Search

Objective: Artificial intelligence (AI) applications in restorative dentistry have remarkably increased in the past 5 years. This review outlines the applications, promises, and limitations of AI in the most performed procedures in restorative dentistry. Method and materials: An electronic search was performed in four databases: MEDLINE/PubMed, Embase, Web of Science, and Scopus. The search included articles published in English language without date restriction. Two independent reviewers assessed the eligibility of the studies and performed data extraction. Any discrepancy was resolved by the consensus of a third reviewer. Results: A total of 33 studies were included in this review. For AI applications in restorative dentistry, the included studies were classified into three main groups: (1) diagnosis, detection, and prediction of the disease, (2) detection and prediction of the longevity of dental restorations, and (3) teeth detection and treatments. For each study, the AI model, type of dataset, sample size, and main results (accuracy, precision, sensitivity, and specificity) were reported. Conclusions: AI systems are promising as advantageous aids for diagnosis, prediction, and treatment in dentistry, with a high degree of accuracy. Despite the AI promises, several limitations are still unresolved and must be addressed to bridge the gap between technology and clinical applications. [ABSTRACT FROM AUTHOR]

Objectives: To compare the mechanical performance of partially replaced (repaired) intra-coronal restorations to totally replaced ones in root canal-treated teeth. Methods: Thirty maxillary second premolars were selected according to strict criteria, mounted on moulds, and had mesio-occluso-distal (MOD) cavities prepared. Resin composite restorative material was used to perform the initial restoration, followed by aging procedures using thermo-mechanical cycling fatigue to replicate six months of intraoral aging. The specimens were then randomly divided into two groups: a totally replaced restoration (TR) group (n = 15), which involved the preparation of a traditional endodontic access cavity after the complete removal of the pre-existing coronal filling; and a partially replaced restoration (PR) group (n = 15), which involved accessing the tooth through the pre-existing restoration without completely removing it. Root canal preparation and filling procedures were conducted, and the access cavity was sealed with a new resin composite restoration, followed by a new thermo-mechanical cycling aging procedure. Finally, the specimens were submitted to a static fracture test to measure specimen fracture strength and determine the failure mode pattern (repairable fracture or irreparable fracture). Chi-square and t-tests were used for statistical analysis. Results: Significant differences between the groups regarding their mechanical resistance were found. The average failure load of the TR group was 1115.13 N and 1330.23 N in the PR group (p = 0.002). Regarding the failure modes, the TR group exhibited eight irreparable fractures, while the PR group had four (p = 0.136). Conclusions: Partially replaced restorations presented higher fracture strength and led to fewer irreparable fractures when compared to totally replaced restorations in root canal-treated teeth. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Overview Conclusion To investigate the nature and availability of evidence on the clinical performance of posterior partial coverage restorations (PCR) fabricated from different ceramic materials, outcome definitions, measurement methods, study drop‐outs and follow ups.A systematic literature search (inception‐February 2024) was performed through MEDLINE, Scopus, CENTRAL, ClinicalTrials.gov, and the International Clinical Trials Registry Platform to identify clinical studies with a focus on posterior PCRs (onlays, occlusal veneers and partial crowns) with a minimum follow‐up of 1 year. Thirteen of 31 included studies were randomized controlled trials (RCT) and 18 non‐randomized studies of intervention (NRS). Six RCTs compared two different ceramic materials and might be suitable for meta‐analysis. Differences in study design, definition of survival, evaluation methods, and statistical models for survival analysis were identified as reasons for expected heterogeneity among studies. The most common reasons for restoration failures were ceramic fractures and retention loss.The evidence informing the effect of PCRs varied in definitions of survival and failure, complication classifications, and workflow approaches. RCTs addressing clinical performance of PCRs comparing different ceramic materials are available for conducting systematic reviews and meta‐analyses. [ABSTRACT FROM AUTHOR]

Ceramic is a commonly used material in dentistry for reconstructing missing teeth or their tissues due to its biocompatibility, durability and excellent esthetic properties. Despite these advantages, the ceramic restoration damage remains a significant clinical problem. Its causes can be divided into clinical and laboratory factors. The most known include uneven occlusion, improper preparation, trauma, or parafunctions. This study focuses on characterizing less known laboratory causes of ceramic restoration damage. We reviewed the current literature available in the PubMed and Scopus databases. On the basis of 63 selected studies, 3 basic causes of damage were identified: excessive stresses between the framework and ceramic veneering, poor quality of the connection between the facing layer and the substructure, and defects resulting from the nature of the ceramic material such as defects in the ceramic layer, brittleness and lack of flexibility. The stages of the manufacturing process of various permanent ceramic restorations were presented. By controlling these procedures, we can eliminate the errors, resulting in long-term effective functioning of the ceramic restorations. [ABSTRACT FROM AUTHOR]

Abstract Objectives To compare the mechanical performance of partially replaced (repaired) intra-coronal restorations to totally replaced ones in root canal-treated teeth. Methods Thirty maxillary second premolars were selected according to strict criteria, mounted on moulds, and had mesio-occluso-distal (MOD) cavities prepared. Resin composite restorative material was used to perform the initial restoration, followed by aging procedures using thermo-mechanical cycling fatigue to replicate six months of intraoral aging. The specimens were then randomly divided into two groups: a totally replaced restoration (TR) group (n = 15), which involved the preparation of a traditional endodontic access cavity after the complete removal of the pre-existing coronal filling; and a partially replaced restoration (PR) group (n = 15), which involved accessing the tooth through the pre-existing restoration without completely removing it. Root canal preparation and filling procedures were conducted, and the access cavity was sealed with a new resin composite restoration, followed by a new thermo-mechanical cycling aging procedure. Finally, the specimens were submitted to a static fracture test to measure specimen fracture strength and determine the failure mode pattern (repairable fracture or irreparable fracture). Chi-square and t-tests were used for statistical analysis. Results Significant differences between the groups regarding their mechanical resistance were found. The average failure load of the TR group was 1115.13 N and 1330.23 N in the PR group (p = 0.002). Regarding the failure modes, the TR group exhibited eight irreparable fractures, while the PR group had four (p = 0.136). Conclusions Partially replaced restorations presented higher fracture strength and led to fewer irreparable fractures when compared to totally replaced restorations in root canal-treated teeth.

ABSTRACT Objectives Material and Methods Results Conclusions Clinical Significance To analyze survival and complication rates for anterior and premolar laminate‐veneers out of different ceramic materials (feldspathic, leucite‐reinforced glass–ceramic [LRGC], lithium‐disilicate [LDS] and zirconia).A systematic literature search was conducted across multiple databases for clinical studies on ceramic laminate‐veneers with a minimum‐follow‐up of ≥ 1 year. The date of last search was on February 19, 2024. Survival, technical, esthetic and biological events were assessed for different laminate‐veneer materials at three observation periods (short‐ [1–3 years], mid‐ [4–6 years] and long‐term [≥ 7 years]).Twenty‐nine studies were included. Meta‐analysis revealed a pooled survival‐rate of 96.13% for feldspathic, 93.70% for LRGC and 96.81% for LDS at 10.4 years. No difference was found between materials. Complication rates (technical/esthetic/biological) were as follows: Feldspathic: 41.48%/19.64%/6.51%; LRGC: 29.87%/17.89%/4.4%; LDS: 6.1%/1.9%/0.45% at 10.4 years. Zirconia showed a 100% survival‐rate with no complications at 2.6 years. No long‐term data was available for zirconia.Feldspathic, LRGC and LDS laminate‐veneers showed high survival‐rates at long‐term observation. LDS slightly outperforms feldspathic and LRGC laminate‐veneers with lower long‐term complication rates. More studies providing long‐term data on zirconia laminate‐veneers are needed.Ceramic laminate‐veneers are a reliable treatment option. LDS may be preferred as a restorative material for long‐term success. [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: Several clinical and individual factors may play a role in the survival rate of dental restorations, such as characteristics related to the child's age and oral hygiene, and factors associated with the tooth, such as the type of material and number of surfaces to be restored. Aim: To analyse the survival rate of adhesive restorations on primary teeth and factors associated with restoration survival. Design: The study included dental records of children aged 3–12 years having received adhesive restorations on primary teeth at a Brazilian dental school between 2009 and 2019. A Kaplan–Meier survival curve was used to plot survival rates using the log‐rank test. A multivariate Cox regression model was run to identify individual and dental factors associated with restoration failure. Result s : The sample comprised 269 restored teeth in 111 children. Survival curves were similar for all materials (p =.20) and types of isolation (p =.05). The annual failure rate was 3.60% for glass ionomer cement, 1.23% for resin‐modified glass ionomer cement and 0.40% for composite resin. The following variables were associated with more failures: Class II restoration compared with Class I (HR = 1.96; 95%CI: 1.28–2.99, p <.001), proportion of decayed teeth (HR = 11.89; 95%CI: 2.80–50.57, p <.001) and child's age (HR = 1.17; 95%CI: 1.06–1.29, p <.001). Conclusion: The different materials and types of isolation had similar survival rates. Children with more decayed teeth have an increased risk of restoration failure. [ABSTRACT FROM AUTHOR]

In contemporary dental practice, clinicians have a variety of materials and options for restoring single teeth compromised by carious or non-carious diseases. According to studies and new concepts in biomimetic restorative dentistry, indirect ceramic restorations will play an increasingly important role in daily practice. We follow up and evaluate clinically three times over a 10-year period on eighty-six indirect restorations (n = 86) of lithium disilicate e.Max Press (Ivoclar, Schaan, Liechtenstein) in 32 patients. Restorations are evaluated in the 2nd, 5th, and 10th years after the fixation. Four of the restorations studied (n = 86) had to be replaced at year 5 follow-up because of fracture (failure rate: 4.65%; Kaplan–Maier). There are no restorations with bulky, cohesive fractures. Lithium disilicate ceramic restorations provide a good treatment alternative for a 5- to 10-year period of observation, and they can be successfully applied in dental practice in 91.73% to 98.84% of cases. Advancements in digital dentistry, including the use of intraoral scanners and CAD/CAM technology, are set to further refine the precision and efficiency of indirect restorations for distal teeth, enabling quicker turnaround times and improved fit. Additionally, ongoing developments in biomaterials promise to enhance the durability and biocompatibility of these restorations, potentially leading to better long-term success rates and patient satisfaction. The goal of this clinical study was to look at how well biomimetic ceramic overlays and onlays made of lithium disilicate held onto teeth with a IV-generation adhesive system for 10 years. The study also looked at how well the edges of the teeth adjusted and how strong the teeth were overall. [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]

Objectives: The latest generation of bonding agents is increasingly embraced and well-suited to fulfilling the requirements for durable restorations. This study aimed to assess microleakage levels of three self-etch adhesives (Clearfil SE (SE), Protect (PB), and Tri-S (TS) Bonds) in composite restorations at both occlusal and cervical borders, while considering the impact of water storage over different time intervals. Methods: Standard Class V cavities were prepared on buccal surfaces of 84 human premolars at the level of cementoenamel junction. The samples were randomly assigned to six groups (N=14). The corresponding bonding procedure in each group was completed, and the cavities were filled using Clearfil AP-X (Kuraray). Following thermocycling, the teeth were stored in deionized water within an incubator for 24-hour and 6-month intervals. Statistical analysis of microleakage data was conducted utilizing Kruskal-Wallis and Mann-Whitney U tests at p<0.05. Results: Following a 24-hour interval, the level of microleakage at the occlusal surface was greater than the gingival surface for SE. No statistically significant differences were observed in microleakage at the occlusal and cervical borders after 24h of water storage for the PB and TS groups (P=0.51, 0.16). None of the SE and TS group samples showed leakage at the occlusal or cervical margins following a 6-month interval. Conclusion: Self-etching bonding agents indicated increased occlusal microleakage compared to the cervical margin microleakage. [ABSTRACT FROM AUTHOR]

Introduction: Endodontic therapy has been regarded as a safe treatment option with highly promising results in preserving natural teeth. Numerous factors may influence the longevity of endodontically treated teeth (ETT), thus altering their success/survival rate. This study aimed to determine the survival and success rates of endodontically treated premolars and molars with different complex restorative/prosthodontic treatments. Materials and Methods: A total of 190 patients with an ETT were included, who had received final coronal restoration up to 14 days after the temporary one and at least one year prior to the enrollment. The investigator evaluated the quality of endodontic filling, coronal restoration, mobility, and proximal contacts. Data were analyzed with multiple binary logistic regression and the Chi-Square test. Results: The average duration of followup was 28.6±11.9 months. Overall, 89.4% (170/190) of the teeth survived. The overall success rate for the investigated teeth was 70.5% (134/190). Success rates of 100% for crown, 95.7% for post and core crown (PCC), and 94.7% for amalgam build-up with post were achieved. However, the success rates were 75%, 52.5%, and 50% for amalgam build-up, composite build-up, and PCC with crown lengthening, respectively. The Chi-square test revealed that there was a significant difference between the different restorations in terms of success (P<0.001). Multiple binary logistic regression models revealed that coronal leakage (P=0.048), obturation void (P=0.037), obturation length (P=0.020), mobility (P=0.002), type of the restoration (P<0.001), and proximal contact (P<0.001) were significant predictors for success. However, apical lucency, root length, marginal caries, tooth type, and post did not appear to be significant indicators of success (P>0.05). Conclusions: ETT with minimal mobility, exhibiting underfilled obturations without visible voids, and having received crown/PCC/amalgam build-up with a post, along with the presence of both proximal contacts, tend to exhibit a significantly high success rate. [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]

Objective: To evaluate the effect of various types of cigarettes on the color of microhybrid (MH) and nanofilled (NF) resin composites. Material and Methods: Disc-shaped specimens (5 × 2 mm; n = 10) of MH (Filtek Z250, 3M) or NF (Filtek Z350XT, 3M) were exposed or not (control) to cigarette smoke (20 cigarettes daily × 5 days) from four commercial cigarettes with increasing concentrations of tar, nicotine, and carbon monoxide (MSL < MFP < MBI < MR). The cigarettes had an additional filter (MFP) or added flavoring (MBI). The color parameters (L*, a*, b*, ΔEab,ΔE00) were determined considering baseline versus after exposure to cigarette smoke. Data were submitted to Mann-Whitney, Kruskal-Wallis, and Dunn tests (α=0.05). Results: Significant differences were observed for ΔL* (toward black), Δa* (toward red), ΔEab, and ΔE00 of both resin composites compared with the control (p

Abstract This study evaluated the effect of different occlusal surface finishes (glaze and silica glass infiltration) on surface characteristics and fatigue behavior of partially stabilized zirconia (PSZ) plates adhesively bonded onto epoxy resin discs. PSZ disc specimens (n = 15; Katana blocks STML, Kuraray Noritake Dental) were produced (Ø = 10 mm; thickness = 1.2 mm) and allocated into 3 groups: As sintered (S), silica glass infiltration (SGI), and glaze application (G). The PSZ intaglio surface was air-abraded with 50-µm alumina powder followed by bonding agent application. All produced PSZ were adhesively cemented onto dentin analogue discs made of epoxy resin material (Ø = 10 mm; thickness = 2 mm). Step stress fatigue test was performed (load ranging from 200 to 1800 N; step size 100 N and 10,000 cycles; 20 Hz). The topographic, microstructural, and fractographic analyses were performed by scanning electron microscopy. Results: No statistically significant difference in fatigue behavior was detected among the groups. All failures started at the bonding surface. Silica glass-infiltration and glaze layer application provided a smoothing effect, while the sintered group had a surface with grooves. The occlusal surface finishing method (silica glass infiltration or glazing) had no deleterious effect on fatigue behavior of adhesively bonded PSZ plates.

With the advancement of science over time, composite resins have undergone several scientific updates. Among these updates is the development of flow resins, characterized by high viscosity particles. But resins have some disadvantages, sunch as the formation of bubbles, a problem that was explored in this research. This article compared 4 different brands of flow resin (Opus Bulk Fill Flow Resin (FGM) - Filtek MR Bulk Fill Flowable (3M) - Tetric N-Flow Bulk Fill Resin and SDR Plus Bulk Fill Flowable Resin (DENSTPLY) took it under the microscope after applying these resins to laboratory prototypes, so that the formation of these bubbles can be evaluated more closely. As a result, it was possible to conclude that the Tetric N-Flow Bulk Fill brand resins are the flow composite resins that enable the formation of the smallest amount of bubbles in the process restorative. Tetric N-Flow Bulk Fill, due to its in vitro clinical performance superior to the competitors compared in this article, must be applied below the layer of conventional resin that will be used by the incremental technique with care in spatulation, so that formation can be avoided. of bubbles in a way that harms the restoration. [ABSTRACT FROM AUTHOR]

Ichraq Oulghazi, Amal El Yamani, Bouabid Morchad Prosthodontics Department, Mohammed V University, Rabat, MoroccoCorrespondence: Ichraq Oulghazi, Prosthodontics department, Mohammed V University, Rabat, 10112, Morocco, Tel +212707163587, Email ichraqoul98@gmail.comPurpose: The aim of this work is to conduct a literature review to highlight all the parameters involved in sub-prosthetic radicular fractures of teeth supported by metallic dental core.Materials and Methods: The following research was performed among published studies over the last 10 years in two PubMed/Medline and Scopus and supplemented by manual searching within the bibliographies. The search was restricted to publications in English and French.Results: Out of the 1464 articles initially identified, 18 studies met our inclusion criteria and were subsequently included in the literature review. These consisted of eight Finite Element Analysis Studies, two Retrospective Studies and one Randomized Controlled Trial. The results of this review show that radicular fractures are influenced by several variables, including predisposition, with maxillary premolars and mandibular molars being the most commonly affected teeth. Intracanal preparation can induce crack formation, leading to localized high stress concentrations. Increased ferrule height to 2 mm significantly enhances dental fracture resistance. Using high modulus of elasticity alloys results in nearly complete stress transmission to dentin due to their limited deformability and absorption capacity. The highest fracture resistance is achieved when posts are sealed using resin-modified glass-ionomer cement. Longer posts may be preferable to prevent vertical fractures. Additionally, occlusal factors, through repetitive stresses, contribute to crack propagation from surface defects, a phenomenon termed fatigue fracture.Conclusion: These findings have significant implications. Practitioners should be aware of the predisposition of certain teeth, the importance of preserving the ferrule effect, the choice of root post materials, post Cement Material and the role of occlusal forces in managing and preventing vertical root fractures.Keywords: endodontically treated teeth, root fracture, radicular fracture, tooth fracture, dental restoration failure, biomechanical factor, stress factor, cast post, metal post, post and core technique, dental posts, metallic coronoradicular restoration

Abstract Background While the concept of angled screw channels has gained popularity, there remains a scarcity of research concerning the torque loss and fracture strength of monolithic zirconia restorations with various screw channel angulations when exposed to thermomechanical cycling. This in-vitro study aimed to evaluate the reverse torque value and fracture resistance of one-piece screw-retained hybrid monolithic zirconia restorations with angulated screw channels after thermomechanical cycling. Methods One-piece monolithic zirconia restorations, with angulated screw channels set at 0°, 15°, and 25° (n = 6 per angulation) were fabricated and bonded to titanium inserts using a dual-cure adhesive resin cement. These assemblies were then screwed to implant fixtures embedded in acrylic resin using an omnigrip screwdriver, and reverse torque values were recorded before and after thermomechanical cycles. Additionally, fracture modes were assessed subsequent to the application of compressive load. One-way ANOVA and Bonferroni post hoc test were used to compare the groups (α = 0.05). Results The study groups were significantly different regarding the fracture resistance (P = 0.0015), but only insignificantly different in the mean percentage torque loss (P = 0.4400). Specifically, the fracture resistance of the 15° group was insignificantly higher compared to the 0° group (P = 0.9037), but significantly higher compared to the 25° group (P = 0.0051). Furthermore, the fracture resistance of the 0° group was significantly higher than that of the 25° group (P = 0.0114). Conclusions One-piece hybrid monolithic zirconia restorations with angulated screw channels can be considered an acceptable choice for angulated implants in esthetic areas, providing satisfactory fracture strength and torque loss.

The aim of this study was to assess whether immediate bone reconstruction after removal of a fractured dental implant in the posterior mandible provides a sound base for implant replacement, with a favourable treatment outcome and high patient satisfaction. Eight consecutive patients with a fractured implant neck were included. The implant was removed via osteotomy, following which the site was immediately repaired with a mixture of autogenous bone and bone substitute. After a 4-month healing period, sufficient bone and favourable soft tissue conditions were present, allowing implant placement with adequate primary stability. After a further 3 months, the implants were restored with an all-ceramic restoration. Patient satisfaction, the aesthetic outcome, complications, and postoperative morbidity were assessed using standardized clinical and radiographic examinations up to 5 years after crown placement. No implant failures were observed during the follow-up. Plaque accumulation, the presence of calculus, bleeding tendency, and peri-implant inflammation indices were low, indicating healthy peri-implant conditions. The mean marginal bone level change at the 5-year follow-up was − 0.17 ± 0.46 mm. All patients reported a high level of satisfaction (mean overall score 9.3 ± 0.5). In conclusion, immediate reconstruction of the hard tissue after removal of a fractured dental implant is a viable treatment option. This approach facilitates rehabilitation, reduces morbidity, and leads to favourable aesthetic outcomes. [ABSTRACT FROM AUTHOR]

PURPOSE. The study aims to investigate the influence of the ferrule effect and types of posts on the stress distribution in three morphological types of the maxillary central incisor. MATERIALS AND METHODS. Nine models were created for 3 maxillary central incisor morphology types: "Fat" type - crown 12.5 mm, root 13 mm, and buccolingual cervical diameter 7.5 mm, "Medium" type - crown 11 mm, root 14 mm, and buccolingual cervical diameter 6.5 mm, and "Slim" type - crown 9.5 mm, root 15 mm, and buccolingual cervical diameter 5.5 mm. Each model received an anatomical castable post-and-core or glass-fiber post with resin composite core and three ferrule heights (nonexistent, 1 mm, and 2 mm). Then, a load of 14 N was applied at the cingulum with a 45° slope to the long axis of the tooth. The Maximum Principal Stress and the Minimum Principal Stress were calculated in the root dentin, crown, and core. RESULTS. Higher tensile and compression stress values were observed in root dentin using the metallic post compared to the fiber post, being higher in the slim type maxillary central incisor than in the medium and fat types. Concerning the three anatomical types of maxillary central incisors, the slim type without ferrule height in mm presented the highest tensile stress in the dentin, for both types of metal and fiber posts. CONCLUSION. Post system and tooth morphology were able to modify the biomechanical response of restored endodontically-treated incisors, showing the importance of personalized dental treatment for each case. [ABSTRACT FROM AUTHOR]

Background: While the concept of angled screw channels has gained popularity, there remains a scarcity of research concerning the torque loss and fracture strength of monolithic zirconia restorations with various screw channel angulations when exposed to thermomechanical cycling. This in-vitro study aimed to evaluate the reverse torque value and fracture resistance of one-piece screw-retained hybrid monolithic zirconia restorations with angulated screw channels after thermomechanical cycling. Methods: One-piece monolithic zirconia restorations, with angulated screw channels set at 0°, 15°, and 25° (n = 6 per angulation) were fabricated and bonded to titanium inserts using a dual-cure adhesive resin cement. These assemblies were then screwed to implant fixtures embedded in acrylic resin using an omnigrip screwdriver, and reverse torque values were recorded before and after thermomechanical cycles. Additionally, fracture modes were assessed subsequent to the application of compressive load. One-way ANOVA and Bonferroni post hoc test were used to compare the groups (α = 0.05). Results: The study groups were significantly different regarding the fracture resistance (P = 0.0015), but only insignificantly different in the mean percentage torque loss (P = 0.4400). Specifically, the fracture resistance of the 15° group was insignificantly higher compared to the 0° group (P = 0.9037), but significantly higher compared to the 25° group (P = 0.0051). Furthermore, the fracture resistance of the 0° group was significantly higher than that of the 25° group (P = 0.0114). Conclusions: One-piece hybrid monolithic zirconia restorations with angulated screw channels can be considered an acceptable choice for angulated implants in esthetic areas, providing satisfactory fracture strength and torque loss. [ABSTRACT FROM AUTHOR]

In contemporary dental practice, clinicians have a variety of materials and options for restoring single teeth compromised by carious or non-carious diseases. According to studies and new concepts in biomimetic restorative dentistry, indirect ceramic restorations will play an increasingly important role in daily practice. We follow up and evaluate clinically three times over a 10-year period on eighty-six indirect restorations (n = 86) of lithium disilicate e.Max Press (Ivoclar, Schaan, Liechtenstein) in 32 patients. Restorations are evaluated in the 2nd, 5th, and 10th years after the fixation. Four of the restorations studied (n = 86) had to be replaced at year 5 follow-up because of fracture (failure rate: 4.65%; Kaplan–Maier). There are no restorations with bulky, cohesive fractures. Lithium disilicate ceramic restorations provide a good treatment alternative for a 5- to 10-year period of observation, and they can be successfully applied in dental practice in 91.73% to 98.84% of cases. Advancements in digital dentistry, including the use of intraoral scanners and CAD/CAM technology, are set to further refine the precision and efficiency of indirect restorations for distal teeth, enabling quicker turnaround times and improved fit. Additionally, ongoing developments in biomaterials promise to enhance the durability and biocompatibility of these restorations, potentially leading to better long-term success rates and patient satisfaction. The goal of this clinical study was to look at how well biomimetic ceramic overlays and onlays made of lithium disilicate held onto teeth with a IV-generation adhesive system for 10 years. The study also looked at how well the edges of the teeth adjusted and how strong the teeth were overall.

Introduction and Objective: Although the use of ceramic veneers is widespread, their failures are seldom reported. When fractures do occur, they are often related to treatment planning. This case report describes a 6.5-year follow-up of a restorative treatment involving ceramic laminate veneers on a patient with a nail-biting habit. Case report: After two restorations failed, repair with composite resin was chosen as an intermediary treatment, and the clinical steps until the ultimate replacement of the ceramics are described. Results and Conclusion: The repair resulted in postponing the restorations replacement for almost five years. It highlights that replacement does not need to be the first treatment option in cases of failures of feldspar ceramic laminate veneers. These failures may be managed conservatively with a composite resin repair, with the advantage of postponing the need for replacement. [ABSTRACT FROM AUTHOR]

Abstract Resin composites containing surface pre-reacted glass (S-PRG) have been introduced to reduce demineralization and improve remineralization of the tooth structure. However, water diffusion within the material is necessary for its action, which can impair its overall physicomechanical properties over time, including color stability. This study aimed to evaluate the color stability and related degree of conversion (DC) of four resin composites. Discs (6 x 4 mm, n = 5/group) of microhybrid (MH), nanofilled (NF), nanohybrid (NH), and S-PRG-based nanohybrid (S-PRG-NH) composites with two opacities (A2/A2E and A2O/A2D) were prepared. Color (CIELab and CIEDE2000) was evaluated with a spectrophotometer after aging in grape juice (2 x 10 min/10mL/7days). The DC was analyzed by using Fourier transform infrared spectroscopy before and after light-curing. Data were statistically analyzed by using two-way analysis of variance and post-hoc least significant difference tests (p

Teeth with altered size and shape, incisal wear, and inadequate position affect the smile and dentofacial harmony. The aim of this article was to describe a simple and safe protocol for an additive technique with composite resin and cosmetic enameloplasty to improve a patient's smile. A 24-year-old man complained about the appearance of his smile regarding color, shape, and position of the maxillary anterior teeth. Relevant dental history included previous orthodontic treatment with inadequate completion. The clinical examination revealed a disharmony of the smile caused by size and shape alterations of the incisors, a white spot on the right central incisor, incisal wear of the canines, and uneven incisal edges between the maxillary anterior teeth. Treatment with direct composite restoration and enameloplasty was performed in line with the current conservative approach in dentistry. The patient was recalled for 54 months. The use of appropriate techniques in enameloplasty allowed the desired outcome to be observed over the 54 months of follow-up. With this method, it is possible to perform future repair and/or modification, and it may increase the longevity of the restoration. Esthetic and functional results were achieved by careful planning and execution as well as periodic recalls. This conservative approach is a useful alternative to conventional restorations, reducing invasive treatments, chairside time, and costs. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the load-to-fracture of procedures changing crown-to-root ratio (RCRR) aimed to restore severely damaged upper central incisors to avoid tooth extraction compared to implant placement. There is no evidence on load capability after apical root resection (AR), orthodontic extrusion (OE), and surgical crown lengthening (SCL) in respect to RCRR, respectively. Material and methods: Human maxillary central incisors were endodontically treated, decoronated, and divided into 4 groups (n = 48). The following specimen preparation was performed: (I) adhesive core-and-post build-up (control), (II) as (I) and 2 mm apical root resection (AR), (III) before adhesive core-and-post build-up teeth were shortened 2 mm coronally (OE) (IV) as (I), but specimens were embedded 4 mm instead of 2 mm below the CEJ (SCL), group (V) implant-borne restoration with individual all-ceramic abutments (n = 12; ∅4.1/l = 12 mm) (IBR). All specimens received all-ceramic crowns, thermo-mechanical (TML), and subsequent linear loading (LL) until failure. RCRR were calculated and log-rank, Kruskal–Wallis, Mann–Whitney U, ANOVA, and chi-square tests applied (p = 0.05). Results: Fracture loads after subsequent LL differed significantly (p = 0.001) between groups, while implants showed the highest values. Fmax median (min/max) were as follows: (I) 252 (204/542), (II) 293 (243/443), (III) 253 (183/371), (IV) 195 (140/274), and (V) 446 (370/539). Pair-wise comparison showed significant differences (p = 0.001) between group I/IV and group V, I, and IV (p = 0.045), II and IV (p = 0.001), and III compared to IV (p = 0.033), respectively. RCRR below 1 significantly increased load capability compared to RCRR = 1. Conclusions: OE appears to preferably ensure biomechanical stability of teeth that are endodontically treated and receive core-and-post and crown placement compared to SCL. AR has no adverse biomechanical impact. RCRR < 1 is biomechanically beneficial. Clinical relevance: For endodontically treated and restored teeth, orthodontic extrusion should be preferred compared to surgical crown lengthening prior single-crown restoration. As orthodontic extrusion, apical root resection has no adverse effect on load capability. Single-crown implant-borne restorations are most load capable. [ABSTRACT FROM AUTHOR]

Despite the widespread use of titanium implants in orthopedic and dental surgeries, concerns have recently emerged regarding potential deformations and fractures after osseointegration. In a recent clinical case, a titanium implant fractured after successful osseointegration. This fracture occurred despite the absence of any significant trauma or excessive external force applied to the area. The fracture was attributed to a combination of factors, including abutment design flaws, material fatigue, and biomechanical stress imposed on the implant during functional loading. This raises concerns about the long-term durability and reliability of titanium implants, particularly in high-stress areas such as the posterior region or weight-bearing bones. An image was made with scanning electron microscopy showing the fracture region near the prosthetic platform and highlighting the knowledge that despite their ductility, titanium implants can fracture. [ABSTRACT FROM AUTHOR]

Purpose: To report the performance of a repair service set for the retrieval of fractured screws and to compare three clinical assessments to an in vitro assessment to verify the completeness of removal of the fractured screws. Materials and Methods: Twelve clinicians were asked to remove fractured implant abutment screws from prepared specimens by means of a repair service set. The completeness of the removal of any abutment screw material was measured by the fit of an impression post, a dental surgery microscope, and the use of an elastomeric impression material. Results: After the participants attempted to remove the fractured screw with the repair service set, 100%, 83.3%, 66.7%, and 75% of the fractured screws were considered successful in the impression post, dental surgery microscope, silicone replica, and stereomicroscope assessments, respectively. Conclusion: The retrieval of fractured screws succeeded in 75% of the cases. The silicone replica technique and the dental surgery microscope had similar diagnostic values to the stereoscopic microscope assessment. [ABSTRACT FROM AUTHOR]

Abstract Objectives The term “cracked tooth” is used to describe an incomplete fracture initiated from the crown and progressing towards a subgingival direction. Despite the high prevalence of cracked teeth and their frequent association with symptoms and pulpal or periapical pathoses, there is still no consensus in the literature with regard to their restorative and endodontic management. Therefore, the aim of this narrative review was to evaluate the most relevant research and provide an up‐to‐date comprehensive overview regarding the treatment of cracked teeth. Materials and Methods An electronic literature search was carried out in MEDLINE (via Ovid), Embase (via Ovid), Scopus, and Web of Science as well as several “Grey literature” sources up to February 22nd 2022 using a combination of pre‐specified ‘free‐text' terms (keywords) and “subject headings.” The search process was supplemented by handsearching in relevant dental journals and reference lists. This narrative review focused on clinical follow‐up studies (observational or interventional studies, case series/reports), laboratory studies and systematic reviews written in English language that reported data on treatment of permanent cracked teeth. The selection of relevant studies was carried out by two reviewers (AK and DG) working independently in two consecutive stages: title/abstract screening and full‐text retrieval. Any discrepancies in the study selection were resolved by discussion between the reviewers. Results In total, 64 articles were selected for inclusion in this narrative review. Conclusions Cracked teeth with normal pulp or reversible pulpitis have exhibited high pulp and tooth survival rates by the provision of direct or indirect composite restorations. Besides, recent data favour monitoring, especially in the absence of symptoms or compromised tooth structure. When endodontic intervention is required, current evidence suggests that along with appropriate restorative management, outcomes of cracked teeth may be comparable to those of non‐cracked root filled teeth.

Introduction: This randomized clinical study aimed to evaluate the clinical performance of composite and compomer materials in primary molars over two years. Methods: Children aged five to six years with at least two carious proximal surface primary molars were screened for resin-hybrid composite (Kerr Herculite Classic) and compomer (Dyract XP and R&D Series Nova) restorations. The restorations were clinically evaluated after 3, 6, 9, 12, 15, 18, and 24 months using the modified United States Public Health Service criteria. Statistical analyses were performed using Chi-square, McNemar, z-tests, and Kaplan-Meier survival analysis. P0.05). No significant differences were observed between the three materials concerning retention, color matching, marginal discoloration, anatomic form, marginal integrity, secondary caries, and surface texture (P>0.05). No statistically significant differences were also found between the effects of the cavity type, the tooth position in the arch, the age of the patient, the restorative material, and the lining material on the survival rates of the teeth (P>0.05). Restoration loss was higher in males than females, and a statistically significant relationship was observed in terms of gender (P=0.017). Restoration loss in the first primary molars (8.3%) was greater than that in the second primary molars (6.7%) (P=0.041). Conclusion: Both composite and compomer restorations were clinically successful over two years.

Damage in the bonding interface is a significant factor that leads to premature failure of dental bonded restorations. The imperfectly bonded dentin-adhesive interface is susceptible to hydrolytic degradation and bacterial and enzyme attack, severely jeopardizing restorations' longevity. Developing caries around previously made restorations, also called "recurrent or secondary caries," is a significant health problem. The replacement of restorations is the most prevailing treatment in dental clinics, leading to the so-called "tooth death spiral". In other words, every time a restoration is replaced, more tooth tissue is removed, increasing the size of the restorations until the tooth is eventually lost. This process leads to high financial costs and detriment to patients' quality of life. Since the complexity of the oral cavity makes prevention a challenging task, novel strategies in Dental Materials and Operative fields are required. This article briefly overviews the physiological dentin substrate, features of dentin bonding, challenges and clinical relevance. We discussed the anatomy of the dental bonding interface, aspects of the degradation at the resin-dentin interface, extrinsic and intrinsic factors affecting dental bonding longevity, perspectives on resin and collagen degradation and how these subjects are connected. In this narrative review, we also outlined the recent progress in overcoming dental bonding challenges through bioinspiration, nanotechnology and advanced techniques to reduce degradation and improve dental bonding longevity. [ABSTRACT FROM AUTHOR]

Dental treatment after endodontic therapy is quite challenging in clinical practice. While multiple post-and-core systems emerged and disappeared in the dental field, the historical process was laborious and still requires several up to date scientific evidence. Furthermore, once considered the gold standard, rigid metallic post-and-cores might be considered a limited option. Moreover, the development of glass-fiber posts and the biomechanical principles for root preparation bring multiple advantages, but also raise concerns over guidelines and indications. This review examined the classic literature so that clinicians may understand the concepts behind post endodontic restorative treatments and the doubts that still remain in the daily practice before performing this restorative modality.

Objectives: To test if cigarette smoke (CS) causes discoloration of enamel, dentin, and composite resin restorations and induces color mismatch between dental hard tissues and the restorations, and to compare the findings with the effects of aerosol generated by the tobacco heating system (THS) 2.2. Method and materials: Twenty-two human premolars were prepared with Class V cavities restored with Filtek Supreme Ultra (3M Espe) composite resin. Teeth were divided into two groups and exposed to either CS from 20 reference cigarettes (3R4F) or aerosol from 20 THS 2.2 tobacco heat sticks 4 days a week for 3 weeks. CIE L*a*b* color was assessed before and after exposure and brushing at 1, 2, and 3 weeks. Color match, marginal discoloration, marginal integrity, and surface texture of the Class V restoration were assessed according to a modified US Public Health Service (USPHS) criterion. Results: Marked discoloration of enamel and dentin was observed following 3 weeks of CS exposure (ΔE = 8.8 ± 2.6 and 21.3 ± 4.4, respectively), and color mismatch occurred between the composite resin restorations (ΔE = 25.6 ± 3.8) and dental hard tissues. Discoloration was minimal in the enamel, dentin, and composite resin restorations in the THS 2.2 group, and no color mismatch was observed after 3 weeks of THS 2.2 aerosol exposure. Conclusion: CS causes significant tooth discoloration and induces color mismatch between dental hard tissues and composite resin restorations. Reducing or eliminating the deposits derived from tobacco combustion could minimize the impact of tobacco products on tooth discoloration. [ABSTRACT FROM AUTHOR]

No evidence-based prosthetic treatment concept for 3-unit fixed-dental-prostheses (FDPs) on ceramic implants is currently available. Therefore, the aim of this in vitro study was to investigate the failure load and fatigue behavior of monolithic and bi-layer zirconia FDPs supported by one-piece ceramic implants. Eighty 3-unit FDPs supported by 160 zirconia-implants (ceramic.implant; vitaclinical) were divided into 4 groups (n = 20 each): Group Z-HT: 3Y-TZP monolithic-zirconia (Vita-YZ-HT); Group Z-ST: 4Y-TZP monolithic-zirconia (Vita-YZ-ST); Group FL: 3Y-TZP zirconia (Vita-YZ-HT) with facial-veneer (Vita-VM9); Group RL (Rapid-layer): PICN "table-top" (Vita-Enamic), 3Y-TZP-framework (Vita-YZ-HT). Half of the test samples (n = 10/group) were fatigued in a mouth-motion chewing-simulator (F = 98 N, 1.2 million-cycles) with simultaneous thermocycling (5–55 °C). All specimens (fatigued and non-fatigued) were afterwards exposed to single-load-to-failure-testing (Z010, Zwick). Statistical analysis was performed using ANOVA, Tukey's post-hoc tests and two-sample t-tests (p < 0.05, Bonferroni-corrected where appropriate). All specimens withstood fatigue application. While the effect of fatigue was not significant in any group (p = 0.714), the choice of material had a significant effect (p < 0.001). Material FL recorded the highest failure loads, followed by Z-ST, Z-HT and RL, both with and without fatigue application. Taken together, all tested FDP material combinations survived chewing forces that exceeded physiological levels. Bi-Layer FL and monolithic Z-ST showed the highest resilience and might serve as reliable prosthetic reconstruction concepts for 3-unit FDPs on ceramic implants. [ABSTRACT FROM AUTHOR]

Objective: The use of vertical margin design in all-ceramic restoration has generated inquiries regarding its clinical efficacy under diverse dynamic oral conditions. This research aims to assess the marginal fit and fracture resistance of monolithic zirconia crowns featuring vertical margin design as opposed to those with conventional horizontal margin design., Materials and Methods: Two metal dies were employed to generate replicated resin dies mimicking mandibular first molar preparation. The metal dies were precision-engineered with two margin designs: vertical margin design presenting a shoulderless configuration (Featheredge) and horizontal margin design (Radial Shoulder). Forty zirconia crowns were produced on the replicated resin dies using two varieties of monolithic zirconia, with twenty crowns in each category: pre-shaded and multilayered zirconia. Both sets were further subdivided into two groups based on the finish line configuration utilized (n = 10). The vertical marginal gap of the zirconia crowns was gauged before and after thermocycling (5-55oC/5000 cycles), followed by loading the crowns until fracture occurred. Statistical analysis was performed using one-way analysis of variance (ANOVA), accompanied by Bonferroni's post hoc test and independent t-test for pairwise comparisons., Results: The Shoulder subgroup of BruxZir exhibited the highest mean marginal gap value (120.06 ± 10.15 µ), while the Featheredge subgroup of BruxZir displayed the lowest value (49.72 ± 6.53 µ). Among the BruxZir group, the Featheredge subgroup showcased the highest mean fracture resistance value (4251.57 ± 279.90 N), whereas the Shoulder subgroup recorded the lowest value (1721.60 ± 225.16 N)., Conclusion: Monolithic zirconia crowns with vertical margin design (Featheredge) demonstrated statistically enhanced performance compared to conventional horizontal margin design, as evidenced by lower marginal gap values and increased fracture resistance tolerance., (© 2025 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Objectives: A new abutment-free implant connection allows for direct screwing of FDPs on implants to avoid complications caused by cement rests or screw loosening, which may affect to screw torque and load distribution. The objective of this study was to test the initial (Fi) and final failure (Ff) loads and torque changes of abutment-free monolithic zirconia CAD-CAM fixed dental prostheses (FDPs) compared to titanium FDPs on different abutment designs., Methods: Three-unit screw-retained FDPs (n = 50) on two implants (n = 100) were divided into groups (n = 10) based on the implant-abutment connection and material of the supra-structure: (1) abutment-free monolithic CAD-CAM zirconia FDP (Abut-free-Zr), (2) abutment-free veneered titanium FDPs (Abut-free-Ti), (3) monolithic zirconia FDPs with titanium base abutments (Zr-Ti-Base), (4) monolithic zirconia FDPs on multi-unit abutments (Zr-MU), (5) veneered titanium FDP on multi-unit abutments (Ti-MU). All specimens were subjected to thermo-mechanical aging (1'200'000 Cycles, 49 N, 1.67 Hz, 5º to 50º C, dwelling time 120 s). Torque of the screws was measured, and static loading was performed. Data were tested using ANOVA and Tukey's tests (p < 0.05)., Results: After thermo-mechanical aging, all screws showed reduced torque, Ti-MU significantly more reduction compared to Abut-Free-Ti (p = 0.0021). Titanium groups showed significantly lower Fi (N) values (171.4-230 vs 1272-1358,) due to veneering porcelain fractures (p = 0.0001) and significantly higher Ff (N) (2922 -3029 N vs. 1272-1358) values than zirconia groups (p < 0.0001)., Conclusions: Three-unit abutment-free monolithic zirconia FPDs showed similar failure loads compared to other zirconia groups, while the titanium groups exhibited superior final failure loads. Different abutment designs did not seem to affect the failure loads., Clinical Significance: The specific design of the novel implant interface allows for the fabrication of implant supported FDPs with personalized design directly on implant level without abutments. The monolithic zirconia FDPs on abutment-free implant connection can be used with good confidence since they exhibit similar mechanical stability as monolithic zirconia FDPs on titanium-base or multi-unit abutments., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: T.S., K.M, M.Ö., and J.H. report no financial interests related to any products involved in this study. R.J. is a patent-holder of the implant connection design of the tested implant (MaTRIx implant, TRI Dental Implants Int. AG, Zürich, Switzerland). Study implant materials such as implants and abutments were provided by TRI Dental Implants for free. Zirconia and titanium materials for the fixed dental prostheses were provided by ZirkonZahn. R.J. received lecture fees and research support from TRI Dental Implants in the past., (Copyright © 2025. Published by Elsevier Ltd.)

Objectives: This study aims to compare the clinical performance of 3D printed endocrowns (ECs) and prefabricated zirconia crowns (PZRCs) in restoring pulpotomized primary molars, over 3, 6, and 12 months., Methods: Thirty pulpotomized mandibular primary molars in 16 children aged 4-8 years were randomized with a 1:1 allocation ratio into two groups: group (A), PZRCs, and group (B), 3D-printed ECs. All restorations were evaluated for esthetic, functional, and biological properties using FDI criteria at 3-, 6-, and 12-month intervals. Restorations requiring repair or replacement (a total restoration score of 4 or 5, respectively) were recorded as failures. For each outcome variable, the Mann-Whitney U test was used for intergroup comparisons, while Friedman's test was used for intragroup comparisons, followed by the Nemenyi post hoc test. The significance level was set at p ≤ 0.05., Results: No statistically significant difference in survival times between PZRCs and ECs was found (12 and 11.36 months, respectively). Both restoration types showed a clinical success rate of 64.3 %. No statistically significant difference was found between the esthetic success of PZRCs and ECs (92.9 % and 71.4 %, respectively), matching their functional success rates. Similarly, no statistically significant difference was observed in the biological success of ECs and PZRCs (78.6 % and 64.3 %, respectively)., Conclusion: 3D-printed ECs can be a promising and convenient alternative to full-coverage restorations in pulpotomized primary molars for up to one year., Clinical Significance: Restoration of pulpotomized primary molars using 3D-printed ECs offers a more conservative and esthetic option with minimal trauma to gingival tissues and reduced chair time, which is crucial for pediatric patients., Clinical Registration Number: NCT04909827., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Restoring extensively damaged endodontically treated teeth presents a challenging task due to the state of biomechanical deterioration affecting long-term prognosis. Therefore, the study aims to assess and compare the biomechanical performance of endocrowns and post core-crown restorations in anterior endodontically treated teeth with severe coronal structure loss. Following PRISMA guidelines, a systematic search was conducted using PubMed, Scopus, Web of Science, and Google Scholar for articles published from January 2014 to March 2024. Two independent reviewers screened and selected studies based on the predefined inclusion and exclusion criteria. The included studies were analyzed using the QUIN tool for risk of bias assessment in in-vitro studies. Additionally, the biomechanical outcomes were collected for qualitative comparative analysis. Twelve studies were included in this systematic review. In most studies, Endocrowns demonstrated comparable fatigue resistance under load to failure to post core-crown restorations. Endocrowns without ferrule exhibited a higher rate of debonding but had significantly more repairable failures. Conversely, post core-crown restorations demonstrated higher fracture resistance with the presence of ferrule, but were associated with more catastrophic failure patterns. Additionally, endocrowns generated lower stress levels in both the restorative material and the luting material compared to post core-crown restorations. Among the tested materials, lithium disilicate ceramics provided the best biomechanical properties. Overall, the studies included provided sufficient information for most evaluation criteria of the QUIN risk of bias assessment tool. Endocrowns are a viable and conservative approach for restoring endodontically treated anterior teeth, offering comparable biomechanical performance to traditional post core-crown restorations and less catastrophic failures. The findings of this systematic review suggest that endocrown restorations, especially with lithium disilicate ceramics and proper ferrule design, can improve fracture resistance and longevity of rehabilitated teeth, enhancing patient outcomes for severely damaged anterior endodontically treated teeth., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Subperiosteal implants have experienced fluctuating popularity since their inception. Initially introduced in the mid-20th century, they were overshadowed by the development and success of endosteal implants, which are now the standard in dental implantology. Modern subperiosteal implants are typically custom-made using computer-aided design and computer-aided manufacturing technologies, which ensure a precise fit to the patient's bone anatomy. A meta-analysis was conducted to evaluate the success rates, complications, and patient satisfaction associated with subperiosteal implants. Studies were selected based on predefined inclusion criteria, focusing on clinical trials and observational studies that reported on the long-term outcomes of subperiosteal implants., Competing Interests: Disclosure The authors received speaker’s honoraria from DePuys Synthes, West Chester, PA, USA, Brainlab AG, Munich, Germany, and KLS Martin Group, Tuttlingen, Germany., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Vertical and horizontal bone insufficiency in both the maxilla and mandible has long been a contraindication for implants. This review provides an overview of the long-term survival rates of implants in augmented alveolar bone after the guided bone regeneration (GBR) technique., Results: GBR in a combination of allogeneic or xenogeneic graft material with a barrier membrane and simultaneous or delayed placement of dental implants has proven to be a very effective and feasible treatment option in long-term studies up to 35 years., Conclusion: Bone reconstruction with various materials is a standard therapy in implantology today., Competing Interests: Disclosure The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This article provides clinicians with 3 main factors that relate to long-term success. Long term in this article represents the lifespan of the patient, often requiring more than 40 years of function on the implant restoration. Literature is reviewed and used to provide evidence for these recommendations. Cases are presented to demonstrate these critical factors., Competing Interests: Disclosure Dr M.S. Block has a financial association with X-Nav (stocks) and Jet Investments (stocks)., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: The growing trend of minimally invasive approaches has encouraged the application of partial coverage designs in restorative dentistry. This study aimed to evaluate the cyclic fatigue performance of different CAD-CAM materials used in various partial coverage designs for premolar restorations., Methods: A freshly extracted upper premolar was prepared using a high-speed handpiece to create mesio-occluso-distal (MOD) cavities with standardized dimensions. Three preparation designs were investigated: onlay, overlay, and vonlay. CAD software was used to create digital models of the restorations, which were milled into one of four CAD-CAM materials: Zr - zirconia polycrystals (4Y-PSZ); EX - lithium disilicate glass-ceramic; VS - zirconia-reinforced lithium silicate glass-ceramic; GB - nanohybrid composite. Partial coverage restorations were bonded to tooth replicas and subjected to step-stress cyclic fatigue testing using a chewing simulator device (n = 10). The number of cycles-to-failure and fatigue fracture resistance (N) were recorded and analysed with Kaplan-Meier survival statistics and Weibull analysis, respectively. Fracture surfaces were analysed using fractography., Results: Zr exhibited significantly higher number of cycles-to-failure and greater characteristic fracture load (L 0 ) than the other materials, for onlay and overlay designs. For vonlay design, Zr, VS and EX had similar and greater number of cycles-to-failure than GB. When comparing different designs for the same material, Zr had lower number of cycles-to-failure for vonlay in comparison to onlay and overlay, while the other materials had similar values among the different designs. Weibull modulus was similar among experimental groups., Significance: The findings of this study emphasize the critical role of material selection and preparation design in optimizing the mechanical performance and clinical success of partial coverage restorations. 4Y-PSZ is recommended for high-stress areas due to its superior fatigue and fracture resistance. Overlay designs provide better fatigue resistance, making them more suitable for clinical scenarios requiring higher durability. Understanding the fatigue performance of different materials and designs aids in making informed decisions to enhance the longevity and success of partial coverage restorations in premolars., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Dental implants in the esthetic zone of the oral cavity have always posed a challenge to the oral surgeon. Multiple variables must be considered, such as available soft and hard tissues, gingival phenotype, position of the lip upon smiling, and other factors that pertain to patient compliance and expectations. It is essential to pay attention to the factors that might compromise the long-term stability of these implants. In this article, a deep exploration of the current consensus regarding the long-term survival of implants in the esthetic zone will be performed. A case-series of the authors is included., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The surgical ablation of head and neck cancer followed by radiotherapy often leads to unfavorable functional and aesthetic outcomes. Studies have demonstrated that these outcomes can significantly impact quality of life. Dental implants play a crucial role in rehabilitation by facilitating the use of suprastructures and obturators. However, the long-term survival of dental implants in patients who have undergone radiotherapy remains uncertain, raising several questions. These include determining the optimal timing for dental implantation (before or after radiotherapy), identifying the radiotherapy threshold for implant loss, and considering the role of hyperbaric oxygen therapy. These and other related concerns will be addressed in the following article., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Successful dental implant therapy relies on a bone-implant interface that is mechanically strong and capable of dynamic remodeling in response to functional loads. There are a number of medical conditions or therapies that can affect either bone metabolism or the resistance of bone to infection. However, their effects are often mitigated by local factors or individual responses so the impact of these conditions is not clear-cut. This article will review a number of these conditions and therapies and describe existing studies that have studied these conditions to guide practitioners in their implant practice., Competing Interests: Disclosure The authors have no relevant financial relationships or conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: The aim of this systematic review and meta-analysis was to evaluate the current literature on the effect of implant surface characteristics on peri-implant marginal bone levels (MBL), soft tissue periodontal parameters, peri-implantitis, and implant failure rates., Materials and Methods: Randomized controlled trials were searched in electronic databases. Risk of bias within the selected studies was assessed using the Risk of Bias Tool 2. Meta-analyses were performed using Review Manager software for studies with similar comparisons reporting same outcome measures., Results: Ten randomized control trials were included in the present review. The primary outcome of changes in peri-implant MBL favoured implants with machined surfaces, however, the difference was not statistically significant (P = .18). The changes in probing pocket depths significantly favoured the use of machined surfaces (P = .01), while the implant failure rates favoured roughened surface implants. However, the difference was not statistically significant (P = .09)., Conclusion: Machined surface implants were favoured in terms of lesser peri-implant MBL, though the difference was not significant. The analysis also demonstrated limited favourable outcomes in terms of periodontal parameters for machined surfaces, with slightly significantly better outcomes in terms of probing pocket depths. However, rough surface implants tended to display a lower implant failure., Competing Interests: Conflict of interest All authors of the current manuscript hereby declare that there are no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The long-term outcomes of dental implants are influenced by a variety of factors, all of which play critical roles in their stability, functionality, and esthetic appeal. This review focuses on several key characteristics of dental implants that impact their success overtime: dimensional, morphologic, material, osseointegrative, and connective/prosthetic characteristics. This article synthesizes current literature to analyze how these factors influence the long-term success of dental implants, emphasizing the need for a comprehensive approach in implant selection and placement., Competing Interests: Disclosure The authors have nothing to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: To evaluate the clinical performance of a universal adhesive system containing 0.1 % copper nanoparticles (CuNp) in non-carious cervical lesions (NCCLs) after 6 years., Material and Methods: Two hundred and sixteen restorations (n = 54) were randomly placed in 36 participants with at least four NCCLs. Groups included: ER-Cu (adhesive in etch-and-rinse strategy with CuNp), ER-Ct (etch-and-rinse without CuNp), SE-Cu (self-etch with CuNp), and SE-Ct (self-etch without CuNp). Restorations were evaluated at baseline and after 1, 3, 4, and 6 years using the FDI and USPHS criteria., Primary Outcome: fracture of material and retention. Examiners and patients were blinded to group assignment., Results: After 6 years, 104 restorations were analyzed (ER-Cu 24, ER-Ct 29, SE-Cu 27, SE-Ct 24). Fourteen restorations loss retention (ER-Cu 6, ER-Ct 1, SE-Cu 2, SE-Ct 7). Retention rates (95 % confidence interval) were 79.3 % (61.6 - 90.1) for ER-Cu; 97.0 % (83.3 - 99.4) for ER-Ct; 93.1 % (78.1 - 98.1) for SE-Cu; and 76.7 % (59.1 - 88.2) for SE-Ct, with statistical differences between SE-Cu vs. ER-Ct, and SE-Ct vs. ER-Ct (p < 0.05). Thirty-one restorations (ER-Cu 6, ER-Ct 5, SE-Cu 9, SE-Ct 11) showed minor marginal staining, and forty-one restorations (ER-Cu 8, ER-Ct 10, SE-Cu 11, SE-Ct 12) presented minimal marginal adaptation defects (p > 0.05). No significant differences were found for other secondary parameters (p > 0.05)., Conclusion: This is the first 6-year clinical trial showing the long-term behavior of a universal adhesive system in NCCLs. The addition of CuNp does not affect the clinical performance of the universal adhesive., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: The aims of this systematic review were to estimate the success rates of root caries restorations, and to identify possible factors associated with the success of root caries restorations., Data and Sources: Literature search was conducted in three databases, PubMed, MEDLINE and Web of Science to identify clinical studies reporting on the success of restorative treatment for root caries. Factors that may influence clinical outcomes of the restorative treatment were summarized and analyzed., Study Selection: A total of 4116 records were identified, and 9 articles were eligible to be included. A total of 415 participants with 1174 root caries restorations were analyzed. The short-term (6-month) estimated success rates (ESRs) (95 % CI) of root restorations with per protocol (PP) and intention-to-treat (ITT) approach were 95.1 % (92.9 % to 97.3 %) and 90.5 % (86.8 % to 94.1 %), respectively. The long-term (24-month) ESRs were 82.2 % (73.9 % to 90.6 %) and 73.8 % (64.0 % to 83.5 %) by using the PP and ITT approaches, respectively. Resin composite restorations had a higher ESR compared to glass ionomer cement restorations at 12-month follow-up (96.3 % vs. 86.9 %, p = 0.037), but no significant differences were found at 6-month and 24-month follow-ups (p > 0.05). Besides filling material, no other factors with statistically significant association with treatment success could be identified, including study setting, material mixing method, moisture control method, use of liner or not, and restorative technique., Conclusion: The overall success rate of root caries restorations is good in the short-term (6-month) but decreases over time, with an approximately 20 % failure rate after two years. Complete/partial loss of restoration and gross marginal defect were the main reported reasons accounted for failure. No studied factor has clear evidence to support its association with long-term (24 months or longer) success of root caries restoration., Clinical Significance: This review provides up-to-date evidence on the overall success rates of root caries restorations. No compelling evidence shows any studied factor is related to the long-term success of root caries restoration, whilst there is a tendency to observe higher success rates of resin composite compared to glass ionomer cement restorations., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)