The Journal of Dentists

Instrumental Colorimetric Evaluation of Direct Enamel Restoration Materials

Rodrigo Rubio — 2025-01-16

Evidence establishes that there are problems regarding colorimetric coding and standardization of composite resin codes around the world that make the work of clinicians difficult. Determine significant quantitative colorimetric differences (ΔE) in enamel composite resins VITA A2 and A3 respect to VITA-Classical shade, allows clinicians to be alerted to real color differences between products of the same coding.

Descriptive in vitro study, 6 resins (N 140) A2 and A3 were used. 7 mm diameter discs, 1 mm (+/-0.1mm) thick were made, measured with spectrophotometry on opaque black background in dark chamber. Values obtained in CIELAB were analyzed obtaining ΔE. ANOVA test of factor 1 (α0.05) was performed.

ΔE for products simulating A2 and A3 with respect to Vita-Classical scale was greater than 5 (5= evident instrumental color difference between reference color and obtained color, unacceptable), with exception of A3 FiltekZ350XT (3MESPE, Saint Paul, Minnesota, USA) (3.39±.65) (3 to 4= evident instrumental color difference between reference color and obtained color, but not visually perceptible).

There are significant colorimetric differences in enamel composite resins with VITA A2 and A3 coding in studied products, with respect to original VITA-Classical color, when measured spectrophotometer in CIELab with an interval confidence of 95%. All resins are over ΔE 5, meaning that differences between shades are considered clinically unacceptable, with exception of FiltekZ350XT 3MESPE, (3.39±.65) for Vita A3. None of the composite resins meet colorimetric characteristics when compared to Vita-Classical scale, (Bad Säckingen, Germany).

Expect the Unexpected: A Case Report on Lingual Bone Perforation During Implant Placement

Nur Zety Mohd Noh — 2025-04-04

Objective; The incidence of lingual bone perforation during implant placement is lower than that of buccal bone perforation and is rarely reported. This case describes an anatomy related implant complication of a 53-year-old lady during implant placement of 36.

Case report; A 3.4mm implant width and 9.5mm implant length with adjunct concentrated growth factor (CGF) were planned for this patient. A full thickness flap was elevated on the edentulous ridge of missing tooth 36. By utilizing the individually constructed surgical stent, the surgery was initiated with a pilot marking drill. The drill angulation was evaluated and an intraoral periapical radiograph was taken. Prior to the implant placement, a careful inspection was conducted on the implant site preparation. However, a lingual bone fenestration was observed. Due to potential complications associated with lingual bone perforation, implant placement was deferred, and a guided bone regeneration procedure was performed. Prior to the flap approximation, a layer of CGF membrane was positioned. Afterwards, the patient was recalled regularly up to one-year post-operative. Following one-year of follow-up, the surgical area healed uneventfully with radiographic evidence of bone formation and maturation.

Conclusion; Although a case can be relatively straightforward with proper surgical planning, clinicians need to always be prepared for the unexpected event.

Puppet Theater as a Strategy for Promoting Oral Self-Care in Children: An Experience Report

Luís Eduardo Genaro — 2025-09-07

Objective: To present an experience report on the use of puppet theater to provide oral health education to preschool children attending a public educational institution in Brazil. Methodology: An educational activity was carried out with 122 children aged 5 to 7 years. The puppet play lasted approximately 10 minutes. For the planning, development, and implementation of this educational action, the team organized itself with clearly defined responsibilities. The script addressed the following aspects: dental caries and its causes, toothbrushing technique and dental flossing, dental visits, and healthy eating. Experience Report: The children’s reactions revealed curiosity, expectation, and anxiety before the presentation; during the play, their responses shifted to fascination, joy, and motivation for new learning. By interacting playfully with the real world, the child establishes harmony and synchrony between imagination and reality, which facilitates the learning process. The drawings produced by the children after the activity were directly related to the theater’s theme, illustrating oral hygiene items such as toothbrushes, toothpaste, and dental floss. Conclusion: Puppet theater enables the presentation of health-related issues in a didactic and engaging manner, especially for children. In this experience, children demonstrated fascination, joy, and motivation toward acquiring new knowledge.

Developing Artificial Intelligence Prototype for Classifying Crude Stingless Bee Propolis towards Innovation in Dentistry

Danica Sawa Samuel — 2025-10-06

Introduction: Stingless bee propolis demonstrates excellent therapeutic properties and its innovation in dentistry. Due to species-specific variations in chemical composition, the nutraceutical potential of each propolis type may be differ.

Purpose: To create an Artificial Intelligence (AI) prototype to classify three different propolis namely Geniotrigona thoracica, Heterotrigona itama, and Tetrigona apicalis, using crude macerated, SEM images.

Methods and Materials; An AI prototype was developed with AI model to perform propolis classification using crude macerated SEM images, for each species. Fine-tuning on the number of images and the number of epochs of the AI model is performed to achieve high performance, which will then use to develop a prototype.

Results: Initial experiment with a small dataset achieved accuracy of 0.67. After augmenting the dataset with 50 additional images per species, accuracy improved to 0.86 after 80 epochs. Other metric evaluations such as precision, recall and F1 score have also been applied to measure the AI model’s performance. The results demonstrate that as the size of the training images and epoch increase, the classification performance is improved. This model has been utilized to develop a prototype with graphical user interface that allows user to insert a new macerated SEM images and the prototype will reveal the propolis species. Expert verification of this prototype has been performed, for use to classify the propolis.

Conclusion: The accuracy of propolis image classification can be further enhanced by using a larger dataset and a higher epoch value. The finding of this study can be used as quality control procedures to profile stingless bee propolis by improving the selection and enriching sustainable sources, as nutraceuticals, employed in dentistry. Future work include the utilization of colour images of crude macerated propolis.

Hydrophilic Properties of Dental Implant Surfaces: Literature Review

Dragana Gabric — 2025-10-25

This literature review investigated the role of implant surface wettability in the success of dental implants, focusing on hydrophilic properties. Thorough search of PubMed, EBSCO, MDPI, and Google Scholar was conducted from November 11 to December 16, 2024, using terms related to implant surface wettability, hydrophilicity, immune cells, soft tissues and osseointegration. Studies published in English, focusing on the hydrophilicity of dental implants, were included. Exclusion criteria applied to studies unrelated to wettability or non-English articles. From 33 initial studies, 28 met inclusion criteria, with 15 undergoing full-text analysis and 13 reviewed from abstracts. Furthermore, each article went through quality analysis using CONSORT checklist designed for dental materials research and new techniques. Hydrophilic surfaces have been shown to enhance early cell adhesion, proliferation, and differentiation, particularly in osteoblastic activity, which is essential for osseointegration. In addition to promoting bone healing, hydrophilic surfaces also support soft tissue integration, improving the formation of a tight epithelial seal and reducing the risk of infection and periimplantitis. The response of innate immune cells, such as neutrophils and macrophages, is also influenced by surface wettability, with hydrophilic surfaces fostering an environment conducive to bone formation by promoting beneficial immune cell activity and osteogenesis. This review highlights the importance of surface modification, specifically hydrophilic treatments, in optimizing the biological response and long-term success of dental implants.

Improved RA-U-Net for Dental Image Segmentation

Du Wenjie — 2025-10-29

The diversity of tooth morphology, irregular arrangement, and blurred grayscale characteristics of the alveolar bone present significant challenges in image recognition and segmentation. While deep learning-based U-Net networks have achieved considerable progress in medical image segmentation, this paper proposes the RA-U-Net architecture, an enhanced version of U-Net, achieving high-precision segmentation of multimodal dental images. To address challenges in dental image segmentation, the U-Net architecture is enhanced by incorporating residual modules and attention mechanisms. A group normalization strategy is applied for feature map channel segmentation, improving deep network learning capabilities and model generalization. The network was tested on a dental CBCT image dataset from the Shanghai Ninth People's Hospital. Results demonstrated an average Dice coefficient of 0.839, surpassing other image segmentation networks, with a precision of 0.961 and a recall of 0.719. These findings indicate that the RA-U-Net model delivers superior image segmentation performance, providing reliable support for dental diagnosis and treatment.

Endodontic Retreatment Due to Periapical Lesion from an Untreated Second Mesiobuccal Canal: Clinical Case Report

Hamilton Antônio Silva Andrade Júnior — 2025-10-29

Objective: To report the endodontic retreatment of tooth 26 with an extensive periapical lesion, assessing the clinical and radiographic evolution. Case report: A 36-year-old male patient, with a history of endodontic treatment of tooth 26 performed approximately six years earlier, presented discomfort in the maxillary molar region. Radiographic and cone-beam computed tomography (CBCT) examinations revealed an extensive periapical lesion and the presence of a second untreated mesiobuccal canal (MB2). Retreatment was performed on the palatal (P), distobuccal (DB), and mesiobuccal (MB) canals, in addition to treatment of MB2, using calcium hydroxide–based intracanal medication and obturation by the lateral condensation technique. During follow-up, evidence of complete lesion regression and bone repair was observed. Conclusions: Endodontic retreatment with the technique used proved effective in promoting regression of the extensive periapical lesion, representing a conservative alternative to periradicular surgery. The high capability of CBCT in elucidating situations involving complex anatomical variations was also evident, highlighting its relevance as a valuable tool in the management of such cases.