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Sjögren’s syndrome is an autoimmune disease that is associated with inflammatory changes, reduced salivary flow, and altered saliva composition. The effects of medications and injuries to the salivary ducts can contribute to the increased salivary viscosity with serious consequences for the teeth and soft tissues. The remineralization capacity of saliva is based on its ability to provide the necessary minerals, maintain a favorable pH balance, and support the natural mechanisms implied in the repair processes of the tooth structure. The aim of this study is to evaluate the impact of salivary pathology in Sjögren’s Syndrome, and the correlations on certain cariogenic risk parameters. Materials and method: The study was conducted on 30 patients: Study group (15 patients) with primary Sjögren’s Syndrome; Control group (15 patients) – without associated general pathology. The evaluation focused on the analysis of DMFT and the following salivary parameters: resting salivary flow (RSF), stimulated salivary flow (SSF), buffering capacity (BC), saliva viscosity (SV), and the index of salivary microcrystallization (IMK). The evaluated results demonstrate that the effects of Sjögren’s syndrome on the selected indicators (DMFT, RFR, RFS, CT, SV, IMK) are significantly different compared to the control group, indicating the Sjögren syndrome’s impact on the dental and salivary status of affected patients. Conclusions: There is a correlation between dental caries, saliva, and Sjögren’s syndrome. Reduced saliva production in Sjögren’s syndrome can lead to xerostomia-associated phenomena, disturb the balance between demineralization and remineralization processes, and may contribute to an increased risk of caries.

The aim of the study was to evaluate the effects of a 2% chlorhexidine digluconate solution on the glass-ionomer cement (GIC) – dentin interface subjected to a simulated cariogenic attack. Forty extracted teeth were used in the study. On each proximal surface a box-only cavity was prepared. Each cavity was initially conditioned using GC Dentin Conditioner (GC Corp., Tokyo, Japan), then the distal cavities were pre-treated with a 2% Chlorhexidine solution. All the cavities were then restored using GIC GC Fuji IX GP Capsule (GC Corp., Tokyo, Japan). Half of the samples (n=40) were submersed in a lactic acid-based solution to simulate the cariogenic attack. The samples were then sectioned and the marginal sealing at the cervical margin was assessed by optical microscopy and scanning electron microscopy. Statistically significant differences were recorded when comparing the samples submersed in demineralizing solution with or without chlorhexidine pre-treatment vs. samples that were not pre-treated and not submersed in acid with significance levels of p=0.044 and p=0.021. In conclusion, the use of 2% chlorhexidine digluconate in dentin pre-treatment do not significantly influence the marginal sealing of glass-ionomer cements to dentin. Seven days of submersion in a lactic acid-based demineralizing solution influences the marginal adaptation of glass ionomer cements to dentin with or without 2% chlorhexidine digluconate pre-treatment.

The aim of the present study was to assess by using a questionnaire, the knowledge and understanding level of dental postoperative sensitivity through dental practitioners. A number of 431 dental practitioners coming from rural or urban practices, in private or public environment, with a bachelor’s degree or with postgraduate studies received this specifically developed questionnaire. The questionnaire consisted of a series of socio-demographic questions, followed by 14 questions related to postoperative sensitivity. The questionnaire contained 7 single-choice and 7 multiple-choice questions. For the statistical analysis of the obtained results Pearson Chi-square and Independent sample t-test were used. For all 14 questions, the correct answers were indicated by the majority of respondents, regardless of the training level or the environment of origin. Both postgraduate and bachelor’s degree dental practitioners had a similar level of knowledge regarding the etiology, symptomatology and therapeutic management of postoperative dental sensitivity. The knowledge level about dental postoperative sensitivity does not differ between dental practitioners in the public and private sectors.

Tobacco smoke contains a variety of harmful chemicals such as tar, benzopyrene, formaldehyde and hydrogen cyanide. These substances can affect both the quality and quantity of saliva, thus disrupting remineralization processes. Smoking can have a significant impact on the inorganic component of saliva and, consequently, can affect its viscosity and degree of mineralization.The aim of this study was to evaluate the impact of smoking and the correlations of some cariogenic risk parameters such as DMFT Index, resting and stimulated salivary flow rate, salivary pH and buffer capacity and micro-crystallization index in smokers using classic and electronic cigarettes. Material and method:The study was performed on 50 patients from the Clinical Base of the Faculty of Dental Medicine, “Grigore T. Popa” University of Iași, Romania with a medium number of carious lesions and a medium carious risk. The patients aged between 19 and 35 years, were divided into five groups (n=10): I – non-smokers, II – light smokers (1-10 classic cigarettes/day), III – moderate smokers (10-20 classic cigarettes/day), IV – high consumption (over 20 classic cigarettes/day) and V – electronic cigarette smokers. Results showed that the DMFT index values were very low in non-smokers while the highest values were reached by the electronic cigarettes users. Regarding the resting and stimulated salivary flow rate, the values decreased significantly in classic cigarettes medium and high consumers and in electronic cigarettes users when compared to non-smokers. When analyzing the pH and buffer capacity values it can be observed that smoking more than 10 cigarettes per day or the use electronic cigarettes can significantly reduce the values. The micro-crystallization index is also reduced in electronic cigarettes smokers or in medium or high classic cigarettes consumers. Conclusions: Consumption of more than 10 classic cigarettes per day or electronic cigarette affects the resting and stimulated salivary flow rate, the salivary pH value, the buffer capacity and the micro-crystallization index. E-cigarette users or smokers of more than 20 cigarettes per day are associated with an increased number of decayed, missing or filled teeth.

Aim of the study Since a century ago, xylitol, a white, crystalline carbohydrate, has been known as a naturally occurring five-carbon sugar polyol. Its impact on dental caries has been extensively researched during the previous forty years. It can be derived from plant materials rich in xylan, like the wood of birch and beech trees, and is naturally present in fruits, vegetables, and berries. The amount of MS in dental plaque and saliva is reduced because xylitol interferes with the energy-producing processes of Mutans Streptococci (MS), causing their death. It also reduces the adhesion of these microorganisms to the surface of teeth and, as a result, decreases their acid-producing potential. Conclusions Despite all the information available on xylitol, further study is still required to fully understand its mechanisms of action, the clinical implications of xylitol resistance, and how it affects Streptococcus Mutans and the plaque-saliva complex. Properly planned randomised controlled clinical trials must be conducted in conjunction with research to show that xylitol prevention is feasible in a variety of groups with various dietary and dental hygiene practices. It is also necessary to thoroughly confirm the best delivery methods for xylitol and the degree to which it can be “diluted” with other polyols without losing its ability to prevent dental caries. It is necessary to calibrate the minimal daily dose and frequency required for xylitol’s effects on MS, dental plaque, and caries.

Aim. To determine factors influencing esthetic, functional and biologic criteria related to the status of the direct nanohybrid composite-based restorations. Materials and methods. The study group consisted of 45 patients (mean age: 24.88 ± 6.709 yr; gender: 24 males, 21 females) with dental caries in posterior dental group that were treated in Clinical Base of Faculty of Dental Medicine, U.M.F. Grigore T.Popa Iasi (Romania). The status of 241 direct nanohybrid composite-based restorations was analyzed by using FDI indices. Risk factors for unacceptable FDI scores (4-5) of nanohybrid composite-based direct occlusal and occlusal-proximal restorations were determined by using Pearson Chi-squared test and multivariate analysis. Results. 71,1% from all posterior composite resin restorations received scores FDI 1-3. Esthetic FDI scores 1-3 were recorded for 73,4% of all restorations, functional FDI scores 1-3 for 79,3% of all restorations, and biological FDI scores 1-3 for 86,25% of all restorations. Class II restorations had a 2.880 times higher risk of receiving FDI scores of 4-5 when compared to class I restorations, and composite restorations with an age of 3-5 years had a 2.081 times higher risk of receiving FDI scores of 4-5 when compared to restorations with an age of 1-2 years. Conclusions: Class II and age of restorations between 3-5 years are statistically significant predictors of unsatisfactory or unacceptable FDI scores for posterior composite resin restorations. Overall, high cariogenic risk is a risk factor for unsatisfactory or unacceptable FDI scores. Gender, class II, and restorations with age between 3-5 years are statistically significant predictors of unsatisfactory or unacceptable FDI esthetic scores. High cariogenic risk patients, class II, and restorations with age between 3-5 years are statistically significant predictors of unsatisfactory or unacceptable FDI functional scores. Class II and age of restorations between 3-5 years are statistically significant predictors of unsatisfactory or unacceptable FDI biological scores.

A unitary model of drug release dynamics is proposed, assuming that the polymer–drug system can be assimilated into a multifractal mathematical object. Then, we made a description of drug release dynamics that implies, via Scale Relativity Theory, the functionality of continuous and undifferentiable curves (fractal or multifractal curves), possibly leading to holographic-like behaviors. At such a conjuncture, the Schrödinger and Madelung multifractal scenarios become compatible: in the Schrödinger multifractal scenario, various modes of drug release can be “mimicked” (via period doubling, damped oscillations, modulated and “chaotic” regimes), while the Madelung multifractal scenario involves multifractal diffusion laws (Fickian and non-Fickian diffusions). In conclusion, we propose a unitary model for describing release dynamics in polymer–drug systems. In the model proposed, the polymer–drug dynamics can be described by employing the Scale Relativity Theory in the monofractal case or also in the multifractal one.

There are two main methods used for dentin hypersensitivity (DH) treatment: dentinal tubule occlusion and blockage of nerve activity. Dentifrices are the most common vehicles for active ingredients used for DH treatment. The aim of this study was to evaluate the efficacy of three toothpastes on dentinal tubule occlusion, mineral acquisition, and dentin hardness. Forty human dentin disks were submerged in 40% citric acid for 30 s and then exposed to tooth brushing for 2 min twice a day for 14 days using three toothpastes: Dontodent Sensitive (group 1), Dr. Wolff’s Biorepair (group 2), and Sensodyne Repair and Protect (group 3). In the control group (group 4), the samples were brushed with water. All of the samples were evaluated using scanning electron microscopy (SEM), energy-dispersive X-ray (EDX), and Vickers dentin hardness determination. On SEM images, the degree of dentinal tubule occlusion was assessed using a five-grade scale. The mean score values in groups 1–4 were 3.60 ± 0.69, 2.20 ± 0.91, 2.30 ± 1.16, and 5.00 ± 0.00, significantly higher in study groups when compared to the control group (Kruskal Wallis test p < 0.05). EDX evaluation showed significantly higher calcium and phosphorus concentrations in groups 1 and 3 when compared to control group d. The mean values of Vickers dentin hardness numbers in groups 1–4 were 243.03 ± 10.014, 327.38 ± 56.65, 260.29 ± 37.69, and 225.83 ± 29.93, respectively. No statistically significant results were obtained when comparing the hardness mean values in groups (Kruskal-Wallis statistical test, p = 0.372 > 0.05). All three toothpastes tested demonstrated significant occlusion of dentinal tubules. Dontodent Sensitive and Sensodyne Repair and Protect toothpastes enhanced the calcium and phosphorus content of the dentin surface. None of the toothpastes increased dentin hardness as a result of mineral acquisition.

The aim of the study was to evaluate if there are significantly differences in immediate marginal adaptation of a self-adhesive flowable composite resin used in association with a universal bonding agent and to compare the sealing ability to a conventional flowable composite resin. Class V cavities were prepared on the buccal and lingual surfaces of eighteen molars and bicusps. The cavities were restore using a self-adhesive flowable composite resin (Vertise™ Flow, Kerr Dental), a conventional flowable composite resin (Neo Spectra™ ST Flow, Dentsply Sirona), and a universal adhesive system (Prime and Bond Active, Dentsply Sirona) applied in etch and rinse or self etch strategy. The teeeth were submersed in distilled water for 24 hours, then in 2% methilen blue solution for 24 hours. Buccal-lingual sections were obtained by cutting the teeth and were evaluated using an optic microscope. The microleakage at gingival and occlusal margins was assessed by dye penetration according to a 4 grade scale. There was no significantly different microleakage when using Vertise™ Flow in association with the universal bonding agent or without it. The use of Vertise™ Flow self-adhesive composite resin determined similar enamel and dentin microleakage, irrespective the use of a bonding system or the strategy of bonding application. Conventional flowable resin Neo Spectra™ ST used in association with the bonding agent lead to a significantly higher microleakage when comparing to self-adhesive composite resin Vertise™ Flow used in the same conditions.The association of a bonding agent applied in etch and rinse or self etch strategy and the conventional flowable resin Neo Spectra™ ST significantly decreases enamel and dentin microleakage.

The hybrid layer is the key for bonding between composite resins and mineralized dental tissues. Bonding to dentin is problematic because of the morphological complexity, high content of water and organic components, and lack of compatibility with hydrophobic monomers. Moreover, the stability of the hybrid layer is challenged over time by degradation phenomena that affects both components of the hybrid layer: the dentin organic matrix and the adhesive resin. Both degradation phenomena are the result of hydrolysis mechanisms involving the residual water preserved in the hybrid layer. The main problem continues to be the dentin collagen degradation determined by host-derived metal proteinases. Various strategies have been proposed to improve the bond stability at dentin-composite resin interface, which aim either to increase the resistance of demineralized dentin and resin to degradation or to decrease the residual water within the hybrid layer. Further studies should aim to identify the most effective combination adhesive – metalloproteinase inhibitor and the most suitable strategy for improved dentin hybridization and stability of the hybrid layer.

The aim of the study was to evaluate the antibacterial activity and surface hardness of a light-activated microhybrid composite resin modified with green silver nanoparticles (AgNPs). AgNPs were synthesized using an Equisetum sylvaticum extract and characterized through different methods such as UV-Vis, EDX, and FTIR. The obtained AgNPs were mixed with a microhybrid composite resin (Herculite XRV, Kerr Corp., Orange, CA, USA) in different concentrations: 0% (group A-control); 0.5% (group B); 1% (group C); and 1.5% (group D). A total of 120 composite resin disk-shaped samples were obtained and divided into 4 groups (n = 30) according to AgNP concentration. Each group was then divided into 2 subgroups: subgroup 1—samples were not soaked in 0.01 M NaOH solution; and subgroup 2—samples were soaked in 0.01 M NaOH solution. The antibacterial activity against Streptococcus mutans was determined using a direct contact test. A digital electronic hardness tester was used to determine the composite resin’s Vickers surface hardness (VH). Statistical analysis was performed using the Mann–Whitney U and Kruskal–Wallis nonparametric tests with a confidence level of 95%. Groups C and D showed higher antibacterial activity against S. mutans when compared to the control group (p < 0.05). No significant differences were recorded between VH values (p > 0.05). The use of AgNPs synthesized from Equisetum sylvaticum as a composite resin filler in 1% wt. and 1.5% wt. reduced the activity of Streptococcus mutans. Soaking of the experimental composite resin decreased the antibacterial efficacy. The loading of a microhybrid composite resin with AgNPs in concentrations of 0.5% wt., 1% wt., and 1.5% wt. did not influence the surface hardness.

Two formulations based on diclofenac sodium salt encapsulated into a chitosan hydrogel were designed and prepared, and their drug release was investigated by combining in vitro results with mathematical modeling. To understand how the pattern of drug encapsulation impacted its release, the formulations were supramolecularly and morphologically characterized by scanning electron microscopy and polarized light microscopy, respectively. The mechanism of diclofenac release was assessed by using a mathematical model based on the multifractal theory of motion. Various drug-delivery mechanisms, such as Fickian- and non-Fickian-type diffusion, were shown to be fundamental mechanisms. More precisely, in a case of multifractal one-dimensional drug diffusion in a controlled-release polymer–drug system (i.e., in the form of a plane with a certain thickness), a solution that allowed the model’s validation through the obtained experimental data was established. The present research reveals possible new perspectives, for example in the prevention of intrauterine adhesions occurring through endometrial inflammation and other pathologies with an inflammatory mechanism background, such as periodontal diseases, and also therapeutic potential beyond the anti-inflammatory action of diclofenac as an anticancer agent, with a role in cell cycle regulation and apoptosis, using this type of drug-delivery system.

The aim of the study was to evaluate the influence of some characteristic of the light curing unit (polymeriyation mode and the distance between light curing tip to the surface of composite resin) on the efficiency of SDR® Plus bulk fill flowable base composite. U (universal), A2, and A3 shades was used in the study. Fiftyfive samples from each shade were prepared by injection the flowable resin in cylindrical plastic molds with the intern diameter of 5 mm. Three types of plastic molds according to their hight were used: 6 mm, 8 mm, and 10 mm. The tip of the light curing unit was placed on top of the mold and composite resin was light cure for 20 seconds for U shade and 40 seconds for A2 and A3 shades. Top and bottom surface Vickers hardness was determined using a digital microhardness. The hardness ratio of each specimen was also calculated Polymerization efficiency of SRD® Plus bulk-fill flowable base composite resin was not affected by the distance from the light sourse to the surface of the material and the light curing mode. Staggared polymerization mode of the light curing unit determines slightly low values of surface hardness when comparing to inclined and normal polymerization modes. Darker shades of bulf fill flowable base composite resin seems to present decreased surface hardness when comparing to ligther shades irrespective the distance from the light curing unit to the material surface and the mode of polymerization.

The aim of the present study was to evaluate, based on a DHEQ questionnaire, the quality of life of a group of 25 students, 12 men and 13 women, from the Faculty of Dentistry, U.M.F. “Grigore T.Popa” Iasi (Romania) suffering from dentinal hypersensitivity. Materials and method. Patients were divided into 4 groups according to age: 20-25; 26-30; 31-35 and 36-40 years. The questionnaire included 15 questions, each with scores from 1 to 7 according to Likert scale. The data were analysed using Excel. Results. High scores values ​​ (5-7) on each question in the questionnaire (> 50% of the respondents) were obtained in 10 of the 15 questions, 84% of the people giving high scores to question no. 3; 80% to question 12; and 76% to questions 4,5,6,7,8. The lowest percentage (40%) of people who gave scores between 5-7 were for questions 9, 10, 13.15. Conclusions. As dental hypersensitivity is increasingly common in young people, we believe that the questionnaire method can be a means of quickly and completely assessing this condition. This method can help the dentist together with the clinical and paraclinical examination in making a correct diagnosis and developing an appropriate treatment plan. At the same time, with this quick method, the patient can become aware that the symptoms cannot be neglected and he must address to the dentist for diagnosis and treatment.

Aim of the study: The aim of this study was to validate and implement the Romanian version of DHEQ-15. Material and methods: A total of 132 questionnaires DHEQ-15 were distributed among senior dental students (6th year of study). The DHEQ-15 consists of 15 items with coded responses on 7-point Likert scales. The form was translated into Romanian using the forward-backward process. The standard descriptive methods were applied to determine the characteristics of the sample. Results: The response rate of the self-administered questionnaire was 87.87%. A total of 74 students (63.8%) declared that had experienced DH in the last month and 58% of them disagreed that this condition had a negative impact on their lives. The average total score recorded was 46.16 ± 19.680. Conclusions: This is the first study that validates the Romanian version of DHEQ-15. The findings of this research indicate that senior dental students do not consider that DH has a negative impact on their quality of life.

The aim of this in vitro study was to analyze, both experimentally and theoretically, the mechanical behavior of two types of composite materials used in restoring dental integrity. The samples of each composite resin, namely Filtek Supreme XT (3M ESPE, St. Paul, MN, USA) and Filtek Z250 (3M ESPE, St. Paul, MN, USA), were experimentally analyzed by determining their compressive strength and fracture behavior. The fractured fragments of the samples were subjected to surface evaluation by scanning electron microscopy. The compressive stress—compressive strain dependencies revealed stronger cracking of the Filtek Supreme XT composite than Filtek Z250 prior to fracture. Theoretically, the evaluation was made by means of holographic implementations of such types of composite materials. A Hooke-type equation in a differential form is presented, which links the proposed theoretical model with the experimentally obtained data.

Background: The aim of the study was to assess the protective effect of applying potassium iodide (KI) over silver diamine fluoride (SDF) on demineralized root dentin in the case of a sustained acidogenic attack. Methods: Forty caries-free third molars were used in the study. A diamond disc was used to separate the roots and the tooth crowns from the roots. Each root fragment was randomly distributed in one of the four study groups: C—samples were not demineralized; DD—demineralized samples; RS1—demineralized samples covered with SDF+KI (RS-Riva Star product, SDI limited, Bayswater, Australia); RS2—demineralized samples covered with SDF+KI and submersed to another acidic challenge for 3 days. SEM and EDX were used for the morphological and elemental analysis. Vickers hardness assessment was performed using a tribometer CETR UMT-2 (Bruker Corporation, Berlin, Germany). One-way ANOVA and post hoc Bonferroni tests were used for the statistical analysis with a significance level of p < 0.05. Results: Morphological and elemental changes were observed on the surface of the study samples. Significant differences were observed between the recorded hardness values of groups C and DD (p = 0.005), C and RS2 (p = 0.002), DD and RS1 (p = 0.011); RS1 and RS2 (p = 0.004). Conclusions: The application of SDF and KI (Riva Star product) on root dentin caries resulted in the formation of a heterogeneous outer layer that sealed the dentin and increased the microhardness of the treated surface. In the conditions of the present study, this layer did not provide enough protection for root dentin exposed to continuous attacks.

The aim of the study was to evaluate the composite resin-tooth interface when using a universal adhesive applied in different etching strategies. Materials and method: 20 class V cavities were prepared in extracted teeth and restored with a composite resin using a universal adhesive system. Half of the restorations were applied using etch-and-rinse technique and the other half were applied with self-etch technique. The samples had been subjected to a dye penetration microleakage test and then the teeth were axially sectioned. The microleakage scores and the morphology of the adhesive joint were evaluated using an optical microscope and a scanning electron microscope. Results: The microleakage scores did not show a significant difference between the self-etch group and the total etch-group. For both groups, no significant gaps were noticed, however few cracks were visible within the adhesive layer. The SEM images showed the preservation of a tide contact between the composite resin and the dental tissues in most specimens of the both groups. An adhesive joint involving a layer of adhesive resin was formed between composite resin and both enamel and dentin regardless of the chosen technique (self-etch or total etch strategy). Conclusions: The immediate sealing qualities and the morphology of the interface did not significantly change when total etch strategy had been used when comparing to self-etch strategy.

Cervical cancer represents a major health problem among females due to its increased mortality rate. The conventional therapies are very aggressive and unsatisfactory when it comes to survival rate, especially in terminal stages, which requires the development of new treatment alternatives. With the use of nanotechnology, various chemotherapeutic drugs can be transported via nanocarriers directly to cervical cancerous cells, thus skipping the hepatic first-pass effect and decreasing the rate of chemotherapy side effects. This review comprises various drug delivery systems that were applied in cervical cancer, such as lipid-based nanocarriers, polymeric and dendrimeric nanoparticles, carbon-based nanoparticles, metallic nanoparticles, inorganic nanoparticles, micellar nanocarriers, and protein and polysaccharide nanoparticles. Nanoparticles have a great therapeutic potential by increasing the pharmacological activity, drug solubility, and bioavailability. Through their mechanisms, they highly increase the toxicity in the targeted cervical tumor cells or tissues by linking to specific ligands. In addition, a nondifferentiable model is proposed through holographic implementation in the dynamics of drug delivery dynamics. As any hologram functions as a deep learning process, the artificial intelligence can be proposed as a new analyzing method in cervical cancer.

Background and Objectives: The aim of this in vitro study was to evaluate the combined effect of a 2% chlorhexidine aqueous solution and a universal adhesive system applied in self-etch and etch-and-rinse strategies on the composite resin–dentin interface. Materials and Methods: Class V cavities were prepared on the facial and lingual surfaces of forty caries-free molars extracted for orthodontic reasons. The samples were randomly divided into two groups corresponding to the used etching protocol: I—etch-and-rinse; II—self-etch. In each tooth, one cavity was assigned for the control subgroups -IA (n = 20) and IIA (n = 20)—adhesive only, and the opposite cavity was pretreated with a 2% chlorhexidine solution—Gluco CHeX Cerkamed—subgroups IB (n = 20) and IIB (n = 20). Both sets of groups were restored using a universal adhesive system (Single Bond Universal Adhesive, 3M-ESPE) and a bulk-fill composite resin (Filtek One Bulk Fill Restorative, 3M-ESPE). The roots and the pulp tissue were then removed, and a needle connected to a perfusor with 100 mL saline solution was used for pulp pressure simulation with a hydrostatic pressure of 20 cm H2O. Cariogenic attack was simulated using a demineralizing solution for 3 days at a constant temperature of 25 °C. The teeth were then sectioned in a facial-lingual direction and the microleakages at the occlusal and cervical margins were registered and scored using an optical Carl-Zeiss AXIO Imager A1m microscope (Carl-Zeiss). The composite resin–dentin interface was analyzed using a SEM Vega Tescan LMH II. Statistical analysis was performed using the Kruskal–Wallis test with a significance level of p < 0.05. Results: Microleakage evaluation showed no significant differences among the study groups (p > 0.05). In subgroup IA, significant differences were recorded between occlusal and cervical margins (p < 0.05). Conclusions: Application of chlorhexidine on tooth substrate before using a universal bonding system in total etch or self-etch mode has no influence on the adhesive interface in the condition of cariogenic attack. The thickness of the adhesive resin layer seems to be less uniform when using chlorhexidine, but the morphological differences at the adhesive interface have no influence on the sealing capacity of the universal bonding system, regardless of the etching strategy.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of simulated gastric acid associated with toothbrushing on the surface condition of three resin-modified glass-ionomer cements (RMGIC). Materials and Methods: One hundred and sixty samples of each material were obtained and included in three study groups according to the tested material: Group I (Ionolux, VOCO GmbH, Cuxhaven, Germany); Group II (Vitremer, 3 M-ESPE, St. Paul, MN, USA); and Group III (Fuji II LC, GC Corporation, Tokyo, Japan). The samples were submersed in hydrochloric acid 0.01 M (pH 3.8) for 3 h and exposed to a toothbrushing procedure at a frequency of 10,000 cycles with medium and hard bristles immediately or 30 min after the acid attack. Profilometric measurements were performed by using a non-contact profilometer (Dektak XT, Bruker, Billerica, MA, USA) in order to assess the surface roughness. ANOVA and Bonferroni post hoc tests were used for the statistical analysis at a significance level of p < 0.05. Results: Exposure of RMGICs to the erosive effect of hydrochloric acid in association with toothbrushing 30 min after the chemical attack increased the surface roughness of all three RMGICs. Exposure of the three tested materials exclusively to the action of hydrochloric acid did not affect the surface roughness. Conclusions: One year of hydrochloric acid challenge associated with one year of toothbrushing with medium-hardness bristles performed 30 min after the acid attack increase the surface roughness of two of the three types of RMGIC tested (Ionolux and Fuji II LC).

The aim of this study was to assess, by using VAS indices and SCHIFF scale, the effectiveness of a desensitising product with role in the blocking of the dentinal tubules, at 24 hours and 1 week after its application. Material and methods. The clinical study was performed on 37 teeth (7 incisive; 9 canines; 17 premolars and 4 molars), divided in two groups: Group 1 (n = 18) –teeth treated with desensitiser agent Voco Profluorid® Varnish; Group 2 (n=19) –placebo (distilled water). Results. VAS indices at baseline were 5.14 (at stimulation with air spray). 24 hours after desensitising session the mean value of VAS indices decreased, in group 1, from 6.07 to 1.00. 1 week after desensitising session the mean value of VAS indices was 1.03. VAS indices for placebo group remained 3.05. Schiff indices at baseline had 1.78 mean values for the teeth taken in study. Schiff indices for group 1 decreased from 2.38 to 0.357 after 24 hours, and increased to 0.864 after 1 week. Placebo group had the same Schiff value (0.86) during the study period. Conclusions. Voco Profluorid® Varnish was effective in the treatment of the dental cervical hypersensitivity with one single session, and the desensitising effect was maintained after 1 week. The use of this product in multiple treatment sessions could determine the complete closure of the dentinal tubules.

The aim of the present study was to assess by atomic force microscopy (AFM) the surface roughness of a traditional glass ionomer cement- GIC (Fuji IX GP, GC Corporation, Tokyo, Japan) and a resin modified glass ionomer cement- RMGIC (Vitremer, 3M ESPE, St. Paul, MN, USA) after different immersion regimes on some acidic drinks. Sixteen cylindrical samples having the height of 5 mm and the thickness of 2 mm were obtained from each material and they were divided into two groups: Group I (Fuji IX samples) and Group II (Vitremer samples). Specimens of each group were then randomly divided into 4 subgroups: subgroup A (control)—15 samples were kept in artificial saliva and in the other three subgroups, each having 15 samples the samples were immersed in Coca-Cola (subgroup B), Cappy lemonade and mint (subgroup C) and Fuzetea (subgroup D) for 7 days (subgroups A1–D1), 14 days (subgroups A2–D2), and 21 days (subgroups A3–D3). AFM qualitative and quantitative surface evaluation (mean value of surface roughness parameter, Sa) of each sample was performed. The highest surface roughness was determined when both materials were submerged 14 days in acidic drinks. Traditional GIC was more affected by acidic environment when comparing to RMGIC.

The aim of this study was to evaluate the Vickers hardness (HV), indentation and Young`s modulus to 4 materials of coronal restoration. Materials and methods Six samples of 5mm in diameter and 6 inches were made of the following materials: Filtek Z250 (3M ESPE Co.), Zmack Comp (Zermack SpA, Italy), Kalore (GC Corporation, Japan); Dyract eXtra (Dentsply De Trey Gmbh, Germany). After polymerization of the samples for 40 seconds using the LEDidition lamp (Ivoclaire Vivadent clinical, Austria), these were finished, polished and kept in distilled water at room temperature for 48 hours. The hardness was measured at the UMT-2 Tribometer (CETR), and the values obtained in GPA were converted to Vickers hardness (kgf/mm2). For each sample, six indentations were made and the mean of the values obtained was calculated. On the same device, the Young`s modulus was also measured for all samples. Results Statistical data showed that the mean HV and modulus of elasticity values were the folowing: Filtek Z 250> Zmack Comp> Dyract eXtra> Kalore. In the case of the depth of the indentation, the values were inversely proportional to the Vickers hardness of the materials: Kalore> Dyract eXtra> Zmack Comp> Filtek Z 250. Conclusion Vickers hardness and Young's modulus were higher to the microhybrid composite compared to nano-hybrid composite and compomer.

Endometriosis is considered a serious public health issue because of the large number of females affected by this illness. Chronic pain management in patients with endometriosis demands new strategies to increase the life quality of these patients. The development of drug delivery systems represents a new approach in pain treatment among endometriosis patients. Diclofenac sodium, one of the most utilized nonsteroidal anti-inflammatory drugs (NSAID), has its own limitations when being used in formulas such as oral, parental, or local applications. In this paper, a series of four drug release formulations based on chitosan, 2-hydroxy-5-nitrobenzaldehyde, and diclofenac sodium salt were prepared in view of the investigation of the drug release ability. The formulations were analyzed from a morphological and supramolecular point of view by scanning electron microscopy and polarized light microscopy. The in vitro drug release ability was investigated by mimicking a physiologic environment. A mathematical model, using the fractal paradigm of motion, is utilized to explain the behaviors of the drug delivery system presented in this paper. These results suggest a great potential of the proposed drug delivery system, based on chitosan and 2-hydroxy-5-nitrobenzaldehyde to improve the diclofenac sodium salt bioavailability, and it may represent a future treatment formula for endometriosis pain.

This in vitro study aimed to assess the erosive effect of hydrochloric acid in association with toothbrushing procedure on the surface condition of three bulk-fill composite resins used for direct restoration. A total of 480 samples (160 from each composite resin): X-tra Fil (VOCO, Germany)—group A, Filtek Bulk-fill Posterior (3M-ESPE, St. Paul, MN, USA)—group B, G-aenial Posterior (GC Japan)—group C were prepared, submitted to chemical attack for 60 min with hydrochloric acid 30% and, subsequently, submitted to the abrasive effect of toothbrushing using 10,000 cycles with medium and hard bristles, at three different times (immediately and after 30 min after acid attack or without any chemical attack). The surface roughness of the samples was measured using a noncontact profilometer (Dektak XT, Bruker, Billerica, MA, USA). The values were analyzed using ANOVA and post hoc Bonferroni tests, with a p < 0.05. Chemical attack for 60 min associated with one year of toothbrushing with toothbrushes having medium or hard bristles increase the surface roughness of tested bulk-fill composite resins. No differences were recorded between toothbrushing with medium or firm bristles immediately or 30 min after acidic challenge for each of the three bulk-fill composite resins. Exposure to hydrochloric acid determines no effect on surface roughness of bulk-fill composite resins.

The aim of this in vitro study was to evaluate the effect of hydrochloric acid associated with the abrasive effect of toothbrushing on the surface condition of three flowable composite resins used for direct restoration. Seventy samples of each composite resin: Grandio Flow (VOCO, Germany)—group A, Filtek Ultimate Flow (3M-ESPE, MN, USA)—group B, G-aenial Flo X (GC Europe)—group C were prepared, submersed in hydrochloric acid 30% for 60 min and then submitted to simulated toothbrushing procedure using 5000 cycles with toothbrushes with medium and hard bristles, immediately after the chemical attack, after 30 min or without any chemical attack. The sample’s surface roughness was analyzed using a noncontact profilometer (Dektak XT, Bruker, USA). ANOVA and post hoc Bonferroni tests, with a p < 0.05, were used to analyze the values. Hydrochloric acid action for 60 min and six months of toothbrushing using toothbrushes having medium hardness or firm bristles affects the surface roughness of tested flowable composite resins. Toothbrushing with firm bristles immediately after acidic challenge determines increased surface roughness for two of the three flowable composite resins (Grandio Flow and Filtek Ultimate Flow). Toothbrushing with medium or firm bristles thirty minutes after the acidic aggression determine no effect on surface condition of flowable composite resins.

The surface characteristics of the dental restoration influence the esthetic quality, the tactile sensation, the resistance to corrosion-abrasion phenomena and the adhesion of the bacterial biofilm. Recently a new system has been introduced for finishing and polishing composite restorations. Profine (Dentatus) system consists of a contraangle handpiece using reciprocating movement and special diamond and carbide tips. The purpose of of this study was to investigate the surface roughness of several composite resins when using the Profine System with Lamineer tips. Four commercially light-cured composite resins were tested. 10 discs were prepared for each material. Profine handpiece was used for finishing procedures. For each material 5 discs were finished using the diamond tips and the other 5 using the tungsten carbide tips. The surface roughness was evaluated using a profilometer (Surftest SJ-210, Mitutoyo). Significant differences of the surface roughness have been found between the tested materials, for both types of Lamineer tips. The surface roughness of composites seems to be dependent on both material and type of Lamineer tip used for polishing. Although the Profine-Lamineer system has shown promising results, further studies on the influence of time, pressure, and speed of the movement are needed in order to assess the best protocols for polishing restorations when using this system

Xylitol is a natural polyol, used as saccharine replacer and noncariogenic edulcorant, promoting the remineralisation both by the increasing of saliva rate and inhibition of bacteria growth. Despite these anticariogenic properties, the proofs related to clinical effectiveness of xylitol are controversial. The aim of study The aim of this study is to assess the effect of xyilitol from oral hygiene products (toothpastes, mouthwashes, chewing gums) on the saliva parameters (saliva microcrystallisation index (IMK), saliva resting flow rate (RFR), saliva stimulated flow rate (SFR), saliva buffering capacity (BC)) and the carioactivity of bacteria biofilm (ATP) for patients with medium cariogenic risk. Material and metods: The study group included 12 patients with medium cariogenic risk, submitted to the use of oral hygiene products xylitol-based for three weeks (toothpastes, mouthwashes, chewing gums). The following parameters were assessed before and after the use of xylitol-based products: saliva microcrystallisation index (IMK), saliva resting flow rate (RFR), saliva stimulated flow rate (SFR), saliva buffering capacity (BC), bacterial biofilm activity (ATP). Results and discution: The results show the significant improving of salivary parameters (IMK, RFR, SFR, BC) and the decrease of ATP levels after the use of xylitol-based oral hygiene products for three weeks Conclusions: The use of xylitol-based products in oral hygiene is effective both in the improvement of salivary parameters and the decrease of bacterial biofilm activity for patients with high cariogenic risk

The study aimed to compare the remineralization capacity of toothpastes containing arginine by surface morphology evaluation and calcium and phosphate ions concentration assessment in enamel and dentine. Colgate Total, Colgate Sensitive ProRelief and Colgate Maximum Cavity Protection were selected for this study. Enamel and dentine samples were subjected to demineralization for 1 hour, three times a day, 14 days (group I, control). In groups II-IV the same demineralization cycles were applied, but the first and the last demineralization cycle was followed by the application of three toothpaste slurries for 3 minutes. In the conditions of this study, all the tested toothpastes provided remineralization of enamel and dentine after acid challenge. The toothpastes containing arginine leaded to higher remineralization when compared to the products that contains only fluoride.

The aim of this study was to analyze the various salivary organic compounds in 158 patients who were divided into three groups: 32 in the control group (without general diseases), 108 with general diseases (asthma, diabetes) and 18 with head and neck radiotherapy. The values of the salivary organic compounds were compared with those in the blood, in all groups studied. Materials and methods: The study consisted of the collection of saliva in test tubes which were maintained at a temperature of – 20 ° C. The samples were centrifuged at 10,000 rotations per minute. Laboratory analyzes were performed at an automatic analyzer, observing the protocols specific to each parameter studied. The results obtained from each component salivary considered in the study were statistically analyzed by performing comparisons between groups of patients examined and between the values of these components in the blood vs. saliva. Were obtained lower salivary amylase levels in the group of patients that followed the head and neck radiotherapy (M amylase = 44633.3) compared to the group of patients with general diseases (M amylase = 105,440.0) and control group (M amylase = 114,456.3). In our study we observed a high concentration of urea in the study group (30,9mmol/L) and the radiotherapy, compared to control group (27,31mmol / L). In diabetic patients examined in our study we found high levels of salivary glucose (M glucose = 5.35) than the control group (M glucose = 1.34). Conclusions: The results confirm previous observations showing that, through different general diseases are mainly affected parotid salivary glands, salivary source of key organic compounds (amylase, total protein, glucose). The variations of these chemical compounds in saliva have repercussions on the protective effect of saliva against cariogenic microbial agents and cause finally increase caries risk.

The incidence of the occlusal dental caries is still high, despite the numerous available preventive and therapeutic methods and materials. Further researches are requested to find the most effective preventive method. The aim of study was to assess during a year, by using Replica Test method, the retention degree and microbiology of the bacterial biofilm adjacent to the sealants performed by three types of materials: glass ionomer cement (group I), fluoride-releasing composite sealant (group II), and composite sealant without fluoride (group III). Results. For the group I, sealed with glass ionomer cement Replica Test results show low variations associated with high protective effect, due to the fluoride release. To the end of the research period, a slight increase of the bacterial biofilm activity was recorded. For the group II, sealed with a fluoride-releasing sealant, Replica Test results show, for the first 6 months, low variations associated with the high protective effect, due to the fluoride release. After 6 months, a slight increase of the bacterial biofilm activity the recorded, due to the decrease of the released fluoride ions level. For the group III, sealed with sealant without fluoride, Replica Test results show a progressive increase of the bacterial biofilm activity during the 12 months study period, more significant than to the other study groups. Conclusions. The results of our study show that all three sealing materials offer a low retentive surface associated with a reduction of the cariogenic bacterial biofilm adjacent to the sealings. The most significant reduction of the bacterial load was associated to the glass ionomer cement GC Fuji Triage, followed by flowable composite Fisurit FX and composite Fluid SDI Wave.

The orthodontic fixed appliances determine increased retention of bacteria associated with increased cariogenic activity and enamel demineralization. The aim of study is to quantify, by ATP luminiscence method the effectiveness of a remineralizing calcium-phosphate-fluoride-based product used to decrease cariogenic activity to patients submitted to orthodontic fixed appliances therapy. Results. Initially, ATP mean values increased from 3818.3 to 7439.2 after 3 weeks of orthodontic therapy; following the non operative treatment with MI Paste Plus, ATP mean value decreased to 3883.0. Conclusions. The use of fixed appliances in orthodontic treatment influences the retention rate and increases the cariogenic activity of the adjacent bacterial biofilm. The remineralizing calcium-phosphate-fluoride-based products can decrease the cariogenic activity of the bacterial biofilm associated to orthodontic braces. ATP bioluminescence technique can be used for the rapid quantification of bacterial levels and for monitoring the oral hygiene and effectiveness of preventive-therapeutic measures during orthodontic therapy.

Dental erosion is a dental non-cariogenic lesion produced by internal (gastro oesophageal reflux, regurgitations, gastro-intestinal diseases, symptoms associated to bulimia) or external factors (foods, beverages, erosive drugs). The treatment of non-cariogenic lesions is complex. It will include the removal of causal factors and preventive-therapeutical measures aiming to increase the resistance of dental tissues by remineralization. The coronal reconstruction varies from direct composite resins restorations to indirect restorations (veneers, inlays, crowns) in severe cases. The aim of this study is to present and discuss a clinical case of dental erosion produced by GERD (gastro oesophageal reflux disease) associated with frequent consume of acid foods (citrics). Conclusions. The treatment of dental lesions produced by erosions, using non-prep ceramic micro-veneers, represent an affordable, esthetical, biological and functional therapeutic solution, with optimal results both for patient and dental team.

The aim of the study was to investigate the chemical corrosion in artificial saliva of some commercial composite resins. Material and method. 20 samples of a nanocomposite resin (Filtek Supreme XT, 3M ESPE) and 20 samples of a microhybrid composite resin (Filek Z250, 3M ESPE) were immersed for 30 days in Fusayama artificial saliva. After that, they were examined by scanning electron microscopy and energydispersive X-ray spectroscopy. Results. It resulted that the corrosion is mainly due to the pitting, micrometric holes being observed for both materials. Also, preferred directions of corrosion resulted, as consequence of micro-scratches formation during the samples preparation. The oxygen content generally increased due to the oxides formation, while carbon, silicon and zirconium normalized atomic percents decreased. Conclusions. The corrosion of the composite resins in artificial saliva is mainly represented by pitting, and micrometric holes. The chemical corrosion affected both polymeric matrix and filler particles.

Root dental caries represent an issue focusing many dental researchers. However due to morphologic and structural particularities of cement and root dentine as well as the nearby of dental pulp, root dental caries is a challenge regarding therapeutical success. The aim of this study was to assess the clinical performance of two restorative materials: glassionomer cement CGI with high density and a resin-modified glassionomer cement (RMGC), using ART technique in complex cervical root cavities. The assessment of restorations quality parameters was performed after 1 and 6 months using ART assessment criteria. After 6 months, success rate was 100 % for GC Fuji II LC and 96,6 % for Fuji VIII. After 6 months, success rate of ART technique for all 20 patients was 98,3 %. A higher success rate of our study, comparing with literature data, is due to the improvement of ART technique combined with the use of superior dental materials. (GC Fuji VIII, GC Fuji II LC), as well as the use of photopolimerisable resin-modified glassionomer cement GC Fuji II LC. More the use of conditioner, previously to the insertion of restoration material, improves significantly the adhesion and prevent microleakage. The superior esthetics and surface parameters are due to the use of varnish. Our study proved that ART method for aged patients, in cervical root dental caries treatment, was more efficient, both for simple cavities (1 surface) and complex cavities, after a 6 months periode. The results were promising for both researched glassionomer cements.

This in vitro study evaluated the effects of dentifrices containing nano-hydroxyapatite (n-HAp) on dentinal tubule occlusion and on mineral deposition. Dentin specimens of ten human teeth were submersed for 30 s in 40% citric acid and then randomly divided into four groups (three study groups and one control group). In the study groups, the dentin samples were exposed to three different n-HAp toothpastes: Karex (Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany), Biorepair Plus Sensitive (Coswell SpA, Bologna, Italy), and Dr. Wolff’s Biorepair (Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany); in the control group no toothpaste was applied. All of the samples were evaluated using scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) analysis. In the control group all of the samples showed a frank and wide opening of the dentinal tubules, whereas in the study groups different degrees of tubule closure by mineral depositions were observed. Toothpastes containing n-HAp determined a significant occlusion of dentinal tubules and a significant increase of mineral deposition on the dentin surface. All three tested toothpastes showed similar results regarding the degree of dentinal tubule closure. Varying degrees of differences in calcium, phosphate, carbon, and oxygen ion concentrations among the three tested toothpastes were obtained.

The aim of study: The aim of this study is to assess the capacity of chemo-mechanical system KariKlinz to remove carious cervical and root dental tissues and effect on cariogenic bacteria comparing with clasical mechanical method. Materials and method: The cervical and root carious lesions (n =28) (active, vital teeth) were randomly distributed to one of the next carious dentine removal methods: (Study group I) chemomechanical method Kariklinz Vladmiva (n = 14), (Study group II) classical mechanical method using conventional speed and spherical bur (n = 14). The assessment was performed using laserfluorescence method DIAGNOdent® (Kavo, Biberach, Germania) before and after preparation and microbial test (Replica Test) used for detection of Mutans Streptococcus localised on the surface of prepared cavities. Results: Both methods have similar results regarding the ability to reduce carious flora level after carious dentine removal; the percentages of residual bacteria are 2,78% for chemo-mechanical method and 2,85% for classical mechanical method. The reading of DIAGNOdent were significantly lower after cavities preparation (9,07 for chemo-mechanical method and 8,85 for classical mechanical method). Conclusions: Both excavation methods investigated in this study demonstrated similar efficiency in carious dentine removal, accordingly to results of DIAGNOdent® method and microbial test (Replica Test).

The aim of this study was to identify the anatomo-clinical features of tissues relations in the cervical area and to establish the presence and retention of bacterial biofilm related to the types of cementoenamel junction (CEJ). Material and methods: The study included 16 extracted teeth (4 incisors, 2 canines, 4 bicusps, 6 molars). The teeth, having unaffected cervical area, were cut in 4 sections preserving the bucal, lingual, mesial and distal cervical areas. The dental sections were assessed regarding the aspect and the morphology of the cementoenamel junction using SEM. Also the retention degree of bacterial biofilm was examined. Results: The highest percent (62%) CEJ are represented by the type of edge-to-edge. The bicusps present a percent of 76% of edge-to-edge CEJ, with a 14% percent of CEJ junctions associated with enamel covered by cement. Conclusions The type of cementoenamel junction varies accordingly to dental type and topography. The retention of bacterial biofilm was highest in cementoenamel junctions with exposed dentine.

The aim of study was to compare the level of fluorescence emission of two types of composite resins customary used in dental practice. Material and method. Two composite resins were used in this study: Herculite XRV (Kerr Company) and Z250 (3M ESPE). The enamel was restored with shades A3 for both composite resins, while dentine was restored with A3 for Herculite and universal dentine shade for Z250. From each material were performed 6 samples having 50 mm in lenght, 5 mm in width and 1mm in height. The samples were obtained by materials photopolymerisation between two glass plates with a LED lamp (LED B, Guilin Woodpwcker Medical Instrument Co., Ltd, China) for 40 seconds. The fluorescence emission of the composite resins was assesed by spectrometry (using spectrometer device LS 55, Perkin Elmer Inc, USA). The samples were excited using an UV fascicle with wavelength spectrum between 330-630 nm. The spectrum of emission was recorded using software FL Win Lab. Results. Considering this spectrum, the fluorescence emission for Herculite XRV dentine had the peak around 452 nm. For Herculite XRV enamel, considering the same spectrum of wavelenght, the fluorescence emission had the peak around 443,5 nm. The fluorescence emission of Z 250 dentine recorded the peak for wavelenght spectrum of UV fascicle between 330 şi 630 nm. Conclusions. For both tested materials, the fluorescence emission of dentine shades was higher comparing with enamel shades. The highest values of fluorescence emission were recorded for highest values of wavelengths, for both composite resins included in study

The aim of the study was to evaluate the effect of three different one-step and two-steps polishing systems on the surface roughness of two composite resins, one with nanoparticles and one microhybrid: Filtek Supreme XT (3M ESPE) and Filtek Z 250 (3M ESPE). 35 samples (30 mm X 8 mm X 2 mm) were made from each material. 5 samples of each material were polished using the finishing long flame bur for composite resins (NTI, Kahla GmbH, Germany) without water cooling, 5 samples using the one-step abrasive rubber P20032 (NTI, Kahla GmbH, Germany) without water cooling, 5 samples using the two-steps finishing system which uses the abrasive rubbers P1932 and P19032 (NTI, Kahla GmbH, Germany). The other samples were finished with the same systems, but under water cooling. 5 non-finished and non-polished samples of each material were considered control samples. The samples surfaces were analyzed using the atomic force microscopy. The use of two-steps polishing systems led to a significantly smoother surfaces of both types of composite resins when comparing with the one-step polishing systems (Anova and Bonferroni statistical test, p

This article presents a retrospective study on the decisions made regarding non-intervention, repair, or replacement of posterior composite restorations. The study analyzed the esthetic, functional, and biological factors that influenced these decisions. The majority of decisions were for non-intervention, followed by repair and replacement. Factors such as the type of tooth, gender, cariogenic risk, location in the arch, and location within the dental group influenced the decisions. The study highlights the importance of considering these factors when making treatment decisions and emphasizes the benefits of clinical trials in informing these decisions. However, the study acknowledges limitations in the research. [Extracted from the article]

This article from the Romanian Journal of Oral Rehabilitation discusses the clinical performance of resin composite restorations in posterior teeth. It reviews factors that influence the longevity of these restorations, such as patient-related factors, dental group, cavity size, and cervical margin extension. The article concludes that resin composites are the material of choice for minimal interventions in posterior teeth, and they demonstrate similar clinical performance to amalgam restorations in medium-sized cavities. The success of these restorations depends on various factors, including the restored tooth, materials and techniques used, patient risks, and clinical decisions. The text discusses the factors that contribute to the failure of posterior resin composite restorations in dental patients. Patient-related risk factors include high cariogenic risk, occlusal stress, periodontal status, smoking, dietary habits, and parafunctional habits. The type of resin composite used, adhesive systems, restorative technique, and isolation technique also play a role in the success of the restorations. The main reasons for failure are fractures within the restoration and secondary marginal caries. The text emphasizes the importance of using minimal interventions such as marginal sealing or refurbishment to extend the lifespan of the restorations. The overall success rate of posterior composite restorations is reported to be between 43.4% and 98.7%. It is suggested that resin composites may be inferior to amalgam in terms of cost-effectiveness. However, various research groups have reported satisfactory results with resin [Extracted from the article]