The increasing demand for biocompatible and effective alternatives to fluoride in enamel remineralization has prompted the development of novel synthetic peptides with a high affinity for calcium. This in vitro study aimed to assess the remineralization potential of one such peptide on artificially induced carious lesions in both primary and permanent enamel, in comparison with fluoride and untreated controls. An in vitro study was conducted in two phases: pilot and comprehensive. Three peptides (P1-P3) were newly synthesized based on amino acid sequences with high calcium affinity (patent pending). In the pilot phase (n = 44), enamel samples were treated with peptides (200/400 µg/mL), fluoride, or left untreated. Based on preliminary results, P2 and P3 (800 µg/mL) were selected for the comprehensive phase (n = 144). Scanning electron microscopy with energy dispersive X-ray (SEM-EDX) analysis was performed at initial, after demineralization, and after pH cycling. Statistical analyses were performed using SPSS software (version 18.0; SPSS Inc., Chicago, Illinois, United States). Descriptive statistics were calculated for calcium and phosphorus levels. Intragroup comparisons were conducted using paired Student's t-test or Wilcoxon's signed-rank test, while intergroup comparisons were performed using one-way analysis of variance (ANOVA) or Kruskal-Wallis test, followed by Tukey HSD or Mann-Whitney U-test where appropriate. The significance level was set at p < 0.05. P2 treatment significantly increased Ca2+ levels in both primary and permanent enamel compared with controls (p < 0.05). The increase was higher than in the fluoride group, though not statistically significant. No meaningful change in phosphorus levels was observed across groups (p > 0.05). This study suggests that novel peptide-based agents may offer effective remineralization in early enamel lesions, particularly in primary teeth. They may serve as promising alternatives to fluoride in pediatric dentistry.

This study aimed to (1) develop a novel method for fabricating simulated root canals, (2) introduce a reliable approach for detecting file fractures, and (3) establish a direct measurement technique for determining the number of cycles to failure (NCF) in bending fatigue tests of rotary files. Bending fatigue tests were conducted using a custom setup consisting of a simulated root canal, a handpiece-controller unit, and a signal extraction module for monitoring motor current and encoder signals. The simulated canals were fabricated to match the geometry of 25.06 ZenFlex rotary files, and included five configurations with varying radii (2, 5, and 8 mm) and angle of curvature (30°, 45°, and 60°). Tests were performed at room and body temperatures. File fracture was identified by an abrupt drop in motor current, and the NCF was directly determined from encoder-derived revolution counts. To verify accuracy, encoder-based revolution counts were compared with those measured with a mechanical counter. In addition, the proposed method was benchmarked against the conventional time-based calculation of NCF. The fabricated canals provided precise confinement of the files, ensuring reproducible curvature with negligible torsional distortion. Fractographic analysis revealed fatigue features, including striations radiating from the crack origin and dimples in the fast-fracture zone, confirming bending fatigue as the dominant failure mechanism. Encoder-based revolution counts closely matched those from the mechanical counter, with discrepancies of less than one revolution, and yielded slightly lower values than the conventional time-based method. Statistical analysis showed no significant difference between the proposed and conventional methods (p > 0.05). Fatigue life was significantly reduced at body temperature compared with room temperature (p < 0.05) and increased with larger radii of curvature (p < 0.05), while angle of curvature had no significant effect (p > 0.05). The proposed simulated root canals improved reproducibility and standardization of in vitro fatigue testing of files. The signal extraction method provided accurate revolution counts and a more realistic estimation of NCF than conventional time-to-failure methods, which overestimated actual values by 1.85 to 6.28% in this study.

To evaluate the potential of a phosphoprotein analogue to mediate mineral deposition and enhance surface integrity in deep carious dentin lesions, compared with mineral trioxide aggregate (MTA) and Sylc air abrasion. Thirty carious dentin discs (3.5 ± 0.1 mm in thickness) were prepared and examined visually (ranging from yellow to light brown), through tactile assessment (leathery sensation), with 0-20 DIAGNOdent pen readings indicating caries-affected dentin (CAD) substrate. The specimens received three treatments: dentin matrix protein-1 (DMP-1, MCE, United States), MTA (Angelus, Brazil), and Sylc air abrasion (AquaCare, United Kingdom), and were immersed in artificial saliva (pH 7, 37°C) for 30 days. Fourier-transform infrared spectroscopy (FTIR) and contact angle measurement were performed on DMP-1. The mineral and organic content was assessed using Raman micro-spectroscopy, while cross-sectional tissue hardness was evaluated by a Vickers tester at 50 and 100 µm depth from the treated surfaces. The morphological assessment was conducted using scanning electron microscopy (SEM). One-way ANOVA followed by Tukey's multiple comparison test and paired t-test were performed for the statistical analyses. The FTIR spectra of DMP-1 displayed the amide bands associated with carbonyl and N-H stretching vibrations, in addition to the phosphate band. DMP-1 exhibited good wettability (contact angle of 27°), and enhanced the phosphate and organic content and tissue hardness of the treated CAD surfaces compared with pretreatment values (p < 0.05). Meanwhile, the MTA-treated surface demonstrated the highest phosphate content and Vickers hardness number up to 100 µm (p = 0.005). The SEM showed compact surfaces completely covered with mineral precipitation. DMP-1 provided a successful biomimetic analogue that enhanced the mineral-organic phases of mineral-depleted dentin surfaces, offering an effective treatment modality for deep carious lesions compared with MTA and Sylc air abrasion.

To describe the effect of short-term oral complications of head and neck cancer (HNC) radiotherapy on patients' quality of life (QoL). Radiotherapy is one of the most common HNC therapy modality, either as the primary therapy or in combination with others. However, high-dose radiotherapy can cause both short- and long-term oral complications. Short-term oral complications of radiotherapy include oral mucositis, hyposalivation, dysphagia, and sensory disturbances which can affect the patients' ability to speak, chewing, and swallowing, leading to weight loss and a decline in QoL, thus delaying the therapy process. This is a cross-sectional study at the Dharmais Cancer Hospital in March to April 2024, with a total of 53 participants. The data collected included participants' sociodemographic profiles, oral conditions, and oral health-related quality of life (OHRQoL) measured with the Oral Health Impact Profile 14 (OHIP-14) questionnaire, which was adapted to Indonesian language. Kendall and Spearman tests with a significance level of 5% were used to analyze the correlations between variables for bivariate analysis. Study participants consisted of 32 males (60.4%) and 21 females (39.6%), with the majority (22 participants, 41.5%) aged 46 to 55 years old. Nasopharyngeal cancer was reported to be the most prevalent HNC diagnosis in this study at 69.8%. All study participants (100%) experienced xerostomia and had clinical oral dryness as their short-term radiotherapy-related oral complications. The distribution of OHIP-14 scores showed that most of the participants (73.6%) had moderate OHRQoL. Xerostomia and dysphagia were shown to have statistically significant influence on OHIP-14 score (Spearman test, p < 0.05). The majority of HNC patients treated with radiotherapy in Dharmais Cancer Hospital have moderate QoL. Dysphagia and xerostomia were reported as the primary drivers of reduced QoL in our study, indicating potential key targets for preventive and management strategies in HNC radiotherapy patients.

The stress distribution of teeth with periapical lesions, which are used as abutments in fixed prostheses, and its effect on the success of the restoration are not well known. This study investigates stress distribution in abutment teeth with periapical lesions and surrounding tissues under occlusal load using finite element analysis. Three models were constructed: (1) a healthy mandibular premolar, (2) a premolar with a periapical lesion restored using a fiber post and single crown, and (3) a similar premolar used as an abutment for a three-unit bridge. A static load of 300 N was applied at a 45-degree angle to the tooth's long axis, targeting the lingual slope of the buccal cusp. Stress and deformation were analyzed across all structural components, including dental tissues and the surrounding trabecular bone. The results demonstrated that, in model 2, stress propagation extended more prominently along the root surface and progressed apically, resulting in a higher stress concentration in the periapical lesion region (0.061 MPa) when compared with model 3 (0.054 MPa). Furthermore, the greatest deformation was also observed in model 2. Across all models, peak stress was consistently localized in the cervicobuccal collar region of the tooth. These findings underline the importance of prosthesis design in reducing the stress concentration in abutment teeth with periapical lesions and demonstrate the biomechanical advantage of splinted restorations over single crowns in cases with periapical lesions.

This study aims to address the Optimum Torque Reverse (OTR) efficacy in root canal obturationmaterials removal, the amount of apically extruded debris, and separating instruments (SI) as a complication compared to continuous rotational motion (CRM) and reciprocating motion (RM).The sample involved 45 straight mandibular first premolars. The crowns were decoronated to standardize the length to 16 mm. The root canals were prepared up to a size 25 taper 0.06, obturated using the lateral compaction technique with a resin-based sealer, stored for 7 days, and divided according to the motion type used during retreatment into three groups (each group consisted of 15 samples); Group 1: CRM using Protaper Universal Retreatment system (D3 20 0.07 last file reach apical third), Group 2: RM using WaveOne Gold system Medium 25 0.07 variant taper, and Group 3: OTR motion using Protaper Universal Retreatment system (D3 20 0.07 last file reach apical third). The extruded debris weight was measured using an analytical balance. Samples were sectioned longitudinally and photographed at 20X magnification using an optical microscope. The images were analyzed in ImageJ to assess the percentage of residual obturation material. The number of SI during retreatment was recorded. Statistical Analysis Data were statistically analyzed using one-way analysis of variance (ANOVA) and chi-square tests at an α = 0.05 significance level.The results indicate that the incidence of SI during retreatment in the OTR motion group was higher than the CRM group and the RM group (p = 0.001). There were no significant differences among the groups regarding the amount of apically extruded debris and the percentage of residual obturation material (p >0.05).The effectiveness of root canal obturation material removal and the amount of extruded debris during retreatment do not depend on the motion used. However, the OTR motion is associated with an increased risk of SI during retreatment.

This study aims to measure the effect of the lateral cutting efficiency of reciprocating and rotary NiTi files on the produced intracanal splitting forces (ICSF) during root canal preparation.Forty-eight mandibular anterior bovine teeth with straight roots were used to create 48 simulated premolar roots and 26 enamel-dentin disks. The required sample size was determined through power analysis conducted with G*Power 3.1.9.7 software, utilizing data from preliminary studies. Based on a large effect size (0.8), significance level of 0.05, and statistical power of 80%, the analysis indicated a need for at least 21 specimens per group for splitting force evaluation and 10 specimens for cutting efficiency assessment. To maintain sufficient statistical power and accommodate possible sample attrition, the study employed 24 specimens per group for splitting force analysis and 13 specimens for cutting efficiency evaluation. The investigation examined two file systems with comparable heat treatment but distinct kinematics, geometries, and designs to assess the intracanal stress forces generated during preparation and their respective cutting abilities in dentin discs. The tested instruments were WaveOne-Gold (WOG) and Pro-Taper GOLD (PTG). Random allocation was performed using a computer-generated randomization sequence (Random.org). Specimens were numbered consecutively and assigned to groups using block randomization to ensure equal group sizes. Tests were carried out on a custom-made platform under automated conditions. The data collected by the force gauge is in newtons (N), and the cutting efficiency was calculated by measuring the depth of cut produced in dentin in mm. Data analysis was carried out with the Kolmogorov-Smirnov test and one-way Anova.The splitting forces test was significantly higher in the PTG group (S1) file when compared to other PTG and WOG files. The force generated in WOG strokes presented an ascending manner as the file went deeper apically. The cutting efficiency of PTG (F2) was significantly higher than WOG's primary file. However, no significant correlation between splitting force and file cutting efficiency was detected.WOG single reciprocating file produced significantly lower splitting force values with significantly less aggressive dentin cutting compared to PTG multi-sequence rotary files. File design, kinematics, depth of strokes, and the maximum diameter of each file at the coronal third in relation to canal diameter may be influencing factors in generating splitting forces.

Pediatric dental stress is a common barrier to effective treatment, often resulting in behavioral management challenges and long-term avoidance of dental care. Wearable technology, such as smart watches capable of measuring heart rate variability (HRV), may offer real-time, noninvasive tools to assess stress in clinical settings. This study aimed to evaluate physiological stress responses in children undergoing different dental procedures by analyzing HRV across treatment phases.Eighty children aged 5 to 10 years (mean age = 7.2 ± 1.6 years) were randomly assigned to four treatment groups: dental hygiene, dental restorations with anesthesia, restorations without anesthesia, and sealant application. Stress levels were measured using Garmin smart watches that analyze HRV and convert the data into a stress score from 0 to 100. Stress was recorded at three time points-beginning, during, and end of the procedure-for a total of nine measurements per patient. A two-way repeated measures ANOVA was used to evaluate the effects of treatment type and phase, along with post hoc tests and linear regression to assess age-related stress variation.While the type of treatment alone did not significantly influence stress levels, stress varied significantly across treatment phases (p = 0.0249), with a strong interaction between treatment and phase (p = 0.0004). Post hoc analyses revealed that dental hygiene led to a significant reduction in stress over time (p < 0.05), whereas restorations with anesthesia caused a significant increase in stress during the procedure (p = 0.0011). No significant changes were observed for restorations without anesthesia and sealant application. Age was inversely correlated with stress (p = 0.0003), although it explained only a small proportion of variance (R 2 = 0.0527).The study confirms that pediatric dental stress is influenced by both the procedure type and the treatment phase. Smart watches represent a practical tool for monitoring stress in real time. These findings highlight the importance of tailoring behavior management strategies to the procedure and the patient's age, promoting individualized and stress-reducing approaches in pediatric dental care. From a clinical perspective, wearable stress monitoring can assist pediatric dentists in real-time identification of anxiety peaks, allowing timely behavioral adjustments and potentially improving treatment outcomes and patient cooperation.

Oral squamous cell carcinoma (OSCC) is one of the most aggressive malignancies of head and neck cancer associated with severe morbidity and high mortality rates. While conventional treatment modalities are effective in eliminating cancer cells, they frequently result in adverse side effects. Research continues to explore plant-based therapeutics with selective cytotoxicity against cancer cells. Goniothalamus umbrosus is traditionally used among medicinal folks and has shown potential in its anticancer properties. This study aims to explore the role of G. umbrosus hexane extract (GUHE) in inducing apoptosis by elucidating its mechanism of action in OSCC (HSC-3) while comparing its effect on human gingival fibroblast (HGF) cells.The expression of proapoptotic gene (Bax) and antiapoptotic gene (Bcl-2) in HSC-3 and HGF cell lines that had been pretreated with GUHE was evaluated by RT-qPCR. The activity of caspase-3 protein was quantified by ELISA assay.RT-qPCR analysis revealed that GUHE significantly upregulated the Bax expression by 1.69-fold and downregulated Bcl-2 expression by 42% in the HSC-3 cell line. The activity of caspase-3 protein was significantly increased in HSC-3 treated with GUHE. The expression of Bax and Bcl-2 genes and caspase-3 protein activity was not significantly modulated in GUHE-treated HGF.GUHE selectively induced apoptosis by activating the mitochondrial apoptosis pathway in the HSC-3 cell line without being detrimental to the HGF cell line. This highlights its promising effect as a targeted therapeutic agent for OSCC therapy.

Prostatitis is the most prevalent urological condition in young adult men and may progress to prostate cancer, representing a significant public health concern. A high prevalence of inflammatory prostate disorders exists without a clearly identifiable cause. This article aimed to investigate the potential association between periodontal status and prognosis in men diagnosed with prostatitis and to evaluate whether oral health influences urological treatment outcomes.A cross-sectional clinical study was conducted on 172 adult patients with prostatitis who provided written informed consent. Participants were assigned to two groups based on bleeding index (BI): Group A (GA, n = 84), BI >7%, and Group B (GB, n = 88), BI ≤7%. All subjects underwent comprehensive periodontal assessment and nonsurgical periodontal therapy, with follow-up at 30 and 120 days.At baseline, GA showed significantly greater probing depths on proximal surfaces and higher BI values than GB (p < 0.01). Posttreatment, BI improved significantly in both groups, although GA maintained higher residual bleeding (p = 0.002). Mean posttreatment prostate-specific antigen (PSA) levels did not differ significantly between groups; however, PSA decreases occurred more frequently in GB (61.5%) than in GA (28.6%, p = 0.039), while PSA increases were more common in GA (57.1% vs. 15.4%, p = 0.005). Overall, 29.4% of patients exhibited lower PSA levels after periodontal therapy.While no direct association was found between periodontal status and absolute posttreatment PSA values, healthier periodontal conditions were linked to more favorable PSA trends. These findings suggest that periodontal health may contribute to PSA stability in men with prostatitis. Larger, longitudinal studies are warranted to clarify potential mechanistic links between oral and prostatic inflammation.