This in vitro study aimed to assess the erosive effect of hydrochloric acid in association with toothbrushing procedure on the surface condition of three bulk-fill composite resins used for direct restoration. A total of 480 samples (160 from each composite resin): X-tra Fil (VOCO, Germany)—group A, Filtek Bulk-fill Posterior (3M-ESPE, St. Paul, MN, USA)—group B, G-aenial Posterior (GC Japan)—group C were prepared, submitted to chemical attack for 60 min with hydrochloric acid 30% and, subsequently, submitted to the abrasive effect of toothbrushing using 10,000 cycles with medium and hard bristles, at three different times (immediately and after 30 min after acid attack or without any chemical attack). The surface roughness of the samples was measured using a noncontact profilometer (Dektak XT, Bruker, Billerica, MA, USA). The values were analyzed using ANOVA and post hoc Bonferroni tests, with a p < 0.05. Chemical attack for 60 min associated with one year of toothbrushing with toothbrushes having medium or hard bristles increase the surface roughness of tested bulk-fill composite resins. No differences were recorded between toothbrushing with medium or firm bristles immediately or 30 min after acidic challenge for each of the three bulk-fill composite resins. Exposure to hydrochloric acid determines no effect on surface roughness of bulk-fill composite resins.

The aim of the study was to evaluate the antibacterial activity and surface hardness of a light-activated microhybrid composite resin modified with green silver nanoparticles (AgNPs). AgNPs were synthesized using an Equisetum sylvaticum extract and characterized through different methods such as UV-Vis, EDX, and FTIR. The obtained AgNPs were mixed with a microhybrid composite resin (Herculite XRV, Kerr Corp., Orange, CA, USA) in different concentrations: 0% (group A-control); 0.5% (group B); 1% (group C); and 1.5% (group D). A total of 120 composite resin disk-shaped samples were obtained and divided into 4 groups (n = 30) according to AgNP concentration. Each group was then divided into 2 subgroups: subgroup 1—samples were not soaked in 0.01 M NaOH solution; and subgroup 2—samples were soaked in 0.01 M NaOH solution. The antibacterial activity against Streptococcus mutans was determined using a direct contact test. A digital electronic hardness tester was used to determine the composite resin’s Vickers surface hardness (VH). Statistical analysis was performed using the Mann–Whitney U and Kruskal–Wallis nonparametric tests with a confidence level of 95%. Groups C and D showed higher antibacterial activity against S. mutans when compared to the control group (p < 0.05). No significant differences were recorded between VH values (p > 0.05). The use of AgNPs synthesized from Equisetum sylvaticum as a composite resin filler in 1% wt. and 1.5% wt. reduced the activity of Streptococcus mutans. Soaking of the experimental composite resin decreased the antibacterial efficacy. The loading of a microhybrid composite resin with AgNPs in concentrations of 0.5% wt., 1% wt., and 1.5% wt. did not influence the surface hardness.

The aim of this in vitro study was to evaluate the effect of hydrochloric acid associated with the abrasive effect of toothbrushing on the surface condition of three flowable composite resins used for direct restoration. Seventy samples of each composite resin: Grandio Flow (VOCO, Germany)—group A, Filtek Ultimate Flow (3M-ESPE, MN, USA)—group B, G-aenial Flo X (GC Europe)—group C were prepared, submersed in hydrochloric acid 30% for 60 min and then submitted to simulated toothbrushing procedure using 5000 cycles with toothbrushes with medium and hard bristles, immediately after the chemical attack, after 30 min or without any chemical attack. The sample’s surface roughness was analyzed using a noncontact profilometer (Dektak XT, Bruker, USA). ANOVA and post hoc Bonferroni tests, with a p < 0.05, were used to analyze the values. Hydrochloric acid action for 60 min and six months of toothbrushing using toothbrushes having medium hardness or firm bristles affects the surface roughness of tested flowable composite resins. Toothbrushing with firm bristles immediately after acidic challenge determines increased surface roughness for two of the three flowable composite resins (Grandio Flow and Filtek Ultimate Flow). Toothbrushing with medium or firm bristles thirty minutes after the acidic aggression determine no effect on surface condition of flowable composite resins.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of simulated gastric acid associated with toothbrushing on the surface condition of three resin-modified glass-ionomer cements (RMGIC). Materials and Methods: One hundred and sixty samples of each material were obtained and included in three study groups according to the tested material: Group I (Ionolux, VOCO GmbH, Cuxhaven, Germany); Group II (Vitremer, 3 M-ESPE, St. Paul, MN, USA); and Group III (Fuji II LC, GC Corporation, Tokyo, Japan). The samples were submersed in hydrochloric acid 0.01 M (pH 3.8) for 3 h and exposed to a toothbrushing procedure at a frequency of 10,000 cycles with medium and hard bristles immediately or 30 min after the acid attack. Profilometric measurements were performed by using a non-contact profilometer (Dektak XT, Bruker, Billerica, MA, USA) in order to assess the surface roughness. ANOVA and Bonferroni post hoc tests were used for the statistical analysis at a significance level of p < 0.05. Results: Exposure of RMGICs to the erosive effect of hydrochloric acid in association with toothbrushing 30 min after the chemical attack increased the surface roughness of all three RMGICs. Exposure of the three tested materials exclusively to the action of hydrochloric acid did not affect the surface roughness. Conclusions: One year of hydrochloric acid challenge associated with one year of toothbrushing with medium-hardness bristles performed 30 min after the acid attack increase the surface roughness of two of the three types of RMGIC tested (Ionolux and Fuji II LC).

Background and Objectives: Dental anxiety can hinder both treatment delivery and dental education. Few studies have examined this issue among Romanian dental students. This study assessed the prevalence, intensity, and main procedural triggers of dental anxiety, with a focus on experiences related to local anesthesia. Methods: A cross-sectional survey was conducted (January–May 2024) among 122 fourth-year students using the validated Romanian version of the Modified Dental Anxiety Scale (MDAS) and additional items on demographics, prior anesthesia and perceived complications. Data analysis included descriptive statistics, chi-square tests, and t-tests. Results: Overall, 21.3% of respondents scored in the low anxiety range, 75.4% in the moderate range, and 3.3% in the severe range (MDAS ≥ 19). No significant gender differences were identified (p > 0.05). Injections with local anesthetic were rated as the most distressing procedure, followed by drilling, whereas scaling was reported as least stressful. The majority (86.9%) had undergone previous local anesthesia, with very few adverse events recalled. Conclusions: Romanian dental students reported moderate dental anxiety overall, with local anesthesia injections as the main trigger. The lack of gender differences points to a potential buffering effect of clinical exposure. Incorporating structured anxiety management into dental curricula may enhance both student well-being and patient care.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of gastric acid associated with the effect of toothbrushing on the surface roughness of different types of composite resin used for direct restorations. Materials and Methods: The materials used in this study were two microhybrid (Filtek Z250, Herculite XRV) and two nanohybrid (Filtek Z550, Herculite XRV Ultra) composite resins. Two hundred and forty cylindrical samples with a height of 2 mm and a diameter of 6 mm were divided into four groups (groups A, B, C and D) corresponding to each tested material (n = 60). Each group was divided in two subgroups: subgroup I—the samples were submersed in hydrochloric acid and immediately submitted to toothbrushing; subgroup II—the samples were submitted only to toothbrushing. The simulation of the acid attack was performed by immersing the samples in a 0.01 M hydrochloric acid solution for 90 min. This procedure was followed immediately by toothbrushing simulation with 10,000 cycles. The acid attack and toothbrushing simulation were performed for two times. The surface roughness evaluation was performed with a Proscan 2100 profilometer. Repeated Measures ANOVA and Bonferroni post-hoc tests were used to perform the statistical analysis. Results: Simulation of one year of toothbrushing associated or not to hydrochloric acid exposure increases the surface roughness of microhybrid and nanohybrid composite resins. Six months of toothbrushing associated to six months of hydrochloric acid exposure increase the surface roughness of nanohybrid composite resins. Conclusions: Microhybrid composite resins surface becomes rougher after toothbrush and acid submersion when comparing to nanohybrid composite resins.