International Arab Journal of Dentistry (IAJD) https://journals.usj.edu.lb/iajd <p style="text-align: justify;"><em>IAJD</em> is the official journal of The Society of Arab Dental Faculties (SARDF). It is a scientific specialized journal published in both French and English by the Faculty of Dental Medicine (FMD – USJ)</p> en-US elie.khoury@usj.edu.lb (Elie Khoury) pierre.lahoud@usj.edu.lb (Pierre Lahoud) Mon, 07 Apr 2025 00:00:00 +0000 OJS 3.1.2.0 http://blogs.law.harvard.edu/tech/rss 60 Comparison of treatment outcome of occlusal splints and physiotherapy regarding their effect on posture: An in vivo pilot study https://journals.usj.edu.lb/iajd/article/view/1381 <p><strong>Objectives:</strong> The primary objective of the research is to assess occlusal splints and physical exercise effect on posture. The secondary objective is to compare which treatment option has more positive feedback regarding posture adjustment.</p> <p><strong>Methods:</strong> twenty patients with temporomandibular disorders (TMD) were divided into two groups equally, one receiving occlusal splints as a treatment for TMD and the other group receiving physical therapy exercises. They underwent a clinical and postural examination at baseline, after 1 week, after 1 month and after 2 months of treatment. Postural stability was assessed using a force platform (SATEL). Subjects were evaluated in static and dynamic conditions, with open and closed eyes. Surface are and sway length were assessed and compared through stabilometric parameters.</p> <p><strong>Results:</strong> A decrease in sway length for both groups according to time was observed for all positions and eye statuses, however, this decrease was only significant between baseline and 2 months for the two treatment groups in dynamic lateral position when eyes were closed, and in dynamic anteroposterior position when eyes were closed. In dynamic anteroposterior position when eyes were open, the decrease in sway length was only significant between baseline and 2 months in occlusal splint group. For the occlusal splint group, surface area decreased significantly between baseline and 2 months when eyes were open in static, dynamic lateral, and dynamic anteroposterior positions. However, when eyes were closed and in dynamic lateral position, the decrease was significant between baseline and 1 month, but an increase was observed at 2 months. No difference was shown between occlusal splint or physical therapy exercise groups. In the two treatment groups, pain scores have significantly decreased between baseline and 2 months.</p> <p><strong>Conclusions</strong>: the decrease in surface area and sway length indicates an improvement in posture. No difference was shown between occlusal splint or physical therapy exercise groups. Further investigation regarding this topic are needed with a larger sample size. Clinical significance: Occlusal splint and physical therapy exercise are effective for TMD patients and they may have an effect on postural balance.</p> Bouchra EL FASSIH , Amine EL ZOGHBI , Pascal F. EL BRAIDY Copyright (c) 2025 https://journals.usj.edu.lb/iajd/article/view/1381 Mon, 07 Apr 2025 00:00:00 +0000 The impact of smoking cessation on clinical outcomes of stage I/stage II, grade A/grade B periodontitis patients in periodontal maintenance phase: A 2-year longitudinal study https://journals.usj.edu.lb/iajd/article/view/1382 <p><strong>Objectives:</strong> The objective of this study is to investigate the influence of smoking cessation interventions on periodontal outcomes in individuals who have successfully abstained from smoking for a minimum of six months following non-surgical periodontal therapy.</p> <p><strong>Methods:</strong> A total of 122 participants, based on inclusion &amp; exclusion criteria, were divided into a smoking cessation group (n=61) and a control group (n=61). Demographic characteristics, smok ing history, and baseline oral health parameters were assessed in these patients. Over a 2-year follow-up period, changes in probing depth and alveolar bone loss were measured, statistically analysis were performed using SPSS software.</p> <p><strong>Results:</strong> The smoking cessation group demonstrated significant improvements in periodontal health, as evidenced by a substantial reduction in probing depth (mean change of -1.5 mm), while the control group exhibited an increase in probing depth (mean change of +0.8 mm). Subgroup analysis revealed a decrease in alveolar bone loss in the smoking cessation group compared to an increase in the control group. These findings align with existing research, highlighting the positive effects of smoking cessation on periodontal health.</p> <p><strong>Conclusions:</strong> Smoking cessation interventions have a substantial positive impact on oral health, particularly in terms of periodontal health and the potential preservation of alveolar bone. Health care professionals should prioritize engaging patients in discussions about smoking cessation and providing support to individuals striving to quit smoking to promote better oral health.</p> Santosh R. PATIL, Shikar DANIEL , Aysha JEBIN Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1382 Mon, 07 Apr 2025 00:00:00 +0000 Effect of adaptation time on retention of maxillary 3D printed denture versus conventional heat-cured acrylic denture: A randomized controlled trial https://journals.usj.edu.lb/iajd/article/view/1383 <p><strong>Objectives:</strong> The study aimed to investigate the effect of adaptation time on the retention of 3d printed versus conventional heat-cured acrylic maxillary complete dentures.</p> <p><strong>Methods:</strong> 20 patients were distributed into: Group A received ten conventional complete heat cured acrylic dentures and Group B received ten printed complete dentures. Denture retention was measured at 0,1, and 3 months.</p> <p><strong>Results:</strong> For acrylic denture and printed denture groups, Mean values in denture retention increased with time but this increase was statistically non-significant. The change in denture retention over time (difference in retention between the third month and at the time of insertion) in the printed denture group was more than that for the conventional denture group with statistically significant differences.</p> <p><strong>Conclusions:</strong> 3D-printed and conventional dentures showed a non-significant retention increase over the 3-month follow-up period but the change in denture retention (increase in retention) was more for the printed denture group.</p> Ahmed HEBESHI, Moataz ELMAHDY, Sayed ELMAHDY, Hala ABDELHAMEED Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1383 Mon, 07 Apr 2025 00:00:00 +0000 Multiple implant placements with simultaneous soft tissue augmentation using a volume-stable collagen matrix compared to autogenous connective tissue graft: A clinical and histological pilot study https://journals.usj.edu.lb/iajd/article/view/1384 <p><strong>Introduction:</strong> The use of soft tissue grafts has been a key component in periodontal and implant surgeries for the past five decades, aiming to increase the width of keratinized tissue and soft tissue volume.</p> <p><strong>Objectives:</strong> This study evaluates the efficacy of a three-dimensional volume-stable collagen matrix (VCMX) compared to subepithelial connective tissue grafts (SCTG) in increasing soft tissue thickness and volume during multiple implant placements.</p> <p><strong>Methods:</strong> A randomized controlled clinical trial was conducted with four patients and eight implants. Patients were allocated to the SCTG or VCMX group, with soft tissue augmentation performed simultaneously with implant placement. Outcome measurements included soft tissue thickness, keratinized tissue height, surgical time, and histological analysis.</p> <p><strong>Results:</strong> Results indicated no statistically significant differences between the two groups over three months in keratinized mucosa height (KMH) and mucosal thickness (MT). However, the VCMX group showed reduced surgical time. Histological analysis demonstrated mature collagen and connective tissue integration in both groups.</p> <p><strong>Conclusions:</strong> Despite the small sample size, the study suggests that both SCTG and VCMX effectively improve mucosal thickness, with VCMX offering reduced surgical time and lowered morbidity and discomfort for the patient due to the absence of connective tissue harvesting from the palate.</p> Jamil BOULOS, Abdel-Rahman KASSIR, Gabriel MENASSA, Nada NAAMAN Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1384 Mon, 07 Apr 2025 00:00:00 +0000 Three-dimensional analysis of dental arch form in relation to the vertical facial pattern in Class I patients: A cross-sectional study https://journals.usj.edu.lb/iajd/article/view/1385 <p><strong>Introduction:</strong> Understanding the relationship between dental arch form and vertical facial pattern is crucial in orthodontic diagnosis and treatment planning. Variations in vertical facial morphology can influence dental arch form, which in turn impacts the effectiveness and stability of orthodontic interventions.</p> <p><strong>Objectives:</strong> The study explores the associations between dental arch form with the different vertical facial patterns, including hyperdivergent, normodivergent, and hypodivergent patterns in skeletal Class I patients.</p> <p><strong>Methods:</strong> A cross-sectional observational design was employed to examine a sample of 48 patients with skeletal Class I seeking orthodontic treatment; of which 24 males and 24 females. Each patient was categorized into one of three groups: hyperdivergent, normodivergent, or hypodivergent. Digital intraoral scans were used to analyze the dental arch form, including arch width, depth, length, and shape. Cephalometric radiographs were utilized to classify the vertical facial pattern. Statistical analyses, including ANOVA and post hoc Tukey’s tests, were performed to investigate the relationships between dental arch form and vertical facial pattern variables.</p> <p><strong>Results:</strong> The analysis revealed a significant association between dental arch width (specifically intercanine and interpremolar widths) and vertical facial patterns. Patients with hyperdivergent facial patterns had significantly narrower dental arches compared to those with normodivergent or hypodivergent patterns. No significant associations were found between intermolar width or arch length and vertical facial patterns. In females, a significant correlation was observed between palatal height and vertical facial patterns, with higher palatal height linked to increased vertical facial dimensions. High-angle facial patterns were associated with a ‘V’-shaped arch form, while low angle patterns typically displayed an ovoid arch form. Additionally, males exhibited significantly larger dental arch widths compared to females.</p> <p><strong>Conclusions:</strong> Significant associations were identified between dental arch widths (especially intercanine and interpremolar widths) and vertical facial patterns, with hyperdivergent facial patterns linked to narrower dental arches. In females, a significant correlation was observed between palatal height and vertical facial patterns, with higher palatal height associated with increased vertical facial dimensions. Furthermore, males had significantly larger dental arch widths compared to females.</p> Ahmad Ghassan DROUBI , Islam GAD, Aly OSMAN Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1385 Mon, 07 Apr 2025 00:00:00 +0000 Evaluation of the accuracy of the NiTi K-files and gutta-percha cones in gauging the apical foramen using the scanning electron microscope: An in vitro study https://journals.usj.edu.lb/iajd/article/view/1389 <p><strong> Objectives:</strong> The aim of this study was to compare the accuracy of apical gauging using NiTi K-files and gutta-percha cones and determine the level of agreement between the two methods using a Scanning Electron Microscope (SEM).</p> <p><strong>Methods:&nbsp;</strong>75 circular and straight canals of mandibular first premolars were used. Canals were shaped using the R-Motion system&nbsp;</p> <p>(RM; FKG Dentaire, La Chaux-de-Fonds, Switzerland) and gauged using NiTi K-files and gutta-percha cones matching the shaping instrument. Diameters measured on SEM images were used as the reference standard.</p> <p><strong>Results: </strong>There was a statistically significant difference in the prediction of apical diameter by gauging with both NiTi K-files (P &lt; 0.001) and gutta-percha cones (P &lt; 0.001) compared with the measurement of the diameter with the SEM. However, there were no significant differences between both gauging methods.</p> <p><strong data-start="1063" data-end="1079">Conclusions:</strong> NiTi K-files and gutta-percha cones have similar accuracy but are not accurate in gauging the apical foramen.</p> Marie Louise SLIM, Roula EL HACHEM, Lara NASR, Romy ZOUEIN, Rami MHANNA, Mia KARAM, Issam KHALIL Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1389 Mon, 07 Apr 2025 00:00:00 +0000 Accuracy and reliability of anatomical landmarks compared between 3D facial scanning and CBCT radiographs: A comparative study https://journals.usj.edu.lb/iajd/article/view/1392 <p><strong>Introduction:</strong> Facial soft tissue evaluation is an important key for the overall patient diagnosis, treatment planning, and long-term prognoses. 3D patient imaging can be an alternative way to define the face providing the clinician with more accurate details, in comparison to the 2D imaging of soft tissues.</p> <p><strong>Objectives:</strong> The objective of this study was to evaluate the accuracy and reliability of anatomical landmarks comparing the 3D facial scanning with the CBCT radiographs.</p> <p><strong>Methods:</strong> The study was a comparative, crossover and descriptive study. Thirty patients (12 males and 18 females) with 15 to 30 years with a mean age of 22.6 years, who needed orthodontic treatment were recruited from the outpatient clinics, Faculty of Dentistry, Beirut Arab University. All patients had a CBCT radiograph at the beginning with a natural head position and relaxed lips. After that, the patient had 3D facial scanning using the same radiographing machine.</p> <p><strong>Results:</strong> The data collected from the 3D facial images and full skull CBCT radiographs were reliable and consistent for most of the measured parameters with Cronbach’s alpha values of 0.870. However, the mouth width parameter exhibited the largest Dahlberg error of 4.08, suggesting substantial variability between the two methods for this parameter. Furthermore, the concordance correlation coefficient (CCC) indicated a positive correlation between the CBCT radiograph and facial scanning for most parameters (average of 0.9). The Bland-Altman revealed a moderate agreement between both sets of scanned measurements with confidence band range (2 and -2), with exceptions, the average mouth width distance (-3.40667).</p> <p><strong>Conclusions:</strong> There was a strong positive linear relationship between the two approaches in the majority of the parameters. However, the mouth width parameter revealed a moderately linear relationship between the two approaches.</p> Mohamad Ahmad Munir SAKHITA, Nayer ABOELSAAD, Aly OSMAN Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1392 Mon, 07 Apr 2025 00:00:00 +0000 A two-stage radiographic study of the prevalence of anomalies associated with tooth number https://journals.usj.edu.lb/iajd/article/view/1393 <p class="" data-start="344" data-end="548"><strong data-start="344" data-end="359">Objectives:</strong> To evaluate the prevalence and distribution of dental anomalies associated with tooth number in the radiographic archives of University Dental Hospital Sharjah, United Arab Emirates (UAE).</p> <p class="" data-start="550" data-end="990"><strong data-start="550" data-end="562">Methods:</strong> Retrospective evaluation of 2000 orthopantomogram (OPG) images taken between January 2015 and December 2022. The OPGs showing dental anomalies of number were further investigated for the availability of Cone Beam Computed Tomography (CBCT). Multiple logistic regression analysis was performed to assess the influence of age and gender on the presence of supernumerary teeth; <em data-start="938" data-end="941">p</em> &lt; 0.05 was considered statistically significant.</p> <p class="" data-start="992" data-end="1293"><strong data-start="992" data-end="1004">Results:</strong> The prevalence of dental anomalies (DA) related to tooth number was 3.8% (hypodontia 0.1%, mesiodens 0.5%, odontoma 0.9%, and supernumerary teeth 2.4%). A significant difference was noted only in the prevalence of supernumerary teeth between males (1.7%) and females (3.5%) (<em data-start="1280" data-end="1283">p</em> = 0.008).</p> <p class="" data-start="1295" data-end="1531"><strong data-start="1295" data-end="1311">Conclusions:</strong> The prevalence of DA in relation to tooth number in the present study was 3.8%. The prevalence, site of occurrence, and gender distribution of DA in UAE residents were similar to populations in other parts of the world.</p> Vellore Kannan GOPINATH, Diaa ELDERINI , Reem SALAMA , Vinayak KAMATH , Sangeetha NARASIMHAN , Shishir SHETTY Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1393 Mon, 07 Apr 2025 00:00:00 +0000 The effect of premolar extractions on the change of angulation and eruption space of the mandibular third molars after orthodontic treatment https://journals.usj.edu.lb/iajd/article/view/1394 <p class="" data-start="172" data-end="365"><strong data-start="172" data-end="187">Objectives:</strong> Our study was designed to analyze the effect of lower premolar extraction on the eruption space, position, and angulation of the lower third molars during orthodontic treatment.</p> <p class="" data-start="367" data-end="775"><strong data-start="367" data-end="379">Methods:</strong> This was a cross-sectional, retrospective, descriptive, and analytical study comparing two groups of patients: the first group included 20 patients treated without premolar extraction, and the second group, 27 patients treated with premolar extraction. Linear and angular measurements were performed on panoramic radiographs and lateral cephalograms taken before and after orthodontic treatment.</p> <p class="" data-start="777" data-end="1011"><strong data-start="777" data-end="789">Results:</strong> The eruption space and the horizontal position of the lower third molars showed favorable and statistically significant changes between the two groups. However, changes in angulation did not show a significant difference.</p> <p class="" data-start="1013" data-end="1279"><strong data-start="1013" data-end="1029">Conclusions:</strong> Premolar extractions have a positive and significant influence on the eruption space and horizontal position of the mandibular third molars. Although angulation changes were favorable in the extraction group, they were not statistically significant.</p> Asmae BENKADDOUR, Khaoula M’RABT, Loubna BAHIJE, Fatima ZAOUI , Asmae BAHOUM Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1394 Mon, 07 Apr 2025 00:00:00 +0000 Continuous monitoring of sterility: Bacterial contamination and disinfectant performance in dental clinics https://journals.usj.edu.lb/iajd/article/view/1395 <p class="" data-start="397" data-end="740"><strong data-start="397" data-end="412">Objectives:</strong> This study aimed to (1) evaluate contamination levels across three clinics (endodontic, extraction and surgery, and fixed prosthodontics), (2) identify the types and prevalence of bacteria, (3) estimate the effectiveness of a commercial disinfectant, and (4) determine the bacterial species most responsive to the disinfectant.</p> <p class="" data-start="742" data-end="1076"><strong data-start="742" data-end="754">Methods:</strong> Equal surfaces (17.98 cm²) were swabbed, cultured on nutrient agar for the total aerobic microbial count before and after disinfection, and analyzed using settle plates. Bacterial identification was conducted through colony characteristics, Gram staining, and biochemical tests. Data were processed using SPSS version 26.</p> <p class="" data-start="1078" data-end="1292"><strong data-start="1078" data-end="1090">Results:</strong> The endodontic clinic exhibited the highest contamination levels, with buttons significantly more contaminated than handles. The disinfectant effectively reduced contamination but did not eliminate it.</p> <p class="" data-start="1294" data-end="1406"><strong data-start="1294" data-end="1310">Conclusions:</strong> Contamination levels varied significantly between the clinics; ongoing evaluation is essential.</p> Tarek ABOU AGWA, Shuaib ALAHMAD, Nermin ALMOUHAMMAD, Nathaly ALSALLOUM Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1395 Mon, 07 Apr 2025 00:00:00 +0000 Caries risk prediction in pediatric patients using machine learning techniques: A retrospective study https://journals.usj.edu.lb/iajd/article/view/1396 <p class="" data-start="406" data-end="773"><strong data-start="406" data-end="423">Introduction:</strong> Dental caries is a multifactorial disease prevalent in children and is often influenced by behavioral, environmental, and genetic factors. Traditional caries risk assessment methods have limited accuracy and objectivity. Machine learning (ML) models provide a data-driven approach for predicting caries risk, thereby enabling targeted interventions.</p> <p class="" data-start="775" data-end="1000"><strong data-start="775" data-end="790">Objectives:</strong> The main objective of this study is to develop and validate ML models for predicting caries risk in pediatric patients aged 6–12 years by incorporating clinical, behavioral, dietary, and socioeconomic factors.</p> <p class="" data-start="1002" data-end="1677"><strong data-start="1002" data-end="1014">Methods:</strong> This retrospective observational study included 148 children aged 6–12 years. Data, including demographic details, Decayed Missing Filling Treatment (DMFT) scores, dietary habits, fluoride exposure, and socioeconomic factors, were collected from clinical records and structured interviews. The dataset was preprocessed using imputation, normalization, and feature-selection techniques. Five ML models (Logistic Regression, Random Forest, SVM, XGBoost, and Neural Networks) were trained and evaluated using metrics such as accuracy, sensitivity, specificity, and AUC-ROC. Patients were stratified into low, moderate, and high-risk categories based on predictions.</p> <p class="" data-start="1679" data-end="2176"><strong data-start="1679" data-end="1691">Results:</strong> The XGBoost model achieved the highest AUC-ROC (0.94), followed by the Neural Networks (0.92). DMFT score (35.2%), sugary food consumption (28.7%), and fluoride exposure (18.3%) were the most significant predictors of caries risk. Risk stratification classified 21.0% of patients as high-risk, emphasizing the need for targeted preventive measures. Significant associations were observed between caries risk and fluoride exposure (<em data-start="2123" data-end="2126">P</em> &lt; 0.01) and sugary food consumption (<em data-start="2164" data-end="2167">P</em> &lt; 0.05).</p> <p class="" data-start="2178" data-end="2505"><strong data-start="2178" data-end="2194">Conclusions:</strong> ML models, particularly XGBoost, provide accurate and actionable caries risk predictions in children and outperform traditional assessment methods. The integration of ML tools in clinical practice can enhance personalized prevention and resource allocation, ultimately improving pediatric oral health outcomes.</p> Nagarathna P. J., Vishnu Priya VEERARAGHAVAN, Aysha JEBIN A., Shikar DANIEL, Kaladhar Reddy AILENI, Santosh R. PATIL Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1396 Mon, 07 Apr 2025 00:00:00 +0000 Evaluation of the effect of 3 bonding protocols on the micro-tensile bond strength of self-adhesive composite to enamel and dentin https://journals.usj.edu.lb/iajd/article/view/1397 <p class="" data-start="392" data-end="664"><strong data-start="392" data-end="407">Objectives:</strong> To investigate the micro tensile bond strength (µTBS) of self-adhesive bulk-fill composite (Surefil One) to enamel and dentin bonded without bonding agent, with an additional phosphoric acid etch, and with the use of a bonding agent in etch and rinse mode.</p> <p class="" data-start="666" data-end="1506"><strong data-start="666" data-end="678">Methods:</strong> 90 sound extracted wisdom teeth were used in this study. Surefil One (Dentsply Sirona, Konstanz, Germany), Prime&amp;Bond Universal (Dentsply Sirona, Konstanz, Germany) and Detrey Conditioner 36 Etch Gel (Dentsply Sirona, Konstanz, Germany) were tested. Teeth were divided in 6 groups of 15 teeth, according to tooth substrate (enamel and dentin) and bonding protocols (no bonding agent, bonding with 36% phosphoric acid etch, bonding in etch and rinse mode using a universal adhesive). µTBS was tested using a universal testing machine and micromorphological observation of the interface was investigated using a magnifier. Data were analyzed using STATA version 15.0. Different bonding protocols were compared using appropriate statistical tests including ANOVA, Kruskal Wallis, Mann-Whitney, and Fisher’s exact tests (p &lt; 0.05).</p> <p class="" data-start="1508" data-end="1996"><strong data-start="1508" data-end="1520">Results:</strong> Surefil One bonded on enamel using etch and rinse mode with a universal adhesive yielded the highest µTBS values compared to control and with phosphoric acid etching. Additional phosphoric acid etching significantly increased µTBS on enamel. On dentin, etch and rinse mode also recorded the highest µTBS and there was a significant difference between control group and with additional phosphoric acid etching. Control groups showed the lowest µTBS in all experimental groups.</p> <p class="" data-start="1998" data-end="2125"><strong data-start="1998" data-end="2014">Conclusions:</strong> Bonding Surefil One in etch and rinse mode with a universal adhesive is recommended on both enamel and dentin.</p> Mohamad YAMAN, Louis HARDAN, Georges NAJJAR, Cynthia KASSIS Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1397 Mon, 07 Apr 2025 00:00:00 +0000 Evaluation of microtensile bond strength of composite under three aging conditions: A comparative in-vitro study https://journals.usj.edu.lb/iajd/article/view/1399 <p class="" data-start="462" data-end="640"><strong data-start="462" data-end="477">Objectives:</strong> To investigate the effects of different in-vitro artificial aging protocols on the micro tensile bond strength (µTBS) of composite restorations applied to dentin.</p> <p class="" data-start="642" data-end="1558"><strong data-start="642" data-end="654">Methods:</strong> A total of 88 teeth were prepared on dentin and divided into three distinct aging conditions and a control group: G1) Control group with no aging (n=22); G2) Thermal Cycling (Thermocycling) involving 10,000 cycles between 5°C and 55°C, with a dwell time of 20 seconds (n=22); G3) Mechanical Loading (Cyclic loading) with a 50 N load, a frequency of 1.5 Hz, and 10,000 cycles (n=22); G4) Combined Thermo-mechanical cyclic loading (TMCL) using the parameters of both Thermocycling and Cyclic loading (n=22). Following the preparation of specimens on dentin using standardized procedures, they were subjected to their respective aging conditions and subsequently underwent micro tensile bond strength µTBS testing. The resulting failure modes were classified into adhesive, mixed, and cohesive failures. Statistical analyses were conducted with α = 0.05 to determine significant differences between groups.</p> <p class="" data-start="1560" data-end="1943"><strong data-start="1560" data-end="1572">Results:</strong> All aged groups showed lower µTBS compared to the control group. The TMCL group exhibited a significantly lower µTBS compared to both the Control and cyclic loading groups. However, no significant differences were observed between the Control, Thermocycling, and cyclic loading groups. Adhesive failure emerged as the predominant mode of failure across all aging groups.</p> <p class="" data-start="1945" data-end="2324"><strong data-start="1945" data-end="1961">Conclusions:</strong> The combined aging condition of TMCL significantly influenced the µTBS of composite restorations, particularly at the adhesive layer located at the dentin/composite interface. Thermal cycling induced a lower µTBS compared to cyclic loading. These findings underscore the importance of standardized aging protocols for reliable comparison of adhesive performance.</p> <p class="" data-start="2326" data-end="2759"><strong data-start="2326" data-end="2352">Clinical significance:</strong> The study establishes that the combined thermo-mechanical cyclic loading (TMCL) condition, evaluated using the micro tensile bond strength (µTBS) test, emerges as the most suitable in-vitro aging protocol for accurately assessing adhesive performance. This finding offers valuable guidance for researchers and clinicians in selecting a standardized aging approach that closely mimics real-world conditions.</p> Fadi HAMMOUD, Louis HARDAN, Maryse NASSIF, Tala GHOUL (EL), Georges NAJJAR, Cynthia KASSIS Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1399 Mon, 07 Apr 2025 00:00:00 +0000 Color stability of conventional, 3D printed, and milled denture teeth after immersion in coloring agents: An in-vitro study https://journals.usj.edu.lb/iajd/article/view/1400 <p class="" data-start="482" data-end="634"><strong data-start="482" data-end="497">Objectives:</strong> This study investigates the color stability of denture teeth made from different materials when subjected to various staining solutions.</p> <p class="" data-start="636" data-end="994"><strong data-start="636" data-end="648">Methods:</strong> Forty-five A1 shade upper central incisors were divided into three groups: prefabricated, 3D printed, and milled denture teeth (N=45). Each group was further divided into three subgroups, with teeth immersed in coffee, wine, and artificial saliva for up to 120 days (n=5). ∆E values for color change were measured using an Optishade colorimeter.</p> <p class="" data-start="996" data-end="1786"><strong data-start="996" data-end="1008">Results:</strong> The type of teeth, type of solution, and immersion time had a significant effect on color stability (<em data-start="1110" data-end="1113">p</em> &lt; 0.001). Interactions between the three variables were all significant (<em data-start="1187" data-end="1190">p</em> &lt; 0.001). Conventional denture teeth showed slight color changes with saliva (∆E = 1.256 by day 120), moderate changes with wine (∆E = 2.893), and more significant changes with coffee (∆E = 5.208). Milled denture teeth exhibited no color changes with saliva, noticeable changes with wine (∆E = 5.359), and moderate changes with coffee (∆E = 3.137). 3D printed denture teeth showed no color changes with saliva, but increased changes with wine (∆E = 2.533) and highly significant changes with coffee (∆E = 10.546). Coffee consistently caused the highest ∆E values, especially in 3D printed teeth.</p> <p class="" data-start="1788" data-end="2108"><strong data-start="1788" data-end="1804">Conclusions:</strong> The study found that material choice in denture teeth fabrication significantly affects color stability, with milled teeth showing the highest color stability and 3D-printed denture teeth exhibiting the least color stability. In addition, coffee has been found to be the most chromogenic staining agent.</p> Dany NASSIF, Nancy CHEMALY, Rim BOURGI, Louis HARDAN, Carole ABI GHOSN, Jihad FAKHOURI Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1400 Mon, 07 Apr 2025 00:00:00 +0000 Surgical symphony: Tackling large periapical cysts with precision https://journals.usj.edu.lb/iajd/article/view/1401 <p>This case report details the comprehensive treatment of a large radicular cyst in a 48-year-old male with a five-year history of swelling and pus discharge in the upper anterior jaw. Clinical and radiographic examinations, including CBCT, revealed a significant periapical lesion involving multiple teeth. The multidimensional treatment began with meticulous endodontic therapy for teeth 12, 11, 21, and 22, followed by platelet-rich fibrin (PRF) application to enhance healing. Surgical cystic enucleation was performed under local anesthesia, involving flap elevation and cyst removal, confirmed by biopsy as a radicular cyst. Apicoectomy and retrograde filling with mineral trioxide aggregate (MTA) were executed. A nanocrystalline hydroxyapatite (NCHA) bone graft was placed in the cystic cavity to promote bone regeneration. Six-month follow-up radiographs showed significant bone regeneration, validating the success of this tailored, evidence-based approach, and contributing valuable insights into periapical cyst management.</p> Paridhi AGRAWAL, Manoj CHANDAK, Pooja AGRAWAL, Nitin BHOLA, Rajnikant KAMBALA, Samiha KHAN, Aayushi PAKHALE, Jay BHOPATKAR, Tejas SURYAWANSHI, Palak HIRANI Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1401 Mon, 07 Apr 2025 00:00:00 +0000 Endodontic management of dens invaginatus using dynamic navigation system in pediatric patient: A case report https://journals.usj.edu.lb/iajd/article/view/1402 <p class="" data-start="153" data-end="1343"><em data-start="153" data-end="171">Dens invaginatus</em>, also known as <em data-start="187" data-end="202">dens in dente</em>, is a dental anomaly resulting from infolding of the enamel organ into the dental papilla. Dynamic Navigation Systems (DNS), like Navident, offer real-time guidance during endodontic procedures, proving especially useful in complex cases, such as calcified canals or pulp obliteration. This case report presents a 13-year-old female who reported the chief complaint of continuous pain in the upper left front tooth region. Based on the clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess in relation to maxillary canine (23) was established, with a dens invaginated palatal canal (Oehler’s type III). Despite CBCT imaging and analysis of canal morphology, difficulty in accessing the palatal canal orifice was encountered. Minimally invasive access with zero deviation from the original plan of negotiating the canal and without iatrogenic errors was achieved using a dynamic navigation system. This system was a valuable tool because it reduced chairside time, improved patient comfort, and, more importantly, completed the procedure without the risk of iatrogenic damage to the tooth structure.</p> Ayesha S. FATHIMA, Sahana SELVAGANESH, Ganesh JEEVANANDAN, Pradeep SOLETE, Prabhadevi C. MAGANUR, Ather SYED AHMED, Satish VISHWANATHAIAH Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1402 Mon, 07 Apr 2025 00:00:00 +0000 Conservative non-surgical endodontic management of a large cyst-like periapical tunnel lesion with 22-month CBCT follow-up: A case report https://journals.usj.edu.lb/iajd/article/view/1403 <p>The present case report epitomises the successful non-surgical management of a large cyst-like periapical tunnel lesion of endodontic origin due to trauma using the Lesion Sterilization and Tissue Repair technique. Endodontic orthograde treatment (and re-treatment) was performed in association with triple antibiotic paste as an intra-canal medication in a sixteen-year-old boy. Preoperative CBCT, as well as the 22-month CBCT follow-up, were used to compare the evolution of the healing of the lesion. Accurate diagnosis in combination with non-surgical orthograde endodontic treatment can lead to complete healing of large lesions without any need for surgical intervention.</p> Smriti ROHILLA, Sameer MAKKAR, Sandeep GUPTA Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1403 Mon, 07 Apr 2025 00:00:00 +0000 Oral lesion as the initial presentation in the diagnosis of histiocytosis X: A case report with 16-month follow-up https://journals.usj.edu.lb/iajd/article/view/1405 <p class="" data-start="132" data-end="628"><strong data-start="132" data-end="149">Introduction: </strong>Langerhans cell histiocytosis (LCH) is a rare neoplastic disease that comes from the abnormal proliferation of Langerhans cells (LCs). It presents with a broad clinical spectrum, varying from involvement of a single organ system to multisystem disease, and frequently affects children, although cases in adults have been reported. Oral manifestations of LCH are non-specific and may mimic common periodontal conditions, posing a diagnostic challenge for dental practitioners.</p> <p class="" data-start="630" data-end="1078"><strong data-start="630" data-end="652">Case presentation: </strong>A 63-year-old female patient presented with complaints of periodontal problems. She was initially diagnosed with periodontitis, but symptoms persisted despite treatment, prompting a referral for further evaluation. Histopathological analysis, supported by immunochemistry (CD1a and S100 positivity), confirmed the diagnosis of LCH. She subsequently underwent systemic chemotherapy with vinblastine and corticosteroids.</p> <p class="" data-start="1080" data-end="1357"><strong data-start="1080" data-end="1095">Conclusion: </strong>LCH is a rare yet important differential diagnosis for patients presenting with persistent oral lesions, requiring a multidisciplinary approach for definitive diagnosis. Early recognition and treatment of LCH can prevent disease progression and complications.</p> Wassim MANHAL, Georgio SAAD, Michael EL DACCACHE, Charbel ANKA, Sophie ABI RAAD, Valerie G. AFTIMOS, Georges BOU JAOUDE Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1405 Mon, 07 Apr 2025 00:00:00 +0000 Patient-related and tooth-related factors as predictors for tooth loss in periodontitis patients: A systematic review https://journals.usj.edu.lb/iajd/article/view/1406 <p class="" data-start="421" data-end="807"><strong data-start="421" data-end="438">Introduction: </strong>The treatment of periodontitis aims to prevent further disease progression, to minimize symptoms and perception of the disease, possibly to restore lost tissues and to support patients in maintaining a healthy periodontium. Management of chronic periodontal disease requires a combination of therapeutic modalities and a lifelong commitment to periodontal self-care.</p> <p class="" data-start="809" data-end="1011"><strong data-start="809" data-end="824">Objectives: </strong>The aim of this study is to evaluate predictors for tooth loss in patients previously diagnosed with periodontitis. This systematic review covers studies of over 10 years of follow-up.</p> <p class="" data-start="1013" data-end="1460"><strong data-start="1013" data-end="1025">Methods: </strong>Electronic literature search was conducted on 19/02/2024 by one author across several databases, including Medline (PubMed), Embase, and Google Scholar, including longitudinal studies investigating the association between predictors and tooth loss in periodontitis patients. A total of 594 publications were screened, and three reviewers analyzed the articles and extracted the data. Of these, 17 studies met the inclusion criteria.</p> <p class="" data-start="1462" data-end="1775"><strong data-start="1462" data-end="1474">Results: </strong>A total of 17 articles were included in this systematic review. The mean year of publication of the included studies was 2014. The mean follow-up period was 13.8 years. The studies involved a total of 2,633 participants. The mean sample size was 154 participants. Patients’ mean age was 42.5 years.</p> <p class="" data-start="1777" data-end="2044"><strong data-start="1777" data-end="1793">Conclusions: </strong>Older, males, smokers or diabetic patients, with irregular attendance to supportive periodontal therapy and teeth with high probing depth, mobility, or molars, especially with furcation involvement, are major modifiable risk factors for tooth loss.</p> Cléane DARAZE, Carole CHAKAR, Abdel Rahman KASSIR, Charbel ANKA, Jean-Marie MEGARBANE Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1406 Mon, 07 Apr 2025 00:00:00 +0000 Comparative evaluation of marginal and internal fit of zirconia crowns designed using artificial intelligence and CAD-CAM software: A systematic review https://journals.usj.edu.lb/iajd/article/view/1407 <p class="" data-start="398" data-end="693"><strong data-start="398" data-end="415">Introduction: </strong>The long-term performance of dental restorations depends on their internal and marginal fits. Improvements in the fit of restorations, especially zirconia crowns, have been investigated through the use of diverse materials, manufacturing processes, and impression techniques.</p> <p class="" data-start="695" data-end="874"><strong data-start="695" data-end="710">Objectives: </strong>The purpose of this review was to examine the internal and marginal fit of zirconia crowns made with CAD/CAM software with artificial intelligence (AI) software.</p> <p class="" data-start="876" data-end="1355"><strong data-start="876" data-end="888">Methods: </strong>Using a combination of keywords and MeSH terms, the literature search was carried out across seven databases: PubMed, Scopus, Web of Science, Cochrane Library, Embase, ProQuest, and ScienceDirect from inception till 1st of September, 2024. To guarantee correctness and uniformity in the data that was retrieved, a standardised form was established. <em data-start="1240" data-end="1250">In vitro</em> or <em data-start="1254" data-end="1263">in vivo</em> studies were considered for inclusion, and two reviewers evaluated the selected literature.</p> <p class="" data-start="1357" data-end="1967"><strong data-start="1357" data-end="1369">Results: </strong>CAD/CAM-generated restorations showed better fit than conventionally manufactured restorations in all 5 of the studies included in the review, especially those made with digital workflows and imprint techniques. Compared to other approaches, digital technologies including completely digital (IOS) and digital intraoral impressions produced a better fit. For single-visit zirconia treatment, high-speed sintering produced encouraging results with lower marginal gap values. When compared to milled zirconia (MZ) crowns, self-glazed zirconia (SGZ) crowns showed superior internal and overall fit.</p> <p class="" data-start="1969" data-end="2510"><strong data-start="1969" data-end="1985">Conclusions: </strong>The results showed that, when compared to restorations that were conventionally produced, CAD/CAM-fabricated restorations, particularly those that were planned with the use of digital workflows and imprint techniques, had greater marginal and internal fit. Zirconia crown fit has improved thanks to promising advances in digital technology, including high-speed sintering and entirely digital operations. To determine the long-term clinical performance of restorations created with CAD/CAM and AI, more research is required.</p> Pritesh GANGDE, Sweta KALE PISULKAR, Arushi BERI , Pritam DAS Copyright (c) https://journals.usj.edu.lb/iajd/article/view/1407 Mon, 07 Apr 2025 00:00:00 +0000