Tag: nevin manimala

J Contemp Dent Pract. 2026 Feb 1;27(2):170-178. doi: 10.5005/jp-journals-10024-4022.

ABSTRACT

AIM: To compare the clinical efficacy of injectable vitamin C and injectable platelet-rich fibrin (i-PRF), each combined with microneedling (MN), in enhancing gingival thickness (GT) among individuals with a thin gingival phenotype.

MATERIALS AND METHODS: This randomized, controlled, split-mouth clinical trial included 16 systemically healthy participants (14 females, 2 males; 18-40 years) presenting with a thin gingival phenotype. In each patient, one side received MN + vitamin C (intervention), and the contralateral side received MN + i-PRF (control). Interventions were performed in three sessions at 7-day intervals. Clinical parameters-GT, keratinized tissue width (KTW), pocket depth (PD), gingival index (GI), and plaque index (PI)-were recorded at baseline, 1, 3, and 6 months. Data were analyzed using two-way repeated measures ANOVA and mixed cumulative linked models (CLMs), with p < 0.05 considered significant.

RESULTS: Both groups showed a statistically significant increase in GT over time (p < 0.001). The vitamin C group achieved significantly greater GT at 1 month (1.71 ± 0.29 vs 1.55 ± 0.35 mm; p = 0.007) and 3 months (1.39 ± 0.33 vs 1.26 ± 0.33 mm; p = 0.034), while differences were not significant at 6 months. Keratinized tissue width changes were minimal and comparable between groups. Pocket depth decreased slightly in both groups, with i-PRF showing a significantly lower PD at 6 months (p = 0.040). Both GI and PI improved significantly over time, with vitamin C showing a trend toward greater GI reduction (p = 0.053). No adverse effects were observed, and 92.3% of participants reported high satisfaction.

CONCLUSION: Injectable vitamin C combined with MN is a safe, minimally invasive, and effective approach for improving GT and esthetics in thin periodontal phenotypes, showing comparable long-term outcomes to i-PRF.

CLINICAL SIGNIFICANCE: Development of newer, less invasive therapeutic approaches that help in the prevention of gingival recession. A thin gingival biotype is more prone to gingival recession and to achieve satisfactory therapeutic results with minimum trauma to tissues of any interventional process. How to cite this article: Abdelhay NM, Elzanaty MT, Ibrahim RO. Comparative Evaluation of Vitamin C and Injectable Platelet-rich Fibrin in the Management of Thin Gingival Phenotype: A Split-mouth Randomized Clinical Trial. J Contemp Dent Pract 2026;27(2):170-178.

PMID:42145166 | DOI:10.5005/jp-journals-10024-4022

J Contemp Dent Pract. 2026 Feb 1;27(2):156-162. doi: 10.5005/jp-journals-10024-4032.

ABSTRACT

BACKGROUND AND AIM: Localization of submerged cover screws during second-stage dental implant surgery may require blind probing or extensive flap reflection, potentially increasing tissue trauma and postoperative discomfort. Implant detector devices (IDDs) have recently emerged as chairside adjuncts for implant localization; however, patient-reported outcomes associated with their clinical use remain underexplored. Therefore, this study aimed to evaluate patient-reported outcomes associated with different IDDs during second-stage dental implant surgery.

METHODOLOGY: A prospective observational study was conducted across multiple clinical settings. Adult patients undergoing second-stage exposure of submerged dental implants were consecutively recruited. Implant localization was performed using one of three detector systems (EasyinSmile, Implant Locator iD1, or Spotter) prior to soft-tissue incision. Immediately after surgery, participants completed a structured questionnaire assessing satisfaction, perceived complications, comfort with device use, perceived pain reduction, and willingness to recommend the technology. Associations between detector type and patient-reported outcomes were analyzed using cross-tabulation and Fisher’s exact test (α = 0.05).

RESULTS: Fifty-four patients were included. Overall satisfaction was high (87.0%, n = 47): 35 (64.8%) were very much satisfied, 12 (22.2%) somewhat satisfied, 7 (13.0%) undecided, and none selected either “not really satisfied” or “not at all satisfied.” Most participants reported comfort with device use (77.8%, n = 42), and 49 (90.7%) perceived less pain during the detector-assisted procedure. No definite complications were reported, although 15 (27.8%) were unsure. Thirty-three participants (61.1%) indicated willingness to recommend the technology. No statistically significant differences were observed among the three detector systems for any patient-reported outcome (p > 0.05).

CONCLUSION: Implant detector devices were associated with high patient-reported satisfaction and a favorable procedural experience during second-stage implant surgery. Outcomes appeared comparable across detector systems; however, because this observational study did not include a conventional control group, superiority over standard localization methods cannot be inferred. Further randomized controlled studies with objective outcomes are needed to confirm these findings.

CLINICAL SIGNIFICANCE: Implant detector devices may support a more patient-centered second-stage implant procedure by enabling minimally invasive implant uncovering, improving patient comfort and acceptance, and potentially reducing procedural anxiety. How to cite this article: Hamdi BA, AlZarea B, AlMoaleem MM, et al. Patient-reported Outcomes of Implant Detector Device Use in Second-stage Dental Implant Surgery. J Contemp Dent Pract 2026;27(2):156-162.

PMID:42145164 | DOI:10.5005/jp-journals-10024-4032

J Contemp Dent Pract. 2026 Feb 1;27(2):148-155. doi: 10.5005/jp-journals-10024-4029.

ABSTRACT

AIM: To evaluate the effect of over-the-counter (OTC) whitening products on postbleaching enamel surface roughness and the ability to recover the postbleaching shade after a standardized staining challenge under in vitro conditions.

MATERIALS AND METHODS: This experimental, longitudinal in vitro study included 40 human enamel specimens. Specimens were subjected to bleaching with 35% hydrogen peroxide (HP) and then immersed in a purple-corn beverage at 37°C for 30 minutes every 24 hour for 28 days; the beverage was renewed daily. Specimens were randomly assigned to four equal groups (n = 10) according to the OTC treatment: Group I, distilled water (control); group II, whitening strips (WS); group III, whitening mouthwash (WM); and group IV, WS + WM. Shade recovery was assessed using the CIEDE2000 color difference (ΔE₀₀) relative to the postbleaching reference shade, and surface roughness (Ra) was measured with a contact profilometer at baseline (post-staining, pre-OTC) and after the assigned OTC regimen. Statistical analyses included paired Student’s t-tests, MANOVA, and one-way between-groups ANOVA (p < 0.05).

RESULTS: At baseline, no between-group differences were observed for Ra (p = 0.893) or ΔE₀₀ (p = 0.304). After exposure, Ra increased significantly compared with control in WS (p = 0.026), WM (p = 0.002), and WS + WM (p = 0.025), with no differences among the three OTC regimens (p > 0.05). Within groups, Ra increased in WS (+0.83 μm; p < 0.001), WM (+1.18 μm; p = 0.001), and WS + WM (+0.72 μm; p = 0.005), but not in the control (p = 0.532). For ΔE_00, there were between-group differences (p < 0.001): WS + WM yielded the lowest values and differed from control, WS, and WM (all p < 0.05), while WS and WM did not differ from each other (p > 0.05). Within groups, ΔE₀₀ decreased in WS (-14.62; p < 0.001), WM (-16.47; p < 0.001), and WS + WM (-21.19; p < 0.001), with no change in the control (p = 0.292). A global multivariate effect of OTC whitening was detected [Wilks’ Λ, p < 0.001; partial η² (η_p²) = 0.753], with a very large effect size for ΔE₀₀ (η_p² = 0.934) and a moderate one for Ra (η_p² = 0.326).

CONCLUSION: Under in vitro conditions, OTC whitening regimens increased enamel surface roughness and reduced color difference, with a larger effect on ΔE₀₀ than on Ra. The combined regimen of strips and mouthwash produced the greatest reduction in ΔE_00, while Ra did not differ among OTC protocols. Longer-term randomized clinical trials are needed to determine the clinical relevance of these findings.

CLINICAL SIGNIFICANCE: After professional bleaching, OTC WS, WM, or both may improve color recovery, but they may also increase enamel surface roughness. Clinicians should advise patients about this esthetic-surface trade-off and recommend judicious use. How to cite this article: Llancari-Alonzo R, Manrique-Guzmán J, Manrique-Chávez J, et al. Effect of Over-the-counter Whitening Products on Postbleaching Enamel Surface Roughness and Shade Recovery: An In Vitro Study. J Contemp Dent Pract 2026;27(2):148-155.

PMID:42145163 | DOI:10.5005/jp-journals-10024-4029

J Contemp Dent Pract. 2026 Feb 1;27(2):141-147. doi: 10.5005/jp-journals-10024-4033.

ABSTRACT

AIM: This study investigated the effect of adding bioactive biocompatible seashell-derived hydroxyapatite (HA) nanofillers on the mechanical properties of acrylic polymethyl methacrylate (PMMA) resin, namely flexural strength, hardness, and compressive strength.

MATERIALS AND METHODS: Sixty acrylic specimens were divided into four groups, with five acrylic specimens for each test; control and experimental specimens containing 5, 10, and 12% seashell nanoparticles (NPs) added to the acrylic. The tests included hardness, compression strength, and flexural strength. According to the required proportion of NPs, these NPs were added to the monomer (liquid) of the cold-cured acrylic resin. The specimens were removed to complete the preparation process and then stored in distilled water at 37°C for 48 hours before testing. Data were analyzed using SPSS software. The difference was considered statistically significant at a p-value ≤ 0.05. For descriptive analysis of all variables, a paired t-test was used to compare the control group with the experimental groups.

RESULTS: For hardness and compression strength, the highest mean values for the groups were 12, 10, and 5%, respectively. For flexural strength, the 12% group was higher than the control group, followed by the 10% group, and then the 5% group, which was lower than the control group. A significant difference was found between the control group at both 5 and 12% for flexural strength, and a significant difference was also found between the control group at both 5 and 10% for hardness, and across all concentration groups for compression.

CONCLUSION: Adding a high concentration of seashell HA NP largely increased the flexural strength of PMMA resin. Cold-cured PMMA resin incorporated with lower concentrations of seashell HA NPs noticeably revealed improved hardness. Seashell HA NPs at the studied three concentrations improved the compression strength of the cold-cured PMMA resin.

CLINICAL SIGNIFICANCE: Natural HA NPs from seashell can be used as a bio-compatible nanofiller that can strengthen self-curing polymer materials. How to cite this article: Al Hamdany AK, Tawfek ZS, Agha NF, et al. Effect of Hydroxyapatite Seashell Nanofiller on Some Properties of Autopolymerized Acrylic Material for Orthodontic Appliances. J Contemp Dent Pract 2026;27(2):141-147.

PMID:42145162 | DOI:10.5005/jp-journals-10024-4033

J Contemp Dent Pract. 2026 Feb 1;27(2):124-129. doi: 10.5005/jp-journals-10024-3914.

ABSTRACT

AIM: The study aimed to characterize the surface morphology and evaluate the surface roughness of clear aligners (CAs) coated with titanium dioxide (TiO₂) nanoparticles.

MATERIALS AND METHODS: In this in vitro study, thermoformed PETG samples (n = 20) were equally divided into TiO₂-coated and noncoated groups. Coated samples underwent TiO₂ nanoparticle deposition via radiofrequency (RF) magnetron sputtering. All samples were analyzed using scanning electron microscopy (SEM) for surface morphology, energy dispersive X-ray analysis (EDAX) for elemental composition, and atomic force microscopy (AFM) for surface roughness. Parameters assessed included average surface roughness (Ra), root mean square roughness (Rms), and mean peak height (mh). Statistical analysis was performed using SPSS v22.0; intergroup comparisons were made using the independent t-test.

RESULTS: Scanning electron microscopy images showed a uniform, crack-free TiO₂ coating in the coated group, while the control group lacked such features. Energy dispersive X-ray analysis confirmed the presence of titanium and oxygen in the coated samples only. Atomic force microscopy results revealed significantly lower surface roughness values in the coated group: Ra (5.17 ± 1.28 nm), Rms (6.77 ± 1.62 nm), mh (36.11 ± 9.27 nm) compared to the control: Ra (11.96 ± 5.80 nm), Rms (14.72 ± 6.30 nm), mh (51.00 ± 7.42 nm) (p < 0.05).

CONCLUSION: Titanium dioxide-coated aligners demonstrated reduced surface roughness and improved surface morphology over non-coated aligners.

CLINICAL SIGNIFICANCE: Titanium dioxide nanoparticle coating may enhance the clinical performance of CAs by improving surface quality and reducing potential bacterial adhesion. How to cite this article: Padmanabhan SV, Kalathur Sridev A, Sankaranarayanan V, et al. In Vitro Evaluation of Surface Morphology and Roughness of TiO₂-coated Clear Aligners Using Scanning Electron Microscopy and Atomic Force Microscopy. J Contemp Dent Pract 2026;27(2):124-129.

PMID:42145160 | DOI:10.5005/jp-journals-10024-3914

J Contemp Dent Pract. 2026 Feb 1;27(2):117-123. doi: 10.5005/jp-journals-10024-4019.

ABSTRACT

AIM: The current study aimed to evaluate the efficacy of vibration and external cooling in contrast to counter-stimulation with audiovisual (AV) distraction in reducing pain and anxiety during inferior alveolar nerve block (IANB).

MATERIALS AND METHODS: The participants in the study included 36 children aged 6-10 years who needed dental work on their mandibular posterior teeth that called for IANB usage. A pulse oximeter was used for the objective measure, which was pulse rate. The patient selected the Wong-Baker FACES Pain Rating Scale (WBFPRS), and the observer recorded the face, leg, activity, cry, and consolability (FLACC) scale among the subjective measures. The participants were randomly assigned to three groups: Group A: Buzzy, group B: Counter-stimulation with AV distraction group, and group C: Control group (IANB without intervention).

RESULTS: Comparison between groups revealed that the differences in pulse rates between the groups were statistically significant during the procedure (p = 0.035). Group B showed the highest mean pulse during the procedure. Regarding Wong-Baker scale results, after the procedure, group A (Buzzy) showed the lowest mean pain score, followed by group C, while group B showed the highest mean pain score, but the difference between groups did not reach a level of statistical significance (p = 0.19). Group B had the highest mean FLACC score, but the groups did not differ significantly.

CONCLUSION: Buzzy was more successful in lowering pediatric dental patients’ perceptions of IANB pain as compared to counter-stimulation with AV distraction and conventional technique, but this effect was not statistically significant.

CLINICAL SIGNIFICANCE: Children with dental anxiety have exaggerated expectations of pain. The use of the Buzzy device during IANB aids in improving comfort and cooperation in pediatric dental patients, supporting effective chairside pain and anxiety management. How to cite this article: Abdel Lattif NA, Abd-Alla NF, Alfadhli HA, et al. Buzzy vs Counter-stimulation with Audiovisual Distraction for Pain and Anxiety Control during Inferior Alveolar Nerve Block in Children: A Randomized Controlled Trial. J Contemp Dent Pract 2026;27(2):117-123.

PMID:42145159 | DOI:10.5005/jp-journals-10024-4019

J Contemp Dent Pract. 2026 Feb 1;27(2):105-116. doi: 10.5005/jp-journals-10024-4020.

ABSTRACT

AIM: The purpose of this study was to assess the clinical performance of recently introduced multilayered ultra-translucent zirconia as a laminate veneer material lithium disilicate laminate veneers in terms of modified United States Public Health Service (USPHS) criteria for assessing dental restorations.

MATERIALS AND METHODS: The minimum estimated sample size was 21 veneers. The sample size was increased to 26 veneers (13 veneers per group) to compensate for a dropout rate of 25%. Healthy patients with normal occlusion and with no parafunctional habits, severe discoloration or rotation, and having sufficient sound enamel thickness, who met the inclusion criteria, were randomly assigned to two groups. In the intervention group, 16 laminates were fabricated from ultra-translucent multilayered (UTML) zirconia. In the control group, 16 laminates were fabricated from lithium disilicate. All preparations were confined to the enamel with chamfer finish line and butt-joint incisal margins. Zirconia veneers were sandblasted and surface-treated with zirconia primer. Acid-etched lithium disilicate veneers were surface-treated with ceramic primer. Both groups were adhesively cemented to the tooth structure with light-cured resin cement. Veneers were assessed immediately after cementation and at 3, 6, 12, and 18 months. United States Public Health Service criteria were used to evaluate each veneer, where retention was specified as the primary outcome. The secondary outcome was the restoration of integrity. The third outcome was color match, and marginal adaptation of the restoration was determined to be the fourth outcome. Data were recorded and statistically analyzed.

RESULTS: Results of multiple follow-ups over 18 months were analyzed using Fisher’s exact test for statistical comparison and showed no statistically significant difference between the two groups. Results of retention at baseline showed that both groups had identical 100% Alpha scores. At 3 months, the lithium disilicate group maintained consistent Alpha scores (100%), while UTML zirconia showed a slight decrease with 93.7% Alpha and 6.3% Bravo scores, with no significant difference between groups (p = 0.31). At 6 months, the lithium disilicate group maintained consistent Alpha scores (100%), while UTML zirconia declined to 81.3% Alpha and 18.7% Bravo scores with an insignificant difference between groups (p = 0.069). Finally, after 12 and 18 months, both groups had identical 100% Alpha scores. Regarding restoration integrity, color matching, and marginal adaptation, both groups recorded Alpha scores throughout the entire follow-up intervals.

CONCLUSION: Although the lithium disilicate group showed better retention results, no significant difference was found in retention, color stability, restoration integrity, and marginal adaptation between the groups.

CLINICAL SIGNIFICANCE: This trial provides evidence-based guidance for selecting materials for conservative restorations. It investigates a new, potentially stronger material for esthetic cases by assessing its clinical performance as a veneer.

TRIAL REGISTRATION NUMBER: https://www.

CLINICALTRIALS: gov. Protocol Registration and Results System, NCT04598737 (22/10/2020). How to cite this article: Elkady MA, Taymour MA, Anwar EM. Clinical Assessment of Teeth Restored with Ultra-translucent Multilayered Zirconia vs Lithium Disilicate Laminates-18-month Follow-up: A Randomized Controlled Trial. J Contemp Dent Pract 2026;27(2):105-116.

PMID:42145158 | DOI:10.5005/jp-journals-10024-4020

Cancer Cytopathol. 2026 Jun;134(6):e70097. doi: 10.1002/cncy.70097.

ABSTRACT

BACKGROUND: Proficiency in cytopathologic diagnosis depends heavily on extensive hands-on practice and immediate error correction. Traditional teaching models, however, are constrained by limited practice opportunities and delayed feedback, which fails to meet the core skill-development needs of residents.

METHODS: In total, 45 pathology residents were enrolled and assigned to two groups. The experimental group (n = 20) adopted a tripartite teacher-artificial intelligence-resident collaborative teaching model, whereas the control group (n = 25) received conventional instruction. Both groups underwent an identical 8-week teaching cycle.

RESULTS: The questionnaire results from the experimental group indicated that 19 of 20 residents (9%) deemed the new model highly necessary, and 15 of 20 (75%) believed it significantly improved their diagnostic competence. Semistructured interviews further revealed that the model enhanced diagnostic ability, facilitated personalized learning, and alleviated learning anxiety. For objective metrics, the experimental group demonstrated a significantly higher postintervention concordance rate for gray-zone cell identification (78.65%) compared with both their preintervention baseline (64.38%) and the contemporaneous control group (66.84%; t = 8.962; p < .001). In addition, the experimental group exhibited a markedly faster diagnostic speed (mean ± standard deviation, 3.05 ± 0.52 minutes per case) compared with their preintervention performance (5.92 ± 0.85 minutes per case) and the control group (5.63 ± 0.79 minutes per case; t = 14.821; p < .001). No statistically significant changes were observed in the control group (p > .05).

CONCLUSIONS: This study demonstrates that artificial intelligence technology integrated with real-time visual interaction effectively improves the cytopathologic diagnostic skills of residents and merits wider promotion in pathology education.

PMID:42145147 | DOI:10.1002/cncy.70097

Dev Neurorehabil. 2026 May 18:1-6. doi: 10.1080/17518423.2026.2674765. Online ahead of print.

ABSTRACT

BACKGROUND: Family-centered care is a foundational principle of early developmental neurorehabilitation; however, family-related outcomes are rarely assessed using instruments specifically developed for this context. The Family Outcome of Early Intervention Questionnaire (FOEI) is an interdisciplinary, family-reported outcome measure currently under development.

OBJECTIVE: To examine selected psychometric properties of the developmental version of the FOEI in a methodological pilot study to inform further instrument refinement, and to provide preliminary evidence that should be interpreted in light of the instrument’s developmental status.

METHODS: In this methodological pilot study with a test-retest design, parents of infants and young children receiving ambulatory early neurorehabilitation completed the FOEI twice within an interval of 7-10 days. Test-retest reliability was assessed using intraclass correlation coefficients (ICC(2,1)). Discriminative validity was explored by comparing families receiving Coping with and Caring for Infants with Special Needs (COPCA®) – based family-centered intervention with those receiving conventional physiotherapy. Convergent validity was examined through correlations with the Family Empowerment Scale (FES). Ceiling effects were assessed using descriptive statistics.

RESULTS: Test – retest reliability of the FOEI total score was moderate in the full sample (ICC(2,1) = 0.58, 95% CI 0.35-0.74) and higher after exclusion of two cases with implausible response patterns (0.79, 95% CI 0.64-0.88). FOEI scores were consistently higher in the COPCA® group, with small to moderate effect sizes, although no differences reached statistical significance after Bonferroni – Holm correction. Convergent validity with the FES was low (ρ = 0.06-0.27).

CONCLUSION: The developmental FOEI version shows preliminary temporal stability in this pilot sample. Further refinement of items and response scaling is required, particularly in light of observed ceiling effects and limited discriminative performance, as part of an ongoing instrument development process.

PMID:42145091 | DOI:10.1080/17518423.2026.2674765

Circulation. 2026 May 18. doi: 10.1161/CIRCULATIONAHA.125.078320. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal transfusion strategy in patients with acute myocardial infarction (AMI) and anemia may be influenced by sex differences in pathophysiology and cardiovascular outcomes. The Myocardial Ischemia and Transfusion trial (MINT) randomized patients with AMI and anemia to restrictive or liberal transfusion thresholds, but sex-stratified outcomes remain undefined. The objective was to evaluate whether the clinical effect of restrictive versus liberal red blood cell transfusion strategies differs by sex in patients hospitalized with AMI and anemia.

METHODS: In this prespecified secondary analysis of the MINT trial, we examined outcomes by sex and transfusion strategy. The primary outcome was 30-day composite death or MI. Secondary outcomes included heart failure, stroke, cardiac death, and 180-day mortality. Adjusted relative risks (RRs) and hazard ratios (HRs) were estimated accounting for sex differences at baseline. Interactions between sex and transfusion effects were assessed.

RESULTS: There were 3504 study participants, of whom 1593 (45.4%) were women. Women received fewer transfusions on average. Primary outcome occurred in 15.4% of women and 15.4% of men and occurred in 16.5% of women and 17.1% of men in the restrictive arm, versus 14.9% and 14.2% in the liberal arm, respectively. Women had a lower 180-day mortality (11.0% versus 13.5%; P=0.04). There were no statistically significant interactions between sex and transfusion strategy for the primary outcome (interaction P=0.60). For 30-day cardiac death, a higher RR in men was observed in the restrictive transfusion arm (RR, 2.34; 95% CI, 1.48-3.70; interaction P=0.05).

CONCLUSIONS: For MINT patients with anemia and AMI, women comprised nearly half of the study population, and randomization to a restrictive or liberal transfusion strategy resulted in comparable outcomes in women and men. These findings support sex-neutral transfusion thresholds.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02981407.

PMID:42145087 | DOI:10.1161/CIRCULATIONAHA.125.078320