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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.

Amelogenesis imperfecta (AI) is a rare genetic condition that affects normal enamel formation of both the primary and permanent dentition. Patients with AI not only present with restorative challenges, but also suffer from extreme hypersensitivity, compromised esthetics, and poor self-esteem. The functional, social, and psychological impairment often leads to an overall lower quality of life. Extensive dental treatment is often required at a young age, therefor early diagnosis, appropriate preventative strategies, and proper dental management is essential for successful treatment outcomes throughout all phases of life. This review presents the dental management and prosthetic reconstruction of patients with amelogenesis imperfecta.

The longevity of direct esthetic restorations is severely compromised because of, among other things, a loss of function that comes from their susceptibility to biofilm-mediated secondary caries, with Streptococcus mutans being the most prevalent associated pathogen. Strategies to combat biofilms range from dental compounds that can disrupt multispecies biofilms in the oral cavity to approaches that specifically target caries-causing bacteria such as S mutans. One strategy is to include those antibacterial compounds directly in the material so they can be available long-term in the oral cavity and localized at the margin of the restorations, in which many of the failures initiate. Many antibacterial compounds have already been proposed for use in dental materials, including but not limited to phenolic compounds, antimicrobial peptides, quaternary ammonium compounds, and nanoparticles. In general, the goal of incorporating them directly into the material is to increase their availability in the oral cavity past the fleeting effect they would otherwise have in mouth rinses. This review focuses specifically on natural compounds, of which polyphenols are the most abundant category. The authors examined attempts at using these either as pretreatment or incorporated directly into restorative material as a step toward fulfilling a long-recognized need for restorations that can combat or prevent secondary caries formation. Repeatedly restoring failed restorations comes with the loss of more tooth structure along with increasingly complex and costly dental procedures, which is detrimental to not only oral health but also systemic health.

Mechanical properties and bioactivity are two important characteristics of glass-ionomer cements (GICs) for application as dental restorative materials. The current study prepared GIC economically by using bamboo leaf as a silica source instead of expensive analytical grade silica precursors. Dopant ions consisting of Mg2+, Zn2+ and Ba2+ were added to study their influence on mechanical properties and bioactivity. The undoped GIC exhibited compressive strength, flexural strength and microhardness of 110.31 (± 2.42) MPa, 25.53 (± 3.11) MPa and 66.48 (± 4.22) KHN, respectively, while those for the doped GIC were 122.85 (± 6.37) MPa, 29.17 (± 5.62) MPa and 72.39 (± 6.04) KHN, respectively. The obtained GICs, when immersed in simulated body fluid (SBF) for 21 days, showed a good degree of stability and capacity to induce the nucleation of hydroxyapatite (HA) on their surface but the doped sample exhibited a superior outcome. Trimetallic doping with Mg2+, Zn2+ and Ba2+ may be a crucial strategy for improving the mechanical and bioactive properties of GIC designed for application in restorative dentistry. [ABSTRACT FROM AUTHOR]

Mechanical properties and bioactivity are two important characteristics of glass-ionomer cements (GICs) for application as dental restorative materials. The current study prepared GIC economically by using bamboo leaf as a silica source instead of expensive analytical grade silica precursors. Dopant ions consisting of Mg2+, Zn2+ and Ba2+ were added to study their influence on mechanical properties and bioactivity. The undoped GIC exhibited compressive strength, flexural strength and microhardness of 110.31 (± 2.42) MPa, 25.53 (± 3.11) MPa and 66.48 (± 4.22) KHN, respectively, while those for the doped GIC were 122.85 (± 6.37) MPa, 29.17 (± 5.62) MPa and 72.39 (± 6.04) KHN, respectively. The obtained GICs, when immersed in simulated body fluid (SBF) for 21 days, showed a good degree of stability and capacity to induce the nucleation of hydroxyapatite (HA) on their surface but the doped sample exhibited a superior outcome. Trimetallic doping with Mg2+, Zn2+ and Ba2+ may be a crucial strategy for improving the mechanical and bioactive properties of GIC designed for application in restorative dentistry. [ABSTRACT FROM AUTHOR]

Avulsion injuries, though relatively uncommon, are one of the most serious of dentoalveolar injuries. Replantation at the scene of the incident is almost always the treatment of choice whenever possible. This paper outlines a step-by-step approach for the management of avulsion injuries, including a splinting protocol. This aims to support general dental practitioners in feeling more confident with managing these injuries. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the shear bond strength of 3D-printed and milled provisional restorations using various resin materials and surface finishes. There were 160 preliminary samples in all, and they were split into two groups: the milled group and the 3D-printed group. Based on the resin used for repair (composite or polymethylmethacrylate (PMMA)) and the type of surface treatment utilized (chemical or mechanical), each group was further divided into subgroups. The specimens were subjected to thermocycling from 5 °C to 55 °C for up to 5000 thermal cycles with a dwell time of 30 s. The mechanical qualities of the repaired material underwent testing for shear bond strength (SBS). To identify the significant differences between the groups and subgroups, a statistical analysis was carried out. Three-way ANOVA was used to analyze the effects of each independent component (the material and the bonding condition), as well as the interaction between the independent factors on shear bond strength. Tukey multiple post-hoc tests were used to compare the mean results for each material under various bonding circumstances. The shear bond strengths of the various groups and subgroups differed significantly (p < 0.05). When compared to the milled group, the 3D-printed group had a much greater mean shear bond strength. When compared to PMMA repair, the composite resin material showed a noticeably greater shear bond strength. In terms of surface treatments, the samples with mechanical and chemical surface treatments had stronger shear bonds than those that had not received any. The results of this study demonstrate the effect of the fabrication method, resin type, and surface treatment on the shear bond strength of restored provisional restorations. Particularly when made using composite material and given surface treatments, 3D-printed provisional restorations showed exceptional mechanical qualities. These results can help dentists choose the best fabrication methods, resin materials, and surface treatments through which to increase the durability and bond strength of temporary prosthesis. [ABSTRACT FROM AUTHOR]

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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. [ABSTRACT FROM AUTHOR]

Objective: Several extrusion techniques have been described to restore teeth with insufficient coronal tooth structure and to avoid their extraction. Still, there is little evidence for a treatment concept combining surgical extrusion using an atraumatic axial extraction system. Materials and Methods: A total of nine patients, each with an iso‐ or subgingival fractured tooth, were retrospectively examined. Treatment of the damaged tooth comprised an atraumatic forced surgical extrusion performed with an axial tooth extraction system and a more coronal positioning within the socket. The teeth were initially splinted and subsequently restored. The follow‐up period was up to 57.1 months and averaged 36.5 (SD: ±13.5) months. Results: All nine teeth were still in situ, without signs of inflammation. During the period of the provisional restoration, six prosthetic complications occurred, which were resolved with little effort, whereas, success rate for the definitive restoration was 100%. No biological complications were observed concerning the root apex or soft tissue. The radiographically measured mean extrusion distance was 3.4 (SD: ±1.0) mm, so that a sufficient prosthetic ferrule could be reestablished. Conclusions: Surgical extrusions using an axial tooth extraction system demonstrate low biological and prosthetic complications rates over observation time. Clinical Significance: The presented extrusion approach preserves soft and hard tissue and is an efficient treatment option for severely destroyed teeth. Saving hopeless teeth by this relatively predictable and feasible procedure has hardly any disadvantages for patients, and in case of failure, an implant or fixed partial denture are still an option. [ABSTRACT FROM AUTHOR]

This article examines the perspectives and motivations of dentistry students at Gaziantep University in Turkey regarding their interest in specializing in restorative dentistry. The study found that the most popular specialty among the students was Oral and Maxillofacial Surgery, and the majority of students first became aware of the Restorative Dentistry department during their preclinical experience. Factors such as clinical exposure, income expectations, and personal interests were found to play a significant role in students' specialty preferences. The study highlights the importance of the preclinical period in shaping students' impressions of different specialties and the various factors that influence their career choices. [Extracted from the article]

Abstract Biomimetics is a branch of science that explores the technical beauty of nature. The concept of biomimetics has been brilliantly applied in famous applications such as the design of the Eiffel Tower that has been inspired from the trabecular structure of bone. In dentistry, the purpose of using biomimetic concepts and protocols is to conserve tooth structure and vitality, increase the longevity of restorative dental treatments, and eliminate future retreatment cycles. Biomimetic dental materials are inherently biocompatible with excellent physico-chemical properties. They have been successfully applied in different dental fields with the advantages of enhanced strength, sealing, regenerative and antibacterial abilities. Moreover, many biomimetic materials were proven to overcome significant limitations of earlier available generation counterpart. Therefore, this review aims to spot the light on some recent developments in the emerging field of biomimetics especially in restorative and regenerative dentistry. Different approaches of restoration, remineralisation and regeneration of teeth are also discussed in this review. In addition, various biomimetic dental restorative materials and tissue engineering materials are discussed.

Introduction: Berry's biometric index correlates the bizygomatic width to the width of the maxillary central incisors (CIs). It has also been suggested that dental and facial esthetics follow the concept of the golden ratio (1.61803). The present research aims to evaluate the practical applicability of Berry's bizygomatic index and the golden ratio to the width of the maxillary anterior teeth. Materials and Methods: The bizygomatic width and the width of all the maxillary anterior teeth were measured for a total sample of n = 100. The width of maxillary CI was calculated by Berry's biometric index and the other teeth by golden ratio. The measured and calculated values were compared by means of statistical analysis. Results: The age of study participants ranged from 19 to 35 years with a mean of 24.99 years (standard deviation = ±5.098). There was no statistically significant difference between the measured and the calculated values (P > 0.05). The relative Dahlberg's error was found to be low for all the teeth. Conclusion: Berry's biometric index along with golden proportion can be reliably used to determine the mesiodistal width of the maxillary anterior teeth. The methods can be implemented in cases where there is no reference to determine the width of upper anterior teeth during any esthetic restorative procedure. Maxillary anterior teeth dictate the esthetics of a smile; therefore, this study attempts to shed light on the importance of the coherent use of these mathematical ratios to provide an objective formula for smile rehabilitation.

ABSTRACTBackground Artificial intelligence (AI) applications in dental restorative procedures have significantly developed over recent years. However, there is a lack of documentation regarding the types of AI used in tooth reconstruction.Types of Studies Reviewed Studies using AI in tooth reconstruction were electronically searched over three databases PubMed, Cochrane library, and Google Scholar. The relevancy of theme tooth reconstruction was prioritized in searching. Only original research was included without the restriction of publication time or any filters.Results A total of 18 studies were included in this review: 5 reported programmable AI systems based on mathematical models such as statistical estimation, 9 studies used biogeneric tooth libraries, and 4 presented the deep learning models.Practical Implications AI has gained significant progress over the past two decades as a powerful tool for automated tooth reconstruction. However, further studies are required to compare different forms of AIs and to assess their clinical performance in the reconstruction of occlusal surfaces.

Objective: The applications of artificial intelligence (AI) are increasing in restorative dentistry; however, the AI performance is unclear for dental professionals. The purpose of this narrative review was to evaluate the applications, functions, and accuracy of AI in diverse aspects of restorative dentistry including caries detection, tooth preparation margin detection, tooth restoration design, metal structure casting, dental restoration/implant detection, removable partial denture design, and tooth shade determination. Overview: An electronic search was performed on Medline/PubMed, Embase, Web of Science, Cochrane, Scopus, and Google Scholar databases. English‐language articles, published from January 1, 2000, to March 1, 2022, relevant to the aforementioned aspects were selected using the key terms of artificial intelligence, machine learning, deep learning, artificial neural networks, convolutional neural networks, clustering, soft computing, automated planning, computational learning, computer vision, and automated reasoning as inclusion criteria. A manual search was also performed. Therefore, 157 articles were included, reviewed, and discussed. Conclusions: Based on the current literature, the AI models have shown promising performance in the mentioned aspects when being compared with traditional approaches in terms of accuracy; however, as these models are still in development, more studies are required to validate their accuracy and apply them to routine clinical practice. Clinical Significance: AI with its specific functions has shown successful applications with acceptable accuracy in diverse aspects of restorative dentistry. The understanding of these functions may lead to novel applications with optimal accuracy for AI in restorative dentistry. [ABSTRACT FROM AUTHOR]

Background: This is the first study to assess Egyptian dental practitioners' knowledge about conservative caries management approaches and investigate whether this knowledge transfers into clinical practice and the barriers to translating research into evidence-based practice. Methods: A sample of dental practitioners was surveyed using an online questionnaire. Convenience and snowball sampling were used to collect data from February to June 2022. We included graduated dentists from Egyptian universities who practiced in Egypt. Data were analyzed with descriptive statistics, and the associations between variables were checked using Kruskal Wallis and Chi-Square tests. Results: This study included 396 participants from throughout Egypt. There were significant correlations between specialty and participants' knowledge and behaviors toward evidence-based caries management (p = 0.002) and between specialization and tools used to detect carious lesions (p < 0.001). Most participants (59.1%) used G.V Black's classification, and (80.8%) removed caries based on the feature of dentin hardness and color, whereas (67%) removed caries until hard dentine remained. The participants' primary hurdle to staying up-to-date was their belief that the newly gained information would not be clinically applicable due to a lack of equipment or working in low-economic areas. Patient-related barriers were the major obstacles for participants in implementing evidence-based practice. Conclusion: Egyptian dentists did not fully embrace minimal invasive approaches for caries management, and practitioners' experiences continue to shape decision-making. It emphasizes the imperative to practically educate dentists using effective knowledge translation dissemination to promote evidence adoption in daily practice and advocate value-based dental care to address the economic crisis's impact on Egypt's healthcare. [ABSTRACT FROM AUTHOR]

Introduction Materials and Methods Results Conclusion This study aims to validate that haptic simulator assistance could distinguish skill levels with haptic simulation in restorative dentistry.This work was carried out with 93 first‐year, 87 third‐year and 44 fifth‐year dental students. The promotions of first‐ and fifth‐year dental students made one session to represent the negative and the positive controls, respectively. The third‐year dental students were the studied population. Whatever the group, the maximum time for each reparation was restricted to 3 min. All students have to perform the same three exercises. The third‐year dental students performed four sessions spread over the whole university year. For each test, the total score provided by the simulator was recorded and analysed.The exercises are not discriminating in direct vision while the exercise in indirect vision is very interesting to distinguish the levels of the learners.The results underline that the exercises in indirect vision could distinguish different profiles of student having different preclinical and clinical levels, while making it possible to follow the acquisition of clinical competence. [ABSTRACT FROM AUTHOR]

Dental adhesives provide retention to composite fillings in dental restorations. Microtensile bond strength (µTBS) test is the most used laboratory test to evaluate bonding performance of dental adhesives. The traditional approach for developing dental adhesives involves repetitive laboratory measurements, which consumes enormous time and resources. Machine learning (ML) is a promising tool for accelerating this process. This study aimed to develop ML models to predict the µTBS of dental adhesives using their chemical features and to identify important contributing factors for µTBS. Specifically, the chemical composition and µTBS information of 81 dental adhesives were collected from the manufacturers and the literature. The average µTBS value of each adhesive was labeled as either 0 (if <36 MPa) or 1 (if ≥36 MPa) to denote the low and high µTBS classes. The initial 9-feature data set comprised pH, HEMA, BisGMA, UDMA, MDP, PENTA, filler, fluoride, and organic solvent (OS) as input features. Nine ML algorithms, including logistic regression, k-nearest neighbor, support vector machine, decision trees and tree-based ensembles, and multilayer perceptron, were implemented for model development. Feature importance analysis identified MDP, pH, OS, and HEMA as the top 4 contributing features, which were used to construct a 4-feature data set. Grid search with stratified 10-fold cross-validation (CV) was employed for hyperparameter tunning and model performance evaluation using 2 metrics, the area under the receiver operating characteristic curve (AUC) and accuracy. The 4-feature data set generated slightly better performance than the 9-feature data set, with the highest AUC score of 0.90 and accuracy of 0.81 based on stratified CV. In conclusion, ML is an effective tool for predicting dental adhesives with low and high µTBS values and for identifying important chemical features contributing to the µTBS. The ML-based data-driven approach has great potential to accelerate the discovery of new dental adhesives and other dental materials. [ABSTRACT FROM AUTHOR]

Various 3D printing systems for interim fixed dental restorations are commercially available. This study aimed to evaluate the physical and mechanical properties of 3D printed resins used for interim restorations fabricated using various 3D printing systems and printing angulations after accelerated aging. Three different interim restorative materials were provided and printed using their specific 3D printing systems (A: NextDent; B: Asiga; C: Nova3D), and the testing specimens from each system were printed at two building angles: (1) 0° and (2) 90°. The six groups were A1, A2, B1, B2, C1, and C2, with sixteen specimens per group. Half of the specimens in each group (N = 8) were subjected to accelerated aging, including simulated brushing and thermocycling. Three-point bending, surface roughness, and Vickers microhardness tests were performed. Two-way ANOVA and Fisher's multiple tests were used for statistical analyses. The most accurate systems were found in groups C1 and C2 for length, A1 and B1 for width, and A1 and C1 for height. The specimen trueness only changed after aging for groups B1, B2, and C1. The flexural strength of the A2 group (151 ± 7 MPa) before aging was higher than that of the other groups, and the strength decreased after aging only for groups A1 and A2. The flexural strength, microhardness, and surface roughness of the 3D printed interim resins after aging varied depending on the material, system used, and printing angle. [ABSTRACT FROM AUTHOR]

An increased number of clinicians are using magnification to facilitate their vision when carrying out dental examinations and treatments. The best instrument for this purpose is the microscope, which has proven to enhance quality, longevity and outcome of clinical work. Its use in some dental specialties (such as endodontics) is now well established, but there is also a role for this equipment in other branches of dentistry. To anticipate the contribution of magnification to dentistry in general, recent research and experimental data on the importance of magnification devices will be considered, from the perspectives of optical issues, diagnosing methods and treatment options. It will be shown that, while the microscope is vital to certain specialties (such as endodontics, periodontics, restorative dentistry and prosthodontics), it has little effect on others (orthodontics, for example). This synthesis of current researchattempts to shed light on the optimal magnification used in certain clinical situations, the distinctive benefits of loupes and microscopes for each dental branch, as well as their drawbacks. [ABSTRACT FROM AUTHOR]

Objectives: Perceptual ability test (PAT) is a valid determinant for spatial perceptions. However, proven psychomotor skill tests for dentistry do not currently exist. This study aimed to determine whether performance on the PAT, Operation game, mirror tracing, and wax carving exercises correlate to preclinical laboratory performance in Dental Anatomy and Restorative Dentistry courses. Methods: First‐year dental students (n = 96) participated in the study. Final laboratory grades were obtained from course directors of preclinical Restorative Dentistry and Dental Anatomy courses. Admissions committee provided participants' PAT results. Participants completed a wax carving exercise by carving a cube and a semicircle into a wax block using the wax subtraction method. Two calibrated faculty graded the carvings as Ideal (5), Satisfactory (3), or Unsatisfactory (1). Time to complete the Operation game and number of infractions were recorded. Participants traced the six‐pointed star pattern on the Auto Scoring Mirror Tracer instrument in both clockwise and counterclockwise directions. Completion times and number of instances outside the pattern were recorded. Spearman Rank Correlations were used to determine associations at 0.05 confidence interval. Results: Mean PAT score was 21.7; mean times to complete the Operation game and mirror tracing exercise were 4:20 and 1:30, respectively. Mean score on the wax carving exercise was 3.19. Correlations between the independent and dependent variables were minimal to weak. The wax carving exercise was the most reliable predictor of performance. Conclusions: When PAT scores are striated into low (less than 20), middle (21–22), and high (23–30), it was possible to predict performance in both preclinical laboratory courses. [ABSTRACT FROM AUTHOR]

Introduction: Berry's biometric index correlates the bizygomatic width to the width of the maxillary central incisors (CIs). It has also been suggested that dental and facial esthetics follow the concept of the golden ratio (1.61803). The present research aims to evaluate the practical applicability of Berry's bizygomatic index and the golden ratio to the width of the maxillary anterior teeth. Materials and Methods: The bizygomatic width and the width of all the maxillary anterior teeth were measured for a total sample of n = 100. The width of maxillary CI was calculated by Berry's biometric index and the other teeth by golden ratio. The measured and calculated values were compared by means of statistical analysis. Results: The age of study participants ranged from 19 to 35 years with a mean of 24.99 years (standard deviation = ±5.098). There was no statistically significant difference between the measured and the calculated values (P > 0.05). The relative Dahlberg's error was found to be low for all the teeth. Conclusion: Berry's biometric index along with golden proportion can be reliably used to determine the mesiodistal width of the maxillary anterior teeth. The methods can be implemented in cases where there is no reference to determine the width of upper anterior teeth during any esthetic restorative procedure. Maxillary anterior teeth dictate the esthetics of a smile; therefore, this study attempts to shed light on the importance of the coherent use of these mathematical ratios to provide an objective formula for smile rehabilitation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Tooth anatomy is fundamental knowledge used in everyday dental practice to reconstruct the occlusal surface during cavity fillings. The main objective of this project was to evaluate the suitability of two types of anatomical tooth reference models used to support reconstruction of the occlusal anatomy of the teeth: (1) a three‐dimensional (3D)‐printed model and (2) a model displayed in augmented reality (AR) using Microsoft HoloLens. The secondary objective was to evaluate three aspects impacting the outcome: clinical experience, comfort of work, and other variables. The tertiary objective was to evaluate the usefulness of AR in dental education. Anatomical models of crowns of three different molars were made using cone beam computed tomography image segmentation, printed with a stereolithographic 3D‐printer, and then displayed in the HoloLens. Each participant reconstructed the occlusal anatomy of three teeth. One without any reference materials and two with an anatomical reference model, either 3D‐printed or holographic. The reconstruction work was followed by the completion of an evaluation questionnaire. The maximum Hausdorff distances (Hmax) between the superimposed images of the specimens after the procedures and the anatomical models were then calculated. The results showed that the most accurate but slowest reconstruction was achieved with the use of 3D‐printed reference models and that the results were not affected by other aspects considered. For this method, the Hmax was observed to be 630 μm (p = 0.004). It was concluded that while AR models can be helpful in dental anatomy education, they are not suitable replacements for physical models. [ABSTRACT FROM AUTHOR]

High-performance polymeric materials have been used in computer-assisted design/ computer-assisted milling (CAD/CAM) dental restorative treatments due to their favorable esthetics as well as their mechanical and biological properties. Biocompatible poly-ether-ether-ketone (PEEK) and glass-fiber-reinforced composite techno-polymer (FRC) resins reportedly possess good flexural and shock absorption properties. However, intraoral thermal fluctuations may adversely affect them. This study aimed to investigate the flexural strength and effect of thermal aging on two commercially available high-performance polymers intended for CAD/CAM milled frameworks for definitive restorations. A total of 20 bar specimens were prepared using two CAD/CAM materials (n = 10); PEEK(P) and Bioloren FRC(F). Specimens from each material group were randomly divided into two sub-groups (n = 5): before aging (uP and uF) and after aging, with 10,000 thermocycles (5–55 °C) (aP and aF). All specimens were subjected to a three-point bending test in a universal testing machine. Flexural strength (Fs) values were calculated for all specimens, and their means were statistically analyzed using a t-test, and a general linear model (GLM) repeated measure ANOVA (p < 0.05). There was a statistically significant decrease in the Fs of (F) materials after aging (p = 0.03). (F) specimens exhibited significantly higher Fs than (P) before and after aging (p < 0.001). This type of material had a significant effect on Fs (p < 0.001). Within the limitations of this study, both materials exceeded the ISO recommendations of dental resins for flexural strength. However, FRC materials may benefit CAD/CAM milled long-span fixed partial dentures and implant-supported denture frameworks. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Proper gingival displacement is an important prerequisite to obtain good quality impressions. Retraction pastes could eliminate the need for retraction cords, as they have advantages such as comfort reported by patients, faster technique, ease of use, no need for anesthesia, and reduced tissue trauma. The objective of this paper was to present a clinical case of ceramic veneers and crowns in which a retraction paste was used for gingival displacement during both the impression and cementation stages, with 3 years of follow-up. Treatment planning consisted of the replacement of preexisting crowns and ceramic veneers on the anterior teeth. After finishing the preparations, gingival displacement with Astringent Retraction Paste was performed without anesthesia or the use of cords and the impression was taken. Before cementation of the crowns and veneers, the Astringent Retraction Paste was applied. Avoiding the use of cords during cementation prevented trauma. The soft tissue margins remained stable and healthy after a period of 3 years. It can be concluded that retraction pastes could be indicated for displacement of soft tissue when preparation margins are at the gingival level or slightly intrasulcular prior to impressions, restoration cementations, direct restorations, and before relining provisional restorations. Clinical significance: The impression appointment can be traumatic to some patients. The use of cords for gingival displacement usually requires local anesthesia and is time consuming. Retraction astringent pastes instead of cords seems to be a good option for some cases in gingival tissue displacement. [ABSTRACT FROM AUTHOR]

The clinical report describes a three-dimensional (3D) printed coping for intraoral evaluation before milling final anterior restorations. The use of printed copings allows restorations for complex and esthetically important restorations to be thoroughly tested at relatively low cost without introducing large delays into the fabrication process. [ABSTRACT FROM AUTHOR]

The aim of this article is to introduce and illustrate the "Teflon tape technique," which provides good lucidity in combination with excellent isolation of the working field. It is intended to serve as a supplement to the gold standard rubber dam for the adhesive working dental practitioner. Primarily, the Teflon tape technique (Teflon is a registered trademark, and not affiliated with Teflon tape) is particularly suitable for the adhesive cementation of restorations with very thin margins. It allows free access to subgingival areas with variable gingival retraction. Furthermore, this principle can also be applied to other indications, such as Class V restorations or deep core buildups. The technique described is therefore flexible and easy to use. This combination allows a fast integration of the Teflon tape technique into the daily workflow of the dental practitioner. [ABSTRACT FROM AUTHOR]

Objective: This prospective clinical study evaluated the clinical performance of one-, two- and multi-surface composite resin inlays over a 12-year period on premolars and molars. Method and materials: One clinician placed 113 indirect composite resin inlays (Signum, Heraeus Kulzer) in 30 patients that were bonded using a three-step bonding system and composite resin luting cement. Evaluations were made at 3 and 12 years by another clinician who was not involved in the placement of the restorations, using the modified US Public Health Service (USPHS) criteria. Data were analyzed using a nonparametric statistical test (Mann-Whitney U test) followed by Bonferroni correction (alpha = .05). Results: Fourteen patients could not be followed, yielding to the follow-up of 99 restorations. After 12 years, compared to the 3-year follow-up, tooth integrity, secondary caries, and sensitivity criteria showed significant change, while other parameters did not show significant difference (P > .05). Parameters such as loss of marginal integrity, loss of restoration integrity, loss of surface polish, and secondary caries received more frequently delta scores. At the 3-year follow-up, the clinical performance of one- or two-surface inlays did not show significant difference from multi-surface ones (P = .6317), but at the 12-year follow-up, the results were more favorable for multi-surface inlays. Overall, the failure rate at 12 years was 12%. Conclusions: Adhesively bonded indirect composite resin inlays showed acceptable long-term clinical results in terms of function, but surface and margin characteristics changed over time. [ABSTRACT FROM AUTHOR]

Restorative dentistry, in particular whole crown preparation is known to cause gingival recession. Inadequate partial dentures and soft tissue support can cause severe gum recession. Incorrect use of elevators in oral surgery procedures can destroy the alveolar bone of adjacent teeth causing recession. The aim of this study is to evaluate the cumulative factors influencing the final therapeutic success following the lowering of periodontal status with the type of prosthetic restoration performed.We evaluated a total of 80 prosthetic restorations, 20 veneers and 25 zirconia-supported ceramic crowns and 35 metal-ceramic crowns(CCM). The percentage of sites showing a periodontal space depth greater than 3 mm was lower in the porcelain veneer group. The frequency of periodontal pockets of 4 mm was 1% in the buccal surfaces of the veneers, 4% in the CCM buccal surfaces and 2% in the CCM palatal surfaces. There were no statistically significant differences between the determinations made at the sites assessed at the CCM level and those assessed at the veneers level. 1. Subgingival placement of prosthetic restorations has a negative impact on periodontal health and consequently on their aesthetic outcome. Ceramic veneers, due to their preparation requirements and the advantage they offer due to their all-ceramic structure, have the least impact on periodontal health status.

Objectives: To develop a patient's attitude questionnaire regarding prevention in oral health for use internationally. Methods: Using a mixed methods approach, a questionnaire was developed and refined as part of ADVOCATE (Added Value for Oral Care) study, involving partners in six countries: Netherlands, Hungary, Denmark, Ireland, Germany, and the UK. A literature review explored the history of oral healthcare delivery systems to develop a template for each of the six ADVOCATE countries. A systematic review identified the perceived barriers and facilitators to preventive oral healthcare and underpinned a topic guide and established the patient questionnaire domains. Focus groups in each ADVOCATE country developed the first version of the questionnaire. Patient and Public Involvement and Engagement (PPIE) in each ADVOCATE country tested the questionnaire and led to further refinement. The questionnaire was produced in five languages. Content validity and reproducibility used principal component analysis (PCA) and exploratory factor analysis (EFA) refined the questionnaire. Results: The literature review aided an understanding of each country's oral healthcare system, and the findings from the 25 studies identified in the systematic review found the main barriers/facilitators to preventive oral healthcare were cost, knowledge (preventive treatments and advice), and a patient awareness and adherence to preventive advice/treatments. Interviews and focus groups with 148 participants in the ADVOCATE study identified receiving the appropriate level of care/feeling valued, cost, level of motivation/priority, not feeling informed, knowledge, and skill mix as the main barriers/facilitators. Fifty‐three PPIE members refined the questionnaire. The pilot questionnaire was tested with 160 participants. Non‐essential or highly correlated variables were then removed, leaving 38 items, covering 6 domains (cost, advice received, advice wanted, message delivery, motivation, knowledge, and responsibility) within the questionnaire. A second pilot test‐run was undertaken with 185 participants. The test‐re‐test reliability demonstrated strong consistency of responses between the two time points (kappa range 0.3–0.7, most p <.0011), which culminated with a final version of the Patient Attitudes to Prevention in Oral Health Questionnaire (PAPOH) questionnaire. Conclusions: This mixed‐methods approach enabled the development of a multi‐language attitudinal questionnaire for use with patients (PAPOH) to compare attitudes to oral disease prevention internationally. [ABSTRACT FROM AUTHOR]

Copyright of Selcuk Dental Journal is the property of Selcuk Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Dental fluorosis is caused by ingestion of excessive fluoride during tooth development resulting in hypomineralization of the enamel and can present as white or brown intrinsic lesions. This case report describes a combination of minimally invasive techniques: microabrasion, bleaching, and resin infiltration to address brown enamel fluorosis present on the maxillary anterior teeth of a young patient. Before resin infiltration, air microabrasion was targeted at subsurface lesions located on the maxillary central and lateral incisors, and chairside bleaching was done with 37% hydrogen peroxide (Opalescence). After which, hypoplastic lesions on the buccal surfaces were etched before being treated with two sessions of resin infiltration (ICON and DMG). Following treatment, satisfactory esthetic outcomes were achieved. Accurate diagnosis, depth of lesions, and understanding the effectiveness and limitations of each technique are essential to select the appropriate type of treatment to obtain the best esthetic outcome. In conclusion, the conservative management of varying severity of dental fluorosis may require the appropriate use of combination treatment modalities, such as microabrasion, bleaching and resin infiltration, when clinically indicated, to address the treatment needs and achieve a desired outcome. [ABSTRACT FROM AUTHOR]

Background: Finding strategies to overcome the rising trends of antimicrobial resistance against currently available antimicrobial agents has become increasingly relevant. Graphene oxide has recently emerged as a promising material due to its outstanding physicochemical and biological properties. This study aimed to validate previous data on the antibacterial activity of nanographene oxide (nGO), double antibiotic paste (DAP), and their combination (nGO-DAP). Methods: The antibacterial evaluation was performed against a wide range of microbial pathogens. Synthesis of nGO was achieved using a modified Hummers' method, and loading it with ciprofloxacin and metronidazole resulted in nGO-DAP. The microdilution method was utilized to assess the antimicrobial efficacy of nGO, DAP, and nGO-DAP against two gram-positive bacteria (S. aureus and E. faecalis), two gram-negative bacteria (E. coli, and S. typhi), and an opportunistic pathogenic yeast (C. albicans). Statistical analysis was conducted using one-sample t-test and one-way ANOVA (α = 0.05). Results: All three antimicrobial agents significantly increased the killing percent of microbial pathogens compared to the control group (P < 0.05). Furthermore, the synthesized nGO-DAP exhibited higher antimicrobial activity than nGO and DAP per se. Conclusion: The novel synthesized nGO-DAP can be used as an effective antimicrobial nanomaterial for use in dental, biomedical, and pharmaceutical fields against a range of microbial pathogens, including gram-negative and gram-positive bacteria, as well as yeasts. [ABSTRACT FROM AUTHOR]

Digital technology is rapidly changing the provision of oral health care, although its adoption for the oral health care of young patients has lagged. The authors describe digitally supported treatment approaches for managing treatment of developmental dental defects in the early permanent dentition. Four adolescent patients with amelogenesis imperfecta received transitional anterior restorations for esthetic and functional rehabilitation using a variety of digital workflows. Combinations of restoration type, materials, and fabrication methods were selected to meet the needs of each patient on the basis of their specific amelogenesis imperfecta phenotype and chief symptoms. These cases highlight the application of digital technology in pediatric and adolescent dentistry for managing the treatment of developmental dental defects. Digitally supported restorative approaches, as described in this report, offer broad applicability of materials and techniques directed at treating the complex restorative needs of young patients in the transitional and early permanent dentition. [ABSTRACT FROM AUTHOR]

Glass ionomers are routinely placed as caries control restorations due to their bioactive properties, including fluoride release and chemical adhesion to the tooth structure. However, their poor physical properties limit their use to minimum stress-bearing cases and caries-control temporization. A novel bioactive hybrid glass restorative material with improved properties with a resin coating (RCHG) has been developed for a definitive restoration comparable to composite resin. This in-vitro study compared the compressive and flexural strength of resin-coated RCHG to nanofilled composite resin restorative material (NFCR). A total of 40 samples, cylindrical and bar-shaped samples, were fabricated from RCHG and NFCR (n=10). Compressive strength and 3-point bending testing were performed in a universal testing machine. The mean values for each material were statistically compared using an independent t-test at a significance level of P<0.05. RCHG had significantly lower mean flexural strength and compressive strength values (57.77 ± 3.95 and 81.52 ± 18.38MPa respectively) than NFCR (201.30 ± 15.25 and 217.55 ± 51.66 MPa, respectively). The investigated RCHG material is still not as reliable in stress-bearing restorations compared to resin composites. However, further testing is needed to appraise the true potential of these bioactive glass materials. [ABSTRACT FROM AUTHOR]

The objective is to evaluate the long-term clinical survival and performance of direct and indirect resin composite restorations replacing cusps in vital upper premolars. Between 2001 and 2007, 176 upper premolars in 157 patients were restored with 92 direct and 84 indirect resin composite restorations as part of an RCT. Inclusion criteria were fracture of the buccal or palatal cusp of vital upper premolars along with a class II cavity or restoration in the same tooth. Forty patients having 23 direct and 22 indirect composite restorations respectively, were lost to follow-up (25.6%). The cumulative Kaplan-Meier survival rates were 63.6% (mean observation time: 15.3 years, SE 5.6%) with an AFR of 2.4% for direct restorations and 54.5% (mean observation time: 13.9 years, SE: 6.4%) with an AFR of 3.3% for indirect restorations. The Cox regression analysis revealed a statistically significant influence of the patient's age at placement on the survival of the restoration (HR 1.036, p = 0.024), the variables gender, type of upper premolar, type of restoration, and which cusp involved in the restoration had no statistically significant influence. Direct composite restorations failed predominantly due to tooth fracture, indirect restorations primarily by adhesive failure (p < 0.05). There was no statistically significant difference in survival rates between direct and indirect composite cusp-replacing restorations. Both direct and indirect resin composite cusp-replacing restorations are suitable options to restore compromised premolars. The longer treatment time and higher costs for the indirect restoration argue in favor of the direct technique. [ABSTRACT FROM AUTHOR]

Background: Evaluation of a new vertical dimension of occlusion (VDO) in complex restorative treatments is considered a necessary step prior to placement of restorations. Objectives: This randomised controlled trial (RCT) aimed to assess the effects of using an evaluation of a VDO increase before restorative treatment in patients with moderate‐to‐severe tooth wear, on OHRQoL, freeway space (FWS) and interventions to restorations. Methods: Forty‐two patients with tooth wear were included and randomly allocated to either a test phase with a Removable Appliance (RA) or no test phase. Restorative treatment consisted of restoration of all teeth using composite restorations in an increased VDO. OHIP‐score, freeway space (FWS) and clinical acceptability of restorations were assessed at baseline and at recall appointments (1 month and 1 year). Intervention to restoration was scored in case of material chipping or when the abutment tooth had increased sensitivity that could be linked to occlusal overloading. ANCOVA analyses, Univariate Cox regression, t‐tests and descriptive analyses were performed (p <.05). Results: Clinical follow‐up after 1 year was completed for 41 patients. No significant effect of testing the VDO with a RA could be found on the OHIP‐score (p =.14). Reduction of FWS in the RA group, compared to the control group, was significantly lower at 1 year (p =.01, 95% CI −1.09 to −0.15). No effect on early interventions to restorations was found (p =.94). Conclusion: This RCT showed that a removable appliance is not indicated to functionally test the increased VDO prior to restorative treatment in patients with tooth wear. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Dental Science is the property of Brazilian Dental Science Journal-ICT-UNESP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)