The primary aim of this review was to synthesize the literature for studies investigating the use of computer simulation (CS) and virtual reality (VR) in undergraduate dental education in operative and restorative dentistry. The secondary aim was to list best practices that maximize the simulation experience in dental education. A literature review of the PubMed and ERIC databases was conducted using the search terms “Dental AND Simulator,” “Dental AND Virtual reality,” and “Simulation AND Dental education.” Studies in English language were categorized into 1 of 5 themes: Manual dexterity and cavity preparation, light curing skills, simulation perception and experience, predictability, and simulation model development. Main practices of simulation education indicated in the McGaghie et al. critical review published in 2010 were used as a reference to identify common practices for dental simulation. Thirty nine of 579 identified abstracts met the inclusion criteria. Skill acquisition and feedback were the two most frequently investigated parameters found in the review. CS was efficient in teaching cavity preparation and light curing skills. Feedback and deliberate practice were among the best practices that should be emphasized in order to enhance the efficiency of the CS and VR simulation exercises. The use of CS is effective in teaching operative skills (such as light curing and cavity preparation) reliably; whereas, the use of VR in undergraduate curricula is debatable. To achieve the maximum benefits of the simulation exercises, emphasis must be given to the timely feedback and deliberate practice approaches.

Objectives: To assess the color stability and surface microhardness of Bulk-Fill composite materials available in the Saudi Arabia market. Methods: Five composite materials (Filtek Z350, Filtek Bulk-Fill, Tetric N-Ceram Bulk-Fill, Sonic Fill 2, and SDR) were investigated. Samples (n = 20; 10 mm in diameter and 2 mm in thickness) were fabricated using a stainless-steel mold and were immersed in tea, coffee, berry juice, and distilled water (control). Baseline (T0) shades of specimens were recorded using a spectrophotometer and after 10 (T1), 30 (T2), 60 (T3), and 90 days (T4) of immersion. Measurements were obtained against a black background and CIE L*a*b* data was used to calculate ΔE for each group. Vickers microhardness values were obtained at T0 and T4. Data was analyzed using mixed model repeated measure ANOVA at 0.05 significance level. Results: Time, material, and solution effects have statistically significant effect on ΔE. Tea was the most staining solution. Z350 was associated with the highest ΔE values while SDR showed the lowest values. No other materials showed significant difference between each other. Solutions were statistically different from each other. All materials were different from each other regarding microhardness. Conclusion: Bulk-Fill materials showed more color stability but lower microhardness values compared to universal resin control.

Because of the tradition of using honey as an antimicrobial medicament, we investigated the effect of natural honey (NH) on Streptococcus mutans growth, viability, and biofilm formation compared to that of an artificial honey (AH). AH contained the sugars at the concentrations reported for NH. NH and AH concentrations were obtained by serial dilution with tryptic soy broth (TSB). Several concentrations of NH and AH were tested for inhibition of bacterial growth, viability, and biofilm formation after inoculation with S. mutans UA159 in 96-well microtiter plates to obtain absorbance and CFU values. Overall, NH supported significantly less (P < 0.05) bacterial growth than AH at 25 and 12.5% concentrations. At 50 and 25% concentrations, both honey groups provided significantly less bacterial growth and biofilm formation than the TSB control. For bacterial viability, the results for all honey concentrations except 50% NH were not significantly different from those for the TSB control. NH was able to decrease the maximum velocity of S. mutans growth compared to AH. In summary, NH demonstrated more inhibition of bacterial growth, viability, and biofilm formation than AH. This study highlights the potential antibacterial properties of NH and could suggest that the antimicrobial mechanism of NH is not solely due to its high sugar content.H oney has been used as a source of nutrients as well as a medicine since ancient times (3). Recent publications indicating the effect of honey in the management of certain conditions have rekindled interest in honey as a natural therapeutic agent. For example, honey can be used as a temporary dressing in burns (20). It has also been found to be effective in the management of radiation-induced mucositis in patients receiving head and neck radiotherapy (26). In addition, Robson and colleagues recorded accelerated healing when honey was used as a wound dressing material in a randomized clinical trial (28).The antibacterial properties of honey have been well documented (37). However, the specific antimicrobial mechanism of honey is still unclear (7). Among the possible mechanisms are the presence of inhibitory factors such as flavonoids (16) and hydrogen peroxide (35, 36), low pH (38), and high osmolarity due to its sugar concentration (38).Honey may have a similar antibacterial effect on Streptococcus mutans, which is considered the main causative organism of dental caries (21). S. mutans along with other oral bacteria forms on the tooth surface a microbial community surrounded by extracellular matrix and salivary proteins (22), collectively known as dental biofilm. Cariogenic bacteria within this biofilm utilize dietary sugars and produce lactic acid as a by-product (34). This acid attacks and demineralizes the tooth structure, leading to decay.Very limited studies have investigated the effect of honey on S. mutans. These studies investigated the effect of honey on several strains of oral bacteria (7). Here, we tried to explore the effect of honey on the growth and viability of S. mutans...

Objective: To investigate how the size of the space between restoration and dentinal wall of the tooth affects the development of secondary caries lesions, especially wall lesions. Methods: Tooth-resin composite specimens were mounted on custom-made gap model stages and divided into 4 groups (n = 10): group 1 with a 30-µm gap throughout both enamel and dentin, group 2 with a 30-µm enamel gap and 530-µm dentinal gap, group 3 with 525-µm gaps in both enamel and dentin, and group 4 with 525-µm and 1,025-µm gaps in enamel and dentin, respectively. Specimens were gas sterilized and incubated in a cycling microbial caries model for 8 days and analyzed with confocal microscopy for lesion size at the enamel outer lesion (EOL), enamel wall lesion (EWL), dentin wall lesion A (DWL-A) next to the dentin-enamel junction (DEJ) and dentin wall lesion B (DWL-B) at 750 µm from the DEJ. Results: No difference in EOL or EWL size was found between the groups. DWL-A and DWL-B were larger in group 3 than groups 1 and 2. A larger DWL-B was found in group 3 than group 4. Conclusions: The presence of additional space at the dentinal wall area did not affect secondary caries development as long as the enamel gap was small. However, with enamel gaps of approximately 500 µm, the presence of the additional gap space at the dentinal wall led to the development of smaller dentinal wall lesions at the deeper parts of the simulated cavity. In uniform gaps, the size of the interface was positively correlated with the size of the dentinal wall lesions.

The aim of this study was to compare color shift, color stability, and post-polishing surface roughness of esthetic restorative materials. Twenty-five disc-shaped specimens (10 mm in diameter and 2 mm in thickness) from five esthetic resin materials (Z250XT, IPS Empress-Direct, G-ænial, Vit-l-escence, and Ceram.X) were fabricated. Color shift before and immediately after light-curing (∆E0) then color stability after immersion in tea, coffee, berry juice, and distilled water were measured using a spectrophotometer. Color changes were measured after 2 (ΔE2), 4 (ΔE4), 6 (ΔE6), and 8 weeks (ΔE8). Surface roughness values (Rq) were determined using an optical profilometer after polishing using a rotary polishing system. Data were analyzed using ANOVA and multiple comparison methods at 0.05 significance level. There were no significant differences between the tested materials regarding color shift except between Vit-l-escence and Ceram.X (p = 0.033). There was no significant difference between coffee and tea solutions (p = 1.0) and between berry juice and distilled water (p = 0.15). There was no difference between the tested materials regarding Rq (p = 0.057). Ceram.X was associated with the lowest ΔE8 values overall. Tested materials were comparable regarding color shift and post-polishing surface roughness. Susceptibility to staining was dependent on the material.

The effect of fluoride concentrations in dental products could be different depending on the Streptococcus mutans strain. The aim of this study was to investigate the effect of different fluoride concentrations corresponding to dental products on biofilm formation and metabolic activity of S. mutans strains. Seven S. mutans strains (UA159, A32-2, NG8, 10449, UA130, LM7, and OMZ175) were inoculated into 96-well microtiter plates and were tested with various concentrations of sodium fluoride (0.0, 1.0, 1.56, 3.13, 6.25, 12.5, 25, 50, 100, 125, 175, 225, 275, 625, 1,250, 2,250, and 5,500 ppm) for inhibition of biofilm formation and bacterial metabolic activity by recording absorbance values followed by scanning electron microscope (SEM) images. Data were analyzed by one-way analysis of variance and Tukey’s tests (α = 5%). Significantly more (p≤0.05) biofilm mass in the presence of fluoride was produced by A32-2 and NG8. UA130, LM7, and OMZ175 were more sensitive to increased fluoride and demonstrated few bacterial cells and extracellular polysaccharide (EPS) production at 100 ppm in SEM images. All strains were unable to produce significant biofilm at concentrations >225 ppm. Patients with tolerantS. mutans strains would potentially benefit less from the inherent antibacterial effect of fluoride.

No abstract

Incipient caries lesions on smooth surfaces may be subjected to toothbrushing, potentially leading to remineralization and/or abrasive wear. The interplay of dentifrice abrasivity and fluoride on this process is largely unknown and was investigated on three artificially created lesions with different mineral content/distribution. 120 bovine enamel specimens were randomly allocated to 12 groups (n = 10), resulting from the association of (1) lesion type [methylcellulose acid gel (MeC); carboxymethylcellulose solution (CMC); hydroxyethylcellulose gel (HEC)], (2) slurry abrasive level [low (REA 4/ RDA 69); high (REA 7/RDA 208)], and (3) fluoride concentration [0/275 ppm (14.5 mM) F as NaF]. After lesion creation, specimens were brushed in an automated brushing machine with the test slurries (50 strokes 2×/day). Specimens were kept in artificial saliva in between brushings and overnight. Enamel surface loss (SL) was determined by optical profilometry after lesion creation, 1, 3 and 5 days. Two enamel sections (from baseline and post-brushing areas) were obtained and analyzed microradiographically. Data were analyzed by analysis of variance and Tukey's tests (α = 5%). Brushing with high-abrasive slurry caused more SL than brushing with low-abrasive slurry. For MeC and CMC lesions, fluoride had a protective effect on SL from day 3 on. Furthermore, for MeC and CMC, there was a significant mineral gain in the remaining lesions except when brushed with high-abrasive slurries and 0 ppm F. For HEC, a significant mineral gain took place when low-abrasive slurry was used with fluoride. The tested lesions responded differently to the toothbrushing procedures. Both slurry fluoride content and abrasivity directly impacted SL and mineral gain of enamel caries lesions.