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Three-dimensionally (3D)-printed fabricated denture bases have shown inferior strength to conventional and subtractively fabricated ones. Several factors could significantly improve the strength of 3D-printed denture base resin, including the addition of nanoparticles and post-curing factors. This study evaluated the effect of TiO2 nanoparticle (TNP) addition and the post-curing time (PCT) on the flexural properties and hardness of three-dimensionally (3D)-printed denture base resins. A total of 360 specimens were fabricated, with 180 specimens from each type of resin. For evaluating the flexural properties, bar-shaped specimens measuring 64 × 10 × 3.3 mm were used, while, for the hardness testing, disc-shaped specimens measuring 15 × 2 mm were employed. The two 3D-printed resins utilized in this study were Asiga (DentaBASE) and NextDent (Vertex Dental B.V). Each resin was modified by adding TNPs at 1% and 2% concentrations, forming two groups and an additional unmodified group. Each group was divided into three subgroups according to the PCT (15, 60, and 90 min). All the specimens were subjected to artificial aging (5000 cycles), followed by testing of the flexural strength and elastic modulus using a universal testing machine, and the hardness using the Vickers hardness test. A three-way ANOVA was used for the data analysis, and a post hoc Tukey’s test was used for the pairwise comparisons (α = 0.05). Scanning electron microscopy (SEM) was used for the fracture surface analysis. The addition of the TNPs increased the flexural strength in comparison to the unmodified groups (p < 0.001), while there was no significant difference in the elastic modulus and hardness with the 1% TNP concentration. Among the TNP groups, the 2% TNP concentration significantly decreased the elastic modulus and hardness (p < 0.001). The SEM showed a homogenous distribution of the TNPs, and the more irregular fracture surface displayed ductile fractures. The PCT significantly increased the flexural strength, elastic modulus, and hardness (p < 0.001), and this increase was time-dependent. The three-way ANOVA results revealed a significant difference between the material types, TNP concentrations, and PCT interactions (p < 0.001). Both concentrations of the TNPs increased the flexural strength, while the 2% TNP concentration decreased the elastic modulus and hardness of the 3D-printed nanocomposites. The flexural strength and hardness increased as the PCT increased. The material type, TNP concentration, and PCT are important factors that affect the strength of 3D-printed nanocomposites and could improve their mechanical performance.

The purpose of this study is to comprehensively review the relationship between malocclusion and anxiety and depression. While the physical implications of malocclusion are well documented, recent scholarship has shifted focus to examining the direct relationship between malocclusion and both anxiety and depression. It has been hypothesized that individuals with skeletal or dental malocclusion experience a range of psychological sequelae, including diminished quality of life (QoL), reduced oral-health-related quality of life (OHRQoL), increased vulnerability and appearance-related bullying, and impaired body image. Furthermore, these factors are postulated to collectively contribute to overall mental health, with malocclusion potentially serving as a contributing etiological factor in the development of elevated levels of anxiety and depression. Contemporary scholarship has established a complex relationship between dentofacial deviations and the psychological well-being of affected individuals. Evidence shows that malocclusion may contribute to increased depression and anxiety levels in some individuals, influencing their social functioning and treatment-seeking behavior. Dentofacial disharmony has also been associated with altered self-perception, potentially impacting an individual’s OHQOL and overall quality of life. While the findings exhibit some inconsistency, a modest body of evidence indicates a possible correlation between pronounced skeletal or dental malocclusion and anxiety and depression. These adverse psychosocial impacts, in turn, contribute to an elevated risk of anxiety and depression, underscoring the far-reaching consequences of malocclusion beyond oral health. Therefore, clinicians need to consider these issues in their treatment plans, incorporating interdisciplinary approaches that address both orthodontic and psychological aspects of patient care.

The aim of this study is to evaluate the effect of different surface treatments on the shear bond strength (SBS) of clear aligner attachments bonded to Bis-acryl provisional crowns. 120 cylindrical bisacrylic composite material (ProTemp type) specimens were prepared and divided into six groups (  = 20) based on surface treatment, control: (no treatment); super coarse grit diamond bur, carbide bur, alumina-blasting, non-thermal plasma treatment, and Er:YAG laser treatment. The features of treated surfaces were examined using scanning electron microscopy (SEM). A flowable composite resin (Transbond XT; 3M Unitek) was bonded to the specimens forming the attachment. Half of specimens were subjected to thermal cycling (5,000 cycles). SBS was measured before and after thermal cycling. Each specimen was loaded at the attachment/resin interface at a speed of 0.5 mm/min until failure. The nature of the failure was analyzed using the composite remnants index (CRI). Two-way ANOVA and Tukey HSD were used for data analysis =  0.5. For CRI scores analysis, Kruskal-Wallis test and Dunn's multiple comparison were used as test. SEM analysis showed that all surface treatments altered surface properties and increase surface bonding area. The specimens treated with plasma, Er:YAG laser, and alumina-blasting had higher SBS values before and after thermal cycling. In comparison to control plasma, Er:YAG laser, and alumina-blasting showed a significant increase in SBS (  < 0.001) while carbide and diamond bur groups showed no significant differences (  > 0.05). Thermal cycling significantly decreased the SBS of control, carbide bur, diamond bur, and Er:YAG laser while no significant effect of alumina-blasting and plasma group. Er:YAG laser and plasma groups significantly exhibited more dominance for scores 2 and score 3 and the absence of score 0. Alumina-blasting, Er:YAG laser, or non-thermal plasma surface treatments increased the shear bond strength between clear aligner attachments and resin-based restorations.

This study aimed to present a new application of 3D printing technology for crowns integrated with orthodontic brackets as one unit and to assess the strength of the bonded groups and the one-unit printed group. A total of 60 lateral incisors with brackets were obtained and allocated into two main groups: bonded groups and one-unit group. For the bonded groups, there were 40 specimens (20 conventionally fabricated crowns and 20 3D-printed crowns with bonded brackets), while for the one-unit group, there were 20 3D-printed crowns and brackets fabricated as one unit. One lateral incisor and one with a bracket were scanned, forming STL files for designing and printing 3D-printed specimens (20 without, 20 with brackets). Half of the specimens (30, n = 10) were thermocycled (5000 cycles). A universal testing machine was used for the bond strength (MPa) measurement, followed by analysis of the debonded areas and failure mode (adhesive, cohesive, or mixed). ANOVA and the post hoc Tukey’s test were used for analysis of the collected data (α = 0.05). The 3D-printed one-unit group significantly showed high strength compared with the bonded brackets (p < 0.001). The 3D-printed bracket showed the highest SBS (10.14 ± 1.93 MPa). After thermocycling, the bond strength of the bonded brackets significantly decreased (p < 0.001). The adhesive failure was dominant in the bonded groups, while the one-unit group exhibited all the fractures in the brackets. The introduced technique for producing a one-unit 3D-printed provisional crown integrated with orthodontic brackets is considered a clinically plausible option in contemporary orthodontic practice. However, further investigations are recommended to verify the findings of the present study before clinical implementation.

The manipulation and handling of three-dimensional (3D) printing liquid resins prior to printing have not been reported in the literature. Therefore, this study was designed to assess the effect of different shaking methods and shaking times, together with the number of times the resin bottle was opened for resin reuse on the flexural strength (FS) of 3D-printed specimens, in conditions simulating routine laboratory handling protocols. Two different resins (ASIGA DentaTOOTH and NextDent C&B MFH) were used for specimens' fabrication. Rollers and horizontal shakers were used to shake the resins for 30 and 60 min before printing. A total of 240 specimens were fabricated and grouped according to shaking method (roller and horizontal) and shaking time (30 and 60 min). Further subdivisions were performed according to resin reuse cycles. The resins were reused at defined 7-day intervals, with each resin bottle reopening considered one reuse cycle, resulting in three groups: first use, second use, and third use (n = 10). Bar-shaped (25 × 2 × 2 mm) specimens were printed according to manufacturers' recommendations and thermally cycled (5000 cycles), followed by 3-point bending test for FS testing. Data analysis was performed by using two-independent samples T-test, One-Way ANOVA and K-factors ANOVA. P-values less than 0.05 were considered statistically significant. K-factors ANOVA results indicated that repeated opening and reuse × material, shaking time × shaker, shaker × material, and shaking time × shaker × material all had significant interacting effects on the flexural strength (p < 0.001). For ASIGA, the roller shaker significantly produced higher FS values across all groups at 60 min shaking time (p < 0.001), but this effect was absent at 30 min shaking time. First use showed significantly higher FS compared to third use at 30-minute shaking time for both shakers (roller, p = 0.005; horizontal, p = 0.004). However, at 60-minute shaking time, no significant differences in FS were observed between the different reuse groups (p > 0.05). For NextDent, no significant differences were found between the two shakers for any reuse groups at either shaking times (p > 0.05). However, first use consistently demonstrated higher FS than second and third uses for both shaking times and shakers (p < 0.001). ANOVA revealed significant interactions among material types, shaking method, shaking time, and reuse cycle on FS (p < 0.001). For ASIGA resin, the roller shaker improved FS at 60 min shaking time, whereas no shaker-related differences were observed at 30 min. FS decreased with repeated use, particularly at shorter shaking times. For NextDent resin, shaker type had no significant effect; however, FS progressively decreased with repeated use cycles regardless of shaking conditions. Resin type, shaking method, shaking time, and repeated bottle opening significantly influenced the FS of 3D-printed resin. Proper resin handling may therefore help maintain the mechanical performance of 3D-printed resins.

Background/Purpose: Whether YouTube videos contain precise and adequate information on certain orthodontic procedures remains unclear. This study aimed to investigate the content and quality of YouTube videos on orthodontic elastics and identify the predictors of high-level content YouTube videos. Materials and Methods: Two hundred YouTube videos were screened for eligibility, and after applying the inclusion criteria, 133 videos were excluded. Student's f-test was used to compare the characteristics, quality parameters, and total content of the low-level and high-level content videos. Chi-square or Fisher's exact tests were implemented to identify the source and content element differences across low-level and high-level content videos. Pearson's correlation coefficients were used to determine the relationship between the total content score, video information and quality index (VIQI), and YouTube characteristics. Stepwise linear multiple regressions with forward selection were used to test the association of the YouTube characteristics and VIQI with the total content score. Results: Among 67 included videos, only 19.4% of videos were classified as high-level content videos. High-level content videos had significantly higher mean number of likes (MD = 4041.7; SD = 4680.7; P- value=0.0068), VIQI score (MD = 4.17; SD = 4.87; P-value=0.0073), and total content score (MD = 4.04; SD = 1.23; P- value=<0.0001). The adjusted linear regression model demonstrated a significant association between the total content score and VIQI, where 1 unit increase in the VIQI was significantly associated with a 0.16 increase in the total content score (B = 0.16; standard error [SE]=0.04; P = 0.0003). Further, a significant association was observed between the total content score and video duration, where 1 minute increase in the video duration was significantly associated with a 0.15 increase in the total content score (B = 0.15; SE = 0.05; P = 0.008). Conclusion: This study demonstrated that YouTube content quality concerning orthodontic elastics is poor. Thus, future implementation of online visual content provided by certified orthodontists will ensure accurate and thorough information delivery. Keywords: dentistry, orthodontics, social media, youtube, patient compliance

Whether YouTube videos contain precise and adequate information on certain orthodontic procedures remains unclear. This study aimed to investigate the content and quality of YouTube videos on orthodontic elastics and identify the predictors of high-level content YouTube videos. Two hundred YouTube videos were screened for eligibility, and after applying the inclusion criteria, 133 videos were excluded. Student's -test was used to compare the characteristics, quality parameters, and total content of the low-level and high-level content videos. Chi-square or Fisher's exact tests were implemented to identify the source and content element differences across low-level and high-level content videos. Pearson's correlation coefficients were used to determine the relationship between the total content score, video information and quality index (VIQI), and YouTube characteristics. Stepwise linear multiple regressions with forward selection were used to test the association of the YouTube characteristics and VIQI with the total content score. Among 67 included videos, only 19.4% of videos were classified as high-level content videos. High-level content videos had significantly higher mean number of likes (MD = 4041.7; SD = 4680.7; P-value=0.0068), VIQI score (MD = 4.17; SD = 4.87; P-value=0.0073), and total content score (MD = 4.04; SD = 1.23; P-value=<0.0001). The adjusted linear regression model demonstrated a significant association between the total content score and VIQI, where 1 unit increase in the VIQI was significantly associated with a 0.16 increase in the total content score (B = 0.16; standard error [SE]=0.04; P = 0.0003). Further, a significant association was observed between the total content score and video duration, where 1 minute increase in the video duration was significantly associated with a 0.15 increase in the total content score (B = 0.15; SE = 0.05; P = 0.008). This study demonstrated that YouTube content quality concerning orthodontic elastics is poor. Thus, future implementation of online visual content provided by certified orthodontists will ensure accurate and thorough information delivery.

Background/Purpose: Whether YouTube videos contain precise and adequate information on certain orthodontic procedures remains unclear. This study aimed to investigate the content and quality of YouTube videos on orthodontic elastics and identify the predictors of high-level content YouTube videos.Materials and Methods: Two hundred YouTube videos were screened for eligibility, and after applying the inclusion criteria, 133 videos were excluded. Student’s t-test was used to compare the characteristics, quality parameters, and total content of the low-level and high-level content videos. Chi-square or Fisher’s exact tests were implemented to identify the source and content element differences across low-level and high-level content videos. Pearson’s correlation coefficients were used to determine the relationship between the total content score, video information and quality index (VIQI), and YouTube characteristics. Stepwise linear multiple regressions with forward selection were used to test the association of the YouTube characteristics and VIQI with the total content score.Results: Among 67 included videos, only 19.4% of videos were classified as high-level content videos. High-level content videos had significantly higher mean number of likes (MD = 4041.7; SD = 4680.7; P-value=0.0068), VIQI score (MD = 4.17; SD = 4.87; P-value=0.0073), and total content score (MD = 4.04; SD = 1.23; P-value=< 0.0001). The adjusted linear regression model demonstrated a significant association between the total content score and VIQI, where 1 unit increase in the VIQI was significantly associated with a 0.16 increase in the total content score (B = 0.16; standard error [SE]=0.04; P = 0.0003). Further, a significant association was observed between the total content score and video duration, where 1 minute increase in the video duration was significantly associated with a 0.15 increase in the total content score (B = 0.15; SE = 0.05; P = 0.008).Conclusion: This study demonstrated that YouTube content quality concerning orthodontic elastics is poor. Thus, future implementation of online visual content provided by certified orthodontists will ensure accurate and thorough information delivery.

Background: this study was to evaluate the fracture resistance and elastic modulus of modified 3D-printed resins containing zirconium dioxide nanoparticles (ZNPs) and silicon dioxide nanoparticles (SNPs). Methods: Tooth-colored 3D-printed resin samples (ASIGA (AS)) and NextDent (ND)) were modified with silanized ZNPs and SNPs. Five groups (n=100) were prepared for each resin type, one without nanoparticles, and four groups (n=20 per group) with varying nanoparticles concentrations (0.5 wt. %ZNP, 1 wt.%ZNP, 0.5 wt.%SNP, and 1 wt.%SNP). Half of the specimens (110 samples) were subjected to thermal aging (TA; 5000 cycles). The fracture resistance and elastic modulus were evaluated, followed by Fourier-transform infrared and scanning electron microscopy analyses. An analysis of variance and Tukey's post-hoc test were applied for data analysis. Results: Incorporating SNPs and ZNPs into the ND material significantly improved the fracture resistance compared to that of the control group, with 1 wt.%SNP showing the highest resistance (1405.9±128.4 N) and 0.5 wt.%ZNP the lowest (1047.5±100.6 MPa). However, the elastic modulus decreased notably with these additions, with the ND control group (3097.5±115.9 MPa) exhibiting the highest elastic modulus and ZNP groups (1772.0±128.8 MPa) exhibiting the lowest. In between NPs-reinforced groups per NPs type, there were no significant differences between SNPs groups (p=0.064) as well as ZNPs groups (p=0.072). For the AS material, similar enhancements in fracture resistance occurred; however, reductions in the elastic modulus were more significant in the ND material (p<0.001*). For the AS material, SNP and ZNP addition improved fracture resistance relative to that of the control group. Post-TA, the elastic modulus significantly decreased in both the ND and AS materials (p < 0.05). Compared to ND material, the increase in fracture resistance was less pronounced in the AS material. Conclusion: The addition of ZNPs and SNPs increased the fracture resistances of both materials. TA significantly reduced the fracture resistance and elastic modulus in most NP-incorporated groups. The ASIGA resin demonstrated superior performance and enhancements were more prominent which demonstrates promising characteristics for clinical use.

Background: Although nanoparticles (NPs) incorporation has been suggested as a strategy to improve the mechanical properties of 3D-printed resins, there is a lack of evidence regarding its effect on the mechanical performance of 3D-printed denture teeth resin modified with different NPs). Therefore, this study was to evaluate the fracture resistance and elastic modulus of modified 3D-printed resins containing zirconium dioxide NPs (ZNPs) and silicon dioxide NPs (SNPs). Methods: Tooth-colored 3D-printed resin samples (ASIGA (AS)) and NextDent (ND)) were modified with silanized ZNPs and SNPs. For each printed resin, 100 specimens were fabricated and divided into five groups (n = 20): one group without NPs and four groups containing different NPs concentrations (0.5 wt.% ZNP, 1 wt.% ZNP, 0.5 wt.% SNP, and 1 wt.% SNP). In addition, 20 prefabricated teeth were included, resulting in a total of 220 specimens (100 AS, 100 ND, and 20 prefabricated teeth). Half of the specimens (110 samples) were subjected to thermal aging (TA; 5000 cycles). The fracture resistance and elastic modulus were evaluated, followed by Fourier-transform infrared and scanning electron microscopy analyses. An analysis of variance and Tukey's post-hoc test were applied for data analysis. Results: Incorporating SNPs and ZNPs into the ND material significantly improved the fracture resistance compared to that of the control group, with 1 wt.%SNPs showing the highest resistance (1405.9±128.4 N) and 0.5 wt.%ZNPs the lowest (1047.5±100.6 N). However, the elastic modulus decreased notably with these additions, with the ND control group (3097.5±115.9 MPa) exhibiting the highest elastic modulus and ZNPs groups (1772.0±128.8 MPa) exhibiting the lowest. In between NPs-reinforced groups per NPs type, there were no significant differences between SNPs groups (p=0.064) as well as ZNPs groups (p=0.072). For the AS material, similar enhancements in fracture resistance occurred; however, reductions in the elastic modulus were more significant in the ND material (p<0.001*). For the AS material, SNPs and ZNPs addition improved fracture resistance relative to that of the control group. Post-TA, the elastic modulus significantly decreased in both the ND and AS materials (p < 0.05). Compared to ND material, the increase in fracture resistance was less pronounced in the AS material. Conclusion: The addition of ZNPs and SNPs increased the fracture resistances of both materials. TA significantly reduced the fracture resistance and elastic modulus in most NP-incorporated groups. The ASIGA resin demonstrated superior performance under the controlled laboratory conditions of this study, and the observed enhancements indicate promising material behaviour; however, any clinical relevance remains uncertain until validated through comprehensive long-term and clinically oriented investigations.