Aim: This in vitro study compared the efficacy of Er,Cr:YSGG laser (2780 nm), diode laser (976 nm), passive ultrasonic irrigation (PUI), and conventional syringe irrigation (CSI) in removing smear layer from root canals, evaluating the influence of irrigant chemistry (NaOCl+EDTA, EDTA, NaOCl, saline) and root canal level (coronal, middle, apical).Materials & Methods: One hundred sixty single-rooted premolars were instrumented and randomly divided into four irrigation groups (n=40/group), Er,Cr:YSGG (25 mJ, 50 Hz) using radial-firing tip; diode laser (CW, 1.5 W); PUI; and CNI side-vented needle. They further subdivided by irrigant (n=10/subgroup). Irrigation was performed in four 15-second cycles. Smear layer removal was scored (1–5) via SEM by blinded evaluators. Data were analyzed using Kruskal-Wallis and Mann-Whitney tests (p ≤ 0.05).Results: Er,Cr:YSGG achieved the lowest scores (optimal cleaning) across all thirds (1.2–2.7), outperforming diode laser (1.7–3.4), PUI (2.3–4.4), and CNI (2.4–4.7) (p < 0.001). NaOCl+EDTA was most effective (p < 0.05), though saline with Er,Cr:YSGG surpassed NaOCl alone. Apical thirds consistently showed poorer removal (p < 0.001).Conclusion: Er,Cr:YSGG laser activation with NaOCl+EDTA is the most effective protocol for smear layer removal. Mechanical effects of Er,Cr:YSGG dominated with saline. Diode laser activation surpassed PUI.

Aim: To compare the accuracy of implant placement when using tooth supported surgical guide using a fully guided surgical guide design performed on different software of them are non-dental software (Blenderfordental) verses a dental software (Exoplan).Subjects and methods: Twenty study models, simulating patients with a missing upper left first molar, were divided into: Group I (Exoplan) and Group II (Blender). Each group underwent digital implant planning and surgical guide fabrication using their respective software. A virtual model, derived from a physical typodont, served as the basis for implant planning. DICOM data of a physical model were integrated into the planning software. Surgical guides were designed and fabricated using the software's features. After implant placement, postoperative scans of scanbodies attached to the implants was done. By superimposing the preoperative and postoperative scans, deviations in implant position were measured along the buccolingual, mesiodistal, and apico-coronal axes.Results: No statistically significant differences were observed between the two groups for buccolingual (p=0.83), mesiodistal (p=0.41), and depth (p=0.75) dimensions. Conclusion: Open-source software designed for non-dental applications like Blenderfordental can be utilized to create dental implant surgical guides with accuracy that is not significantly different from commercially available dental implant treatment planning software like Exoplan.

Objectives: The aim of this research was to investigate the fracture resistance of premolar teeth with standardized mesioocclusodistal (MOD) cavities restored with different dentin replacement protocols. Materials and Methods: Sixty sound maxillary premolar teeth with standardized MOD cavities were assigned to six groups (n=10): G1: sound teeth (positive control); G2: unrestored premolars with MOD cavities (negative control); G3: restored incrementally with nanohybrid resin composite; G4: restored by bulk fill flowable followed by nanohybrid resin composite; G5: restored with packable fiber-reinforced composite followed by nanohybrid resin composite and G6: restored with flowable fiber-reinforced composite followed by nanohybrid resin composite. After being thermocycled at 37oC, 4mm diameter steel sphere was used in a universal testing machine to apply stresses on specimens at a cross-head speed of 5mm/min until fracture occurred. The results were statistically analyzed with statistical significance set at (P ≤ 0.05).Results: Intergroup comparison has shown statistically significant difference (P < 0.001). The highest fracture resistance was in G5 followed by G1 (natural tooth) then G6 with no difference between them. G4 and G3 showed intermediate results, which was statistically lower than G1, G5 and G6. The least fracture resistance was in G2 (unrestored MOD cavity), which was statistically lower than all groups.Conclusions: using fiber-reinforced composite (either packable or flowable) as dentin substitute material under resin composite is considered a perfect choice to restore fracture resistance of maxillary premolars with MOD cavities.

Objectives: To investigate the clinical and radiographic outcome of the regenerative treatment of molars with grade II furcation involvement (FI) using minimally invasive surgical technique (MIST) with silk fibroin (SF) membrane in comparison to MIST. The research is planned as a prospective, controlled, single-blind, randomized clinical experiment.Patients and methods: A total of twenty patients with Grade II FI were randomly assigned to two groups; Group I: MIST (n=10); Group II: MIST+ SF membrane (n=10). Clinical (Clinical Attachment Level [CAL], Probing Pocket Depth [PD], Plaque Index [PI] and Gingival index [GI]) and radiographic (filled bone volume [FBV]) parameters were evaluated at baseline and 6 months postsurgical. FBV was the primary outcome.Results: For both groups, a statistically significant improvement was reported for CAL (1.63 ± 1.02, 2.75 ± 0.65), PD (1.63 ± 0.68, 2.25 ± 0.47) and FBV (0.02 ± 0.07, 0.056 ± 0.062) for control and test group respectively, at 6 months evaluation period. There was an insignificant difference between the study groups.Conclusions: The addition of SF membrane to MIST improve clinical and radiographic outcomes when treating molars with degree II FI, however, this improvement was statistically insignificant.

Aim: This study aimed to investigate the etiology, microbiology, and antibiotic sensitivity profiles of odontogenic infections among patients presenting to the department of oral and maxillofacial surgery at Cairo University. Subjects and methods: A total of sixty-five patients with odontogenic infections were enrolled over a 40-month period, following thorough preoperative assessments including clinical, radiographic, and bacteriological examinations. Pus samples were collected via aspiration and subjected to aerobic and anaerobic cultures. Bacterial isolates were identified, and antibiotic susceptibility testing was performed. Treatment protocols consisted of surgical interventions such as incision and drainage, coupled with empirical antibiotic therapy tailored to individual patient profiles. Results: Predominant bacterial isolates included enterococci, streptococci, and staphylococci, with variable susceptibility to commonly used antibiotics. Notably, enterococci exhibited sensitivity to ampicillin and levofloxacin but demonstrated reduced sensitivity to vancomycin. Streptococci showed sensitivity to cefotaxime and linezolid. Penicillin showed an accepted overall sensitivity rate. Conclusion: Aerobic bacterial isolates were predominantly found, notably enterococci, differing from some international studies and emphasizing the need for region-specific research in clinical practice. Antibiotic sensitivity varied among isolates, with penicillin group antibiotics showing promise as first-line treatments, but caution advised.