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The preservation of interfacial integrity in esthetic dental restorations remains a critical challenge, with hybrid layer degradation being a primary factor in restoration failure. This degradation is driven by a combination of host-derived enzymatic activity, including matrix metalloproteinases (MMPs), bacterial proteases, and hydrolytic breakdown of the polymerized adhesive due to moisture exposure. This review examines the multifactorial mechanisms underlying hybrid layer degradation and presents current advancements in restorative materials aimed at counteracting these effects. Principal strategies include collagen preservation through the inhibition of enzymatic activity, the integration of antimicrobial agents to limit biofilm formation, and the use of ester-free, hydrolysis-resistant polymeric systems. Recent research highlights acrylamide-based adhesives, which exhibit enhanced resistance to acidic and enzymatic environments, as well as dual functionality in collagen stabilization. Furthermore, innovations in bioactive resins and self-healing materials present promising future directions for developing adhesives that actively contribute to long-term restoration stability. These findings underscore the importance of continuous advancements in adhesive technology to enhance the durability and clinical performance of dental restorations.

Universal shade flowable composites have been introduced to mimic tooth structure with reduced color mismatch and reduced chair time and cost. However, the polymerization shrinkage of resin material may lead to sensitivity and restoration failure. The purpose of this study was to compare the polymerization shrinkage of recently introduced universal shade flowable resin-based composites using both wet and dry density methods. Using two measurement methods, ISO 17304 (wet method) and a gas displacement pycnometry system (dry method), the density of the unpolymerized and the polymerized RBCs were measured, and the polymerization shrinkage was calculated from the density difference. Scanning electron microscopy was used to visualize filler particles. The polymerization shrinkage showed significant differences between many materials. In particular, Bulk Base HARD II Medium Flow showed significantly lower polymerization shrinkage than all the other materials. Shrinkages measured by different methods were significantly different in all cases. The wet method measured a smaller shrinkage than the dry method in most cases, but the shrinkage measured for Gracefil LoFlow was larger with the wet method. Shrinkage between universal shade flowable resin-based composites significantly varied based on both material and measurement method. The polymerization shrinkage of resin-based composites is an important factor in biomimetic clinical dentistry, and work must be conducted to measure it accurately and with more standardization.

Marginal enamel fractures (MEF) are a common clinical concern in dentistry, particularly in anterior teeth. These fractures occur at the enamel margins and their etiopathogenesis involves a complex interplay of mechanical, chemical, and biological factors. The ongoing research focuses on an overview of MEF to improve the knowledge about this condition. Understanding the multifaceted nature of MEF is crucial for devising effective preventive and therapeutic strategies in contemporary restorative dentistry. Indeed, mechanical stresses, such as occlusal forces and parafunctional habits are primary contributors for MEF. Additionally, it can happen at the enamel-restoration interface due to expansion and contraction of restorative materials. Chemical degradation, including acid erosion and the breakdown of adhesive bonds, further exacerbates the vulnerability of enamel. Biological factors, such as enamel composition and the presence of micro-cracks also play a role in the development of MEF. Clinical management of MEF involves subtractive or additive techniques, repairing or replacing the compromised tooth structure using techniques to ensure the integration with the natural enamel.

Sandblasting materials used for dental restoration are a valuable preconditioning technique that enhances the physical properties and promotes osseointegration and cell adhesion. Triplicate groups of Ti medical grade 4 and Ti6Al4V were blasted with 16 series of various naturally occurring and synthetically produced spraying materials of controlled granulometry at three spraying durations each and two spraying pressures, and the results were tested for the determination of the surface roughness taken as an average of 80 points ±5 points for each particular series of operating parameters. SEM analysis and specific tests to see whether or not cell cultures proliferate on the treated materials were also conducted. It was found that in all cases, regardless of the spraying material or working conditions, the roughness profile achieved is a uniformly distributed one. A reduction in the blasting pressure by half led to a decrease in the roughness between 30 and 35%. The use of glass balls as blasting material led to decreased roughness and more uniformly distributed roughness values for Ti as well as for Ti6Al4V, regardless of spraying duration or applied pressure compared to other spraying materials. Blasting with olivine led to increased, as well as uniformly distributed, values, and hence the conclusion that one may control the roughness size by choosing one or another of the above materials without the need to change any other operating parameters. In the case of Ti, the achieved roughness is greater than in the case of Ti4Al6V, regardless of the blasting material; the differences are smaller the softer the sandblasting material due to the fact that Ti alloys have better mechanical properties and increased hardness compared to pure Ti. SEM analysis showed that the use of sintered hydroxyapatite as an additive to the blasting material does not necessarily lead to a substantial deposition of hydroxyapatite on the substrate materials; only traces of it were identified during the analysis. As a general conclusion, this study showed that by sandblasting Ti and Ti6Al4V with different spraying materials, one may control the surface roughness, and this technique may be an attractive method for preconditioning these materials for restorative dentistry.

Implant abutments are essential components of implant prosthetic restorations. The golden standard for abutment material is titanium; however, due to its properties, the esthetic result can be compromised. The most popular esthetic material alternatives are one- and two-piece zirconia. The study aimed to answer the questions of whether zirconia abutments can be used interchangeably with titanium in both anterior and posterior regions and how aging of the abutment affects durability. For this study, an electronic search of MEDLINE (PubMed) and Scopus (Embase) was conducted. The PRISMA guidelines were followed, and a systematic review was registered with PROSPERO. The search revealed 4031 results, of which 17 studies were selected. The strongest material for abutments is titanium, closely followed by two-piece zirconia. One-piece zirconia abutments were the weakest. The cyclic loading above 1,000,000 cycles decreased the fracture resistance of the abutments. Differences in implant diameter, angulation, and restoration affected the fracture strength of all compared materials. The main mode of failure for titanium abutments was screw bending or screw fracture. One-piece zirconia most often presented catastrophic failure with internal hexagon fracture below the implant neck. Two-piece zirconia exhibits a combination of failure modes. Two-piece zirconia abutments may be suitable for use in the posterior region, given their comparable fracture resistance to titanium abutments. Despite the fact that one-piece zirconia is capable of withstanding forces that exceed those exerted during mastication, it is recommended that it be employed primarily in the anterior dentition due to its propensity for unfavorable failure modes.

This report describes multidisciplinary care combining orthodontics and restorative dentistry for a patient with Class II occlusion and stained mandibular and maxillary resin composite veneers. The orthodontic treatment improved severe overjet and malocclusion prior to restorative care. Occlusal assessment was provided with a novel digital device (PlaneSystem, Zirkonzahn) that is integrated with digital workflows for the evaluation of the occlusal plane and condylar path inclination. Diagnostic digital impressions and digital wax-up for intraoral mock-ups led to the patient’s treatment acceptance. Minimally invasive tooth preparation, final digital impressions, and bonding under dental dam isolation fulfilled the patient’s esthetic and functional demands with all-ceramic restorations.

The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures.

Internal bleaching is a conservative treatment applied to a darkened endodontically treated tooth to restore its original colour, either as a single treatment or as a treatment prior to a subsequent prosthetic phase. The aim of this study was to objectively measure and compare using an experimental model the expansive capacity of four bleaching groups: carbamide peroxide 37% (CP 37%), hydrogen peroxide 30% (HP 30%), HP 30% mixed with sodium perborate (SP) and SP mixed with distilled water. A total of 150 lower incisors (n = 30 in each group) were prepared for the Walking Bleach technique and a glass tube with oil was introduced into the coronal access cavity to measure the expansive capacity through oil displacement, due to the reaction that occurs when bleaching agents interact with dental tissues. The results after 10 days were analysed with the Games–Howell post hoc test to compare the samples. Significant higher expansion was observed with HP 30% (p < 0.05) and lower expansion with SP (p < 0.05) compared to the other groups. No significant differences were observed between CP 37% (p > 0.05) and HP 30% + SP (p > 0.05). This provides significant and observable information on the behaviour of each bleaching group and its evolution after 10 days.

(1) Background: the current study investigated three nanohybrid composites: two commercial products ClearfilMajestyTM (CM) and HarmonizeTM (HU), compared with an experimental product PS2. (2) Methods: Two sample types were molded using Teflon dies. The first sample type was represented by standard discs (20 mm diameter and 2 mm thickness) (n = 60, 20/each material), used for surface conditioning investigation, specifically roughness monitoring and color stability analysis using AFM and the CIELab test, respectively. The second sample type was a standard cylindrical specimen (4 mm diameter and 6 mm height) for compression testing (n = 60, 20/each material). After complete polymerization, the samples were ground with sandpaper and further polished. The filler size and distribution in the polymer matrix were investigated with SEM. Data were statistically analyzed using the Anova Test followed by Tukey’s post hoc test on the Origin Lab 2019 software produced by OriginLab Corporation, Northampton, MA, USA. (3) Results: A mono-disperse system was identified in HU samples, while CM and PS2 revealed both nano- and microfiller particles. The samples’ observation after immersion in coffee and tea indicated that a lower roughness combined with optimal filler lamination within the polymer matrix assured the best color preservation. The compression strength was lower for the HU sample, while higher values were obtained for the complex filler systems within CM and PS2. (4) Conclusions: the behavior of the investigated nanohybrid composites strongly depends on the microstructural features.

In dentistry, various animal models are used to evaluate adhesive systems, dental caries and periodontal diseases. Metalloproteinases (MMPs) are enzymes that degrade collagen in the dentin matrix and are categorized in over 20 different classes. Collagenases and gelatinases are intrinsic constituents of the human dentin organic matrix fibrillar network and are the most abundant MMPs in this tissue. Understanding such enzymes’ action on dentin is important in the development of approaches that could reduce dentin degradation and provide restorative procedures with extended longevity. This in silico study is based on dentistry’s most used animal models and intends to search for the most suitable, evolutionarily close to Homo sapiens. We were able to retrieve 176,077 mammalian MMP sequences from the UniProt database. These sequences were manually curated through a three-step process. After such, the remaining 3178 sequences were aligned in a multifasta file and phylogenetically reconstructed using the maximum likelihood method. Our study inferred that the animal models most evolutionarily related to Homo sapiens were Orcytolagus cuniculus (MMP-1 and MMP-8), Canis lupus (MMP-13), Rattus norvegicus (MMP-2) and Orcytolagus cuniculus (MMP-9). Further research will be needed for the biological validation of our findings.

Direct pulp capping (DPC) is reliable in pulp exposure management. Objective: This study aimed to assess the success rate of DPC materials and different laser protocols. The included procedures were CO2 laser (n = 1147), Er: YAG laser (n = 69), and 980 nm diode laser (n = 124), on the one hand, and Ca (OH)2 (n = 376) and bioactive tricalcium silicate paste, on the other (n = 279). Materials and methods: Data from 1995 DPC cases were included. For laser groups, irradiation was used to coagulate the pulp exposure followed by Ca (OH)2 placement. Data with follow-up at 12, 24, and 36 months post-treatment were included. The irradiation parameters for the CO2 laser were as follows: energy density per pulse of 141 J/cm², 1 W power, 0.3 mm beam diameter, 100 ms pulse duration, and 1 Hz, and a series of five pulses maximum were delivered during 5 s. For the 980 diode lasers: 1.5 W power, continuous wave (CW), 400 μm fiber diameter, contact mode, 190.98 W/cm2 power density, and total delivered energy density of 2387 J/cm2. For the Er: YAG laser: 0.5 W output power, 9.95 J/cm2 energy density, a beam diameter of 0.8 mm, 300 µsec pulse duration, 10 Hz, non-contact mode, irradiation with air without water spray, and an average irradiation time of 8–10 s. Results: At the 3-year follow-up, the success percentages were as follows: CO2 (88.01%) > Ca (OH)2 (75.72%) > diode (70.01%) > Er: YAG (54.55%) > bioactive tricalcium silicate paste (51.1%). The timing of permanent filling (immediate or delayed), patient age, size of pulp exposure, tooth type, and exposure etiology significantly affected the success rate. Patients aged ≤ 35 years presented higher success (70.91%) compared to those ≥ 36 years (61.2%). Immediate permanent fillings increase the success rate (71.41%) compared to delayed permanent fillings (65.93%). Exposure in molars and premolars significantly lowers the success rate (60.3%) compared to canines and incisors (72.1%). Idiopathic pulp exposure presented higher success (72.58%) compared to caries-related causes (63.7%). Conclusion: The highest success rate was in the CO2 laser group followed by the diode and Ca (OH)2, Er: YAG, and bioactive tricalcium silicate material (biodentine) groups. The age factor, filling timing, size of exposure, tooth type, and exposure etiology can significantly affect the success rate of DPC.

The restoration of endodontically treated teeth (ETT) is challenging as these teeth often present with structural deficiencies. Currently, there is no consensus regarding the final restoration choice. Historically, the full coverage crown was the universally selected treatment for endodontically treated teeth. With advances in adhesive and biomimetic dentistry, more minimally invasive treatment modalities have become a viable option. With this study, we aim to understand the restorative decision of the general dentist with or without additional training in biomimetic dentistry. Seventy-eight general dentists, with or without biomimetic training, were surveyed to determine their restorative preferences on five extracted posterior teeth, categorized according to volumetric loss of tooth structure, as indicated by the number of missing walls, the isthmus width, the presence or absence of marginal ridges, and cusps. CAD/CAM reconstructions were made with the teeth to analyze the volume of tooth loss and compare these with the survey results. Data were compared using the chi-squared test and Fisher’s exact test. The frequency of responses recommending a crown and the volume of tooth loss were correlated using the Pearson test (p < 0.05). For all five teeth, survey responses showed a statistically significant difference in the restorative decision of full coverage versus alternative restorations, with biomimetic dentists selecting a direct restoration or inlay/onlay in lieu of a full coverage crown (n = 63, p < 0.05). The age of the participant did not have a significant impact on the restorative decision making process for these teeth. The biomimetic trained dentists showed a greater tendency to select a crown option only when the volume of tooth loss was greatest, otherwise their restorative decisions tended towards the conservative treatment options. This study also demonstrates a novel method of digitally developing a volume of tooth loss to compare against the visual interpretation of the volume of tooth loss.

The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.

An esthetically pleasing smile is a valuable aspect of physical appearance and plays a significant role in social interaction. Achieving the perfect balance between extraoral and intraoral tissues is essential for a harmonious and attractive smile. However, certain intraoral deficiencies, such as non-carious cervical lesions and gingival recession, can severely compromise the overall aesthetics, particularly in the anterior zone. Addressing such conditions requires careful planning and meticulous execution of both surgical and restorative procedures. This interdisciplinary clinical report presents a complex case of a patient with esthetic complaints related to asymmetric anterior gingival architecture and severely discolored and eroded maxillary anterior teeth. The patient was treated using a combination of minimally invasive ceramic veneers and plastic mucogingival surgery, resulting in a successful outcome. The report emphasizes the potential of this approach in achieving optimal esthetic results in challenging cases, highlighting the importance of an interdisciplinary team approach in achieving a harmonious balance between dental and soft tissue aesthetics.

Background: Achieving correct tooth anatomy and saving time at the dental chair are some of the goals of modern restorative dentistry. Stamp technique has gained acceptance in clinical practice. The aim of this study was to evaluate the effectiveness of this technique in terms of microleakage, voids, overhangs and marginal adaptation of Class I restorations, and to analyse the operative times in comparison with traditional restorative procedures. Methods: Twenty extracted teeth were divided into 2 groups. Ten teeth in the study group (SG) were Class I prepared and restored using stamp technique, and ten teeth in the control group (CG) were Class I restored traditionally. SEM analysis was performed to evaluate voids, microleakage, overhangs, and marginal adaptation, and operative times were recorded. A statistical analysis was performed. Results: There were no significant differences in microleakage, marginal adaptation and filling defects between the two groups, however, the stamp technique seems to facilitate the formation of large overflowing margins that require a careful finishing phase. Conclusions: Stamp technique does not seem to have any critical aspects in terms of restoration durability and it can be performed in a short time.

Minimally invasive dentistry is a considered process that requires the clinician to be prepared with the ideal sequence and the tools needed. This report describes a well-planned ultraconservative approach using only two ceramic laminate veneers for the maxillary central incisors to significantly improve the patient’s overall smile. A 30-year-old female presented with the chief complaints of having diastemas between the central and lateral incisors as well as incisal wear. Diagnostic wax-up and mock-up were performed, and the patient approved the minimally invasive treatment with veneers only for central incisors. A reduction guide aided the conservative tooth preparations, and hand-crafted feldspathic veneers were bonded under total isolation with a rubber dam. The two final conservative veneers significantly improved the smile and fulfilled the patient’s expectations. Following proper planning and sequencing, predictable outcomes were obtained and fulfilled the patient’s esthetic demands. Minimally invasive restorative dentistry with only two single veneers can impact the entire smile frame. Overtreatment in the esthetic zone is unnecessary to meet a patient’s esthetic expectations.

The aim of this retrospective study was to investigate the clinical performance of posterior complex resin composite (RC) and amalgam (AM) restorations after a five-year period. One hundred and nineteen complex Class II restorations placed by dental students were evaluated using the USPHS criteria. Data were analyzed using Chi-square, Mann–Whitney, and Wilcoxon tests at a 0.05 level of significance. After five years, the percentages of clinically satisfactory complex Class II RC and AM restorations were 78% and 76.8%, respectively. The main reasons for the failure of AM restorations included secondary caries (Bravo—10.1%), defective marginal adaptation (Charlie—8.7%), and fracture of the tooth (Bravo—7.2%). RC restorations presented failures related to the fracture of the restoration (Bravo—16%) and defective marginal adaptation (Charlie—8.2%). There was a significantly higher incidence of secondary caries for AM restorations (AM—10.1%; RC—0%; p = 0.0415) and a higher number of fractures for RC restorations (AM—4.3%; RC—16%; p = 0.05). Regarding anatomy, AM restorations presented a significantly higher number of Alfa scores (49.3%) compared to RC restorations (22.4%) (p = 0.0005). The results of the current study indicate that complex class II RC and AM restorations show a similar five year clinical performance.

In the oral environment, restorative and prosthetic materials and appliances are exposed to chemical, thermal and mechanical challenges. The mechanical properties of a material define how it responds to the application of physical force. This Special Issue focuses on all the recent technology that can enhance the mechanical properties of materials used in all of the different branches of dentistry. This Special Issue is closed, but the topic is certainly of interest, and therefore new research will be needed to explore further evolution in dental materials.

Resin composites are the most versatile restorative materials used in dentistry and the first choice for restoring posterior teeth. This article reviews aspects that influence the clinical performance of composite restorations and addresses clinically relevant issues regarding different direct techniques for restoring posterior teeth that could be performed in varied clinical situations. The article discusses the results of long-term clinical trials with resin composites and the materials available in the market for posterior restorations. The importance of photoactivation is presented, including aspects concerning the improvement of the efficiency of light-curing procedures. With regard to the restorative techniques, the article addresses key elements and occlusion levels for restoring Class I and Class II cavities, in addition to restorative strategies using different shades/opacities of resin composites in incremental techniques, restorations using bulk-fill composites, and shade-matching composites.

In this retrospective study, data for three different laser-assisted approaches for the management of dentinal hypersensitivity (DH) was collected (n = 920 teeth). In total, 387 teeth were treated with photobiomodulation (PBM) therapy with 660 nm red light laser (PBM group), 327 were treated with the Nd:YAG laser (1064 nm) and 206 were treated with the Nd:YAP laser (1340 nm). To assess the effectiveness of each treatment, a visual analogue scale (VAS) was used, where zero represented no pain at all and ten represented the greatest pain. VAS was used before (T0), immediately after (T1), one week after (T2), four weeks after (T3), six months after (T4) and one year after treatment (T5). Means and standard deviations of VAS at different follow-up times were calculated. Values were compared within and between groups. Statistical significance was considered to be achieved when p-value was less than 0.05. Confidence level was proposed to be 99% with a P value lower than 0.001. Within groups, a statistically significant reduction was obtained when the mean value of VAS at T0 was compared with T5. At T5, the PBM group had the highest reduction of VAS (with mean value of 0), while the Nd:YAG and Nd:YAP groups had scores of 1.065 ± 0.674 and 4.665 ± 0.674, respectively. Conclusion: this retrospective study showed that PBM therapy and irradiation with Nd:YAG and Nd:YAP lasers are effective in managing DH pain. However, PBM therapy was the only procedure that showed complete pain relief at six and twelve months after treatment.

Background: This study looks at the clinical applications of nanotechnology in dentistry, with an emphasis on implantology, preventive care, orthodontics, restorative dentistry, and endodontics. Methods: Following PRISMA criteria and registered in PROSPERO (ID: CRD 564245), a PubMed, Scopus, and Web of Science search was conducted for studies from January 2014 to April 2024. The criteria were English-language research on nanotechnology in dental coatings, with a focus on clinical trials and observational studies. The electronic database search yielded 8881 publications. Following the screening process, 17 records were selected for qualitative analysis. Results: Nanotechnology has revolutionized dentistry. In orthodontics, nanoparticles improve antibacterial characteristics, durability, and biocompatibility, lowering bacterial colonization and plaque. In preventative care, Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) combined with stannous fluoride (SnF 2 ) and nano-sized sodium trimetaphosphate (TMPnano) substantially remineralizes enamel. Nanostructured surfaces in dental implants, particularly those containing calcium, improve osseointegration and stability. Nanoparticles in restorative dentistry improve composite and adhesive strength, aesthetics, and longevity. Conclusions: Nanotechnology improves dental materials and equipment, resulting in better treatment outcomes and increased patient comfort. Its integration provides more effective treatments, which improves dental care and patient outcomes. More research is needed to overcome present problems and expand nanotechnology's medicinal applications.

Restorative procedures for caries affecting primary molars are a daily challenge for pediatric dentistry, and one of the main factors influencing the results of these restorative procedures is the choice of dental material used: bioactive materials were recently introduced, combining the strength of composites and the benefits of glass ionomers. The present study’s objective is to clinically evaluate the aesthetic, functional and biological properties of Activa™ Bioactive composite in approximal and occlusal carious lesions for 1 year using the FDI criteria for evaluating direct dental restorations. Forty-five children with occlusal or approximal caries in first or second primary molars were included in the study: the cavities were then randomized to be restored with either Activa BioActive or SDR Bulk-fill and evaluated over time according to Federation Dentaire Internationale (FDI) criteria. Results showed that Activa BioActive composite has similar performance over time compared to Bulk-fill composite, for both functional and aesthetic properties. Thus, within the limitations of this study, including the short follow-up period, it can be concluded that bioactive materials might be the material of choice to restore primary molars. A longer follow-up period is desirable to confirm these findings.

Consumption of acidic beverages and foods could provoke erosive damage, both for teeth and for restorative materials. Temperatures of consumption could influence the erosive effects of these products. The aim of this in vitro study is to assess the influence of an acidic challenge on the weight loss of different restorative materials. Resin composites and glass-ionomer cements (GIC) were tested. The medium of storage was Coca-Cola (Coca-Cola, Coca-Cola Company, Milano, Italy) at two different temperatures, 4 and 37 °C, respectively for Group A and Group B. For each group, nine specimens were prepared for each material tested. After 7 days, weight was assessed for each sample, and the percentage weight loss was calculated. For all the resin composites (Groups 1–13), no significant weight losses were noticed. (

Three-dimensionally (3D) cultured dental pulp stem cells (DPSCs) reportedly exhibit superior multi-lineage differentiation capacities and have a higher expression in regeneration-related gene categories compared to conventionally cultured DPSCs. This study aimed to evaluate the effects of various mineral trioxide aggregates (MTAs) on DPSCs cultured in 3D, assessing their cell viability and tissue mineralization properties. We examined the morphology, cell viability, alkaline phosphate (ALP) activity and qualitative alizarin red S staining assay of the DPSCs that reacted with various MTAs, which included ProRoot (PRM), Biodentine (BIO), and Well-Root PT (WRP), in two different culture plates, an ultra-low attachment plate (ULA) and a conventional monolayer plate (2D). As a control, MTA-free and IRM samples were prepared. None of the MTA groups affected the microsphere-forming characteristics of DPSCs that had been cultured in ULA. The DPSCs that were cultured in ULA showed high cell viability in all MTA groups compared to IRM. The mineralization potential was favorable in all MTA groups, with a significantly higher ALP activity among the DPSCs that were cultured in ULA. Among MTAs, the PRM group showed substantially higher ALP activity than the other MTA groups. In conclusion, our results indicate that 3D-cultured DPSCs with various MTAs showed comparable viability and mineralization capacity similar to those cultured without reacting with MTA cement.

Despite developments and advances in dental materials which allow for greater restorative performance, there are still challenges and questions regarding the formulation of new compositions and chemical reactions of materials used in restorative dentistry. The aim of this study was to assess and compare the mechanical and tribological characteristics of a bioactive resin, a composite resin, and a glass ionomer. Twenty specimens of each material were divided into two groups: one control group (n = 10), not subjected to thermocycling, and one test group (n = 10) submitted to thermocycling. The Vickers microhardness test was carried out and surface roughness was evaluated. The tribological sliding indentation test was chosen. The bioactive resin had the lowest hardness, followed by the composite resin, and the glass ionomer. The bioactive resin also showed greater resistance to fracture. For the tribological test, the wear rate was lower for the bioactive resin, followed by the composite resin, and the glass ionomer. The bioactive resin presented a smooth surface without visible cracks, while the other materials presented a brittle peeling of great portions of material. Thus, the bioactive resin performs better in relation to fracture toughness, wear rate and impact absorption than the composite resin and much better than the glass ionomer.

Hydroxyapatite is one of the most studied biomaterials in the medical and dental field, because of its biocompatibility; it is the main constituent of the mineral part of teeth and bones. In dental science, hydroxyapatite nanoparticles (HAnps) or nano-hydroxyapatite (nano-HA) have been studied, over the last decade, in terms of oral implantology and bone reconstruction, as well in restorative and preventive dentistry. Hydroxyapatite nanoparticles have significant remineralizing effects on initial enamel lesions, and they have also been used as an additive material in order to improve existing and widely used dental materials, mainly in preventive fields, but also in restorative and regenerative fields. This paper investigates the role of HAnps in dentistry, including recent advances in the field of its use, as well as their advantages of using it as a component in other dental materials, whether experimental or commercially available. Based on the literature, HAnps have outstanding physical, chemical, mechanical and biological properties that make them suitable for multiple interventions, in different domains of dental science. Further well-designed randomized controlled trials should be conducted in order to confirm all the achievements revealed by the in vitro or in vivo studies published until now.

This retrospective cohort study evaluated overall parental satisfaction of zirconia crowns (ZC) placed on primary maxillary anterior teeth with that of two independent, blinded dentists. 131 ZC placed in 37 children, aged 24.8–62.2 months (mean = 42.8), who had at least one recall visit a minimum of 6 months after placement were rated (average = 13.3). Crown colour match, crown contour and crown durability were evaluated by parents and compared to photographic evaluations of two independent raters. Overall parental satisfaction was also evaluated. The overall retention rate was 99.7% and parental satisfaction was 100%. Colour match was rated excellent by 84% of parents and 36% of dental evaluators. Crown contour was rated excellent by 97% of parents and 55% of dental evaluators. The length of follow-up had no effect on colour match or crown contour. ZC comprises an aesthetic and durable option for restoring carious primary maxillary incisors and were well-accepted by parents. Parents were less critical than dental evaluators of crown appearance.

Nanotechnology and nanoparticles (NPs) are at the forefront of modern research, particularly in the case of healthcare therapeutic applications. Polymeric NPs, specifically, hold high promise for these purposes, including towards oral diseases. Careful optimisation of the production of polymeric NPs, however, is required to generate a product which can be easily translated from a laboratory environment to the actual clinical usage. Indeed, considerations such as biocompatibility, biodistribution, and biodegradability are paramount. Moreover, a pre-clinical assessment in adequate in vitro, ex vivo or in vivo model is also required. Last but not least, considerations for the scale-up are also important, together with an appropriate clinical testing pathway. This review aims to eviscerate the above topics, sourcing at examples from the recent literature to put in context the current most burdening oral diseases and the most promising polymeric NPs which would be suitable against them.

Biomimetic has emerged as a multi-disciplinary science in several biomedical subjects in recent decades, including biomaterials and dentistry. In restorative dentistry, biomimetic approaches have been applied for a range of applications, such as restoring tooth defects using bioinspired peptides to achieve remineralization, bioactive and biomimetic biomaterials, and tissue engineering for regeneration. Advancements in the modern adhesive restorative materials, understanding of biomaterial–tissue interaction at the nano and microscale further enhanced the restorative materials’ properties (such as color, morphology, and strength) to mimic natural teeth. In addition, the tissue-engineering approaches resulted in regeneration of lost or damaged dental tissues mimicking their natural counterpart. The aim of the present article is to review various biomimetic approaches used to replace lost or damaged dental tissues using restorative biomaterials and tissue-engineering techniques. In addition, tooth structure, and various biomimetic properties of dental restorative materials and tissue-engineering scaffold materials, are discussed.

Breakthroughs in technology have not been possible without influencing the medical sciences. Dentistry and dental materials have been fully involved in the technological and information technology evolution, so much so that they have revolutionized dental techniques. In this study, we want to create the first collection of articles on the use of digital techniques and software, such as Digital Smile Design. The aim is to collect all of the results regarding the use of this software, and to highlight the fields of use. Twenty-four articles have been included in the review, and the latter describes the use of Digital Smile Design and, in particular, the field of use. The study intends to be present which dental fields use “digitization„. Progress in this field is constant, and will be of increasing interest to dentistry by proposing a speed of treatment planning and a reliability of results. The digital workflow allows for rehabilitations that are reliable both from an aesthetic and functional point of view, as demonstrated in the review. From this study, the current field of use of Digital Smile Design techniques in the various branches of medicine and dentistry have emerged, as well as information about its reliability.

Multicomponent silicate glasses and their corresponding glass-ceramic derivatives were prepared and tested for potential applications in dentistry. The glasses were produced via a melting-quenching process, ground and sieved to obtain fine-grained powders that were pressed in the form of small cylinders and thermally treated to obtain sintered glass-ceramic samples. X-ray diffraction investigations were carried out on the materials before and after sintering to detect the presence of crystalline phases. Thermal analyses, mechanical characterizations (assessment of bending strength, Young’s modulus, Vickers hardness, fracture toughness), and in vitro bioactivity tests in simulated body fluid were performed. On the basis of the acquired results, different potential applications in the dental field were discussed for the proposed glass-ceramics. The use of such materials can be suggested for either restorative dentistry or dental implantology, mainly depending on their peculiar bioactive and mechanical properties. At the end of the work, the feasibility of a novel full-ceramic bilayered implant was explored and discussed. This implant, comprising a highly bioactive layer expected to promote osteointegration and another one mimicking the features of tooth enamel, can have an interesting potential for whole tooth substitution.

Achieving local anaesthesia for various clinical dental applications is a challenge that we encounter in our daily practice. Pre-emptive pulpal laser analgesia (PPLA) treatment strategy could be a promising non-pharmacological modality. Hence, our ex vivo laboratory study is aimed at evaluating the changes in enamel surface morphology when irradiated with various published PPLA protocols using scanning electron microscopy (SEM). To do so, 24 extracted healthy human permanent premolar teeth were collected, and each tooth was divided into equal halves randomised into six groups. The following laser parameter protocols based on published protocols of clinical Er:YAG laser-induced PPLA were randomly assigned for each group: 0.2 W/10 Hz/3 J/cm 2 (Group A-100% water spray; Group B-no water); 0.6 W/15 Hz/10 J/cm 2 (Group C-100% water spray; Group D-no water); 0.75 W/15 Hz/12 J/cm 2 (Group E-100% water spray; Group F-no water); 1 W/20 Hz/17 J/cm 2 (Group G-100% water spray; Group H-no water). Each sample was irradiated at an angle of 90° to the dental pulp, with a sweeping speed of 2 mm/s for a 30 s exposure time. Our results have shown, for the first time, no alteration to the mineralised tooth structure when irradiated with the following protocols: 0.2 W/10 Hz/3 J/cm 2 with 100% water spray or without water spray with an irradiated area fixed at a 10 mm tip-to-tissue distance, sweeping motion with 2 mm/s speed of movement; average power output of 0.6 W/15 Hz/10 J/cm 2 , maximum water cooling of 100%, tip-to-tooth distance fixed at 10 mm, 30 s exposure time, sweeping motion with 2 mm/s speed of movement. The authors concluded that the current available proposed PPLA protocols in the literature might cause an alteration to the enamel surface. Hence, future clinical studies are warranted to validate our study's PPLA protocols.