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Statement of problem Porcelain laminate veneers without tooth preparation (no-prep veneers) might represent a convenient and conservative option for the esthetic rehabilitation of anterior teeth. However, controversy exists about their predictability. Purpose The purpose of this clinical study was to retrospectively evaluate the performance of no-prep porcelain veneers placed as per the recently proposed “CH no-prep” protocol, which claimed to overcome many of the drawbacks of previous no-prep veneer solutions. Material and methods One hundred eight no-prep porcelain laminate veneers based on the CH no-prep protocol were placed in 21 patients between 2015 and 2017. All participants were contacted, and 15 received a recall examination: a total of 78 veneers were evaluated as per the Clinical-Photographic-Micromorphologic coding. Plaque and gingival indexes and any increase in gingival recession were recorded. Pulp vitality was verified. A survival rate based on the count of absolute failures and a success rate summarizing the effect of both absolute and relative failures were calculated. Results The mean observation period was 43.1 months, with an observation interval of 36 to 60 months and a survival rate of 97.4%. From the 5 relative failures (3 minimal fractures or chips and 2 limited marginal discolorations) and the 2 absolute failures (unrepairable fractures), an overall success rate of 91.0% was recorded, with 71 restorations that were judged excellent in terms of clinical acceptance after the recall examination. From the Clinical-Photographic-Micromorphologic evaluation, 5 restorations (6.4%) showed minimal issues for marginal integrity, while a limited porcelain overhang was identified on 2 restorations (2.8%). Micromorphologic analyses confirmed the clinical evaluations. No periodontal recession was observed, and plaque and gingival indexes appeared stable. Conclusions Porcelain laminate veneers placed as per the CH no-prep protocol demonstrated excellent performances after 36 to 60 months of clinical service. The achieved outcomes, in terms of color match and overall esthetic and anatomic integration, confirmed that a prepless approach may be safely adopted provided that strict rules for patient selection and finish line placement are adopted.

This study aimed to evaluate the effects of a new photodynamic protocol (ALAD-PDT) on primary human osteoblasts (hOBs). The ALAD-PDT protocol consists of a heat-sensitive gel with 5% 5-delta aminolevulinic acid commercialized as Aladent (ALAD), combined with 630 nm LED. For this purpose, the hOBs, explanted from human mandible bone fragments, were used and treated with different ALAD concentrations (10%, 50%, 100% v/v) incubated for 45 min and immediately afterwards irradiated with a 630 nm LED device for 7 min. The untreated and unirradiated cells were considered control (CTRL). The cellular accumulation of the photosensitizer protoporphyrin IX (PpIX), the proliferation, the alkaline phosphatase (ALP) activity, and the calcium deposition were assessed. All concentrations (10, 50, 100%) determined a significant increment of PpIX immediately after 45 min of incubation (0 h) with the highest peak by ALAD (100%). The consequent 7 min of light irradiation caused a slight decrease in PpIX. At 48 h and 72 h, any increment of PpIX was observed. The concentration 100% associated with LED significantly increased hOB proliferation at 48 h (+ 46.83%) and 72 h (+ 127.75%). The 50% and 100% concentrations in combination to the red light also stimulated the ALP activity, + 12.910% and + 14.014% respectively. The concentration 100% with and without LED was selected for the assessment of calcium deposition. After LED irradiation, a significant increase in calcium deposition was observed and quantified (+ 72.33%). In conclusion, the ALAD-PDT enhanced proliferation, the ALP activity, and mineralized deposition of human oral osteoblasts, highlighting a promising potential for bone tissue regeneration.

Objectives Resin-based materials are applied in every branch of dentistry. Due to their tendency to release substances in the oral environment, doubts have been raised about their actual safety. This review aims to provide a comprehensive analysis of the last decade literature regarding the concentrations of elutable substances released from dental resin-based materials in different type of solvents. Materials and methods All the literature published on dental journals between January 2010 and April 2022 was searched using international databases (PubMed, Scopus, Web of Science). Due to strict inclusion criteria, only 23 papers out of 877 were considered eligible. The concentration of eluted substances related to surface and volume of the sample was analyzed, considering data at 24 h as a reference. The total cumulative release was examined as well. Results The most eluted substances were HEMA, TEGDMA, and BPA, while the less eluted were Bis-GMA and UDMA. Organic solvents caused significantly higher release of substances than water-based ones. A statistically significant inverse correlation between the release of molecules and their molecular mass was observed. A statistically significant positive correlation between the amount of released molecule and the specimen surface area was detected, as well as a weak positive correlation between the release and the specimen volume. Conclusions Type of solvent, molecular mass of eluates, and specimen surface and volume affect substances release from materials. Clinical relevance It could be advisable to rely on materials based on monomers with a reduced elution tendency for clinical procedures.

Objective To investigate the shear bond strength (SBS) of a glass ionomer (GI) cement, an 10-methacryloyloxy-decyl dihydrogen phosphate (MDP)-based adhesive resin cement (MDP-based AC), an MDP-based self-adhesive resin cement (MDP-based SAC), an MDP-free self-adhesive resin cement (MDP-free SAC), and a resin-modified GI (RMGI) cement to a 3 mol% yttria-stabilized (3Y-TZP) and a 5 mol% yttria partially stabilized zirconia (5Y-PSZ). Materials and methods Fifty blocks were produced using 3Y-TZP and 5Y-PSZ, assigned to subgroups based on the five cements investigated (n = 10) and luted to cylindrical specimens of the same substrate. Each specimen was loaded in a SBS apparatus to failure. Mean SBS (MPa) values and standard deviations were calculated. Data were analyzed using a two-way analysis of variance and Tukey tests (α = .05). Failed specimens were subjected to fractographic analysis. Results MDP-based AC and MDP-based SAC cements displayed the highest SBS values with both the substrates; GI cement showed the lowest. RMGI and MDP-free SAC cements performed better with 3Y-TZP than with 5Y-PSZ. Fractographic analysis revealed only adhesive and mixed failures. Conclusions MDP-based AC and MDP-based SAC cements are suitable for both 3Y-TZP and 5Y-PSZ. MDP-free SAC and RMGI cements are adequate choices for 3Y-TZP, but seem less effective with 5Y-PSZ. Clinical significance MDP-based SACs appear to be as reliable as MDP-based ACs for both 3Y-TZP and 5Y-PSZ cementation. Specifically, for 5Y-PSZ cementation, resin-based MDP-free SACs do not seem to guarantee predictable results in terms of SBS.

The aim was to evaluate the effects of two LED devices, TL-01 and TL-03 in photodynamic therapy (PDT), onBoth TL-01 and TL-03 showed a significant reduction of bacterial load. The photoinactivation was inversely proportional to the PpIX accumulation. TL-01 and TL-03 promoted proliferation and adhesion of HGFs.Both tested devices for ALAD-PDT were equally effective in significantly reducing

The aim of this study was to compare three different light-curing-units (LCUs) and determine their effectiveness in the adhesive cementation of indirect composite restorations when a light-curing resin cement is used. Two resin composites were selected: Enamel Plus HRI (Micerium) and AURA (SDI). Three thicknesses (3 mm, 4 mm and 5 mm) were produced and applied as overlays and underlays for each resin composite. A standardized composite layer was placed between underlay and overlay surfaces. Light curing of the resin-based luting composites was attained through the overlay filters using LCUs for different exposure times. All specimens were allocated to experimental groups according to the overlay thickness, curing unit and curing time. Vickers Hardness (VH) notches were carried out on each specimen. Data were statistically evaluated. The curing unit, curing time and overlay thickness were significant factors capable of influencing VH values. The results showed significantly decreased VH values with increasing specimen thickness (p &lt, 0.05). Significant differences in VH values were found amongst the LCUs for the various exposure times (p &lt, 0.05). According to the results, a time of cure shorter than 80 s (with a conventional quartz–tungsten–halogen LCU) or shorter than 40 s (with a high-power light-emitting diode (LED) LCU) is not recommended. The only subgroup achieving clinically acceptable VH values after a short 20 s curing time included the 3 mm-thick overlays made out of the AURA composite, when the high-power LED LCU unit was used (VH 51.0). Composite thickness has an intense effect on polymerization. In clinical practice, light-cured resin cements may result in insufficient polymerization for high thickness and inadequate times. High-intensity curing lights can attain the sufficient polymerization of resin cements through overlays in a significantly shorter time than conventional halogen light.

Current research on dental implants has mainly focused on the influence of surface roughness on the rate of osseointegration, while studies on the development of surfaces to also improve the interaction of peri-implant soft tissues are lacking. To this end, the first purpose of this study was to evaluate the response of human gingival fibroblasts (hGDFs) to titanium implant discs (Implacil De Bortoli, Brazil) having different micro and nano-topography: machined (Ti-M) versus sandblasted/double-etched (Ti-S). The secondary aim was to investigate the effect of the macrogeometry of the discs on cells: linear-like (Ti-L) versus wave-like (Ti-W) surfaces. The atomic force microscopy (AFM) and scanning electron microscopy (SEM) analysis showed that the Ti-S surfaces were characterized by a significantly higher micro and nano roughness and showed the 3D macrotopography of Ti-L and Ti-W surfaces. For in vitro analyses, the hGDFs were seeded into titanium discs and analyzed at 1, 3, and 5 days for adhesion and morphology (SEM) viability and proliferation (Cck-8 and MTT assays). The results showed that all tested surfaces were not cytotoxic for the hGDFs, rather the nano-micro and macro topography favored their proliferation in a time-dependent manner. Especially, at 3 and 5 days, the number of cells on Ti-L was higher than on other surfaces, including Ti-W surfaces. In conclusion, although further studies are needed, our in vitro data proved that the use of implant discs with Ti-S surfaces promotes the adhesion and proliferation of gingival fibroblasts, suggesting their use for in vivo applications.

The aim of the study was to evaluate the cytotoxic and genotoxic potential of five commercially available dental composite resins (CRs), investigating the effect of their quantifiable bisphenol-A-glycidyl-methacrylate (Bis-GMA) and/or triethylene glycol dimethacrylate (TEGDMA) release. Experiments were performed using the method of soaking extracts, which were derived from the immersion of the following CRs in the culture medium: Clearfil-Majesty-ES-2, GrandioSO, and Enamel-plus-HRi (Bis-GMA-based), Enamel-BioFunction and VenusDiamond (Bis-GMA-free). Human Gingival Fibroblasts (hGDFs) were employed as the cellular model to mimic in vitro the oral cavity milieu, where CRs simultaneously release various components. Cell metabolic activity, oxidative stress, and genotoxicity were used as cellular outcomes. Results showed that only VenusDiamond and Enamel-plus-HRi significantly affected the hGDF cell metabolic activity. In accordance with this, although no CR-derived extract induced a significantly detectable oxidative stress, only VenusDiamond and Enamel-plus-HRi induced significant genotoxicity. Our findings showed, for the CRs employed, a cytotoxic and genotoxic potential that did not seem to depend only on the actual Bis-GMA or TEGDMA content. Enamel-BioFunction appeared optimal in terms of cytotoxicity, and similar findings were observed for Clearfil-Majesty-ES-2 despite their different Bis-GMA/TEGDMA release patterns. This suggested that simply excluding one specific monomer from the CR formulation might not steadily turn out as a successful approach for improving their biocompatibility.

Background: Several different dental implant microgeometries have been investigated in the literature for use in low-density bone sites. The polyurethane solid rigid blocks represent an optimal in vitro study model for dental implants, because their composition is characterized by symmetrical linear chains of monomers of hexa-methylene sequences producing a self-polymerization process. The aim of the present investigation was to evaluate the primary stability of cylindrical and tapered implants positioned into low-density polyurethane solid rigid blocks. Materials and Methods: Two different macrogeometries, cylindrical (4 mm diameter and 10 mm length) and tapered dental implants (4.20 mm diameter and 10 mm length), were investigated in the present study. The implants were inserted into 10 PCF and 20 PCF polyurethane blocks, with and without an additional cortical layer. The insertion torque (IT) values, the removal torque values (RTVs), and the resonance frequency analysis (RFA) values were measured and recorded. Results: A total of 80 sites were tested, and a significant increased primary stability (PS) was detected in favour of tapered dental implants when compared to cylindrical implants in all experimental conditions (p &lt, 0.05). Higher IT, RT, and RFA values were measured in tapered implants in 10 and 20 PCF polyurethane blocks, both with and without the additional cortical layer. Conclusions: Both implants showed sufficient primary stability in poor density substrates, while, on the other hand, the tapered microgeometry showed characteristics that could also lead to clinical application in low-density posterior maxillary sites, even with a drastically decreased bone cortical component.

Thanks to adhesive techniques and strengthened glass ceramics, ultrathin bonded occlusal veneers have been recently introduced. However, since a universally accepted thickness limit for ultrathin ceramics has yet to be established, their resistance to fracture needs to be better investigated. The purpose of this in vitro study was to evaluate the effect of dentin bonding on the flexural properties (ie, fracture load and flexural strength) of a lithium-disilicate (LD) glass ceramic when used in thicknesses equal to or less than the manufacturer's recommendations for occlusal restorations.A total of 96 dentin slices (2.0 mm thick and 15 mm long) were obtained by sectioning bovine teeth along their long axes. LD slices of different thicknesses (1.5 mm/1.3 mm/1.0 mm/0.8 mm/0.6 mm) and 15 mm in length were cut from CAD/CAM LD blocks (IPS e.max CAD-C16). In each of 5 experimental groups, 16 dentin slices were adhesively luted to 16 LD slices (n = 16) of the same thickness, in order to create 16 bi-layered dentin-LD bonded assemblies. In the control group, the 16 remaining dentin slices were conventionally cemented to 1.5-mm-thick LD slices (n = 16) using a resin-modified glass-ionomer cement (FujiCEM 2). All dentin-LD assemblies were cut perpendicularly to their joint interface, in order to obtain 1-mm-wide, 15-mm-long bi-layered prismatic beams, having the following final thicknesses: for the 5 experimental groups, 2 mm (dentin layer) + 1.5 mm/ 1.3 mm/1.0 mm/0.8 mm/0.6 mm (LD layer); for the control group, 2 mm (dentin layer) + 1.5 mm (LD layer). All prismatic beams were subjected to a three-point bending test (14-mm span, load applied on the LD side). Fracture loads (N) and flexural strengths (MPa) were recorded. Data were analyzed using one-way ANOVA on ranks tests (α = 0.05). The correlations between the recorded flexural strengths and the dentin:LD thickness ratio and between the flexural strength and the luting strategy were also investigated. The failure modes were observed and classified.No statistically significant differences were recorded between the conventionally luted control group (LD thickness 1.5 mm; fracture load 35.26 N; flexural strength 60.44 MPa) and the thinnest adhesively luted experimental group (LD thickness 0.6 mm; fracture load 28.97 N; flexural strength 90.01 MPa) in terms of fracture load and flexural strength. A fracture involving both the dentin and the LD of the bi-layered prismatic beam, but without any debonding between the LD and the dentin substrates of the broken specimen, was the most common failure mode observed on the adhesively luted samples.Compared to conventional cementation, when LD is bonded to dentin, the flexural properties of the whole system are improved, and the two different substrates seem to behave like a single unit. Once adhesively luted, 0.6-mm-thick LD has the same fracture load and flexural strength as that of the conventionally luted 1.5-mm-thick LD.

Aim of the study is to compare the quality of the apical seal offered by a zinc-eugenol and a tricalcium-silicate-based sealer, both used with the single-cone or with the continuous wave of condensation technique. Forty central incisors were divided into four groups (n = 10), according to the two sealers and the two obturation techniques under investigation, and their outer surface was isolated with nail varnish. After endodontic treatment, samples were immersed in methylene blue dye for 72 h, then included in self-curing resin and sectioned to longitudinally expose the canal apical third. The depth of dye penetration was measured in each group. Mean values were compared by two-way-ANOVA test. Multiple comparisons were performed by Tukey test. The level of significance was set at 0.05 in all tests. The continuous wave of condensation technique led to reduced microleakage. Moreover, dye penetration values were reduced for the tricalcium-silicate sealer. In terms of microleakage, the warm continuous wave of condensation technique seems promising even when combined to a bioceramic sealer.

The aim of this in vitro study was to evaluate the effect of air polishing on the implant abutment surface using different abrasive powders: sodium bicarbonate and amino acid glycine. Fifteen grade III machined surface titanium disks with 8-mm diameter and 2-mm thickness were divided in 3 groups of 5 samples each and subjected to air polishing for 20 seconds with an Ultrajet Flex air-abrasive device and a distinct prophylaxis protocol: air and water (G1); air, water, and sodium bicarbonate (G2); and air, water; and amino acid glycine (G3). After the air polishing, the average roughness (Ra) of the samples was measured using an optical profilometer, and the obtained data were statistically analyzed. We found that G1 and G3 had similar Ra, while Ra values for G2 were significantly higher. This study demonstrated that air-polishing powders containing glycine had less of an effect on the roughness of the surface of titanium disks compared with sodium bicarbonate powders. Future in vivo studies will be conducted to investigate the clinical relevance of the present results.

Implant surfaces are known to influence the osseointegration process; therefore, their modifications represent an important subject of investigation. On this basis, the purpose of this study was to evaluate the response of human oral osteoblasts (hOBs) to three different GR4 titanium discs: Machined, double-etched (Osteopore), and double-etched, surface-enriched with calcium and phosphorus (CaP) (Nanopore). The superficial topography was investigated with scanning electron microscopy (SEM) and the sessile drop technique. To test cellular response and osteoinductive properties, the following points were evaluated: (i) proliferation by MTS assay after 2 and 5 days; (ii) adhesion by multiphoton microscopy at day 2; (iii) the interaction with Ti discs by blue toluidine staining at day 5; (iv) alkaline phosphatase (ALP) activity by ALP assay after 14 days; (v) calcium deposition by alizarin red staining and by cetylpyridinium chloride after 14 days. The SEM analysis showed that Nanopore and Osteopore surfaces were characterized by the same micro-topography. Nanopore and Osteopore discs, compared to Machined, stimulated higher osteoblast proliferation and showed more osteoinductive properties by promoting the ALP activity and calcium deposition. In conclusion, the CaP treatment on DAE surfaces seemed to favor the oral osteoblast response, encouraging their use for in vivo applications.

Agenesis of lateral incisors, besides the functional issues, represents a great esthetic drawback. The selection of an appropriate treatment is a complex decision, which should consider the stability of the clinical outcomes over time. The aim of the present study was a histological and clinical comparison of two-stage split crest technique (SCT), with bone chips alone or mixed with porcine bone in patients affected by unilateral and bilateral agenesis of the upper lateral incisors. Eleven patients were enrolled, and randomly assigned to receive a treatment with autologous bone chips (group 1) or autologous bone chips mixed 1:1 to porcine-derived xenogenic bone (group 2). After a 2-month healing period, implants were placed and biopsies harvested for histomorphometrical evaluation. Clinical assessment, according to ICOI PISA health scale, and radiographic marginal bone loss evaluation at 12- and 24-month follow-ups were conducted. The histomorphometry showed significantly greater new bone formation (p > 0.0229) in group 2. At 12- and 24-month follow-ups, all the evaluated implants, regardless of the group they were allocated, could be categorized as “success” in the ICOI Pisa Health Scale for Dental Implants, and did not show significant difference in crestal bone loss. To the best of our knowledge, these are the first histological and clinical outcomes indicating that the use of bone chips mixed 1:1 to porcine bone in SCT could be a promising technique for the rehabilitation of patients with agenesis of the upper lateral incisors, although studies with a larger number of patients and implants, and a longer follow up are needed.

SUMMARY The purpose of this laboratory study was to compare the two-body wear resistance of different restorative materials commonly used for the indirect restoration of posterior teeth. The tested materials, based on ceramic (Imagine Press X, IPS e.max CAD, Milled Celtra Duo, Glaze-Fired Celtra Duo, Vita Mark II) and composite (Enamel Plus HRi, Enamel Plus HRi Bio-Function, Filtek Supreme XTE, Lava Ultimate), were compared with the wear properties of a type III gold alloy (Aurocast 8). Flat samples were prepared with a 6-mm thickness (n=10). Composite samples were tested after a heat polymerization cycle. All samples were exposed to a two-body wear test in a dual axis chewing simulator performing over 120,000 loading cycles. The opposing abrader cusps were fabricated from yttria-stabilized tetragonal zirconia polycrystal. The vertical substance loss (mm) and the volume loss (mm3) were recorded, as was the wear of the antagonist cusp (mm). Mean values were analyzed by one-way analysis of variance. Significant differences among materials were detected. The heat-cured resin-based composite material Enamel Plus Bio-Function and the type III gold alloy demonstrated similar mean values for wear depth and volumetric loss.

This study examined the effects of two deproteinization protocols on dentin microtensile bond strength (µTBS), in situ degree of conversion (DC) and interfacial nanoleakage (NL) of two self-adhesive resin cements (SARCs) after 24 h or 200,000 load cycles. One hundred fourteen third molars were distributed into six groups according to the type of cement and the strategy of deproteinization. Resin cements used were RelyX U200 (RU) and Maxcem Elite (ME) following the manufacturer´s instructions and after deproteinization protocols (NaOCl for 2 min or acid etching before NaOCl for 2 min). The bonded specimens were randomly divided and submitted to microtensile test after 24 h or after 200,000 load cycles. Two slices from each subgroup were prepared for NL using ammoniacal silver nitrate solution, and analyzed through SEM. The in situ DC of three bonded-specimens from each group was measured through micro-Raman spectroscopy. Data was statistically analyzed by Two-way ANOVA and Tukey's test (p

Este artículo se encuentra disponible en la siguiente URL: https://www.sciencedirect.com/science/article/pii/S1751616117304083?via%3Dihub Este es el pre-print del siguiente artículo: Zenobi, W., Pinheiro Feitosa, V., Martins Moura, ME., D'Arcangelo, C., Azevedo Rodrigues, LK. de & Sauro, S. (2018). The effect of zoledronate-containing primer on dentin bonding of a universal adhesive. Journal of the Mechanical Behavior of Biomedical Materials, vol. 77 (jan. 2018), pp. 199-204 que se ha publicado de forma definitiva en https://doi.org/10.1016/j.jmbbm.2017.09.015. El título del preprint es Improvements of zoledronate-containing primer on dentin bonding of an universal adhesive. Objectives. To evaluate the bonding ability and nanoleakage of an universal adhesive applied to dentin after zoledronate-containing primer (zol-primer) before and after mechanical load cycling. Materials and Methods. Flat superficial dentin surfaces were exposed on human molars and ascribed to one of the following adhesion procedures (n=6): 1-Adper Single Bond Universal (SBU) applied in etch-and-rinse mode, 2- SBU applied as etch-and-rinse after the application of zol-primer, 3- SBU applied in self-etch strategy, and 4- SBU applied as self-etch after the use of zol-primer. Half of bonded teeth were processed for microtensile bond strength test after 24h and further were cut and surveyed after 200,000 mechanical cycles. Silver-impregnated specimens were assayed for interface nanoleakage by SEM. Data were analyzed by two-way ANOVA and Tukey’s test (p0.05) in microtensile test. Lower nanoleakage was observed for etch-and-rinse specimens treated with zol-primer. However, noteworthy reduction of adhesive layer thickness was observed with the combination of zol-primer and self-etch strategy. Conclusion. It can be concluded that zol-primer should not be used along with an universal adhesive in etch-and-rinse mode, but its application before self-etch application provides minor alterations. This is the pre-peer reviewed version of the following article: Zenobi, W., Pinheiro Feitosa, V., Martins Moura, ME., D'Arcangelo, C., Azevedo Rodrigues, LK. de & Sauro, S. (2018). The effect of zoledronate-containing primer on dentin bonding of a universal adhesive. Journal of the Mechanical Behavior of Biomedical Materials, vol. 77 (jan. 2018), pp. 199-204 which has been published in final form at https://doi.org/10.1016/j.jmbbm.2017.09.015. Preprint.

SUMMARY The purpose of the present in vitro study was to compare the two-body wear resistance of a type 3 gold alloy (Aurocast8), two lithium disilicate glass ceramics (IPS e.max CAD and IPS e.max Press), a heat-pressed feldspathic porcelain (Cerabien ZR Press), an yttria-stabilized tetragonal zirconia polycrystal ceramic (Katana Zirconia ML), and three heat-cured composite resins (Ceram.X Universal, Enamel Plus Function, and Enamel Plus HRi) opposing antagonistic cusps made out of the same restorative materials. Ten 6-mm-thick samples and 10 cusp-shaped abraders were manufactured with each test material (n=10) according to standard laboratory procedures. All sample/antagonist pairs made out of the same material were subjected to a two-body wear test in a dual-axis chewing simulator for up to 120,000 loading cycles. The total vertical wear (mm) and the total volumetric loss (mm3) for each sample/antagonist pair were calculated. Data were statistically analyzed using one-way analysis of variance tests. The total vertical wear for the gold alloy was not significantly different compared to Ceram.X Universal, Enamel Plus Function, IPS e.max CAD, and Cerabien ZR Press. Significantly increased wear values were observed for Enamel Plus HRi and IPS e.max Press. The lowest values for total vertical wear and volumetric loss were recorded on the monolithic zirconia.

Objectives No-prep veneers, although ideally considered the best option because of tooth structure maximum preservation, have been frequently criticized for some potential limitations including esthetic outcomes and periodontal complications. Clinical considerations A new protocol to optimize no-prep veneers restorations is presented. A key point of the proposed technique is to identify optimal margins’ positions: margin is positioned in the point of maximum convexity of teeth, avoiding the over contouring of traditional no-prep veneers. Conclusion The procedure can be appreciated for the marginal accuracy and the resulting aesthetic stability. The case reports show that properly managed no-prep veneers can have biologically healthy and aesthetically pleasant tooth-restoration transitions and emergence profiles. Clinical Significance High-quality no-prep veneers can be more challenging to realize than conventional veneers and the success seems to depend on a combination of good case selection, margins’ position, sound adhesive principles, clinical, and laboratory experience.

Bulk-fill flowable composites provide functional and aesthetic restorations while eliminating incremental composite layering and saving time. The degradation of the adhesive interface with subsequent gap formation is a concern when adhesively luted restorations are placed. Moreover, the number of adhesive interface failures increases when they are exposed to long-term water storage. The aim of the present study was to evaluate the morphological characteristics of the tooth-composite interface in class II cavities restored with a low stress bulk-fill flowable composite after aging in an oral environment. We describe a case of a patient with class II cavities in four premolars restored with a low stress bulk-fill flowable composite Surefil SDR (Dentsply DeTrey GmbH, Konstanz, Germany). The occlusal part was restored with nano-hybrid resin composite Ceram X Mono (Dentsply DeTrey GmbH). After one year of clinical function, the teeth were extracted and examined in a scanning electron microscope (SEM). It can be concluded that the application of bulk-fill covered with conventional composite seems to provide the homogeneous and stable bond to tooth structure after one year of aging in an oral environment. However, some defects within the dentin-resin composite interface were observed.

Objective Therapeutic options for dental trauma depend on the injuries' features. For patients with uncomplicated tooth fractures, adhesive materials and composite partial veneers may be a therapeutic solution that completely preserves healthy tooth structure. Clinical considerations An ultra-conservative approach, using indirect composite partial veneers to restore fractured anterior teeth is described in these case reports. Conclusion Despite the position of the finish line in the middle of the clinical crown, this solution offers functional and esthetic outcomes using an indirect composite technique, and appears to be a suitable alternative to direct composite restorations or less conservative indirect veneers. Clinical significance Indirect composite partial veneers present considerable advantages, such as ultra-minimally invasive properties and excellent esthetic appearances. The success seems to depend on a combination of sound adhesive principles, adequate design of the restoration, laboratory experience, and cementation techniques. (J Esthet Restor Dent 28:351-358, 2016).

Statement of problem Contemporary pressable and computer-aided design/manufacturing (CAD/CAM) ceramics exhibit good mechanical and esthetic properties. Their wear resistance compared with human enamel and traditional gold based alloys needs to be better investigated. Purpose The purpose of this in vitro study was to compare the 2-body wear resistance of human enamel, gold alloy, and 5 different dental ceramics, including a recently introduced zirconia-reinforced lithium silicate ceramic (Celtra Duo). Material and methods Cylindrical specimens were fabricated from a Type III gold alloy (Aurocast8), 2 hot pressed ceramics (Imagine PressX, IPS e.max Press), 2 CAD/CAM ceramics (IPS e.max CAD, Celtra Duo), and a CAD/CAM feldspathic porcelain (Vitablocs Mark II) (n=10). Celtra Duo was tested both soon after grinding and after a subsequent glaze firing cycle. Ten flat human enamel specimens were used as the control group. All specimens were subjected to a 2-body wear test in a dual axis mastication simulator for 120000 loading cycles against yttria stabilized tetragonal zirconia polycrystal cusps. The wear resistance was analyzed by measuring the vertical substance loss (mm) and the volume loss (mm 3 ). Antagonist wear (mm) was also recorded. Data were statistically analyzed with 1-way ANOVA tests (α=.05). Results The wear depth (0.223 mm) of gold alloy was the closest to that of human enamel (0.217 mm), with no significant difference ( P >.05). The greatest wear was recorded on the milled Celtra Duo (wear depth=0.320 mm), which appeared significantly less wear resistant than gold alloy or human enamel ( P Conclusions The milled and not glazed Celtra Duo showed a small but significantly increased wear depth compared with Aurocast8 and human enamel. Wear depth and volumetric loss for the glaze-fired Celtra Duo and for the other tested ceramics did not statistically differ in comparison with the human enamel.

By means of a finite element method (FEM), the present study evaluated the effect of fiber post (FP) placement on the stress distribution occurring in endodontically treated upper first premolars (UFPs) with mesial–occlusal–distal (MOD) nanohybrid composite restorations under subcritical static load. FEM models were created to simulate four different clinical situations involving endodontically treated UFPs with MOD cavities restored with one of the following: composite resin; composite and one FP in the palatal root; composite and one FP in the buccal root; or composite and two FPs. As control, the model of an intact UFP was included. A simulated load of 150 N was applied. Stress distribution was observed on each model surface, on the mid buccal–palatal plane, and on two horizontal planes (at cervical and root-furcation levels); the maximum Von Mises stress values were calculated. All analyses were replicated three times, using the mechanical parameters from three different nanohybrid resin composite restorative materials. In the presence of FPs, the maximum stress values recorded on dentin (in cervical and root-furcation areas) appeared slightly reduced, compared to the endodontically treated tooth restored with no post; in the same areas, the overall Von Mises maps revealed more favorable stress distributions. FPs in maxillary premolars with MOD cavities can lead to a positive redistribution of potentially dangerous stress concentrations away from the cervical and the root-furcation dentin.

In a previous study, we have shown that non-coherent light-emitting diodes (LEDs) are able to significantly decrease Enterococcus faecalis viability, in vitro. In particular, the concurrent treatment for 5 min with sodium hypochlorite (NaOCl) 1.0% and LED permitted to obtain the total inactivation of the culture. The primary outcome of this study was to verify if the photoinactivation was only temporary or stable over 1 week. The secondary outcome was to verify if using a minor concentration of NaOCl together with LED irradiation, it was possible to reach the total inactivation of the culture. Bacterial suspensions were subjected to different protocols. NaOCl samples were treated with 0.5% sodium hypochlorite for 5 min; LED 5 were subjected to 880-nm LED irradiation for 5 min and LED+NaOCl were contemporary subjected to LED irradiation and 0.5% sodium hypochlorite for 5 min. Then the colony forming units per milliliter (CFU/mL) were analyzed and recorded at 5 min, 24 h, 48 h and 1 week. The data were submitted to ANOVA and LSD post hoc tests at a level of significance of 0.05. Live dead assay and fluorescent microscope observations were also performed for all group at all timing points. The results showed that the 3 protocol treatments were able to decrease significantly the bacterial count respect controls, however, after 5 min, 24 h and 48 h the most effective reduction was measured for NaOCl and NaOCl+LED 5. In the first 48 h LED 5 alone reduced significantly the bacterial count respect controls, but it was higher respect the other tested groups. On the contrary, after 1 week we found an interesting result: samples treated with LED were characterized by a decrement of bacterial count, independently from the addition of sodium hypochlorite. Samples treated with NaOCl alone were characterized by a mild increment of bacterial count, although results were still significant respect C+. The secondary outcome was not confirmed: a concentration of NaOCl 0.5% together with LED irradiation did not permit to reach the total inactivation of the culture.