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Purpose: To investigate the esthetic outcomes based on the color differences in zirconia (Zr) of varying thickness, resin cement color, and types of titanium (Ti) implant surface treatments. Materials and Methods: Overall, 28 high-translucency monolithic zirconia (HTMZ) specimens were arranged into four groups based on Zr thickness: 1.0, 1.5, 2.0, and 2.5 mm (n = 7 per thickness). Each group was tested using two resin cement colors (clear and opaque) in combination with six surface-treated Ti groups (n = 7), including untreated titanium (UT), anodization (AN), 50-µm alumina airborne-particle abrasion followed by AN (SBAN), AN followed by 50-µm alumina airborne-particle abrasion (ANSB), 9.5% hydrofluoric acid followed by AN (HFAN), and AN followed by 9.5% hydrofluoric acid (ANHF). This created a total of 48 experimental groups, including the use of composite resin (n = 7, shade A2D) for four control groups. All specimens were measured using a spectrophotometer and subsequently compared with composite resin (control) with the corresponding Zr thickness to establish color differences. A color difference of < 2.7 was considered clinically acceptable. The data obtained were statistically analyzed using ANOVA and post hoc test (P = .05). Results: Zr thickness, resin cement color, and type of Ti implant surface treatment significantly affected the observed color differences (P < .05). When using 2.5-mm HTMZ with clear resin cement on AN, UT, SBAN, HFAN, and ANSB, the mean color differences were below the clinically acceptable values, and the 95% CIs of color differences were below the clinically acceptable values for AN, UT, and SBAN groups. Conclusions: HTMZ with a minimum thickness of 2.5 mm and clear resin cement on AN, UT, and SBAN groups potentially result in acceptable color matching with 95% CIs. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the dimensional accuracy of implant impressions obtained using five different tray types and two techniques. Materials and Methods: A partially dentate maxillary Kennedy Class II model was created as a reference model through 3D printing. Then, implant analogs 4.3 mm in diameter were placed at the first premolar, first molar, and second molar sites. Five types of trays were used to create impressions: (1) metal stock trays, (2) plastic stock trays, (3) custom trays fabricated using liquid crystal display (LCD), (4) custom trays fabricated using fused deposition modeling (FDM), and (5) custom trays fabricated using urethane dimethacrylate (UDMA) resin. Open and closed tray techniques were also compared. In total, 150 impressions were obtained. The reference model and impressions were scanned using a laboratory scanner. Additionally, the positional and angular deviations of implants with different tray types and techniques were evaluated using the superimposition method. Results: There was no statistically significant difference (P > .05) between the impression accuracy with the different tray types and impression techniques. The angular deviations with plastic and UDMA trays were greater than those with metal, FDM, and LCD trays. Angular deviation at the second molar was greater when using closed plastic trays compared to open plastic trays. The highest and lowest positional deviations were observed at the first molar implant with an open plastic tray impression (mean ± SD of 62.46 ± 28.54 mm) and a closed LCD tray impression (36.59 ± 29.93 mm). The greatest angular deviation was observed with an open FDM tray impression at the first premolar implant (0.067 ± 0.024 degree), and the lowest angular deviation was observed with a closed metal stock tray impression at the second molar implant (0.039 ± 0.025 degree). Statistical differences were detected using the Mann-Whitney U test for paired groups and the Kruskal-Wallis test for groups with more than three comparisons (P > .05). Conclusions: Plastic and metal stock trays or conventional and 3D-printed custom trays can be used to obtain implant impressions for maxillary partially edentulous arches with similar dimensional accuracy. The five tray types and two techniques may be safely used to obtain impressions of partially edentulous maxillary arches with three implants. [ABSTRACT FROM AUTHOR]

This clinical case outlines a comprehensive digital workflow for a minimally invasive multidisciplinary treatment. The process utilizes one open-source software for digital wax-up and one low-cost software to address esthetic concerns related to teeth misalignment. The patient's function was stabilized with a digitally made occlusal splint. The application of the described digital workflow technique, incorporating open-source, lowcost, and closed software, played a pivotal role in attaining a straightforward and predictable outcome with minimally invasive treatment. Furthermore, the continual evolution of technology contributes to the growing precision of dental procedures. The presented digital workflow helped formulate a predictable treatment plan, replicate a diagnostic digital wax-up, and achieve precise teeth alignment. This approach satisfactorily addressed the patient's esthetic concerns, providing an outstanding approximation of the definitive result. [ABSTRACT FROM AUTHOR]

Objectives: The objective was to evaluate the polymerization efficiency of different bulk-fill resin-based composites cured by monowave and polywave light-curing units, by assessment of the degree of conversion and Vickers microhardness at different depths. Method and materials: Two commercially available bulk-fill resin-based composites were used: Filtek One Bulk Fill Restorative (3M ESPE) and Tetric N-Ceram Bulk Fill (Ivoclar Vivadent). The light-curing units utilized were two LED light-curing units: a monowave LED light-curing unit (BlueLEX LD-105, Monitex) and a polywave LED light-curing unit (Twin Wave GT-2000, Monitex). For each test, 20 cylindrical specimens (4 mm diameter, 4 mm thickness) were prepared from each bulk-fill resin-based composite using a split Teflon mold. Ten specimens were light-cured by the monowave light-curing unit and the other ten were light-cured by the polywave light-curing unit according to the manufacturer's recommendations. Attenuated total reflectance-Fourier transform infrared spectroscopy (ATRFTIR) was used to assess the degree of conversion, and a Vickers microhardness tester was used to assess Vickers microhardness. Statistical analysis was performed using three-way ANOVA and Tukey post-hoc tests (P < .05). Results: The degree of conversion and Vickers microhardness in bulk-fill resin-based composites containing only camphorquinone as photoinitiator were similar when cured with either monowave or polywave light-curing units. However, bulk-fill resin-based composites containing a combination of photoinitiators exhibited significantly higher degree of conversion and Vickers microhardness when cured with a polywave light-curing unit. Although all groups showed statistically significant differences between the top and bottom surfaces regarding degree of conversion and Vickers microhardness, all of them showed bottom/top ratios > 80% regarding degree of conversion and Vickers microhardness. Conclusion: The polywave light-curing unit enhanced the polymerization efficiency of bulk-fill resin-based composites especially when the latter contained a combination of photoinitiators, but does not prevent the use of a monowave light-curing unit. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the periodontal responses of subgingival proximal margins elevated using different restorative materials. A total of 120 proximal cavities with dentin/cementum gingival margins were elevated using one of four materials (resin-modified glass ionomer, glass hybrid, flowable bulk-fill resin composite, or bioactive ionic resin) and completed with the same overlaying resin composite. At 2 weeks (baseline), 6 months, 1 year, and 2 years postrestoration, periodontal parameters and the radiographic distance between the restoration margin and bone crest were evaluated. Appropriate statistical analyses were performed. The values of all periodontal parameters increased with time, although only the increases in Plaque Index and probing depth within each material group were statistically significant. There were no statistically significant differences in any of the periodontal parameters between the different materials within the same evaluation period, nor between different time points or material groups in the radiographic distances. Both glass ionomer--based and resin-based materials were periodontally safe as subgingival open sandwich restorations. [ABSTRACT FROM AUTHOR]

Objective: Mucogingival surgery involving tissue grafts is commonly employed for cosmetic procedures like root coverage, and is increasingly applied in implant therapy to modulate peri-implant soft tissues and enhance implant survival. These procedures involve harvesting autologous connective or epithelial connective tissue, often from the palate or tuber maxillae. However, this can cause patient morbidity due to postoperative pain. Substitute materials, including animal-derived and xenografts, have been developed but lack qualities of autologous grafts. Method and materials: To address postoperative discomfort, a novel technique, named "palatal shield," using composite resin stabilized on adjacent teeth's palatal surface is proposed as an aid to donor site healing after mucogingival procedures. Two cases are reported where this technique was successfully applied. The first case involves a 53-year-old woman undergoing free gingival graft surgery for peri-implant treatment. The second case features a 58-year-old man receiving subepithelial connective tissue graft surgery for root sensitivity. Results: Ten days post surgery, both patients reported excellent postoperative comfort. The technique's effectiveness is highlighted in these cases, demonstrating its applicability in various surgical cases involving free gingival graft or connective tissue graft harvesting. Conclusion: The proposed "palatal shield" technique offers several advantages, including enhanced patient comfort, ease of application, and cost-effectiveness, making it a promising addition to mucogingival surgical procedures. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of sonic oscillation on penetration depth and marginal adaptation of resin-based fissure sealants. Method and materials: Thirty-six extracted human third molars were randomized into three groups: in the HF group, teeth were sealed with a filled-resin-based sealant (Helioseal F); in the Sonic-HF group, teeth were sealed with Helioseal F and subjected to sonic oscillation (Compothixo Device, 140 Hz vibration frequency and ± 150 µm amplitude) before curing; in the CO group, teeth were sealed with an unfilled-resin-based sealant (Clinpro). All teeth were thermocycled for 1,500 cycles at 5°C and 55°C, then sectioned buccolingually into four sections (mesial, two middle, and distal). Sections were evaluated under SEM for marginal adaptation and scored. For penetration depth, three independent measurements from each tooth were recorded under SEM, and data were subjected to statistical analysis. Results: The group subjected to sonic oscillation (Sonic HF) resulted in significantly superior penetration depth and marginal adaptation compared with the HF group, but with no significant difference compared with the CO group. Conclusions: Sonic activation of resin-based sealant increased penetration depth into fissures and marginal adaptation to the enamel wall without decreasing filler load or compromising sealant mechanical properties. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the fracture behavior of human molars with extensive MOD restorations using short‐fiber‐reinforced resin composite of varying viscosities. Materials and Methods: Human molars were randomly divided into seven groups (n = 12): intact teeth (control); restoration using conventional high‐viscosity resin composite without (Filtek Z350XT, 3M) or with fibers (everX Posterior, GC); conventional low‐viscosity resin composite without (Filtek Supreme Flowable, 3M) or with fibers (everX Flow Dentin Shade, GC); bulk‐fill low‐viscosity resin composite (Filtek Bulk Fill Flow, 3M) or with fibers (everX Flow Bulk Shade, GC). Restorations were performed on extensive MOD preparations, following the manufacturers' recommendations for each material. Specimens underwent fracture strength testing (N) and fracture pattern (%) categorized as repairable, possibly repairable, or non‐repairable. Results were analyzed using a generalized linear model (N) and Fisher's exact test (%), with α = 0.05. Results: Restorations performed with high‐viscosity materials showed fracture strength values similar to the control and higher than those of restorations using low‐viscosity resin composites (p < 0.0001), except for the bulk‐fill low‐viscosity resin composite with fibers (p > 0.05). Teeth restored using low‐viscosity resin composite with fibers showed a higher % of repairable and possibly repairable fractures than the control (p = 0.0091). Conclusions: The viscosity of materials mediated the fracture strength, with restorations using high‐viscosity resin composites promoting values similar to the intact tooth; however, the presence of fibers influenced the fracture pattern. Clinical Significance: Teeth with MOD cavities restored with high‐viscosity resin composites showed similar fracture strength to intact teeth. Fiber‐reinforced low‐viscosity resin composite for the base of restoration resulted in a more repairable/possibly repairable fracture pattern. [ABSTRACT FROM AUTHOR]

Background: Children with dental caries are treated with stainless steel metal crowns (SSC), but the aesthetics and precision still need to be improved. Currently, both 3D‐printed resin crowns (PRC) and computer‐aided design/computer‐aided manufacture (CAD/CAM) resin crowns (CRC) meet the clinical requirements for crown applications in terms of strength, production time, cost, and aesthetics. Aim: This study replaced SSC with customized resin crowns by 3D printing and CAD/CAM. Design: In this study, PRC, CRC, and SSC were used for incisor and molar restorations, and 60 crowns were made with 10 for each group. The fabrication efficiency, surface characteristics, marginal fit, and stability of the two different crowns were evaluated. Results: PRC and CRC show superior color and surface characteristics, though production times are longer (5.3–12.4 times and 3.3–9.1 times, respectively) than for SSC (p <.05). They, however, can be completed within 80 min. Edge gaps for PRC and CRC are significantly lower (13.0–19.2 times and 13.0–13.7 times) than for SSC (p <.05). All materials exhibit good stability. Conclusion: The 3D‐PRCs and CAD/CAM resin crowns may replace SSCs as a potential choice for clinical child caries. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusions Clinical Significance To map the evidence regarding the clinical performance of posterior restorations with bulk‐fill resin composites and identify research gaps.This mapping review was conducted following PRISMA‐ScR guidelines for scoping reviews, and its protocol was registered on the Open Science Framework platform. Systematic searches were conducted, considering studies published between 2013 and February 2024 in the PubMed, Embase, and Cochrane databases. Clinical studies investigating the performance of bulk‐fill resin composite restorations in class I and/or class II preparations with increments of 4 to 5 mm were included.A total of 147 articles were identified, and based on the eligibility criteria, 26 studies were selected for descriptive analysis. Of the reviewed studies, 73% (n = 19) investigated high‐viscosity bulk‐fill composites, while 30% (n = 8) focused on low‐viscosity bulk‐fill composites. Evaluation periods ranged from 1 week to 10 years. Reported annual failure rates varied from 0% to 3%, with survival rates between 78.9% and 100%.Bulk‐fill resin composites of high viscosity were the most analyzed in the published studies, with evaluation periods of up to 10 years. The review of available scientific evidence showed clinically acceptable performance for composite bulk‐fill restorations, with high survival rates and minimal annual failure rates. There is a need for long‐term clinical studies on bulk‐fill resin composites.This review demonstrates that both high and low‐viscosity bulk‐fill resin composites exhibit satisfactory clinical performance, which can help clinicians optimize chairside time. However, it is important to highlight the need for further studies with longer follow‐up periods. [ABSTRACT FROM AUTHOR]

This study assessed the bond strength of resin‐based restorative materials to fast‐setting calcium silicate cement (Aarhus Uinversity, Denmark) when treated with each of two one‐bottle universal adhesive systems. The cement surface (N = 256) was treated with a self‐priming adhesive and a self‐etch phosphate monomer‐containing adhesive with and without etching of the cement surface. Specimens then received either resin composite or compomer restorative materials (n = 32). The bond strength was measured after 1 day and 1500 thermocycles (n = 16). The failure type was visually inspected. The cement‐adhesive‐restorative material interface was visualized using scanning electron microscopy (SEM). The data were analyzed using multiple linear regression. Restorative material type, resin adhesive system, and thermocycling had a statistically significant effect on the bond strength. Compomer restorative material and self‐etch universal adhesive system demonstrated statistically significantly higher bond strength values to fast‐setting calcium silicate cement, predominantly exhibiting cement cohesive failure. Etching the cement surface enhanced the bond strength of the self‐priming universal adhesive. Thermocycling significantly reduced the bond strength. SEM showed self‐etch universal adhesive seemingly diffused over the etched cement surface compared to other groups. Self‐etch phosphate monomer‐containing universal adhesive and compomer resulted in the highest bond strength to fast‐setting calcium silicate cement. [ABSTRACT FROM AUTHOR]

Background: Accumulation of biofilm over composite resin restorations is one of the principal causes of recurrent caries. Therefore, this study aimed to develop antibacterial composite resins by crystalline selenium nanoparticles (SeNPs), assessing the antibacterial, mechanical, and physical properties of the composite resin after SeNPs incorporation. Methods: SeNPs were synthesized via a green method. The nanoparticles were characterized by UV-Vis spectroscopy, fourier transform infrared (FT-IR) spectroscopy and transmission electron microscopy (TEM). The nano-filled composite (Filtek™ Z350XT) was considered as a control group (G0). Two concentrations of SeNPs (0.005 wt% and 0.01 wt%.) were added to the tested resin composite (G1& G2), respectively. The physical/mechanical and antibacterial properties of the composite specimens (n = 10/group) were characterized. A one-way ANOVA was conducted to analyze these data followed by Bonferroni post hoc test for pairwise comparison. Results: Modified composites with SeNPs showed antibacterial activity against E. coli and S. mutans. Mechanical properties including diametral tensile strength, compressive strength, or surface roughness were not affected by nano-incorporation compared to control. Furthermore, the degree of conversion showed no statistical difference. However, SeNPs incorporation into resin composite produces color change that can be visually perceived. Conclusions: The green synthesized SeNPs significantly improved the antimicrobial properties of the dental composite without compromising mechanical performance. However, it shows color change after SeNPs incorporation. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of crown seating speed, crown seating force, quantity of cement used, and type of implant cement on the amount of remnant cement in the subgingival region (RCS) after cementation. Cement-retained implant crowns were cemented to titanium abutments using the following methods: four types of implant cement (TBN: TEMP BOND NE, NR: NEXUS RMGI, ME: MAXCEM ELITE, and U200: RELYX U200), three quantities of cement (0.02 ml, 0.04 ml, and 0.06 ml), three crown seating speeds (5 mm/s, 10 mm/s, and 15 mm/s), and two crown seating forces (25 N, 50 N). The surface area and length of the RCS were measured using a 3D intraoral scanner. The total RCS weight was measured using an analytical balance. The RCS increased significantly as the seating speed increased, the seating force increased, and the quantity of cement increased (p < 0.05). The RCS values were the highest for TBN, followed by U200, NR, and ME (p < 0.05). The lower seating speed, smaller quantity of cement used, and smaller seating force applied in cement-retained implant restorations minimized the RCS in cement-retained prostheses. The type of cement is a factor that determines the aspects of the RCS. [ABSTRACT FROM AUTHOR]

Background: The passive fit of 3-unit implant supported prefabricated metal screw-retained prosthesis before implant placement might be difficult. Hence, we aim to evaluate the passive fit and time efficiency of CAD/CAM 3-unit implant supported fixed prostheses that were constructed based on virtual versus those based on actual implant positions in Kennedy Class I models. Methods: A sample of 5 Kennedy class I models with thin wiry ridges were restored by 20 frameworks bilaterally, 10 based on actual (group A) and 10 based on virtual (group V) implant positions. The models were imaged using cone beam computed tomography and scanned using an intraoral scanner. The STL (Standard Tessellation Language files) and the DICOM (Digital Imaging and Communications in Medicine) files were registered on a 3D planning software. A CAD/CAM surgical guide was planned, resin printed and used for installing 6 implants bilaterally. In group V, the framework was designed based on the virtual scan bodies and virtual multi-unit abutments, while in group A intra-oral scanning of the model after attaching the scan bodies was necessary. Frameworks of both groups were milled and tested for passive fit using 8 clinical tests. McNemar and Wilcoxon signed rank tests were used to study the effect of the group on passive fit and time efficiency, respectively. The significance level was set at P ≤ 0.05. Results: No statistically significant difference was found between group V and group A frameworks regarding passive fit (p-value = 1, OR = 0.5) and time efficiency (P = 0.179, Effect size = 0.948). Conclusion: Within the limitations of this study, it can be concluded that in free end saddle cases, prefabricated CAD\CAM 3-unit implant-supported cobalt chromium screw retained prostheses can achieve an adequate passive fit. However, their fit might be negatively affected in thin ridges and they might require some adjustments. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate and compare the ion-releasing capability of three different restorative systems at the restoration/tooth interface elemental analysis using energy-dispersive X-ray technique. Additionally, micromorphological patterns of the restoration/tooth interfaces was investigated. Materials and methods: Eighteen freshly extracted sound human premolars were collected for the study. The premolars were randomly assigned into 3 groups (n = 6) based on the type of restorative materials used: Giomer (Beautifill II), ion-releasing composite (Activa Presto), and RMGI (Riva Light Cure). Half of the specimens in each group were tested after 24 h (the "immediate group"), while the remaining half were tested after 6 months of storage in deionized water (the "delayed group"). Standardized box-shaped cavities along the cervical area of teeth crowns and restored them with the assigned restorative material following manufacturers' instructions. The specimens were sectioned buccolingually into 2 halves. One half of each specimen was subjected to elemental analysis using energy-dispersive X-ray technique (EDX), while the remaining half was sputter coated and underwent micromorphological analysis of the restoration/tooth interface using a scanning electron microscope (SEM). The collected data from elemental analysis test were tabulated and subjected to statistical analysis. Results: The two-way ANOVA test showed significant differences in both phosphorus and calcium levels among the tested restorative systems (p < 0.05). In the immediate subgroup, RMGI recorded the highest phosphorus level (0.1527), followed by the ion-releasing composite (0.1172), while Giomer exhibited the least levels (0.0326) (p < 0.05). The ion-releasing composite group had the highest calcium level (0.2797), followed by RMGI (0.248), and Giomer (0.2385) respectively (p < 0.05). In the delayed subgroups, Giomer recorded the highest phosphorus level (0.1526), followed by the ion-releasing composite (0.1058), and RMGI group (0.0466) respectively (p < 0.05). RMGI had the highest calcium level (0.2801), followed by the ion-releasing composite (0.2659), and Giomer had the lowest level (0.1792) (p < 0.05). The micromorphological analysis of the restoration/tooth interfaces showed good adaptation between the composite and tooth substrate in different restorative groups. Conclusions: The ion-releasing capability of the three restorative systems appears to be comparable. The rate of mineral release and diffusion is affected by time and composition. [ABSTRACT FROM AUTHOR]

Background: To evaluate the comprehensive effect of translucency, thickness, cement shades, and background color on the masking ability of resin-matrix ceramic veneer restorations. Methods: Resin-matrix ceramic specimens with 2 translucencies (LT, HT) and 3 thicknesses (0.5, 1.0, and 1.5 mm) were made of Upcera Hyramic (A2 shade). Cement specimens were made of Variolink N in 4 shades (yellow, white, transparent, and bleach XL). Five background specimens were made of IPS Natural Die Material in 5 shades (ND1, ND2, ND3, ND4, and ND5). Color coordinates of 120 subgroups (n = 5) of combined specimens composed of different ceramic, cement, and background specimens were obtained using a spectroradiometer. Color difference (ΔE00) compared with a 4-mm thick specimen of LT and HT ceramics was calculated and four-way ANOVA was used for statistical analysis (α = 0.05). Results: Translucency, thickness, cement shade, background color, and their interaction had significant effects on ΔE00 (p < 0.001). ΔE00 values of HT groups were always higher than that of LT groups and were greater than 1.8 against all background colors. ΔE00 values of LT groups could be achieved to be less than 1.8 with appropriate thickness and cement shade. ΔE00 value decreased with increasing ceramic thickness. The effect of cement shade on ΔE00 had no obvious regularity, but ΔE00 values of bleach XL cement shade group were always lower than other cement shade groups under ND3 and ND5 background color. Conclusions: The masking ability of CAD-CAM resin-matrix ceramics can be simultaneously affected by translucency, thickness, cement shade, and background color. Resin-matrix ceramics with low translucency has a better masking ability than that with high translucency. The masking ability of CAD-CAM resin-matrix ceramics increase with increasing thickness. Cement shade has less impact on the final color of resin-matrix ceramic restorations. [ABSTRACT FROM AUTHOR]

Background: To overcome the color layering procedure, monochromatic resin composites have been introduced. However, little is known about their polishability, gloss and color stability. This study aimed to investigate the surface roughness, gloss, and color change of monochromatic resin composites polished with wheel systems after being immersed in coffee. Materials and methods: Omnichroma, Zenchroma, Essentia Universal, Charisma Diamond One and NeoSpectra ST were used to obtain 120-disc samples of 8 × 2 mm. Only one side of the sample was polished with Twist Dia (TWD) or Nova Twist (NOV). The samples were examined for surface roughness, gloss, and color (ΔE and ΔE00) before and after 7 days of immersion in coffee and subsequent repolishing. The discs were examined via SEM. Surface roughness and gloss values were analyzed using ANOVA, Tukey and Pearson correlation tests. ΔE and ΔE00 values were evaluated using T tests, multivariate ANOVA, and Dunnett's post-hoc tests. Results: For TWD groups, the smoothest material was Omnichroma (p < 0.05), while for NOV groups, it was Omnichroma and Zenchroma. Omnichroma was the glossiest, while Charisma Diamond One was the least glossy. In TWD groups, Charisma Diamond One and Essentia Universal were the most discolored, while Zenchroma and Omnichroma were the least. For NOV groups, Essentia Universal and Charisma Diamond One were the most discolored, while NeoSpectra ST, Omnichroma and Zenchroma were the least. After repolishing, Charisma Diamond One did not reach the level of ΔE < 2, while the other groups showed values below. Color evaluation with the CIELab and CIEDE2000 systems revealed similar results for the TWD groups after post-staining. Conclusions: Smooth and glossy surfaces could be achieved with the wheel system regardless of the composite resin. Repolishing after discoloration ensures that the color recovery is below the acceptable limit. Color evaluations with CIELab and CIEDE2000 yielded similar results. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the microtensile bond strength (µTBS) of different resin composite restorations bonded to mid-coronal dentin and proximal root dentin using light-cured, chemical-cured, and dual-cured adhesives immediately and after aging. Nanoleakage and degree of cure were also assessed. Methods: Eighty-four molars were divided into mid-coronal dentin and proximal root dentin. Each group was further subdivided into three subgroups based on the restorative systems used, which involved the utilization of light-cured, chemical-cured, and dual-cured adhesives. Half of the specimens underwent µTBS testing after 24 h, while the other half after aging. Representative specimens were analyzed for nanoleakage. The degree of cure of the tested adhesive systems was also assessed. Results: Aging showed a significant negative effect on µTBS results and led to increased nanoleakage (p < 0.001). Furthermore, in all subgroups, the µTBS values of proximal root dentin were lower compared to mid-coronal dentin, except in the aged subgroup for the system utilizing the dual-cured adhesive. The restorative systems with chemical and dual-cured adhesives demonstrated comparable bonding properties. However, the system with the light-cured adhesive exhibited the worst bonding properties after aging when bonded to proximal root dentin and cured at a large distance (p < 0.05). Conclusions: All tested restorative systems were negatively affected by aging, and the regional dentin had variable effects on the bonding properties. Clinicians should exercise caution when using the tested light-cured adhesive in areas where the curing distance exceeds 3 mm. [ABSTRACT FROM AUTHOR]

Background and Purpose: This study aimed to evaluate the flexural strength, color change and antimicrobial effect of silver–zeolite nanoparticles (NPs) in acrylic resin materials. Methods: Fifty-six disc-shaped acrylic resin samples were divided into four groups (n = 7) according to concentrations of silver–zeolite NPs (0%, 2%, 4%, 5%). Discs were contaminated with C. albicans and S. mutans. The antimicrobial effect was tested by inoculating contaminated discs on Tryptic soy agar (TSA), Sabouraud Dextrose Agar (SDA), Tryptic soy broth (TSB), and Sabouraud dextrose broth (SDB). Forty rectangular 65 × 10 × 2.5 mm acrylic resin specimens were also classified into four groups (n = 10) according to concentrations of silver–zeolite NPs. For the color change, L, a, and b values of rectangular specimens were examined with a spectrophotometer. A three-point bending test was also performed using a Devotrans device to determine the flexural bond strength of rectangular specimens. Scanning electron microscope analysis (SEM/EDX analysis) was also performed. Results: In this study, the antimicrobial effect increased with the concentration of silver–zeolite NPs added to acrylic resin discs. In our study, adding 2% silver–zeolite NPs was more effective against C. albicans. The antimicrobial effect against S. mutans increased with concentration of silver–zeolite NPs (<0.001). The colonization of C. albicans was significantly reduced by silver–zeolite NPs. A significant increase was observed in the color change as the nanoparticle percentage ratio increased (p < 0.001). The flexural strength values of the groups containing 2% and 4% nanoparticles were found to be clinically acceptable. Conclusions: The study showed that bacterial and fungal colonization is significantly reduced by adding silver–zeolite nanoparticles to acrylic resin discs. Based on its antimicrobial, physical, and mechanical properties, we recommend adding 2% silver–zeolite nanoparticles to the acrylic resin material for optimal results. [ABSTRACT FROM AUTHOR]

(1) Objectives: This study investigated and compared the wear and flexural strength of two highly filled (injectable), one flowable and one paste composite. (2) Methods: Two highly filled flowable composites (G-aenial Universal Injectable and Beautifil Plus F00), a paste composite (Empress Direct) and a conventional flowable (Tetric EvoFlow) were tested. A two-body wear test was carried out using 10 disc-shaped samples from each group, which were subjected to 200,000 wear machine cycles to simulate wear, followed by Scanning Electron Microscope analysis. Flexural strength was tested using a three-point bend test using 15 beam samples for each of the four groups. Values were statistically compared using one-way analysis of variance (ANOVA) for flexural strength and a Kruskal–Wallis test for wear. (3) Results: The median volume loss for G-aenial Universal Injectable and Beautifil Plus F00 was statistically lower than that of both Empress Direct and Tetric EvoFlow. For flexural strength the two highly filled flowable composites both exhibited statistically higher mean flexural strength values compared to Empress Direct (p < 0.004) and Tetric Evoflow (p < 0.001). There were no statistically significant differences in the values of wear and flexural strength between the two highly filled flowable composites. (4) Conclusions/significance: Highly filled flowable composite resins with nano filler particles outperformed a conventional flowable and a paste composite resin in terms of wear resistance and flexural strength, and may be suitable to use in occlusal, load-bearing areas. [ABSTRACT FROM AUTHOR]

Objective: The present clinical report describes a long‐term temporary restorative approach using injectable composite to reshape a canine into a central incisor, within the context of an ongoing orthodontic treatment. This treatment protocol describes a fully‐digital workflow, incorporating digital designed and 3D printed diagnostic wax up, reduction guides and resin‐injection index. Clinical Considerations: Effective planning is important when aiming to deliver a comprehensive and multidisciplinary workflow, and digital tools serve as invaluable aids. Conclusion: The use of a fully digital workflow in a comprehensive dental treatment resulted in a predictable and successful outcome for a restoration of a canine that was transformed into a central incisor. Clinical Significance: This approach highlights the efficacy of digital technology in achieving precise and successful dental restorations, emphasizing its significance in modern dental practice. [ABSTRACT FROM AUTHOR]

Objective: This article describes a novel 3D‐printed template armed with interproximal matrices to isolate interproximal contact areas and guide injectable resin composite for consecutive closure of multiple diastema. Clinical Considerations: Among several treatment options proposed for diastema closure, direct resin composite is noninvasive and easy to repair. The "composite injection technique" has been introduced to improve time efficiency and reduce technique sensitivity for clinicians. However, in the case of multiple diastema, the overflow of excess resin materials onto the adjacent teeth during injection poses challenges for recontouring the interproximal anatomy. A 3D‐printed template with special‐designed gaps at interproximal areas was designed and fabricated based on a virtual diagnostic wax‐up. Flowable resin composite was then consecutively injected through the template to close diastemata at multiple adjacent teeth. Conclusion: This technique using a 3D‐printed template with interproximal isolation design contributed to an efficient and accurate operation for multiple anterior diastema closure. Clinical Significance: Efficient and accurate freehand buildups of composite restoration for multiple diastema are challenging in operative dentistry. The described noninvasive full digital workflow provides a predictable method to accurately recontour the multiple target restorations and reduce the chair‐side time and technical sensitivity. [ABSTRACT FROM AUTHOR]

This study evaluated the changes in surface properties of three resin‐based restorative materials after two laser‐assisted, in‐office tooth bleaching protocols using erbium, chromium: yttrium‐scandium‐gallium‐garnet (Er,Cr:YSGG) or diode (980 nm) lasers. A nanohybrid composite (Enamel Plus HRi), a Bis‐GMA‐free composite (Enamel Plus HRi Bio Function), and a resin‐matrix CAD‐CAM ceramic (Shofu Block HC) were tested. Forty specimens for each material were prepared and divided into four groups (n = 10/group). The control specimens did not undergo any bleaching treatment, whereas group 2 received bleaching with 40% hydrogen peroxide (H2O2), while groups 3 and 4 underwent the same bleaching procedure with the use of diode (980 nm) or Er,Cr:YSGG lasers, respectively. Surface microhardness and roughness measurements were conducted using a Vickers tester and an optical profilometer. Microhardness was lower in bleached specimens, with the nanohybrid composite exhibiting the largest difference from the no bleaching group. For the Bis‐GMA‐free composite the microhardness difference between no bleaching and laser‐assisted bleaching were smaller than seen for the conventional bleaching technique. Surface roughness was higher in bleached specimens, with nanohybrid composite showing the largest differences from the control specimens. The examined laser‐assisted tooth bleaching protocols were found not to impact surface microhardness and roughness of the tested resin‐based specimens and they are deemed suitable for clinical use. [ABSTRACT FROM AUTHOR]

Polymerization shrinkage of bonded resin composite restorations will result in the development of curing contraction stresses during setting and can cause debonding of the restoration or failure of the surrounding tooth structure. However, the hygroscopic expansion that occurs after exposure of the restorative to the wet oral environment can compensate for this shrinkage. The purpose of this study was to determine the hygroscopic expansion of six commercial resin composites and relate it to their composition, mechanical properties, shrinkage, and contraction stress development. Short-term volumetric shrinkage and contraction stress of the different composites were measured by mercury dilatometry and a universal testing machine. The long-term contraction stress was measured by the deflection of a bilayer strip of metal and a resin composite, which were stored dry as well as wet to determine the effect of hygroscopic expansion. The curvature of the strip was measured by profilometry over a period of 3 months. The curvature of the strip correlated well (r2 =0.74) with the initial contraction stress, showing that the contraction stress is an important factor in initial deformation. The water sorption in all specimens showed that the initial deformation, within 2–4 weeks after curing, was completely counteracted. A high correlation (r2 =0.90) between deflection and relative water sorption was found, where the relative water sorption is defined as the absolute water sorption corrected for the inorganic filler volume of the composite. Within a period of 2–4 weeks after curing most of the curing contraction stresses of resin composite restoratives will be released by hygroscopic expansion. [ABSTRACT FROM AUTHOR]

The aim of this study was to design and assess composite resin composition for patient-specific esthetic color-graded temporary veneer. Various compositions of composite structures (assorted by Ba 2 SiO 4 filler, TiO 2 pigment, and photoinitiator) were prepared via additive manufacturing with 3 s UV exposure (405 nm, 10 W/cm2) per 50 µm thick layer followed by 20 min post-curing treatment after fabrication. The effect of each component on the generated color shades was observed and compared to the commonly used VITA shade guide. The coloration was explored by staining aging treatment under dry, wet, artificial saliva environments, coffee, and cola. The mechanical properties were also evaluated. Color measurement and comparison were done using a colorimeter (lightness (L*), green-red color (a*), and blue-yellow color (b*)), and the changes were calculated by CIEDE2000 (ΔE 00), translucency parameter (TP) and whiteness index (WI D). The composition color analysis results were then applied to produce a color-graded temporary veneer for mimicking a natural look. Mechanically, all composition result in adequate bending strength with maximum achievable strength of 111.64 MPa. At the same time, the composite color was affected by each constituent differently. The L* value, which indicates the color lightness of the composite, was considerably tuned by the TiO 2 pigment, whereas Ba 2 SiO 4 filler only triggered minor changes. Photoinitiator concentration significantly affected the yellowness, indicated by the increased b* value. Similar tendency also observed toward the calculated TP and WI D as well. Based on these evaluations, color-graded temporary veneer successfully generated, matching the VITA A3, A2, and B1 shades gradation. However, the stability of the composite color decreased at high amounts of Ba 2 SiO 4 and photoinitiator. The study presents a composition guide for fabricating temporary patient-specific color-graded veneer. It provides insights on the effect of the constituent material on dental esthetics. [Display omitted] • Practical use of functionally graded AM (FGAM) for esthetic composites veneer. • Customized composites (varying filler, pigment, photoinitiator) for dental implant • Improved esthetics, mimicking natural teeth, achieved via composition control • High strength and stain resistance composites comparable to conventional implants [ABSTRACT FROM AUTHOR]

To formulate an experimental methacrylate-based photo-polymerizable resin for 3D printing with ytterbium trifluoride as filler and to evaluate the mechanical, physicochemical, and biological properties. Resin matrix was formulated with 60 wt% UDMA, 40 wt% TEGDMA, 1 wt% TPO, and 0.01 wt% BHT. Ytterbium Trifluoride was added in concentrations of 1 (G 1 %), 2 (G 2 %), 3 (G 3 %), 4 (G 4 %), and 5 (G 5 %) wt%. One group remained without filler addition as control (G C). The samples were designed in 3D builder software and printed using a UV-DLP 3D printer. The samples were ultrasonicated with isopropanol and UV cured for 60 min. The resins were tested for degree of conversion (DC), flexural strength, Knoop microhardness, softening in solvent, radiopacity, colorimetric analysis, and cytotoxicity (MTT and SRB). Post-polymerization increased the degree of conversion of all groups (p < 0.05). G 2 % showed the highest DC after post-polymerization. G 2 % showed no differences in flexural strength from the G 1 % and G C (p > 0.05). All groups showed a hardness reduction after solvent immersion. No statistical difference was found in radiopacity, softening in solvent (ΔKHN%), colorimetric spectrophotometry, and cytotoxicity (MTT) (p > 0.05). G 1 % showed reduced cell viability for SRB assay (p < 0.05). It was possible to produce an experimental photo-polymerizable 3D printable resin with the addition of 2 % ytterbium trifluoride as filler without compromising the mechanical, physicochemical, and biological properties, comparable to the current provisional materials. • Ytterbium trifluoride was inserted up to 5 wt% to a 3D printing resin. • Inorganic fillers could be used as reinforcements 3D printing resin. • Ytterbium trifluoride as filler did not affect the properties of the experimental resin. [ABSTRACT FROM AUTHOR]

To assess the prediction accuracy of recent optical and numerical models for the spectral reflectance and color of monolithic samples of dental materials with different thicknesses. Samples of dental resin composites of Aura Easy Flow (Ae1, Ae3 and Ae4 shades) and Estelite Universal Flow Super Low (A1, A2, A3, A3.5, A4 and A5 shades) with thicknesses between 0.3 and 1.8 mm, as well as Estelite Universal Flow Medium (A2, A3, OA2 and OA3 shades) with thicknesses between 0.4 and 2.0 mm, were used. Spectral reflectance and transmittance factors of all samples were measured using a X-Rite Color i7 spectrophotometer. Four analytical optical models (2 two-flux models and 2 four-flux models) and two numerical models (PCA-based and L*a*b*-based) were implemented to predict spectral reflectance of all samples and then convert them into CIE-L*a*b* color coordinates (D65 illuminant, 2°Observer). The CIEDE2000 total color difference formula (Δ E 00 ) between predicted and measured colors, and the corresponding 50:50% acceptability and perceptibility thresholds (A T 00 and P T 00 ) were used for performance assessment. The best performing optical model was the four-flux model RTE-4F-RT, with an average Δ E 00 = 0.72 over all samples, 94.87% of the differences below A T 00 and 65.38% below P T 00 . The best performing numerical model was L*a*b*-PCHIP (interpolation mode), with an average Δ E 00 = 0.48, and 100% and 79.69% of the differences below A T 00 and P T 00 , respectively. Both optical and numerical models offer comparable color prediction accuracy, offering flexibility in model choice. These results help guide decision-making on prediction methods by clarifying their strengths and limitations. • Reflectance data of dental materials can be estimated by numerical algorithms. • Reflectance data of dental materials can be estimated by optical models. • Predicted — measured color differences are generally lower than AT 00. [ABSTRACT FROM AUTHOR]

The biodegradation of methacrylate (MA)-based dental restoratives has been suggested to contribute to a loss of adhesion and subsequent detachment, or secondary caries, both major causes of restoration failure. Previous studies have demonstrated that intermolecular interactions between resin monomers may affect the hydrolytic-susceptibility of composites. Altering the intermolecular interactions by shielding or masking the hydrolytically-susceptible ester groups found in MA monomers could be an effective strategy to mitigate the biodegradation of resin composites. The objective of this work was to assess whether shielding/masking MAs using fluorinated groups could improve the biostability of experimental composites. Eight fluorinated monomers (FM) were synthesized, characterized (1H NMR), and formulated into experimental resin composites (FC, 65 wt%, microfill). FCs were assessed for interactions with water (water contact angle, water sorption, gel fraction), mechanical properties (both compressive and flexural strength and modulus), cytocompatibility, resistance to biodegradation using simulated human salivary esterase (SHSE) and compared to a control composite (CC) without FM. Integration of FMs was found to generally decrease both the physical and mechanical properties under all incubation conditions when compared to the CC. Additionally, all FCs had a negative influence on composite biodegradation following immersion in SHSE when compared to the CC. Shielding/masking MA-esters inherently inserts molecular spaces between the polymer chains within the resin network, and shielding is likely not possible while also maintaining the necessary cohesive forces that regulate the physical and mechanical properties of resin composites. Novel dental resin development should seek to remove/replace vulnerable ester-containing MAs rather that adopting a shielding/masking approach. [ABSTRACT FROM AUTHOR]

Smart dental materials refer to materials used in dentistry with additional functionality to enhance treatment outcomes, which may improve oral health. Smart materials for dental restorations can react to stimuli such as a specific temperature, a different pH, or mechanical stress, repair small cracks or damage by themselves, and interact beneficially with biological surroundings. For example, they might release ions and promote tooth remineralization or have antibacterial properties to prevent bacterial growth. Others can have enhanced mechanical properties like strength and wear resistance to ensure these materials can withstand daily masticatory forces. This review presents our current comprehension of smart dental materials designed for tooth restoration. We focused on what these materials need to be effective, like durability, biocompatibility, and aesthetic requests, besides identifying new ideas for their design. A detailed analysis of the current challenges in formulating these materials, such as the balance between enough ions released with proper physicochemical properties and achieving the desired biological response, was discussed. We also discussed how these cutting-edge technologies are leveraged to overcome existing limitations, creating more dental materials with potential clinical translation. The review also discusses the practical challenges in implementation and the prospects for these materials in dentistry. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the reasons for retreatment of dental restorations is crucial to preventing potential tooth failure. Due to limited information on retreatment causes in our region, this study aims to compare the factors leading to the failure of posterior amalgam and composite restorations. Materials & Methods: This cross-sectional, observational study was conducted on patients referred to the restorative department of Ilam Faculty of Dentistry and private clinics who required retreatment of existing posterior restorations. Failure criteria for posterior restorations were evaluated based on established reference guidelines. Results: The study found that secondary caries had an odds ratio (OR) of 3.08 (95% CI: 2.85 - 3.29; p < 0.001), indicating a strong association with restoration failure. Additionally, restoration fractures were significantly correlated with retreatment, with an adjusted OR of 2.50 (95% CI: 2.46-2.86; p < 0.001). Conclusion: Secondary caries emerged as the most common reason for retreatment, regardless of whether composite or amalgam materials were used. Restoration fractures also significantly contributed to the need for retreatment. Therefore, it is essential to consider factors such as restoration material, classification, and the number of restoration levels to reduce the likelihood of retreatment. [ABSTRACT FROM AUTHOR]

Background: The pre-polymerization temperature of resin composite restorative materials could influence their adaptation to cavity details. As a current debate is existing about the refrigeration of resin composite restorative materials, this study was designed to assess the effect of refrigeration of 3 types of resin composite restorative materials with different matrix systems on their marginal adaptation in Class II restorations. Methods: Forty-two sound maxillary molars, each with two separated Class II cavities, were used in this study. The teeth were assigned into 3 main groups (n = 14) according to the restorative /adhesive system used; an Ormocer-based composite (Admira Fusion/Futurabond M+, Voco GmbH, Cuxhaven, Germany), a methacrylate modified Ormocer-based (Ceram.X SphereTEC One/Prime&Bond Universal, Dentsply Sirona GmbH Konstanz, Germany), and a methacrylate-based (Tetric N-Ceram/Tetric N-Bond Universal, Ivoclar Vivadent AG, Schaan, Liechtenstein). Each group was then divided into 2 subgroups (n = 14) according to the gingival margin location; 1 mm above and 1 mm below the cemento-enamel junction (C.E.J). Each subgroup was further divided into 2 categories (n = 7) according to the storage temperature; stored at room temperature or stored in refrigerator at 4°- 5° C. Epoxy resin replicas were observed under scanning electron microscope (SEM) to examine the marginal gaps. A gab scoring system was used to assess the marginal adaptation of each restoration by giving scores on the basis of measurements of the maximum marginal gaps. The data obtained were statistically analyzed using the Chi-square test at a significance level of p < 0.05. Results: None of the tested groups exhibited 100% gap-free margins irrespective of margin location or storage temperature. For both storage temperatures, no statistically significant difference was observed among all tested groups either with margins located above or below C.E.J (p > 0.05). As well, there was no statistically significant difference when comparing both marginal locations for each material (p > 0.05). Regarding the effect of storage temperature, statistically significant difference was only observed between the room-temperature stored groups with margins located above C.E.J and their corresponding groups stored in refrigerator (p < 0.05). Conclusion: The refrigeration of resin composite restorative materials prior to the restorative procedures revealed a deleterious effect on marginal adaptation of the restorations with margins located in enamel regardless the type of material used. [ABSTRACT FROM AUTHOR]

Additive manufacturing resins used in dental prosthetics may retain uncured monomers post-polymerization, posing potential long-term patient exposure risks. Understanding the biological safety of these materials is crucial, particularly for 3D-printed acrylic-based prosthodontic devices such as occlusal nightguards, complete and partial dentures, and temporary fixed prostheses. This paper reviews the literature evaluating the cytotoxicity of such materials. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a scoping review using the MESH keywords related to population (P), intervention (I), comparison (C), and outcome (O) across databases, including OVID Medline, EMBASE, and SCOPUS. Our search, limited to peer-reviewed English language articles from 2015 to 2023, resulted in 22 papers. These studies, utilizing digital light processing (DLP) or stereolithography (SLA) printing methods, varied in examining different 3D-printed materials, as well as washing and post-curing protocols. The primary experimental cells used were human gingival fibroblasts (HGF) and mouse fibroblasts (L929). There are no statistical differences in biocompatibility regarding different commercially available resins, washing solutions, or methods. Improvements in cell viability were related to an increase in washing time, as well as post-curing time. After the polishing procedure, 3D resin-based printed occlusal devices perform similarly to milled and conventionally processed ones. Our findings underline the importance of appropriate washing and post-curing protocols in minimizing the cytotoxic risks associated with these 3D-printed resin-based devices. [ABSTRACT FROM AUTHOR]

Background: Different materials have been used as wound dressings after vital pulp therapies. Some of them have limitations such as delayed setting, difficult administration, slight degree of cytotoxicity, crown discoloration and high cost. Therefore, to overcome these disadvantages, composite scaffolds have been used in regenerative dentistry. This study aims to construct and characterize the physicochemical behavior of a novel injectable alginate hydrogel loaded with different bioactive glass nanoparticles in various concentrations as a regenerative pulpotomy filling material. Methods: Alginate hydrogels were prepared by dissolving alginate powder in alcoholic distilled water containing mesoporous bioactive glass nanoparticles (MBG NPs) or boron-doped MBG NPs (BMBG NPs) at 10 and 20 wt% concentrations. The mixture was stirred and incubated overnight in a water bath at 50 0 C to ensure complete solubility. A sterile dual-syringe system was used to mix the alginate solution with 20 wt% calcium chloride solution, forming the hydrogel upon extrusion. Then, constructed hydrogel specimens from all groups were characterized by FTIR, SEM, water uptake percentage (WA%), bioactivity and ion release, and cytotoxicity. Statistical analysis was done using One-Way ANOVA test for comparisons between groups, followed by multiple pairwise comparisons using Bonferroni adjusted significance level (p < 0.05). Results: Alginate/BMBG loaded groups exhibited remarkable increase in porosity and pore size diameter [IIB1 (168), IIB2 (183) (µm)]. Similarly, WA% increased (~ 800%) which was statistically significant (p < 0.05). Alginate/BMBG loaded groups exhibited the strongest bioactive capability displaying prominent clusters of hydroxyapatite precipitates on hydrogel surfaces. Ca/P ratio of precipitates in IIA2 and IIB1 (1.6) were like Ca/P ratio for stoichiometric pure hydroxyapatite (1.67). MTT assay data revealed that the cell viability % of human gingival fibroblast cells have declined with increasing the concentration of both powders and hydrogel extracts in all groups after 24 and 48 h but still higher than the accepted cell viability % of (˃70%). Conclusions: The outstanding laboratory performance of the injectable alginate/BMBGNPs (20 wt%) composite hydrogel suggested it as promising candidate for pulpotomy filling material potentially enhancing dentin regeneration in clinical applications. [ABSTRACT FROM AUTHOR]

Background: To predict the long-term performance of restorative materials in the oral environment, it is important to evaluate their resistance to chemical and mechanical degradation and to know the toxic potential of the type and amount of ions eluted from the filling material. In this study, home bleaching was applied to dental materials with different contents and it was aimed to determine the type and amount of ions released from these materials. Methods: In this study, amalgam, posterior composite resin, anterior composite resin, bulk fill composite resin, indirect composite resin, hybrid ceramic and all-ceramic were used as restorative materials. 10 specimens of each material were prepared according to the manufacturer's instructions. Each material group was divided into two subgroups as the bleached group and the control group. After bleaching, all specimens were stored in 1 ml of 75% ethanol/water solution. Solutions were renewed after 1, 14 and 28 days. The type and amount of ions released from the materials were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). Data were analyzed using the Friedman, Wilcoxon Signed Ranks, and Mann-Whitney U tests (α = 0.05). Results: It was determined that the amount of ions release from the restorative materials decreased over time (p < 0.05). According to the results of the Mann-Whitney U test, there was no difference between the bleaching and control groups in most of the restorative materials (p > 0.05). Conclusion: Within the limits of this study, home bleaching system does not have a significant effect on ion release from restorative materials. [ABSTRACT FROM AUTHOR]

Background: Partial coverage concepts have met the main goal of conservative dentistry. Vonlays, which combine features of veneers and onlays, are a recent alternative to full coverage designs and overlay partial coverage restorations. This in vitro study was conducted to compare the fracture resistance of the newly introduced pressable zirconia-reinforced lithium silicate with pressable lithium disilicate ceramic and to determine the optimal preparation design for partial coverage on upper premolars. Methods: Fifty-two duplicated epoxy resin dies were prepared following vonlay and overlay preparation guidelines. For each preparation (n = 26), the specimens were divided into two subgroups to be restored with lithium disilicate (IPS e.max Press) or zirconia-reinforced lithium silicate (Vita Ambria) (n = 13 each). Ceramic vonlays and overlays were bonded using dual cure resin cement, subjected to thermomechanical fatigue, and the load to fracture was tested by using a universal testing machine. The specimens were fractographically analyzed via scanning electron microscopy (SEM). The normality of the fracture resistance data was checked using the Shapiro‒Wilk test and Q‒Q plots, and two-way ANOVA was used to assess the effect of the type of preparation and ceramic material on the fracture resistance. Results: The group of overlays restored with zirconia-reinforced lithium silicate showed the highest mean fracture load (1218.69 N), while the group of vonlays restored with lithium disilicate had the lowest mean fracture resistance (967.15 N). The effect of preparation design and material type on fracture resistance was significant for both factors, p = 0.003 and p < 0.0001, respectively. Different features of the fracture surfaces, such as arrest lines, hackles, and directions of crack propagation, were observed. Conclusions: Zirconia-reinforced lithium silicate exhibited greater resistance to fracture compared to lithium disilicate, making it a potential substitute for partial coverage restorations. Additionally, the overlay showed superior fracture resistance when compared to the vonlay preparation design. [ABSTRACT FROM AUTHOR]

Bioactive glasses are renowned for their applications in dentistry, serving as restorative materials, dental adhesives, intracanal medicaments, and agents for enamel remineralization. Niobium pentoxide (Nb 2 O 5) is employed in dental adhesive resins and orthodontic adhesives, offering radio-pacifying properties essential for dental materials. Samarium oxide (Sm 2 O 3) emerges as a potential additive in aesthetic restorative dental ceramics and resins, enhancing the natural fluorescence of teeth. In this study Nb 2 O 5 and Sm 2 O 3 -doped (1, 3, and 5 wt%) 13–93 bioactive glass particles were synthesized via the sol-gel method, tailored for dental implementations. We conducted a comprehensive analysis of the physical, structural, and optical properties of the resultant glass powders. Additionally, their in vitro bioactivity and ionizing radiation shielding characteristics were rigorously evaluated. The results indicate that Sm3+ ions preserve the amorphous nature of the silicate glasses, while Nb5+ incorporation leads to the crystallization of the T-Nb 2 O 5 phase. Bioactivity assays across three physiological fluids—simulated body fluid, α-minimum essential medium, and phosphate-buffered saline, demonstrated the ability of doped glasses to facilitate hydroxyapatite layer formation, with the most pronounced bioactivity observed in phosphate-buffered saline immersed samples. Furthermore, radiation shielding simulations reveal that the addition of Nb 2 O 5 and Sm 2 O 3 enhances the ionizing radiation attenuation capabilities of the glasses, a property that holds significant promise for protecting against radiation in dental radiology. It can be concluded that the dual functionality of Nb5+ and Sm3+-doped bioactive glasses, which may revolutionize restorative dental practices and offer improved protection in radiological applications. [ABSTRACT FROM AUTHOR]

The lack of mechanical and antibacterial characteristics of most dental resins impedes their broader applications in dentistry. Therefore, this study aimed to enhance biocompatibility and mechanical and antibacterial features of bioepoxy (BE) to be used in dentistry. The properties of BE were assessed prior to and after reinforcing with several loading of nanoalumina (Al2O3)/nanosilver (AgNPs) particles. The mechanical characteristics were evaluated using three‐point bending and Izod impact tests. The morphologies and surface roughness of pristine BE and nanoalumina/nanosilver‐reinforced BE composites were observed by scanning electron microscopy (SEM) and atomic force microscopy (AFM), respectively. The influence of these additives on the BE antibacterial properties were evaluated using the agar diffusion approach. The flexural strengths of the modified BE composites with nanoalumina/nanosilver particles were higher than those for additive‐free BE, and their values were considerably dependent on filler loading. The impact strength and flexural strength of composite materials were greater at hybrid reinforcement loading of 2 wt%. At such ratio, an increase of approximately 33.8% was obtained in the flexural strength compared with that of blank BE. On the other hand, the incorporation of higher proportions of nanoparticles led to a decrease in overall properties of composites, yet they were higher than that of additive‐free BE. The flexural strength for the composite containing 0.5 wt% AgNPs and 3.5 wt% Al2O3 was higher than the value stated for the nanoparticles‐free BE by 18.7%. Furthermore, the composite comprising 0.5 wt% of each of the nanoparticles had a great ability to alleviate the spreading of Staphylococcus aureus and Escherichia coli when compared with the resin and composites with other formula. For instance, the diameter of inhibition zone (DIZ) against Staphylococcus aureus of the aforementioned composite increased about 16% than that of additive‐free BE. All these features make this composite system a promising candidate in biomedical applications especially in dental related applications. [ABSTRACT FROM AUTHOR]

This study aims to optimize the photopolymerization process of a dental composite in order to increase the degree of conversion and reduce the release of unpolymerized monomers. In addition, it seeks to understand the kinetics of composite degradation under various oral environmental conditions. Optimization of the photopolymerization process is carried out using a Box-Behnken design, exploring factors such as irradiation time, intensity and distance. Infrared spectroscopy is used to evaluate photopolymerization parameters. Release of unpolymerized monomers is quantified using liquid chromatography at different pH levels, incubation media and time. Thermogravimetric analysis is used to study thermal degradation and establish a kinetic model. Optimized conditions for photopolymerization, determined as an irradiation time of 40 s, an intensity of 1500 mW cm−2, and a distance of 5 mm, lead to a degree of conversion of 61%, reducing the presence of unpolymerized monomers. Chromatographic analysis reveals a pH-dependent release of monomers, with acid saliva showing the highest release. Thermal analysis indicates variable activation energy values depending on ageing conditions, underlining the importance of optimal conversion for increased material strength. This study offers a comprehensive approach to improving the properties of dental resins, and provides optimized conditions for light-curing that increase material strength. [ABSTRACT FROM AUTHOR]

Dental resin composites are widely used in clinical settings but often face longevity issues due to the development and accumulation of microcracks, which eventually lead to larger cracks and restoration failure. The incorporation of microcapsules into these resins has been explored to introduce self-healing capability, potentially extending the lifespan of the restorations. This study aims to enhance the performance of self-healing dental resins by optimizing the microcapsules–resin matrix physicochemical interactions. Poly(urea–formaldehyde) (PUF) microcapsules were reinforced with melamine and subsequently subjected to surface functionalization with 3-aminopropyltriethoxysilane (APTES) and (3-mercaptopropyl)trimethoxysilane (MPTMS). Additionally, microcapsules were functionalized with a bilayer approach, incorporating tetraethyl orthosilicate (TEOS) with either APTES or MPTMS. X-ray photoelectron spectroscopy (XPS) and thermogravimetric analysis (TGA) confirmed an increased Si:C ratio from 0.006 to 0.165. The functionalization process did not adversely affect the structure of the microcapsules or their healing agent volume. Compared to PUF controls, the functionalized microcapsules demonstrated enhanced healing efficiency, with TEOS/MPTMS-functionalized microcapsules showing the highest performance, showing a toughness recovery of up to 35%. This work introduces a novel approach to functionalization of microcapsules by employing advanced silanizing agents such as APTES and MPTMS, and pioneering bilayer functionalization protocols through their combination with TEOS. [ABSTRACT FROM AUTHOR]

Objective: This randomized controlled clinical trial compared the clinical efficacy of self‐adhesive bulk‐fill Surefil One with a traditional bulk‐fill composite in class II restorations. Materials and Methods: Sixty‐four direct class II composite restorations were categorized into two groups. Group I, control group (n = 32): cavities were restored by Filtek One bulk‐fill composite with Scotchbond Universal (SBU) adhesive in self‐etch mode, Group II, test group (n = 32): cavities were restored by Surefil One self‐adhesive bulk‐fill composite. The study involved a follow‐up period of 1 year, during which restorations were assessed at baseline (BL), 6 months, and 12 months using Federation Dentaire Internationale (FDI) criteria. Data analysis was performed using nonparametric tests. A comparison of restoration characteristics was performed utilizing the chi‐square test (X2). The significance level was set at 0.05. Results: Filtek One and Surefil One bulk‐fill composites revealed clinically acceptable FDI scores over 12‐month recalls. Thirty‐two patients (64 restorations) were available for all follow‐up visits; 100% of the restorations survived. For esthetic properties, Filtek One was far better than Surefil One at all time points. However, in terms of functional and biological properties, both restorations demonstrated comparable performances. Conclusions: Filtek One bulk‐fill restorations were superior in terms of surface luster, surface staining, color match, and translucency, but Surefil One restorations performed well and were similar to Filtek One restorations; however, additional advancements and research are needed to obtain better esthetics. Furthermore, longitudinal studies with extended follow‐up periods are needed to assess the clinical potential of both materials. Clinical Significance: Both Filtek One and Surefil One met the FDI criteria, with Filtek One demonstrating superior esthetic and functional qualities and similar performance regarding biological criteria. Both innovative restorative materials show potential for clinical use. Trial registered on ClinicalTrials.gov under registration number; NCT06120868:07/11/2023. [ABSTRACT FROM AUTHOR]

Background: Contemporary fixed orthodontic appliances are shifting from non‐customized pre‐adjusted appliances to custom‐designed and printed appliances with novel digital setup systems. We are one step closer to precision dentistry and orthodontics using personalized mechanics and custom appliances. However, despite the evidential enhancement and other improvements to fixed appliances, tooth movement is still limited to five degrees of freedom. Opening or closing spaces still requires manually placing elastomeric chains or coil springs. Aim: In this article, we aimed to demonstrate how advancements in CAD/CAM technology, reverse engineering, and digital customization are helping orthodontics constantly evolve, enabling treatment with enhanced esthetics and minimal compliance. The clinical system (InBrace®, Irvine, CA) described in this article uses a patient‐specific, digitally designed multiloop NITI wire that delivers friction‐free, light, and continuous forces and activates automatically whenever the malocclusion deviates from the digital setup. Conclusion: Through digital customization, InBrace allows for automated tooth movement in all six degrees of freedom, including space opening or closure, via programmed non‐sliding mechanics. Clinical Significance: Precision orthodontics and personalized treatment have been significant developments in orthodontics recently. This article focuses on how a technologically advanced lingual appliance system could achieve targeted cosmetic results methodically via automation and personalization. [ABSTRACT FROM AUTHOR]

Objective: To describe a shift from injectable resin composite technique to composite resin computer‐aided design and computer‐aided manufacturing (CAD/CAM) veneers in addressing esthetic concerns associated with diastemas between anterior lower teeth in a clinical case. Clinical Considerations: Among several techniques proposed for direct resin composite restoration, the "Injectable resin composite technique" has gained popularity for its time‐efficiency, reduced technique sensitivity, and diminished reliance on clinician skills. However, challenges such as staining and the need for frequent polishing follow‐ups may prompt the consideration of more stable alternatives such as indirect veneer restorations. While ceramic veneers offer superior mechanical and optical properties, resin ceramic veneers, especially those milled from CAD/CAM resin ceramic blocks, offer advantages such as rapid, cost‐effective production, simplified intra‐oral repairs, less susceptibility to fracture, superior stress absorption, and requires minimal tooth preparation, making them an appealing option for many patients. Moreover, a fully‐digital approach not only streamlines the process but also saves time and labor while ensuring the delivery of high‐quality restorations to patients. Conclusion: In addressing a patient's dissatisfaction with constant polishing of direct resin composite restorations, a shift to resin composite CAD/CAM veneers was implemented. Utilizing a fully‐digital approach with CAD/CAM resin ceramic restorations successfully restored both esthetics and function. Clinical Significance: While the injectable resin composite technique achieves immediate esthetic results, its low color stability necessitates frequent polishing sessions. The replacement of direct resin composite restorations with CAD/CAM resin composite veneers becomes a viable option for patients seeking more stable restorations that require fewer follow‐ups. This transition addresses both esthetic concerns and the need for enduring solutions in restorative dentistry. [ABSTRACT FROM AUTHOR]

The purpose of this study was evaluating the performance of new Bis-EFMA based bulk-fill composites with common methacrylate based composites and commercial dental composites. The Bis-EFMA monomer was synthesized and the novel Bis-EFMA based bulk-fill composites were prepared. The resin composite samples were co-cultured with human gingival epithelial cells and human dental pulp stem cells to test the biocompatibility. The edge adaptation was observed under a combination of stereoscope and scanning electron microscope. The internal hardness was measured using a Vickers microhardness tester after one-time filling of cavities prepared in extracted teeth. After friction and wear test on the surface of the resin composites, the surface morphology and volume wear of each group were measured by the optical profilometer. The color stability was measured by a colorimeter. Direct contact with human gingival epithelial cells and human dental pulp stem cells did not cause significant changes in their growth density and morphology, indicating good biocompatibility of Bis-EFMA group (p > 0.05). The continuous margin proportion of the Bis-EFMA group was as good as commercial bulk-fill composites (p > 0.05). The sectional microhardness results showed that the Bis-EFMA group had the highest microhardness. After the friction and wear test, the volume wear of the Bis-EFMA group was minimal, indicating its good wear resistance and mechanical strength. Color changes in all resin groups after 28 days of immersion were within the clinically acceptable range. The addition of Bis-EFMA demonstrated excellent biocompatibility, edge adaptation and color stability comparable to commonly used clinical bulk-fill composites, along with preferable mechanical strength, friction and wear resistance. Bis-EFMA based bulk-fill composites have the potential to be employed as a bulk filling material in commercial dental composite applications. • Bis-EFMA BF-DRCs showed good biocompatibility to the pulp periodontal tissue. • Bis-EFMA BF-DRCs adapted well to cavity wall. • The rigid structure got Bis-EFMA BF-DRCs higher microhardness and anti-friction property compared with SDR™. • Bis-EFMA BF-DRCs had reliable color stability. [ABSTRACT FROM AUTHOR]

The study aimed to assess the impact of diphenyliodonium hexafluorophosphate (DPI) on the physicochemical properties of experimental resin composites (ECRs) featuring reduced concentrations of camphorquinone (CQ)/amine. Five concentrations of CQ (0.125, 0.25, 0.5, 0.75, and 1 mol%) with dimethylaminoethyl amine benzoate (EDAB) in a 1:2 mol% ratio (CQ:EDAB) were incorporated into a 50:50 mass% monomer blend of bisphenol glycidyl methacrylate (BisGMA) and triethyleneglycol dimethacrylate (TEGDMA). An additional 5 groups with the same CQ:EDAB concentrations had 0.5 mol% DPI added. Each resin group contained 60 wt% of 0.7 µm barium-alumino-silicate glass. Light transmission (n = 3), real-time degree of polymerization (n = 3), temperature change during polymerization (n = 5), polymerization shrinkage strain (n = 3), flexural strength, and modulus (n = 12), as well as water sorption and solubility (n = 5), were evaluated. Data were analyzed using two-way ANOVA and Tukey's post-hoc test (α = 0.05). Light transmission was reduced in groups containing 0.125 and 0.25 mol% of CQ without DPI. DPI increased temperature, degree and rate of polymerization, despite the reduction in CQ/amine concentration. Additionally, there was an increase in polymerization shrinkage strain, flexural strength and modulus, and a reduction in water sorption and solubility in ECRs with DPI, even with lower concentrations of CQ/EDAB. DPI improved the assessed properties of composites across various concentrations of CQ/EDAB, showing the benefit of reducing the quantity of CQ used without compromising the properties and curing of the resin composites. [ABSTRACT FROM AUTHOR]

The present work demonstrates the optimization of a renilla-based real-time, ultra-bright, non-disruptive, high-throughput bioluminescence assay (HTS) to assess the metabolism of intact Streptococcus mutans biofilms and its utility in screening the antibacterial efficacy of experimental nanofilled dental adhesive resins containing varying concentrations of nitrogen-doped titanium dioxide nanoparticles (N_TiO 2). Methods. Optimization of the assay was achieved by screening real-time bioluminescence changes in intact Streptococcus mutans biofilms imposed by the various experimental biofilm growth parameters investigated (bacterial strain, growth media, sucrose concentration, dilution factor, and inoculum volume). The optimized assay was then used to characterize the antibacterial efficacy of experimental nanofilled dental adhesive resins. The assay's ability to discriminate between bacteriostatic and bactericidal approaches was also investigated. Results. Relative Light Units (RLU) values from the HTS optimization were analyzed by multivariate ANOVA (α = 0.05) and coefficients of variation. An optimized HTS bioluminescence assay was developed displaying RLUs values (brightness) that are much more intense when comparing to other previously reported bioluminescence assays, thereby decreasing the error associated with bioluminescence assays and displaying better utility while investigating the functionalities of antimicrobial nanofilled experimental dental adhesive resins with proven long-term properties. Significance. The present study is anticipated to positively impact subsequent research on dental materials and oral microbiology because it serves as a valuable screening tool in metabolic-based assays with increased sensitivity and robustness. The assay reported is anticipated to be further optimized to be used as a co-reporter for other Luc based assays. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess factors associated with higher odds of undergoing repeat general anesthesia (GA2) for dental treatments. The authors studied children up to age 48 months of age enrolled in Medicaid who underwent dental treatment under first general anesthesia (GA1). The authors used a case-control design to compare children who had a GA2 within 48 months of GA1 (case patients) with those who did not (control patients). In total, 60 case patients were age and sex matched to 120 control patients. Mean (SD) age at GA1 was 38 (5.2) months for case participants and 40 (4.7) months for control participants (P =.08). Higher caries involvement of maxillary incisors (P =.04), and lower caries involvment of canines (P =.003), first molars (P =.012), and second molars (P <.001) at GA1 was associated with higher odds of occurrence of GA2. There was a significant inverse association between full-coverage restoration on canines (P =.003), first molars (P =.001), and second molars (P =.002) at GA1 and occurrence of GA2. There was a significant direct association between the use of composites or sealants on second molars in GA1 and occurrence of GA2 (P =.02). The number of extractions at GA1 was not associated significantly with the occurrence of GA2. The use of full-coverage restorations on primary molars and canines under general anesthesia (GA) was associated with lower odds of occurrence of GA2. Resin restorations and sealants on primary second molars were associated with higher odds of occurrence repeat GA. The findings support preferential use of full-coverage restorations for young children undergoing dental GA. Full-coverage restorations should be considered strongly for young children undergoing GA for dental treatments to reduce the risk of requiring GA2. [ABSTRACT FROM AUTHOR]

A conservative approach to restoration assists in preserving the remaining tooth structure of extensively destroyed vital teeth. This case report describes a single-appointment chairside technique for placement of ceramic restorations in posterior teeth. A patient presented for treatment of her mandibular right first molar, which had a fractured resin-based composite restoration. Due to the presence of vital pulp, extent of the restoration, and presence of caries in the tooth, the following treatment plan was proposed: placement of a lithium disilicate glass-ceramic onlay fabricated with a computer-aided design/computer-aided manufacturing workflow. After the dentist removed the restoration and performed selective caries removal, structural analysis guided the reduction of the buccal cusps. Immediate dentin sealing was performed with a 2-step self-etching adhesive system, and a 1-mm-thick layer of flowable resin-based composite was placed as a resin coating. A digital impression was obtained, the onlay restoration was designed, and a lithium disilicate block was milled and subsequently crystallized. When the onlay was completed, the tooth preparation was sandblasted, selectively etched, and coated with a universal adhesive. The intaglio surface of the onlay was cleaned and primed, the onlay was bonded with dual-cure resin cement, and occlusal adjustments were completed. Follow-up examinations at 1 and 4 months revealed the clinical success of the case. From start to finish, it takes approximately 2.5 hours to produce a single-appointment chairside restoration. The technique used in this case offers a fast-paced workflow that is comfortable and practical for the patient and provides a predictable clinical outcome without the need for a temporary restoration. [ABSTRACT FROM AUTHOR]

This in vitro study evaluated the influence of radiant exposure and material shade on the degree of conversion (DC) and microhardness of a resin-based composite (RBC). Sixty-four RBC specimens in shades A1E (enamel) and A4D (dentin) were light cured at a calibrated exitance of 1000 mW/cm² for 5, 10, 15, or 20 seconds, resulting in radiant exposure levels of 5. 10. 15 or 20 J/cm². The DC was determined using Fourier-transform infrared spectroscopy (n = 3 per shade per exposure level). The Knoop hardness number (KHN) was measured on the top and bottom surfaces of each specimen (n = 5 per shade per exposure level). Data were analyzed using 2- and 3-way analyses of variance and post hoc Tukey tests (α = 0.05). The RBC shade did not affect the DC (P = 0.860), and the lowest DC values were achieved with an exposure level of 5 J/cm² (P < 0.001). The shade did not affect the KHN on the top surface, but the radiant exposure level did, with the application of 5 J/cm² resulting in significantly lower values (P< 0.05). For the bottom surface, shade A1E showed significantly higher KHN values than A4D (P < 0.001). An increase in the radiant exposure led to increased DC and KHN for both shades of RBC until reaching a saturation point of 10 J/cm² for A1E and the top surface of A4D. The darker and more opaque shade was not adequately polymerized at a 2-mm depth, even when the highest radiant exposure level was applied. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the influence of different mouthwash solutions on the color stability of a nanohybrid composite resin. Forty discs of Luna nanohybrid composite resin were prepared and randomly assigned to 4 experimental groups (n = 10), determined by the type of immersion solution: distiiled water (DW); Oral-B Pro-Health mouthwash (OBPH); Listerine Total Care mouthwash (LTC); or Colgate Plax Infinity mouthwash (CPI). The discs were immersed in solution for 30 minutes a day and stored at 37°C for 24 hours. Digital photographs of each specimen were taken at each timepoint and transferred to a computer program for color analysis. The International Commission on Illumination L*a*b* system was used to analyze the color of the specimens at baseline and the overall color change (ΔE*) at baseline, 30 days, 60 days, and 90 days. Two-way analysis of variance was used to evaluate the influence of solution and time on 82 values (α = 0.05). The f test was used as a post hoc test to compare the mean values between groups (α = 0.05). After 30 days, all groups showed small color change values compared with baseline (ΔE*1 < 1.0). However, after 60 days, the LTC and CPI groups showed greater color change (ΔE*2) than the other groups, and the difference was statistically significant (P < 0.05). After 90 days, all groups differed significantly compared with the control group (P < 0.05), and all mouthwash groups presented color change values that are considered clinically unacceptable (ΔE*3 > 3.0). The results of this in vitro study indicate that mouthwash solutions do not cause significant color changes in nanohybrid composite resin for a period of up to 30 days; however, longer periods (90 days) of exposure could make the restorative material esthetically unacceptable. [ABSTRACT FROM AUTHOR]