Search

Aim: To evaluate the fracture resistance of printed crowns with two different designs. Methods: Forty restorations (n = 20/group) were fabricated using resin matrix ceramic (VarseoSmileTM) with different designs as follows: group 1: overlay restoration with chamfer margin; group 2: overlay restoration with chamfer margin located 3 mm above the gingiva. Restorations were bonded to resin dies using 3M RelyX Luting Cement. Compression forces were applied with a 4 mm diameter steel bar at the midline fissure of each crown using the universal testing machine. Restorations were loaded until fracture, and fracture resistance at maximum load was recorded. Statistical analysis: A t-test was used for statistical comparison between groups. Results: No difference in the fracture resistance was detected for both groups. Conclusions: Different designs of composite resin crowns fabricated using CAD/CAM techniques can be used, however further research is needed to assess the clinical outcomes.

Comparative studies of interim veneer restorations crafted using subtractive computer-aided manufacturing (s-CAM) milling technology and traditional direct hand-made approaches are needed. This comparative in vitro study evaluated the fracture resistance of two types of provisional veneer restorations for maxillary central incisors: milled (s-CAM) and traditional direct hand-made bis-acryl veneers. Fifty maxillary right central incisor veneers (25 specimens per group) were fabricated and divided according to the fabrication method: (1) s-CAM milled (Structure CAD, VOCO Dental); and (2) hand-made (Protemp Plus, 3M). The restorations were cemented onto 3D-printed resin dies using temporary cement and subjected to 1000 cycles of thermal cycling between 5° and 55 °C. These restorations subsequently were subjected to compressive loading until fracture occurred. Images of the fractured samples were captured using a scanning electron microscope (SEM). Statistical analysis was performed using the one-way ANOVA test and the Mann-Whitney U test. Significant differences (p < 0.001) in the fracture resistance were observed between the two groups. s-CAM milled interim veneers displayed higher fracture resistance values (439.60 ± 26 N) compared to the traditional method (149.15 ± 10 N). The manufacturing method significantly influences the fracture resistance of interim veneer restorations. s-CAM interim laminate veneer restorations for maxillary central incisors exhibit a fracture resistance superior to that of the traditional method using bis-acryl. Clinical relevance Clinicians should consider CAD/CAM milled veneers for scenarios demanding long-term interim restoration and the withstanding of high occlusal forces. [ABSTRACT FROM AUTHOR]

Aim of this prospective study was to assess full mouth rehabilitation of severe tooth wear patients using minimally invasive CAD/CAM resin-based composite (RBC) restorations and direct veneers by evaluating restoration survival up to 5.5-years. Twenty-two patients with generalized severe tooth wear with functional and/or esthetic problems were included. Following minimally invasive preparation, CAD/CAM RBC restorations (LAVA Ultimate,3M) were adhesively luted, direct RBC veneers (Filtek Supreme XTE, 3M) were applied in the aesthetic region. Patients were recalled after 1m,1y,3y,5y and seen in between recalls by their general dentists or at the clinical study center if complaints occurred. Failures were categorized as F1 (severe deficiencies requiring replacement/extraction), F2 (localized deficiencies requiring re-cementation/repair) and F3 (small chippings requiring refurbishment/monitoring). Survival of indirect restorations was evaluated using lifetables and Kaplan-Meier-graphs, distinguishing between failure categories and tooth type (front teeth=FT, premolars=PM, molars=M). F1 + F2 and F1 + F2 + F3 failures were analyzed using Cox regression on the variables tooth type/ location, age, gender and VDO increase (p < 0.05). 568 indirect restorations and 200 direct veneers in 21 patients evaluated for up to 5.5-years. For indirect restorations, 96 failures were recorded (F1:6;F2:41;F3:49) and annual failure rates were 0.29%(FT), 1.56%(PM), 2.93%(M) for F1 +F2 and 0.53%(FT), 2.42%(PM), 6.11%(M) for F1 + F2 + F3. Reasons for failure were chipping fracture (48), adhesive fracture (32), complete debonding (7), caries (4), endodontic treatment (1) and reasons unknown (documentation general dentists, 4). Molar tooth type had a statistically significantly increased probability of failure compared with front teeth and premolars for F1 + F2 + F3 (p < 0.006). Direct veneer restorations showed 18 failures (F1:2;F2:9;F3:7). Minimally invasive CAD/CAM RBC restorations combined with direct RBC veneers showed an acceptable clinical mid-term survival for restorative rehabilitation of severely worn dentitions. • Minimal-invasive CAD/CAM RBC restorations can protect severely worn dentitions. • Restorations on molars exhibited higher failure probability than those on other tooth types. • Refurbishment and repair of RBC restorations should be considered before replacement. [ABSTRACT FROM AUTHOR]

The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures. [ABSTRACT FROM AUTHOR]

Determining the appropriate technique for diastema closure is challenging, and the decision must be evidence based. The objective of these case reports is to describe different approaches to diastema closure using direct and indirect techniques, focusing on the characteristics of the patient and clinical requirements to guide treat-ment. In the first case, a 16-year-old patient had multiple diastemas in the maxillary anterior dentition. The clinical evaluation revealed microdontia of the lateral incisors and malpositioned teeth. The treatment included tooth whitening and placement of composite resin veneers using a direct technique. In the second case, a 54-year-old patient displayed a disharmonious and esthetically compromised smile due to small teeth, color changes, multiple diastemas, incisai wear, and severe dentogingi-val disproportion. Based on the patient's expectations, the patient's age, and the presence of a "black triangle" interdental space, a multidisciplinary restorative treatment was proposed, including gingivoplasty, tooth whitening, and placement of ceramic laminate veneers using an indirect technique. Both approaches achieved successful esthetic rehabilitation and diastema closure with minimal intervention. The choice of procedure and restorative material, as well as the need for tooth preparation, varied based on the clinical requirements, patient expectations, and financial constraints. Careful treatment planning avoided lengthy and inefficient procedures. [ABSTRACT FROM AUTHOR]

The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures.

Copyright of Necmettin Erbakan University Dental Journal (NEU Dent J) is the property of Necmettin Erbakan University Dental Journal (NEU Dent J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are important esthetic considerations when restoring posterior teeth, and the more visible aspects of posterior areas require more harmoniously blended and imperceptible restorations. Unfortunately, despite their necessity to the esthetic restorative process, precise shade analysis, color matching, and subsequent replication of the dentition's unique characteristics are often difficult undertakings. However, knowledge-based collaboration between the dentist and laboratory ceramist greatly enhances success when evaluating, analyzing, communicating, and then replicating tooth shade/color in the final restorations. This article provides a quick, basic review of tooth color and optical properties; outlines an approach for shade analysis and laboratory communication; and describes the use of custom ingot guides, light-cured stump shade dies, and sample restorations to increase esthetic accuracy. [ABSTRACT FROM AUTHOR]

Abstract Background Evaluating the effect of different surface treatment methods on the micro-tensile bond strength (µTBS) of two different resin-matrix computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics (RMCs). Methods A standardized inlay preparations were performed on 100 intact maxillary premolars. According to the type of the restorative material, the teeth were randomly divided into two equally sized groups (n = 50): (polymer-infiltrated ceramic (Vita Enamic) and resin-based composites (Lava Ultimate)). The inlays were fabricated using CAD/CAM technology. In each group, the specimens were randomly assigned to five subgroups (n = 10) according to the surface treatment method: group 1 used was the control group (no surface treatment); group 2, was treated with air abrasion with 50 μm Al2O3 (A) and universal adhesive (UA); group 3, was treated with air abrasion with 50 μm Al2O3 (A) and silane coupling agent (S); group 4, was treated with hydrofluoric acid (HF) and universal adhesive (UA) and group 5, was treated with Hydrofluoric acid (HF) + silane coupling agent (S). The inlays were then cemented to their respective preparations using dual-cure self-adhesive resin cement (RelyX U200, 3 M ESPE) according to the manufacturer’s instructions. The µTBS test was conducted in all groups, and stereomicroscope and scanning electron microscope were used to inspect the failure mode. The data were statistically analyzed using a two-way analysis of variance (ANOVA) and Tukey’s post-hoc multiple comparison tests at a significance level of p

The purpose of this review was to analyze the existing literature on surface conditioning of the veneering surface of substructure restorative materials in dental laboratories. New technologies are constantly improving the treatment options for fabricating dental restorations, and new materials and adhesion procedures are being offered to clinicians and dental technologists. To establish a reliable adhesion between the veneer and substructure in the dental laboratory, various surface treatment procedures and adhesion promoters are employed. The composition of a material influences the adhesion approach selected, and implementing a reliable adhesion strategy is critical for the predictability of veneered indirect dental restorations. However, surface treatment of a wide range of available material options can be challenging. Therefore, understanding various adhesion processes for different restorative materials may assist dental technologists in selecting the best and appropriate surface conditioning protocol for each dental restorative material category.

Zika virus congenital syndrome (ZVCS) is a congenital viral infection resulting from the transmission of the Zika virus (ZV) to the fetus during pregnancy. This report describes a clinical case involving a 20-month-old female child with ZVCS, who presented with systemic changes related to the syndrome, such as microcephaly, arthrogryposis, ocular and auditory changes, and oral changes such as delayed dental eruption, ogival (high-arched) palate, short lip frenum, and altered morphology of a superior primary incisor. For esthetic and functional rehabilitation of the oral health of this child, an indirect composite resin restoration was performed using intraoral digital scanning technology. This case presents an accurate, rapid, and comfortable restorative treatment option that might result in excellent outcomes in children with ZVCS or similar syndromes with neurological impairment.

Copyright of Universidad Médica Pinareña is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Evaluating the effect of different surface treatment methods on the micro-tensile bond strength (µTBS) of two different resin-matrix computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics (RMCs). Methods: A standardized inlay preparations were performed on 100 intact maxillary premolars. According to the type of the restorative material, the teeth were randomly divided into two equally sized groups (n = 50): (polymer-infiltrated ceramic (Vita Enamic) and resin-based composites (Lava Ultimate)). The inlays were fabricated using CAD/CAM technology. In each group, the specimens were randomly assigned to five subgroups (n = 10) according to the surface treatment method: group 1 used was the control group (no surface treatment); group 2, was treated with air abrasion with 50 μm Al2O3 (A) and universal adhesive (UA); group 3, was treated with air abrasion with 50 μm Al2O3 (A) and silane coupling agent (S); group 4, was treated with hydrofluoric acid (HF) and universal adhesive (UA) and group 5, was treated with Hydrofluoric acid (HF) + silane coupling agent (S). The inlays were then cemented to their respective preparations using dual-cure self-adhesive resin cement (RelyX U200, 3 M ESPE) according to the manufacturer's instructions. The µTBS test was conducted in all groups, and stereomicroscope and scanning electron microscope were used to inspect the failure mode. The data were statistically analyzed using a two-way analysis of variance (ANOVA) and Tukey's post-hoc multiple comparison tests at a significance level of p < 0.05. Results: Surface treatments significantly increased the µTBS of the materials compared to the control group (p < 0.05). For CAD/CAM RBCs, the µTBS value highest in group 2 whereas, for PICN, the µTBS value was highest in group 3. Cohesive failure of CAD/CAM restorative material was the most predominant mode of failure in all treated groups, whereas adhesive failure at restoration-cement interface was the most predominant failure mode in the control group. Conclusion: Surface treatments increase the µTBS of resin-matrix CAD/CAM ceramics to tooth structure. Air abrasion followed by universal adhesive and hydrofluoric acid followed by silane application appears to be the best strategies for optimizing the bond strength of CAD/CAM RBCs and PICN respectively. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the fatigue to cyclic and static resistance of indirect restorations with different preparation designs made either of lithium disilicate (LS) or polymer-infiltrated ceramic network (PICN). Eighty-four (n = 84) molars were chosen, endodontically treated, and prepared with standardized MOD cavities. The molars were randomly divided into 6 study groups (n = 14) taking into account the "preparation design" (occlusal veneer with 1.2 mm occlusal thickness; overlay with 1.6 mm occlusal thickness; adhesive crown with 2 mm occlusal thickness) and the "CAD/CAM material" (E-max CAD, Ivoclar vivadent; Vita Enamic, Vita). A fatigue test was conducted with a chewing simulator set at 50 N for 1,500,000 cycles. Fracture resistance was assessed using a universal testing machine with a 6 mm diameter steel sphere applied to the specimens at a constant speed of 1 mm/min. A SEM analysis before the fracture test was performed to visually analyze the tooth-restoration margins. A statistical analysis was performed with a two-way ANOVA and a post-hoc pairwise comparison was performed using the Tukey test. The two-way ANOVA test showed that both the preparation design factor (p = 0.0429) and the CAD/CAM material factor (p = 0.0002) had a significant influence on the fracture resistance of the adhesive indirect restorations. The interaction between the two variables did not show any significance (p = 0.8218). The occlusal veneer had a lower fracture resistance than the adhesive crown (p = 0.042) but not lower than the overlay preparation (p = 0.095). LS was more resistant than PICN (p = 0.002). In conclusion, in the case of endodontically treated teeth, overlay preparation seems to be a valid alternative to the traditional full crown preparation, while occlusal veneers should be avoided in restoring non-vital molars with a high loss of residual tooth structure. LS material is more resistant compared to PICN. [ABSTRACT FROM AUTHOR]

The purpose of this review was to analyze the existing literature on surface conditioning of the veneering surface of substructure restorative materials in dental laboratories. New technologies are constantly improving the treatment options for fabricating dental restorations, and new materials and adhesion procedures are being offered to clinicians and dental technologists. To establish a reliable adhesion between the veneer and substructure in the dental laboratory, various surface treatment procedures and adhesion promoters are employed. The composition of a material influences the adhesion approach selected, and implementing a reliable adhesion strategy is critical for the predictability of veneered indirect dental restorations. However, surface treatment of a wide range of available material options can be challenging. Therefore, understanding various adhesion processes for different restorative materials may assist dental technologists in selecting the best and appropriate surface conditioning protocol for each dental restorative material category. [ABSTRACT FROM AUTHOR]

Purpose: The primary objective of this systematic review was to compare treatment outcomes of direct and indirect permanent restorations in endodontically treated teeth, and provide clinical suggestions for restoring teeth after endodontic treatment. Materials and Methods: Electronic databases (Medline, EMBASE, CENTRAL) and gray literature were screened for articles in English that reported on prospective and retrospective clinical studies of direct or indirect restorations after endodontic treatment with an observation period of at least 3 years. Primary outcomes were determined to be short-term (≤ 5 years) and medium-term (> 5 and ≤ 10 years) survival. Secondary outcomes included restorative and endodontic success of restored teeth. The quality of included studies and risk of bias were assessed using Cochrane Collaboration's tool for RCTs (randomized controlled trials), the Newcastle-Ottawa Scale for cohort studies, and the Agency for Healthcare Research and Quality (AHRQ) methodology checklist for cross-sectional studies. The GRADE system was used for assessing collective strength of the overall body of evidence. Results: Of 2547 screened articles, only 9 (2 RCTs, 3 retrospective cohort studies, 3 cross-sectional studies) met the inclusion criteria, and 8 studies were used in the meta-analysis. In general, indirect restorations (mostly full crowns) showed higher 5-year survival (OR 0.28, 95% CI 0.19-0.43, p < 0.00001) and 10-year survival (OR 0.20, 95% CI 0.12-0.31, p < 0.00001) than direct restorations. However, there was no statistical difference in short-term (≤ 5-years) restorative success (OR 0.32, 95% CI 0.05-2.12, p = 0.24) and endodontic success (OR 0.88, 95% CI 0.72-1.08, p = 0.22). Conclusions: Based on current evidence, there is a weak recommendation for indirect restorations to restore endodontically treated teeth, especially for teeth with extensive coronal damage. Indirect restorations using mostly crowns have higher short-term (5-year) and medium-term (10-year) survival than do direct restorations using composite or amalgam (GRADE quality of evidence: low to moderate), but no difference in short-term (≤ 5 years) restorative success (low quality) and endodontic success (very low quality). There is a need for high-quality clinical trials, especially well-designed RCTs. Purpose: The primary objective of this systematic review was to compare treatment outcomes of direct and indirect permanent restorations in endodontically treated teeth, and provide clinical suggestions for restoring teeth after endodontic treatment. Materials and Methods: Electronic databases (Medline, EMBASE, CENTRAL) and gray literature were screened for articles in English that reported on prospective and retrospective clinical studies of direct or indirect restorations after endodontic treatment with an observation period of at least 3 years. Primary outcomes were determined to be short-term (≤ 5 years) and medium-term (> 5 and ≤ 10 years) survival. Secondary outcomes included restorative and endodontic success of restored teeth. The quality of included studies and risk of bias were assessed using Cochrane Collaboration's tool for RCTs (randomized controlled trials), the Newcastle-Ottawa Scale for cohort studies, and the Agency for Healthcare Research and Quality (AHRQ) methodology checklist for cross-sectional studies. The GRADE system was used for assessing collective strength of the overall body of evidence. Results: Of 2547 screened articles, only 9 (2 RCTs, 3 retrospective cohort studies, 3 cross-sectional studies) met the inclusion criteria, and 8 studies were used in the meta-analysis. In general, indirect restorations (mostly full crowns) showed higher 5-year survival (OR 0.28, 95% CI 0.19-0.43, p < 0.00001) and 10-year survival (OR 0.20, 95% CI 0.12-0.31, p < 0.00001) than direct restorations. However, there was no statistical difference in short- term (≤ 5-years) restorative success (OR 0.32, 95% CI 0.05-2.12, p = 0.24) and endodontic success (OR 0.88, 95% CI 0.72-1.08, p = 0.22). Conclusions: Based on current evidence, there is a weak recommendation for indirect restorations to restore endodontically treated teeth, especially for teeth with extensive coronal damage. Indirect restorations using mostly crowns have higher short-term (5-year) and medium-term (10-year) survival than do direct restorations using composite or amalgam (GRADE quality of evidence: low to moderate), but no difference in short-term (≤ 5 years) restorative success (low quality) and endodontic success (very low quality). There is a need for high-quality clinical trials, especially well-designed RCTs. [ABSTRACT FROM AUTHOR]

Theodora-Kalliopi Samartzi,1 Dimokritos Papalexopoulos,2 Aspasia Sarafianou,2 Stefanos Kourtis2 1Private Dentistry Practice, Athens, Greece; 2Department of Prosthodontics, National and Kapodistrian University of Athens, Athens, GreeceCorrespondence: Dimokritos PapalexopoulosDepartment of Prosthodontics, National and Kapodistrian University of Athens, Athens, GreeceEmail dimpapalex@hotmail.comPurpose: The immediate application of a dentin-bonding agent after tooth preparation and before impression-taking (immediate dentin sealing [IDS]) has been suggested to provide several advantages concerning bacterial microleakage, hypersensitivity, and bonding quality. We reviewed the literature and clarified certain aspects related to each step of IDS application.Materials and Methods: The search strategy comprised an electronic research in MEDLINE, Cochrane, Ovid and Scopus for studies published from January 1990 to December 2020 regarding the IDS technique and including both in vitro and clinical studies.Results: After exclusion of irrelevant or duplicate articles, 88 articles focusing on aspects of the IDS technique were assessed. IDS seems to be advantageous with regard to bond strength, gap formation, bacterial microleakage, and dentin hypersensitivity. However, issues arising from interaction with impression materials, the provisional phase, and conditioning methods before cementation require further investigation.Conclusion: There are no documented reasons preventing clinicians applying IDS in their everyday practice. On the contrary, the presented technique seems to be beneficial in certain aspects regarding indirect restorations.Keywords: IDS, indirect restorations, restorative dentistry, review

Objective: To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations. Materials and methods: An electronic search of 3 databases (The National Library of Medicine (MEDLINE/PubMed), Scopus, and the Cochrane Central Register of Controlled Trials) was conducted. English clinical studies published between 2005 and September 2020 that evaluated the clinical performance of CAD/CAM resin-matrix ceramics inlays, onlays, or overlays were selected. The primary clinical question was applied according to PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). The included studies were individually evaluated for risk of bias according to the modified Cochrane Collaboration tool criteria. Results: A total of 7 studies were included according to the established inclusion and exclusion criteria. From the included studies, 6 were randomized clinical trials while one study was longitudinal observational study without control group. According to the results of the included studies, the success rate of CAD/CAM resin-based composite ranged from 85.7 to 100% whereas the success rate reported for ceramic partial coverage restorations ranged from 93.3 to 100%. Fractures and debondings are found to be the most common cause of restorations failure. Conclusion: CAD/CAM resin-based composite can be considered a reliable material for partial coverage restorations with clinical performance similar to glass ceramic restorations. However, this result needs to be confirmed in long-term evaluations. Clinical relevance: CAD/CAM resin-based composites provide a potential alternative to ceramic indirect restorations. However, clinicians must be aware of the lake of knowledge regarding long-term outcome. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review investigated the hypothesis that preheated resin composites (RCs) used as luting agents improve the mechanical properties, physicochemical performance, and color of indirect ceramic restorations. Materials and methods: Literature search was performed in three databases (Medline/PubMed, Scopus, and Web of Science) and in the grey literature (OpenGrey, ProQuest, and Catalog of Theses & Dissertations from CAPES). Eligibility criteria included only studies comparing at least one preheated RC used as a luting agent with resin cements. Results: Data regarding the mechanical properties, physicochemical characteristics, and color were analyzed qualitatively, and the microtensile bond strength and film thickness were also evaluated by meta-analysis. The search strategy identified 3894 papers, and 28 were full-text screened. Seven studies were included in the review, and 5 were included in the meta-analysis. No significant difference was found for microtensile bond strength (P = 0.14). Preheated RCs showed significantly higher film thickness than resin cements (P = 0.001). Conclusion: Overall, the use of preheated RCs as luting agents offers similar to poorer performance than using resin cements for bonding indirect restorations. Clinical relevance. Despite the claim that preheated RC could be used as a luting agent, further studies should investigate the effect of clinically unacceptable film thickness. [ABSTRACT FROM AUTHOR]

Objective: The restoration durability is essentially governed by optimum marginal integrity of an indirect restoration that is obtained and maintained by essential factors. This study aimed to evaluate the internal gap of indirect restorations fabricated from CAD/CAM composite blocks versus ceramic blocks in badly broken teeth using cone beam CT (CBCT) to determine their internal fit accuracy over the cast. Materials and methods: Fifty-four participants were allocated into two groups: composite blocks or ceramic blocks. The trial participants and assessors were blinded to the material assignment, whereas the operator was not. Cavity preparation was performed followed by cavity optimization and impression taking. The produced master cast was scanned, restoration was designed using Exocad 2019 software and the final restoration was milled. The restoration was doubled-checked on the cast for internal fit using cone beam computed tomography (CBCT), and intraorally for interproximal contact and marginal adaptation before final cementation. CBCT measurements were collected and statistically analyzed. Restoration was cemented with resin cement and was immediately assessed clinically, then after one year and two years of follow-up periods. Results: Results of an independent t-test revealed Composite blocks samples (0.25mm ± 0.03) to have a significantly better adaptation than ceramic blocks samples (0.29 mm ± 0.04) (p = 0.008). Conclusions: Both materials have acceptable internal adaptation with a noticed difference reflected in their clinical performance. Clinical relevance: Both indirect esthetic CAD/CAM restorations exhibit acceptable internal and marginal adaptation in posterior teeth however, composite blocks have a better adaptation than ceramic blocks. Trial registration: This trial was registered in clinicaltrials.gov (NCT04784676).

Zika virus congenital syndrome (ZVCS) is a congenital viral infection resulting from the transmission of the Zika virus (ZV) to the fetus during pregnancy. This report describes a clinical case involving a 20-month-old female child with ZVCS, who presented with systemic changes related to the syndrome, such as microcephaly, arthrogryposis, ocular and auditory changes, and oral changes such as delayed dental eruption, ogival (high-arched) palate, short lip frenum, and altered morphology of a superior primary incisor. For esthetic and functional rehabilitation of the oral health of this child, an indirect composite resin restoration was performed using intraoral digital scanning technology. This case presents an accurate, rapid, and comfortable restorative treatment option that might result in excellent outcomes in children with ZVCS or similar syndromes with neurological impairment. [ABSTRACT FROM AUTHOR]

The clamor for aesthetics has become more and more frequent and is no longer limited to anterior teeth only, as patient demand is making the aesthetic restoration of posterior teeth more sought-after. Indirect restorations with composite resin in posterior teeth aim to restore their aesthetics and functionality. As these restorations are performed with the usage of an extraoral method, they assist the redefinition of the occlusal anatomy, the contact point and allow for better finishing and polishing performance. When executed with composite resin, the restorations grant the preservation of the tooth remnant, providing support for the compromised tooth. This paper reports the rehabilitation of a mandibular molar using the indirect composite resin restoration technique. The female patient attended the clinic reporting being dissatisfied with an old restoration, which often fractured. On clinical examination, an extensive amalgam restoration was observed in the tooth 47, then a radiographic examination was performed, and it was found that the tooth was vital. Throughout the procedure, the preparation of the dental element, the molding, the production of the piece and, subsequently, the cementation were carried out. The treatments adopted were effective to recover the anatomical and aesthetic shape of the involved dental element, reaching the desired result by both the patient and the dentist. [ABSTRACT FROM AUTHOR]

The choice of restorative material in extensive loss of tooth structure because of caries or fracture depends upon the amount of remaining tooth structure that can be utilized for gaining resistance and retention form. The direct restorations are usually not feasible and advisable in teeth where more than half tooth structure is lost. The indirect restorations such as inlays and onlays provide the required resistance and retention forms as well as support for the remaining tooth tissue. Indirect restorations such as ceramic veneers play a major role in esthetic rehabilitation. This article critically reviews applications and materials used for indirect restorations.

The aim of the present study was to evaluate the fatigue to cyclic and static resistance of indirect restorations with different preparation designs made either of lithium disilicate (LS) or polymer-infiltrated ceramic network (PICN). Eighty-four (n = 84) molars were chosen, endodontically treated, and prepared with standardized MOD cavities. The molars were randomly divided into 6 study groups (n = 14) taking into account the “preparation design’’ (occlusal veneer with 1.2 mm occlusal thickness; overlay with 1.6 mm occlusal thickness; adhesive crown with 2 mm occlusal thickness) and the “CAD/CAM material’’ (E-max CAD, Ivoclar vivadent; Vita Enamic, Vita). A fatigue test was conducted with a chewing simulator set at 50 N for 1,500,000 cycles. Fracture resistance was assessed using a universal testing machine with a 6 mm diameter steel sphere applied to the specimens at a constant speed of 1 mm/min. A SEM analysis before the fracture test was performed to visually analyze the tooth-restoration margins. A statistical analysis was performed with a two-way ANOVA and a post-hoc pairwise comparison was performed using the Tukey test. The two-way ANOVA test showed that both the preparation design factor (p = 0.0429) and the CAD/CAM material factor (p = 0.0002) had a significant influence on the fracture resistance of the adhesive indirect restorations. The interaction between the two variables did not show any significance (p = 0.8218). The occlusal veneer had a lower fracture resistance than the adhesive crown (p = 0.042) but not lower than the overlay preparation (p = 0.095). LS was more resistant than PICN (p = 0.002). In conclusion, in the case of endodontically treated teeth, overlay preparation seems to be a valid alternative to the traditional full crown preparation, while occlusal veneers should be avoided in restoring non-vital molars with a high loss of residual tooth structure. LS material is more resistant compared to PICN.

Purpose: This study was done to compare the survival rates of cast gold and ceramic onlays placed in a dental school setting. Material and Methods: An electronic search was conducted in the patient records at Adams School of Dentistry, University of North Carolina at Chapel Hill for onlay codes that were in the database (From 1998 until 2018). Progress notes and radiographs were scrutinized to establish the survival time of the restorations. Any complications that occurred during the life time of the restorations were noted. The survival was summarized by categorization based on ranges of survival time in years; group 1: 1 to 5 years, group 2: 6 to 22 years. The mean survival time and standard deviation were calculated. One‐way ANOVA was used to determine whether there was a statistically significant difference in the survival times between gold and ceramic onlays. Results: The mean survival rate of cast gold onlays (86.6%) was comparable to that of ceramic onlays (81.1%). The gold onlays in Group 1 had a higher mean survival time (2.43 years) than the ceramic onlays (2.03 years). This difference was statistically significant (p = 0.002). The ceramic onlays in Group 2 had a mean survival time of 19.75 years while gold onlays had a mean survival time of 17.63 years. This difference was not statistically significant (p = 0.91). Conclusion: It was concluded that while the survival rate of ceramic onlays (81.1%) was inferior to that of cast gold onlays (86.6%), it was comparable [ABSTRACT FROM AUTHOR]

Background and Aim: The restoration of endodontically treated teeth is one of the most challenging situations of the dentist's clinical practice, because it involves procedures related to several areas, such as endodontics, operative dentistry, and prosthetics. The aim of present systematic review and meta-analysis was evaluate and compared the outcome of direct and indirect permanent restorations in endodontically treated teeth. Methods: The PubMed, Embase, ISI, Scopus, Medicine, have been used to search articles until December 2020. Odds ratio with 95% confidence interval (CI), fixed effect model, Mantel-Haenszel methods were calculated. Random effects were used to deal with potential heterogeneity and I² showed heterogeneity. I² values above 50% signified moderate-to-high heterogeneity. The Meta analysis have been evaluated with the statistical software Stata/MP v.16 (The fastest version of Stata). Result: 214 studies were selected to review the abstracts, six papers met these crucial criteria to do a systematic review and Meta-analysis. Odds ratio of five and ten years survival rate was (OR, -1.27 95% CI -1.69, 0.85. P= 0.00) and (OR, -1.63 95% CI -2.09, -1.17. P= 0.00), respectively. Odds ratio of restorative and endodontic success rate was (OR, -1.15 95% CI -2.32, 0.32. P= 0.05) and (OR, - 0.09 95% CI -0.24, 0.06. P= 0.22), respectively. Conclusion: direct restorations had a higher survival rate than Indirect restorations and no statistically significant difference was found between the direct and Indirect restorations in terms of restorative and endodontic success rate. [ABSTRACT FROM AUTHOR]

Young patients frequently sustain dental trauma. Clinical guidelines are in place to ensure proper treatment protocol for such patients and cases. One simple restorative option--particularly for cases presenting with dentinenamel fractures without pulp exposure--may be an indirect composite resin restoration. This alternative, which takes into account the difficulty of treating young, fearful, and uncooperative patients, offers a safe, predictable, and less anxiety-inducing experience for the patient and greater convenience, ease, time efficiency, and control of the esthetic and biological results for the clinician. This article describes a simple step-by-step protocol in which an indirect composite resin was performed to restore a dentin-enamel fracture of a maxillary central incisor in an uncooperative patient in order to achieve optimal esthetics and biological results. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the differential composition of resin/dentin interfaces of indirect restorations created by the application of 4th and 5th generation dual-curing luting systems (bonding agents/resin cements), when each material was either light cured or allowed to self-cure. Materials and Methods: Occlusal flat dentin surfaces of 60 human third molars were assigned into 12 groups (n = 5) according to curing mode and dual-curing cementing system: 4th generation All Bond2 (AB2)/Duolink (Bisco) and 5th generation (B1) Bond1/Lute-it (Pentron). Fluorescein-labeled dextran (FDx) was mixed with the bonding agents, while rhodamine-labeled dextran (RhDx) was incorporated into resin cements and Pre-Bond resin from AB2. Resin cements were applied to 2-mm-thick, precured resin composite disks (Z250, 3M ESPE), which were fixed to dentin surfaces containing adhesive resin in either cured (light cured; LC) or uncured (self-cured; SC) states. The restored teeth were light activated (XL3000, 3M ESPE) according to the manufacturers' instructions (LRC) or allowed to self-cure (SRC), were stored for 24 h, and then vertically, serially sectioned into 1-mm-thick slabs, which were analyzed using confocal laser scanning microscopy. Fluorescent additives indicated where individual components of the bonding/cement systems were located. Additional specimens were prepared and analyzed using a conventional scanning electron microscope. Results: AB2/LC and B1/LC exhibited nonuniform primer/adhesive layer thickness. AB2/SC showed adhesive resin penetration within the primed dentin, and resin cement penetration at the entrance of the dentin tubules. B1/SC/LRC demonstrated resin cement penetration within the hybrid layer and into the dentin tubules. More resin cement penetration was observed in B1/SC/SRC groups than in its LRC equivalent. Conclusion: The morphological features and component interactions among materials at resin/dentin interfaces are related to the activation modes of the primer/adhesive layer and of the resin cement used. [ABSTRACT FROM AUTHOR]

Classic bonded indirect ceramic or resin composite restorations necessitate at least 2 appointments. The present article describes an updated technique for the first appointment comprising cavity preparation, dentin sealing, impression, and provisionalization. Two clinical cases are presented to illustrate the procedures step by step. [ABSTRACT FROM AUTHOR]

Fracture resistance of dentin-bonded inlays may be influenced by the restorative material used. The purpose of this study was to evaluate, in vitro, the fracture resistance of teeth restored with four tooth-colored materials: feldspathic ceramic, Duceram LFC, and three laboratory resins, Solidex, Artglass, and Targis. Sixty mandibular molar teeth were placed in resin cylinders, reproducing the periodontal ligaments. Mesiai-occlusal-distal (MOD) inlay preparations were made in a standard cavity preparation appliance. Subsequently, the teeth were molded, and the restorations were prepared following the manufacturer's instructions. The inlays were cemented with resin composite cement. Rely X, and stored at 37° C and 100% humidity for 24 hours. The samples were then submitted to an axial compression load at a speed of 0.5 mm/minute. Statistical analysis by one-way ANOVA and Tukeys multiple comparison test revealed that the teeth restored with Duceram LFC (205.44 ± 39.51 kgf) showed statistically inferior fracture resistance than the three other groups restored with Indirect resin composites (Solidex [293.16 ± 45.86 kgf], Artglass [299.87 ± 41.08 kgf], and Targis [304.23 ± 52.52 kgf]). (Quintessence Int 2004:35:281-286) [ABSTRACT FROM AUTHOR]

Objectives: Evaluating the fit of CAD/CAM lithium disilicate ceramic crowns fabricated on basis of direct and indirect digitalization of impressions by CBCT or of dental casts. Material and methods: A metal model with a molar chamfer preparation was digitized (n = 12 per group) in four ways: IOS—direct digitalization using an Intra-Oral scanner (CS3600), cone-beam computed tomography scan (CBCT 1)—indirect digitalization of impression (CBCT-CS9300), CBCT 2—indirect digitalization of impression (CBCT-CS8100), and Extra-Oral scanner (EOS)—indirect digitalization of gypsum-cast (CeramillMap400). Accuracy of 3D datasets was evaluated in relation to a reference dataset by best-fit superimposition. Marginal fit of lithium disilicate crowns after grinding was evaluated by replica technique. Significant differences were detected for 3D accuracy by Mann–Whitney U and for fit of crowns by One-way ANOVA followed by Scheffe's post hoc (p = 0.05). Results: 3D analysis revealed mean positive and negative deviations for the groups IOS (− 0.011 ± 0.007 mm/0.010 ± 0.003 mm), CBCT 1 (− 0.046 ± 0.008 mm/0.093 ± 0.004 mm), CBCT 2 (− 0.049 ± 0.030 mm/0.072 ± 0.015 mm), and EOS (− 0.023 ± 0.007 mm/0.028 ± 0.007 mm). Marginal fit presented the results IOS (0.056 ± 0.022 mm), CBCT 1 (0.096 ± 0.034 mm), CBCT 2 (0.068 ± 0,026 mm), and EOS (0.051 ± 0.017 mm). Conclusions: The marginal fit of EOS and IOS, IOS and CBCT 2, and CBCT 2 and CBCT 1 showed statistical differences. The marginal fit of CBCT 1 and CBCT 2 is within the range of clinical acceptance; however, it is significant inferior to EOS and IOS. Clinical relevance: The use of a CBCT enables clinicians to digitize conventional impressions. Despite presenting results within clinical acceptable levels, the CBCT base method seems to be inferior to Intra-Oral scans or to scanning gypsum models regarding the resulting accuracy and fit. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of the selective etching in the survival rates of indirect restorations cemented with self‐adhesive resin luting. Materials and Methods: The eligibility criteria were formulated based on PICOS strategy. The search without restrictions was performed in PubMed/Medline, the Cochrane Library, Web of Science, Scopus, LILACS databases and gray literature until May 2018. Cochrane Collaboration's tool was performed for assessing the risk of bias. According to the bias risk analysis, the studies were classified as low risk of bias and high quality of evidence. The systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42018091202). The meta‐analysis was performed using RevMan 5.3 software (RevMan, Copenhagen, Denmark) and the risk ration and confidence interval was obtained (p < 0.05). Results: After database screening, removal of duplicates and eligibility criteria application, two studies were selected for this systematic review, with 65 participants (34 in one and 31 in the other). The pooled meta‐analysis demonstrated no statistically significant difference in clinical longevity for selective etching in indirect restorations (P > .05; I2 = 0%) and risk ratio of 0.46 [0.19‐1.09]. Conclusions: Based on the findings, the results of this systematic review suggest that the selective enamel etching prior to application of self‐adhesive luting cements systems for indirect restoration do not influence the clinical longevity of indirect restorations. Clinical significance: The knowledge of the clinical steps of adhesive procedures is fundamental to the success of adhesive restorations and their longevity. Self‐adhesive resin cements simplify the luting procedure of indirect restorations. However, adding a step that could significantly improve long‐term survival would be of great value. Thus, the results of this systematic review will provide data so that the decision making regarding materials used for adhesive cementation is conducted based on scientific evidence. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Dentistry & Research is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Speaking about the indirect restoration of the anterior region of dental arch, functions recovery, preservation of the maximum number of vital tissues or aesthetic smile, we mean adherence to the mandatory principles of careful restoration of dental tissues. Porcelain veneers meet all these requirements. Nowadays they are the best method for restoration of the anterior region of dental arch. 50 patients at the age of 18 – 45 were chosen for the research. Carious lesions of 3-5 classes by Black and noncarious lesions of hard tissues were diagnosed in the patients of this group. 120 indirect restorations with porcelain veneers were performed. The results of our clinical research indicate that the veneers are the best appliances to replace the defects of crown portion of frontal teeth. Re-examination in 3, 4 and 5 years suggests the durability of appliances and satisfactory aesthetic result under condition of a correct assessment of the clinical situation and the strict adherence to the stage-by-stage approach of veneer manufacturing.

Introduction: The restoration of endodontically treated teeth is a topic that has been studied extensively but it is still a challenge for dental practitioners. The aim of this study was to evaluate fracture resistance, fracture patterns and fracture location of endodontically treated human maxillary premolars restored with direct and indirect composite resin and ceramic restoration. Methods: Eighty non-carious maxillary premolars were selected and divided into four groups (n=20). Endodontic treatment and mesio-occluso-distal preparations were carried out in all the groups except for the control group (group I). Subsequently, the prepared teeth were restored as follows: group II: indirect composite restoration; group III: ceramic restoration; group IV: direct composite restoration. The specimens were subjected to compressive axial loading until fracture occurred. The mode of failure was also recorded. Results: Group I had higher fracture resistance (1196.82±241.74) than the other groups (P

Determining the appropriate technique for diastema closure is challenging, and the decision must be evidence based. The objective of these case reports is to describe different approaches to diastema closure using direct and indirect techniques, focusing on the characteristics of the patient and clinical requirements to guide treatment. In the first case, a 16-year-old patient had multiple diastemas in the maxillary anterior dentition. The clinical evaluation revealed microdontia of the lateral incisors and malpositioned teeth. The treatment included tooth whitening and placement of composite resin veneers using a direct technique. In the second case, a 54-year-old patient displayed a disharmonious and esthetically compromised smile due to small teeth, color changes, multiple diastemas, incisal wear, and severe dentogingival disproportion. Based on the patient's expectations, the patient's age, and the presence of a "black triangle" interdental space, a multidisciplinary restorative treatment was proposed, including gingivoplasty, tooth whitening, and placement of ceramic laminate veneers using an indirect technique. Both approaches achieved successful esthetic rehabilitation and diastema closure with minimal intervention. The choice of procedure and restorative material, as well as the need for tooth preparation, varied based on the clinical requirements, patient expectations, and financial constraints. Careful treatment planning avoided lengthy and inefficient procedures., Competing Interests: No conflicts of interest reported.

New technologies are changing the therapeutical options to do indirect restorations and new adhesive systems are continuously introduced to be used by clinicians. Different interactions between restorations, adhesive systems components, enamel and dentin require having criteria based on the selection of the adhesive system, ensuring the longevity of the restorations and the preservation of the biological remnant. The adhesion force to the dental tissue is one of the indicatives of the behavior of the adhesive systems and influences the behavior of the treatments with direct and indirect restorations. The objective of this search was to find the adhesive systems with the best results in terms of the adhesion strength of indirect restorations on the dental tissues. The search was conducted in two MEDLINE digital databases (PubMed), and the Cochrane Library with a search strategy based on the combination of MeSH (Medical Subject Headings) keywords. This systematic review used the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). According to this review, the 3-step adhesive systems were the best performing and still are the gold standard for the cementing of indirect restorations. In addition, it can be concluded that self-etched adhesive systems reduce the time spent in clinical practice, however at the interface level they behave as permeable membranes more susceptible to degradation.

This study evaluated the effect of different ceramic primers and heat treatment of silane coupling agents on bond strength of resin cement to glass ceramic. Five ceramic primers (Clearfil Ceramic Primer/CCP, MonoBond-S, ProSil, RelyX Ceramic Primer and Silano) and one conventional resin cement (RelyX ARC) were tested. Lithium disilicate-based ceramic plates were previously etched with hydrofluoric acid, except for CCP (n = 10). All silane agents were applied to ceramics according to the manufacturer's instructions and primed ceramics plates were heated (in oven at 100 °C for 1 min) or not before resin cement placement. Dual-cure resin cement was mixed and inserted in tubes (0.75 mm diameter × 1 mm height) that were positioned over primed ceramic surfaces. Micro-shear testing was performed using a universal testing machine. Bond strength data were analyzed using two-way ANOVA and Tukey's test (5%). Ceramic primer heating did not improve the bond strength of the resin cement to lithium disilicate. Most of ceramic primers did not indicate significant difference in bond strength among them; however, CCP yielded the lowest bond strength among the ceramic primers. In conclusion, when the silane was applied on etched surface the bond strength was higher and heat treatment of silane coupling agents did not affect the bond strength. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this systematic review and meta-analysis was to evaluate and compare the failure rates of direct and indirect restorations for single-tooth restorations., Methods: A literature search was conducted by using electronic databases and relevant references for clinical studies on direct and indirect dental restorations with a follow-up of at least 3 years. The risk of bias was assessed with the ROB2 and the ROBINS- I tools. The I2 statistic was used for the assessment of heterogeneity. The authors reported summary estimates of annual failure rates of single-tooth restorations using a random-effects model., Results: Of 1415 screened articles, 52 (18 RCTs, 30 prospective, 4 retrospective) met the inclusion criteria. No articles with direct comparisons were identified. No significant difference was found in the annual failure rates of single teeth restored with either direct or indirect restorations, which were calculated as 1% using a random-effects model. High heterogeneity was found, ranging from 80% (P⟨0.01) for studies on direct restorations to 91% (P⟨0.01) for studies on indirect restorations. Most of the studies presented some risk of bias., Conclusions: Annual failure rates were similar for direct and indirect single-tooth restorations. Further randomized clinical trials are needed to draw more definitive conclusions., (Copyright© 2023 Dennis Barber Ltd.)

Replacement of lost tooth surface and short clinical crown height is a common problem for restorative dentists. Multiple options including surgical crown lengthening, relative axial tooth movement, orthodontics, increasing the vertical dimension of occlusion and devitalisation of tooth are employed alone or in combination to create space for a durable and stable restoration. A variety of factors need to be assessed prior to such a decision making. This paper present an overview of the commonly used management options for the restoration of teeth with short clinical crown heights. [ABSTRACT FROM AUTHOR]