AIM. This systematic review aims to systematically assess the efficacy of selective enamel etching compared to conventional etching methods in reducing the incidence and severity of white spot lesions during fixed orthodontic therapy.

MATERIALS AND METHODS. A systematic literature search was performed following the PRISMA 2020 statement and was registered on PROSPERO (CRD420251026790). The databases PubMed, Scopus, Embase, and Google Scholar were searched for randomized controlled trials, split-mouth studies, and prospective cohorts up to 15 July 2025 that compared selective and conventional enamel etching in patients undergoing fixed orthodontic treatment. The primary outcomes included incidence, severity, and timing of white spot lesions during orthodontic treatment. The study quality was assessed using the JBI checklist.

RESULTS. Four studies, including 131 patients, fulfilled the inclusion criteria. All the included studies showed that selective etching decreased the early development of white spot lesions or delayed it for a period, especially in the first 3–6 months of orthodontic treatment. The long-term differences, however, were less pronounced at the end of the treatment. No adverse effects or an increased bond failure rate related to selective etching was reported.

CONCLUSIONS. Selective enamel etching offers an initial protective effect because it delays the development of white spot lesions in the early stages of orthodontic treatment. However, it is not known with certainty if selective enamel etching has a long-term benefit due to the limitation of evidence. Therefore, it must be considered an adjunctive preventive measure until confirmation is obtained from larger, standardized clinical trials.

AIM. Enterococcus faecalis is a gram-positive facultative anaerobe commonly known as the primary pathogen implicated in persistent and secondary endodontic infections, due to its exceptional capacity to invade dentinal tubules, form resistant biofilms and survive in nutritionally adverse alkaline environments. Although effective, conventional chemical irrigants like sodium hypochlorite and chlorhexidine have been found to cause cytotoxicity and other unwanted effects. Sea buckthorn (Hippophae rhamnoides L.) is a medicinal plant that has shown promise as a natural antimicrobial agent due to its richness in flavonoids, polyphenols, carotenoids and unsaturated fatty acids. The purpose of this review is to summarize and examine existing evidence on the antimicrobial efficacy, mechanisms of action, and clinical potential of sea buckthorn against E. faecalis in the context of root canal infections.

MATERIALS AND METHODS. The literature review was conducted thoroughly by using the PubMed, Embase and Cochrane Library databases. The review incorporated studies in English that involved phytochemical, microbiological, in vitro, and in vivo studies that were relevant to the study involving the use of sea buckthornderived agents when conducting dentistry and endodontics research.

RESULTS. Extracts of sea buckthorn exhibit broad-spectrum antimicrobial activity that can be ascribed to bioactive compounds, such as quercetin, kaempferol, isorhamnetin, palmitoleic acid and ascorbic acid. Disruption of bacterial cell membranes, inhibition of biofilm formation, suppression of acid production, and modulation of host inflammatory responses are all reported antibacterial mechanisms. Aqueous and hydroalcoholic leaf extracts have demonstrated growth-inhibitory action against E. faecalis, whilst, pulp oilbased preparations have demonstrated anti-biofilm activity against a variety of oral pathogens. Comparative studies indicate similar, and in certain cases better, efficacy compared with chlorhexidine, and much better biocompatibility.

 CONCLUSIONS. Sea buckthorn is a biocompatible, multifunctional adjunct that can be used as an endodontic irrigant or intracanal medicament. Nonetheless, before it can be adopted into routine clinical practice, standardization of extraction techniques, optimal concentrations, and optimally designed randomized clinical trials are required.

AIM. Preventing bacterial adhesion and eventual secondary caries requires maintaining a smooth dentin surface. The aim of this study is to reduction of dentin surface roughness (Ra) using Er,Cr:YSGG Laser with or without Silver Diamine Fluoride (SDF).

MATERIALS AND METHODS. In order to simulate beginning demineralisation, 65 dentin specimens were prepared and put through a pH-cycling model. After that, the specimens were split into four treatment groups (each with 13 participants) and a control group (also with 13 participants) at random: (1) Laser alone, (2) SDF alone, (3) Laser followed by SDF (Laser + SDF), and (4) SDF followed by Laser (SDF + Laser). Three phases were used to quantify Ra: baseline, pH-cycling, and treatment.in addition, Scanning Electron Microscopy was used to characterize the surface morphology of dentin specimens. Least Significant Difference (LSD) post-hoc analysis was performed after One-Way ANOVA and Paired Samples t-tests and Independent Samples t-tests were used to analyse the data.

RESULTS. The SDF + Laser, Laser, and SDF groups all produced statistically significant increase in surface roughness as compared to their pre-treatment values, according to the Paired Samples t-test. On the other hand, there was a slight and insignificant shift in the Laser + SDF group (p = 0.861). The LSD-test and One-Way ANOVA revealed a highly significant difference (p < 0.0001) between the treated groups’ final roughness levels. At 0.60 ± 0.018 µm, the Laser + SDF group had the lowest final roughness, whereas at 0.68 ± 0.019 µm, the SDF + Laser group had the highest.

CONCLUSION. The demineralized dentin surface’s roughness was considerably increase by all treatment methods, except Laser followed by SDF protocol where the smoothest surface was created. This is the best order for maintaining the integrity of the dentin surface.

INTRODUCTION. Maxillary lateral incisor (MLI) hypodontia is a significant developmental dental anomaly with profound aesthetic and functional implications. While global prevalence typically ranges from 1.6% to 6.9%, data regarding its occurrence in specific Middle Eastern populations remains limited. This study aimed to investigate the prevalence, distribution, and sex-specific patterns of MLI agenesis in an Iraqi adolescent cohort from Babylon City.

MATERIALS AND METHODS. A retrospective cross-sectional analysis was conducted on 2,196 high-quality orthopantomograms of patients aged 12–18 years, retrieved from academic and private clinical archives between 2017 and 2023. Cases with craniofacial syndromes, previous orthodontic extractions, or trauma were excluded. MLI agenesis was radiographically confirmed by the absence of the tooth germ. Statistical analysis was performed using chi-square tests (p < 0.05).

RESULTS. The overall prevalence of MLI hypodontia was 13.8% (n = 304), notably exceeding reported global averages. No significant difference was found in overall occurrence between males (13.8%) and females (13.9%) (p = 0.98). Unilateral agenesis was significantly more frequent than bilateral involvement (70.1% vs. 29.9%, p < 0.001). Left-sided agenesis (52.6%) was the most common presentation. Distinct sex-dimorphic patterns were observed: males exhibited higher proportions of bilateral and right-sided agenesis, whereas females demonstrated a predilection for unilateral left-sided involvement (p = 0.016).

CONCLUSIONS. The prevalence of MLI hypodontia in Babylon City is remarkably high, characterized by a predominant unilateral, left-sided distribution. The identified sex-specific patterns suggest potential underlying genetic or epigenetic influences within this population. These findings underscore the necessity for early radiographic screening and a coordinated multidisciplinary approach to mitigate the long-term aesthetic, occlusal, and psychological sequelae associated with this condition.

AIM. The objective of this study is to understand the knowledge of periodontal medicine among third year, final year and dental interns.

MATERIALS AND METHODS. This cross-sectional questionnaire-based study was conducted among dental students in Chengalpattu district, Tamil Nadu – India, belonging to third year, final year and Interns. A total of 15 questions about the prevalence, etiology, signs, association, risk factors, and treatment of periodontal medicine were included in the questionnaire.

RESULTS. Based on our study findings, a Moderate level of overall periodontal medicine knowledge was found. Although there were differences between genders in years of study in regards to disease prevalence / reasons / associations – there were statistically significant differences (p < 0.05) regarding the clinical signs of periodontal disease (i.e., clinical signs of scurvy). A few associations were also identified as having a relationship between periodontal disease as well as two or more systemic diseases i.e., atherosclerotic heart disease. In each domain of knowledge there were identifiable risk factors associated with periodontal disease – while low-dose doxycycline was found by essentially all participants to be the best treatment of periodontitis for diabetic patients in comparison to other medications. There was no statistically significant difference found for either gender or the year of study.

CONCLUSIONS. Among the dental students, there is a good amount of knowledge regarding the relationship between periodontal disease and various systemic illnesses. Further, knowledge should be spread on anticipatory guidance to patients on periodontal disease and its association with systemic illnesses.

AIM. Systemic lupus erythematosus (SLE) is an autoimmune disease known by immune response disturbance and imbalanced in oxidative stress status. one of the SLE features is an oral ulcer that is associated with oxidative stress, the present study aims to assess some oral ulcer types and features with GST (GSTT1, GSTM1 and GSTP1) null genotyping in SLE with and without oral ulcer in addition to its types and features.
MATERIALS AND METHODS. Null genotyping PCR was used to detect GSTT1, GSTM1 and GSTP1.
RESULTS. They show significant association of GSTM1 and GSTP1 with SLE (p = 0.0010, p = 0.0024) respectively, and non-significant changes of GSTT1 (p = 0.7426) when compared with the control group. a cross section comparison GST between SLE patients with and without oral ulcer shows a significant association of GSTT1 (p = 0.0367) and a non-significant association of GSTM1 (p = 0.1056) and GSTP1 (p = 0.218). The number of oral ulcers (single and multiple ulcers) shows a non-significant association in all GST genes (p = 0.882, 0.959, 0.552) respectively. The painful oral ulcers show non-significant association of GST genes (p = 0.803, 0.143, 0.585) respectively, the oral ulcer types included buccal, palatal, labial and tongue, were non-significantly (p = 0.608) correlated with GST.
CONCLUSIONS. There was a strong association of GSTM1 and GSTP1 with SLE, a non-significant association of the GST with oral ulcer types and features.

AIM. This study aimed to evaluate the influence of different instrument tapers on the enlargement and morphological alterations of the apical foramen in curved mesial canals of mandibular molars.

MATERIALS AND METHODS Forty mesial canals from mandibular molars with moderate curvature were randomly allocated into five experimental groups (n = 8) based on the taper of the final instrumentation file: 25/.01, 25/.03, 25/.04, 25/.05, and 25/.06. Irrigation was performed with 2.5% sodium hypochlorite and 17% EDTA. The foraminal area and shape were assessed using stereomicroscopy (40x magnification) and ImageJ before and after preparation. Non-parametric tests (Dunn and Wilcoxon) were used for intragroup and baseline comparisons. Parametric tests (ANOVA and Tukey) were applied to compare the percentage of foraminal enlargement between groups, and the Chi-square test evaluated alterations in foraminal shape. The significance level was set at 5% (α = 0.05).

RESULTS. All tapers resulted in a statistically significant increase in the apical foraminal area (p < 0.05). The 25/.01 and 25/.06 instruments produced the greatest percentage increases in area (85.09% and 92.76%, respectively), whereas the 25/.03 and 25/.05 instruments promoted the most conservative enlargement (39.43% and 32.41%, respectively). However, no statistically significant difference was observed among the groups regarding the alteration of the foraminal shape (p > 0.05).

CONCLUSIONS. The taper and the cross-section design of the endodontic instrument significantly influenced the apical foraminal enlargement but did not have a significant effect on the preservation of its original morphology. Instruments with .03 and .05 tapers resulted in the most conservative foraminal preparation.

INTRODUCTION. Dental caries is one of the most common and multifactorial dental diseases. Dental caries in children aged 6 to 71 months is a complex and serious issue in pediatric dentistry. Risk factors for the development of this disease require a comprehensive and integrated assessment to understand the causes and develop prevention programs. Sociological research is essential for assessing and analyzing the risk factors for early childhood caries. Surveys, as one of the sociological research methods, can provide a high level of sample size and the data necessary for analyzing the risk factors for early childhood caries.

AIM. To study prenatal and postnatal risk factors for early childhood caries based on questionnaire data.

MATERIALS AND METHODS. A survey of 1,440 children aged 1 to 5 years living in Moscow was conducted. During the clinical examination, a questionnaire was administered to parents (legal guardians) to assess prenatal and postnatal risk factors for early childhood caries. The questionnaire questions concerned the course of pregnancy, especially the second half; at what age it is necessary to visit a pediatric dentist; whether primary teeth need to be treated; whether the child was night-fed after the eruption of primary teeth; the timeliness of primary teeth eruption; and at what age teeth cleaning and oral hygiene are started. All questions had one answer option. The questionnaire data were entered into Excel tables and statistical processing of the research results was performed using the R 4.2.2 programming language for statistical data processing. Statistical significance was assessed at the α = 0.05 level; the results were considered statistically significant at p < 0.05.

RESULTS. A statistically significant relationship was found between the prevalence of early childhood caries and the pathological course of the mother’s second pregnancy (χ² = 600.1, df = 1, p < 0.0001). A statistically significant relationship was found between the prevalence of early childhood caries and the timing of eruption of primary teeth (χ² = 278.1, df = 2, p < 0.0001). The risk of developing caries with early eruption is 2.6 (95% CI (2.24–2.92)) times higher than with timely eruption, and 3.96 (95% CI (3.09–5.07)) times higher than with late eruption. A statistically significant relationship was found between the prevalence of early childhood caries and the time of initiation of tooth brushing (χ² = 15.15, df = 2, p < 0.00051). The risk of developing caries in the absence of oral hygiene is 1.3 times higher (95% CI (1.07–1.56)) than in children who start brushing their teeth at 12 months, and 2.6 times higher (95% CI (1.98-3.48)) than in children with good oral hygiene from the moment of eruption. A statistically significant association was found between the absence of caries and night feeding of a child after the eruption of primary teeth (χ² = 227.8, df = 1, p < 0.0001). Night feeding of children up to 12 months after the eruption of primary teeth is not a risk factor for early childhood caries. The prevalence of early childhood caries in patients who began visiting a pediatric dentist before 12 months was 33.3%, from 12 – 40.8%, in case of the need for dental treatment – 33.4% (χ² = 7.38, df = 2, p < 0.025). However, the odds ratio for the groups before 12 and from 12 months did not reach statistical significance 1.22 (95% CI (0.91–1.65)), which makes it difficult to interpret the effect size. A statistically significant relationship was found between the prevalence of early childhood caries and parents’ knowledge about the need for treatment of primary teeth (χ² = 13.33, df = 1, p < 0.001).

CONCLUSIONS. The questionnaire method allowed for a high level of participation in the study and the data necessary for analysis. Analysis of the questionnaire results revealed that the most important prenatal risk factor for early childhood caries is the course of pregnancy, particularly the second half, as this is when the mineralization of primary tooth buds begins. Postnatal risk factors for early childhood caries include the early eruption of primary teeth, the lack of hygiene measures after the eruption of primary teeth, the lack of awareness among parents regarding the need for visits to a pediatric dentist to discuss a preventive care plan, and a lack of awareness regarding the need for treatment of primary teeth. In children under 12 months of age, night feeding after the eruption of primary teeth is not a risk factor for early childhood caries.

INTRODUCTION. The optimum root canal treatment outcome is usually governed by excellent instrumentation and shaping of the endodontic system, debridement and ultimate disinfection protocol. Therefore, it is extremely necessary to investigate the complicated morphology of the endodontic system with a reliable and accurate methodology.

MATERIALS AND METHODS. Three hundred and eighty-four CBCT images (620 total number of teeth) of Iraqi people aged 15–45 years old and obtained between 2019–2024 were collected. CBCT scans of maxillary premolars (U4 and U5) were examined in three different planes (axial, coronal, and sagittal) to identify root number, root canal number and its configuration (according to Vertucci classification) and, tooth anomalies including. These findings were correlated with gender. Pearson chi-square (χ²) test was used for data comparison at confidence interval (95%), and margin of error (0.05).

RESULTS. Seventy percent of the examined U4 had 2 roots, while triple and single-rooted represented 1% and 29% of overall samples, respectively. Seventy-nine percent of the examined U5 had 1 root, while triple and double-rooted represented 0% and 21%, respectively. The predominant canal number in the U4 was two (71%), followed by single and triple canals in 27% and 1% respectively with predominant type V configuration. For U5, 70% comes with single canal and 29% with double canals with type I predominant configuration. Majority of these parameters showed statistical relations with tooth and gender.

CONCLUSION. This study used CBCT to identify internal canal anatomy in a sample of permanent maxillary premolars drawn from an Iraqi population, with variations in prevalence related to gender and tooth. With particular reference to the little likelihood of presenting more than two roots and canals in the U4 and more intricate canalicular anatomy in the middle third of this root, clinicians should be mindful of the tooth’s diversified anatomical complexity. This could help dentists perform endodontic procedures and hence impact the result. However, there is not enough data to suggest that this tooth be scanned in three dimensions prior to endodontic treatment.

AIM. The study was intended to compare the shear bond strength (SBS) of universal composite with three different liners and two different adhesive systems.

MATERIALS AND METHODS. Sixty maxillary premolar teeth with 3mm diameter and 2 mm depth cavities were prepared and categorized into 3 groups of twenty each. Each group was filled with the respective liners Group I: Biodentine; Group II: Resin Modified Glass Ionomer Cement (RMGIC); Group III: Mineral trioxide aggregate (MTA). Each group had two subgroups according to the adhesive system used: Group A (Prime & Bond, universal adhesive) and Group B (Te-Econom Bonding agent). A split teflon mould was used to build a composite resin of dimensions 2 mm in diameter and 4 mm in depth, and light-cured. The SBS was determined by utilising a knife-edge blade in a universal testing machine, and fractured surfaces were evaluated under a scanning electron microscope.

RESULTS. The findings revealed that RMGIC achieved adequate SBS to universal composite and showed a mixed mode of failure compared to other groups. Applying a self-etch adhesive (Prime & Bond) between RMGIC and universal composite resin significantly enhances SBS as opposed to a total-etch adhesive (Te-ECONOM). Whereas Biodentine and MTA exhibited lower SBS when immediately bonded to the universal composite.

CONCLUSIONS. Based on the findings of this study, RMGIC is established as an optimal material for indirect pulp capping in clinical practice, and Biodentine and MTA are ideal for vital pulp therapy in cases of pulp exposure, with Biodentine yielding superior results.

INTRODUCTION. Geographic Tongue is the most common abnormalities of the tongue that etiopathogenesis of them remains to be clarified. This disorder is strongly suspected to be influenced by genetic factors and other predisposition factors. Several studies have revealed that this lesion occur more frequently on women than on men.

AIM. The aim of this research is to determine the distribution of geographic tongue, based on the gender, burning sensation, sites of occurance and predisposing factors among the dental students.

MATERIALS AND METHODS. By distributing a questionnaire, 110 dental students participated in a cross-sectional study. A statistical study that was both descriptive and inferential was conducted.

RESULTS. Geographic tongue was mostly reported in female students (51.1%), most of the affected student was suffered from burning. The higher percentage was recorded in both dorsal and lateral tongue sites (77.0%). Stress showed the most common etiological factor for geographic tongue among dental students (48.6%).

CONCLUSION. Fifth grade dental students reported geographic tongue with female predilection and different etiological factors, stress was the most common one.

INTRODUCTION. Chronic periodontitis, especially its destructive forms, remains one of the leading causes of tooth loss. This requires the improvement of therapeutic approaches to preserve the functionality of the dentofacial system and enhance the quality of life.

AIM. To systematically analyze the literature and summarize the available evidence on modern approaches to the treatment of chronic apical periodontitis associated with stable positive outcomes.

MATERIALS AND METHODS. Modern data from Russian and international literature, 80 sources, over the past 15 years on effective methods and aspects of treatment of chronic apical dental periodontitis have been studied and analyzed in the databases: PubMed, eLibrary.ru, CyberLeninka, Google Scholar, Crossref, and Green Version.

RESULTS. The analysis of this literature allows us to consider chronic periodontitis as a widespread pathology. Effective treatment requires: a comprehensive approach, strong manual skills of the dentist, adequate equipment and a structural understanding of the processes occurring at each stage of treatment. The sources we have studied report an 85% success rate in treating periodontitis. Furthermore, crown fracture accounts for 15% of treatment failures, occurring sometime after successful endodontic therapy. This issue can be resolved through post-supported restoration and appropriate crown prosthodontics.

CONCLUSIONS. Modern treatment methods include comprehensive, conservative, and innovative technologies supported by evidence-based medicine and confirmed by numerous clinical studies. The use of an endodontic microscope, ultrasound activation, irrigation solutions of antiseptics, antibiotics, guided bone regeneration drugs, bioceramic filling materials and new physiotherapy techniques significantly increases the effectiveness of therapy and reduces the duration of treatment.

INTRODUCTION. The leading problem of modern dentistry is the treatment of caries and its complications: diseases of the pulp and periapical tissues, and as a result, these pathologies in the adult population make up the basis of therapeutic procedures in the daily dental appointment of a practicing doctor. Currently, in order to provide an effective treatment method during conservative therapy with a diagnosis of pulp hyperemia, a dentist should clearly interpret the algorithm of therapeutic procedures and the means used.

AIM. To improve the effectiveness of treating pulp hyperemia.

MATERIALS AND METHODS. The study was conducted on the basis of the Kuban State Medical University Dental Polyclinic of the Russian Ministry of Health. This study was conducted with the approval of the Kuban State Medical University Ethical Committee, Protocol No. 125 dated September 12, 2023. A total of 127 patients with a diagnosis of pulp hyperemia (K04.0) and a chewing group of I-class teeth according to Black were observed. The patients were divided into 3 groups and 6 subgroups for the study.

RESULTS. Among the patients examined, on the 30th day of the study, the Biodentine+Trigexylon method demonstrated a statistically significant advantage over the other two methods in terms of the frequency and intensity of complaints, especially in the subgroup of patients with tooth cavity opening. On the 180th day of observation, the Biodentine+Trigexylon method ensured complete absence of complaints in all patients, while in Groups 2 and 3, single complaints persisted in a small number of patients. By the end of the first year from the start of treatment, the Biodentine+Trigexylon method provided complete and stable relief of symptoms in all patients, regardless of whether the tooth pulp was exposed, while in Groups 2 and 3, there were occasional complaints related primarily to the subgroup with exposed pulp.

CONCLUSION. The obtained data confirm that in the long-term period, all three methods provide a comparable objective result. This is consistent with scientific evidence on the choice of material for the treatment of deep caries and direct pulp coverage. However, the subjective outcome (absence of complaints) is achieved most reliably when using the combination Trigexylon+Biodentine.

INTRODUCTION. The problem of persistent infection of the root canal system remains one of the key causes of failures in endodontic treatment. Despite the improvement of instrumental processing, the anatomical complexity of the root system and the stability of microbial biofilms necessitate effective drug treatment.

AIM. The purpose of the review is to systematize data on the role of irrigation in endodontic treatment based on the analysis of modern domestic and foreign literature, to evaluate the effectiveness of basic irrigation solutions and methods of their activation.

RESULTS. The analysis showed that sodium hypochlorite retains the status of the “gold standard” due to its pronounced antimicrobial activity and ability to dissolve organic tissues. Ethylenediaminetetraacetate is effective in removing the lubricated layer due to chelated binding of calcium. Chlorhexidine has pronounced antimicrobial activity and substantiality, but does not dissolve organic tissues. Methods of activating irrigants (ultrasound, sound and laser activation) significantly increase the efficiency of cleaning complex anatomical areas of the root system compared to standard needle irrigation.

CONCLUSIONS. An integrated approach to irrigation using a combination of solutions and their activation is a key factor in improving the effectiveness of endodontic treatment.

INTRODUCTION. Diseases associated with root canal system pathology remain one of the most pressing problems in modern endodontics because of the difficulty of achieving complete elimination of microorganisms from the root canal. The choice of an optimal irrigating solution is a key factor determining the efficacy of disinfection and the long-term prognosis of endodontic treatment.

AIM. To analyze current literature data on the efficacy of the most widely used root canal irrigating solutions and to evaluate their advantages, limitations, and potential for rational clinical application.

MATERIALS AND METHODS. An analysis of contemporary scientific literature on the use of the most common irrigating solutions in endodontics – sodium hypochlorite (NaOCl), chlorhexidine (CHX), and ethylenediaminetetraacetic acid – was performed. A comparative assessment was made of their antimicrobial properties, their capacity to dissolve organic tissue, their effect on dentin structure, features of their clinical use, and their efficacy when applied as part of combined irrigation protocols.

RESULTS. The literature analysis showed that each of the irrigating solutions considered has its own mechanism of action, advantages, and limitations. Sodium hypochlorite remains the “gold standard” of irrigation owing to its high antimicrobial activity and its ability to dissolve organic tissue. At the same time, reducing its concentration in combination with heating and physical activation makes it possible to preserve efficacy while decreasing toxicity and adverse effects on dentin properties. Chlorhexidine is characterized by a broad antimicrobial spectrum, low toxicity, and a pronounced prolonged effect; however, it lacks sufficient tissue-dissolving capacity and requires adherence to the application protocol to prevent the formation of a potentially toxic precipitate upon contact with NaOCl. EDTA effectively removes the smear layer and inorganic components of dentin, improving the permeability of dentinal tubules and the conditions for subsequent obturation. The greatest clinical efficacy is achieved with the combined use of EDTA and NaOCl, which acts on both the organic and inorganic components of the root canal system.

CONCLUSION. None of the currently available irrigating solutions is universally applicable for endodontic treatment. The most justified approach appears to be their rational combined use, taking into account the clinical situation, the concentration employed, and the activation methods, which makes it possible to ensure an optimal balance between the efficacy of antimicrobial treatment, safety, and the quality of endodontic treatment.

The resorcinol-formalin method, widely used approximately two decades ago due to its simplicity and low cost, has significant disadvantages, including cytotoxicity, incomplete root canal filling, increased tooth brittleness, discoloration, and ankylosis. It remains one of the common causes of exacerbation of apical periodontitis. Current trends in endodontic treatment are focused on tooth preservation. Therefore, tooth-preserving surgical procedures, such as root-end resection and hemisection, are recommended in selected cases. The key principle is a combination of a therapeutic phase aimed at eliminating intracanal biofilm and a surgical phase involving removal of periapical inflammatory lesions. This clinical case describes the treatment of a 54-year-old female patient with mandibular first molar (tooth 4.6) previously treated using the resorcinol-formalin method approximately 30 years earlier. In 2000, a radicular cyst was diagnosed, and root-end resection with cyst removal was performed. The tooth remained asymptomatic for 25 years. After this period, the patient developed pain on biting; cone-beam computed tomography revealed incomplete root canal filling and widening of the periodontal ligament space. Nonsurgical retreatment was performed using dental microscopy, advanced irrigation protocols, intracanal medication, an MTA apical plug, and vertical compaction of gutta-percha. One year after treatment, cone-beam computed tomography demonstrated a reduction in the periapical lesion and restoration of bone structure. Thus, even in cases with an unfavorable initial treatment history, such as previous resorcinol-formalin therapy, successful retreatment and long-term tooth preservation may be achieved. The elimination of intracanal infection combined with appropriate management of periapical pathology plays a decisive role in treatment success.

INTRODUCTION. A thorough understanding of the root-canal systems of various human teeth can facilitate successful root-canal treatment (RCT). The mandibular canines typically have one root and one canal, with two roots being uncommon.

AIM. This case series aimed to increase the knowledge about root-canal morphology in the Saudi population. It reported three successful clinical retreatment management of mandibular canines with different canals and root morphology in Abha City.

RESULTS. A mini-review of the published relevant case reports in different cities of Saudi Arabia was included. We presented the successful management of earlier unsuccessful RCT in three mandibular canine cases with a previously lost second canal owing to their uncommon root-canal morphology. This case series also broadly reviews the literature, concentrating on the clinically important anatomical differences and describing systems for the actual management of such canal and root configurations in RCTs. Finally, a detailed clarification of each step of handling cases as preoperative diagnosis, intraoperative identification of morphological differences, and a current RCT approaches is provided.

CONCLUSION. Stress is placed on confirming a thorough understanding of these phases to accomplish effective consequences in managing complex cases involving root-canal anatomical variations.

AIM. To analyze the ability of the oral cavity, represented as a patient–tooth graph and processed by a graph neural network, to reflect systemic health, using the detection of concomitant cardiovascular disease as an example.

MATERIALS AND METHODS. On a large population-based cohort, each patient was represented as a heterogeneous patient – tooth graph encoding periodontal status and dentition configuration, and a Heterogeneous Graph Transformer with attention was trained. The capacity of the structure to carry a systemic signal was probed two ways: ablation of the graph structure while keeping the aggregate DMFT index and the graph contribution in a dental-chair scenario (“age, sex + tooth graph” vs “age and sex only”). The cardiovascular example comprised atherosclerotic cardiovascular disease (ASCVD) and chronic heart failure (CHF); discrimination was assessed by AUC with the DeLong test and applicability by an operating point.

RESULTS. The cardiovascular signal resided in the graph structure: removing the tooth structure while keeping the DMFT index significantly reduced AUC for both cardiovascular outcomes – CHF (−0.024; p = 0.026) and ASCVD (−0.011; p = 0.032). In the dental-chair scenario the graph yielded an AUC gain of +0.083 for CHF (p = 2 × 10^-⁴) and +0.030 for ASCVD (p = 1.5 × 10^-⁵); at ~0.80 sensitivity the model reached 0.70–0.74 specificity and 0.97–0.99 negative predictive value.

CONCLUSION. This is the first confirmation that a graph representation of the oral cavity can be “read” as a map of systemic health: the cardiovascular signal lies in the structure of the dentition and is irreducible to aggregate indices. Periodontal examination is applicable as a screening point for concomitant cardiovascular disease with referral to a physician.

INTRODUCTION. Zirconium dioxide (ZrO₂) is among the most widely used materials for fixed dental prostheses, and the reliability of adhesive luting largely depends on surface cleanliness. Contact of the framework with mixed saliva during try-in results in adsorption of organic components that reduces bond strength to resin cements. Conventional cleaning procedures do not always remove the protein film completely, and objective methods for monitoring residual contamination are lacking in clinical practice.

AIM. To assess the character of zirconia surface contamination by organic components of mixed saliva using a mucin model and X-ray photoelectron spectroscopy (XPS).

MATERIALS AND METHODS. Yttria-stabilized zirconia (Y-TZP) plates were examined in three states: pristine surface, surface after application of a mucin model (snail secretion filtrate), and the same surface after three-fold rinsing with distilled water. XPS was performed on a PREVAC EA15 spectrometer (Al Kα, hν = 1486.6 eV). Atomic concentrations of nitrogen (N) and zirconium (Zr) were quantified and the N/Zr ratio was calculated (n = 6 per group). Data were analysed by one-way ANOVA with Tukey post-hoc test.

RESULTS. The N/Zr ratio was 0.120 ± 0.002 on the pristine surface and increased to 0.181 ± 0.003 after mucin application (+51%; p < 0.001). After rinsing it remained 0.181 ± 0.003, not differing from the mucin group (p = 0.82) and remaining significantly higher than baseline (p < 0.001; one-way ANOVA F = 918.3, p < 0.001).

CONCLUSION. Organic nitrogen-containing components of mixed saliva adsorb onto zirconia almost irreversibly; threefold water rinsing does not restore the pristine surface state. The N/Zr ratio measured by XPS is an objective and reproducible marker of residual contamination, underlying the developed method for identifying saliva residues on zirconia devices.

INTRODUCTION. Dentin hypersensitivity is a common clinical condition that may negatively affect oral function and quality of life. Several desensitizing approaches are available, but no universally accepted treatment protocol has been established.

AIM. This study aimed to compare the clinical effectiveness of 5% potassium nitrate toothpaste and diode laser combined with 2% sodium fluoride gel in reducing dentin hypersensitivity.

MATERIALS AND METHODS. This assessor-blinded randomized clinical trial included 170 hypersensitive teeth from 17 patients aged 20–33 years. The teeth were allocated equally into two groups: 85 teeth were treated with 5% potassium nitrate toothpaste applied professionally for 30 seconds, and 85 teeth were treated with 2% sodium fluoride gel followed by diode laser irradiation using a 650 nm diode laser at 25 mW in continuous mode for 60 seconds. Pain intensity was assessed using a 10-point Visual Analog Scale at baseline, immediately after treatment, and after 1 week, 2 weeks, 1 month, and 3 months.

RESULTS. Both treatment groups showed significant reductions in VAS scores over the three-month follow-up period. In the 5% potassium nitrate group, the mean VAS score decreased from 6.20 ± 1.80 at baseline to 1.54 ± 2.21 after 3 months, corresponding to a 75.2% reduction. In the diode laser plus 2% sodium fluoride group, the mean VAS score decreased from 5.47 ± 1.15 to 0.42 ± 0.89, corresponding to a 92.3% reduction. The diode laser plus sodium fluoride group showed lower VAS scores at all post-treatment follow-up intervals. However, baseline VAS scores differed significantly between the groups and should be considered when interpreting the comparative findings.

CONCLUSION. Both 5% potassium nitrate toothpaste and diode laser combined with 2% sodium fluoride gel were effective in reducing dentin hypersensitivity. Diode laser combined with 2% sodium fluoride showed a greater and more sustained reduction in VAS scores over three months, although the baseline imbalance between groups warrants cautious interpretation. Further randomized clinical trials with larger samples and baseline-adjusted analyses are recommended.

INTRODUCTION. One of the causes of the post-operative pain could be the irrigation solution used during the endodontic treatment.

AIM. The aim of this study was to evaluate the pain symptoms after endodontic treatment of teeth with necrotic pulp, using two different concentrations of NaOCl during root canal instrumentation, as well as the necessity of using analgesics.

MATERIALS AND METHODS. Fifty single-rooted upper incisors or canines were randomly divided into two groups (n = 25) according to the concentration of NaOCl used: 5.25% or 8.25%. All canals were instrumented with the Reciproc system (R50) and irrigated with 10 mL of the respective chemical solution for each third, and subsequently obturated. Treatments were performed in a single session. Post-operative pain evaluation was conducted at intervals of 24 hours, 48 hours, 72 hours, and 7 days after treatment using a visual analogue scale (VAS), with patients being advised to take 400 mg of Ibuprofen in case of pain.

RESULTS. The VAS results were analyzed using the Kruskal-Wallis test, with a significance level of 5%. There was no significant difference between the different concentrations of NaOCl regarding post-operative pain at any of the evaluated times (p > 0.05). Considering the different evaluation times within the same group, it was observed that at the NaOCl concentration of 8.25%, the pain, although tolerable, was greater after the 24-hour interval compared to later periods. No patient reported the use of analgesics.

CONCLUSION. It was concluded that there was no influence of the NaOCl concentration on post-operative pain, as both solutions exhibited similar responses, except at the 24-hour interval, where 8.25% NaOCl exhibited more post-operative pain. There was no need for the use of analgesics after treatment with the solutions used.

Post-extraction alveolar osteitis (dry socket) is the most common inflammatory complication of tooth extraction. Reported prevalence rates vary widely, which hampers comparison of data and assessment of the true burden of the complication. The aim of this review is to summarise current understanding of the prevalence of post-extraction alveolar osteitis worldwide and in the Russian Federation and to analyse the reasons for the observed variability. It is shown that after routine tooth extraction the incidence of alveolar osteitis is predominantly 0.5–7.3%, whereas after removal of impacted mandibular third molars the pooled prevalence reaches 6.7%, and up to 30–45% in selected samples. Between-study variability is determined mainly by the type and traumatic nature of the extraction, patient case mix (smoking, oral contraceptive use, diabetes mellitus) and differences in diagnostic criteria rather than by geography. In the Russian literature direct population-based estimates are scarce: according to official statistics the incidence does not exceed 1%, while up to 55–70% of cases are associated with tooth extraction against the background of exacerbation of chronic periodontitis. Russian prevalence studies are virtually absent from international bibliographic indices. The lack of standardised, including regional, data necessitates further epidemiological studies based on unified criteria and the development of effective preventive and therapeutic agents.

INTRODUCTION. In surgical dentistry, patient rehabilitation following complex tooth extractions – molars and premolars – is crucial. Complex molar and premolar extractions carry the risk of complications that significantly impede healing of the postoperative alveolar ridge and lead to a decrease in patients’ quality of life in the early postoperative period. Recovery after complex molar or premolar extractions can be lengthy, and careful postoperative management is essential to ensure healing and patient comfort. Rehabilitation in this context refers to both surgical interventions and the development of a postoperative care strategy for patients. This should be implemented in the immediate perioperative and early postoperative periods to ensure optimal restoration of the surgical site and maintain the patient’s previous level of comfort.

AIM. This review article examines the key intra- and postoperative rehabilitation measures aimed at minimizing complications following complex molar and premolar extractions.

MATERIALS AND METHODS. To analyze current data on complications following atypical molar and premolar extractions, articles from the past seven years were reviewed from the following databases: PubMed, Scopus, Web of Science, ResearchGate, Google Scholar, the Russian Science Citation Index (RSCI), COPERNICUS, and EBSCO. In the first stage, 736 articles were identified. During the second stage, 143 scientific articles were referenced and cited during the analysis of the selected material and the writing of this article.

RESULTS. Complex extractions can significantly impact patients’ well-being, causing pain, swelling, trismus, and sometimes serious complications such as dry socket or nerve damage. Therefore, any advances that can reduce postoperative morbidity or accelerate healing are of great interest. In this context, photobiomodulation (low-level laser therapy) has emerged as a promising complement to traditional postoperative rehabilitation after tooth extraction. A multifactorial approach to patient rehabilitation after complex tooth extraction improves patient comfort and allows for a faster return to normal function.

CONCLUSION. Rehabilitation after complex tooth extractions requires a multifaceted approach – managing acute pain with appropriate analgesics, reducing swelling, accelerating wound healing, and new treatment methods such as photobiomodulation.

Over the past 30 years, more than 5 million patients worldwide with various dentofacial anomalies have undergone orthodontic treatment using clear aligner therapy. The indications for aligner treatment continue to expand, and their clinical use has steadily increased. Owing to continuous advances in biomaterials, the materials used for aligner fabrication have evolved from conventional polymers to more flexible and highly transparent thermoplastic materials. The rapid development of three-dimensional digital technologies has also created new opportunities for the design and manufacturing of aligners. With further technological advancements and the development of novel materials, aligners are expected to achieve additional improvements in treatment efficiency, patient comfort, and manufacturing cost.

INTRODUCTION. Currently, the use of a gnathometer to determine centric jaw relationship allows for the fabrication of splints based on individual anatomical parameters, which improves the functional and physiological characteristics of occlusion and masticatory muscles.

AIM. To optimize the fabrication process of a muscle relaxation splint for the treatment of individuals with masticatory muscle hypertonicity to increase its effectiveness.

MATERIALS AND METHODS. This study presents the results of a survey of 59 patients aged 18 to 44 years. All study participants were divided into two groups. The first group included 29 patients who received a muscle relaxation splint based on centric jaw relationship determined anatomically and physiologically. The second group consisted of 30 patients who received a muscle relaxation splint based on centric jaw relationship determined with an intraoral gnathometer. Statistical data processing and graphical presentation were performed using Microsoft Excel 2007 (Microsoft Corporation, USA).

RESULTS. According to the study, after using a muscle relaxation splint, at maximum masticatory muscle tension, bioelectrical activity of the masticatory muscles decreased by 5% on the right side in Group 1 and by 13% in Group 2; by 19% on the left side in Group 1 and by 29% in Group 2. Bioelectrical activity of the temporal muscles decreased by 10% on the right side and by 12% in Group 2; by 23% on the left side in Group 1 and by 32% in Group 2 (statistically significant, p < 0.05).

CONCLUSIONS. Using a gnathometer to determine the centric relation of the jaws allows for the fabrication of muscle relaxation splints based on individual anatomical parameters, which improves the functional and physiological characteristics of occlusion and masticatory muscles.

AIM. To evaluate the root canals’ microstructure using mechanical and ultrasonic treatment by examining the tooth cavity hard tissues under experimental conditions using scanning electron microscopy (SEM) and atomic force microscopy (AFM).

MATERIALS AND METHODS. The study included extracted single-root premolars that had not undergone endodontic treatment. After creating endodontic access, apical patency was confirmed using No. 15 K-file. Then UltraPath Files and Ultrataper Next files were used to shape the root canal. Irrigation in each group was performed with 3.25% sodium hypochlorite and 17% EDTA solution. In the second group, the EDTA solution was activated with an ultrasonic tip for 2 minutes. Subsequently longitudinal sections (for scanning electron microscopy) and transverse sections (for atomic force scanning) were obtained. Afterwards a qualitative comparative analysis of the microstructure of the root canals’ middle third was performed.

RESULTS. When using ultrasonic (US) activation, an increase in dentin roughness was observed. The number of open dentinal tubules was also higher in second group. According to SEM data, the amount of smear layer and dentin debris without US activation was greater than with additional treatment using ultrasound. According to AFM and SEM data, the US removal of mineralized areas revealed depressions and microcracks connecting the dentinal tubules. The presence of microcracks in samples without US activation was not detected.

CONCLUSION. The root canal wall surface is more defined and roughened when using ultrasound, which can impact material retention during obturation. Almost complete absence of a smear layer when using ultrasound can reduce the risk of biofilm formation and root canal reinfection and improve the adherence of the obturation material. Increasing the time or force of ultrasound exposure can cause the microcracks between dentinal tubules to develop into larger cracks visible using an operating microscope.

INTRODUCTION. Periapical lesions result from bacterial infection of necrotic pulps, triggering immune responses that cause periapical bone resorption. Nonsurgical root canal treatment with effective infection control remains the primary approach to promote healing. The advent of bioceramic sealers, with their bioactivity, biocompatibility, and excellent sealing ability, has enhanced the potential for periapical healing and tissue regeneration. Their use may improve clinical outcomes and support predictable long-term success.

CASE SERIES. This case series reports on mature teeth with periapical lesions treated using root canal treatment with bioceramic sealers. Pre-operative and follow-up imaging, including periapical radiographs and Cone-Beam Computed Tomography up to a period of 48 months, was assessed. All cases showed radiographic healing, with periapical tissues exhibiting favorable biological responses. The bioactive properties of bioceramic sealers may have contributed to tissue repair. Careful clinical protocols, including appropriate case selection, thorough canal disinfection, and precise obturation technique, were consistently applied.

DISCUSSION. Bioceramic sealers are highly biocompatible and non-cytotoxic, promoting predictable periapical healing. This series emphasizes the importance of integrating material selection, meticulous clinical technique, and systematic radiographic follow-up to monitor healing and guide prognosis. These findings support the clinical advantages of bioceramic-based obturation in enhancing tissue regeneration and longterm treatment success. Finally, non-surgical root canal treatment remains a reliable and effective approach for the management of periapical lesion of endodontic origin.

AIM. The aim of this study was to compare the clinical performance of pedodontists with that of the GPT-4.1 mini model, operating on the ChatGPT platform developed by OpenAI, in the diagnosis and treatment planning of traumatic dental injuries in pediatric patients.

MATERIALS AND METHODS. This study was conducted using clinical and radiographic records of 18 pediatric patients aged 8–14 years who presented to the clinic with dental trauma, completed treatment successfully, and were followed for at least 12 months. Excluding avulsion cases, a total of 19 maxillary central incisors with different types of trauma were evaluated. Clinical findings and radiographic images for each tooth were digitized. The questionnaire used in this study was developed by expert pedodontists based on trauma types, diagnostic criteria, and treatment approaches outlined in the current American Academy of Pediatric Dentistry (AAPD) trauma guidelines, as well as the clinical procedures routinely applied in practice. Accordingly, a total of 36 multiple-choice questions were created (18 related to diagnosis and 18 to treatment planning). A pilot study involving five pediatric dentists was conducted to assess questionnaire clarity and administration time, and minor revisions were made accordingly. The prepared questions were individually submitted to GPT-4.1 mini, and the same questions were distributed to 17 pedodontists via Google Forms. The most recent AAPD dental trauma guideline (2020) was accepted as the gold standard for diagnosis and treatment comparisons. Statistical analysis was performed using IBM SPSS Statistics version 23. The level of agreement between GPT-4.1 mini and pedodontists was assessed using Cohen’s Kappa statistic, and 95% confidence intervals were calculated using the asymptotic (Wald) method. Categorical data were presented as frequencies and percentages, and the level of statistical significance was set at p < 0.05.

RESULTS. A substantial level of agreement was observed between GPT-4.1 mini and pedodontists in diagnostic decisions (Kappa = 0.75; p < 0.001). Diagnostic agreement ranged from 50% in extrusion cases to 100% in intrusion, root fracture, lateral luxation, enamel fracture, and enamel-dentin fracture cases. Agreement for complicated crown-root fractures was 67%. Similarly, a substantial agreement was found between GPT-4.1 mini and pedodontists in treatment planning decisions (Kappa = 0.75; p < 0.001).

CONCLUSION. In cases of traumatic dental injuries, when diagnosis and treatment processes are evaluated in accordance with current guidelines and individualized approaches, GPT-4.1 mini demonstrates a considerable level of agreement with pedodontists.