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A diastema between the maxillary central incisors affects an esthetic smile and has been treated in various ways. Precise diagnosis is essential to guide the choice of the most appropriate treatment. This clinical report describes closing a maxillary midline diastema with a computer-aided design and computer-aided manufacturing (CAD-CAM) composite resin., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Aim: To evaluate the efficiency of fluoride-releasing adhesives for the prevention of secondary caries on in-vitro tests., Materials and Methods: This study was performed according to the PRISMA checklist. The bibliographic research was performed to identify in-vitro studies between January 2000 and September 2017. The selected studies were submitted to bias risk assessment and data extraction. In the meta-analysis the data were evaluated using Review Manager Software., Results: The 11 studies that met all inclusion criteria showed that the most common risks of bias were: absence of the sample size calculation description, absence of the single operator protocol and blind operation of the test machine. The meta-analysis was performed with six studies that used polarised light microscopy in order to quantify the mineral content of dentine and presented the values as means and standard deviations., Conclusions: Most of the authors presented that the fluoride-containing adhesive systems had a significant effect to reduce in-vitro secondary caries. The meta-analysis did not present statistical difference between fluoride-free and fluoride-containing adhesive systems. The artificial caries challenge methodology may have affected the results.

Purpose: The purpose of this meta-analysis was to evaluate how the thickness variations in ceramic restorations of lithium disilicate and the use of different photopolymerizers influence the degree of conversion of the resin cements., Methods: This study was performed according to the PRISMA checklist. The bibliographic research was performed to identify in vitro studies until December 2017 in the databases MEDLINE via PubMed, Web of Science, and Scopus. The selected studies were submitted to bias risk assessment. In the meta-analysis the data were evaluated using Review Manager Software v.5.3, with random-effect model at a 5% significance level., Results: The meta-analysis in this study showed that despite the translucency of lithium disilicate, significant reduction of light was observed when activated through the ceramic. The degree of conversion was higher in the control groups in which the resin cement was photopolymerized without the interposition of the ceramic material., Conclusions: The thinner the ceramic material, the higher the degree of conversion. A thickness greater than 1.0 mm drastically reduces the degree of conversion of dual-curing or light-curing resins. The curing unit with irradiance of 3200 to 3505 mW/cm 2 showed improvements in conversion values., (© 2018 by the American College of Prosthodontists.)

Objective: The beneficial mechanical properties of zirconia, together with the adhesive techniques, provide a wide range of clinical applications, including the construction of thin structures and minimally invasive adhesive restorations., Clinical Considerations: A periodontal disease-related missing maxillary central incisor, in a pregnant patient with chronic periodontal disease in the first trimester of pregnancy, and with type II diabetes treated with resin-bonded fixed partial denture using the missing tooth cemented to a zirconia framework and then bonded to the abutment teeth., Conclusions: According to the systemic conditions presented in this case report, using a low-cost technology and the missing tooth it was possible to obtain an easier and satisfactory esthetic and functional result., Clinical Significance: The mechanical properties of zirconia made it possible to treat a pregnant patient with chronic periodontal disease in the first trimester of pregnancy, and with type II diabetes with a thin zirconia framework and minimally invasive adhesive restorations., (© 2018 Wiley Periodicals, Inc.)

Objective: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) complexes are anticariogenic and capable of remineralizing the early stages of enamel lesions. The use of fluoride prevents dental decay and the association of CPP-ACP with fluoride can increase remineralization. To evaluate the effect of CPP-ACP and CPP-ACPF creams associated with a fluoride dentifrice to prevent enamel demineralization in a pH cyclic model., Material and Methods: Previously selected by surface microhardness (SH) analysis, human enamel blocks (n = 56) were submitted to daily treatment with dentifrice in a pH-cycling model. The enamel blocks were divided into four groups; G1: Crest™ Cavity Protection - Procter & Gamble (1,100 ppmF of NaF); G2: Crest™ +MI Paste (MP) - Recaldent™ GC Corporation Tokyo, Japan); G3: Crest™ + MI Paste Plus (MPP) - Recaldent™ 900 ppm as NaF, GC Corporation Tokyo, Japan), and G4: control, saliva. Specimens were soaked alternatively in a demineralizing solution and in artificial saliva for 5 d. The fluoride dentifrice, with proportion of 1:3 (w/w), was applied three times for 60 s after the remineralization period. The undiluted MP and MPP creams were applied for 3 m/d. After cycling, SH was re-measured and cross section microhardness measurements were taken., Results: The SH values observed for the groups G3 (257±70), G1 (205±70), and G2 (208±84) differed from the G4 group (98±110) (one-way ANOVA and Tukey's post hoc test). There were no differences between the groups G1xG2, G2xG3, and G1xG3 for demineralization inhibition. The percentage of volume mineral showed that, when applied with fluoride dentifrice, MPP was the most effective in preventing enamel demineralization at 50 µ from the outer enamel surface (Kruskal-Wallis and Mann Whitney p<0.05)., Conclusion: Fluoride dentifrice associated with CPP-ACPF inhibited subsurface enamel demineralization.