Incomplete and inadequate removal of endodontic biofilm during root canal treatment often leads to the clinical failure. Over the past decade, biofilm eradication techniques, such as sonication of irrigant solutions, ultrasonic and laser devices have been investigated in laboratory settings. This review aimed to give an overview of endodontic biofilm cultivation methods described in papers which investigated sonic-, ultrasonic- and Er:Yag laser-assisted biofilm removal techniques. Furthermore, the effectiveness of these removal techniques was discussed, as well as methods used for the evaluation of the cleaning efficacy. In general, laser assisted agitation, as well as ultrasonic and sonic activation of the irrigants provide a more efficient biofilm removal compared to conventional irrigation conducted by syringe/needle. The choice of irrigant is an important factor for reducing the bacterial contamination inside the root canal, with water and saline being the least effective. Due to heterogeneity in methods among the reviewed studies, it is difficult to compare sonic-, ultrasonic- and Er:Yag laser-assisted techniques among each other and give recommendations for the most efficient method in biofilm removal. Future studies should standardize the methodology regarding biofilm cultivation and cleaning methods, root canals with complex morphology should be introduced in research, with the aim of simulating the clinical scenario more closely.

Several lubricant materials can be used to model resin-based composites (RBCs) during restorative procedures. Clinically, instruments or brushes are wet with bonding agents (BAs) or modeling liquids (MLs) for sculpturing purposes. However, a knowledge gap exists on their effects on the mechanical properties of RBCs, requiring greater insight. Five databases were searched, including 295 in vitro studies on the use of lubricant materials for modeling RBCs during restorative procedures. Only articles in the English language were included, with no limits on the publication date. The last piece of research was dated 24 March 2022. In total, 16 studies were included in the review process, together with a paper retrieved after screening references. A total of 17 BAs and 7 MLs were investigated. Tensile (n = 5), flexural strength (n = 2), water sorption (n = 2), color stability (n = 8) and translucency (n = 3), micro-hardness (n = 4), roughness (n = 3), degree of conversion (n = 3), and monomer elution (n = 2) tests were carried out. In general, a maximum of 24 h of artificial storage was performed (n = 13), while four papers tested the specimens immediately. The present review identifies the possibilities and limitations of modeling lubricants used during restorative procedures on the mechanical, surface, and optical properties of RBCs. Clinicians should be aware that sculpturing RBCs with modeling resins might influence the composite surface properties in a way that is material-dependent.

Resin infiltration is a conservative treatment of initial enamel carious lesions. Only one infiltrant material is available on the market (Icon, DMG), and research is now investigating new chemical compositions so as to further exploit the benefits of the resin infiltration technique. A literature search of the articles testing the effects of different formulations on mechanical properties, resin penetration ability, remineralizing, and antibacterial activities was conducted. Of 238 articles, 29 resulted in being eligible for the literature review. The formulations investigated were all different and consisted in the inclusion of hydrophobic monomers (i.e., BisEMA, UDMA), solvents (ethanol, HEMA), alternative etchants (PAM) or molecules with antibacterial or bioactivity features (i.e., AgNP, YbF_3, MTZ, chitosan, DMAMM, HAp, MC-IL, NACP, PUA, CHX) and microfilled resins. Information on the long-term performances of the tested experimental materials were scarce. The combination of TEGDMA with hydrophobic monomers and the inclusion of a solvent alternative to ethanol reinforced mechanical properties of the materials. Hybrid-glass materials demonstrated an enhanced remineralization capacity. Techniques such as tunnelization increased the penetration depth and preserved the recourse to less-conservative treatments. Combining the min-invasive infiltrant approach with remineralizing and bacteriostatic properties would be beneficial for therapeutic and economical aspects, according to the principles of minimally invasive dentistry.

Orthodontic aligners 3D-printed in resin currently provide a viable alternative to thermoformed ones. However, concerns have been raised regarding their biocompatibility. This review addressed the available scientific evidence on the biological properties of marketed resins for 3D printing of orthodontic aligners, encompassing cytotoxicity, estrogenicity, biofilm formation, and oral soft tissues reactions. A comprehensive literature search of several databases was conducted and PRISMA guidelines were followed to summarize the retrieval. Eleven studies were included in the review. They provided information on only three marketed resins: Tera Harz TC-85 DAC and Tera Harz TA-28 (Graphy) and Clear-A (Senertek). For the last two materials, only one investigation has been performed. Despite the large variability in experimental protocols, the lack of cytotoxicity of Tera Harz TC-85 DAC was a consistent finding. Also, no estrogenic effect was detected for this resin, in line with the lack of any bis-phenol A precursor in its chemical composition. In two clinical studies, oral soft tissue reactions were reported as rare and non-serious occurrences. Biofilm adhesion was regarded as critical for the clinical safety of 3D-printed aligners. Standardization of in vitro protocols, also including more clinically relevant settings, chemical characterization of the resins’ eluates, and collection of additional in vivo data are advised to improve the quality of the evidence.

The aim of this study was to evaluate the effect of different concentrations of chitosan polymer on dentinal enzymatic activity by means of gelatin and in situ zymography. Human dentin was frozen and ground in a miller. Dentin powder aliquots were demineralized with phosphoric acid and treated with three different concentrations of lyophilized chitosan polymer (1, 0.5 and 0.1 wt%) dissolved in distilled water. Dentin proteins were extracted from each experimental group and electrophoresed under non-reducing conditions in 10% SDS-PAGE containing fluorescein-labeled gelatin. After 48 h in the incubation buffer at 37 °C, proteolytic activity was registered under long-wave UV light scanner and quantified by using Image J software. Furthermore, additional teeth (n = 4) were prepared for the in situ zymographic analysis in unrestored as well as restored dentin pretreated with the same chitosan primers. The registered enzymatic activity was directly proportional to the chitosan concentration and higher in the restored dentin groups (p < 0.05), except for the 0.1% chitosan primer. Chitosan 0.1% only showed faint expression of enzymatic activity compared to 1% and 0.5% concentrations. Chitosan 0.1% dissolved in water can produce significant reduction in MMPs activity and could possibly contribute to bond strength preservation over time.