This study aimed to investigate the cytotoxicity and bioactivity of a novel nanocomposite containing nanoparticles of bioactive glass (nBGs) on human dental pulp stem cells (hDPSCs). nBGs were synthesized by the sol–gel method. Biodentine (BD) nanocomposites (nBG/BD) were prepared with 2 and 5% wt of nBG content; unmodified BD and glass ionomer cement were used as references. Cell viability and attachment were evaluated after 3, 7 and 14 days. Odontogenic differentiation was assessed with alkaline phosphatase (ALP) activity after 7 and 14 days of exposure. Cells successfully adhered and proliferated on nBG/BD nanocomposites, cell viability of nanocomposites was comparable with unmodified BD and higher than GIC. nBG/BD nanocomposites were, particularly, more active to promote odontogenic differentiation, expressed as higher ALP activity of hDPSCs after 7 days of exposure, than neat BD or GIC. This novel nanocomposite biomaterial, nBG/BD, allowed hDPSC attachment and proliferation and increased the expression of ALP, upregulated in mineral-producing cells. These findings open opportunities to use nBG/BD in vital pulp therapies.

To assess the effects of application of an oxalic acid-based desensitizing agent before restoration of noncarious cervical lesions (NCCLs) with either a silorane-based or a methacrylate-based composite resin on decreasing the absolute risk and intensity of dentin hypersensitivity over the course of a 1-year follow-up. NCCLs in 31 patients (age range 24-66 years) were selected and randomly divided into four groups (n = 31 in all groups). In the Z250 and P90 groups, the restorations were performed with a methacrylate-based composite resin (Filtek Z250) and a silorane-based composite resin (Silorane P90), respectively. In the Z250 + OA and P90 + OA groups, the same composite resins were used, but an oxalic acid-based desensitizing agent (Desenssiv, SSWhite) was first applied. All NCCLs were evaluated before restoration (BR) and at 30, 60, 90, 180, and 360 days after treatment. Teeth sensitivity to evaporative and tactile stimuli was measured by a visual analog scale (VAS). The results were analyzed with statistical tools including Wilcoxon and Friedman tests for within-group comparisons and ANOVA and Bonferroni post hoc tests for between-group comparisons (P < .05). Reduction in dentin hypersensitivity was observed for all treatment groups; however, these reductions were more pronounced when oxalic acid was applied before restoring the NCCL (P < .001). Complete elimination of pain was not achieved by any treatment modalities for the first 6 months; afterwards, in the groups that had received application of the oxalate-based desensitizing agent, the absolute risk of dentin hypersensitivity was significantly reduced (P < .01). The restoration of sensitive NCCLs with composite resins reduces dentin hypersensitivity. This reduction is more pronounced if an oxalic acid-based desensitizing agent is applied prior to the restoration. In addition, its application reduces the absolute risk of dentin hypersensitivity after 6 months of treatment.

The aim of this study was to develop a Preventive Oral Health Exam for Elderly People (EDePAM), using the e-Delphi technique, to diagnose oral health problems in people 65 or older. The e-Delphi technique was used with experts in multiple stages, and in a final workshop, where an agreement on an examination protocol was reached for diagnosing dental caries, oral mucosa lesions, periodontal diseases, and masticatory function disorders. Quantitative analyses of all the rounds of the e-Delphi method were conducted. It was agreed that the International Caries Detection and Assessment System (ICDAS) should be used together with a modified version of the Nyvad criteria to detect and assess caries lesions. It was also agreed that an assessment was needed of the different factors involved in determining caries risk, namely socioeconomic level, access to fluoride, level of dependence/functionality, salivary flow, history of head and neck cancer treatment, use of medications that decrease salivary flow, diet, use of removable dental prostheses, exposure of root surfaces, and caries history. Furthermore, patients would be required to undergo an examination of the oral mucosa, where any existing lesion should be described in terms of its clinical appearance, location, and risk potential. It was also agreed that an assessment of masticatory function should be performed using the Leake index, together with chewing-gum combined with a color scale to categorize masticatory performance. The number of pairs of occluding antagonist teeth was considered as the best predictor of masticatory function. The 2018 classification by the American Academy of Periodontology (AAP) / European Federation of Periodontology (EFP) was accepted as the standard to assess periodontal status, and it was agreed that this assessment should include an evaluation of clinical attachment loss and bleeding on probing. The novel EDePAM was considered as appropriate for conducting a functional assessment of oral health by providing a comprehensive diagnosis of oral diseases.

The aim of this study was to systematically review the literature of in vitro studies comparing the mechanical properties of teeth restored after selective caries excavation (SCE) and complete caries excavation (CCE). The PubMed/MEDLINE and EMBASE electronic databases were searched systematically. In vitro studies investigating the mechanical properties of teeth restored after SCE, were independently checked by two authors. Inclusion criteria were: (1) performing SCE (2) mentioning the teeth were later restored, and (3) evaluating mechanical properties of the restored teeth. Meta-analysis was performed with and without discriminating between shallow and deep lesions. From 1,859 potentially eligible studies, 14 were selected for full text analysis and 5 were included in the meta- analysis. Fracture resistance was significantly lower after SCE than after CCE in overall analysis (SMD[95%CI]=-1.62[-3.04,-0.20]) and for deep lesion (SMD[95%CI]=-1.62[-2.62,-0.61]), whereas cuspal deflection at 200 and 400N was significantly higher after SCE than after CCE for discriminated and non- discriminated analyses. Furthermore, for shallow lesions the risk of catastrophic fracture was significantly lower after SCE than CCE (RR[95%CI]=0.58[0.43,0.78]). The included studies presented low and medium risk of bias. The mechanical behavior of restored teeth seems to be affected by the excavation strategy. Although there is a tendency for lower fracture resistance and higher cuspal deflection after SCE, there is a lower risk of catastrophic failure when compared to CCE. However, this conclusion is based on very few in vitro studies.