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Objectives To investigate the impact of fluoridated (1450 ppm F⁻) and CPP-ACP (MI Paste) toothpastes applied after different time points following erosive-abrasive challenge on the perseverance of enamel hardness.  Materials and Methods  Enamel specimens were subjected to an erosive-abrasive model using erosive beverage and toothbrushing simulation. The erosive challenge was achieved by soaking the specimens in Coca-Cola for 2 min. Distilled water was used as a control. Then, the specimens were subjected to brushing using fluoridated and CPP-ACP dentifrices applied via a brushing simulation device. The waiting time between the erosive and abrasive challenges was investigated at four levels (0, 15, 30, 60 min). The Vickers’ microhardness values of enamel at baseline and after the erosive-abrasive challenge were analyzed. Paired t-test and ANOVA analyzed the data. Results Following brushing with distilled water and fluoridated toothpaste, a significant reduction in enamel microhardness was observed at all time points (before vs. after) ( P  < 0.01). Brushing with CPP-ACP toothpaste achieved significant enamel microhardness reduction at 0 min ( P  < 0.001) and 30 min ( P  = 0.007). The erosive challenge and the toothpaste type were significant factors ( P  < 0.001) in modulating the enamel microhardness but not the waiting time ( P  = 0.149). There were significant interactions between the erosive challenge and the waiting time ( P  = 0.005), the toothpaste time and the waiting time ( P  < 0.001), and there was a significant interaction between the three variables ( P  = 0.005). CPP-ACP and fluoridated toothpastes resulted in less microhardness reduction compared to brushing using distilled water ( P  < 0.05), with no difference between CPP-ACP and fluoridated toothpastes. Conclusion This study found that both fluoridated and CPP-ACP toothpastes are equally effective in protecting enamel, and delaying toothbrushing offers no protective benefits after such exposure. Delaying toothbrushing did not provide any protective benefits for enamel following exposure to the erosive-abrasive model, as fluoridated and CPP-ACP toothpastes were effective in protecting the enamel hardness.

Candida albicans (C. albicans) adhering to denture-based resins (DBRs) is a known cause of denture stomatitis. A new approach to prevent denture stomatitis is to include antimicrobial substances within DBRs. Here, we examined the mechanical performance and antifungal properties of DBRs containing benzyldimethyldodecyl ammonium chloride (C12BDMA-Cl) as an antimicrobial compound. C12BDMA-Cl is a quaternary ammonium compound, and its antifungal properties have never been investigated when combined with dental acrylic resin. Therefore, we modified a commercially available heat-polymerized acrylic DBR to contain 3 and 5 wt.% of C12BDMA-Cl. Unmodified DBR was used as a control group. Specimens were prepared using the conventional heat processing method. The specimen’s flexural strength, elastic modulus, microhardness, and surface roughness were evaluated. C. albicans biofilm was grown on the specimens and assessed via colony-forming units (CFUs) and scanning electron microscopy (SEM). In silico molecular docking was applied to predict the potential C12BDMA-Cl inhibition activity as an antifungal drug. The 3% C12BDMA-Cl DBR demonstrated antifungal activities without a deterioration effect on the mechanical performance. SEM images indicated fewer colonies in DBR containing C12BDMA-Cl, which can be a potential approach to managing denture stomatitis. In conclusion, C12BDMA-Cl is a promising antifungal agent for preventing and treating denture stomatitis.

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: 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 MPa) 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 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 MPa) 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. For the AS material, similar enhancements in fracture resistance occurred; however, reductions in the elastic modulus were more significant in the ND material. 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 the 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 AS material may be recommended owing to its high fracture resistance during testing.

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.

Introduction: The preferred PK/PD goal for vancomycin is now AUC0–24/MIC-guided dosing, which requires two blood samples, additional time, increased cost, and possibly specialized staff, potentially limiting its use. Our study compared vancomycin target attainment using trough versus single-sample Bayesian AUC0–24/MIC in critically ill patients, using a validated online calculator. Methods: This retrospective cohort study included adults aged ≥18 years with stable renal function who were receiving vancomycin. Exclusions were age under 18, unstable renal function, hemodialysis, missing data, or non-steady-state vancomycin. Steady-state troughs were obtained, and AUC0–24/MIC was calculated using ClinCalc. The primary endpoint was discordance in target attainment between trough (15–20 mg/L) and AUC0–24/MIC (400–600 mg·h/L). The secondary endpoint was AKI within 48 h of initiating vancomycin. Results: The mean trough was 14.8 ± 8.0 mg/L, and the mean AUC0–24/MIC was 499.7 ± 201.3 mg·h/L. Trough levels were within target in 20%, and AUC0–24/MIC in 67%. The 3 × 3 cross-tabulation showed a significant association (χ2 = 27.33, p < 0.001), but only fair agreement (Cohen’s κ = 0.215) and a biased disagreement pattern (p < 0.001). Thirty-eight patients (38%) had “false alarming” results: trough < 15 mg/L despite AUC0–24/MIC ≥ 400 mg·h/L. Three patients (3.0%) showed “falsely reassuring” results: trough 15–20 mg/L with AUC0–24/MIC > 600 mg·h/L. The odds of supratherapeutic AUC0–24/MIC > 600 mg·h/L were tenfold higher in patients with trough 15–20 mg/L than in those below 15 mg/L (OR 10.24, p = 0.048). Conclusions: In critically ill ICU patients, calculator-derived AUC0–24/MIC showed significant discordance with single-trough vancomycin monitoring, primarily indicating apparent under-exposure by trough criteria in patients with adequate AUC0–24/MIC levels, which may lead to unnecessary dose escalation.

Background and Objectives: All-ceramic prosthesis is widely used in modern dental practice because of its improved physico-mechanical and optical properties. These restorations are exposed to coloring agents from various nutrition and beverages in the oral cavity. Long-term color stability is critical for the success of these restorative materials. The purpose of this in vitro study was to assess the effect of common beverages and mouthwash on the color stability of lithium disilicate (LD), monolithic zirconia (MZ) and bilayer zirconia (BZ) surfaces. Materials and Method: Thirty disc-shaped specimens from each material were fabricated; each group was subdivided (n = 10) according to coffee, green tea and chlorhexidine immersion solutions. The baseline color of ceramic discs was recorded according to the CIE L*a*b* system with a portable spectrophotometer. The second measurement was recorded after 3000 thermocycling and immersion in coloring agents for 7 days. The mean color difference was calculated and data were compared with Kruskal-Wallis and Mann-Whitney post hoc tests (0.05). Results: ΔE values for LD with the immersion of coffee, tea, and Chlorhexidine gluconate (CHG) were 1.78, 2.241 and 1.58, respectively. Corresponding ΔE values for MZ were 5.60, 5.19, and 4.86; marginally higher than the clinically acceptable level of 3.5. Meanwhile, BZ showed better color stability compared to MZ with ΔE values of 4.22, 2.11 and 1.43. Conclusions: Among the ceramics evaluated, LD ceramic was found to be more color stable, while MZ ceramics displayed a higher susceptibility to discoloration. MZ and BZ ceramic colors were significantly altered with coffee immersion, while LD ceramics were more affected by green tea.

Background Acceptance of COVID-19 vaccination was noticed to be less common among parents of children with autism spectrum disorder (ASD) and other neurodevelopmental disorders. This study aimed to explore the beliefs and willingness of parents of children with neurodevelopmental disorders about COVID-19 vaccine and understand how certain factors influencing the vaccine decision-making process differ between them and other parents’ groups. Methods A cross-sectional study was conducted between August to November 2021. An Arabic online survey was distributed in August 2021 to collect the study’s data. 400 parents from all the major regions in Saudi Arabia participated in and shared their beliefs about the new COVID-19 vaccination for their children. Results Out of 400 participants, 381 of them were eligible to answer the survey (95.2%). The total number of parents of children with neurodevelopmental disorder was 158 (41.5%), was compared to responses of parents of heathy children 223 (58.5%). 85 (53.8%) of them were ready to vaccinate their children with COVID-19 vaccine. While 36 (22.8%) were hesitant, the rest 37 (23.4%) did not want to vaccinate their children at all. Only a small number 16 (10.1%) have beliefs of vaccines as a cause of their child’s neurodevelopmental disorder. A total of 79 out of 131 responses were received from both parents’ groups. Fear of long-term side-effects was the most common reason reported by 41 responders out of 64 (64.06%) from parents of healthy children and 38 responders out of 67 (56.71%) from parents of diagnosed children. Another reason reported by parents of younger children in both groups was the child’s age. Having a healthcare relative worker was significantly associated with the vaccine decision making ( p  < .001). Conclusion The acceptance rate of COVID-19 vaccination of parents of children with neurodevelopmental disorders was low compared to the parents of healthy children in Saudi Arabia. Authorities can benefit from this study results to offer more accessible information about the vaccine importance and safety to the targeted population.