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Research
Article
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Clinical trial of
essential oil-based dentifrices for denture cleaning and patient satisfaction
Arthur Augusto Martins e Silva, dds, msc, Lorena Mosconi Clemente, dds, msc, Adriana Barbosa Ribeiro, dds, msc, phd, Viviane de Cássia Oliveira, bsc, msc, phd, Ana Paula Macedo, bee, msc, phd, Evandro
Watanabe, dds, msc, phd, & Cláudia
Helena Silva-Lovato, dds, msc, phd
Abstract: Purpose: This randomized, controlled,
crossover, and triple-blind clinical trial evaluated the antibiofilm action and
patient acceptance of four experimental dentifrices with essential oils at 1%. Methods: Participants (n= 24) selected based on eligibility criteria were randomly
assigned to five groups: a positive control (chloramine T dentifrice), Melaleuca
alternifolia (Ma), Pinus strobus (Ps), Bowdichia virgilioides
Kunth (BvK), or Eucalyptus citriodora (Ec). They brushed their
dentures three times/day with the provided brush and dentifrice for 14 days. A
7-day washout was established between each dentifrice use. Biofilm removal
(computerized method), microbial load of Candida spp., Candida albicans, Candida tropicalis, Candida glabrata,
Staphylococcus spp., Mutans streptococci, gram-negative bacteria, and
total aerobes (colony-forming unit counting), cellular metabolism (XTT-assay),
cell viability (flow cytometry), and patient satisfaction (questionnaire) were
evaluated at baseline and after use of the dentifrices. Data were analyzed
using Friedman’s ANOVA and Cochran’s Q Test for related samples (α= 0.05). Results: The amount of biofilm (P= 0.004) and the microbial load of C.
albicans (P= 0.003) were significantly lower after the use of the
dentifrices compared to baseline. The dentifrices did not significantly affect
cell viability (P= 0.170) or cellular metabolism (P= 0.814). No significant
differences in patient acceptance were found between the experimental
dentifrices and the positive control. Experimental dentifrices with 1% Melaleuca
alternifolia, Pinus strobus, Bowdichia virgilioides Kunth,
and Eucalyptus citriodora effectively cleaned dentures, reduced C.
albicans load, and were well accepted by users. (Am J Dent 2026;39:110-116).
Clinical
significance: Essential oil-based dentifrices
effectively remove denture biofilm and reduce Candida albicans load,
providing a natural and sustainable alternative to synthetic agents while being
well accepted by users.
Mail: Dr.
Arthur Augusto Martins e Silva, Ribeirão Preto School of Dentistry, University
of São Paulo, Café Avenue, s/n – Campus of USP, Ribeirão Preto, 14040-904,
Brazil. E-mail:
arthur.amsilva@usp.br
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Research
Article
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Laboratory evaluation of mixed-species biofilm formation by Streptococcus
mutans and Lactobacillus casei on three dental resin-based
restorative materials
Clint Conner,
dds, Parveez
Ahmed AbdulAzees,
phd, Xiao-Dong Chen, md,
phd, Chih-Ko Yeh,
bds, phd & Franklin
Garcia-Godoy,
dds, ms, phd,
Abstract: Purpose: To evaluate the biofilm-forming
potential of mixed-species bacteria on three commercially available dental
restorative composites and compare their resistance to biofilm accumulation.
Given the increasing emphasis on bioactive and fluoride-releasing materials in
caries prevention, the study specifically assessed the difference between
restorative with and without fluoride content. Methods: Three
restorative materials, Activa (bioactive fluoride releasing), Filtek Bulk Fill
(non-fluoride releasing) and TPH (non-fluoride containing) were tested in the
laboratory. Standardized resin-discs were fabricated, saliva-coated to simulate
oral conditions, and inoculated with a 1:1 mixed culture of Streptococcus
mutans and Lactobacillus casei. Biofilm development was assessed
at 24- and 48-hours using colony forming unit (CFU) quantification. Statistical
analysis was performed using one-way ANOVA and Tukey’s post hoc test (α=
0.05). Results: Significant differences in biofilm accumulation were
observed among materials at both points (P< 0.05). TPH exhibited the highest
CFU counts at 24 hours (0.24 ± 0.03 × 107 CFU/mL) and 48 hours (1.07
± 0.12 × 107 CFU/mL). In contrast, Activa and Filtek showed
significantly lower biofilm formation at both points (24 hours: 0.093 ± 0.05 ×
107 CFU/mL; 48 hours: 0.47 ± 0.31 and 0.53 ± 0.12 × 107 CFU/mL, respectively), with no significant difference between them. (Am J
Dent 2026;39:117-120).
Clinical significance: The
restorative materials tested demonstrated varying degrees of resistance to
biofilm formation. Activa and Filtek showed reduced biofilm accumulation
compared to TPH at both early and mature stages of growth. The selection
of restorative materials should consider their potential to resist bacterial
colonization, especially in high-caries-risk patients and restorations placed
near gingival margins.
Mail:
Dr. Franklin Garcia-Godoy, Department of Bioscience Research, College of
Dentistry, University of Tennessee Health Science Center, 875 Union Avenue,
Memphis, TN 38183 USA. E-mail:
fgarciagodoy@gmail.com
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Research
Article
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Effect
of herbal ingredient toothpastes on resin composites’ surfaces and their antimicrobial
activities
Elif Reyhan Durak, dmd, msd, Melek Hilal Kaplan, dmd, msd & Pelin
Ozmen, ms, phd
Abstract: Purpose: To investigate the effects of herbal toothpastes compared to chemical
toothpastes on restorative materials’ structure and antimicrobial effects. Methods: Four experimental herbal toothpastes and one chemical toothpaste (positive
control group) were tested. Microhardness values, weights, and volumes of
samples formed with dental composites were recorded before and after brushing.
Minimal inhibitory concentration and agar well diffusion tests were used to
evaluate the antimicrobial effect of toothpastes on contaminated surfaces.
After brushing the samples with Streptococcus mutans plaque, colony
counts were made as CFU/ml, and plaque inhibition was monitored by field
emission scanning electron microscope (FE-SEM) examination. The data obtained
were evaluated statistically. Results: The study’s results showed a
statistically significant change in the microhardness, weight, and volume
values of dental composites used in both the anterior and posterior regions. In
the antimicrobial activity evaluation results, plaque inhibition was detected
in the FE-SEM images of the composite blocks where herbal toothpastes were
used. (Am J Dent 2026;39:121-124).
Clinical significance: The results showed a statistically significant change in the microhardness,
weight, and volume values of dental composites used in both the anterior and
posterior regions. In the antimicrobial activity evaluation results, plaque
inhibition was detected in the field emission scanning electron microscope
images of the composite blocks where herbal toothpastes were used.
Mail: Dr. Elif Reyhan Durak, Section of Restorative
Dentistry, Department of Clinical Sciences, Faculty of Dentistry, University of
Nevsehir Hacı Bektas Veli, 2000 Evler Mah. Zübeyde Hanım Cad. 50300,
Nevsehir, Turkey. E-mail: elfryhndrk@gmail.com
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Review
Article
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Locally delivered simvastatin and rosuvastatin in the
treatment of chronic periodontitis: A systematic review and meta-analysis
Roza Zarei, Pooya Vatankhah, dds, Saman Chaparzade, pharmd, Farbod Ebrahimirad, dds, Pardis Hassani, dds, Nima Khamisi,
dds, Sahar Dehzadeh, dds, Zahra Sezavar, dds,
Abstract: Purpose: This systematic review and meta-analysis evaluated the effectiveness of
locally delivered simvastatin and rosuvastatin in the treatment of chronic
periodontitis. Methods: A thorough literature review was performed
utilizing PubMed, Scopus, Google Scholar, and ClinicalTrials.gov for studies
published until June 2025. Titles, abstracts, and full texts of the eligible
studies were obtained and reviewed. Data were subsequently extracted from the
chosen studies and analyzed accordingly. Results: A total of 30 RCT
studies with 1,211 participants were included. Our study showed that the local
delivery of simvastatin and rosuvastatin significantly improved pocket depth
[Weighted Mean Difference (WMD) 95% confidence interval (CI)] = -0.83, -1.31
respectively, P< 0.001), clinical attachment level
(-1.20, -1.59, P< 0.001), gingival index (-0.60, -1.42, P< 0.001),
modified sulcus bleeding index (-0.61, -0.36, P< 0.001), plaque index
(-0.38, P< 0.001), and relative attachment level (-0.54, -0.89, P<
0.001). However, there was no significant association between the plaque index
and the use of rosuvastatin (-0.20, P< 0.05). (Am J Dent 2026;39:125-133).
Clinical significance: The local
delivery of simvastatin and rosuvastatin along with scaling and root planing
significantly reduced pocket depth and improved clinical attachment level,
gingival index, modified sulcus bleeding index, and relative attachment level.
Further clinical trials are still required to support the results of the
current meta-analysis.
Mail:
Dr. Niloofar Deravi, SBUMS, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, Iran.
E-mail: niloofarderavi@sbmu.ac.ir Mail:
Dr. Alireza Mokhtari Sakhvidi, IAU Tehran Medical Sciences, Shariati St,
Tehran, Iran. E-mail: dralirezamokhtari95@gmail.com
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Research
Article
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Agreement
among tooth color measurement devices: An experimental comparison
Ezgi
Türkoğlu Tarı, dds & Yusuf Bayraktar,
dds, phd
Abstract: Purpose: To compare
the measurement results of different instrumental color analysis methods with a
reference spectrophotometer. Methods: Six different methods (DSLR camera
and smartphone camera with and without cross-polarizing filter, VITA Easyshade
and Spectroshade spectrophotometers) were evaluated using four different shade
tabs (1M1, 3R2.5, 3L2.5, 5M3). X-Rite MetaVue VS3200, a highly repeatable
spectrophotometer, was used as the reference method. All images were captured
in RAW format using standardized lighting and white balance for photographic
methods and analyzed using Adobe Photoshop. Beside the L*, a*, b* values, the
ΔE00 values were measured. Data was analyzed using one-way
ANOVA and Tukey tests (P= 0.05). Results: According to ANOVA test, the
L*, a*, b* values of all groups showed significant differences for all shades
(P< 0.05). When compared with the X-Rite MetaVue VS3200 group, the obtained
ΔE00 values also showed significant differences (P< 0.001)
and were above the acceptability threshold. All ∆E00 values
were above the acceptability threshold (∆E00> 1.8) for all
groups. The color measurement methods used in dental literature often produce
inconsistent results when compared to each other. In this study, the results
obtained from the tested methods were also inconsistent with the reference
method. Therefore, the commonly used color measurement methods in dental
research should be reconsidered. (Am J Dent 2026;39:134-138).
Clinical
significance: Accurate tooth color determination
relies on controlled lighting, geometry, and proper device calibration. This
study demonstrated that variations among instrumental methods may exceed
clinically acceptable limits, underscoring the importance of standardized
measurement conditions. Clinicians should recognize that color analysis can
differ between devices, even under identical settings, highlighting the
significance of accurate color detection for optimal clinical outcomes.
Mail: Dr. Ezgi Türkoğlu
Tarı, Department of Restorative Dentistry, Kırıkkale University
Faculty of Dentistry, Kırıkkale, Turkey. E-mail: dtezgiturkoglu@gmail.com
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Research
Article
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A
randomized controlled clinical evaluation of anti-gingivitis and desensitizing
efficacy of a newly developed toothpaste with zinc chloride and oriental herb
extract
Kyo Tae Moon, phd, Jong
Hyun Lim, phd, Kyeonghee
Oh, ms, Wonho Ha, phd, Min-Jeong Cho, phd & Kyu-Hwan
Lee, dds, phd
Abstract: Purpose: To evaluate the efficacy of a novel toothpaste formulation containing potassium
phosphates,
zinc chloride, and botanical extracts in managing periodontal conditions and
dentin hypersensitivity. Methods: A single-center, double-blind,
randomized controlled trial was conducted over 4 weeks with 97 participants
aged 30 years and older, all experiencing dentin hypersensitivity. Participants
were randomly assigned to three groups: a negative control group using standard
toothpaste, an experimental group using the test toothpaste with conventional
brushing, and another experimental group using the test toothpaste with topical
application followed by brushing. Efficacy was assessed by measuring plaque
deposition with the Patient Hygiene Performance (PHP) Index, gingival health
with the Gingival Index (GI) and the Papillary, Marginal, and Attached gingival
inflammation index, and dentin hypersensitivity with an electric pulp tester
(EPT). Statistical analyses were performed using SPSS version 25.5, with
analysis of variance and paired t-tests to compare results across groups and
time points. Results: The topical application followed by brushing
method (Group 3) demonstrated significantly greater efficacy in reducing dentin
hypersensitivity, plaque accumulation, and gingival inflammation than both the
control group and the conventional brushing group (Group 2). After 4 weeks,
Group 3 demonstrated a 38.7% reduction in plaque index scores and a 50.8%
reduction in GI scores, significantly outperforming the control group. For
dentin hypersensitivity, Group 3 exhibited a 10.8% immediate desensitization
effect, which was statistically significant compared with the control group.
Questionnaire responses indicated higher satisfaction and perceived
improvements in gingival health and sensitivity reduction in Group 3. These
findings suggest that prolonging the contact time of active ingredients through
delayed brushing enhances therapeutic outcomes for both dentin hypersensitivity
and periodontal disease management. (Am J Dent 2026;39:139-145).
Clinical significance: The modified application method of the newly developed toothpaste exhibited
significantly greater reductions in plaque accumulation, gingival inflammation,
and dentin hypersensitivity than the control and conventional brushing methods.
Mail:
Prof. Min-Jeong Cho, Gimcheon University, Gyeongsangbuk-do, 39528, Korea, E-*:
bada964@hanmail.net and Prof. Kyu-Hwan Lee, Seoul National University Bundang
Hospital, Gyeonggi-do 13620, Korea. E-mail: khlee@snudh.org
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Research
Article
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Effect
of pre-diagnostic stain removal on the detection of occlusal fissure caries: A
laboratory study
Merve
Kocuk, dt, Dilan
Kopuz, dds , Semsi Alp, phd, Ozlem Kanar, dds, Ozlem ErCin,
dds, Bora Korkut, dds, phd, Pınar Yılmaz Atalı,
dds, phd, Dilek TaGtekin, dds, phd & Funda YanıkoGlu, dds, phd
Abstract: Purpose: To evaluate
the laboratory cleaning efficacy of six commonly used non-invasive methods for
removing stains from occlusal fissures before caries diagnosis. Methods: 60 extracted, caries-free permanent molars with visible occlusal staining were
divided into six groups (n= 10): AquaCare air abrasion, Kerr prophylactic
paste, Whiteness HP (35% H₂O₂), HealOzone, oxygenated water +
pumice, and Opalustre. All samples were analyzed pre- and post-treatment using
a dental microscope, Diagnodent Pen, QLF imaging (Qraypen), 3D Geomagic Control
X software for volumetric evaluation and photo editing software for pixel
evaluation. Statistical analyses were performed with Kruskal-Wallis and the
Friedman’s two-way ANOVA test (P< 0.05). Results: All methods
significantly reduced surface discoloration (P< 0.05). AquaCare showed the
least residual staining, while HealOzone had the highest (P= 0.043). Volumetric
analysis revealed no intergroup enamel loss (P> 0.05), although a
significant change was noted in the Whiteness HP group (P= 0.017). QLF parameters (ΔF and ΔQ) improved
significantly in Aquacare, HealOzone, and Opalustre (P< 0.05). Diagnodent
Pen readings decreased significantly in the Aquacare, Kerr paste, HealOzone, and
oxygenated water + pumice groups (P< 0.05). All tested methods effectively
removed fissure stains without causing measurable enamel loss. HealOzone,
Aquacare, and Opalustre demonstrated the most balanced performance, combining
high cleaning efficacy with minimal surface alteration. The findings emphasize
the value of multimodal, minimally invasive approaches for optimizing
diagnostic accuracy in occlusal fissure caries detection. (Am J Dent 2026:39:145-153).
Clinical significance: When making a
caries indication, the staining of the fissures may affect the accuracy of the
indication, but the most minimally invasive method should be preferred to clean
the stained fissures.
Mail: Dr.
Merve Kocuk, Department of Restorative Dentistry, Faculty of Dentistry,
Istanbul Kent University, Istanbul, Turkey. E-mail: merve.kocuk@kent.edu.tr
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Research
Article
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Effect
of different surface treatments on the repair bond strength of flowable
single-shade bulk-fill composites
Betül
Kübra Kurucu Karadeniz, dds, phd & İbrahim
Doğan, dds, phd
Abstract: Purpose: To assess how
various surface treatment methods affect the repair shear bond strength (SBS)
of flowable single-shade bulk-fill composite resins. Methods: 200
composite discs were fabricated using a nanohybrid composite (GrandioSo, VOCO)
to simulate aged restorations. All specimens underwent 5,000 thermal cycles to
mimic oral aging. Five different surface treatment approaches were tested: no
treatment (control), diamond bur abrasion, phosphoric acid etching, Er,Cr:YSGG
laser irradiation, and silane application. After treatment, three flowable
single-shade bulk-fill composites: Omnichroma Flow Bulk (Tokuyama Dental),
SimpliShade Bulk Fill Flow (Kerr), and Charisma Bulk Flow ONE (Kulzer) were
bonded onto the aged surfaces using a universal adhesive (Tokuyama Universal
Bond). SBS was measured with a universal testing machine, and failure modes
were examined under a stereomicroscope. Statistical analyses were conducted
with robust ANOVA and chi-square tests (α= 0.05). Results: Both
resin composite type and the surface treatment protocol, as well as their
interaction, had significant effects on SBS values (P< 0.001). Among the
tested groups, the highest SBS was recorded for GrandioSo combined with silane
treatment (23.85 MPa), while the lowest was found for Charisma Bulk Flow ONE
after acid etching (10.8 MPa). Silane application resulted in significantly
greater SBS compared to other treatments (P< 0.001). Adhesive failures were
most prevalent in the acid and control groups, whereas laser and silane groups
displayed more cohesive and mixed failures. (Am J Dent 2026:39:153-159).
Clinical
significance: Effective surface conditioning is
essential for durable and predictable composite repairs. Silane application and
Er,Cr:YSGG laser irradiation significantly improved the repair bond strength of
flowable single-shade bulk-fill composites, whereas phosphoric acid etching
alone was insufficient.
Mail: Dr. Betül Kübra Kurucu
Karadeniz, Department of Restorative Dentistry, Faculty of Dentistry, Giresun
University, Giresun, Turkey. E-mail: kurucubetulkubra@hotmail.com
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Research
Article
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Surface hardness
ratios and surface roughness of bulk-fill resin composites following different
heating protocols
Dilan
Kopuz, dds, Özlem Erçin, dds, Merve Kocuk, dt, Elif
Alkan, dds, Bora Korkut, dds, phd, Dilek
Tağtekin, dds, phd & Funda Yanıkoğlu, dds, phd
Abstract: Purpose: To evaluate the impact of preheating on the physical
properties of bulk-fill resin composites, with a particular focus on
microhardness and surface roughness. Methods: In this study, seven
bulk-fill resin composites (SonicFill 3, Opus Bulk-Fill Flow, Opus Bulk-Fill,
Metafil Bulk-Fill, Tetric PowerFlow, Tetric N-Ceram, and Estelite Bulk-Fill
Flow) and one conventional resin composite (Filtek Z250) were tested. Specimens
were divided into two main groups: Group 1 (preheated 68°C for 10 minutes) and
Group 2 (stored at room temperature). For each group, five disc-shaped resin
composites (4 mm thickness x 5 mm diameter) were prepared. Each bulk-fill resin
composite was applied in a single increment, whereas Filtek Z250 was placed in
the molds in 2 mm layers. To complete the polymerization, the samples were kept
in distilled water at 37°C for 24 hours. Then, the surfaces of the samples were
polished with Twist Dia (Clearfil) polishing discs to imitate the finishing and
polishing processes. Baseline microhardness and surface roughness values were
measured. Subsequently, specimens underwent artificial aging simulating 2 years
of clinical use (10,000 brushing cycles + 1,200 thermal cycles). Post-aging
measurements were repeated, and statistical analyses were conducted. Results: Significant differences in microhardness values were observed among the
experimental groups for all restorative materials, except for Estelite
Bulk-Fill Flow (P> 0.05). The highest bottom-to-top hardness ratio was found
in both preheated and non-preheated Opus Bulk-Fill Flow, while the lowest was
observed in preheated Tetric PowerFlow. Microhardness generally decreased with
depth, and the impact of preheating varied among materials. Post-aging surface
roughness increased in all groups. Preheated Metafil Bulk-Fill exhibited the
highest surface roughness, whereas Estelite Bulk-Fill Flow (both preheated and
non-preheated) showed the lowest. Preheating reduced viscosity and enhanced
microhardness in certain resin composites but also increased surface roughness
over time. The effects of preheating are material-dependent due to
compositional differences. (Am J Dent 2026;39:160-164).
Clinical significance: Preheating
may improve handling and selected properties of resin composites; however, its
long-term effects should be considered when selecting materials for clinical
use.
Mail: Dr.
Özlem Erçin, Department of Restorative Dentistry, Faculty of Dentistry,
Istanbul Kent University, Istanbul, Turkey. E-mail: ozlem.ercin@kent.edu.tr