Cockle shells are a natural reservoir of calcium carbonate (CaCO₃), which is widely used in bone repair, tissue scaffolds, and the development of advanced drug delivery systems. Although many studies report on the preparation of CaCO₃, the development of a nanosized spherical CaCO₃ precursor for calcium oxide (CaO) that is suitable to be incorporated in dental material was scarce. Therefore, this study aimed to synthesize a nanosized spherical CaCO₃ precursor for CaO derived from cockle shells using a sol–gel method. Cockle shells were crushed to powder form and mixed with hydrochloric acid, forming calcium chloride (CaCl₂). Potassium carbonate (K₂CO₃) was then fed to the diluted CaCl₂ to obtain CaCO₃. The effect of experimental parameters on the morphology of CaCO₃, such as volume of water, type of solvents, feeding rate of K₂CO₃, and drying method, were investigated using field-emission scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffractometry (XRD), Brunauer–Emmett–Teller surface area analysis, and thermogravimetric analysis. Optimized CaCO₃ was then calcined to form CaO. XRD analysis of CaCO₃ nanoparticles was indicative of the formation of a calcite phase. The well-structured spherical shape of CaCO₃ was obtained by the optimum condition of the addition of 50 mL of water into CaCl₂ in ethanolic solution with a 1 h feeding rate of K₂CO₃. Less agglomeration of CaCO₃ was obtained using a freeze-drying technique with the surface area of 26 m²/g and average particle size of 39 nm. Spherical shaped nanosized CaO (22–70 nm) was also synthesized. The reproducibility, low cost, and simplicity of the method suggest its potential applications in the large-scale synthesis of the nanoparticles, with spherical morphology in an industrial setting.

Numerous studies have been conducted in the previous years with an objective to determine the ideal biomarker or set of biomarkers in temporomandibular disorders (TMDs). It was recorded that tumour necrosis factor (TNF), interleukin 8 (IL-8), IL-6, and IL-1 were the most common biomarkers of TMDs. As of recently, although the research on TMDs biomarkers still aims to find more diagnostic agents, no recent study employs the biomarker as a targeting point of pharmacotherapy to suppress the inflammatory responses. This article represents an explicit review on the biomarkers of TMDs that have been discovered so far and provides possible future directions towards further research on these biomarkers. The potential implementation of the interactions of TNF with its receptor 2 (TNFR2) in the inflammatory process has been interpreted, and thus, this review presents a new hypothesis towards suppression of the inflammatory response using TNFR2-agonist. Subsequently, this hypothesis could be explored as a potential pain elimination approach in patients with TMDs.

Temporomandibular disorders (TMDs) are a type of idiopathic orofacial pain. Inflammation, particularly elevated circulating levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and interleukin-8 (IL-8), has been linked to pain symptoms. The purpose of this study was to compare hs-CRP, IL-6, and IL-8 biomarkers and pain intensity with different treatment strategies (LLLT, standard conservative treatment, and combination) for TMD patients. Methods: A total of 32 participants were randomly included in the study and divided into three groups (Group I, Group II, and Group III) referred from the Dental Clinic, School of Dental Science, HUSM. Patients received LLLT (Groups II and III) in five sessions for the duration of 10 days. Patients in Groups I and III received standard conservative TMD treatment (diet and stress counseling, jaw exercises, physical therapy, which was a hot towel application) by the principal investigator. All blood samples for biomarkers were performed before starting treatments and directly after finishing the treatment protocols, where all results were recorded. Results: The result showed a significant difference in the mean IL-8 (p = 0.001) between the three intervention groups (LLLT, standard treatment, and combined treatment). IL-6 showed an increase in the mean of IL-6 levels from baseline to post-treatment with a better mean in the LLLT treatment group without any significant differences. Additionally, there were no significant mean differences found between the groups and in the group for the hs-CRP biomarker. Conclusions: A statistically non-significant difference was found in hs-CRP and IL-6 before and after LLLT, conservative, and combined treatment strategies of TMD. A statistically significant difference was observed in the mean levels of IL-8 between the LLLT intervention group and the combined treatment group. Although there was no statistically significant correlation between pain intensity and biomarkers, a statistically significant difference was found in pain intensity before and after LLLT, conservative, and combined treatment strategies. TMJ degeneration could be exacerbated by elevated IL-8 levels. Thus, this can be an important biomarker to mark or identify the painful condition of TMJ.

Various oxides are used to stabilize zirconium oxide (ZrO₂), but their superior hardness causes wear of the machining tool. Calcia-doped zirconia has been studied but reports on properties suitable for dental application are lacking. Therefore, this study aimed to fabricate and characterize zirconia stabilized by calcium oxide (CaO) derived from cockle shells and compare it with zirconia stabilized by commercial CaO, sintered at different temperatures. In this study, 176 pressed pellets of zirconia mixed with CaO either derived from cockle shells or commercial CaO were sintered between 1200 and 1500 °C to produce calcia-doped zirconia. Characterizations were made with SEM and XRD. Specimens were subjected to density, compressive and flexural strength, and Vickers hardness testing. Data were analyzed using the independent t-test and one-way ANOVA. XRD revealed the zirconia was stabilized into tetragonal and cubic phases (Ca-SZ). Ca-SZ cockle shells (CS) and Ca-SZ commercial (CC) have average particle sizes of 267 nm and 272 nm, respectively, with similar surface roughness. At 1400 °C sintering temperature, flexural strengths were 1165 and 1152 MPa, compressive strengths were 4914 and 4913 MPa, and Vickers hardness were 977 and 960 MPa for Ca-SZ(CS) and Ca-SZ(CC), respectively. Both Ca-SZ materials showed no significant difference in most properties (p < 0.05) when sintered at different temperatures. The fully sintered Ca-SZ is less hard compared to the ceria-stabilized tetragonal zirconia polycrystal (Ce-TZP) available on the market. Thus, Ca-SZ may be used as an alternative to the current zirconia available on the market for dental application.

Objective. The aim of this systematic review was to evaluate the effectiveness of laser application in temporomandibular joint disorder. Methods. PubMed, SCOPUS, Science Direct, Web of Science, and Google Scholar electronic databases were searched systematically with restricting the languages to only English and year (January 2001 to March 2020), and studies were selected based on the inclusion criteria. Study quality and publication bias were assessed by using the Robvis, a software package of R statistical software. Results. This systematic review included 32 studies (1172 patients) based on the inclusion and exclusion criteria. Most of the studies reported significant reduction of pain by the use of the laser during TMD treatment. Two-thirds of the study (78.13%) found a better outcome comparing with conventional one. According to Robvis, 84.4% of the studies were high methodological studies with low risk of bias. Conclusion. TMD patients suffer with continuous pain for long time even after conventional treatment. Laser therapy shows a promising outcome of pain reduction for TMD patients. Therefore, laser therapy can be recommended for the TMD patients’ better outcome. This trial is registered with PROSPERO (CRD42020177562).

Objectives: To investigate the effect of acidic solution on surface roughness and microleakage of tooth-colored restorative materials. Materials and Methods: A 160 box-shaped cavities were prepared on the buccal surfaces of 160 human molars, and assigned to four groups: Group A restored with Ketac™ Molar Easymix, Group B with Fuji II™ LC, Group C with Ketac™N100, and Group D with Filtek™ Z250, and subdivided into study and control groups (n = 20). Study groups were immersed in lemon juice (pH = 2.79) for 24 h, whilst controlgroups in deionized distilled water. All samples were immersed in 2% methylene blue dye, sectioned into two equal halves for surface roughness, and microleakage tests. Data were analyzed using Mann-Whitney and Kruskal-Wallis tests at P < 0.05. Results: There was a significant difference in surface roughness of Ketac™ Molar, Fuji II™LC, and Ketac™N100. No significant difference was found in microleakage of Ketac™ Molar and Fuji II™LC; however, there were significant differences in the gingival margin of Ketac™N100, and the occlusal margin of Filtek™Z250. Conclusions: All glass ionomer cements were eroded after exposure to the acidic drink. Filtek™ Z250 and Ketac™ Molar Easymix showed more microleakage. All materials showed more microleakage at the gingival margins.