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Statement of Problem: The optimal pretreatment of radicular dentin before cementing a post with glass ionomer cement is unclear., Purpose: The purpose of this in vitro study was to evaluate the retention of prefabricated tapered titanium posts to endodontically treated teeth after applying different pretreatment protocols on the radicular dentin., Material and Methods: The coronal part of 32 single-rooted human teeth was removed 1-mm coronally to the cemento-enamel junction. All specimens received endodontic treatment, and the root canals were prepared with an instrument to a depth of 10 mm to receive a titanium post. The dentin walls of each specimen were roughened with a hand-held diamond cutting instrument. The specimens were randomly divided according to the surface treatments into 4 groups (n=8): KW: etched with 20% to 30% polyacrylic acid (PAA) (Ketac Conditioner) and rinsed with water; KWI: etched with 20% to 30% PAA, rinsed with water and 70% isopropanol; DW: etched with 30% to 50% PAA (Durelon Liquid) and rinsed with water; DWI: etched with 30% to 50% PAA, rinsed with water and 70% isopropanol. The prefabricated titanium posts were airborne-particle abraded and cemented with glass ionomer cement. The specimens were fixed in custom-made brass cylindrical holders with autopolymerizing acrylic resin with the holder parallel to the long axis of the post. All specimens were stored in water for 3 days at 37 °C. Retention was evaluated using a tensile test with a universal testing machine (Zwick Z010) at a crosshead speed of 2 mm/min. Data were statistically analyzed with a 1-way ANOVA, followed by the Tukey post hoc test for pairwise comparisons between groups (α=.05)., Results: Mean ±standard deviation retention values ranged from 201.8 ±55.5 N (KW) to 328.1 ±70.9 N (DWI). Groups DWI and KWI (316 ±58.3 N) showed statistically higher retention values than group KW (P<.05) but did not significantly differ from retention values obtained in group DW (P>.05)., Conclusions: An additional final rinse with isopropanol after using PAA increased the retention of the post significantly for all groups. Although group DWI achieved the highest retention values, pretreatment of radicular dentin as in group KWI may also be considered., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate the effects of sterilization, conditioning method, and thermal aging on the retentive strength of two-piece zirconia abutments., Materials and Methods: In total, 128 stock zirconia abutments were divided into four groups (n = 32) according to the conditioning parameters: (A) air-abrasion using 50 μm alumina particles/1.0 bar, (B) 50 μm/2.0 bar, (C) 100 μm/1.0 bar, and (D) 100 μm/2.0 bar. All abutments were bonded onto titanium bases using DTK adhesive resin and stored in water bath (37°C) for 72 h. Each group was subdivided into two subgroups (n = 16), group 1 was disinfected, whereas group 2 followed disinfection and autoclave sterilization. Half of the specimens of each subgroup (n&#x02009;=&#x02009;8) was directly subjected to the axial retention test (groups N), while the other half was first subjected to 150&#x02009;days of thermocycling followed by retention test (groups T). Statistical analysis was performed with three-way ANOVA, additional statistical analysis was performed by using separate one-way ANOVAs followed by the Tukey's post-hoc test for post hoc pairwise comparisons among groups., Results: The highest median retention strength was recorded for group B2N (1390 N), whereas the lowest strength was recorded for group C1T (688 N). No significant interaction (p ≥ 0.05) was detected between the different variables; conditioning method, sterilization, and the thermal cycling regarding the effect on the resulting retention. However, the sterilization always showed a positive effect. Thermocycling presented an adversely significant effect only in the absence of sterilization (p < 0.05), with the exception of subgroups A. For the sterilized groups, thermocycling had no statistically significant effect on the retention., Conclusion: Steam autoclaving increased the retention of hybrid zirconia abutments. DTK adhesive resin for two-piece zirconia abutments performed well after sterilization and thermocycling., (© 2024 The Authors. Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.)

Aim of Study: This systematic review aimed to compare the physical-mechanical properties of 3D-printed (additively manufactured (AM)) zirconia compared to conventionally milled (subtractive manufactured: SM) zirconia specimens., Materials and Methods: A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies that evaluated AM zirconia specimens and restorations regarding the physical-mechanical properties and mechanical behavior of zirconia. The main topic focused on 3Y-TZP. However, records of 4YSZ and 5YSZ were also included to gather more comprehensive evidence on additively manufactured zirconia ceramic. The quality of studies was assessed using the ROB2 tool, Newcastle Ottawa scale, and the Modified Consort Statement. Of 1736 records, 57 were assessed for eligibility, and 38 records were included in this review, only two clinical trials meet the inclusion criteria and 36 records were laboratory studies. There were no signs of mechanical complications and wear to antagonists with short-term clinical observation. SM thin specimens ≤1.5 mm showed statistically significant higher flexural strength than AM zirconia (p ≤ 0.01), while thicker specimens showed comparable outcomes (p > 0.5). The fracture resistance of dental restorations was dependent on the aging protocol, restoration type, and thickness. The bond strength of veneering ceramic to zirconia core was comparable., Conclusions: The results pooled from two short-term clinical trials showed no signs of mechanical or biological complications of additively manufactured 3Y-TZP zirconia crowns. The flexural strength might depend on the specimens' thickness, but it showed promising results to be used in clinical applications, taking into account the printing technique and orientation, material composition (yttria content), solid loading, and sintering parameters. 3D-printed restorations fracture resistance improved when adhered to human teeth. The veneering ceramic bond was comparable to milled zirconia specimens. Long-term RCTs are recommended to confirm the mechanical behavior of 3D-printed restorations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: This systematic review aimed to compare the clinical outcome, internal gap, trueness, precision, and biocompatibility of 3D-printed (AM) compared to milled (SM) zirconia restorations., Data Source: A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies compared AM zirconia to SM zirconia restorations regarding clinical outcome, fit, trueness, precision, and biocompatibility., Study Selection: Of 1736 records, only 59 were screened for eligibility, and 22 records were included in this review. The quality of studies was assessed using the revised Cochrane risk-of-bias tool (ROB2), and the Modified Consort Statement. One clinical study exhibited a low risk of bias. All laboratory studies revealed some bias concerns. Short-term observation showed 100 % survival with no signs of periodontal complications. 3D-printed zirconia crowns showed statistically significant lower ΔE and a better match to adjacent teeth (p ≤ 0.5). The fit, trueness, and precision vary with the printing technique and the tooth surface., Conclusions: 3D-printed zirconia crowns provide better aesthetic color and contour match to adjacent natural teeth than milled crowns. Both 3D printing and milling result in crowns within the clinically acceptable internal and marginal fit. Except for nanoparticle jetting, the marginal gap of SM crowns was smaller than AM crowns, however, both were clinically acceptable. Laminate veneers might be more accurately produced by 3D printing. 3D-printed axial surface trueness was better than milled axial surfaces. Long-term RCTs are recommended to confirm the clinical applicability of 3D-printed restorations., Clinical Significance: Internal fit and gap, precision, and trueness are fundamental requirements for successful dental restorations. Both techniques produce restorations with clinically acceptable marginal and internal fit. Axial surfaces and narrow or constricted areas favored 3D-printed than conventionally milled zirconia., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

The aim of this study was to evaluate the influence of weight ratio, the shape of the precursor particles, and the application of a phosphate-monomer-containing primer on the mechanical properties of polymer infiltrated ceramic networks (PICNs) using zinc oxide. Two different types of zinc oxide particles were used as precursors to produce zinc oxide networks by sintering, each with two different densities resulting in two different weight ratios of the PICNs. For each of these different networks, two subgroups were built: one involving the application of a phosphate-monomer-containing primer prior to the infiltration of Bis-GMA/TEGDMA and one without. Elastic modulus and flexural strength were determined by using the three-point bending test. Vertical substance loss determined by the chewing simulation was evaluated with a laser scanning microscope. There was a statistically significant influence of the type of precursor particles on the flexural strength and in some cases on the elastic modulus. The application of a primer lead to a significant increase in the flexural strength and in most cases also in the elastic modulus. A higher weight ratio of zinc oxide led to a significantly higher elastic modulus. Few statistically significant differences were found for the vertical substance loss. By varying the shape of the particles and the weight fraction of zinc oxide, the mechanical properties of the investigated PICN can be controlled. The use of a phosphate-monomer-containing primer strengthens the bond between the infiltrated polymer and the zinc oxide, thus increasing the strength of the composite.

Introduction: The aim of this study was to measure the wear progress of three high performance polymers (HPP) materials as well as that of zirconia after artificial aging (simulated 2.5- and 5-year of clinical service with thermo-mechanical loading) and compare it with the well-documented wear of lithium disilicate., Methods: Forty implants were used to restore a maxillary first premolar, where the abutment and the crown were manufactured as hybrid-abutment-crown and connected to the implant using a titanium insert. The implants were randomly divided, according to the restorative materials used, into five groups: 3Y-TZP zirconia (Z), lithium disilicate (L), ceramic-reinforced polyetheretherketon (P), nano-hybrid composite resin (C) and polymer-infiltrated ceramic-network (E). All hybrid-abutment-crowns were produced using CAD/CAM technology. A design of a maxillary first premolar was created with an angle of 120° between the buccal and palatal cusps, which were designed as planes. The restorations were adhesively luted onto the titanium inserts, according to the manufacturers' recommendations for each material individually, by means of dual-curing luting resin with the exception of group P, where the blocks were pre-fitted (heat-pressed) with an integrated titanium insert. The suprastructures were assembled onto the implants through titanium screws. The screw channels were sealed with Teflon tape and composite resin filling material that was polished to high-gloss. All specimens underwent 1 200 000 thermo-dynamic loading cycles with 49 N in a dual-axis chewing simulator. Elastomeric impressions were made for all specimens after 600 000 and after 1 200 000 cycles. The corresponding impressions were imaged using a laser scanning microscope and then 3D-analyzed using the software (Geomagic Wrap) to measure the volume loss of the wear area for all specimens. Statistical analysis was performed using Wilcoxon-Test regarding the two different time measurements for each material. For the analysis of the material variable, Kruskal-Wallis test was conducted followed by Mann-Whitney test., Results: Group Z showed statistically the lowest volume loss compared to the other test materials, both after 600 000 and 1 200 000 cycles of artificial aging, with a median value of 0.002 mm 3 volume loss after 1 200 000 cycles. In contrast, group E showed the highest volume loss with median values of 0.18 and 0.3 mm 3 after 600 000 and 1 200 000 cycles, respectively. Artificial aging had significantly negative effect on the volume loss for all test materials. In addition, the choice of material had statistical influence on the outcome., Conclusion: Monolithic zirconia ceramic demonstrated lower wear than that reported for enamel after simulated 5-year of clinical service, whereas all other test materials showed higher volume loss after artificial aging., (© 2023 The Authors. Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.)

Background: Achieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = V baseline -V 1-5 ; in µm 3 )., Methods: Two operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests., Results: Ninety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 10 6 (4.8 × 10 6 )µm 3 versus 8.79 × 10 4 (1.05 × 10 6 )µm 3 for control at V 5 (p ≤ 0.001). No significant differences of ∆V 1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 10 7 (7,2 × 10 6 ) µm 3 ), followed by LAPA-2 on CAB (∆V: -6.29 × 10 6 (4,24 × 10 6 ) µm 3 ), LAPA-1 on CGIZ (∆V: -4.15 × 10 6 (3,25 × 10 6 ) µm 3 ), LAPA-2 on CGIZ (∆V: -3.0 × 10 6 (2,23 × 10 6 ) µm 3 ), RCP on CAB (∆V: -1.86 × 10 6 (2,23 × 10 6 ) µm 3 ) and CGIZ (∆V: -1.2 × 10 6 (1,31 × 10 6 ) µm 3 ; p ≤ 0.001))., Conclusions: Within study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower., (© 2024. The Author(s).)

Statement of Problem: The influence of the ferrule thickness and post materials on the fracture resistance of endodontically treated teeth remains unclear., Purpose: The purpose of this laboratory study was to evaluate the influence of post material and ferrule thickness on the fracture resistance of endodontically treated mandibular premolars., Material and Methods: Sixty-four extracted and endodontically treated mandibular first premolars were used and divided into 4 test groups (n=16) depending on the ferrule thickness: F-0: without a ferrule, F-0.5: with a 0.5-mm ferrule thickness, F-1: with a 1-mm ferrule thickness, and F-1.5: with a 1.5-mm ferrule thickness. In groups with ferrules, the height ranged from 2 mm buccally/lingually to 1 mm proximally. Teeth in subgroups (n=8) were restored with either prefabricated glass fiber (FF) or titanium posts (FT) (ISO size 70 and length of 7.5 mm) and then adhesively restored with composite resin foundation materials. After foundation procedures, each specimen was restored with a cobalt chromium crown which was cemented with glass-ionomer cement. All specimens were subjected to dynamic loading in a masticatory simulator for 1 200 000 loading cycles with a nominal load of 5 Kg at 1.2 Hz and simultaneous thermocycling (5 to 55 °C). Specimens were then quasistatically loaded at 30 degrees in a universal testing machine until fracture. Fracture loads were analyzed by using 2-way ANOVA followed by the Tukey honestly significant difference test (α=.05)., Results: Fracture loads ranged from 610 ±45 N (no ferrule - glass fiber post) to 1216 ±169 N (1.5 mm ferrule thickness - glass fiber post). A statistically significant increase in fracture resistance was observed with increasing ferrule thickness (P<.001). However, post materials did not show a statistically significant influence (P=.977)., Conclusions: Under the conditions of this laboratory study, increasing the ferrule thickness had a significant effect on the fracture resistance of endodontically treated teeth after thermomechanical fatigue, irrespective of post materials., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: This clinical study aimed to evaluate the outcomes of resin-bonded attachments (RBAs) for precision-retained removable dental prostheses (RDPs) after at least two years of clinical maintenance., Methods: Since December 1998, 205 RBAs (44 bonded to posterior teeth, 161 to anterior teeth) have been inserted in 123 patients (62 females and 61 males; mean age, 63.6 ± 9.6 years) who were recalled annually. The abutment teeth underwent a minimally invasive preparation limited to the enamel. RBAs were cast in a cobalt-chromium alloy with a minimum thickness of 0.5 mm and adhesively luted with a luting composite resin (Panavia 21 Ex or Panavia V5, Kuraray, Japan). We evaluated caries activity, plaque index, periodontal condition, and tooth vitality. The Kaplan-Meier survival curves were used to account for the reasons for failure., Results: The mean observation time of RBAs until the last recall visit was 84.5 ± 51.3 months (range, 3.6-270.6). During the observation period, 33 RBAs debonded in 27 patients (16.1%). The 10-year success rate according to the Kaplan-Meier analysis was 58.4%, which dropped to 46.2% after 15 years of observation if debonding was considered a failure. If rebonded RBAs were regarded as surviving, the 10- and 15-year survival rates would be 68.3% and 61%, respectively., Conclusions: The use of RBAs for precision-retained RDPs appears to be a promising alternative to conventionally retained RDPs. As reported in the literature, the survival rate and frequency of complications were comparable with those of conventional crown-retained attachments for RDPs.

Purpose: To investigate the influence of contamination and different cleaning methods on resin bonding to cobalt-chro- mium (CoCr) alloy disks., Materials and Methods: A total of 160 CoCr disks were divided into 3 groups. The first group (N = 64) was air abraded with alumina particles and contaminated with a silicone disclosing agent and saliva; the second group (N = 64) was air abraded but not contaminated; the third group (N = 32) was neither air abraded nor contaminated. The first two groups were di- vided into 4 subgroups (N = 16) according to the cleaning method: ultrasonic bath in 99% isopropanol, use of a cleaning suspension of zirconium oxide particles, use of a cleaning suspension based on 10-MDP salt, and treatment with atmo- spheric plasma. The third group was divided into 2 subgroups (N = 16): treatment with atmospheric plasma and no treat- ment. All CoCr specimens were bonded to plexiglas tubes filled with a bonding resin that contained phosphate monomer. Tensile bond strength (TBS) was examined by tensile testing after 3 and 150 days of water storage plus 37,500 thermal cy- cles (N = 8)., Results: After contamination, TBS was significantly reduced after 150 days of water storage. Groups without air abrasion showed initially low TBS and debonded spontaneously after 150 days of water storage., Conclusion: None of the cleaning methods was able to remove saliva and silicone disclosing agent on CoCr-alloy sur- faces. Surface activation by plasma treatment has no long-term effect on the bond strength.

This laboratory study was conducted to evaluate and compare the resin bond strength of different adhesive resin systems in different combinations and the durability of their bonds with zirconia ceramic., Materials and Methods: One hundred and twenty-eight specimens were milled from 3Y-TZP zirconia ceramic. The bonding surfaces of all disks were wet polished, steam cleaned, airborne-particle abraded and ultrasonically cleaned in 99% isopropanol. The specimens were randomly divided into four main groups according to the applied resin system; two conventional and two self-adhesive systems were used. Each group was further subdivided into two subgroups; the first was conditioned with the specified primer for conventional luting resins or not conditioned for the self-adhesive systems, whereas the second subgroup of each was conditioned with the same phosphate monomer-containing primer (Alloy Primer). The zirconia specimens were adhesively bonded, using the allocated luting resin, to plexiglass tubes filled with self-curing composite resin (Clearfil FII). Half of the specimens of each subgroup were stored in distilled water at 37 °C for 3 days, whereas the other half were subjected to artificial aging, 150 days of storage and additional thermal cycling. Thereafter, all specimens were subjected to TBS testing using a universal testing machine. Statistical analysis was conducted using two-way ANOVA followed by separate one-way ANOVAs. The Games-Howell post-hoc test was applied for pairwise comparisons., Results: All specimens survived storage with thermal cycling. The mean TBS values ranged from a minimum of 43.4 ± 5.0 MPa to a maximum of 66.4 ± 3.5 after 3 days and from a minimum of 13.6 ± 2.5 MPa to a maximum of 50.1 ± 9.4 MPa after 150 days., Conclusions: Artificial aging had a significantly negative effect on all test groups. The chosen adhesive-resin system had a significant effect on the resulting TBS values. The highest TBS values were achieved for the self-adhesive luting resin G-Cem One but were statistically comparable to the results obtained for the dual-cure luting resin G-Cem LinkForce.

Objectives: To assess the long-term clinical outcome of posterior inlay-retained fixed dental prostheses (IRFDPs) with a modified design made from zirconia ceramic., Methods: In 30 patients thirty 3-unit IRFDPs were placed to replace 7 premolars (4 in the maxilla, 3 in the mandible), and 23 first molars (15 in the maxilla, 8 in the mandible). Preparations were accomplished in agreement with the general principles for ceramic inlay restorations and modified with a short retainer-wing bevel preparation within the enamel at the buccal and oral sides. The frameworks were milled from 3Y-TZP ceramic, and the pontics were veneered with feldspathic ceramic. All IRFDPs were bonded with a phosphate monomer containing luting resin after air-abrasion of the intaglio surfaces. The patients were recalled 6-12 months after placement, and then annually. Kaplan-Meier analysis was used to calculate the survival and complication rates of the IRFDPs., Results: The mean observation time was 10.6 ± 1.5 years. The 10-year cumulative survival rate was 89% with 4 failures, two of them were due to deep secondary caries with loss of retention, one due to repeated debonding with enamel fractures, and one due to generalized progressive periodontitis. The most common complication was chipping of the veneering ceramic (20.1%). Eighteen IRFDPs were free of any type of complication up to 15.4 years, which corresponds to a 10-year cumulative success rate of 70.4%., Conclusion: The long-term clinical performance of modified IRFDPs made of veneered zirconia ceramics was favorable after 10 years, therefore, they represent a treatment alternative to replace posterior single missing teeth., Clinical Significance: Zirconia-based IRFDPs fabricated in the modified design may represent a substance-preserving alternative to conventional posterior FDPs to replace posterior single missing teeth, particularly in cases where implants cannot be placed, and when the adjacent teeth already have small restorations or defects., Competing Interests: Declaration of Competing Interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome., (Copyright © 2023. Published by Elsevier Ltd.)

Purpose: To evaluate the effects of post length, post material, and substance loss on the fracture resistance of endodontically treated mandibular premolars., Materials and Methods: A total of 96 extracted human mandibular first premolars were endodontically treated and divided into 12 test groups (n = 8 each) based on the number of residual walls (one/two), post material (glass-fiber/titanium), and post length (5 mm, 7.5 mm, and 10 mm). After luting the posts, specimens received a composite resin core and a crown preparation with a 1.5-mm ferrule. Cast cobalt-chromium crowns were cemented using glass-ionomer cement. After 1,200,000 chewing cycles with a load of 49 N and simultaneous thermocycling (5°C to 55°C), specimens were quasi-statically loaded at 30 degrees to the longitudinal axis of the tooth until fracture. Fracture loads were analyzed using three-way, two-way, and one-way ANOVA (α = .05). Fracture modes were examined under a stereomicroscope (×25 magnification) and recorded., Results: The mean ± SD fracture loads ranged from 642 ± 190 N (one wall, glass fiber, 5 mm) to 1,170 ± 130 N (two walls, titanium, 7.5 mm). The mean fracture load of titanium posts was significantly higher than that of glass-fiber posts (P < .001), and the 7.5-mm post length exhibited significantly higher fracture loads than groups with 5-mm and 10-mm post length (P = .008)., Conclusions: Teeth restored with titanium posts revealed considerably higher fracture resistance than teeth restored with glass-fiber posts, especially if 7.5-mm-length posts were used.

Purpose: To evaluate the effect of thermomechanical dynamic loading on the retention of telescopic mandibular overdentures with different metallic and nonmetallic material combinations., Materials and Methods: Four groups were tested: (1) ZP (zirconia abutments/PEEK framework); (2) PP (PEEK abutments/PEEK framework); (3) TP (titanium abutments/PEEK framework); and (4) TG (titanium abutments/gold copings/cobalt-chromium framework). Each specimen contained four implants positioned over a polyvinylchloride-cylindrical base. After 10,000 removal/insertion cycles, the specimens were subjected to thermomechanical dynamic load in a chewing simulator for 1,200,000 loading cycles, corresponding to 5-year clinical fatigue. A screw was used to receive the chewing load, and 0.5 mm was permitted between the screw and the metal top fixed into the base to simulate the resilience of the posterior residual ridge tissues. Vertical chewing loads of 60 N were applied at a speed of 30 mm/second. Thermocycling was applied with a temperature ranging between 5°C and 55°C. The retentive force was measured using a universal testing machine 10 times before and after the thermomechanical dynamic loading test with a speed of 8 mm/second., Results: The mean retentive force increased significantly from 13.2 (± 4.6) N to 16.4 (± 6.1) N in group ZP (P = .002), while in group TP, it decreased significantly from 4.9 (± 2.1) N to 3.3 (± 1.7) N (P = .046). There was no statistically significant change in the retentive force for groups PP and TG., Conclusions: The investigated metallic and nonmetallic combinations of double-crown-retained mandibular overdentures maintained acceptable levels of retention after thermomechanical dynamic loading. Further laboratory and clinical studies are needed before their routine clinical use can be recommended.

Aim: The aim of the present article is to describe a new method to reduce the undesirable loss of material thickness that results from overmilling due to the tool diameter compensation correction of common CAD/CAM software., Materials and Methods: Today's CAD/CAM software (eg, 3Shape or Exocad) specifies the same tool diameter compensation for different ceramics. In the case of zirconia ceramics milled in the raw state, this leads to excessive milling of the inner surfaces of crowns, which results in unnecessarily large cementation gaps and a restoration that is thinned out from the inside. By manually reducing the preset correction in the digital design process by the volumetric sintering shrinkage factor specified by the manufacturer, excessive thinning of the zirconia can be avoided., Results: The inner geometry of the restorations changes only slightly after manually reducing the preset tool diameter compensation correction. Consequently, a design of the restoration with the required minimum interocclusal thickness yet with accurate passive seating and marginal fit is possible without any further interventions., Conclusions: Understanding the specifics of the subtractive fabrication process as well as the properties of the restorative materials is a key factor in achieving optimal clinical outcomes with all-ceramic restorations fabricated with CAD/CAM technology. The use of monolithic zirconia combined with a calculated reduction in the preset tool diameter compensation correction might be beneficial in cases with thin or uneven geometry.

Critical-sized bone defects resulting from trauma, inflammation, and tumor resections are individual in their size and shape. Implants for the treatment of such defects have to consider biomechanical and biomedical factors, as well as the individual conditions within the implantation site. In this context, 3D printing technologies offer new possibilities to design and produce patient-specific implants reflecting the outer shape and internal structure of the replaced bone tissue. The selection or modification of materials used in 3D printing enables the adaption of the implant, by enhancing the osteoinductive or biomechanical properties. In this study, scaffolds with bone spongiosa-inspired structure for extrusion-based 3D printing were generated. The computer aided design process resulted in an up scaled and simplified version of the bone spongiosa. To enhance the osteoinductive properties of the 3D printed construct, polycaprolactone (PCL) was combined with 20% (wt) calcium phosphate nano powder (CaP). The implants were designed in form of a ring structure and revealed an irregular and interconnected porous structure with a calculated porosity of 35.2% and a compression strength within the range of the natural cancellous bone. The implants were assessed in terms of biocompatibility and osteoinductivity using the osteosarcoma cell line MG63 and patient-derived mesenchymal stem cells in selected experiments. Cell growth and differentiation over 14 days were monitored using confocal laser scanning microscopy, scanning electron microscopy, deoxyribonucleic acid (DNA) quantification, gene expression analysis, and quantitative assessment of calcification. MG63 cells and human mesenchymal stem cells (hMSC) adhered to the printed implants and revealed a typical elongated morphology as indicated by microscopy. Using DNA quantification, no differences for PCL or PCL-CaP in the initial adhesion of MG63 cells were observed, while the PCL-based scaffolds favored cell proliferation in the early phases of culture up to 7 days. In contrast, on PCL-CaP, cell proliferation for MG63 cells was not evident, while data from PCR and the levels of calcification, or alkaline phosphatase activity, indicated osteogenic differentiation within the PCL-CaP constructs over time. For hMSC, the highest levels in the total calcium content were observed for the PCL-CaP constructs, thus underlining the osteoinductive properties., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Kühl, Gorb, Kern, Klüter, Kühl, Seekamp and Fuchs.)

Objectives: The aim of this study was to determine the phase transformation and the influence of aging on the flexural strength of different colored zirconia. The effect of hydrothermal aging in an autoclave was compared with the effect of mechanical stress by simulating chewing., Methods: High-strength zirconia (3Y-TZP) was investigated in three different colors: uncolored, A3, and D3. Disc-shaped specimens (N = 3) were analyzed by X-ray diffraction (XRD), and flexural strength was determined on bar-shaped specimens (N = 15) in a 4-point bending test before and after performing two different aging protocols: aging in an autoclave (134 °C, 70 h) and aging in a chewing simulator (5 kg load, 1.2 million cycles). During autoclave aging, the fraction of monoclinic phase on the surface was determined every 5 h. Once this exceeded 25 vol%, aging of the bar specimens was stopped., Results: While in the unstained group the mean value of the proportion of monoclinic phase already exceeded 25 vol% after 30 h in the autoclave, this was the case in both stained groups only after 70 h. No measurable phase transformation could be detected after chewing simulation. Only color A3 showed a statistically significant (p ≤ 0.05) decrease in flexural strength after aging in the chewing simulator., Significance: The colored zirconia showed a higher resistance to phase transformation through hydrothermal aging. The metal oxides in the staining solutions are assumed to hinder the phase transformation in the zirconia. Therefore, the significant reduction in the stained zirconia after chewing simulation is particularly interesting., (Copyright © 2023 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

This study was conducted to evaluate the accuracy of 3D-printed surgical guides before and after sterilization in a steam sterilizer. A test-model incorporating three implant replicas was customized. A total of forty guides were printed from five printable resins. A group made from a self-curing composite served as control group. The guides were checked for fit. Vertical discrepancies between the model and guides were measured at standardized points at a load of 500 g (P1). The guides were connected to implant replicas and scanned, and their angles were digitally measured. The specimens were sterilized in a steam sterilizer at 121 °C for 20 min at 2 bar pressure. Vertical discrepancies (P2) and angulations were remeasured. Additionally, the specimens were repositioned with an increased load, and measurements were repeated (P3). All specimens were repositionable after sterilization. The smallest variation in discrepancy at a 500 g load was 428 µm, whereas the greatest was 1487 µm. Under an increased force, the smallest change was 94 µm, while the greatest was 260 µm. The level of significance α = 0.05 (95% confidence interval) was set for all tests. The variation in the measured angles was not statistically significant (Kruskal-Wallis's test, p > 0.05). The accuracy was affected by the material and sterilization, but it was clinically acceptable when an increased load was applied during repositioning.

Statement of Problem: Scientific data on the decontamination effectiveness of a newly introduced cleaning agent are lacking., Purpose: The purpose of this in vitro study was to evaluate and compare the tensile bond strength (TBS) of 3 different restorative bonding surfaces after contamination with saliva following different cleaning protocols., Material and Methods: A total of 192 disk specimens were made out of 3 materials (n=64); Katana Avencia (A), Katana Zirconia (Z), and e.max CAD (L). The bonding surfaces of all disks were polished, steam cleaned, and then pretreated by following the recommended protocol for each material. The specimens of each group were divided into 4 subgroups (n=16). The first subgroup served as the reference (R), where no contamination was applied. The 3 other subgroups were contaminated with saliva and subsequently rinsed with water for 20 seconds and dried with oil- and water-free air spray. They were then either not treated with any cleaning method (0), cleaned with Katana Cleaner (K), or cleaned with Ivoclean (I). The bonding surfaces of the specimens were perpendicularly luted to plexiglass tubes filled with dual-polymerizing composite resin (Clearfil DC Core) with resin cement (Panavia V5) after the recommended surface conditioning. Each subgroup was further subdivided into 2 groups: stored in 37 °C water for 3 days or subjected to thermal-cyclic loading for 150 days with 37 500 thermal cycles (7500 per month), temperature 5 to 55 °C, and dwell time of 30 seconds. All specimens were subjected to TBS testing in a universal testing machine. Three-way ANOVA was applied. A significant interaction (P<.01) was detected between the 3 different variables (material, treatment, aging). After significant interactions had been revealed by 3-way ANOVA, additional statistical analysis was performed by using separate 2-way ANOVAs, then separate 1-way ANOVAs followed by the Tukey-HSD test for post hoc pairwise comparisons among groups (α=.05 for all tests). All specimens underwent failure mode analysis after TBS testing RESULTS: All specimens survived the storage with thermocycling except for group Z-0, where all specimens debonded during thermocycling. The mean ±standard deviation TBS values ranged from 18.3 ±5.3 MPa to 34.0 ±5.4 MPa after 3 days and from 6.7 ±5.5 MPa to 26.9 ±5.4 MPa after 150 days., Conclusions: Contaminated groups that did not receive any cleaning had significantly lower TBS. Thermocycling had a negative effect on the TBS but was not statistically significant for all groups. Using the same cleaning method, the restorative material did had a significant effect on the TBS after 150 days., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Aim: To investigate the effect of using different materials for the fabrication of implant abutments and crowns on the mechanical behavior of implant-supported single crowns after artificial aging. The materials were tested in different combinations to reveal whether using stiff or resilient materials as an abutment or a crown material might influence the fracture strength of the whole structure., Materials and Methods: A total of 40 implants (blueSKY, bredent GmbH & Co. KG) were restored with identical custom-made CAD/CAM abutments milled out of lithium disilicate or ceramic-reinforced PEEK and were divided into 5 test groups (n &#61; 8 each). Forty crowns made of three different materials (zirconia, lithium disilicate, and ceramic-reinforced PEEK) were used to restore the abutments. Specimens were subjected to mechanical load up to 1,200,000 cycles in a chewing simulator (Kausimulator, Willytech) with additional thermal cycling. The surviving specimens were subjected to quasi-static loading using a universal testing machine (Z010, Zwick)., Results: PEEK abutments with zirconia crowns showed the highest median failure load (3890.5 N), while PEEK abutments with lithium disilicate crowns exhibited the lowest (1920 N). Fracture and deformation occurred in both crowns and abutments., Conclusion: The failure load of the restorations was influenced by the material of the abutment and the crown. Restoring PEEK abutments with zirconia crowns showed a high failure load and no screw loosening.

Objectives: The aim of this study was to evaluate the mechanical properties and cost efficiency of direct ink writing (DIW) printing of two different zirconia inks compared to casting and subtractive manufacturing., Methods: Zirconia disks were manufactured by DIW printing and the casting process and divided into six subgroups (n = 20) according to sintering temperatures (1350 °C, 1450 °C and 1550 °C) and two different ink compositions (Ink 1, Ink 2). A CAD/CAM-milled high strength zirconia (3Y-TZP) was added as reference group. The biaxial flexural strength (BFS) was measured using the piston-on-three-balls test. X-ray-diffraction (XRD) was used for microstructural analysis. The cost efficiency was compared for DIW printing and subtractive manufacturing by calculation of the manufacturing costs of one dental crown., Results: Using XRD, monoclinic and tetragonal phases were detected for Ink 1, for all other groups no monoclinic phase was detected. The CAD/CAM-milled ceramic showed a significantly higher BFS than all other groups. The BFS of Ink 2 was significantly higher than the BFS of Ink 1. At a sintering temperature of 1550 °C the mean BFS of the printed Ink 2 was 822 ± 174 MPa. The BFS of the cast materials did not show a significantly higher BFS than the corresponding printed group for any tested parameter-set. The manufacturing costs of DIW printed crowns are lower than the manufacturing costs of CAD/CAM-milled crowns., Conclusion: DIW has a high potential to replace subtractive processes for dental applications, as it shows promising mechanical properties for appropriate ink compositions and facilitates a highly cost effective production., (Copyright © 2023 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: The purpose of this study was to investigate the survival rate, the debonding resistance, and the failure modes of different occlusal veneer designs when used as a retainer for posterior cantilever, resin-bonded fixed dental prostheses (RBFDPs) at two tooth wear levels., Methods: Four test groups were assigned: two groups with occlusal-proximal preparation (PT1 and PT2 for grade 2 and 3 wear), and two groups for occlusal-proximal and lingual preparation (PLT1 and PLT2 for grade 2 and 3 wear) Monolithic zirconia ceramic (3Y-TZP) RBFDPs were luted with an adhesive bonding system (Panavia V5). The specimens underwent a chewing simulation for 1.200.000 cycles with a load of 5 kg and thermocycling for 7500 cycles between 5 °C and 55 °C. The surviving restorations were debonded under quasi-static conditions. The results were analyzed with ANOVA., Results: The specimens exhibited a 100 % survival rate after thermomechanical fatigue loading. The debonding resistance was statistically significant higher for group PLT1 than for group PT1 (P = 0.004), and higher for group PT2 than group PT1 (P ≤ 0.001). However, the debonding resistance showed no statistically significant difference between groups PT2 and PLT2 (P = 0.343), and groups PLT1 and PLT2 (P = 0.222). Groups PT1 and PT2 showed favorable failure modes in 62.5 % and 0.00 % of the specimens, respectively. While groups PLT1 and PLT2 presented 25 % favorable failure modes., Significance: Occlusal veneers showed promising results as a retainer for cantilever RBFDPs. The lingual extension might increase debonding resistance. Nevertheless, conservative designs with lingual and proximal bevels are to be recommended, irrespective of the level of tooth wear., (Copyright © 2023 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Scientific data to support scannable and computer-aided design and computer-aided manufacturing (CAD-CAM)-compatible interocclusal registration materials are lacking., Purpose: The purpose of this in vitro study was to evaluate the ability of different registration materials (conventional versus scannable) to record maxillary-mandibular relationships and compare the dimensional stability of these records after storage times of 1 hour and 48 hours., Material and Methods: Six groups of interocclusal registration materials were tested: 3 conventional (Registrado X-tra, Futar D Fast, and O-Bite) and 3 scannable (Registrado Scan, Futar Cut & Trim Fast, and O-Bite Scan). Eight registrations were made for each group by using a custom-made device with a dial gauge to measure vertical discrepancies. Records were stored at room temperature, and discrepancies measured after 1 hour and 48 hours. The data were statistically analyzed with the Wilcoxon test with respect to time and the Kruskal-Wallis test with respect to materials, followed by the Mann-Whitney test with the Bonferroni-Holm correction (α=.05)., Results: The median vertical discrepancies ranged from -2 μm (FS) to 11 μm (O-Bite) after 1 hour and from 3 μm (Futar Cut & Trim Fast) to 13 μm (Registrado X-tra and O-Bite) after 48 hours. A statistically significant difference (P<.001) was found between the results after 1 hour and 48 hours for all materials. All scannable interocclusal registration materials showed significantly lower vertical discrepancies than the corresponding conventional materials after 1 hour and 48 hours (P<.05)., Conclusions: All registration materials showed vertical discrepancies that might be clinically acceptable. Vertical discrepancies increased after 48 hours of storage for all materials but were still clinically acceptable., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The single midline implant in the edentulous mandible is a treatment concept that has often been controversially discussed. Nearly 30 years ago, the first available clinical results revealed high implant survival rates and remarkable improvements in oral comfort, function, patient satisfaction and oral health-related quality of life for edentulous patients compared to the situation with no implant. However, the clinical trials were predominantly conducted with a small number of patients over a short to medium follow-up period. Today, numerous clinical investigations on the single midline implant in the edentulous mandible, which increasingly include longer-term observation periods, are available. It is the aim of this overview to present the current literature and to highlight the clinical problems. This article is a 2023 update of a review published by the authors in the German language in 2021 in the German journal Implantologie . In total, 19 prospective clinical trials with a follow-up period of 0.5-10 years were analyzed. Over this observation period, single implants with modern rough implant surfaces in the edentulous mandible reveal high implant survival rates of between 90.9 and 100% when a conventional delayed loading protocol was applied.

Purpose: To present a minimally invasive treatment approach for the replacement of two missing adjacent teeth with two single-retainer resin-bonded fixed dental prostheses (RBFDPs)., Materials and Methods: Two missing adjacent premolars were restored by two RBFDPs with an innovative design of the proximal section. Both RBFDPs were digitally designed and milled from monolithic 3Y-TZP zirconia ceramic using CAD/CAM. Following construction of the anterior RBFDP, a shallow interlock was designed in the area of proximal contact in the same insertion direction as the posterior RBFDP. In this way, different paths of insertion of the RBFDPs could be provided without compromising the proximal hygiene capability., Results: The presented minimally invasive restorations were successful over 5 years of clinical bservation without any complications., Conclusion: The presented restoration design secures the transversal position of the RBFDPs while maintaining physiologic tooth mobility. In addition, it allows for varying paths of insertion while improving hygienic conditions. Last, in case of a unilateral debonding of one retainer wing, rebonding might be possible. Int J Prosthodont 2023;36:155-160. doi: 10.11607/ijp.7711.

Background: The valine (branched-chain amino acid) metabolite 3-hydroxyisobutyrate (3-HIB), produced by 3-Hydroxyisobutyryl-CoA Hydrolase (HIBCH), is associated with insulin resistance and type 2 diabetes, but implicated tissues and cellular mechanisms are poorly understood. We hypothesized that HIBCH and 3-HIB regulate hepatic lipid accumulation., Methods: HIBCH mRNA in human liver biopsies ("Liver cohort") and plasma 3-HIB ("CARBFUNC" cohort) were correlated with fatty liver and metabolic markers. Human Huh7 hepatocytes were supplemented with fatty acids (FAs) to induce lipid accumulation. Following HIBCH overexpression, siRNA knockdown, inhibition of PDK4 (a marker of FA β-oxidation) or 3-HIB supplementation, we performed RNA-seq, Western blotting, targeted metabolite analyses and functional assays., Findings: We identify a regulatory feedback loop between the valine/3-HIB pathway and PDK4 that shapes hepatic FA metabolism and metabolic health and responds to 3-HIB treatment of hepatocytes. HIBCH overexpression increased 3-HIB release and FA uptake, while knockdown increased cellular respiration and decreased reactive oxygen species (ROS) associated with metabolic shifts via PDK4 upregulation. Treatment with PDK4 inhibitor lowered 3-HIB release and increased FA uptake, while increasing HIBCH mRNA. Implicating this regulatory loop in fatty liver, human cohorts show positive correlations of liver fat with hepatic HIBCH and PDK4 expression (Liver cohort) and plasma 3-HIB (CARBFUNC cohort). Hepatocyte 3-HIB supplementation lowered HIBCH expression and FA uptake and increased cellular respiration and ROS., Interpretation: These data implicate the hepatic valine/3-HIB pathway in mechanisms of fatty liver, reflected in increased plasma 3-HIB concentrations, and present possible targets for therapeutic intervention., Funding: Funding was provided by the Research Council of Norway (263124/F20), the University of Bergen, the Western Norway Health Authorities, Novo Nordisk Scandinavia AS, the Trond Mohn Foundation and the Norwegian Diabetes Association., Competing Interests: Declaration of interests S.N.D. received grants to the institution (University of Bergen) from the Research Council of Norway, the Novo Nordisk Scandinavia AS and the Norwegian Diabetes Association. M.B. has received personal honoraria for consultations/presentations from Amgen, AstraZeneca, Bayer, Boehringer-Ingelheim, Lilly, Novo Nordisk, Novartis and Sanofi, and served on an advisory board for Boehringer-Ingelheim. G.M. received funding from the Trond Mohn Foundation (to the University of Bergen), consulting fees from Novo Nordisk Norway and payment for expert testimony from the Throne Holst Nutrition Research Foundation, Norway., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: The aim of this case report was to present a minimally invasive and esthetic treatment approach for the replacement of missing teeth removable partial dentures retained by zirconia ceramic resin-bonded attachments., Method and Materials: The resin-bonded attachments were digitally designed and milled using CAD/CAM technology from monolithic 3Y-TZP zirconia ceramic. The resin-bonded attachments had an optimized attachment design approved for zirconia ceramic. The preparation was based on general preparation guidelines for resin-bonded attachments and resin-bonded fixed dental prostheses (RBFDPs). After placement of rubber dam, the resin-bonded attachments were bonded with a phosphate monomer-containing luting resin., Results: The presented resin-bonded attachment-retained removable partial denture was successful over 30 months of clinical observation without any complications. The patient was satisfied with the minimally invasive treatment procedure., Conclusion: Zirconia ceramic resin-bonded attachments fabricated with a special attachment design are an esthetic and minimally invasive treatment approach. However, clinical data on the long-term outcome of zirconia resin-bonded attachments are still needed. (Quintessence Int 2023;54:220-226; doi: 10.3290/j.qi.b3819523).

Purpose: Various surface roughness parameters are utilized to describe the surface in the tooth to ceramics abrasion and to assess the resulting wear. The use of three-dimensional parameters may offer a better estimation for wear and an improved deduced clinical surface treatment. The aim of this study was to determine the influence of various surface roughness parameters of zirconia and lithium disilicate ceramics on the wear of steatite antagonists., Material and Methods: Forty zirconia specimens with a diameter of 7 mm and a thickness of 3 mm and 40 lithium disilicate specimens with the dimensions 10×10×4 mm were each divided into five subgroups. Two subgroups were treated with different clinically established diamond burs; a third subgroup was treated with a silicone polishing set. Two additional subgroups were produced by glazing the surfaces after treatment. Surface roughness parameters were determined by laser scanning microscopy. All specimens underwent 1.2 million loading cycles using steatite antagonists. After regular intervals of cycles, precision impressions were made to assess the wear. The correlation between wear and different roughness parameters was evaluated using the Spearman correlation test., Results: For the glazed zirconia, unglazed zirconia, and glazed lithium disilicate specimens no significant correlations (p > 0.05) between the investigated roughness parameters and antagonist wear could be found. In the unglazed lithium disilicate groups, significant (p ≤ 0.05) correlations with steatite substance loss could be found for several roughness parameters after 1.2 million cycles., Conclusions: For lithium disilicate, it seems not sufficient to use only one roughness parameter to indicate the wear behavior of the surface. There was no correlation between wear and the tested roughness parameters of zirconia surfaces., (© 2022 The Authors. Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.)

Objectives: This systematic review aimed to collect and interpret the randomized clinical trials (RCTs) that investigated the outcome of the self-adhesive luting resins (SA) compared to total-etch (TE), selective etch with dentin adhesives (Sle), selective etch without dentin adhesives (SleSA) or self-etch adhesives (SE)., Data Sources: A thorough search of Internet databases was conducted without language restrictions, and the search ran up to and including April 2022. The illegible records citations were checked for more relevant clinical studies., Study Selection/results: The inclusion criteria were randomized controlled trials (RCTs) that compared self-adhesive luting resins with total-etch, selective-etch, or self-etch adhesives regarding postoperative sensitivity, incidences of debonding, and survival rates of indirect restorations. From 1732 records, 9 RCTs met the eligibility criteria. Three RCTs compared total-etch adhesive to self-adhesive luting resin for intracoronal restorations, one RCT compared selective etch to self-adhesive luting resin for inlays, and 5 RCTs compared self-adhesive to other protocols for partial ceramic crowns. Postoperative sensitivity showed a non-statistically significant difference between SA and other adhesive protocols, SA revealed a non-statistically significant difference in debonding and survival to TE, but a lower statistically significant difference to Sle, SleSA, and SE., Conclusions: Postoperative sensitivity might not be affected by the adhesive protocol. In relatively short observation, TE revealed comparable survival to SA for intracoronal restorations. SE and Sle exhibited the best clinical outcomes, followed by SleSA. Selective etch, and self-etch adhesives are preferable to self-adhesive resins., Clinical Significance: The significance of enamel etching and the superiority of self-etching adhesives over self-adhesive luting resins for reliable and durable bonding and improved clinical outcomes. However, long-term RCTs, particularly for total-etch comparison to self-adhesive luting resins, might be recommended to derive further evidence., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Purpose: Various oral rehabilitation approaches are available for severely worn dentition. However, evidence-based guidelines for permanent treatment are limited. This review aims to investigate clinical observational findings and compare in-vitro outcomes of thin and ultrathin occlusal veneers using different materials and approaches., Methods: An electronic search of online databases, such as PubMed (MEDLINE), BioMed Central (BMC), Cochrane, and Scopus, was performed for the 2009 - Jun 2021 period, following the PRISMA 2020 criteria. The reports sought for retrieval were all the articles evaluating the clinical outcomes of permanent full-mouth rehabilitation, and all in-vitro records that investigated and compared fracture strength, survival rate, and modes of failure of ultrathin (0.3 - 0.6 mm), thin (0.5 - 0.8 mm), and thick (0.8-1.5 mm) occlusal veneer restorations, with regard to the available indirect restorative materials. The Newcastle Ottawa risk of bias criteria was used to judge the clinical studies and a modified consort statement was used for the evaluation of in-vitro studies. The data of the included studies were extracted and grouped based on the similarity of the outcomes and study protocols. Data heterogeneity determined the qualitative and quantitative grouping of the results., Results: Two clinical and 17 in-vitro studies were included. Data exhibited heterogeneity within the materials, variables, testing protocols and observation periods. Therefore, only qualitative synthesis of the results was feasible. Clinically used 1 mm lithium disilicate overlays and ultrathin one-step no-prep polymer infiltrated ceramic network (PICN) occlusal veneers exhibited very high success and survival rates. The analysis of in-vitro studies exhibited variable survival rates and fracture load values, based on materials, thickness, and restorative approaches used., Conclusions: Within the limitations of this systematic review, it can be concluded that the clinical outcomes of thin and ultrathin occlusal veneers/overlays are auspicious. In-vitro experimental results support the usage of the thin and ultrathin occlusal veneers.

Objectives: To present an update on the concept of cantilevered single-retainer all-ceramic resin-bonded fixed dental prostheses (RBFDPs) first presented 25 years ago in the Journal of Esthetic Dentistry., Overview: The initially presented case of the concept was followed clinically over 26 years and is presented along with two additional clinical long-term cases using varying methods to obtain an esthetic and hygienic ovate pontic design. Veneered alumina and zirconia ceramic (3 mol% yttria-tetragonal zirconia polycrystalline ceramic; 3Y-TZP) was used and bonded with a phosphate monomer containing luting resin after 50 μm alumina particle air-abrasion at 0.25 MPa pressure. The restorations replacing incisors did not debond and soft tissues in the pontic area were maintained over 26 years., Conclusions: Cantilevered single-retainer all-ceramic RBFDPs today made from veneered 3Y-TZP zirconia ceramic can be considered a standard of care for the replacement of single incisors and provide an excellent esthetic outcome with a long-term preservation of soft tissues in the pontic area., Clinical Significance: Bonding nonretentive oxides ceramics such as alumina and zirconia ceramic with phosphate monomer containing luting resins after alumina particle air-abrasion is durable over decades. This proves that bonding to zirconia ceramic is not of any problem when adequate methods are used. Single-retainer zirconia ceramic RBFDPs maintain soft tissues in the edentulous area of single missing incisors and often deem implants unessential for this indication., (© 2022 The Authors. Journal of Esthetic and Restorative Dentistry published by Wiley Periodicals LLC.)

Background: When dental patients seek care, treatments are not always successful,that is patients' oral health problems are not always eliminated or substantially reduced. Identifying these patients (treatment non-responders) is essential for clinical decision-making. Group-based trajectory modeling (GBTM) is rarely used in dentistry, but a promising statistical technique to identify non-responders in particular and clinical distinct patient groups in general in longitudinal data sets., Aim: Using group-based trajectory modeling, this study aimed to demonstrate how to identify oral health-related quality of life (OHRQoL) treatment response patterns by the example of patients with a shortened dental arch (SDA)., Methods: This paper is a secondary data analysis of a randomized controlled clinical trial. In this trial SDA patients received partial removable dental prostheses replacing missing teeth up to the first molars (N = 79) either or the dental arch ended with the second premolar that was present or replaced by a cantilever fixed dental prosthesis (N = 71). Up to ten follow-up examinations (1-2, 6, 12, 24, 36, 48, 60, 96, 120, and 180 months post-treatment) continued for 15 years. The outcome OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). Exploratory GBTM was performed to identify treatment response patterns., Results: Two response patterns could be identified - "responders" and "non-responders." Responders' OHRQoL improved substantially and stayed primarily stable over the 15 years. Non-responders' OHRQoL did not improve considerably over time or worsened. While the SDA treatments were not related to the 2 response patterns, higher levels of functional, pain-related, psychological impairment in particular, and severely impaired OHRQoL in general predicted a non-responding OHRQoL pattern after treatment. Supplementary, a 3 pattern approach has been evaluated., Conclusions: Clustering patients according to certain longitudinal characteristics after treatment is generally important, but specifically identifying treatment in non-responders is central. With the increasing availability of OHRQoL data in clinical research and regular patient care, GBTM has become a powerful tool to investigate which dental treatment works for which patients., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study is to analyze the esthetic perception of selected canine features, namely crown length, shade, inclination, and angle of incisal edge tip., Materials and Methods: The anterior maxillary teeth of a Central European woman were photographed and digitally modified in order to investigate esthetic perceptions of the above four categories. Three groups of examiners with different levels of experience in the field of dentistry (laypersons/inexperienced dental students, advanced dental students, dentists) evaluated the photographs twice with the help of visual analogue scales., Results: The best-evaluated canines have approximately the same length as the central incisor, have the same shade as the other anterior teeth, are best embedded in a lighter overall tooth shade, are neutral to slightly palatal inclined, and have a right angled to rounded incisal edge (≥ 90°). The canines evaluated as least esthetic, however, are longer than the central incisors, darker, inclined labially, and have a tapered incisal edge. No significant differences could be found between the evaluations of the groups with regard to the four feature categories., Conclusions: Laypersons, advanced dental students, and dentists generally evaluate according to the same esthetic standards. Gender does not have a significant influence on evaluation. Clear definitions of esthetically favored shades, incisal edge shapes, inclination, and lengths of the canines can be given., Clinical Relevance: Since the esthetics of the smile line play a critical role for patients, dentists, dental technicians, and their supplying industry, knowledge of the esthetically preferred morphology of canines is essential., Clinical Significance: The aim of this study is to give clear definitions of esthetically favored shades, incisal edge shapes, and lengths of the canines, as the esthetics of the smile line play a critical role for patients, dentists, dental technicians, and their supplying industry (e.g., denture tooth manufacturers). Precise knowledge of esthetic preferences is important in clinical practice for both dentists and dental technicians, for example, in order to adequately advise patients regarding esthetic corrections. Also, in the case of missing teeth, this knowledge is essential for optimal and satisfactory restorations. Thus, this study can contribute to the satisfaction of general practitioners and patients., (© 2022. The Author(s).)

Purpose: To test a newly introduced implant-abutment material combination against bacterial endotoxin leakage in a human whole blood assay., Materials and Methods: Two dental implant systems with internal connections and the following material combinations at the implant-abutment interface (IAI) were used (implant material/abutment material): yttrium-stabilized tetragonal zirconium dioxide (Y-TZP)/polyetherketoneketone (PEKK), and titanium (Ti/Ti). Test implants were inoculated with lipopolysaccharide (LPS) and sealed and submerged in human whole blood. Untreated implants served as the control groups. Changes in gene expression levels of inflammatory markers indicating LPS leakage were assessed after 1, 8, and 24 hours using quantitative real-time polymerase chain reaction., Results: In the Y-TZP/PEKK test group, a significant influence of the implant system (P < .001) on increases in gene expression indicating leakage were detected after 8 hours for TLR-4 and after 24 hours for interleukin 1-β and nuclear factor kappa-light-chain-enhancer of activated B-cells (NF-κB), indicating microleakage of LPS at the IAI. In the Ti/Ti test group, differences in gene expression were found only for NF-κB after 8 hours., Conclusion: The internal hexalobe IAI of two-piece dental implants fabricated from Y-TZP and PEKK do not prevent LPS molecular microleakage.

Purpose: The purpose of this study was to assess the effect of aging and alumina-particle air abrasion at different pressures on the bond strength of two luting composites to a translucent 3Y-TZP zirconia., Materials and Methods: Half of the 192 disk-shaped zirconia specimens were aged in an autoclave (group A) for 20 h (134°C, 2 bar), and the other half was not aged (group N). For each group, a different surface treatment was applied: as-sintered (group SIN), alumina-particle air abrasion either at 1 bar (group 1B) or at 2.5 bar (group 2.5B). Disks were bonded to Plexiglas tubes filled with composite resin using a phosphate monomer-based luting composite (group SA) or with a separate phosphate monomer containing primer before using a phosphate-monomer-free luting composite (group V5). All specimens were subjected to tensile bond strength testing (TBS) before and after thermocycling., Results: There were no statistically significant differences caused by autoclave aging for the test groups before thermocycling, except for the A-SIN-SA group, where the TBS decreased significantly. The variation of the aluminaparticle air abrasion pressure showed no statistically significant effect, except in the N-1B-V5 group, where TBS was significantly lower than N-2.5B-V5. After thermocycling, the TBS of most groups decreased significantly. Specimens of the primer group, which were abraded at 1 bar, showed a significant decrease in TBS in comparison with alumina-particle air abrasion at 2.5 bar., Conclusion: Twenty hours of autoclave aging had almost no influence on the bond strength of the test groups. For the primer/resin bonding system, higher pressure during alumina-particle air abrasion might help obtain a higher and more durable bond strength to zirconia.

Objectives: To investigate the chewing efficiency and oral health-related quality of life of edentulous patients wearing complete dentures, successively supported by one, two, and three implants in the mandible., Methods: Thirteen (13) edentulous patients of at least 50 years of age received three implants in the mandible. After a conventional submerged healing period, the central implant was uncovered and connected to the denture base using a stud attachment. Two months later, chewing efficacy was evaluated, and the two lateral implants were uncovered and connected to the denture base. The central retention element was replaced by a short healing abutment with no connection to the denture base. Chewing efficiency was evaluated two months later. Afterward, the healing abutment of the central implant was replaced by a stud attachment and again connected to the denture base. Two months later, chewing efficacy was evaluated again. Oral health-related quality of life (OHRQoL) was measured at each recall visit using the summary score of the oral health impact profile. For statistical analysis of chewing efficacy, the changes from baseline (with no implants) to one, two, and three implants were used and tested by analysis of variance with repeated mesurements., Results: Chewing efficacy clearly increased after implant loading, with a significant increase when two implants were loaded (p ≤ .05), compared to the chewing efficacy with no implants. OHRQoL also significantly improved after implant loading., Conclusions: Within the limitations of the present clinical trial regarding the number of patients, chewing efficacy as well OHRQoL of edentulous patients improve after implant placement in the mandible, irrespective of the number of implants. The best chewing efficacy was achieved with two implants., (© 2022 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.)

The clinical use of one-retainer RBFDPs in the anterior region has shown higher survival rates compared to conventional two-retainer RBFDPs. The motivation for this study was to assess the validity of this observation when extended to the posterior region. The aim was thus to evaluate different preparation and framework designs for replacing premolars, particularly one-retainer versus two-retainer designs, on the retention of monolithic zirconia posterior RBFDPs. Extracted caries-free human premolars and third molars were embedded in auto-curing resin to create models with an edentulous space of premolar width. Abutment teeth were prepared according to these six designs (n = 8 each): one or two upper retainers with narrow rests, one or two upper retainers with wide rests, and one or two-retainers with wide rests. RBFDPs were milled from monolithic zirconia (KATANA Zirconia HT), and were adhesively bonded using Panavia V5 with corresponding primers. After thermodynamic loading, the quasi-static tensile force required for failure was determined. Failure modes were evaluated using a microscope. Survival rates after thermodynamic loading were 75% for one group (one upper-molar retainer with narrow rest), 100% for the other groups. The debonding forces ranged from 310 ± 224 N (group one upper-molar retainer with narrow rest) to 927 ± 292 N (group two upper retainers with narrow rests). Two-retainer designs failed at significantly higher tensile forces than designs with one retainer (p ≤ 0.05). There were no significant differences between upper and lower designs, or rest widths. Although RBFDPs with two retainers withstood higher debonding forces, RBFDPs with one retainer and wide rest still have a high potential for clinical treatment because of the high forces required for their debonding., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Preservation and restoration of teeth with little coronal tooth structure due to crown-root fractures or caries lesions, ensuring restoration margins do not encroach on the biologic width, constitute a challenge. Available treatment options include surgical crown lengthening and orthodontic or surgical extrusion. This report presents two patients in which teeth were restored by surgical extrusion with an atraumatic extraction system and prosthetic therapy.

The aim of this study was to analyze the influence of different surface treatments and the corresponding surface roughness on the ball-on-three-balls test and piston-on-three-balls test for measuring flexural strength 3Y-TZP and 5Y-PSZ. Additionally, the influence of cutting the material into the specimens when pre-sintered or fully sintered was analyzed. A total of 120 specimens for each material group, 3Y-TZP zirconia (Katana HT, Kuraray) and the 4 different layers of multilayered 5Y-PSZ zirconia (Katana UTML, Kuraray), were produced. The used material was cut into half of the specimens in a fully sintered stage, the other half was cut when pre-sintered. Each subgroup was divided into 3 different surface treatment groups being air abraded with 50 µm alumina particles at 1 bar pressure, ground with 600 SiC paper or polished up to 1 µm with a polycristalline diamond suspension. These were then analyzed by X-ray diffraction (XRD) (N = 3) and tested for flexural strength using the ball-on-three-balls test (N = 10) or piston-on-three-balls test (N = 10). For 3Y-TZP groups different surface roughness did not result in statistically significant differences in flexural strength but cutting the specimens in fully sintered state significantly reduced flexural strength of 1133 ± 109 to 741 ± 81 MPa. For 5Y-PSZ groups air abrasion of the specimens with alumina particles significantly reduced the flexural strength of 562 ± 68 MPa to 358 ± 58 MPa. Cutting and surface treatment in pre-sintered or fully sintered state had no significant influence. Flexural strength testing with the ball-on-three-balls test resulted in about 20% higher strengths compared to the piston-on-three-balls test. Results of both tests showed the same tendencies when compared.

Objectives: The aim of this study is to investigate vascular and neurosensory complications in edentulous patients following the installation of mandibular midline single implants in relation to lingual canals., Materials and Methods: After performing a cone beam computed tomography scan for the 50 recruited patients, the relationship between the potential implant site and the lingual canals was assessed, and all vascular and neurosensory complications were recorded., Results: Six patients (12%) reported profuse bleeding during implant placement, and 13 (26%) reported transient neurosensory changes, which were resolved after 3 months. According to the virtual implant planning, 44 patients (88%) would have their implants touching the lingual canals, six of them reported vascular changes (14%), and 12 out of 44 patients reported neurosensory changes (27%). For the six patients who would have their implants not touching the lingual canals, one patient reported transient neurosensory changes., Conclusions: The mandibular lingual canals are constant anatomic landmarks. Injury to the supra-spinosum lingual canals may occur during midline implant placement, depending on the implant length and the bone height., Clinical Relevance: Despite that injury to the supra-spinosum lingual canals during implant insertion does not result in permanent vascular or neurosensory complications, caution is required to avoid the perforation of the lingual cortices., (© 2022. The Author(s).)

Objectives: To characterize human-gingival-fibroblast-(HGFs) viability, proliferation and adhesion on polymer-infiltrated-ceramic-network-(PICN), polyetheretherketone-(PEEK), hydroxyapatite-reinforced-polyetheretherketone-(HA-PEEK), polyetherketoneketone-(PEKK), as well as conventional titanium-(Ti) and zirconia ceramic-(Zr) implant materials in-vitro., Methods: Six materials (n = 40/group, 240 specimens) were standardized for surface roughness, assessed employing water contact angle measurements (WCA) and loaded with HGFs. HGF viability and proliferation were assessed at 24 and 72 h. Cell adhesion strength was evaluated after 24 h exposure to lateral shear forces using a shaking-device at 320 and 560-rpm.and qualitatively tested by scanning-electron-microscopy-(SEM) at 3, 24 and 72 h., Results: PICN demonstrated the lowest mean WCA (48.2 ± 6.3º), followed by Zr (73.8 ± 5.1º), while HA-PEEK showed the highest WCA (87.2 ± 1.5º; p ≤ 0.05). After 24 h, Zr showed the highest mean HGFs-viability rate (88 ± 14%), while PEKK showed the lowest one (78 ± 7%). At 72 h, Zr continued to show the highest HGF-viability (80 ± 6%) compared to PEKK (67.5 ± 6%) and PEEK (67%±5). SEM did not reveal differences between different materials with respect to cell attachment at 3, 24 or 72 h. At 320 rpm shaking, HGFs showed to be best attached to PICN (mean%-of-detached-cells ± SD; 26 ± 11%) and worst to PEEK (54 ± 18%). At 560 rpm shaking, Zr showed the least detached cells (32 ± 4%), while HA-PEEK revealed the highest number of detached cells (58 ± 3%; ANOVA/Tukey-post-hoc-test, differences not statistically significant)., Significance: Dental implant abutment materials and their wettability strongly affect HGF proliferation and adhesion properties. Although, PICN showed the best wettability properties, Zr exhibited the strongest adhesion strength at high shaking. Within the current study's limitations, Zr remains the most biocompatible abutment material., Competing Interests: Declaration of Competing Interest The authors have stated explicitly that there are no conflicts of interest in connection with this article., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

(1) Adipsin is an adipokine that may link increased fat mass and adipose tissue dysfunction to obesity-related cardiometabolic diseases. Here, we investigated whether adipsin serum concentrations and adipose tissue (AT) adipsin mRNA expression are related to parameters of AT function, obesity and type 2 diabetes (T2D). (2) Methods: A cohort of 637 individuals with a wide range of age and body weight (Age: 18-85 years; BMI: 19-70 kg/m 2 ) with (n = 237) or without (n = 400) T2D was analyzed for serum adipsin concentrations by ELISA and visceral (VAT) and subcutaneous (SAT) adipsin mRNA expression by RT-PCR. (3) Results: Adipsin serum concentrations were significantly higher in patients with T2D compared to normoglycemic individuals. We found significant positive univariate relationships of adipsin serum concentrations with age (r = 0.282, p < 0.001), body weight (r = 0.264, p < 0.001), fasting plasma glucose (r = 0.136, p = 0.006) and leptin serum concentrations (r = 0.362, p < 0.001). Neither VAT nor SAT adipsin mRNA expression correlated with adipsin serum concentrations after adjusting for age, sex and BMI. Independent of T2D status, we found significantly higher adipsin expression in SAT compared to VAT (4) Conclusions: Our data suggest that adipsin serum concentrations are strongly related to obesity and age. However, neither circulating adipsin nor adipsin AT expression reflects parameters of impaired glucose or lipid metabolism in patients with obesity with or without T2D.

Objectives: To evaluate the bonding durability after artificial aging provided by a self-etching and a no-etching ceramic primer compared to primers, which are applied by the etch and rinse method., Methods: Lithium disilicate blocks were bonded to a composite resin (Clearfill Core, Kuraray) using 5 bonding methods (N = 24). Specimens of group MEP were bonded using a self-etching primer and the corresponding luting resin (Monobond Etch&Prime/Variolink Esthetic, Ivoclar Vivadent) Specimens of group UBE were bonded using a two-bottle silane solution (Universal Primer/Estecem, Tokuyama) without hydrofluoric acid ceramic etching. Specimens of the other 3 groups were bonded using etch and rinse bonding systems with prior hydrofluoric acid ceramic etching (MPV: Monobond Plus/Variolink Esthetic, Ivoclar Vivadent; SUR: Scotchbond Universal/RelyX Ultimate, 3 M; GML: G-Multi Primer/G-CEM LinkForce, GC). Each group was divided into 3 subgroups (n = 8) according to the storage conditions (3 days water storage (37 °C), 30 days water storage, 7,500 thermal cycles (5-55 °C) and 150 days water storage, 37,500 thermal cycles). The tensile bond strength (TBS) was measured and the data was statistically analyzed., Results: After 3 days the median TBS ranged from 14.6 to 41.7 MPa, after 30 days from 4.2 to 39.0 MPa and after 150 days from 0 to 29.7 MPa. Both bonding systems utilizing a self-etching primer showed a significantly lower TBS than group MPV using a conventional ceramic bonding system., Significance: Especially after long-term storage with additional thermal cycling the bonding systems using primers without hydrofluoric acid ceramic etching do not provide a high bond strength., (Copyright © 2022 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the effect of three different designs and two monolithic ceramic materials on the durability and fracture resistance of endocrowns on maxillary first premolars, in comparison to post-and-core crowns., Methods: Fifty-six maxillary premolars were endodontically treated and shortened to a level of 2 mm from the cervical line, and randomly categorized into six endocrown groups and post-and-core crown control group (n=8); E1; endocrowns with flat occlusal table (without ferrule), E2; endocrowns with 1.5 mm circumferential ferrule, E3; endocrowns with 1.5 mm buccal ferrule preparation. Two materials were used for endocrowns: zirconia (4YSZ; Z), and lithium disilicate (L). The control group was restored with zirconia posts, and lithium disilicate crowns. All restorations were bonded using Panavia V5 and its respective primers and underwent thermo-mechanical fatigue with a 10 kg dynamic load for 1,200,000 cycles and thermocycling between 5 and 55 °C. Thereafter all survived specimens were loaded to fracture. The results were statistically analyzed using ANOVA and T-Test., Results: None of the specimens showed any signs of debonding or fracture caused by the fatigue test. The PC control group showed no statistically significant difference in comparison to groups ZE1, ZE2 and LE2 (p > 0.05). However, it was significantly different from groups LE1, LE3, and ZE3 (p ≤ 0.05)., Conclusions: Preparation designs and materials affected the fracture resistance of endocrowns. The results showed a superiority of the post-and-core crowns, zirconia/lithium disilicate endocrowns with 1.5 mm circumferential ferrule, and zirconia endocrowns with the flat occlusal table.

Objectives: This clinical study evaluated the outcome and survival rate of resin-bonded fixed dental prostheses (RBFDPs) made of 3Y-TZP zirconia ceramic with a single-retainer design in the replacement of missing canines, premolars and molars., Methods: Twenty-one patients that were provided with twenty-seven cantilevered zirconia ceramic RBFDPs replacing maxillary or mandibular missing canines or posterior teeth were recruited from the patients' database at the University of Kiel, Germany. The preparation of the abutment teeth was minimal and limited to the enamel and consisted of a retainer wing and an occlusal rest on the abutment tooth. The restorations were observed over up to 12 years., Results: The patient age ranged from 16 to 72 years old with a mean age of 34 ± 21 years and 57% were females and 43% were males. The restorations were observed for a mean period of 53 ± 39 months with a minimum of 13 months and a maximum of 151 months of observation. No debonding for any of the restorations was detected, which amounts up to a survival rate of 100%. The development of treatable cervical caries on one abutment tooth of an elderly patient without extending to the retainer wing was the only recorded complication., Conclusions: Zirconia ceramic single-retainer RBFDPs provide an esthetic, functional and minimally invasive treatment alternative to replace missing canines, premolar and molars with promising results due to excellent clinical outcome resulting from a survival rate of 100% and a success rate of 96.3% over a mean observation time of 53 ± 39 months., Clinical Significance: Zirconia ceramic single-retainer RBFDPs might be a valid minimally-invasive option for replacing missing canines and missing teeth in the posterior area especially for young patients, in whom implants are contraindicated and conventional fixed dental prostheses are too invasive., (Copyright © 2021. Published by Elsevier Ltd.)

Objective: To evaluate the volume loss after air abrasion with alumina particles with different morphology on bovine enamel and luting composite resin., Methods: Air abrasion was performed on 12 unscathed bovine teeth and 72 luting composite resin discs with 85 μm round-shaped and 50 μm sharp-edged alumina particles applied for 20 s, 40 s and 60 s (n = 12). Air abrasion was standardized by uniform areas of 2 mm diameter, a pressure of 0.25 MPa and a distance of 3 mm. The volume loss was determined by using a laboratory scanner., Results: Air abrasion with round-shaped alumina particles was mostly not measurable with the laboratory scanner, while sharp-edged alumina air abrasion resulted in significant loss of enamel. The median of volume loss by sharp-edged alumina particles ranged from 0.78 mm 3 (20 s) to 2.52 mm 3 (60 s). In contrast to round-shaped alumina the removal caused by sharp-edged alumina increased significantly with increasing application times (p ≤ 0.05). For air abrasion on luting composite resin the median of the removed volume ranged from 2.25 mm 3 (20 s) to 6.18 mm 3 (60 s), while round-shaped alumina showed a range from 0.45 mm 3 (20 s) to 1.40mm 3 (60 s). The round-shaped alumina produced a statistically significant lower volume loss than sharp-edged alumina for all three air abrasion times., Significance: The 85 μm round-shaped alumina particles removed less composite resin than 50 μm sharp-edged alumina particles but barely any enamel, making it an option for removing composite resin residues from enamel., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Background: A shortened dental arch (SDA) is an established treatment concept for patients with missing molars. However, little is known regarding long-term course of oral health-related quality of life (OHRQoL) in patients with SDA and the benefits from replacement of missing molars., Objective: Purpose of this multi-center randomized clinical trial was to assess OHRQoL over a period of 15 years in patients with molar replacement by a removable partial denture (RPD) compared to patients with a restored SDA without molar replacement., Methods: Patients at least 35 years of age with all molars missing in 1 jaw and at least the canine and one premolar present on each side were included. Patients received either a precision attachment-retained, RPD for replacement of missing molars (n = 79), or the dental arch ended with the second premolar (SDA) that had to be present or replaced by a cantilever fixed dental prosthesis (n = 71). Follow-up examinations continued for 15 years. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). OHIP summary and dimension scores were longitudinally modeled in the statistical analyses to assess course of OHRQoL over time applying an intention-to-treat approach. In addition, scores for the OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were analyzed., Results: After an initial improvement in OHRQoL indicated by a mean decrease of 20.0 OHIP points with an effect size of 0.61 in the entire study population, OHRQoL stayed relatively constant over the entire follow-up period. Assuming a constant time and treatment effects over the study period, OHRQoL did not differ statistically significant between the 2 treatments (0.4 OHIP points; 95%-CI: 7.1 - 6.2). OHRQoL after treatment did not change notably over 15 years and was statistically nonsignificant as well (P = .872). Similar findings were observed in all 4 OHRQoL dimensions., Conclusions: In patients, missing all molars in one jaw OHRQoL improved providing RPD or restoring SDA to a clinically relevant degree. Treatment-related improvement remained mostly stable over a period of at least 15 years. Therefore, patients can be informed that both treatment concepts are equivalent concerning long-term OHRQoL. Accordingly, patients' preferences regarding treatment options should be granted priority in treatment decision making with the SDA treatment option being the default., (Copyright © 2021 Elsevier Inc. All rights reserved.)