INTRODUCTION. Under conditions of increasing exposure to chemical factors that predispose individuals to the development of pathology, the processes of hard-tooth-tissue destruction undergo modification not only in terms of their kinetics but also through the direct incorporation of exogenous chemical agents. These circumstances inevitably affect the macro- and microelement composition of enamel, as well as dentin and cementum in cases of disease progression. Obtaining reliable information on elemental composition is crucial for choosing appropriate treatment strategies and substantiating preventive measures.

AIM. To perform X-ray fluorescence analysis of teeth from employees of chemical enterprises, assessing qualitative and quantitative changes in elemental composition associated with pathological processes.

MATERIALS AND METHODS. The dental status of 100 workers and engineering personnel involved in the production of biologically active substances, paint-and-coating materials, and metal products, all of whom had direct contact with inorganic and organic reagents, was assessed. The control group included teeth from 50 individuals working at the same enterprises but not exposed to occupational hazards. The chemical composition of tooth hard-tissue samples was determined using an M4 TORNADO (Bruker) X-ray fluorescence spectrometer. The MultiPoint mode was used. The software provides the content of each element relative to the total amount of detected elements, considering the entire spectrum as 100%. A relatively constant Ca/P ratio served as an additional reference point for discussing deviations from normal values.

RESULTS. The identified diseases in the affected zones were accompanied by atypical accumulations of trace elements detected via XRF spectra. In several employees of a metallurgical plant, high titanium content – up to 1.14 wt% of total elemental content – was found in areas of dental erosion. Titanium levels in adjacent intact enamel were significantly reduced, although trace amounts were still present. In patients with long-term employment at a paint, coating, and anti-corrosion materials enterprise, potassium content in deep carious lesions reached 12.64%, and most individuals also showed substantial levels of zinc, barium, iron, sulfur, chlorine, manganese, and copper. Among workers of an agrobiological enterprise without hot workshops or industrial dust – due to multistage air purification and sterilization – caries prevailed. In employees of a chemical-pharmaceutical production facility, no cases of caries were detected; only non-inflammatory conditions such as increased tooth wear and wedge-shaped defects were diagnosed.

CONCLUSIONS. XRF analysis demonstrated that enamel demineralization processes in workers of chemical industries are accompanied by qualitative and quantitative changes in trace-element profiles within pathological zones. Environmental exposure results in the isomorphic and isoinic incorporation of elements into apatite structures of hard tooth tissues and disrupts the natural kinetics of mineralization and demineralization. The intensity of trace-element accumulation in tooth tissues is directly related to the degree of industrial air purification. Treatment and prevention of dental disorders in these workers must account for industry-specific occupational factors.

AIM. White spot lesions (WSLs) are initial carious formations marked by the demineralization of enamel, commonly seen in individuals with fixed orthodontic appliances. This study aims to compile and analyze existing research on the prevalence, causes, risk factors, prevention, and treatment of WSLs in orthodontic patients.

MATERIALS AND METHODS. A comprehensive literature review was performed using the PubMed, Embase, and Cochrane Library databases. The review included studies published in English that involved human subjects and focused on WSLs in orthodontic contexts.

RESULTS. The occurrence of WSLs in orthodontic patients ranges significantly (8–97%), influenced by diagnostic techniques and patient demographics. Key factors include inadequate oral hygiene, high sugar intake, decreased saliva production, and the design of fixed appliances. Effective preventive and treatment methods include fluoride-based solutions, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and resin infiltration.

CONCLUSIONS. Timely detection and tailored preventive measures are essential to lessen the frequency and effects of WSLs. Future studies should aim to enhance minimally invasive treatments and assess the longterm results of preventive measures.

INTRODUCTION. Dental caries is teeth decay due to bacteria. One of the most preventable of oral health problems and the most prevalent ongoing health issue in primary school children, it is also the most anticipated chronic disorder in children around the globe. Bad oral health influences the quality of life of children.

AIM. The aim of this study was to establish the prevalence rate of dental carries and the potential demographical variables among the major pupils in the primary school in the Al-Samawah City.

MATERIALS AND METHODS. This survey study conducted between February and June 2025 and, carried out in Al-Muthanna province in four schools (2 public + 2 private) randomly drawn from a list of all primary schools in the governorate. This study used a total sample of 100, 5 schools was also used in random selection of 25 children in each school who were taken to the dentists by the research personnel, to determine the prevalence on Dental caries and other relevant information on the demographical characteristic and sociodemographic status was obtained through a structured questionnaire that was set aside to carrying it out. The data analyses were conducted using the Statistical Package for Social Sciences (SPSS) version-23.

RESULTS. Overall, the results of this study revealed the highest no. of dental caries was in children of private school (48), while the non-dental caries children prevalence highest in public school with no (10). However, numbering of decay teeth according to type of school illustrated of the following [the no. of children that not have dental caries in public school were highest (10), while the no. of children that have (1-4) teeth decay were highest in public school also with no (29). In contrast to that, the private school children illustrated highest no. of dental caries in (4-10) and in more than 10 teeth with numbering (16 and 5, respectively). In term of cleaning status of children, the college or institutional education level of father showed highest percentage in public and private school (39.13% and 63.64%, respectively). On the other hand, the highest percentage of tooth brush children in public school was in intermediate economic level family (67.39%), while the highest percentage of tooth brushing children in private school were in good economic level family (65.91%). Overall, study findings indicated that it was found that a higher no. of dental caries was related to that of a children, mothers and fathers with secondary as well as, college or institutional education level.

CONCLUSIONS. The study is useful in giving me ideas on the distribution patterns and causes of caries as well as influences of the sociodemographics on dental caries in adolescent schoolchildren. According to this research, in general, a wide range of prevalence of dental caries among primary schoolchildren was present in the Al-Muthanna province. But the difference in the prevalence rates is seen in respect of sampling technique, sample size related to the factors associated with this province like economic conditions of the family, education level of mother and father and youngsters brushing their teeth. Nevertheless, the findings depicted that the highest no. of dental caries was observed in kids of a private school. In addition, more decay teeth were linked with a child whose parents had secondary and as well as college or institutional education level.

INTRODUCTION. Early childhood caries (ECC) is one of the most pressing and unresolved problems in modern pediatric dentistry. The incidence and severity of this pathology show no trend toward decline worldwide. Some researchers note gender differences in caries incidence rates, while other studies deny a link between caries rates and gender. It is believed that the primary mechanisms underlying the genetic influence on the higher prevalence and severity of dental caries in females compared to males lie in the sex chromosomes, demonstrating sex-linked inheritance patterns. Delayed dental development in boys is due to the fact that males have larger teeth, which requires a longer development time. The causes of sexual dimorphism in dental development are associated with differential activity of genes that control dental tissue histogenesis.

AIM. To study the index of dental caries intensity and its structural components in children aged 1 to 5 years living in Moscow, depending on age and gender.

MATERIALS AND METHODS. A survey of children aged 1 to 5 years in Moscow was conducted. All children were categorized by age and gender. The average dental caries incidence was calculated for each age group and by gender. The results were analyzed statistically.

RESULTS. An analysis of dental caries incidence in young and preschool-aged children showed that this indicator increases with age. Statistically significant differences in caries incidence were found between age groups (H = 27.83; df = 4; p < 0.001). Statistically significant differences were found separately for boys and girls (p < 0.001 and p = 0.0002, respectively). A comparison of caries incidence in different age groups using the nonparametric Mann-Whitney test showed that caries incidence was higher in girls than in boys (p = 0.000003). At 1 and 5 years of age, the caries intensity in boys and girls differs statistically significantly (p = 0.000003 and p = 0.002, respectively), while for ages 2 to 4, the differences are statistically insignificant (p = 0.123, p = 0.103, and p = 0.730, respectively, for ages 2, 3, and 4). In the caries intensity index, the “k” indicator (caries) predominates across all age groups, and this indicator is higher in girls than in boys.

CONCLUSIONS. Dental caries occurs in all age groups and in both sexes. At all ages, the “k” component – caries of primary teeth – predominates in the intensity index structure. The dental caries intensity index is higher in girls than in boys at all ages. Statistically significant differences in the intensity index are observed between girls and boys at 1 and 5 years of age. Statistically significant differences in the caries intensity index are observed as children age.

INTRODUCTION. The branch of dentistry known as preventive dentistry focuses on treatments and lifestyle choices that assist individuals in preventing the onset or progression of oral disease. It involves both patient-performed dental care at home and professional dental staff-performed dental care and education in an office or clinic. Fluoride is frequently used to avoid and eradicate dental cavities, new unfavorable media coverage and worries regarding careless fluoride usage contributed to a change in parental attitudes. The benefit of fluoride and possible natural or herbal substitutes, this study investigates parental knowledge, preferences, and attitudes toward preventive interventions.

MATERIALS AND METHODS. A survey study was the design of our investigation. Parents of children ages 6 to 14 whom brought their children to the Dijlah University Department of Pediatric Dentistry for examination or treatment were given a 9-questions survey form as part of the study, 300 parents participated in the study. Numbers and percentages were used to record the data.

RESULTS. 155 (51.6%) of the parents said they would prefer natural alternatives to fluorinated varnish if they were given a choice to use natural herbal components instead. There was a statistically significant correlation found between the parents’ educational level and their observations on the effects of fluoride (p < 0.05). Just 19 parents (6.3%) who were university graduates believed fluoride had negative consequences, in contrast to 59 (19.6%) of parents who were primary graduates believed fluoride had negative consequences.

CONCLUSIONS. some parents continue to avoid using fluoride products, and parents lack adequate attitudes and thoughtful regarding oral and dental health prevention measures. Therefore, parents need to be aware of fluoride consumption and its impact on children’s health.

INTRODUCTION. Midline diastema, gingival recession, and functional and aesthetic issues are possible outcomes of a high labial frenum. Although the traditional scalpel frenotomy is still effective, it is often characterized by intraoperative bleeding, the necessity to sew a wound, and a long postoperative period. Diode lasers with wavelengths of 810–980 nm have been reported to provide better hemostasis and reduced tissue trauma. The current study compared the clinical results of the diode laser and scalpel frenotomy.

MATERIALS AND METHODS. A randomized controlled trial was done on 50 patients (age 12 to 55 years) with high labial frenum who were referred to the Al Falah Special Dental Centre in Baghdad in 2024–2025. The subjects were randomly grouped either in the diode laser group (n = 25) or the scalpel group (n = 25). The outcomes of the postoperative period were measured with pain intensity using a visual analogue scale (VAS), bleeding, edema, oral functional status, and patient satisfaction on postoperative day 1, week 1, week 2, and week 4. The data were analyzed by means of the Mann-Whitney U test, and the statistical significance threshold of the test was p below 0.05.

RESULTS. Patients who had laser frenotomy had better outcomes. The laser group did not require any intraoperative bleeding or suturing, compared with the scalpel group. At the conclusion of week 2, the pain and edema scores were significantly lower in the laser group (p < 0.001). Oral functional recovery was faster, and patient satisfaction scores were mostly above all the measurements of the same (p < 0.001).

CONCLUSIONS. Diode laser frenotomy is a safe, less invasive, and patient-friendly procedure compared to the conventional use of a scalpel. It provides superior hemostasis, reduced postoperative pain and edema, faster functional recovery, and increased patient satisfaction, making it the modality of choice in periodontal practice.

INTRODUCTION. Low-level laser therapy (LLLT), known as photobiomodulation (PBM), has recently attracted the attention of clinicians to speed up orthodontic tooth movement. Nevertheless, the sex-related effects of LLLT have not been investigated yet, although the role of sex hormones on bone remodeling has already been reported. The objective of this study was to determine if LLLT preferentially accelerates the rate of mandibular canine retraction in men or women.

MATERIALS AND METHODS. Twenty systemically healthy patients (10 male, 10 females; age range from 18 to 25 years) who were undergoing fixed orthodontic treatment were included in a split-mouth randomized control trial. Subjects were stratified into two groups: Group 1 (n = 10) was treated with 650 nm LLLT on the experimental side, while group 2 (n = 10) was treated with 976 nm LLLT. Opposite sides of the animals were used as a sham-irradiated control. PBM parameters were compatible (8 J/cm² energy density, 0.26 W/cm² power density) and administered on d 0, 3, 7, 14, then bi-weekly thereafter. Retraction of canine was done with 150 g force produced by elastics. Amount of linear tooth movement was evaluated at 1 month and space closure duration was monitored until complete closure.

RESULTS. The amount of the canine movement was significantly higher on LLLT treated sides compared to control ones after 1 month (p < 0.001, mean difference: 0.92 ± 0.46 mm; 1.44 ± 0.29 mm vs control sides, respectively). Better acceleration was obtained at 976 nm (1.12 ± 0.44 mm gain) vs. 650 nm (0.71 ± 0.39 mm; p < 0.001). LLLT sides closed spaces in 3.3 months, whereas controls took 6.2 months for complete closure. Sex stratification found that the accelerations were consistently higher in waves for both males and females indicating no sex-by-wavelength interactions.

CONCLUSIONS. LLLT efficiently speeds up the retraction of the mandibular canine, and the 976 nm wavelength works best. Sex does not affect the effectiveness of LLLT, which supports the consistent use of similar procedures across different groups of patients.

INTRODUCTION. This study compared the mechanical performance of short E-glass fiber (sFRC) reinforcement with woven polyethylene ribbon reinforcement, both embedded in the same nanofilled resin.

MATERIALS AND METHODS. Fifty specimens (n = 25 per group) were fabricated and mechanical properties were tested. T-tests were used for statistical analysis.

RESULTS. sFRC showed significantly higher values than polyethylene ribbon reinforcement across all measured parameters. Mean fracture resistance was 1196.92 N for sFRC and 1028.36 N for polyethylene. Tensile strength was 49.69 MPa versus 45.36 MPa, and fatigue limit averaged 420,174 versus 301,191 cycles.

CONCLUSIONS. Short E-glass fiber reinforcement improved mechanical properties compared with polyethylene ribbon reinforcement. These findings suggest sFRC is a strong candidate for bulk reinforcement in high-load restorations.

INTRODUCTION. The extensive loss of coronal and radicular tooth structure, changes to dentin characteristics, and biomechanical constraints make endodontically treated teeth (ETT) more prone to fractures. Prosthodontic rehabilitation, including post-and-core systems and full-coverage crowns, is a standard approach to restore their function and structural integrity. However, a clear, stepwise comparison of the fracture resistance imparted by endodontic treatment alone versus subsequent stages of prosthodontic restoration is needed to guide clinical decision-making.

MATERIALS AND METHODS. Forty extracted human maxillary premolars of similar dimensions were selected and randomly allocated into four groups (n = 10): Group I (Control) – intact sound teeth; Group II (ETT) – endodontically treated teeth with access cavities left unrestored; Group III (ETT + PC) – endodontically treated, restored with a fiber post and composite core; and Group IV (ETT + PC + C) – endodontically treated, restored with a fiber post, composite core, and a full-coverage cast metal crown. After the specimens underwent thermocycling, they were placed in acrylic resin blocks that included a periodontal ligament simulation. Until fracture occurred, a universal testing machine was used to apply a compressive force at a speed of 1 mm/min to the central fossa of each tooth, which was angled at 90 degrees to the occlusal plane. It was noted the maximum load at crack (in Newtons, N). The data was examined with the use of Tukey’s post hoc test (α = 0.05) and one-way ANOVA.

RESULTS. The average fracture resistance values (± standard deviation) for the four groups were as follows: 1650.5 ± 180.2 N for Group I, 615.8 ± 95.4 N for Group II, 950.3 ± 110.7 N for Group III, and 1425.6 ± 155.1 N for Group IV. Statistical analysis using one-way ANOVA showed that there was a notable difference between the several groups (p < 0.001). Every group except Group I (intact) was much weaker. Group IV (ETT + PC + C) showed a noticeably greater resistance to fracture compared to Group II (ETT) and Group III (ETT + PC) (p < 0.05). In comparison to Group II, Group III was likewise much stronger (p < 0.05). The fracture resistance of Group IV was still noticeably lower than the intact control group (p < 0.05), nevertheless.

CONCLUSIONS. For premolars, the fracture resistance is significantly reduced only by preparing the endodontic access. Placing a full-coverage crown is necessary to provide a major strengthening of the tooth structure, while adding a post-and-core gives a small improvement in strength. But, the strength of an unbroken tooth when it was first cracked is not entirely restored by modern restorative procedures.

INTRODUCTION. Immediate implant placement offers clinical advantages include shortened treatment duration and alveolar bone preservation.To improve soft tissue healing and osseointegration, adjunctive grafting materials are frequently utilized. AIM of this study was to compare the efficacy of gap filling materials (xenograft and hyaluronate versus xenograft and I-PRF) of immediate implant in maxillary anterior and premolar region.

MATERIALS AND METHODS. A total of 20 patient enrolled in this study. Dental implant placed following a traumatic tooth extraction .the patients divided equally in two group: group A (n = 10) received xenograft and hyaluronate. while group B (n = 10) received xenograft and I-PRF. Clinically, Implant stability was assessed immediately and after 6 months postoperatively using penguin ® RFA device. Radiographically, the assessment of marginal bone loss and buccal bone thickness ,immediately and six months after implant placement using CBCT.

RESULTS. All dental implant in both group were successfully ossteointergrated and functionally stable. Regarding implant stability, plalatal bone loss and buccal bone thickness not significant difference between the two group while buccal bone loss statically significant between them.

CONCLUSIONS. Both grafting materials effectively preserved the ridge dimensions and supported implant stability, but xenograft combined with HA showed a modest advantage in maintaining the buccal bone crest.

INTRODUCTION. Radiographic imaging is an essential component in the management of destructive forms of periodontitis. It is used for diagnostic purposes, for assessing the quality of treatment after root canal obturation, and for long-term follow-up evaluation of treatment outcomes.

AIM. To perform a comparative analysis of the effectiveness of different radiographic diagnostic methods in chronic destructive periodontitis.

MATERIALS AND METHODS. To determine diagnostic informativeness, radiographic examinations of 413 patients with destructive forms of periodontitis (454 teeth) were analyzed. Intraoral dental radiography using a 5D2 unit was performed in 122 patients (134 teeth), radiovisiography with SOPIX 2 (Acteon Group, France) in 199 patients (228 teeth), and cone-beam computed tomography (CBCT) using Vatech (Model: ECT-12, Korea) in 88 patients (92 teeth).

RESULTS. The overall detection rate of periapical lesions using radiovisiography and CBCT was 37.28% and 21.73%, respectively. With the use of the intraoral dental X-ray unit, only 5.97% of periapical pathology was detected, indicating the low effectiveness of this diagnostic method, especially in severe cases.

CONCLUSIONS. CBCT is effective in detecting periapical lesions that cannot be identified by radiovisiography, particularly in the maxillary region.

INTRODUCTION. Endodontic microsurgery (EMS) has become an effective modality regarding the treatment of enduring periapical pathology after non-surgical failure of retreatment of the root canal. Nevertheless, the predictability of EMS in periodontal destruction that accompanies teeth is still an area of controversy. The aim of the study was to determine the difference in clinical and radiographic healing of isolated endodontic lesions (IEL) and endodontic-periodontal combined lesions (EPCL) after using microsurgical intervention.

MATERIALS AND METHODS. A cohort retrospective study was carried out on 148 teeth among 148 patients who attended EMS between the year 2022 and 2024. Cases were classified into two according to the preoperative probing depths in radiograph and clinical probing depths: Group A (IEL, n = 76) which included lesions of a strictly endodontic nature, and Group B (EPCL, n = 72) which included lesions of a true combined nature with periodontal communication. Each of the procedures involved the use of an operating microscope, ultrasonic retropreparation, and bioceramic retrograde filling. Group B also was targeted with guided tissue regeneration (GTR). Molven criteria were used to determine clinical and radiographic healing at a 12-month follow-up.

RESULTS. The general success rate was 87.2. The success rate of Group A (IEL) was much higher, 94.7% (72/76), than the success rate of Group B (EPCL) was, 79.2% (57/72) (p = 0.006). The average decrease in lesion size was 84.3 ± 12.1 in Group A and 66.8 ± 18.4 in Group B (p < 0.001). Although the marginal stability of the bone was attained at 88 per cent in EPCL cases, full regeneration of the periodontial apparatus was not predictable as compared with apical bone healing.

CONCLUSIONS. Although endodontic-periodontal mixed lesions have lower success rate of treatment than endodontic lesion alone, combination of microsurgery with regenerative therapies is still a tooth-saving procedure. But the level of periodontal loss is a decisive prognostic factor.  

INTRODUCTION. Implementation of artificial intelligence (AI) in the endodontic motor technology offers improved safety due to real-time torque monitoring and adaptive control. Nevertheless, there is little comparative evidence on their clinical effectiveness in preventing instrument separation and reduction of iatrogenic dentinal damage.

MATERIALS AND METHODS. Ninety human mandibular molars with mesial canals (curvature 25–35°) were randomly divided to three groups (n = 30) Group A (AI-based smart motor with adaptive torque control), Group B (conventional motor with preset torque limits), and Group C (conventional motor with auto-reverse operation). ProTaper Next rotary files were used to prepare the standardized canals. The main variables were file separation rate and dentinal microcracks incidence evaluated through micro-computed tomography (micro-CT). Preparation time, apical transportation, canal centering ratio, and motor operational parameters were the secondary outcomes.

RESULTS. Group A exhibited a much lower file separation rate (0% vs. 10.0% vs. 13.3% in Group B vs. Group C, p = 0.038) and fewer dentinal microcracks formed (16.7% vs. 43.3% vs. 50.0% p = 0.006). Group A recorded significantly lower peak of mean torque (2.1 + 0.4 Ncm compared to 2.8 + 0.6 Ncm in Group B compared to 2.9 + 0.7 Ncm in Group C, p < 0.001). Apical transportation (p = 0.284) and canal centering ratio (p = 0.412) showed no significant differences. Time of preparation did not differ among groups (p = 0.156).

CONCLUSIONS. Smart endodontic motors with adaptive torque control powered by AI allow a significantly lower file separation and dentinal microcrack formation than using conventional motors and offer similar shaping efficiency and preparation quality. Based on these findings, AI-based motor technology can be clinically adopted to improve the safety of the procedures.

INTRODUCTION. NiTi rotary files, which have been heat-treated, have shown an increase in the flexibility and cyclic fatigue resistance. But the effect of the changes of intracanal temperature during clinical instrumentation on file performance is not well known.

MATERIALS AND METHODS. NiTi files with heat treatment (n = 108) were used (ProTaper Gold, WaveOne Gold, and Reciproc Blue, n = 60 each) in a standardized artificial canal (angled at 60 and radius of curvature = 5 mm). The files were randomly selected into three temperature conditions (n = 20 / group): Group A (20°C – room temperature), Group B (37°C – normal body temperature) and Group C (45°C – higher inflammatory temperature). Fatigue test was carried out in a cyclic manner until file fracture. Fracture time (TTF) and cycles to failure (NCF) were measured. One-way ANOVA and Tukey post-hoc tests (0.05) were used in statistical analysis.

RESULTS. A major difference in cyclic fatigue resistance was found across temperature groups in each file system (p < 0.001). ProTaper Gold showed 412 ± 68 NCF at 45°C relative to 584 ± 92 at room temperature (20°C) (p < 0.001). WaveOne Gold was found to have 738 + 114 NCF at 45°C compared to 1024 + 156 NCF at 20°C (p < 0.001). Reciproc Blue used showed 896 ± 128 NCF at 45°C unlike 1246 ± 182 NCF at 20°C (p > 0.001). High temperature (45°C) decreased the cyclic fatigue resistance by 28929.5 percent in all the systems subjected to it.

CONCLUSIONS. Artificially reproduced elevated pulpal temperatures have a great influence in reducing cyclic fatigue resistance of heat-treated NiTi files. Endodontic practice requires the clinical awareness of temperature-dependent mechanical behavior to avoid instrument separation and complicate endodontic practice especially in inflamed teeth.

INTRODUCTION. The bond between gutta-percha and sealer is crucial for successful root canal (RC) filling, requiring sealers with optimal physical, chemical, and biological characteristics. Newer sealers aim to improve clinical outcomes, especially when smear layer removal enhances sealer flow and adhesion. This study compares the push-out bond strength (POBS) and failure modes of an MTA-based bioceramic sealer and a bioactive glass (BG)-based sealer using four different final irrigants.

MATERIALS AND METHODS. Eighty single-rooted mandibular premolars were decoronated to a length of 16 mm and prepared using ProTaper Gold rotary files with intermittent irrigation using 5.25% NaOCl. Samples were categorised into two main groups depending on the sealer employed [n = 40 (Nishika Canal Sealer BG and MTA Fillapex)] and further into four sub-groups according to the final irrigant [n = 10 (10% glycolic acid, MTAD, 18% Etidronic acid and normal saline). Following obturation with gutta-percha, the specimens were incubated at 37°C and 95% humidity. POBS was evaluated using a universal testing machine, and failure modes were analysed under a scanning electron microscope.

RESULTS. POBS obtained from the study were in the following order: Nishika Canal Sealer BG + Etidronic acid > MTA Fillapex + etidronic acid > Nishika canal sealer BG + glycolic acid > MTA Fillapex + glycolic acid > Nishika canal sealer BG + Normal saline > MTA Fillapex + MTAD > MTA Fillapex + normal saline > Nishika canal sealer BG + MTAD.

CONCLUSIONS. All irrigants used allowed proper setting of both sealers. This study indicates that the choice of chelating agent affects bond strength, with etidronic acid showing the highest dislodgement resistance for both sealers, while MTAD showed the lowest.

INTRODUCTION. Drug-induced osteonecrosis of the jaw (MRONJ) is one of the most severe complications of antiresorptive therapy in patients with osteoporosis, significantly impairing the quality of life. Despite the growing awareness of doctors, the frequency of MERS with prolonged use of bisphosphonates or denosumab remains in the range of 0.8–12.0%. The purpose of this work was to develop a comprehensive preventive strategy based on the analysis of risk factors aimed at reducing the incidence of MRONJ in patients with osteoporosis.

MATERIALS AND METHODS. A retrospective analysis of the medical records of 267 patients who received antiresorptive therapy at the Yizhida Dental Clinic in Shangqiu (China) from 2019 to 2023 was conducted. Dental status, biochemical markers of bone metabolism, treatment regimens, and concomitant risk factors were assessed. Various preventive approaches were compared. The results show that dental screening and oral sanitation before starting antiresorptive treatment reduces the risk of MERS by 72.6%.

RESULTS. Maintaining the level of β-CrossLaps above 150 pg/ml was associated with a 63.8% reduction in risk. Individualized surgical interventions, taking into account risk stratification, reduced the incidence of postoperative complications from 11.1% to 0% (with the combined protocol). The comprehensive preventive model provided a significant reduction in the 4-year cumulative incidence of MRONJ from 7.1% to 1.1%, while the effectiveness of the main antiresorptive therapy was not affected.

CONCLUSIONS. The analysis makes it possible to recommend a multi-level prevention system, including dental screening, biomarker monitoring, and surgical tactics adapted to individual risk, as an effective strategy for preventing MERS in patients with osteoporosis.

INTRODUCTION. Metal, polymer, and ceramic implants are examples of biocompatible implants that are frequently suggested to enhance osseointegration and promote bone formation. The goal of this study was to improve osseointegration by developing a new interface. This contact exists between bone tissue and the polymeric component. Silicon dioxide material is applied to PEEK (polyether ether ketone) plastic in this work coat.

MATERIALS AND METHODS. Thirty New Zealand rabbits received sixty implants. Each rabbit has two implants in its tibia. Ten rabbits were scarified at two, four and six, weeks following implantation. The left tibia implant was experimental (coated with silicon dioxide), while the right tibia implant was control (uncoated) for every animal. Following hematoxylin and eosin staining, each section was histologically inspected and evaluated for histomorphometric analysis to count bone cells (osteoblast, osteocyte, and osteoclast) and the area of new bone is formed.

RESULTS. In comparison to control groups, histological results for silicon dioxide-coated PEEK implants showed a more rapid of bone growth, mineralization, and maturation. Significant difference of histomorphometric examination of every bone parameter was very high between the control and experimental groups during the course of all healing intervals.

CONCLUSIONS. According to the current study, the nano-silicon dioxide coating promotes faster osseointegration than an uncoated implant, improving bone formation and increasing the healing rates.

INTRODUCTION. Buccal infiltration using 4% articaine with epinephrine is a widely preferred anesthetic technique for maxillary molars. However, failures in achieving profound pulpal anesthesia, especially in teeth with irreversible pulpitis, remain clinically challenging. Anatomical factors such as root length may influence anesthetic diffusion but are seldom investigated.

AIM. To evaluate the effect of root length on the success rate of buccal infiltration anesthesia in maxillary first molars diagnosed with irreversible pulpitis.

MATERIALS AND METHODS. A prospective single-arm clinical trial was conducted on 60 adult patients with irreversible pulpitis in maxillary first molars. Following buccal infiltration with 1.7 ml of 4% articaine containing 1:100,000 epinephrine, pain responses during dentin removal, pulp chamber access, and canal instrumentation were recorded using the Heft-Parker Visual Analog Scale. Root lengths were measured radiographically using a standardized endodontic protocol. Anesthetic success was defined as no or mild pain at any procedural stage.

RESULTS. Overall anesthetic success was 81.1%. Success rates by root were: mesiobuccal 83.3%, distobuccal 81.7%, and palatal 78.3%. Mean root lengths were 18.8 ± 1.5 mm (mesiobuccal), 19.1 ± 1.5 mm (distobuccal), and 20.6 ± 1.7 mm (palatal). No statistically significant correlation was found between increased root length and anesthetic failure (p > 0.05).

CONCLUSIONS. The variations in the lengths of different roots of maxillary first molars do not significantly affect the success rate of buccal infiltration anesthesia in cases of irreversible pulpitis.

Fusion between a tooth and a supernumerary one that involves the union of two distinct tooth germs into a single with an enlarged dental structure. This case reports the endodontic treatment of a fusion involving a third molar and a supernumerary tooth (distomolar) in the left mandibular region of a 46-year-old female. This condition presented significant diagnostic and clinical challenges due to its atypical crown anatomy, two distinct pulp chambers, and morphological complexities that complicate traditional access and preparation. The diagnosis relied on comprehensive clinical examination and conventional radiographic analysis and the cone beam computed tomography, emphasizing the clinician’s skill in interpreting subtle findings. Non-surgical endodontic therapy was planned, executed in two sessions, with the use of the Logic 2 (25.05) nickel-titanium rotary instruments and an extensive irrigation protocol using 5.25% sodium hypochlorite and 17% EDTA under active ultrasonic agitation. A key element of success was the consistent use of an operating microscope (20x magnification), which was instrumental in refining access, navigating complex anatomy, and ultimately confirming the presence of five distinct root canals. Tri-dimensional canal sealing was achieved with Tagger’s Hybrid technique. This meticulous approach resulted in the functional maintenance of the tooth for over five years, showing that despite rare and complex morphological variations, advanced technological aids and thorough clinical expertise are paramount for achieving successful, long-term outcomes in endodontic treatment.

INTRODUCTION. Endodontic-periodontal combined lesions are complicated clinical cases with prognoses that vary in their predictability with regard to the underlying etiology and involvement. The interdependence between lesion classification and outcome of treatment is yet to be fully defined.

MATERIALS AND METHODS. 165 teeth with endodontic-periodontal lesions were used in a prospective cohort study (Group A primary endodontic lesions with secondary periodontal involvement, n = 55), Group B primary periodontal lesions with secondary endodontic involvement, n = 55) and Group C true combined lesions, n = 55). Every tooth was subjected to the right endodontic and periodontal treatment. Clinical outcomes such as probing pocket depth (PPD), clinical attachment level (CAL), tooth mobility, as well as periapical index after 3, 6, 12 months were evaluated. Success with the treatment, survival of the teeth, and patient-reported outcomes were assessed.

RESULTS. The general success rate of treatment was 73.3 and the differences between the groups were significant: Group A (89.1%), Group B (69.1%), Group C (61.8%), p<0.001. Groups A showed better results with 4.82 plus or minus 1.24 mm difference in mean PPD reduction compared to 3.41 plus or minus 1.38 mm difference in Group B and 2.87 plus or minus 1.52 mm difference in Group C at the age of 12 months (p < 0.001). Group A, Group B and Group C showed a mean CAL gain of 4.15 + 1.18 mm, 2.94 + 1.32 mm and 2.31 + 1.45 mm respectively (p < 0.001). The tooth survival rates in Group A (94.5), Group B (83.6), and Group C (76.4) were significant (p = 0.012). Patients with initial PPD > 7 mm (OR = 3.84, p < 0.001) and true combined lesions (OR = 4.92, p < 0.001) were important predictors of treatment failure.

CONCLUSIONS. Primary endodontic lesions through secondary periodontal involvement portray highly better treatment results than primary periodontal lesions or true combined lesions. Lesion classification is a vital prognostic factor, which is used in the treatment planning and counseling of patients.

INTRODUCTION. Chronic periapical lesions are an outcome of pulpal necrosis that necessitates final treatment. Although the traditional endodontic treatment is still the gold standard, the use of adjunctive interventions based on oral medicine and conservative pharmacological approaches as potential modes of treatment have been proposed.

MATERIALS AND METHODS. A prospective comparative study was performed on 180 patients with chronic periapical lesions who were grouped as Group A (conventional endodontic therapy only, n = 60), Group B (endodontic therapy plus systemic pharmacological intervention, n = 60) and Group C (conservative oral management and delayed endodontic intervention, n = 60). The main outcomes were the level of healing success, reduction of the size of the lesion, and the resolution of the symptoms measured at 3, 6, and 12 months. Secondary outcomes were pain scores, quality of life and treatment complications.

RESULTS. 12 months overall success rates were: Group A (83.3%), Group B (91.7%), Group C (45.0%), p < 0.001. The lesion size reduction in terms of the mean was also 4.82 ± 1.24 mm (Group A), 5.67 ± 1.18 mm (Group B) and 2.14 ± 1.52 mm (Group C), p < 0.001. Total periapical healing Group A (76.7), Group B (85.0) and Group C (33.3), p < 0.001. The Group B (4.2 + 1.8 days) and the Group C (12.6 + 4.8 days) had significantly shorter pain resolution times when compared to Group A (6.8 + 2.4 days), p < 0.001. The highest level of patient satisfaction was obtained in Group B (8.64 + 1.12) in comparison to Group A (7.92 + 1.34) and Group C (5.28 + 1.86), p = 0.001. Group A, 10.0%: Group B, 5.0%: Group C, 41.7%: treatment failure requiring surgical intervention was found.

CONCLUSIONS. Endodontic therapy with systemic pharmacological intervention has better results compared to endodontic therapy or conservative oral medicine treatment. The outcome of conservative pharmacological treatment without conclusive endodontic therapy is far worse and thus there is a need to treat the infectious etiology to achieve success in treating periapical lesions.

INTRODUCTION. Convolutional neural networks (CNNs) show strong promise for automating dental diagnosis from radiographic images. Robust head-to-head comparisons across tasks and datasets are needed to guide model selection for clinical use.

MATERIALS AND METHODS. We compared three lightweight CNNs – EfficientNet-B0, ResNet-18, and MobileNetV3 – for two classification tasks: enamel caries on intraoral images and periapical lesions on panoramic radiographs. Data comprised the Caries-Spectra dataset (2,000 intraoral images; advanced, earlystage, and no caries) and a panoramic radiograph set with 13,071 images labeled with periapical lesion scores (PAI 3–5). For the periapical task, data augmentation was applied to the panoramic training split only, increasing its size to 17,004 training instances; validation and test splits (as well as all Caries-Spectra splits) remained at their original sizes. Models were trained via transfer learning with early stopping and evaluated using accuracy, precision, recall, F1-score, and confusion matrices.

RESULTS. EfficientNet-B0 achieved the best overall performance on both tasks, reaching 99.74% accuracy for caries detection and 69.65% accuracy for periapical lesion detection, outperforming ResNet18 and MobileNetV3 across the reported metrics.

CONCLUSIONS. Lightweight CNNs – particularly EfficientNet-B0 – are effective for dental image classification and are suitable candidates for integration into clinical diagnostic workflows. Model architecture choice and data quality materially influence performance

INTRODUCTION. Evaluation of endodontic treatment outcomes through radiographic assessment is subject to interobserver variability and depends heavily on clinician experience. Artificial intelligence (AI) platforms offer potential for standardized, objective assessment of periapical healing.

MATERIALS AND METHODS. This retrospective study analyzed 400 panoramic radiographs from patients who underwent root canal treatment between January 2023 and December 2024. An AI platform developed using TensorFlow and Keras, with model training in PyTorch and validation in MATLAB Deep Learning Toolbox, was employed. Three blinded expert endodontists independently assessed all radiographs, with consensus serving as the gold standard. Outcomes were classified as healed, healing, or diseased based on periapical index criteria. Diagnostic performance metrics including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

RESULTS. The AI platform demonstrated overall accuracy of 89.8% in classifying treatment outcomes. For detecting healed cases, sensitivity was 92.3%, specificity 87.6%, PPV 88.9%, and NPV 91.5%. For diseased / persistent pathology detection, sensitivity was 88.7%, specificity 93.2%, PPV 84.3%, and NPV 95.1%. Agreement between AI and expert consensus was substantial (Cohen’s κ = 0.834, p < 0.001). AI performance was superior in anterior teeth (93.2% accuracy) compared to molars (86.4% accuracy, p = 0.008). Processing time per radiograph averaged 2.3 ± 0.4 seconds.

CONCLUSIONS. The AI-driven platform demonstrated high diagnostic accuracy comparable to expert assessment, with potential for standardized, rapid evaluation of endodontic treatment outcomes. Further prospective validation and clinical integration studies are warranted.

INTRODUCTION. The article presents the results of a study of the ratios of apex roots of premolars and molars of the upper jaw to the bottom of the maxillary sinus based on the analysis of 288 cone-beam computed tomograms (CBCT).

MATERIALS AND METHODS. The sample included patients older than 25 years, divided into five age groups, adjusted for gender. Measurements were made in the sagittal and axial planes with an accuracy of 0.1 mm, using Romexis Viewer software and statistical analysis in SPSS (ANOVA, Pearson correlation analysis).

RESULTS. Key findings: Distances from apex to sinus floor decrease with age (r = –0.45 to –0.72, p < 0.01), with lower values in females and variability up to 50% in older groups. Minimum distances (up to –0.95 mm) are observed in the 65+ year group, indicating a risk of perforation in 15-30% of patients. ANOVA revealed significant differences between groups and sexes (F = 4.12–6.78, p < 0.05), with a tendency for apexes of premolars and molars to approach the bottom. The clinical significance of the results obtained lies in the reduction of the risks of complications (sinusitis, perforation) during dental interventions due to the preventive use of CBCT.

CONCLUSIONS. The data contribute to personalized treatment planning, particularly in older patients and women.

INTRODUCTION. The intracanal fracture of nickel-titanium (NiTi) rotary instruments remains a significant procedural concern in endodontics. Advances in metallurgy, manufacturing processes, and geometric design have led to the development of new file systems with enhanced mechanical properties. The Hyflex EDM OGSF (HEDM), Protaper Ultimate (PTU), and RACE EVO (RE) systems represent distinct technological approaches to improving instrument safety. However, a direct comparative evaluation of their fracture resistance is limited.

MATERIALS AND METHODS. A total of 120 new NiTi files, 40 from each system (HEDM, PTU, RE), with a tip size of 25 and a .07 taper, were selected. For the cyclic fatigue test (n = 20 per group), instruments were rotated in a custom-fabricated stainless steel artificial canal with a 60° angle of curvature and a 5 mm radius until fracture. The number of cycles to fracture (NCF) was calculated. For the torsional resistance test (n = 20 per group), the apical 3 mm of each file was clamped, and the instrument was rotated clockwise at 2 RPM until fracture, following ISO 3630-1 standards. Maximum torque (Ncm) and angular deflection (degrees) at failure were recorded. Data were statistically analyzed using one-way ANOVA and Tukey’s HSD post-hoc test (α = 0.05).

RESULTS. HEDM exhibited a significantly higher mean NCF (852.5 ± 75.3) compared to both RE (621.8 ± 60.2) and PTU (455.1 ± 55.4) (p < 0.001). RE also showed significantly higher cyclic fatigue resistance than PTU (p < 0.001). In the torsional test, PTU demonstrated the highest maximum torque to fracture (0.46 ± 0.05 Ncm), which was significantly greater than RE (0.41 ± 0.04 Ncm) and HEDM (0.34 ± 0.06 Ncm) (p < 0.001). The difference in torque resistance between RE and HEDM was also statistically significant (p < 0.01).

CONCLUSIONS. Within the limitations of this laboratory study, the Hyflex EDM OGSF file system demonstrated the highest resistance to cyclic fatigue. The Protaper Ultimate file system exhibited the greatest resistance to torsional fracture. The choice of instrument should be guided by the specific anatomical challenges of the root canal system.

AIM. The aim of the study was to compare the effectiveness of a new method of endodontic treatment a chronic fibrous pulpitis with a standard, generally accepted method at the end of 1 month and 12 months after treatment.

MATERIALS AND METHODS. were examined a total of 186 patients aged 20 to 60 years, including 94 (50.5%) men and 92 (49.5%) women, who underwent primary endodontic treatment of 302 teeth of various groups with a diagnosis of a chronic fibrous pulpitis (K04.03). A comparative assessment of the effectiveness of treating this pathology using various methods was carried out through an analysis of patient complaints, clinical examination, and radiographic monitoring of the condition of the tooth root canals and surrounding tissues. To statistically analyze the effectiveness of chronic fibrous pulpitis treatment using our method (Russian Federation Patent No. 2771916, May 13, 2022), we used the McNemar Q-test over time for the periods at the end of 1 month and 12 months after treatment.

RESULTS. In the first month after treatment, patients in Group III experienced minimal or no pain compared to patients in Groups I and II (p < 0.05). A comparative analysis of immediate radiographic treatment results revealed significant improvements in clinical outcomes when using our method compared to standard protocols (p < 0.05). After 12 months from the completion of treatment, a higher number of teeth with changes in the periodontal tissues was determined in patients of the first group and gradually decreased in the second and especially in the third group (χ² = 9.75, df = 1, p = 0.002; χ² = 7.03, df = 1, p = 0.008).

CONCLUSIONS. The conducted comparative analysis of the effectiveness of the new method and standard methods of treating a chronic fibrous pulpitis allows us to establish a significant advantage of our proposed method based on clinical and radiographic research methods (χ² = 9.87, df = 1, p = 0.002).

INTRODUCTION. Oral cancer screening during dental consultations is a simple and non-invasive method for identifying pre-malignant lesions and early-stage malignancies. This research aimed to examine the knowledge, behaviours, and attitudes related to oral cancer screening among dentists in Najaf City.

MATERIALS AND METHODS. Data were gathered using a structured questionnaire and self-reported interviews with 250 dentists, performed from October 15, 2023, to December 20, 2024, at the Martyr Nasser specialised Centre and the specialised centre in the Maysan area. Each dentist required around 5 to 10 minutes to complete the self-report questionnaire and participate in the interview on their knowledge of screening.

RESULTS. 250 dentists were asked to participate in the research, and all of them filled out the survey, yielding a 100% response rate. The dentists’ knowledge of oral cancer in this study was not very good overall. Most dentists in this survey (87.6%) regularly check their patients’ oral mucosa, but only a small number (49.2%) say they are sure they can diagnose and find oral cancer. About 49% of dentists lack confidence in diagnosing and detecting oral cancer.

CONCLUSIONS. Dentists have a good understanding of oral cancer, but they need more training on how to prevent it and find it early. They should also keep learning and going to seminars.

INTRODUCTION. Modern approaches to the prevention of dental diseases in children require the use of objective methods for assessing oral hygiene, particularly in socially vulnerable groups.

AIM. The aim of this study was to evaluate the effectiveness of quantitative light-induced fluorescence (QLF) technology in assessing oral hygiene status in children living in residential care institutions.

MATERIALS AND METHODS. The study included 207 students of boarding schools in the Yaroslavl and Moscow regions and 197 children living in families (control group). The observation period lasted 24 months. Examination was carried out before and after the implementation of a comprehensive preventive program, which included instruction in proper oral hygiene techniques, motivational sessions, and supervision of individual oral care. The Qscan (QLF) system, the IGR-U oral hygiene index (modified Green–Vermillion index), and clinical assessment of periodontal tissues (PMA index) were used.

RESULTS. A statistically significant reduction in the area and intensity of fluorescent dental plaque was observed in children from residential care institutions after the program (p < 0.05), accompanied by improvement in hygiene indicators. In the control group, positive changes were present but less pronounced.

CONCLUSIONS. QLF technology enabled early detection of hygiene deficiencies and provided more precise monitoring of individual preventive measures compared with visual methods. The findings support the inclusion of QLF in clinical monitoring protocols for oral health in children living in residential care institutions.

AIM. To evaluate the attitude of practicing prosthodontists toward the use of implant-supported provisional crowns in the esthetic zone and to identify the main clinical challenges and complications associated with temporary restorations.

MATERIALS AND METHODS. A pilot survey study was conducted using a structured electronic questionnaire consisting of nine questions. A total of 120 prosthodontists with more than 10 years of clinical experience in implant-supported restorations participated. Forty percent worked in public dental institutions and 60% in private clinics. The survey analyzed the frequency of provisional crown use, treatment protocols, application of digital technologies, and soft tissue complications.

RESULTS. Sixty percent of respondents routinely use provisional crowns in the esthetic zone. Immediate implantation is performed by 86% of clinicians. However, 66.7% reported soft tissue complications, including gingival recession, loss of interdental papillae, and changes in gingival contour and color. Digital workflows are implemented by 66.7% of clinicians, while only 20% possess 3D crown modeling skills. Notably, 73% of respondents do not follow a standardized prosthetic protocol in the esthetic zone.

CONCLUSIONS. Implant-supported provisional crowns represent a critical component of esthetic rehabilitation. The absence of a unified treatment protocol highlights the need for evidence-based clinical guidelines. The integration of digital technologies and 3D modeling enhances treatment personalization and improves predictability of esthetic outcomes.