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Aim of the study was to evaluate the long-term reliability and effectiveness of inlays and onlays in ceramic and composite material, examining scientific studies published from 2004 to 2013. The results of this review were analyzed and compared with the important literature review proposed by Manhart in 2004.With this review it was possible to analyze a total sample of 5858 Class I and II restorations, made in the posterior region: 5295 ceramic and 563 composite restorations in 2377 patients. Works were evaluated using USPHS, modified USPHS and CDA criteria after a mean observation period of 5.4 years (5.9 years for ceramic restorations, 2.6 for composite restorations).The arithmetic average of success was 94%, higher in ceramic restorations (94.9%) than composite materials (91.1%). The weighted average success rate was 95.3%, 92.8% for composite restorations and 96.3% for ceramic ones. The highest rates of success were found in ceramic restorations notwithstanding the longer observation period.Indirect restorations have a low failure rate and they prove to be an excellent choice in the treatment of both class I and II lesions. During the last 6 years, the parameters related to these restorations have improved, with a 4% increase of success.

The effects of light curing units (LCU) and energy doses on the chemical and physical properties of a dental composite were investigated.The effects on the chemical and physical properties of a bisphenol A diglycidylether methacrylate (Bis-GMA) based dental restorative material were evaluated through photospectrometry, differential scanning calorimetry, and mechanical measurements.The light curing conditions associated with direct and indirect restorations were replicated in vitro using optical investigation techniques. A slight attenuation resulted independently of the LCU and a strong attenuation was measured for the cement luting a thick inlay, as well as for the deepest layer of a composite filling increment. Calorimetric measurements indicated that the curing degree is very sensitive to the light energy dose rather than to the LCU. Mechanical testing showed a transient phase during which properties increased. The delay of the composite in reaching adequate properties is strongly dependent on the energy dose.It is recommended that composites subject to unfavorable light curing conditions undergo a prolonged light curing process.

To compare two different impression techniques for implants in totally edentulous patients.A total of 38 patients had impressions taken both using plaster and splinted vinyl polysiloxane (splinted-VPS). Two casts per patient were generated and allocated as test (plaster) and control (splinted-VPS) cast groups according to a randomised cross-over design. One of the two casts from each patient was randomly selected as master cast according to a parallelgroup design and used to fabricate the definitive prosthesis. Outcome measures were implant and prosthetic success rates, complications, marginal bone level (MBL) changes, patient satisfaction, chair time required to take the impressions, inter-implant discrepancy between the casts, sulcus bleeding index (SBI) and plaque score (PS).In total, 76 impressions were taken in 38 patients. Two plaster impressions failed. Furthermore, 38 computer-aided design/computer-assisted manufacturing screw-retained complete-arch prostheses were fabricated onto the master cast (18 from plaster and 20 from splinted-VPS impressions) and the patients were followed up for 3 years after loading. No drop-out occurred and no implants or prostheses failed, accounting for a cumulative implant and prosthesis survival rate of 100% over the 3-year post-loading period. Plaster impressions yielded significantly greater patient satisfaction and shorter chair time. The discrepancy between the casts was 0.055 ± 0.067 mm (P = 0.931). Mixed model analysis revealed a significant main effect from both the implant number and the inter-implant distance, while no difference was found with regard to implant angulation. Five chip-off fractures of the porcelain veneer occurred in 5 of the 38 patients (3 in restorations fabricated onto the plaster cast group and 2 in the splinted-VPS cast group) with no effect from the type of impression on the prosthetic success rate (P = 0.331). However, all of the patients were functionally and aesthetically satisfied with their prostheses. Furthermore, mean MBL, SBI and PS showed no significant differences (P0.05) between the groups.The clinical outcome of plaster impressions for completely edentulous patients was found to be the same as that for splinted-VPS impressions. The intraoral pre-scan resin framework try-in can be avoided. Plaster impressions may be less time consuming and thus more comfortable for the patient, but sometimes may have to be repeated due to fractures.All materials used in this study were purchased by the authors and there were no commercial or institutional interests.

Introduction: The purpose of this study was to determine, by a non-destructive method, the extent to which cusps are weakened by endodontic and restorative procedures. Methods: Fifty maxillary sound premolars were evaluated applying axial forces (range 98-294N) on their occlusal surface by the use of a mechanically controlled loading device inducing cuspal deflection while sophisticated Laser LTS twin sensor registered their cuspal movement. Cusp deflection values in micron were recorded for each tooth sequentially in intact condition and after conclusion of endodontic and restorative procedures (MOD cavity. Teeth were randomly divided in 10 groups (n =5) and restored with ten different materials as reported on Tab. 1. For all ten groups were evaluated: a) amount of cusps deflection; b) average stiffness; c) percentage structural recovery, in both intact and restored state. Results: Average stiffness in intact and restored status and percentage of structural recovery have been calculated for all experimental groups respectively. Results are reported on table below. Conclusions: Bonded composite restorations in endodontically treated teeth could be an appropriate way to afford good resistance to occlusal loads. It is important to highlight how the use of fibber glass posts and micro-hybrid composite materials in such restorations came out to be a suitable solution for structural recovery of the treated element. Concluding, direct composite techniques could guarantee an adequate aesthetic and structural recovery of endodontically treated elements.

Adhesion is the pivot of the modern restorative dentistry. Inlays, onlays and veneers have become a valid alternative to the traditional prosthetic treatments even in the rehabilitation of extremely damaged teeth, allowing a consistent saving of sound tooth tissues. Composite resins and dental adhesive are continously investigated and improved, nevertheless the optimization of the tooth-adhesive interface has to be considered: in fact, the long-term stability of adhesion between tooth and composite material depends on the treatment of the amelo-dentinal surfaces. THIS STUDY INVESTIGATED THE QUALITY OF THE OCCLUSAL WALLS OF A CAVITY PREPARED TO RECEIVE AN INLAY AND FINISHED WITH FOUR DIFFERENT SYSTEMS: thin and extra-thin diamond coated burs, a 12-blades carbide burs and a diamond-coated tip driven by sonic instrument. Consequently, prophylometric and SEM analyses were performed on the samples. The average roughness values recorded by the prophylometer were expressed by the parameters Ra and RZ: there is a correspondence between the numeric values and the pictures of the SEM. The results show a better quality (low roughness values) of the surface treated with multi-blade burs, followed by the this and extra-thin diamond coated burs. The 25 micron diamond-coated tip of the sonic instrument obtains the roughest surface and a sensibly higher amount of smear layer than the other tested systems.