International Arab Journal of Dentistry (IAJD)

Efficacy of Autologous Platelet-Rich Fibrin (PRF) in Promoting Soft Tissue Healing and Bone Regeneration Following Extraction in the Anterior Maxilla: A Digital and Radiological Study

Tue, 14 Oct 2025 00:00:00 +0000

Objectives:
The main objective of this study was to evaluate the effectiveness of PRF in promoting soft tissue healing and bone regeneration after extraction in the anterior maxillary region. A secondary objective was to correlate soft tissue change with underlying bone structure variation. Finally, the study also aimed to compare soft and hard tissue alteration based on different types of extracted teeth.

Methods:
The sample included five adult patients requiring the extraction of at least two symmetrical teeth in the anterior maxilla, totaling fourteen teeth. Participants underwent CBCT scans and digital impressions before extraction. Concerned teeth were then extracted, and extraction sites were randomly assigned either to the experimental group (PRF) or the control group (without PRF). Ten weeks after extraction, follow-up CBCT scans and digital impressions were performed. The evaluation of soft and hard tissue changes was carried out by superimposing and aligning preoperative and postoperative CBCT scans and STL files.

Results:
After ten weeks of healing, the study revealed an increase in soft tissue thickness of 38% and 34% at 2 mm and 4 mm, respectively, for the control group. As for the experimental group, soft tissue thickness increased by 18% and 22%. Regarding hard tissues, the control group showed a resorption of 33% and 25% at 2 mm and 4 mm, respectively, while the experimental group showed a resorption rate of 23% and 22%. The central incisor exhibited the highest hard tissue resorption, followed by the canine, while the first premolar showed the least resorption.

Conclusions:
Within the limitations of this study, we observed better dimensional changes in hard tissue and soft tissue healing after extraction in the group where PRF was used.

Effect of ingot thickness and translucency of lithium disilicate glass ceramic and final shade: an in vitro study

Tue, 14 Oct 2025 00:00:00 +0000

Introduction: Laminate veneers can alter the final shade depending on factors like resin cement shade or material used. Other factors such as ceramic thickness and translucency will be discussed in this study.

Methods: The study sample consists of 60 discs made of lithium disilicate glass ceramic divided into four groups (HT, LT, MO, HO) according to their translucency; each group was subsequently divided into three subgroups (1, 0.75, 0.5 mm) according to their thickness. L, a, b values were measured for each disc. One-Way ANOVA was carried out with a 95 % confidence interval.

Results: Statistical analysis showed a significant difference between all groups in L, a, b and ΔE parameters.

Conclusions: MO and HO translucencies have the ability to mask substrate shade and affect value, whereas HT and LT translucencies have a slight ability to modify substrate hue without any noticeable change in value. Increasing ceramic thickness can aid in shade modification.

A comparison of shear bond strength of denture teeth to denture base using different means of retention: in vitro pilot study

Dima TAHA EL BABA, Paul BOULOS — Tue, 14 Oct 2025 00:00:00 +0000

Objectives: The objective of this work is to evaluate the shear bond strength between denture base resin and three different acrylic artificial denture teeth. The latter was subjected to three different surface modifications on the ridge lap area and compared to unmodified acrylic artificial denture teeth.

Methods: In this experimental in vitro study, twenty-four maxillary central incisor acrylic teeth were used from each of three manufacturers; namely Major®, Ivoclar® and Myerson®. The teeth were additionally divided into four test groups with six specimens in each: a control group, a chemical retention group, a mechanical retention group, and a mechanical plus chemical retention group. The teeth in each group, with the exception of the control group, are subjected to one of the four different surface modifications prior to packing of the denture base resin. Seventy-two acrylic resin test blocks thus obtained are submitted to 5,000 cycles of thermocycling between 5 and 55°C for 30 seconds in each water bath and 10 seconds in between. The resins are subsequently tested for shear bond strength between the acrylic resin teeth and the denture base resin in the Universal Testing Machine using the strength mode. The compression load is applied through a roll pin at a crosshead speed of 1 mm/min and at an angle of 45° (relative to the long axis of the tooth). Anova, Kolmogorov–Smirnov, Kruskal–Wallis and Post hoc tests were used for statistical data analysis. The significance level retained corresponds to a p-value ≤ 0.05.

Results: The multilayer teeth of the nano hybrid composite “Ivoclar®” had the highest bonding strength in the control and chemical bonding groups. For the mechanical or mechanical plus chemical retention groups, no significant difference between the three types of teeth was observed.

Conclusions: The multilayer nanohybrid “Ivoclar®” teeth are the most retentive teeth to the denture base. If resin teeth are desirable, applying combined retentive measures would be recommended.

Impact of systemic statins on periodontal health: a retrospective study in a Lebanese population

Elsa BOUSTANY, Georgio SAAD, Wassim AL MANHAL — Tue, 14 Oct 2025 00:00:00 +0000

Introduction: Statins, primarily used for cholesterol management, have shown potential in improving periodontal health due to their anti-inflammatory and bone-regenerative properties.

Methods: A retrospective study was conducted on 30 patients under statin medication. A control group of 30 non-statin users was selected using propensity score matching (PSM) to minimize bias. Data on pocket depth, attachment loss, and radiographic bone loss were collected at two time points: T0 and T1. Statistical analysis was performed using RStudio, with a significance threshold set at p < 0.05.

Results: The study revealed significant decrease in pocket depth (p = 0.0027), attachment loss (p < 0.001), and radiographic bone loss (p < 0.001) in the statin group compared to the control group from T0 to T1.

Conclusions: These findings suggest that systemic statins contribute to improved periodontal health. Further research is needed to confirm these effects and evaluate long-term clinical implications.

Comparative evaluation of heat treated retreatment files on canal transportation and dentin thickness in endodontically treated teeth: an in vitro CBCT study

Monisha BHATE, Pradeep SOLETE, Aparna MOHAN E — Tue, 14 Oct 2025 00:00:00 +0000

Introduction: Non-surgical retreatment is a conservative approach for managing recurrent endodontic infections requiring efficient removal of obturating material while preserving dentin. Retreatment file systems, through their design and function, play a vital role in ensuring effective cleaning and minimal structural compromise.

Methods: Forty-five extracted mandibular molars were decoronated and obturated at a standardized root length of 16 mm in both mesial canals. Samples were divided into three groups (n = 15): Group 1 – SoliteRS3, Group 2 – Dentsply Protaper Universal Retreatment Files, and Group 3 – Neoendo Retreatment Files. Pre- and postoperative CBCT scans were used to assess remaining dentin thickness, canal centering ability, and centering ratio. Data were analyzed using one-way ANOVA and post hoc Tukey tests (p < 0.05).

Results: There was a statistically significant difference among the three file systems in all evaluated parameters (p < 0.05). SoliteRS3 showed better dentin preservation and superior centering ability.

Conclusions: SoliteRS3 files demonstrated superior dentin conservation and canal centering, making them a favorable choice for endodontic retreatment.

Cytotoxicity and osteogenic potentials of mesenchymal stem cells via a novel formulation of mineral trioxide aggregate: an in vitro study

Tue, 14 Oct 2025 00:00:00 +0000

Objectives: Root perforations can lead to periodontitis and alveolar bone loss. This study compared cytotoxicity and osteogenic potential of zirconia-containing mineral trioxide aggregate (MTA) Matreva (MAT group) to MTA Angelus (ANG group) as root perforation repair materials.

Methods: Bone marrow mesenchymal stem cells (BM-MSCs) were extracted from two albino rats and cultivated. The cytotoxicity of the studied materials was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay at three time points: 3, 7, and 14 days. The evaluated materials were employed to guide the osteogenic differentiation of BM-MSCs into osteoblasts. The osteogenic impact was evaluated by assessing calcium deposition with Alizarin red staining (ARS) and expression of receptor activator of nuclear factor-kappa B (NFκB) ligand (RANKL) protein in BM-MSCs seeded on the investigated materials for 14 days. Genes analyzed included tumor necrosis factor (TNF-α), transforming growth factor beta (TGF-β), and interleukin 1 beta (IL-1β). The data was statistically examined.

Results: Cytotoxicity and osteogenic potential did not differ significantly between the ANG and MAT groups (p > 0.05). The MAT group had the greatest average calcific area percentage (90%), followed by the ANG group (68%) and negative controls (NC, 48%). BM-MSCs in the MAT group had the greatest amount of RANKL protein expression, followed by the ANG group. The ANG group had considerably higher levels of TNF-α and IL-1β compared to NC. TGF-β levels were considerably higher in the MAT group compared to the NC.

Conclusions: Zirconia-based MTA exhibits comparable cytotoxicity and osteogenic capability to standard MTA Angelus.

Assessment of external root resorption during the first stage of the orthodontic treatment: a prospective cone beam tomography study

Tue, 14 Oct 2025 00:00:00 +0000

Introduction: Predisposition to root resorption as a result of a dental movement may be a consequence of clinical, biological, and biomechanical factors that should lead the clinician to objectively assess each patient to reduce associated risk factors.

Objectives: To establish an association between clinical and tomographic findings related to external root resorption (ERR) using cone beam tomography (CBCT) on maxillary incisors during the first stage of orthodontic treatment.

Methods: An observational, follow-up, cohort study that analyzed the association between clinical and radiographic variables on maxillary incisors using CBCT before placing fixed orthodontic appliances and finishing the first stage of orthodontic treatment in 20 patients was performed.

Results: Using the Levander and Malmgren criteria on root length, no statistically significant changes were observed at any evaluation time. When exploring the association between malocclusion type, the vertical component, and type of orthodontic appliance used, no statistically significant changes were observed for teeth 11, 12, 21, and 22 (Vp KW>0.05). However, significant changes in class I patients compared to class III in tooth 22 were observed.

Conclusions: It is important to evaluate using 3D tools from the beginning of the orthodontic treatment to assess the individual risk of developing ERR as the etiology of such condition is multifactorial. It is noteworthy to mention that, after 6 months, no diagnosis of significant ERR was made. However, a reduction in total root length was observed in most patients. The selected clinical variables did not have an impact on the first stage of the orthodontic treatment.

Evaluation of the remineralizing agents after orthodontic bracket debonding: a SEM-EDX investigation

Tue, 14 Oct 2025 00:00:00 +0000

Objectives: To compare the remineralizing efficacy of fluoride (Fl) varnish, nanohydroxyapatite (n-HAp) serum, and NovaMin-containing toothpaste on premolars subjected to orthodontic debonding and a pH-cycling model.

Methods: Sixty human premolars were divided into six groups (n = 10). Group IA: sound enamel; IB: orthodontically treated premolars; IC: orthodontically treated premolars subjected to demineralization cycles. Three experimental groups included orthodontically treated premolars subjected to demineralization cycles and treated with Fl varnish (IIA), n-HAp serum (IIB), and NovaMin toothpaste (IIC). Surface topography and mineral content were evaluated using SEM-EDX analysis, and data were statistically analyzed using ANOVA and Tukey’s post-hoc test.

Results: SEM images of the experimental groups showed signs of surface precipitants and enamel prism reorganization. EDX analysis showed increased Ca and P levels, with NovaMin recording the highest Ca/P ratio, followed by n-HAp serum, and then Fl varnish.

Conclusions: NovaMin demonstrated the highest remineralization potential by increasing Ca and P content. n-HAp serum exhibited comparable remineralization efficacy to NovaMin, while Fl varnish demonstrated the lowest remineralization potential.

A clinical investigation of the correlation of black stains with oral cavity pH and dental caries presence in children: a cross-sectional study

Maguy SFEIR, Nada CHEDID — Tue, 14 Oct 2025 00:00:00 +0000

Introduction : Black stains (BS) on teeth often lead to dental visits in children due to their esthetic impact. Beyond cosmetic concerns, black stains may play a role in oral health, potentially suggesting a lower risk of dental caries through the regulation of oral microbiota and pH levels. Understanding the association of black stains with oral pH and caries presence can offer insights into protective and preventive strategies in pediatric dentistry.

Objectives : The purpose of this study is to assess the correlation between black stains, oral cavity pH, and the presence of caries in a sample of 6- to 8-year-old Lebanese children.

Methods : In this clinical comparative study, 80 healthy children aged from 6 to 8 years were selected from Lebanese schools, the Department of Pediatric Dentistry at the Saint Joseph University Faculty of Dental Medicine in Beirut, and a private practice in Rayfoun (Mount Lebanon). Participants were classified into two groups: 40 children with and 40 without black stains on their teeth. Data including the presence or absence of black stains on teeth surfaces, oral pH, age, gender, and carious teeth number were registered for each participant. Clinical examination for black stain presence and caries detection was conducted through visual and tactile inspection without radiographs. Black stains were recorded as present or absent and carious teeth count was scored. Salivary samples were obtained following standard protocols, with at least a 30-minute interval away from eating, drinking, or tooth brushing. Oral pH was determined by placing salivary samples on litmus paper (TRIXES® pH Test Paper Book); this test was performed twice per subject, the values obtained were added then divided by two, and the mean value obtained was recorded as the subject’s salivary pH.

Results : Children with black stains on teeth surfaces had a higher oral cavity pH and fewer dental carious teeth compared to those without black stains. No meaningful differences in age or gender were detected between groups.

Conclusions : Black stains’ association with a higher oral cavity pH and a lower number of carious teeth may imply a potential protective role in children’s oral health against the development of caries.

Evaluation of anti-bacterial efficacy of ginger, resin gum, and nigella sativa irrigants against enterococcus faecalis: an in-vitro study

Iman EL GHAZZAWY, Leen HASBINI, Reem CHAMSEDDINE, Wael BETBOUT, Roula ABIAD — Tue, 14 Oct 2025 00:00:00 +0000

Objectives : To evaluate the antibacterial efficacy of Ginger, Resin Gum, and Nigella Sativa, against Enterococcus faecalis.

Methods : Thirty-eight extracted single-rooted premolars were inoculated with E. faecalis (except the negative control) and incubated for 4 weeks. After instrumentation, samples were divided into four groups (n = 7) according to final irrigation: NaOCl + EDTA (Group A), Nigella sativa (B), Resin Gum (C), Ginger (D), plus two control groups (n = 5): Saline (E) and Saline without bacterial inoculation (F). Cultures were collected at baseline and after irrigation.

Results : One-way ANOVA showed that in groups A–D a statistically significant reduction of bacterial load was observed at T1 after final chemo-mechanical instrumentation (p < 0.05). The antibacterial reduction rate was as follows: Nigella sativa (99.89%), Ginger (99.85%), and Resin Gum (99.64%).

Conclusions : Herbal irrigants can be used as adjuncts to NaOCl in eradicating E. faecalis.

Full arch rehabilitation of post-mucormycosis edentulous maxilla using quad zygomatic implants: a clinical case report

Tue, 14 Oct 2025 00:00:00 +0000

Abstract : Rehabilitating the maxilla in the patient who has had surgical resection for mucormycosis poses a distinctive set of anatomical, surgical, and prosthetic challenges. The extensive maxillary bone loss after aggressive debridement often makes traditional implant-supported prosthetic options impossible. In these circumstances, zygomatic implants have proven to be a predictable, graftless solution, especially in patients with extremely atrophic maxillae. Where the bone loss is severe, the quad zygoma procedure — two implants for each zygomatic arch — is possible to support full arch rehabilitation with a fixed prosthesis. This report presents the successful rehabilitation of oral function and appearance in a patient with post-mucormycosis edentulous maxilla, treated with four zygomatic implants and a screw-retained hybrid prosthesis. The article addresses preoperative evaluation, surgery protocol, prosthetic process flow, and clinical results, stressing the long-term effectiveness and clinical applicability of this method for medically compromised individuals.

Management of a periapical cyst in an 8-year-old patient with challenging etiology: a case report with three-year follow-up

Tue, 14 Oct 2025 00:00:00 +0000

The success of pulp therapy in primary teeth depends on accurate diagnosis and effective treatment. Periapical inflammation due to bacterial infection or pulpal necrosis can result in granulation tissue and may activate epithelial rests of Malassez, leading to a periapical cyst. In large cysts, especially in children, marsupialization is preferred to preserve developing teeth and minimize damage to surrounding structures. This case report describes an 8-year-old presenting with spontaneous pain in the lower right jaw. Radiographic examination revealed a round, well-defined radiolucency over 1 cm around tooth #84 with root canal treatment and #85 with pulpotomy, with dental bud displacement. The preliminary diagnosis was in favor of a periapical cyst due to pulp therapy failure. Teeth #84 and #85 were extracted, and marsupialization was performed. Over three years, the cyst resolved completely, and teeth #44 and #45 erupted naturally in proper alignment.

Allergy in dentistry: mechanisms of development and effective treatment methods

Maria Zofia LISIECKA — Tue, 14 Oct 2025 00:00:00 +0000

Objectives : This study was conducted to analyze the mechanisms of allergic reaction development in dentistry and evaluate the effectiveness of treatment methods.

Methods : A review of current scientific sources in allergology, immunology, dentistry, pharmacology, and materials science was carried out. The mechanisms underlying various types of allergic responses were identified, treatment effectiveness was assessed, and clinical recommendations for allergy management in dental practice were developed.

Results : The findings show that allergic reactions develop through two primary mechanisms.

Immediate-type (IgE-mediated) reactions occur when allergens bind to specific IgE antibodies on mast cells, triggering the release of histamine, serotonin, and other inflammatory mediators. In dentistry, such reactions may result from exposure to local anesthetics, antibiotics, latex, nickel, amalgam, or acrylic resins. Symptoms range from mild local irritation to severe, life-threatening responses.
Delayed-type reactions are mediated by T-lymphocytes. Upon contact with an allergen, these immune cells activate macrophages and neutrophils, which secrete cytokines such as interferon-gamma and TNF-alpha. In dentistry, these are commonly caused by metals (nickel, cobalt, chromium), cements, gutta-percha, and composite materials.

Conclusions : A comprehensive understanding of allergic mechanisms allows clinicians to distinguish true allergies from pseudo-allergic reactions that mimic inflammation without immune mediation. Based on the review, four main therapeutic approaches are emphasized: pharmacotherapy, immunotherapy, probiotic therapy, and targeted dental management strategies.

Sickle cell anemia and its impact on the oral cavity: integrative review

Fernanda LEAL, Maria Inês GUIMARÃES, Ambre NATBETH, Inês LOPES CARDOSO — Tue, 14 Oct 2025 00:00:00 +0000

Introduction: Sickle cell anemia, a hereditary disease, results from a mutation in the β-globin coding gene that makes up hemoglobin, leading to the deformation of erythrocytes. Numerous oral manifestations result from this disease; however, some may not be specific.

Objectives: This study’s objective is to recognize these clinical manifestations of the disease to be able to manage oral health in sickle cell anemia patients.

Methods: This integrative review analyzes scientific literature on the impact of sickle cell anemia on the oral cavity. A bibliographic search was performed in PubMed, ScienceDirect, CINAHL Plus (via EBSCO host), Web of Science and Google Scholar databases using several combined keywords. The research question was: “What is the impact of sickle cell anemia on the oral cavity and dental treatments?”.

Results: By applying the inclusion and exclusion criteria, 11 articles were included in this review.

Conclusions: Studies show that the most common oral manifestations in these patients are periodontal disease and caries, although this association is not well understood.

Impact on oral health of the post-COVID-19 infections: a systematic review

Aouatif AOUIDATE, Hanane OUDDOUD, Loubna BAHIJE — Tue, 14 Oct 2025 00:00:00 +0000

Introduction: The COVID-19 pandemic has been associated with a diverse range of oral health implications, including mucosal lesions, periodontitis, and disruptions of the oral microbiota. Since airborne particles primarily transmit COVID-19, understanding its potential impact on oral health is crucial for dental care and infection control.

Objectives: This systematic review aimed to evaluate the effects of post-COVID-19 infections on oral health, highlighting clinical manifestations, periodontal disease associations, and microbiota disturbances.

Methods: Electronic literature searches were conducted between January 2020 and July 2024 by one author across several databases, including PubMed/MEDLINE, Scopus, Cochrane Library, EMBASE, ScienceDirect, Google Scholar, and Web of Science. A total of 3,642 publications were screened. Two reviewers analyzed the articles and extracted the data. Of these, 25 studies met the inclusion criteria.

Results: A total of 25 studies were included in this systematic review, addressing oral manifestations, the link between periodontal disease and COVID-19, and broader oral health impacts. Lesions such as ulcers, candidiasis, and taste disorders were reported, with causes attributed to viral effects or secondary inflammation. Evidence suggests a bidirectional relationship between periodontitis and COVID-19, potentially mediated by elevated cytokines (IL-6, TNF-α).

Conclusions: Post-COVID-19 conditions are associated with a range of oral health issues, including opportunistic infections, a potential bidirectional link with periodontitis mediated by inflammation, and altered oral microbiota. However, the evidence is heterogeneous, and the quality of many studies is limited, underscoring the need for more rigorous research to establish causality.