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Background/purpose: Development and acquisition of communication, logical thinking, team-building, critical appraisal, critical thinking and person-centred multi-disciplinary care planning must be considered as skill sets and global core competencies for a dental professional. Therefore, an international online study course to foster undergraduate dental students’ skill sets in these areas was established and this study aimed to report the perceptions of participants. Materials and methods: An international online course consisting of three levels pertaining to the school year was delivered to dental undergraduates of Japan and Thailand from September to December in 2021. An online questionnaire survey was conducted to obtain feedback from the participants and assess the implementation of the course. Results: In total, 64 responses were obtained from students who participated in all the assigned online sessions and completed the questionnaire (a response rate of 88%). More than 95% of students from each level felt that the programme increased their motivation to study clinical dentistry, and was beneficial for their future and made them appreciate the importance of participating in international exchange. The ratio of favourable respondents was more than 90% with a 95% confidence interval. Conclusion: Fostering globally competent dental students is important and the acquisition of necessary skill sets could be enhanced through international virtual team-working, problem-solving and person-centred multi-disciplinary care planning activities. These are beneficial for undergraduate dental student training so that they graduate with a broader global perspective and an appreciation of the importance of delivering person-centred culturally sensitive dental care.

To examine the fracture strength and fracture mode of flared root canals reinforced with different post and core materials.Forty endodontically treated bovine teeth structured to mimic human mandibular premolars with flared root canals were reinforced with resin composite and glass fiber post (FRC), composite resin (RC), ceramic core (LD), and ceramic core with resin composite reinforcement (RLD), and restored with single zirconia crowns (n = 10 in each group). The fracture strength and mode of the root canals restored with zirconia crown were assessed. The fracture strength was compared with a one-way analysis of variance (ANOVA) following Tukey HSD tests. A multiple regression analysis was conducted to test the effect of the post/core materials on the fracture loads. Fisher's exact test was used in the failure mode analysis.The mean fracture strength of RLD was significantly higher than RC, FRC, and LD (p0.05), while no significant differences were found among RC, FRC, and LD (p0.05). The regression analysis found that the fracture strength using the lithium disilicate was significantly lower for the post and higher for the core than that using the resin composite (p0.05), and there were no significant difference in the fracture strengths between the resin composite and glass fiber used for the post (p0.05). Most of the specimens exhibited root fractures, and no significant differences were observed among the groups (p0.05).The results of this study suggest that reinforcement of flared root canals using a combination of resin composite for the core and lithium disilicate ceramic for the post is superior to resin composite and glass fiber in mechanical properties when restoring a single crown.

Background/purpose With the advancement of an over aging society, the average number of remaining teeth has increased. However, these remaining teeth do not always have sufficient alveolar bone support, and sometimes fabricated connected crowns are applied. This study evaluated the influence of crown material, crown thickness, and alveolar bone resorption on the stress distribution within the abutment teeth of connected crowns. Materials and methods Using structural analysis software, a premolar crown model was fabricated. Three kinds of crown materials, two types of crown thickness, two types of post and core systems, and two levels of alveolar bone were assumed and evaluated for the stress distribution within the abutment teeth. Results The higher material properties crown was, the more stress was concentrated at the marginal area. The composite resin core showed larger stress values around the marginal area, and the metal core showed larger stress values at the tip of the post. Alveolar bone resorption progressed, the marginal area stress value increased. Conclusion The low elastic modulus crown material polyetheretherketone (PEEK) prevented stress concentrations at the marginal area of the crown and dentine, even with alveolar bone resorption. However, the amount of bone resorption has a great influence on the stress distribution around the tip of the post compared to the type of crown material.

This study aimed to evaluate the surface strain at the cervical area of endodontically treated molars with a large pulp chamber restored using a composite resin core with three different types of core build-up systems.Reproduction models of human mandibular molars with prepared post spaces were used in this study. Roots duplicated with a composite resin were used as the experimental teeth. Three types of core build-up systems were used: composite resin core(RC), composite resin core with fiber posts (FC), and composite resin core with a prefabricated zirconia tube (ZC). Each group comprised eight specimens. Crowns made of yttria partially stabilized zirconia were cemented with dual-cure resin cement. Four strain gauges were attached to the surfaces of each specimen: the cervical area of the root and crown, on the buccal and lingual sides. The surface strain at each cervical area was measured using a static loading test and statistically analyzed.In the case of static loading to the buccal cusp inner slope, ZC showed a significantly lower strain than RC in the crown on the buccal side and in the root and FC in the root. In the central fossa, ZC showed a significantly lower strain than FC in the root on the lingual side.The prefabricated zirconia tube reduced the surface strain at the cervical area of the buccal/lingual root in molars; however, the effect was small in the cervical area of the crown.

The adhesion of composite resin to caries-affected dentin differs from the adhesion of resin to sound dentin. We evaluated the bond strengths of dual-cure resin composites applied to caries-affected root canal dentin under various clinical conditions and using several caries removal indicators. In the dye stain 1 group, caries were removed to a pale pink stain level using a caries detector. In the dye stain 2 group, caries were removed to a stain-free level using a caries detector. In the probing group, caries were removed to the level of hardness based on probing with a sharp explorer. Additionally, a sound dentin group was used as a control. We compared the resin composite microtensile bond strengths and failure mode distribution among the groups. The bond strengths (MPa) of the probing (64.6 ± 11.9) and the sound dentin (68.7 ± 11.1) groups were significantly higher than those of the dye stain 1 (46.9 ± 7.9) and 2 (47.5 ± 8.4) groups (p < 0.05). The removal of caries-affected dentin using a dentin-hardness-based technique showed higher tensile strength than that using a dye stain technique involving removal to any color level. Thus, the caries removal technique used on root canal dentin affects the bond strength of the resin composite.

Purpose This article describes a novel, minimally invasive procedure called Er:YAG laser micro-keyhole surgery (EL-MIKS) that removes metal or amalgam tattoos in the gingiva adjacent to prosthetic teeth without gingival deformity and recession. We aimed to evaluate the clinical efficacy of EL-MIKS for removing metal tattoos and present its long-term treatment outcomes. Methods The EL-MIKS procedure consists of several steps that are all performed under a microscope. First, a micro-keyhole (1-2 mm diameter) was prepared using an Er:YAG laser in the center of the metal pigmentation. The connective tissue was evaporated in the deep layer, where metal debris was deposited. Second, within the accessible range, the irradiation angle was changed in various directions to ablate the metal pieces and discolored connective tissue without enlarging the keyhole. Finally, after blood filled the space created by the tissue evaporation, the surface of the blood clot at the entrance of the micro-keyhole was thermally coagulated with defocus laser irradiation. Pigmentation that could not be successfully removed from a single micro-keyhole was treated by forming new micro-keyholes at a distance of 3 mm or more from each previously created hole. Depigmentation over an extended area was completed over a few sessions every 4 weeks without gingival recession after surgery. Conclusions EL-MIKS, a novel depigmentation technique, was able to successfully remove an extended area of metal tattoos in the gingiva using a simpler, easier, and less invasive procedure than conventional periodontal plastic surgery. Esthetic restoration was successfully achieved without postoperative alteration of the gingival contour.

Recently, metal-free restoration has become the standard in prosthetic treatment. However, it is still unclear which combination is most effective in preventing root fracture and secondary caries. The purpose of this study was to evaluate the influence of different post systems, crown materials, crown thickness and luting agents on the stress distribution around the crown margins, cervical dentin and the tip of the post.Ninety-six mandibular first premolar models were developed and analyzed using finite element analysis (FEA). Two designs of crowns, six kinds of crown materials, four types of post and core systems and two kinds of luting agents were included and evaluated for the stress distribution within the abutment teeth. The Von Mises stress magnitudes were compared among all models.The stress at the tip of the post decreased as the young's modulus of luting agent decreased; The stress concentrated more at the cervical area (dentin and crown), as the physical properties of the crown material increased.Crowns fabricated using polyetheretherketone (PEEK) can reduce the stress concentration at the cervical area, so it may be possible to reduce the amount of tooth reduction during abutment tooth preparation. The stress distribution around the post tip is affected by the post and core systems and luting agent, regardless of crown materials and thickness. When inserting a post of the higher Young's modulus such as zirconia post, methyl methacrylate luting cement can reduce the stress concentration at the tip of the post.

The purpose of this study was to evaluate the surface strain of zirconia fixed partial denture frameworks and their abutment roots when restored with two types of post and core materials. Artificial mandibular first premolars and second molars were used as the abutment teeth. Posts and cores were of two types: resin composite with glass fiber posts (RC) and cast platinum gold alloy (MC). The cores and 4-unit zirconia frameworks were bonded to the specimens. Static loading was applied to the occlusal surfaces, and the surface strain of the frameworks and roots (distal premolar and mesial molar) was measured by strain gauge method. Premolar root showed a significantly higher magnitude of principal strain than molar root. RC showed a significantly higher magnitude of principal strain than MC. The results suggest that MC restrain the surface strain compared to RC when the missing teeth are replaced by a 4-unit zirconia framework.

This study evaluated the fracture strength and mode of failure of structurally compromised teeth with flared root canals restored using composite resin with four different systems.Sixty endodontically treated bovine teeth were uniformly shaped to simulate human mandibular premolars with flared root canals. The roots were divided into four groups of 15 specimens each based on the type of restoration: composite resin core only (control), glass fiber post, cylindroid glass fiber ribbons, and glass fiber post and ribbons. All specimens were loaded until fracture occurred using a universal testing machine. Average fracture loads were compared with a one-way ANOVA and Tukey HSD test (α=.05). The modes of failure were observed and the Fisher exact test and Bonferroni correction were used for statistical analysis.The fiber post and ribbon group (1035.70N) and the fiber ribbon group (881.77N) showed significantly higher fracture strength than the controls (567.97N) (p.05). The fiber post and ribbon group also showed significantly higher fracture strength than the fiber post group (769.40N). Almost all specimens showed unrestorable root fractures (p.008). The control group had a significantly higher ratio of core sectional fractures (p.017).Cylindroid glass fiber ribbons significantly increased the fracture strength of the composite resin post and cores in the case of the dentin within the thin root canal wall. Based on the results, this study recommends the combined use of glass fiber post and ribbons.

The aim of this study was to compare three types of post and core systems by analyzing the stress magnitude within the root. To this end, two-dimensional photoelastic simulation models of endodontically treated maxillary central incisors were fabricated. Three different types of post and core systems were selected for this study: composite resin post and core, composite resin core in combination with a glass fiber post, and conventional cast metal post and core. The fabricated models were observed in a transmission polariscope with the same loading force (400 N) on 45 degrees palatal direction and the fringe orders registered were thereby analyzed. Results obtained in this study suggested that abutment build-up using composite resin core in combination with a glass fiber post model produced the lowest stress concentration and is hence effective in preventing stress concentration in the case of restored endodontically treated teeth.

The purpose of this study was to identify crown materials to decrease the stress concentrated at the cervical area of endodontically treated teeth. To this end, 14 extracted human mandibular premolars were divided into two groups for this study: complete cast crowns versus polymer-based crown and bridge material crowns. Both complete cast crowns (MC) and polymer-based crown and bridge material crowns (HC) were cemented with a glycidyl methacrylate-based resin cement (RC) to composite resin cores with glass fiber posts. Static loading was applied and distortion was measured with four pieces of strain gages attached to the marginal area. Findings showed that there was a large difference in distortion between crown and root in MC. On the other hand, distortions at the cervical area of crown and root were similar in HC.

Although composite resin core is used with various types of prefabricated posts, it remains unclear which kind of material is most suitable for the post. The aim of this study was to evaluate the influence of prefabricated posts on the stress distribution within the root by finite element analysis. Posts and cores were built up with composite resin and four types of prefabricated posts: two types of glass fiber posts (GFP1, GFP2) with low and high Young's moduli, a titanium post (TIP), and a stainless steel post (SSP). In all models, stress distribution during function was calculated. There were differences in stress concentration at the root around the end of posts. The magnitudes of stress for GFP1, GFP2, TIP, and STP were 8.7, 9.3, 11.7, and 13.9 MPa respectively. Given the results obtained, GFP1 was the most suitable material for post fabrication since this model showed a lower stress value. It would therefore mean a lower possibility of root fracture.

Purpose The purpose of this study was to evaluate the influence of water immersion on the mechanical properties of three kinds of glass fiber posts and the fracture resistance of structures using resin composites with glass fiber posts. Methods Each post was divided into three groups; a control group and two water immersion groups (30 and 90 days). Flexural strength was determined by three-point bending test. Each structure was divided into two groups; a control group and a water immersion group for 30 days. The fracture strength of structures was determined by a static loading test. Results In the flexural strength, two kinds of post in water immersion groups showed lower values than control groups. In the fracture strength, two kinds of structures in water immersion group showed lower values than control groups. Conclusion The prefabricated glass fiber posts and structures using resin composites with glass fiber posts were affected by water immersion.

This study aimed to investigate the maximum depth imaging and optical properties of the dentin near the pulp by using optical coherence tomography (OCT) and to explore the possibility of measuring the remaining dentin thickness (RDT). Human third molars were used. In experiment 1, the cuspal dentin blocks (0.50-mm to 1.75-mm thickness) were prepared. Each specimen was scanned using OCT. OCT images could be obtained for all specimens with 1.00-mm or less thicknesses. In experiment 2, dentin-pulp complex slices (0.50-mm and 1.00-mm RDT) were prepared. Each specimen was scanned using OCT and micro-computed tomography, and compared. The resulting length change rates of OCT images for the 0.50-mm RDTs were significantly lower than those of the 1.00-mm RDTs. Within the limitations of this study, OCT was effective for measuring the 1.00-mm or less RDT and preventing pulpal injury, while considering the length change rate of OCT image as a variable.

The aim of the present study was to evaluate the fracture load and fracture mode of thin Ceria-stabilized tetragonal zirconia polycrystals/Al(2)O(3 )nanocomposites (Ce-TZP/A) and Yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) crown frameworks. Artificial maxillary second premolars were prepared for metal-ceramic crown and all-ceramic crown restorations and Co-Cr tooth analogs were duplicated. 10 standard (0.5 mm overall thickness) zirconia-ceramic crown frameworks (Y-TZPs) for all-ceramic crown preparation and 10 modified (a 0.3-mm-thick framework increased in thickness by adding a 1.0-mm-thick palatal margin with a height of 2.0 mm) zirconia-ceramic crown frameworks (Y-TZPm, Ce-TZP/Am) for metal-ceramic crown preparation were fabricated. The frameworks were cemented to the Co-Cr tooth analog and loaded vertically until fracture. The fracture load of Y-TZPs (180.0 N) and Ce-TZP/Am (183.7 N) were significantly higher than that of Y-TZPm (133.7 N). There was a significant difference in fracture mode between Y-TZPm and Ce-TZP/Am. Within the limitation of this study, Ce-TZP/Am provide sufficient strength for clinical application.

The purpose of this study was to evaluate the influence of flexural modulus of non-metal posts on the fracture strength and failure mode of composite resin cores. Thirty-two human premolars were divided into four groups: prefabricated glass fiber post with 1.0 mm diameter and composite resin core (Group PE1.0), that with 1.5 mm diameter and composite resin core (Group PE1.5), experimental post (flexural modulus; 4.25GPa) and composite resin core (Group EX), and preparation for abutment teeth only (Group NT). After a static loading test, the fracture strength and failure mode were recorded. Group NT (1670.81 N) showed higher fracture strength than Groups PE1.0 (866.44 N), PE1.5 (825.19 N) and EX (1075.63 N) (p

This study was aimed at evaluating the fracture resistance of structurally compromised roots restored with four different post and core systems. Thirty-two bovine roots were uniformly shaped to simulate human mandibular premolar roots. The roots were divided into four groups based on the type of restoration: cemented cast post and core (Group MC), resin composite build-up (Group CR), resin composite and prefabricated glass fiber post build-up (Group FRC), and thick-layer dual-cured resin composite-reinforced small-diameter tapered cast post and core (Group CRM). After a static loading test, the failure mode and fracture resistance were recorded. Group CRM (719.38+/-196.73 N) exhibited a significantly high fracture resistance compared with the other groups (Group MC: 429.56+/-82.43 N; Group CR: 349.56+/-66.21 N; Group FRC: 398.94+/-112.71 N; p0.05). In conclusion, Group CRM exhibited better mechanical properties for structurally compromised roots with no ferrules, although all types of restorations showed non-restorable fracture modes.

The purpose of this study was to identify crown materials and luting agents that would decrease the stress concentrated at the roots of endodontically treated teeth. To this end, natural tooth model (NT), full cast crown model (gold-silver-palladium alloy; MC), polymer-based restorative material crown model (HCC), and all-ceramic crown model (ACC) were constructed. In each model, methyl methacrylate-based resin cement (MMA) and composite cement (CC) were used as luting agents. The magnitudes of von Mises stress of the roots during function were compared. When the luting agent was changed from MMA to CC, von Mises stress in the cervical area decreased by 37.8 % for MC, 27.1 % for HCC, and 37.0 % for ACC. Within the limitations of this study, the combination of HCC and CC gave rise to the lowest stress concentration at the cervical area.

This study evaluated the influence of alveolar bone level on the fracture resistance of root restored with post and core. Forty-eight extracted human mandibular premolars were divided into six groups. Cast posts and cores were cemented (MN8 and MP8) or resin cores were built up with fiber posts and composite resin (FN8, FP8, FN4, and FP4). Post length was 8 mm (MN8, MP8, FN8, and FP8) or 4 mm (FN4 and FP4). Specimens were embedded 2 mm (MN8, FN8 and FN4) or 5 mm (MP8, FP8 and FP4) below cement-enamel junction. All specimens were loaded at 45 degrees to the long axis until fracture. With normal bone model, cast post and core (MN8) showed the highest fracture resistance (2262.4 N). However, in the resorbed bone model, there were no significant differences in fracture resistance between cast post and core and fiber post with composite resin.