (IDBs) on gingival bleeding among dental and dental hygiene students within academic curricula. Methods: A prospective cohort of 117 students from three Italian universities was followed over three months. All participants received personalized training and calibrated interdental brushes matched to their interdental spaces. The primary outcome was the percentage of interdental sites exhibiting bleeding on interdental brushing (BOIB), assessed at baseline (T0), one month (T1), and three months (T2). Adherence was self-reported. Statistical analyses included Wilcoxon tests, multivariate regression, and adjusted ANCOVA models. Results: Median bleeding scores decreased from 50.0% [IQR: 26.9–69.2] at baseline to 15.4% [IQR: 3.8–30.8] at one month and further to 11.5% [IQR: 0.0–26.9] at three months (p < 0.001). Regular interdental brush users showed a 15 to 16 percentage point greater reduction in bleeding compared to occasional users (p < 0.001). Dental hygiene students had significantly lower baseline bleeding scores than dental students, but both groups experienced comparable benefits from the intervention. Adjusted analyses confirmed a sustained beneficial effect of regular interdental brushing. Initial weak and transient correlations between behavioral factors and bleeding likely reflect multifactorial influences and variable adherence. Conclusions: Daily use of calibrated interdental brushes produces a rapid, significant, and sustained reduction in gingival bleeding among dental students. Systematic integration of this protocol within dental education programs is feasible and effective, promoting early adoption and maintenance of essential preventive oral health behaviors.

Background/Objectives: Nickel–titanium (Ni-Ti) rotary instruments have significantly enhanced the efficiency and safety of root canal shaping. However, the variety of Ni-Ti systems, characterized by differences in alloy composition, taper design, and heat treatment, may influence their usability, particularly for novice operators. This study aimed to evaluate the perceptions of dental students using four Ni-Ti rotary systems (MTwo, SlimShaper Pro, ProTaper Gold, and HyFlex EDM) in a simulated environment. Methods: Forty dental students from two universities participated in the study and completed a standardized preoperative training session. Root canal shaping was performed on resin teeth models, and an 11-item questionnaire was used to assess various parameters, including flexibility, ease of use, and the ability to maintain working length. Results: The results indicated significant differences in student feedback. SlimShaper Pro and HyFlex EDM were preferred for their flexibility, reduced resistance, and ease of instrument transitions, likely due to their smaller tapers and martensitic alloys. MTwo was rated the least flexible and more challenging to use. Conclusions: These findings underline the importance of user-friendly Ni-Ti systems in pre-clinical training to reduce procedural difficulties and operator stress. Further research should validate these findings in clinical settings to improve the training of novice operators.

Background: The widespread adoption of clear aligners in orthodontic practice has driven the development of biomechanical devices to improve treatment efficiency. The mechanical properties of these materials play a critical role in determining their clinical performance and efficacy. This study investigates the Young’s modulus of Clear-Blokker^® (Scheu Dental), a photopolymerisable resin used for the attachment of clear aligner, and evaluates its mechanical behaviour under different curing times (5 s and 10 s) and environmental conditions (dry storage and immersion in artificial saliva at 37 °C). Methods: Forty-eight cylindrical specimens were prepared and subjected to quasistatic compression tests after 14 days. A multi-factorial analysis of variance (ANOVA) at a significance level of 5% was performed to compare the variances. Results: The results showed that samples immersed in artificial saliva had significantly reduced Young’s moduli compared to samples stored in dry conditions (p = 0.0213), while no significant difference was observed between curing times. Conclusions: The results suggest that Clear-Blokker^® has mechanical properties comparable to those of clear aligner materials, making it suitable as a biomechanical aid for orthodontic treatment. However, further clinical studies are required to confirm its long-term efficacy in the oral environment.

Marginal enamel fractures (MEF) are a common clinical concern in dentistry, particularly in anterior teeth. These fractures occur at the enamel margins and their etiopathogenesis involves a complex interplay of mechanical, chemical, and biological factors. The ongoing research focuses on an overview of MEF to improve the knowledge about this condition. Understanding the multifaceted nature of MEF is crucial for devising effective preventive and therapeutic strategies in contemporary restorative dentistry. Indeed, mechanical stresses, such as occlusal forces and parafunctional habits are primary contributors for MEF. Additionally, it can happen at the enamel-restoration interface due to expansion and contraction of restorative materials. Chemical degradation, including acid erosion and the breakdown of adhesive bonds, further exacerbates the vulnerability of enamel. Biological factors, such as enamel composition and the presence of micro-cracks also play a role in the development of MEF. Clinical management of MEF involves subtractive or additive techniques, repairing or replacing the compromised tooth structure using techniques to ensure the integration with the natural enamel.

Background: Augmented reality (AR) enhances sensory perception by adding extra information, improving anatomical localization and simplifying treatment views. In dentistry, digital planning on bidimensional screens lacks real-time feedback, leading to potential errors. However, it is not clear if AR can improve the clinical treatment precision. The aim of this research is to evaluate if the use of AR-based instruments could improve dental procedure precision. Methods: This review covered studies from January 2018 to June 2023, focusing on AR in dentistry. The PICO question was “Does AR increase the precision of dental interventions compared to non-AR techniques?”. The systematic review was carried out on electronic databases, including Ovid MEDLINE, PubMed, and the Web of Science, with the following inclusion criteria: studies comparing the variation in the precision of interventions carried out with AR instruments and non-AR techniques. Results: Thirteen studies were included. Conclusions: The results of this systematic review demonstrate that AR enhances the precision of various dental procedures. The authors advise clinicians to use AR-based tools in order to improve the precision of their therapies.

This article proposes a technique to simplify the cementation of indirect restorations by exploiting the advantageous properties of bulk-fill composites (BFCs). The proposed technique consists of using a thin layer of a high-viscosity (HV) BFC in the interproximal margins of the preparation and applying low-viscosity (LV) resin luting agents (RLAs) to the rest of the prepared surface. The application of the HV BFC limits the extrusion of the LV RLAs in the interproximal area, deviating the excesses of LV RLAs only on the vestibular and lingual side. This deviation allows the management and control of the excess material in complicated interproximal spaces, simplifying the cementation procedure of indirect restorations and achieving a reliable final result in terms of removing excess in a safe and repeatable way. This technical report provides an alternative clinical approach for cementing indirect restorations using the consistency and viscosity of different RLAs.