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Introduction: Due to the presence of ion reservoir, saliva may facilitate enamel remineralization and neutralize pH of acidic beverage leads to prevent enamel demineralization. Saliva substitute/artificial saliva has been developed in subsequent years and may differ in physical properties, function, or pH level from 5.0 to 7.3. Objectives: To evaluate the biomimetic effect of saliva (neutralization) on tooth enamel exposed to carbonated beverage (pH 2.44) and to observe therapeutic capability (remineralization) of artificial saliva over previously eroded (grade 3 and grade 5) enamel surface. Methods: After scanning with electron microscope (SEM‐EDX), nondemineralized crown samples (n = 40) were randomly grouped into two. Samples (50%) were flushed all around to carbonated beverage with collected natural saliva bathing simultaneously (experimental group, n = 20), and the rest flushed to beverage only without saliva bathing simultaneously (control group, n = 20). Flushing action was performed for 3 min by a customized digital automatic flusher for 30 times for each sample. Samples (n = 40) were further scanned under SEM‐EDX to evaluate the demineralization grade and concentration of Ca, P, O, and C elements of crown samples to find out the neutralization effect of saliva. In the second phase, already demineralized crown samples (n = 30) were randomly treated with artificial saliva having two different pH (7 or 6.8, experimental groups) and distilled water (control group) for 15 min 3 times daily for 30 days. The remineralization score of experimental samples was graded, and therapeutic capability was established. Results: Samples, when exposed to a carbonated beverage with saliva bathing simultaneously, showed low level of demineralization (mean 2.9 ± 0.3) than the control (without saliva) (mean 4.8 ± 0.3) (p = 0.01) which indicated neutralization (bioimimetic) effect of natural saliva. All (100%) of demineralized samples treated with both artificial saliva (pH 7 or pH 6.8) showed significant remineralization (p = 0.01), thus revealed biomimetic capacity. SEM‐EDX analysis showed initial (before beverage exposure) concentrations of calcium, phosphorus, oxygen, and carbon elements of crown samples were 32.48%, 31.5%, 28.3%, and 5.5%, respectively. The calcium (Ca) (9.7%) and phosphorous (P) (18.5%) values were more decreased after beverage exposure without saliva bathing simultaneously compared to after beverage exposure with saliva bathing simultaneously. The concentration of oxygen (54.4%) and carbon (15.5%) were more increased after beverage exposure without saliva bathing simultaneously compared to after beverage exposure with saliva bathing simultaneously. Though the concentration of calcium (38.5%) of the crown sample was increased after treatment with artificial saliva (pH 7), but the phosphorus (18.5%) concentration of the crown sample was not increased. Conclusion: Within the context of the present study, both natural and artificial saliva showed significant biomimetic effects with respect to neutralization and remineralization. [ABSTRACT FROM AUTHOR]

Purpose: Children's fear of the injection of local anesthetic agents affects their cooperation in pediatric dentistry. Different techniques are available to decrease the injection pain, including the use of precooling agents or vibrators. The present study investigated the effectiveness of Buzzy (Buzzy MMJ Labs, Atlanta, GA, USA). This device transfers cold and external vibration to the injection site during the inferior alveolar nerve block (IANB) injection. Materials and Methods: The present self‐control, randomized, and double‐blind clinical trial evaluated 30 children aged 6–12, who had bilateral mandibular permanent or primary carious molar teeth. On one side, the BUZZY was applied before and during the IANB injection, and the other side was considered as control. On both sides, a topical anesthetic gel was applied before injection. The pain severity and children's anxiety were determined using Wong–Baker, face, leg, activity, cry, consolability (FLACC) scales, and the heart rate. Results: The mean age of the participants was 7.18 ± 1.5 years, with 12 girls and 18 boys. The Wong–Baker scale and FLACC scale did not show any statistically significant difference between BUZZY and control (p value = 0.9 and 0.15, respectively). In addition, BUZZY tool did not significantly decrease pain and anxiety during injection, assessed through the heart rate difference (p = 0.38). Conclusion: Under the limitations of the present study, a combination of precooling and vibration using the BUZZY device did not decrease pain and anxiety in children during the IANB injection. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to assess the impact of lockdown due to the coronavirus COVID-19 pandemic on the periodontal status of patients with periodontitis in supportive periodontal therapy. Method and materials: A retrospective analysis of patients affected by periodontitis stage III-IV-grade A, B, and C, who had their supportive periodontal therapy to September 2020, after a period of 6 months from the planned maintenance recall (March 2020) was performed. Clinical parameters full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), and probing depth (PD) were evaluated. Patients were assigned to three groups: A (nonsmokers); B (< 10 cigarettes/day); and C (> 10 cigarettes/day). Statistical analysis was used to compare intra-group and inter-group differences. Results: In total, 55 subjects with the mean age of 47.7 ± 7.0 years were enrolled. The number of participants in group A and group B decreased, respectively, from 25 (45.5%) to 20 (36.4%) and from 17 (30.9%) to 13 (23.6%). The C group increased from 13 (23.6%) to 22 (40.0%). A statistically significant increase in mean FMPS was recorded in group A (from 22.5 ± 3.5 to 30.0 ± 28.3; P < .0001); group B (from 22.5 ± 12.7 to 42.5 ± 3.5; P < .0001); and group C (from 22.5 ± 25.5 to 42.5 ± 10.6; P < .0001). A statistically significant increase in mean FMBS was recorded in group A (from 15.0 ± 7.1 to 25.0 ± 21.2; P < .0001); group B (from 15.0 ± 0.0 to 37.5 ± 3.5; P < .001); and group C (from 12.5 ± 3.5 to 30.0 ± 7.1; P < .0001). A statistically significant increase in mean PD was recorded in group A (from 4.48 ± 0.5 to 5.25 ± 1.2; P < .001); in group B (from 4.71 ± 0.7 to 5.38 ± 1.31; P < .0001); and group C (from 6.00 ± 0.0 to 7.09 ± 1.1; P < .0001). Conclusions: Within the limitations of this study the results showed that the pandemic period resulted in an increase in probing depth for the patients in regular SPT, possibly due to increased tobacco consumption. [ABSTRACT FROM AUTHOR]

Background: Dental implants have become the standard for replacing missing teeth. However, patients' demands for shorter treatment times and the desire for aesthetics in their results can complicate the rehabilitation process, particularly when poor-quality bone is involved. In order to address these challenges, new methods of treating implant surfaces have been introduced. These methods aim to make the implants superhydrophilic and bioactive, enhancing their functionality and interactions with the surrounding tissues. Aim: The aim of the study was to retrospectively examine the efficacy of a superhydrophilic and bioactive implant for treatment of the edentulous maxillary anterior area. The study also aimed to evaluate whether this improved implant surface, by enhancing the osseointegration processes, could serve as a factor in speeding up the loading protocols. Materials and Methods: For this retrospective study, a total of 13 implants were included: 6 delayed restored implants and 7 immediately loaded implants placed in the anterior maxillary area. Clinical, radiographic, and esthetic outcomes were assessed. Baseline measurements of the insertion torque value (ITV) and stability implant quotient (ISQ) were recorded for all implants. In the early-loaded group, these measurements were also taken 30 days (t30) and 45 days (t45) after the placement of the implant to monitor their changes over time. Marginal bone loss (MBL) was calculated according to the changes in marginal bone level on intraoral X-rays taken at two different time points: at baseline and one year after loading. To evaluate the esthetic results, the pink esthetic score (PES) and the white esthetic score (WES) were assessed. For this evaluation, intraoral photographs were taken one year after implant loading. Results: A total of 7 implants were immediately restored, with a mean ITV of 32.29 ± 9.01 Ncm and a mean ISQ of 72.71 ± 2.81. These implants were placed in a bone environment with a mean density of 410.00 ± 194.42 HU. On the other hand, 6 implants with delayed loading had a mean ITV of 28.50 ± 3.27 Ncm, an ISQ of 67.92 ± 8.43, and a mean bone density of 607.50 ± 140.83 HU. The mean PES and WES after 1 year were, respectively, 8.71 ± 1.89 and 8.57 ± 0.79 for immediate and 8.33 ± 1.36 and 9.17 ± 1.33 for delayed-loaded implants. At 12 months after loading, the immediately loaded group had a MBL of 0.29 ± 0.29 mm, while the delayed-loaded group had a MBL of 0.33 ± 0.25. No statistically significant differences between the two treatment groups were found for any of the evaluated outcomes. Conclusions: Despite the limitations of this study, the obtained results may support the use of a superhydrophilic and bioactive implant surface for implant-prosthetic rehabilitation in critical loading protocols with satisfactory esthetic results. [ABSTRACT FROM AUTHOR]

Purpose: The present systematic review and meta-analysis aimed to investigate the available evidence in the literature to answer the following focused question: In partially edentulous arches with reduced bone width, do implants placed after horizontal bone augmentation exhibit differences in survival and success rate compared to narrow-diameter implants placed in native bone? Materials and methods: A population, intervention, comparison and outcome question was defined and an electronic search was conducted using the MEDLINE (via PubMed) and Cochrane Oral Health Group databases to identify all studies analysing the use of standard-diameter implants inserted in regenerated bone or narrow-diameter implants for the rehabilitation of partially or completely edentulous atrophic maxillae and mandibles. Inclusion criteria and quality assessments were established, and studies were selected on this basis. Results: Twenty-four studies met the inclusion criteria and were analysed cumulatively. A comparative meta-analysis was not possible due to the lack of studies directly comparing the two rehabilitation methods in question. A cumulative implant survival rate of 97.80% (1246/1274; pooled proportion 0.984, 95% confidence interval 0.977-0.991) was reported for the narrow implants placed in atrophic ridges, while similar results were obtained for the standard-diameter implants placed in regenerated bone, with a cumulative implant survival rate of 97.94% (1332/1360; pooled proportion 0.983, 95% confidence interval 0.976-0.990). Conclusions: The present systematic review found high and comparable survival rates between narrow- and standard-diameter implants placed in regenerated bone; however, well-designed randomised controlled trials are required to support the hypothesis that both treatment strategies are successful in comparable circumstances. [ABSTRACT FROM AUTHOR]

Purpose: The present systematic review and meta-analysis aimed to investigate the available evidence in the literature to answer the following focused question: In partially edentulous arches with reduced bone width, do implants placed after horizontal bone augmentation exhibit differences in survival and success rate compared to narrow-diameter implants placed in native bone?, Materials and Methods: A population, intervention, comparison and outcome question was defined and an electronic search was conducted using the MEDLINE (via PubMed) and Cochrane Oral Health Group databases to identify all studies analysing the use of standard-diameter implants inserted in regenerated bone or narrow-diameter implants for the rehabilitation of partially or completely edentulous atrophic maxillae and mandibles. Inclusion criteria and quality assessments were established, and studies were selected on this basis., Results: Twenty-four studies met the inclusion criteria and were analysed cumulatively. A comparative meta-analysis was not possible due to the lack of studies directly comparing the two rehabilitation methods in question. A cumulative implant survival rate of 97.80% (1246/1274; pooled proportion 0.984, 95% confidence interval 0.977-0.991) was reported for the narrow implants placed in atrophic ridges, while similar results were obtained for the standard-diameter implants placed in regenerated bone, with a cumulative implant survival rate of 97.94% (1332/1360; pooled proportion 0.983, 95% confidence interval 0.976-0.990)., Conclusions: The present systematic review found high and comparable survival rates between narrow- and standard-diameter implants placed in regenerated bone; however, well-designed randomised controlled trials are required to support the hypothesis that both treatment strategies are successful in comparable circumstances.