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The aim of this study was to examine the wear of three different composite materials usable for vertical bite reconstruction under erosive/abrasive conditions and to compare them with the bovine dental hard tissues enamel and dentin in-vitro. The composite materials Filtek Supreme XTE, CeraSmart and Brilliant Crios and bovine enamel and dentin specimens were evenly allocated to five groups (n=10). Samples were firstly exposed to hydrochloric acid for 1 min, then stored for 30 min in artificial saliva. In the second step, the samples were brushed for 1 min with 100 brushing strokes each and an applied force of 2.5 N in an automated brushing device. After 60 of these erosive/abrasive cycles, wear of the samples was determined by contact profilometry. Filtek Supreme XTE showed significantly less wear (mean ± standard deviation; 0.15 ± 0.11 μm) compared to the other two composite materials (p < 0.05). No significant difference (p > 0.05) could be found between CeraSmart (0.25 ± 0.03 μm) and Brilliant Crios (0.24 ± 0.04 μm). The two bovine dental hard tissues, enamel (13.70 ± 0.94 μm) and dentin (50.08 ± 4.46 μm), each showed a significantly higher amount of wear than the three restorative materials (p <0.05). In conclusion, this study exhibited that the three composite materials, Filtek Supreme XTE, CeraSmart and Brilliant Crios, were more resistant under erosive/abrasive conditions compared to bovine enamel and bovine dentin, respectively.

Aim of this study was to get an overview of what dentists estimate to be the reason for failure of adhesive composite restorations and to gain knowledge about potential future foci for targeted further education. Therefore, a survey about the fabrication of composite restorations was conducted in the course of seven dental conferences with the main topic tooth-prevention. A total of 577 dentists participated in the survey. The most often called estimated factor for failure of composite restorations was the "dentist" (70.7%), followed by "indication" (32.2%), "material" (8.5%) and "patient" (8.1%). Participants estimated insufficient drying and fluid management (67.9%), incorrect application of the adhesive system (41.8%), insufficient lightpolymerisation (31.2%) and errors in incremental technique (27.6%) to be the main mistakes. The participating dentists claimed to attach great importance to careful drying and fluid management (60.8%), thorough adhesive application (37.3%), adequate incremental technique (32.6%) and sufficient lightpolymerisation (28.8%) while placing their own restorations. According to the survey participants, the treating dentist has the greatest influence on the quality and longevity of composite restorations. Drying and fluid management was the most often called estimated reason for failure but at the same time the step which is given the greatest caution.

This review assessed defined specific areas of diagnostic, prophylactic and therapeutic procedures in the field of preventive and restorative dentistry and determined the prevalence and risk of bacteremia, given the assumption that any direct or indirect manipulation of perfused dental and periodontal tissues may lead to bacterial access to the systemic circulatory vascular system. We found that all of the evaluated interventions presented at least some risk of bacteremia. With increasing “degree of invasiveness”, the probability of a possible bacteremia increased. A targeted and synoptic case planning remains therefore mandatory, especially in cases with increased risk, for instance for endocarditis.

We compared the prevention of erosive and erosive/abrasive enamel loss by a medical minerals gel system (R.O.C.S.) to that by an anti-erosive toothpaste. Seventy-two bovine enamel samples were randomly allocated to six groups (E1–E3 and EA1–EA3; n=12). Per day, samples were eroded (2 min) 9 times using HCl (pH 2.6). Between erosive challenges and over night samples were stored in artificial saliva. Per day, samples were stored (100 s; groups E1–E3) or additionally brushed (20 brushing strokes; groups EA1–EA3) in/with slurries prepared from artificial saliva plus: no additional toothpaste (control groups E1 and EA1), elmex erosion protection toothpaste (groups E2 and EA2), or R.O.C.S. toothpaste (groups E3 and EA3). Once per day, samples of groups E3 and EA3 were additionally treated (40 min) with a slurry prepared from artificial saliva and R.O.C.S. medical minerals gel. After 7, 14 and 21 days enamel loss was measured by surface profilometry and analyzed by Kruskal-Wallis tests and Conover post-hoc tests. Under erosive conditions only (groups E1–E3), at each time point of measurement the significantly lowest enamel loss was observed in group E2. Substance loss in group E3 was significantly higher, but significantly lower compared to that of group E1. Under erosive/abrasive conditions (groups EA1–EA3), at each time point of measurement the significantly lowest enamel wear was observed in group EA2. Wear in group EA3 was significantly higher even compared to that of group EA1. The tested R.O.C.S. medical minerals gel system was able to reduce erosive enamel loss but not erosive/abrasive enamel wear, and it was less effective than the elmex erosion protection toothpaste.

It was the aim of the current in vitro study to test the erosion-preventive potential of an experimental surface sealant (K-0184) and currently marketed self-etch adhesive systems under abrasive conditions. Ninety-six dentine specimens were randomly allocated to eight groups (n=12): (1) positive control (no treatment), (2) K-0184, (3) Shield Force Plus, (4) Xeno Select, (5) Scotchbond Universal, (6) Adhese Universal, (7) OptiBond All-In-One, and (8) Clearfil SE Bond. Before and after sealing, dentine specimens were measured profilometrically to determine the layer thickness of the protective agents.During 12 days, the specimens were demineralized daily for 5 min using hydrochloric acid (pH=3) and abraded by applying 600 brushing strokes (F=2.5 N). Calcium content in the hydrochloric acid was determined using atomic absorption spectroscopy. Calcium concentration was consistently highest in the positive control group (p < 0.05 compared to all other groups). The lowest cumulated Ca release was measured for K-0184; it differed significantly (p < 0.05) from that determined in groups 4, 6, and 7. K-0184 also had the highest layer thickness (p < 0.05 compared to all other groups). It was concluded that the experimental surface sealant K-0184 and the adhesive systems Xeno Select, Scotchbond Universal, Adhese Universal, and Clearfil SE Bond prevent dentine erosion under the current abrasive conditions with a total of 7,200 brush strokes.

Eroded enamel is more susceptible to abrasive wear than sound enamel. New toothpastes utilizing diamond particles as abrasives have been developed. The present study investigated the abrasive wear of eroded enamel by three commercially available toothpastes (one containing diamond particles) and compared it to the respective wear of sound enamel caused by these toothpastes. Seventy-two bovine enamel samples were randomly allocated to six groups (S1–S3 and E1–E3; n=12). Samples were submitted to an abrasive (S1–S3) or erosion plus abrasion (E1–E3) cycling. Per cycle, all samples were brushed (abrasion; 20 brushing stokes) with the following toothpastes: S1/E1: Signal WHITE SYSTEM, S2/E2: elmex KARIESSCHUTZ and S3-E3: Candida WHITE DIAMOND (diamond particles). Groups E1–E3 were additionally eroded with HCl (pH 3.0) for 2 min before each brushing procedure. After 30, 60 and 90 cycles enamel wear was measured by surface profilometry. Within the same toothpaste and same number of cycles, enamel wear due to erosion plus abrasion was significantly higher than due to mere abrasion. After 30, 60 and 90 cycles, no significant difference in the wear in groups S1 and S2 was observed while the wear in group E1 was significantly (p<0.05, ANOVA, Scheffecyc) lower than that in group E2. After 90 cycles, wear in group S3 was about 5 times higher than that in group S2, while wear in group E3 was about 1.3 times higher than that in group E2. As compared to the other two investigated toothpastes, the dentifrice containing diamond particles caused slightly higher abrasive wear of eroded enamel and distinctly higher wear of sound enamel compared to the conventional toothpastes under investigation.

The aim of this study was to carry out a representative survey on the implementation of and experience with repairs of single-tooth restorations among dentists in the Canton of Zurich, Switzerland. An anonymous questionnaire was sent to all 1,411 dentists registered in the Canton of Zurich; 38.9% of the delivered questionnaires were returned and 35.3% could be evaluated. The statistical analysis comprised Kendall’s rank correlation coefficient (tau), Wilcoxon signed-rank tests, and Kruskal-Wallis tests. The level of significance was set at p≤0.05. Repair restorations are frequently made (composite: 98.5%, ceramic: 88.9%, crowns: 86.5%, metal: 54.6%, amalgam: 51.5%). Main indications for repairs were the partial loss of an existing restoration or of the adjacent dental hard substance, while restoration failures due to secondary caries were repaired to a lesser extent. The decision to repair is largely dependent on the size of the defect (90%), the size of the original restoration (63%), and the material of the failed restoration (84%). Repair restorations are most frequently made with composite following adequate conditioning of the repair surface. A majority of the dentists rate the lifespan of repair restorations as reduced in comparison with newly made restorations. In summary, repairs of defective single-tooth restorations are frequently performed by dentists in the Canton of Zurich, Switzerland, and constitute a well-established treatment procedure.

This study analyzed the anti-erosive effect of a self-assembling peptide fibre gel. One hundred and twelve bovine enamel samples were ground flat and subjected to a three times de- and re-mineralization cycle: erosion (5 min, HCl, pH 2.6) alternated with storage in artificial saliva under agitation. Then, samples were covered with different anti-erosive compounds (2 min): Duraphat toothpaste (DT), Elmex Erosion Protection Toothpaste (EET) or Elmex Gelée (EG) – all mixed with saliva (1:3) –, Elmex Erosion Protection Mouthwash (EEM), Curodont Protect (CP; self-assembling peptide gel) or MI Paste Plus (MIP). Untreated, water stored samples served as control. In experiment 1, half of the samples of each group were continuously superfused with HCl (pH 2.6, 60 μl/min, 8 min). In experiment 2, the second half of samples were subjected to eight cycles, each consisting of application of the respective anti-erosive compound followed by an erosion (60 s, HCl, pH 2.6), followed by remineralization in artificial saliva (45 min). Enamel loss was profilometrically determined. In experiment 1, EEM and EET performed significantly better compared to all other compounds. Substance loss of all other compounds did not differ significantly from control. In experiment 2, significantly better performance was achieved by EEM and EET. EG showed significantly lower protection than the control. All other applied compounds yielded no significant difference compared to control. Under the chosen conditions, the self-assembling peptide-containing compound showed no anti-erosive effect.

The extrinsic sources for erosion-causing acids are primarily acidic beverages and foodstuffs. Effervescent tablets also contain organic acids (e.g. citric, tartaric, malic) in order to form carbon dioxide by contact with water – with the help of the carbonate salts of the tablets. To adequately inform patients about the possible erosive potential of effervescent tablets, this study was undertaken in order to investigate the erosive potential of effervescent tablets (ET), containing either a combination of vitamins and minerals or vitamins only, commercially available in Switzerland. One hundred and ninety-two bovine enamel samples were prepared and allocated to 16 groups (A–H and 1–8; n = 12/group). Samples were eroded (120 s/erosive cycle) in freshly prepared solutions (200 ml/12 samples) comprised of tap water and a supplement as follows: none (control groups, A and 1); vitamin+mineral ET: Qualite and Prix (B), Optisana (C), Well and Active (D), Actilife All in One (E), Berocca (F), Isostar (G) and Qualite and Prix Mg + Vit C (H); vitamin ET: Actilife-Multivitamin (2), Sunlife Vitamin C (3), Optisana Vitamin C (4), Optisana Multivitamin (5), Well and Active Multivitamin (6), Kneipp Vitamin C+Zink (7) and Sunlife Multivitamin (8). Enamel loss was measured using profilometry after 10 and 20 erosive cycles. For the vitamin+mineral ET, no loss was observed in groups B–E. Significantly highest enamel loss (mean ± SD) after 20 cycles was observed for Isostar (5.26 ± 0.76 µm) and Qualite and Prix Mg + Vit C (5.12 ± 0.67 µm). All vitamine ET showed erosive enamel loss. Significantly highest loss was observed for Sunlife Multivitamin (8.45 ± 1.08 µm), while the lowest loss was observed for Actilife-Multivitamin (5.61 ± 1.08 µm) after 20 cycles. Some of the tested effervescent tablets showed a considerable erosive potential and patients should be informed accordingly.