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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.

Shetty, S., et al. (2023). "Artificial intelligence systems in dental shade-matching: A systematic review." J Prosthodont. DOI: 10.1111/jopr.13805. Information not available. Systematic review. [ABSTRACT FROM AUTHOR]

The restoration of teeth affected by molar-incisor hypomineralization (MIH) is challenging. To this end, preformed stainless steel crowns (SSCs) are a good option; however, their conventional use involves the removal of tooth structure. In the Hall technique, the SSC is seated over the primary teeth without caries removal or tooth preparation, aiming to seal carious lesions. This case series reports the use of SSCs in a similar way to the Hall technique for 3 pediatric patients with MIH. The high-caries-risk patient in case 1 lost hypomineralized enamel and developed a carious lesion immediately after eruption of a permanent first molar. The patient in case 2 complained of hypersensitivity associated with MIH of a first molar that had previously been restored. The patient in case 3 experienced atypical restoration failures in MIH-affected first molars. In all 3 cases, the use of SSCs without tooth preparation was an effective restorative treatment. Although this conservative treatment is a temporary solution, it provides good longevity and preserves tooth structure until the patient reaches physical and emotional/behavioral maturity for a definitive restoration. [ABSTRACT FROM AUTHOR]

This article describes a step-by-step protocol for obtaining predictable and repeatable outcomes in adhesive restorative treatment planning. The key elements of the protocol, which the authors call the Minimally Invasive Restorative Approach (MIRA), are to identify patients' expectations, evaluate risk factors, establish proper communication between the interdisciplinary team and the laboratory technician, previsualize the desired result, and utilize tools to effectively guide the clinical procedures. This straightforward protocol is designed to help clinicians achieve the desired outcome in restorative cases at all levels of complexity. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: The current study was undertaken to investigate whether self‐assessment of clinical skills of undergraduate dental students could be bridged with faculty assessment by deliberate training over an extended period. A secondary aim was to explore students' perception of self‐assessment and its effect on their learning and motivation. Material and Methods: A prospective pilot study was conducted at the Department of Restorative Dentistry at Damascus University. Sixteen students participated in the study, ranging in age between 22 and 23 years. A modified Direct Observation of Procedural Skills form with a grading rubric was used to register and guide students' self‐assessment; both were pretested on four students before the study. In total, four clinical encounters were completed by each student. Students were trained on how to conduct proper self‐assessment before and after each clinical encounter. A postcourse questionnaire was used to investigate students' perception of self‐assessment. Results: Bias in self‐assessment decreased consistently after each encounter, and the difference in bias between the first (bias = 0.77) and the last encounter (bias = 0.21) was significant with a medium effect size (p =.022, d = 0.64). The percentage of disconfirming performance dimensions decreased from 39.7% to 26.9%. Students' ability to exactly pinpoint strengths improved consistently and significantly. However, their ability to pinpoint areas of improvement was volatile and showed no significant difference. Bland–Altman graph plots showed higher levels of agreement between self‐assessment and faculty assessment. Moreover, students' perception of self‐assessment was very positive overall. Conclusions: These findings suggest the possibility that the gap between self‐assessment and faculty assessment could be bridged through deliberate training. Future longitudinal research using a larger sample size is still required to further explore whether self‐assessment can be actively bridged with faculty assessment by deliberate training. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the effect of different repair procedures on the repair bond strength of bulk-fill and nanohybrid resin composites after different aging periods. The resin composite blocks (8 × 8 × 4 mm3) were prepared from a bulk-fill (reliaFIL Bulk) and a nanohybrid (reliaFIL LC) resin composite and grouped according to aging duration (6 months, 1 year, and 2 years). Following aging, the blocks were assigned to different surface treatments; air-abrasion with aluminum oxide powder, roughening with a diamond bur, and no treatment. After cleansing with phosphoric acid, a silane layer (Porcelain Primer) was applied on the surface of half of the specimens in each group. The specimens were subdivided into two groups (n = 5): Scotchbond Universal (3M Oral Care) and All-Bond Universal (Bisco). The blocks were repaired with the nanohybrid composite (8 × 8 × 8 mm 3). The repaired specimens were stored in distilled water (37 °C/24 h) and segmented into beams. Half of the beams were immediately subjected to microtensile μTBS testing (1 mm/min), while the other half was stored in distilled water (37 °C) for 6 months before testing. Failure modes were analyzed using stereomicroscope and SEM. Statistical analyses were performed with ANOVA and least significant difference tests (LSD) tests (p = 0.05). The extension of aging periods (6 months, 1 year, and 2 years) reduced the repair bond strength in some groups for both resin composites (p < 0.05). The air-abrasion and bur roughening improved the repair bond strength (p < 0.05). The silane application did not influence the repair bond strength and durability (p > 0.05). There was no difference among the universal adhesives in the same surface treatment groups (p > 0.05). The mechanical roughening treatments are necessary for the repair of resin composite. The universal adhesives might be used for the repair of resin composites regardless of silane content without prior silane application. [ABSTRACT FROM AUTHOR]

Matrix metalloproteinases (MMPs) are a group of enzymes that are correlated with the degradation of the hybrid layer. This article describes the effect of adhesive systems on the MMPs. A systematic review of the literature was conducted analyzing articles published on PubMed, Google scholar, Scopus, ResearchGate and ScienceDirect between 2011 and 2021, activity of the MMPs was the selected outcome variable. A total of 22 publications were selected, 9 of which were selected for detailed review. Chief question in this article was: which generation of adhesive systems has more effect on MMPs? How does it affect them? Etch-and rinse adhesive systems showed higher level gelatinolytic activity, when compared to Self-etch adhesive systems. Activation of the MMPs is due in most adhesive systems, which is responsible for the degradation of the hybrid layer. Etch-and-rinse adhesive systems showed higher gelatinolytic activity when compared to self-etch adhesive systems, further studies are needed on new chemicals capable of inhibiting MMP activity. Moreover, further studies are needed to check MMP activity in non-vital teeth. [ABSTRACT FROM AUTHOR]

With advances in technology, dentists nowadays manage dental caries with the philosophy of minimally invasive dentistry. Dental restoration is now performed most conservatively with minimal destruction of tooth structure when operative dentistry is indicated. Some operative dentists suggested using tunnel restoration for treating proximal caries as a conservative alternative to the conventional box preparation. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique sensitive and requires advanced operative skills. Tunnel restoration can be an option to restore proximal caries if the dentist selects the proper case and pays attention to the details of the restorative procedures. With the dentist's advanced training, advanced light-emitting diode handpieces, magnifying loupes, precise digital imaging and new generation restorative materials, good results can be obtained in selected cases. This study reviews the literature on tunnel restoration and provides updated techniques and clinical data that can be used in tunnel restoration to oversee its limitations and the perspective on restorative treatment. [ABSTRACT FROM AUTHOR]

Theodora-Kalliopi Samartzi,1 Dimokritos Papalexopoulos,2 Aspasia Sarafianou,2 Stefanos Kourtis2 1Private Dentistry Practice, Athens, Greece; 2Department of Prosthodontics, National and Kapodistrian University of Athens, Athens, GreeceCorrespondence: Dimokritos PapalexopoulosDepartment of Prosthodontics, National and Kapodistrian University of Athens, Athens, GreeceEmail dimpapalex@hotmail.comPurpose: The immediate application of a dentin-bonding agent after tooth preparation and before impression-taking (immediate dentin sealing [IDS]) has been suggested to provide several advantages concerning bacterial microleakage, hypersensitivity, and bonding quality. We reviewed the literature and clarified certain aspects related to each step of IDS application.Materials and Methods: The search strategy comprised an electronic research in MEDLINE, Cochrane, Ovid and Scopus for studies published from January 1990 to December 2020 regarding the IDS technique and including both in vitro and clinical studies.Results: After exclusion of irrelevant or duplicate articles, 88 articles focusing on aspects of the IDS technique were assessed. IDS seems to be advantageous with regard to bond strength, gap formation, bacterial microleakage, and dentin hypersensitivity. However, issues arising from interaction with impression materials, the provisional phase, and conditioning methods before cementation require further investigation.Conclusion: There are no documented reasons preventing clinicians applying IDS in their everyday practice. On the contrary, the presented technique seems to be beneficial in certain aspects regarding indirect restorations.Keywords: IDS, indirect restorations, restorative dentistry, review

Use of lasers in restorative dentistry fields brings many advantages both for dental practitioner and patients. Dental lasers can assist restorative procedures in treatment of dental caries, endodontic mechanical preparation and root canals decontamination, periodontal pockets decontamination, periodontal regenerative procedures, sulcus uncovering, and crown lenghtening. Features of laser-assisted procedures in restorative treatments of vital and non-vital teeth are as follows: absence or a low level of pain; absence of vibrations; reduction of patient’s anxiety; selective removal of infected dentin; decontamination of root cement and periodontal sulcus; elimination of the pulp or periapical area damage risk; faster periodontal tissues regeneration; faster healing of gingival tissues following crown lengthening or sulcus uncovering.

Background and Aims: Due to the review of general dental courses, it was necessary to assess the students' satisfaction with this curriculum. The aim of this study was the assessment level of students’satisfaction with the new educational curriculum of the Ministry of Health at the department of restorative dentistry of Tehran university of medical sciences in 2019-2020. Materials and Methods: In this descriptive cross-sectional trial,72 sixth year dental students of Tehran University who passed the restorative dentistry courses based on the new curriculum were studied. A questionnaire was developed and for validity content assessment, it was presented to 5 professors and then revised. For reliability approval of the questionnaire, test-retest approach was used. The questionnaire was given to the 30 students of the main pilot group in one session and two-week later and agreement percentage and Kappa index were calculated. After conducting the "test" process and re-testing, the "questions" were statistically analyzed using STATA software. Results: The most level of satisfaction regarding to practicality of subjects was found for fundamental of restorative dentistry including principles of amalgam class I cavity preparations and restorations on the dentic (81.94% and 76.39% acceptable respectively) and the principles of amalgam classII cavity restorations on the dentic (72.22%). The least satisfaction levels were obsereved in the first and second theoretical restorative courses including tooth-colored restorations (47.22%), onlays and inlays (47.22%) and tooth-colored classII cavity preparations and restorations (48.61%). The amount (P-value or error of the first type) was reported in all questions>0.001. Conclusion: Despite the limitation of this study, final-year dental students’ satisfaction of theoretical restorative dentistry courses was medium, while it was high for the fundamental and practical restorative courses of 2017 educational curriculum.

Abstract Background Stainless-steel crowns (SSCs) are recommended for restorative treatment of young teeth severely affected by caries, fractures or dental developmental disorders (DDDs). However, despite recommendations and clinical evidence, SSCs are not widely used by general dentists, who favour extraction and more conventional restorations. The present study aimed to investigate the views of and use of SSCs among Norwegian and Finnish dentists. Methods The present study was a cross-sectional survey among Norwegian and Finnish dentists. An electronic questionnaire was sent to Norwegian and Finnish dentists asking whether they used SSCs and on which indications. In addition, the questionnaire assessed reasons for non-use and dentists’ perceptions regarding advantages and challenges in the use of SSCs, as well as the need for additional training. Distributions of background characteristics, use of and views on SSCs were calculated, and statistical significance of the associations between respondents’ background and their answers were evaluated. Results Of the 574 Norwegian and 765 Finnish respondents, only 12.0% and 12.9% reported to use SSCs, respectively. The most frequently reported barrier reported by those who did not use SSCs was lack of practical training. The most frequent challenge reported by those using SSCs was difficulties in crown adjustment followed by aesthetic issues, and the most frequently reported advantage was that SSCs maintain the function and occlusion. The majority of respondents reported a need for more information and practical training in the use of SSCs, with hands-on course as their most frequently preferred education type. Conclusion Although the value of SSCs for restoring young molars is recognized by Norwegian and Finnish dentists, SSCs are rarely used by general dentists. The majority of the respondents reported lack of training and materials and was interested in receiving more information and education.

Abstract Recovery from periodontal disease is not completed until the esthetic sequelae of the disease have been restored. This paper introduces a new technique to restore the natural appearance of the smile in a periodontal patient in a single appointment.

Abstract Background Adhesive restorations allow a conservative approach to caries management and are increasingly used as a restorative option in pediatric dentistry. Placement can be difficult in children because of the cooperation required for multiple bonding steps. Due to this, it is vital to assess if novel, simpler strategies have been featured in clinical trials and if clinical trials are researching the different existing adhesive strategies. Methods This review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis adapted for Scoping Reviews (PRISMA-ScR) guidelines. PubMed/Medline, Cochrane Central, Scopus and EMBASE were used for systematic search, using free keywords and controlled search terms. Clinical trials of children requiring a restorative intervention which featured adhesive strategies were included. Only peer-reviewed trials of primary teeth restored with resin composites, published in the last 10-year period were eligible. Data charting was accomplished independently by two reviewers, and studies were summarized according to their date, type, intervention, sample size, observation period, outcomes and conclusions. Quality assessment was performed using Cochrane’s Risk of Bias 2.0 tool. Results 700 potentially relevant references were found, which after a rigorous inclusion scheme, resulted in a total of 8 eligible clinical trials. Out of these, 7 were randomized clinical trials. Most trials featured a split-mouth design and the observation period ranged from 12 to 36 months. The trials evaluated interventions of two self-adhesive composites, two bulk-fill composites, two novel composites, one compomer and eight adhesives from different strategies. Most studies (4/8) included were judged to raise some concerns regarding risk of bias, while two were classified as high risk and two as low. Conclusion Few studies comparing adhesive strategies were found, especially adhesives in sound substrates. The existing studies do not reflect all current approaches that could be used in pediatric dentistry. Further studies addressing bioactive composites and contemporary adhesives are necessary.

Purpose: To investigate the short- and long-term outcomes of zirconium dioxide-based restorations (ZDBR), and changes in masticatory function (MF). Methods: One hundred and two (102) patients who received restorative dentistry procedures were divided into two groups using random number method: control group (CG, n = 52, alloy-based restorations) and study group (SG, n = 50, zirconium dioxide restorations). Treatment efficacy, quality, levels of IL-8 and IL-6 in gingival sulcus fluid, and satisfaction scores were compared. Results: The SG showed better outcomes and restoration quality than CG. After restoration, SG showed greater decrease in IL-8 and IL-6 levels than CG (p < 0.05), while IL-8 and IL-6 levels were higher in SG and CG than those before restoration (p < 0.05). After 1 and 6 months of restoration, SG showed increased dental appearance satisfaction and a higher success rate than CG (p < 0.05). Occlusal force and MF were significantly improved in both groups (p < 0.05). Gingival index, bleeding index, plaque index, and tooth looseness after restoration significantly improved in both groups, but were lower in SG than in CG (p < 0.05). Conclusion: In oral restorations, ZDBR is more effective in terms of short-term and long-term outcomes. Patients' occlusal force and MF are better restored, and patients' quality of life is also significantly improved. Therefore, ZDBR in oral restorations is feasible but further clinical trials are required. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the study was to determine the relative predictive power of admissions criteria and predoctoral academic performance in the area of restorative dentistry in order to better understand and guide the dental school admissions process. Methods: In addition to admissions criteria, student performance in restorative dentistry, such as the Final Restorative Treatment course, the didactic and preclinical examinations, and the objective structured clinical examinations (OSCE), was measured for the 172 predoctoral students representing the graduating classes of 2017–2021. Results: The association between the didactic score in restorative dentistry and grade point average (GPA, p = 0.009) and Dental Admission Test (DAT, p = 0.002) score was statistically significant. Although no statistically significant association was found between preclinical scores and gender, GPA, or DAT, there was a statistically significant association between preclinical scores and the Perceptual Ability Test (PAT) score (p = 0.012). Preclinical scores included laboratory examinations for fixed prosthodontics, such as crown preparation and temporization, representing hand skills assessment. Finally, there was no statistically significant association found between the OSCE score and any of the admissions criteria. Conclusion: The dental admissions criteria could play a role in predicting academic performance in the didactic portion and preclinical component of restorative dentistry. [ABSTRACT FROM AUTHOR]

Background: Evidence on the effect of magnification devices on procedure quality in restorative dentistry is scant. This study therefore aimed to assess, under simulated clinical conditions, if magnification loupes affect the quality of preparations carried out by undergraduate dental students. Methods: 59 undergraduate dental students underwent two visual acuity tests, based on which they were divided into a "low visual acuity group" (visus < 1) and a "good visual acuity group" (visus ≥ 1). In a randomized crossover experiment, participants performed a two-dimensional S and a three-dimensional O figure preparation with a dental handpiece on standardized acrylic blocs designed for preclinical restorative training. Each participant carried out the preparation tasks twice, once with magnification loupes (2.5×) and once without. Two blinded investigators independently evaluated parameters of preparation precision. Data were analyzed using Spearman rank correlation coefficients, intra-class correlation coefficients, and Wilcoxon rank-sum tests (α = 0.05). Results: Participants from the "low visual acuity group" did not show a statistically significant improvement in accuracy when they used magnification loupes for the S figure preparation (p ≥ 0.0625). Participants from the "high visual acuity group" obtained a higher level of accuracy (p ≤ 0.0012) when they used magnification loupes for the S figure preparation. The use of magnification loupes had no statistically significant effect on the accuracy parameters of the O figure cavity preparations (p ≥ 0.1865). Participants with high visual acuity achieved only a marginally better accuracy than participants with a visus < 1. Conclusions: This study suggests that loupes with 2.5× magnification increase the accuracy of two-dimensional preparations while they have no significant effect, favorable or otherwise, on the accuracy of complex, three-dimensional cavity preparations of untrained dental students. [ABSTRACT FROM AUTHOR]

[Display omitted] Bioactive glasses (BAGs) have been researched extensively for dentistry due to their favourable biocompatibility and hard tissue bonding ability. However, the specific application of BAGs produced through sol-gel synthesis in restorative dentistry has not been reviewed previously. This review provides a comprehensive account of the principles behind sol-gel derived BAGs and their investigation for dental tissue restoration materials. A search for in vitro and in vivo studies was performed using the databases Web of Science®, Medline®, Scopus® and Google Scholar®. Articles published over the past 20 years were selected and data on the BAG composition and morphology was extracted. Analysis of the effect of specific BAG additives on the properties of experimental dental materials was also performed. A majority of BAG particles investigated were spheres ranging in size from 5 nm to ~650 µm. Sol-gel BAGs are mainly applied in the treatment of hypersensitive dentine and for pulp-dentine tissue engineering, while a handful have been used in target drug delivery. BAG fillers are promising additives that result in improved biological properties, antibacterial effects, hardness, acid buffering and remineralization. Unfortunately, some detrimental effects on optical properties have been observed with BAG addition. Additionally, in vivo data, investigations into radiopacity and standardization of test protocols are identified as areas for improvement and further studies. Future work should consider the pertinent issues raised in order to improve the quality of available data and expand knowledge in this area of dental biomaterials research and development. [ABSTRACT FROM AUTHOR]

This retrospective study evaluated the performance of posterior composites after up to 33 years of clinical service and investigated factors associated with the risk of failures over time including patient- and tooth-related variables. Patients who received at least one Class I or Class II direct composite restoration in a private office in 1986–1992 and had follow-up appointments were included. Failures and interventions over time were investigated using the dental records. A follow-up clinical recall was carried out in 2020. Two scenarios were considered: restorations that did not require any intervention (success) or restorations that were repaired and still functional (survival). Multivariate Cox regression analyses and Kaplan-Meier curves were performed using success and survival rates (p < 0.05). One hundred patient records and 683 restorations were included. A total of 353 failures were reported (success rate= 48%). Main reasons for failure were fracture and secondary caries. Most interventions after failures were repairs. Replacements were registered in 183 cases (survival rate= 73%). Annual failure rates were below 2.5% (success) and 1.1% (survival). Larger restorations and maxillary molars had higher failure risks. No significant differences in success rates among different resin composites was observed. A typical observation in this sample of restorations was the presence of moderate to advanced signs of aging, including marginal and surface staining, wear, chipping, changes in anatomical shape and translucency. Clearly aged restorations were still clinically satisfactory. Significance: This long-term, practice-based study indicates that resin composites can be used to restore posterior teeth with a long-lasting durability. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the effect of finishing protocol and exposure to staining solutions on color stability of dental resin composites. Materials and Methods: A nanofill and microhybrid composite, three finishing protocols (mylar, Soflex disc, and white polishing stone) and four staining solutions (tea, red wine, khat extract—two concentrations, control—distilled water) were evaluated. A digital spectrophotometer was used for color change (ΔE) measurements employing the CIE‐Lab‐color system. Paired/independent‐sample t test and two‐way analysis of variance (ANOVA) followed by Tukey's honestly significant difference posthoc test were used for inferential statistics at α =.05. Results: Soflex finish was associated with least staining and comparable color stability for the two materials in tea and red wine. In Khat 2, microhybrid composite had statistically significant better color stability than nanofill for Soflex finish (14 days t = 3.270, p =.011). For microhybrid composite, mylar resulted in highest mean ΔE, whereas Soflex recorded the least in all staining solutions. For nanofill composite, white stone resulted in highest mean ΔE, whereas Soflex demonstrated the least mean ΔE in all staining solutions, except red wine where mylar demonstrated the least mean ΔE. For mylar finish, nanofill demonstrated statistically significant better color stability than microhybrid in both red wine (14 days t = 4.902, p =.001) and Khat 1 (14 days t = 3.252, p =.012). For stone finish, microhybrid demonstrated statistically significant better color stability than nanofill in all staining solutions (14 days t ≥ 4.785, p ≤.001). Two‐way ANOVA showed a statistically significant difference in mean ΔE between and within specimens (F = 42.658, p <.001). All staining solutions caused clinically unacceptable discoloration for mylar and white stone finish. For Soflex finish, red wine produced clinically unacceptable color difference beyond 48 h. Conclusion: There was a difference in color stability of resin composites depending on filler type, further influenced by finishing protocol. Soflex disc finish results in better color stability than mylar and white stone in both microhybrid and nanofill composites. Clinical significance: Esthetic dental restorations such as resin composites are routine in contemporary restorative practice. Color stability of composites may be influenced by surface finish, dependent on the filler type, and consumption of chromogenic substances such as khat. To prolong their service, selection of suitable finishing protocols is an important consideration. [ABSTRACT FROM AUTHOR]

Molar–incisor–hypomineralization (MIH) is a developmental defect of enamel dental tissue caused by the disturbances in the maturation stage of amelogenesis. It usually affects the permanent first molars and incisors. In children, MIH condition clinically appears as the demarcated discolored hypomineralized defects of affected teeth, post-eruptive breakdown (PEB) of affected enamel, dentine exposure, hypersensitivity, increased susceptibility to dental caries and behavioral management challenges owing to dental anxiety/fear and dental esthetic concerns. This case report describes the comprehensive dental management of MIH in an 8-year-old male pediatric patient by conservative and noninvasive treatment approach with preventive, palliative, and restorative treatment modalities under nonpharmacological behavior management techniques. [ABSTRACT FROM AUTHOR]

Introduction: New generation composite resin materials have revolutionized the art of aesthetic dentistry. The clinical success is dependent on effective polymerisation and surface hardness which in turn are dependent on the performance of Light Curing Units (LCU). This study utilises surface hardness as a measure of degree of polymerisation of composite resins achieved by LCUs. Aim: To evaluate the difference in surface hardness of nanohybrid and microhybrid resin composites cured by light curing systems, Light Emitting Diode (LED) and Quartz Tungsten Halogen (QTH). Materials and Methods: In this invitro experimental study, two types of hybrid composites (Nanohybrid and Microhybrid) were tested for surface hardness by using two different light curing systems (LED and QTH). All the Nanohybrid and Microhybrid specimens were cured using LED and QTH LCUs, thus giving four combinations. A total of 60 specimens (6 mm diameter and 2 mm depth) were prepared using Teflon mould with 15 samples for each combination. Surface hardness was measured on upper and lower surface after 24 hours and hardness ratio was calculated. Data was analysed using independent t-test for intergroup comparison. Level of significance was kept at 5%. Results: Surface hardness of resin composites cured by LED LCU was greater than those cured by QTH LCU. Additionally, the hardness value was greater for the upper surface. Nanohybrids showed better surface hardness than Microhybrids for both the LCUs. Conclusion: Nanohybrid composite resins and LED system were found to be more effective in terms of surface hardness as compared to their counterparts.

Background: Restorative dentistry is an important branch of dentistry and therefore it is very important to train students that have all or the majority of the skills to start practice. The aim of this study was to compare new and old curricula of restorative lessons form the perspective of faculty members of selected Iranian universities. Methods: The perspectives and viewpoints of the faculty members of dentistry schools in the cities of Tehran, Qazvin, Gilan, Shiraz, and Yasuj were collected using a valid and reliable researcher-made questionnaire. A demographic questionnaire was also applied to collect the characteristics of the participants. SPSS was used for data analysis and the Friedman test was administered to explore the strong and weak points. Results: The results showed a significant correlation between the new and the old curriculum (p

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.

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

Background and Objective: Dental composites' dependence on pricey imported components often raises price concerns and restricts accessibility in restorative dentistry. In Pakistan, using locally produced materials presents a viable alternative for more affordable and environmentally friendly dental treatments. This study aimed to develop and evaluate dental composites sourced from locally available materials in Pakistan for cost-effectiveness, performance, and durability., Methodology: A study comprising 385 patients, aged 18-65 years, who underwent composite restorations made of novel materials, was carried out at Sardar Begum Dental College, Peshawar, from January 2023 to December 2023. Patient comfort, aesthetic quality, and durability were the three main criteria used to assess clinical performance. The physical characteristics of adhesion strength, wear resistance, and hardness were evaluated in lab settings. Costs for materials, processing, and clinical application were all considered in a thorough cost study. SPSS version 26 (Armonk, NY: IBM Corp.) was used for the statistical analysis, and both descriptive and inferential statistics were used. The novel composites were compared with standard materials using t-tests, and cost differences were assessed. A p-value of less than 0.05 was considered statistically significant., Results: The novel composites exhibited superior performance with a durability of 12.57 ± 1.83 months (n = 385 patients), compared to 11.05 ± 2.38 months for conventional composites (p < 0.05). They also scored higher in aesthetic quality (8.35 ± 1.48 vs. 7.82 ± 1.59) and patient comfort (4.52 ± 0.79 vs. 4.27 ± 0.83) (p < 0.05). Laboratory tests showed greater hardness (48.79 ± 3.22 Vickers), better wear resistance (0.28 ± 0.05 mm³), and higher adhesion strength (22.96 ± 1.68 MPa) (p < 0.05). Cost analysis revealed significant savings, with total costs per patient of PKR 8,980 for novel composites vs. PKR 33,000 for conventional composites (p < 0.05)., Conclusion: Novel dental composites developed from locally sourced materials demonstrate superior performance and significant cost reductions, highlighting their potential to enhance the accessibility and affordability of dental care in Pakistan., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Ethical Review Committee of Sardar Begum Dental College and the Ethical Committee of Gandhara University issued approval #188/2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ejaz et al.)

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

Background and Aims: Due to the review of general dental courses, it was necessary to assess the students' satisfaction with this curriculum. The aim of this study was the assessment level of student's satisfaction with the new educational curriculum of the Ministry of Health at the department of restorative dentistry of Tehran university of medical sciences in 2019-2020. Materials and Methods: In this descriptive cross-sectional trial,72 sixth year dental students of Tehran University who passed the restorative dentistry courses based on the new curriculum were studied. A questionnaire was developed and for validity content assessment, it was presented to 5 professors and then revised. For reliability approval of the questionnaire, test-retest approach was used. The questionnaire was given to the 30 students of the main pilot group in one session and two week later and agreement percentage and Kappa index were calculated. After conducting the "test" process and re-testing, the "questions" were statistically analyzed using STATA software. Results: The most level of satisfaction regarding to practicality of subjects was found for fundamental of restorative dentistry including principles of amalgam class I cavity preparations and restorations on the dentic (81.94% and 76.39% acceptable respectively) and the principles of amalgam classII cavity restorations on the dentic (72.22%). The least satisfaction levels were obsereved in the first and second theoretical restorative courses including tooth-colored restorations (47.22%), onlays and inlays (47.22%) and tooth-colored classII cavity preparations and restorations (48.61%). The amount (P-value or error of the first type) was reported in all questions>0.001. Conclusion: Despite the limitation of this study, final-year dental students’ satisfaction of theoretical restorative dentistry courses was medium, while it was high for the fundamental and practical restorative courses of 2017 educational curriculum. [ABSTRACT FROM AUTHOR]

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

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

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

The field of dentistry is consistently innovating with the introduction of novel hybrid and polymer materials for computer-aided design and manufacturing (CAD/CAM). It is noteworthy that the temperature within the oral cavity has a significant impact on the strength of new biomaterials utilized for CAD/CAM fabrication of fixed partial dentures (FPDs). Studies have demonstrated that alterations in intraoral temperature may significantly affect the longevity and durability of dental restorative materials. This study aimed to evaluate the flexural strength, flexural modulus, and effect of thermal aging on CAD/CAM restorative materials. Five CAD/CAM materials were investigated: nano-ceramic-hybrid (GR), polymer-infiltrated-ceramic-network (VE), polyether-ether-ketone (PK), fiberglass-reinforced epoxy-resin (CT), and Feldspar Ceramic (VB). A total of 100 bar-shaped specimens were prepared (N = 20). Each group was subdivided into thermocycling (TC) and no-thermocycling (NTC) subgroups (n = 10). All the specimens underwent a 3-point bending test. The mean flexural strengths and moduli were statistically analyzed using paired t-test, analysis of variance (ANOVA), and Bonferroni pair-wise comparison (p < 0.05). Significant differences were observed in the flexural strength (FS) and modulus (E) between the materials (p < 0.001). GR had the highest FS among tested hybrid materials. NTC CT had the highest FS (924.88 ± 120.1 MPa), followed by GR (385.13 ± 90.73 MPa), then PK (309.56 ± 46.84 MPa). The FS of brittle ceramic VB was the lowest (p < 0.001), but similar to that of PICN VE. Only resin-containing VE and CT significantly decreased in E after thermocycling (p < 0.01, p = 0.013), showing the softening effect of thermocycling on their resin matrix. It can be concluded that new hybrid materials (GR) had higher flexural strength than feldspar ceramic and other resin/polymeric CAD/CAM materials. Polymeric PEEK and GR hybrid materials were resistant to significant deleterious effects of TC. Therefore, they would be appropriate for situations with a higher stress load.

The purpose of this study is to investigate occlusal stresses in beveled versus non-beveled tooth preparation in class I restoration when using composite restorative material. Completed plastic tooth preparations were scanned using a 3D intra-oral scanner. Then the files were further processed using meshing software. The Finite Element Method (FEM) was used to model the performance of one non-beveled and two different types of beveled restorations which were being subjected to the chewing forces. The performed FEM simulations illustrated the benefits of the beveled restorations for composite Class I restorations. This is an experimental study. Further research is needed to provide more information to determine the benefits of beveling in teeth preparation both in in-vitro and in-vivo studies. The outcome of this study illustrates the advantage of using bevel over no bevel during class I cavity preparation.

Background: Esthetic dentistry has become a very important aspect of every dental treatment from the patient perspective, whether it is orthodontics or implant therapy. The aim of this article is to describe the advantages of a newly developed branch of five-to-five clear aligner therapy (CAT) (Invisalign Go, Align Technology, San Jose, Calif) in interdisciplinary treatments especially in terms of minimally invasive interventions. Case presentation: Two case reports are presented together with a comprehensive analysis using the SAFE (Safety, Assessment, Function, Ethics) assessment. This paper aims to introduce a new systematic in CAT. Invisalign Go (Align Technology, Santa Clara, California, USA) allows orthodontic treatment from second premolar and second premolar in both arches. It is specially designed for general practitioners devoted to restorative dentistry for a better planning of a multidisciplinary and mini-invasive treatment plan. Discussion and conclusion: The clinical results demonstrate how CAT is extremely useful in multidisciplinary treatment plan in order to straighten teeth especially in a pre-restorative phase to allow minimally invasive and adhesive restorations. [ABSTRACT FROM AUTHOR]

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

Background. The objective of the present study was to compare the outcome of direct composite restorations, with and without the use of additional magnification. Methods. Twenty extracted molars were selected for the study. Class 1 Black cavities were prepared. All teeth were etched, and bonding agent was applied. Teeth were assigned randomly into two groups of ten each. Group I: restorations were done without the use of magnification, first by placing a layer of SDR® flow +Bulk Fill Flowable on the base of the cavity, and then restoring the morphology with Ceram.X SphereTEC® One. Group II: the same protocol was applied, but using the dental microscope. Teeth were then evaluated before and after finishing the protocol by 5 dental professionals using a series of established criteria. The results were documented and statistically analyzed using the non-parametric Mann-Whitney test. Results. Statistically significant differences were found when using magnification, before the polishing protocol in "marginal adaptation integrity" and "excess material", and after polishing in "marginal adaptation integrity". Conclusions. Magnification may be used to increase the quality of the final direct posterior restoration by improving the marginal adaptation integrity, reducing excess material, preventing marginal microleakage, and avoiding subsequent failure. [ABSTRACT FROM AUTHOR]

Objective: This case will illustrate the interdisciplinary management of an adolescent female patient with amelogenesis imperfecta (AI). It will contrast this approach and compare it to the previous "multidisciplinary" treatment rendered before the patient was referred for a second opinion. Clinical considerations: The patient had a family history of AI affecting all of her permanent teeth. There were many impacted teeth. The majority of her family and relatives afflicted by this opted for dentures. The patient had undergone 2 years of treatment and was told that her "braces would be removed next week." Her new dentist was concerned because the case was not ready to restore. Conclusion: He recommended referral to another orthodontist for a second opinion and formulation of an interdisciplinary treatment plan that would include a periodontist, endodontist, and restorative dentist. The patient's family accepted the second opinion referral and restarted treatment with an interdisciplinary team. The restorative dentist was the quarterback for this integrated and sequenced approach. The case was ultimately restored. A 35 year follow‐up shows stability with a caries free, periodontally healthy, esthetic result. [ABSTRACT FROM AUTHOR]

Determining the shade of dental materials is a challenging requirement for the restorative dentist. Improper shade selection is the second cause for laboratory remakes, resulting in inefficiency and additional cost, and unnecessary stress for the clinician and patient. The process of shade selection is somewhat subjective, with no consensus on the protocol. This research investigation aimed to develop a novel software application to provide an accurate, objective, and systematic approach to shade determination for teeth, soft tissues, and dental materials. An IOS software application was developed, termed Smile Shade, to facilitate a simple approach for dental shade determination. Smile Shade functions on a high-dynamic-range microcolor sensor with automatic temperature control and inter-device repeatability of

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

Nanotechnology has various applications in restorative dentistry in order to achieve reliable treatment outcomes. The present study aimed to comprehensively review the studies focused on the applications of nano-based materials, technologies, and methods used in restorative dentistry. Related articles were retrieved via searching in databases such as PubMed, Google Scholar, and Scopus. Afterwards, the appropriate references regarding the research subject were assessed, and findings were collected to achieve a comprehensive review study. According to the obtained results, the utilization of nanotechnology in restorative dentistry could yield beneficial outcomes. The dispersion of nano-sized structures in restorative materials could enhance mechanical properties such as diametral and flexural strength and fracture toughness. However, the improvement of the mentioned mechanical properties depends on the type of the nano-sized materials, their content, and type of the additional materials used along with nano-based restorative materials.

Introduction: the Restoration of endodontically treated teeth is critical, and the Awareness of stresses developed by oblique and vertical forces in restorative methods take a great role in treatment plans. Due to the anatomical shape and inherent form of the stress distribution premolars, could be lost by fractures. Some fractures such as vertical fracture which is probable in endodontically treated teeth, makes the teeth a candidate for extraction and other surgical procedures. According to this fact that the dental restorations should be conservative, the aim of this study was to determine stress distribution using four composite restorative methods. Methods: Endodontically treated maxillary second premolars were restored with composite resin using four methods. For restoration, the models representing standard Mesio-occlusal-distal (MOD) restoration, cusps capping with thickness of 1 and 2mm, and the use of woven fiber in occlusal part, were prepared. The effects of the different restorative approaches on stress distribution were analyzed using three-dimensional finite element stress analysis. Results: the highest stress rate was observed in MOD tooth restoration and the amount of stress in natural parts of the tooth in woven fiber was found the lowest. Conclusion: The simulation results show that in all models, oblique forces caused more stress than vertical forces. Moreover, there was a slight difference between different types of restorations regarding the magnitude of stress; however, the results obtained from this study showed that woven fiber could partly reduce stresses.

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

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