Journal of Esthetic and Restorative Dentistry最新文献

{"title":"Effect of Heat-Pressing Technique and Adhesive Systems on the Bond Strength of PEEK Abutments With Titanium and Chromium-Cobalt Bases.","authors":"Buse Özdemir Önal, Volkan Şahin","doi":"10.1111/jerd.70104","DOIUrl":"10.1111/jerd.70104","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the tensile bond strength of polyetheretherketone (PEEK) hybrid abutments bonded to titanium (Ti) and chromium-cobalt (Cr-Co) bases using two adhesive systems or the heat-pressing technique.</p><p><strong>Materials and methods: </strong>Ninety PEEK abutments were fabricated using titanium or cobalt-chromium bases: 60 milled from BioHPP blocks and cemented with MKZ Primer-DTK or Monobond Plus-Multilink Hybrid (n = 15) and 30 produced by heat-pressing technique. Tensile bond strength was measured and failure modes were evaluated under a stereomicroscope. Statistical analysis was performed using two-way robust ANOVA with Bonferroni correction (α = 0.05).</p><p><strong>Results: </strong>Both the bonding method and the interaction between method and base materials had a statistically significant effect on bond strength (p < 0.001). The heat-pressing technique resulted in higher bond strength than the resin cement groups (p < 0.001). The highest bond strength was observed in the Cr-Co heat-pressed group (124 MPa) (p < 0.001). All failures in the cemented groups were adhesive type. In the Cr-Co heat-pressed group, failures were cohesive and mixed. In the titanium heat-pressed group, failures were adhesive and mixed.</p><p><strong>Conclusion: </strong>The heat-pressing technique significantly improved the bond strength of PEEK abutments compared with resin cementation. Cr-Co bases also demonstrated favorable bonding with PEEK using the heat-pressing technique.</p><p><strong>Clinical significance: </strong>The heat-pressing technique improved the bond strength of PEEK abutments to titanium and cobalt-chromium bases.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":"1000-1008"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Surgical and Prosthetic Factors on Peri-Implant Health or Disease. Clinical Recommendations From a Spanish Society of Periodontology (SEPA) Expert Consensus.","authors":"Beatriz de Tapia, Alberto Monje, Guillermo Pradíes, Ramon Pons, Irene García, Ignacio Sanz-Martín, Ana Carrillo de Albornoz, Ferran Puigrefagut, Iria López, Javier Pérez, Herminio García-Roncero, Pep Serra, Juan Golobart, Ignacio Sanz-Sánchez","doi":"10.1111/jerd.70108","DOIUrl":"10.1111/jerd.70108","url":null,"abstract":"<p><strong>Objective: </strong>To examine which prosthetic factors, including design, materials, and cleansability, may influence the onset of peri-implant diseases.</p><p><strong>Materials and methods: </strong>The Spanish Society of Periodontology (SEPA) convened a group of experienced periodontists, prosthodontists, and laboratory technicians to develop clinical recommendations based on expert consensus.</p><p><strong>Results: </strong>Emerging evidence highlights the importance of prosthetic design, implant positioning, and material selection in mitigating biological complications. Notably, access for self-performed oral hygiene is a significant predictor of peri-implant health, and designs that facilitate cleaning and prosthetic configurations that minimize plaque accumulation are favored. Additionally, the use of less porous materials, such as zirconia, has been shown to improve soft tissue integration and plaque control. Other critical considerations include minimizing prosthetic manipulation and ensuring optimal implant-abutment connections to prevent bone loss.</p><p><strong>Conclusions: </strong>This review presents clinical recommendations on prosthetic design, material selection, and implant placement in order to reduce the risk of peri-implant diseases. Future research should focus on refining these strategies and evaluating the long-term effectiveness of digital manufacturing techniques in improving prosthetic accuracy and reducing the incidence of disease.</p><p><strong>Clinical significance: </strong>Peri-implant diseases, including peri-implantitis, are major concerns in implant dentistry, often linked to suboptimal prosthetic designs and maintenance. This review underscores the importance of prosthetic design in preventing such diseases. Clinicians should prioritize prosthetic configurations that enhance accessibility for self-performed oral hygiene. Furthermore, proper implant positioning in a 3D prosthetically driven position is essential for preventing peri-implant complications. Additionally, the choice of materials, such as ceramic-based and zirconia prostheses, can influence plaque accumulation and soft tissue health. Regular follow-ups and patient education on maintaining good oral hygiene are critical for the prevention of peri-implant diseases. Finally, the increasing use of digital technologies in implant placement and prosthesis manufacturing offers the potential for improving accuracy and minimizing prosthetic misfits, which may further reduce the risk of disease. Future research is needed to explore the impact of digital tools on peri-implant health and to refine best practices in prosthetic design and material selection.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":"1082-1100"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The FACE Difficulty Scale Applied to a Retrospective Case Series of Vertical Bone Augmentation.","authors":"Leticia Sala, Juan Zufía","doi":"10.1111/jerd.70089","DOIUrl":"10.1111/jerd.70089","url":null,"abstract":"<p><strong>Objective: </strong>Vertical bone augmentation (VBA) presents variable levels of difficulty depending on the defect morphology and soft-tissue conditions. We propose the FACE scale as a preoperative tool to guide clinicians in evaluating the anticipated surgical complexity of VBA procedures.</p><p><strong>Clinical considerations: </strong>The FACE scale evaluates the following four dimensions, each scored from 1 to 3: flap configuration (F1-3), apical mucosa position (A1-3), crestal bone peak alignment (C1-3), and defect extent (E1-3). The total score ranges from 4 to 12 points (maximum difficulty). The scale was retrospectively applied to 43 VBA procedures, performing bilateral analyses to assess the association between FACE scores and complications. Complications were recorded in 23.3% of cases and overall success in 76.7%. A tendency toward higher complication rates was observed in cases with extensive defects (E3) and apical dehiscence (A3), although statistical significance was not reached.</p><p><strong>Conclusions: </strong>The FACE scale provides a structured framework for anticipating surgical complexity in VBA by integrating defect-related and soft-tissue factors. Preliminary results suggest a trend toward increased complication rates with higher FACE scores. These findings should be interpreted as exploratory, offering a preliminary framework to guide future validation of the FACE scale in larger prospective studies.</p><p><strong>Clinical significance: </strong>The FACE scale offers clinicians a practical tool to anticipate the complexity of VBA procedures by incorporating both defect-related and soft-tissue factors. Its application may be useful for surgical planning, risk assessment, and patient counseling.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":"955-969"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Ozonized Oil on At-Home Tooth Bleaching: A Double-Blind Randomized Clinical Trial.","authors":"Murilo Guimarães Campolina, Lia Dietrich, Julia Marques Martins, Larissa Victoria Miranda Ubagai, Guilherme José Pimentel Lopes Oliveira, Ceci Nunes Carvalho, Hugo Lemes Carlo, Carlos José Soares, Gisele Rodrigues Silva","doi":"10.1111/jerd.70083","DOIUrl":"10.1111/jerd.70083","url":null,"abstract":"<p><strong>Objective: </strong>This double-blind, randomized clinical trial evaluated the effect of ozonized sunflower oil on tooth sensitivity, color change, and patient perception during at-home bleaching with 10% hydrogen peroxide.</p><p><strong>Clinical considerations: </strong>Forty participants were randomly assigned to receive ozonized or nonozonized sunflower oil, applied in trays for 1 min after each bleaching session (30 min daily for 21 days). Sensitivity was assessed daily using visual and numerical scales. Tooth color was measured at baseline, 1 week, and 1 month after treatment using a spectrophotometer (ΔEab, ΔE00, ΔWID) and a visual shade guide (ΔSGUs). Patient perception was evaluated through Likert-scale questionnaires.</p><p><strong>Conclusions: </strong>Overall, 72.5% of participants experienced sensitivity, with no significant difference in intensity (p = 0.536) or duration (p = 0.256) between groups. Color changes were similar (p > 0.05), although ΔEab and ΔE00 values decreased at 1 month (p = 0.010 and p = 0.026). Ozonized oil had an unpleasant taste (p = 0.002) and odor (p = 0.010). The use of ozonized sunflower oil did not reduce bleaching-related sensitivity or enhance whitening effectiveness, and its poor sensory properties may limit patient acceptance.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":"921-929"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-Implant Inflammation Varies With Different Restorative Emergence Angles: An Histological Evaluation.","authors":"Franz J Strauss, Alberto Monje, Jin-Young Park, Jung-Seok Lee, Sonja Hitz, Ronald E Jung, Jae-Kook Cha, Daniel S Thoma","doi":"10.1111/jerd.70098","DOIUrl":"10.1111/jerd.70098","url":null,"abstract":"<p><strong>Objectives: </strong>To histologically evaluate peri-implant inflammatory responses associated with varying restorative emergence angles and to assess differences between buccal and lingual implant sites.</p><p><strong>Materials and methods: </strong>Six healthy male mongrel dogs received four bone-level implants (3.8 × 7 mm) per hemi-mandible in the posterior mandible. Customized abutments with standardized restorative angles of 20°, 40°, 60°, and 80° were immediately connected. After 24 weeks, all implants were retrieved for histological processing and quantitative analysis of inflammatory cell infiltration within three defined peri-implant soft tissue regions. A linear mixed-effects model was used to compare the groups to account for within-subject correlations.</p><p><strong>Results: </strong>Histological sections were obtained for all specimens (N = 48). Inflammatory cell counts increased progressively with wider restorative angles, demonstrating a significant dose-dependent relationship (p < 0.001). At buccal sites, inflammation remained low up to 40° (20° = 3%; 40° = 6%) but increased sharply at 60° (≈10%) and 80° (≈13%) (p < 0.001), indicating a threshold beyond which wider emergence angles markedly intensified the inflammatory response. Lingual sites exhibited a similar, though less pronounced pattern. Values were stable up to 40° (20° = 4%; 40° = 3.1%), followed by a moderate rise at 60° (≈7%) and a pronounced increase at 80° (≈12%) (p < 0.001). When both aspects were analyzed together, significant angle-by-site interactions emerged at 40° and 60°, indicating a consistently higher inflammatory response on the buccal compared with the lingual side.</p><p><strong>Conclusions: </strong>Wider restorative emergence angles (> 40°) are associated with increased peri-implant inflammatory cell infiltration, particularly at buccal sites.</p><p><strong>Clinical relevance: </strong>Wide restorative emergence angles (> 40°) favor peri-implant inflammation, potentially compromising the long-term stability of peri-implant tissues.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":"1009-1016"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Masking Ability of Milled and 3D-Printed Monolithic Zirconia on Discolored Substrates.","authors":"Soraya Soleimani, Kiana Shakeri, Elaheh Beyabanaki, Reza Eftekhar Ashtiani","doi":"10.1111/jerd.70107","DOIUrl":"10.1111/jerd.70107","url":null,"abstract":"<p><strong>Objectives: </strong>The masking ability of printed zirconia over discolored backgrounds is unknown. This study assessed the impact of method of manufacturing, thickness, and the method of surface treatment on the color masking ability of zirconia.</p><p><strong>Materials and methods: </strong>Forty 0.5 mm × 10 mm and 40 1 mm × 10 mm zirconia disks (Dental Direct Medical Zirconia, Germany) were designed, fabricated using a milling machine (DWX-51D, Roland DGA, Irvine, CA) and a 3D printer (AON 3D printer; ZIPRO dentistry; South Korea), and divided into eight groups: (1) printed-polished, (2) printed-glazed, (3) milled-polished, and (4) milled-glazed. ΔE ₀₀ values between each group and substrates made of natural die composite resin (IPS, IvoclarVivadent, Schaan, Liechtenstein) in shades of ND₁ (control), ND₃, ND₅, and ND₉ were measured. Data were analyzed using three-way ANOVA and Games-Howell tests (α = 0.05).</p><p><strong>Results: </strong>Printed zirconia with either thickness showed a better masking ability as compared to their milled zirconia. Milled zirconia (0.5 mm) showed the highest ΔE ₀₀ values (ND_3-1: 1.70, ND_5-1: 3.62, ND_9-1: 6.46), while 1 mm printed zirconia had the lowest ΔE ₀₀ values (ND_3-1: 0.73, ND_5-1: 1.71, ND_9-1: 3.04). Moreover, ΔE ₀₀ values of printed zirconia were below the acceptability threshold (< 1.8) for ND₃ and ND₅ substrates, except for 0.5 mm zirconia against the ND₅ substrate.</p><p><strong>Conclusion: </strong>All zirconia specimens showed clinically acceptable masking ability against a normal dentin shade (ND₃) (< 1.8). Also, printed zirconia (1 mm) against ND₃ substrate showed the highest masking ability. Moreover, only 1 mm printed zirconia over a darker shade of dentin (ND₅) showed a clinically acceptable color difference. However, no zirconia specimen could mask severely discolored dentin (ND₉).</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":"981-990"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a 10-MDP-Containing Cleaner on the Bond Strength to Saliva Contaminated Dentin.","authors":"Rie Hayashi-Wells, Jin-Ho Phark, Sillas Duarte","doi":"10.1111/jerd.70175","DOIUrl":"https://doi.org/10.1111/jerd.70175","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effect of saliva contamination and a 10-MDP-containing cleaner (Katana Cleaner; Kuraray Noritake, Japan) on the shear bond strength (SBS) of an ultra-mild universal adhesive applied in self-etch mode to human dentin.</p><p><strong>Materials and methods: </strong>Mid-coronal dentin of extracted molars was prepared with standardized smear layers and assigned to four groups: control (SU), saliva-contaminated (C + SU), cleaner-treated (K + SU), and saliva-contaminated plus cleaner-treated (C + K + SU). Each group was evaluated either after 24 h storage or after artificial aging by 20,000 thermal cycles (designated \"+A\"). SBS was measured using a universal testing machine, failure modes were classified, and dentin surfaces were examined by SEM. Data were analyzed with three-way and one-way ANOVA and Bonferroni post hoc tests (α = 0.05).</p><p><strong>Results: </strong>SBS ranged from 9.69 ± 6.03 MPa (C + SU + A) to 16.98 ± 6.53 MPa (SU + A). Saliva contamination significantly reduced SBS after aging (p = 0.002). The cleaner had no significant effect on immediate or long-term bond strength, and aging alone was not statistically significant. Failures were predominantly adhesive at dentin (63.3%). SEM analysis revealed partial collagen exposure with cleaner or adhesive use, but smear plugs remained intact.</p><p><strong>Conclusions: </strong>Saliva contamination compromised the long-term performance of the universal adhesive. The 10-MDP-containing cleaner did not restore bond strength but also did not adversely affect bonding to dentin.</p><p><strong>Clinical significance: </strong>Saliva contamination is a critical factor that compromises the durability of adhesive restorations and should be strictly avoided. When contamination occurs, decontamination agents that do not adversely affect tooth structure or interfere with adhesion may be useful. The 10-MDP-containing cleaner tested in this study was safe for dentin and showed a trend toward mitigating the effects of saliva contamination, although it did not fully restore bond strength.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Color Stability of a Reduced 37.5% Hydrogen Peroxide In-Office Bleaching Protocol: A Randomized Clinical Trial.","authors":"Mariana Evangelista Santos, Danielle Araújo Izídio Carvalho de Azevedo, Virgínia Feitosa Nogueira Rocha, Sônia Saeger Meireles","doi":"10.1111/jerd.70173","DOIUrl":"https://doi.org/10.1111/jerd.70173","url":null,"abstract":"<p><strong>Objective: </strong>This randomized clinical trial evaluated the one-year color stability and patient satisfaction regarding dental esthetic improvement after 37.5% hydrogen peroxide (37.5HP) in-office bleaching with a reduced application protocol.</p><p><strong>Materials and methods: </strong>Forty participants with a shade mean C2 or darker were randomly allocated into two treatment groups (n = 20): two (37.5HP2) or three (37.5HP3) 8-min applications per clinical session. Three bleaching sessions were performed at one-week intervals. Tooth color was measured using a spectrophotometer at baseline, 1 week (1 W), 6 months (6 M), and 1 year (1 Y) post-bleaching. Esthetic self-perception was assessed using a 6-point visual analogue scale. Statistical analysis was performed using the Shapiro-Wilk, Student's t-test, Tukey, Mann-Whitney, and Friedman tests (p < 0.05).</p><p><strong>Results: </strong>No significant differences were observed between 37.5HP2 and 37.5HP3 for Δ <math> <semantics> <mrow><msubsup><mi>E</mi> <mi>ab</mi> <mo>*</mo></msubsup> </mrow> <annotation>$$ {E}_{mathrm{ab}}^{ast } $$</annotation></semantics> </math> , ΔE₀₀, or ∆WI_D across the evaluation periods (p > 0.05). Although both treatment protocols remained effective at 1Y post-bleaching, a significant color rebound was observed from the 6 M assessment (p < 0.05). Patient satisfaction with dental esthetics was comparable between groups (p = 0.3).</p><p><strong>Conclusions: </strong>Two and three 37.5% HP applications provided similar bleaching stability after one year. Patients remained highly satisfied with their smile, regardless of the number of gel applications.</p><p><strong>Clinical significance: </strong>Clinicians may consider using a neutral 37.5% HP in-office bleaching gel with two 8-min applications per session, as it provides the same one-year bleaching longevity as the manufacturer's recommended protocol of three applications.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Study on the Efficacy of 35% Hydrogen Peroxide Gel According to Exposure Time (40 min vs. 20 min) by Spectrophotometry.","authors":"Trinidad Rincón, Maria Portillo Muñoz, Maria Lobato, Ana María Martín Casado, Laryssa Mylenna Madruga Barbosa, Alessandro Loguercio, Cristina Gómez-Polo","doi":"10.1111/jerd.70165","DOIUrl":"https://doi.org/10.1111/jerd.70165","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the chromatic effect on CIELAB coordinates and the clinical effectiveness of in-office whitening treatment (perceptible changes) with 35% hydrogen peroxide (HP) gel according to the number of clinical sessions and exposure time (40 min vs. 20 min) in the three thirds of the tooth.</p><p><strong>Materials and methods: </strong>Seventy-four participants were assigned to two groups: Group 1 (n = 37) received 40-min applications, and Group 2 (n = 37) received 20-min applications, both undergoing two in-office bleaching sessions with 35% HP, with a 1-week interval. CIELAB coordinates (L*, a*, b*) were recorded in the three thirds using the Cobra-Raypicker RP-0201 spectrophotometry at baseline (T0), after the first (T1), and the second session (T2). Separate two-way ANOVAs were performed for each color coordinate (L*, a*, b*) at each tooth third, and color differences (ΔE_ab, ΔE₀₀) were calculated and compared between exposure groups with the Mann-Whitney U test and between sessions with the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Significant increases in L* and decreases in a* and b* were observed in all thirds after bleaching, with greater changes after two sessions, with the largest changes in b and the smallest in a*. No significant differences were observed between Group 1 and Group 2. The greatest change was in b*, with large effect sizes, while a* showed the smallest variation. After one session, perceptible color change (ΔE_ab and ΔE₀₀) occurred in over 80% of participants in Group 1 and 75% in Group 2, increasing to nearly 100% in both groups after two sessions.</p><p><strong>Conclusion: </strong>The 35% HP treatment significantly alters the color coordinates of the three thirds of the tooth, with perceptible color changes in most patients. The treatment is more effective with two sessions than with one, but its effectiveness does not change when reducing the 35% HP exposure time from 40 to 20 min per session. The largest chromatic change in all thirds is the reduction in yellowness (b*), while lightness (L*) increases and redness-greenness (a*) shows smaller changes.</p><p><strong>Clinical significance: </strong>This study suggests that reducing application time to 20 min with 35% HP in-office is sufficient to achieve clinically perceptible color change while optimizing chair time and potentially reducing tooth sensitivity risk. The greatest effect was observed in the reduction of yellowness (b*), suggesting that teeth with more yellowish tones may show greater whitening benefit.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Temporal Consistency of ChatGPT and Gemini in Responding to Textbook and Patient-Oriented Dental Bleaching Questions: A Multi-Session Comparative Study.","authors":"Soner Sismanoglu, Serre Sena Kotan, Vasfiye Isik","doi":"10.1111/jerd.70172","DOIUrl":"https://doi.org/10.1111/jerd.70172","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the accuracy and temporal consistency of ChatGPT and Gemini in responding to dental bleaching questions across three weekly sessions.</p><p><strong>Materials and methods: </strong>A total of 280 true/false questions were developed comprising 200 textbook-based and 80 patient-oriented frequently asked questions. Both chatbots were queried weekly under controlled conditions. Accuracy was compared using generalized estimating equations, consistency was assessed using Fleiss' kappa, and weekly stability was evaluated using Cochran's Q test. Open-ended responses were scored for quality and misinformation by two evaluators.</p><p><strong>Results: </strong>For textbook questions, ChatGPT achieved significantly higher accuracy than Gemini (77.7% versus 70.5%, p = 0.0009). For frequently asked questions, both chatbots performed comparably (92.9% versus 90.8%, p = 0.252). Temporal consistency was only fair for textbook questions but almost perfect for frequently asked questions in both chatbots. Both chatbots showed significant upward trends in textbook accuracy across sessions. Gemini received higher global quality scores for open-ended responses, while misinformation rates were similarly low.</p><p><strong>Conclusions: </strong>Within the limitations of this study, ChatGPT achieved significantly higher accuracy than Gemini for textbook-based dental bleaching questions, while both chatbots performed comparably for patient-oriented questions. Temporal consistency differed markedly, with almost perfect consistency for patient-oriented questions and only fair consistency for textbook-based questions.</p><p><strong>Clinical significance: </strong>Chatbot responses to common patient questions about dental bleaching are generally accurate and consistent, but their reliability drops substantially for specialized academic content, suggesting these tools should complement rather than replace professional clinical judgment.</p>","PeriodicalId":15988,"journal":{"name":"Journal of Esthetic and Restorative Dentistry","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}