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A total of 57 interproximal restorations invading the supracrestal tissue attachment were evaluated in terms of crestal bone loss over a mean period of 15 years (10 to 23 years). The distance from the cavity margin to the bone was measured at T0 (after the restoration; baseline) and controlled using radiographs and a measurable landmark. The mean vertical bone loss was 0.46 mm, with a 96.49% survival rate. Smoking habits (P = .02) and tooth type (P = .03) significantly affected bone loss. The proposed technique could help the clinician in adopting a minimally invasive approach in the treatment of heavily compromised teeth. Future research with rigorous study designs would be interesting to guide the clinical decision-making. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this retrospective study was to assess the short- to mid-term restorative and periodontal outcome of deep margin elevation (DME) performed using resin composite. Materials and Methods: Twenty-eight teeth treated with DME and indirect adhesive restorations were followed-up for a mean of 25.4 months (minimum: 12 months). Clinical and radiographic examination assessed the adaptation of the DME material and indirect restorations, presence of recurrent caries or discoloration, periodontal health at DME and non-DME sites, and periapical health. Results: The overall success rate was 96.6%. One tooth showed signs and symptoms of apical pathology after 34 months following DME. No caries, discoloration, or periodontal pockets were detected in any of the treated teeth. DME had no detrimental effect on the gingival/periodontal health or plaque accumulation. There was no correlation between the distance from the DME material to the marginal bone level and pocket depth, gingival inflammation, and plaque accumulation (p > 0.05). Conclusion: Deep margin elevation might be considered a safe procedure for teeth with deep subgingival proximal caries in the short- and mid-term. [ABSTRACT FROM AUTHOR]

Background: The early detection of dental caries is crucial for successful dental care. New intraoral scanners using near-infrared irradiation (NIRI) technology track preventive lesions without ionizing radiation. This study aimed to evaluate the performance of intraoral scanners (IOSs) in detecting proximal caries in primary posterior teeth, compared to conventional methods such as loupes-assisted clinical exams and bitewing (BW) radiography. Methods: Fifteen examined tooth surfaces were used to produce a total of 60 scores by a restorative dentistry consultant (RDC). The tooth surfaces were categorized into caries-free (n = 5 × 4 exam methods) and carious (n = 10 × 4 exam methods) subgroups. Artificial caries lesions were created on specified surfaces and mounted on typodont in sets for evaluation using a simplified modified ICDAS visual and BW radiographic examination, DIAGNOcam device, and iTero Element 5D NIRI-assisted IOS. Reference surface scores were recorded. Investigators (RDCs and recent dental graduates (RDGs)) were trained and calibrated. Inter-examiner agreement, agreement with reference, specificity, and sensitivity were checked. Results: The results showed that the sensitivity and specificity differed between the diagnostic tests. The best agreement of all investigated diagnostic methods with the reference was found using the DIAGNOcam device (ĸ = 0.87) and BW radiography (ĸ = 1.00). High agreement was found for visual examination (by the RDC and RDGs (ĸ ≈ 0.85)) and iTero 5D examination (ĸ = 0.87). Conclusions: The iTero Element 5D IOS had lower sensitivity and specificity compared to other methods. The potential use of IOSs with NIRI as a substitute for conventional diagnostic methods in primary teeth shows promise but requires further investigation. [ABSTRACT FROM AUTHOR]

The preservation of interfacial integrity in esthetic dental restorations remains a critical challenge, with hybrid layer degradation being a primary factor in restoration failure. This degradation is driven by a combination of host-derived enzymatic activity, including matrix metalloproteinases (MMPs), bacterial proteases, and hydrolytic breakdown of the polymerized adhesive due to moisture exposure. This review examines the multifactorial mechanisms underlying hybrid layer degradation and presents current advancements in restorative materials aimed at counteracting these effects. Principal strategies include collagen preservation through the inhibition of enzymatic activity, the integration of antimicrobial agents to limit biofilm formation, and the use of ester-free, hydrolysis-resistant polymeric systems. Recent research highlights acrylamide-based adhesives, which exhibit enhanced resistance to acidic and enzymatic environments, as well as dual functionality in collagen stabilization. Furthermore, innovations in bioactive resins and self-healing materials present promising future directions for developing adhesives that actively contribute to long-term restoration stability. These findings underscore the importance of continuous advancements in adhesive technology to enhance the durability and clinical performance of dental restorations. [ABSTRACT FROM AUTHOR]

Background: Home bleaching is a promising option for addressing discolored teeth conservatively. However, its impact on the physical and mechanical properties of indirect restorations remains unknown. This study provides comparative insights into the material responses to aesthetic treatments by assessing the effects of home bleaching agents on two hybrid ceramics: VITA ENAMIC® and Grandio Blocs. The focus is on evaluating color stability and biaxial flexural strength. Methods: 60 discs (12 × 1 mm) were prepared from hybrid ceramics. Specimens were divided into two groups according to type of hybrid ceramic (30 specimens in each group); group A: VITA ENAMIC®, group B: Grandio Blocs. Each group was further subdivided into 3 subgroups according to the concentration of home bleaching agents used (10 specimens in each subgroup); subgroup C: unbleached control group, subgroup C10%: carbamide peroxide 10% bleaching agent, and subgroup C35%: carbamide peroxide 35% bleaching agent. Samples of subgroup C10% were bleached with Home Bleaching Opalescence PF (10%) for 8 h per day for 14 days, as directed by the manufacturer. Samples of subgroup C35% were bleached using WHITEsmile Carbamide Peroxide (35%), following the manufacturer's directions for 30 min every day for 14 days. Color change (ΔE) was assessed using of the CIE L*a*b* system. Then, the biaxial flexural strength test was done. The data were analyzed using two-way ANOVA tests and Weibull analysis. Results: VITA ENAMIC samples exhibited significantly higher color change than Grandio Blocs (p < 0.001), while Grandio Blocs showed significantly higher biaxial flexural strength (p < 0.001). The concentration of the bleaching agent had no significant effect on color change (p = 0.086). However, regardless of its concentration, bleaching significantly reduced biaxial flexural strength in both materials (p < 0.001). Weibull analysis showed that Grandio Blocs had higher characteristic strength, while VITA ENAMIC demonstrated more reliable failure behavior. Conclusions: Compared to Grandio Blocs, VITA ENAMIC® exhibited a greater color change with both 10% and 35% carbamide peroxide home bleaching agents. Additionally, both concentrations of carbamide peroxide reduced the biaxial flexural strength of hybrid ceramics. These findings can guide clinicians in selecting hybrid ceramics based on clinical demands for aesthetics and durability. VITA ENAMIC® offers greater structural reliability and predictability for aesthetic restorations, while Grandio Blocs provide superior durability and stress resistance for high-stress clinical applications. [ABSTRACT FROM AUTHOR]

Abstract Background Home bleaching is a promising option for addressing discolored teeth conservatively. However, its impact on the physical and mechanical properties of indirect restorations remains unknown. This study provides comparative insights into the material responses to aesthetic treatments by assessing the effects of home bleaching agents on two hybrid ceramics: VITA ENAMIC® and Grandio Blocs. The focus is on evaluating color stability and biaxial flexural strength. Methods 60 discs (12 × 1 mm) were prepared from hybrid ceramics. Specimens were divided into two groups according to type of hybrid ceramic (30 specimens in each group); group A: VITA ENAMIC®, group B: Grandio Blocs. Each group was further subdivided into 3 subgroups according to the concentration of home bleaching agents used (10 specimens in each subgroup); subgroup C: unbleached control group, subgroup C10%: carbamide peroxide 10% bleaching agent, and subgroup C35%: carbamide peroxide 35% bleaching agent. Samples of subgroup C10% were bleached with Home Bleaching Opalescence PF (10%) for 8 h per day for 14 days, as directed by the manufacturer. Samples of subgroup C35% were bleached using WHITEsmile Carbamide Peroxide (35%), following the manufacturer’s directions for 30 min every day for 14 days. Color change (ΔE) was assessed using of the CIE L*a*b* system. Then, the biaxial flexural strength test was done. The data were analyzed using two-way ANOVA tests and Weibull analysis. Results VITA ENAMIC samples exhibited significantly higher color change than Grandio Blocs (p

Background: The lack of standardised studies remains an obstacle to developing a consistent approach to integrating virtual dental simulation (VDS) into dental education. The aim of this study was to develop consensus among experienced educators and dental practitioners on the optimal integration of VDS at various stages of dental curricula. The goal was to propose clear yet flexible recommendations that could be implemented by most educational institutions. Methods: Focus groups were established, consisting of experienced academic educators involved in VDS, experienced academic staff who had not previously been involved in VDS, and experienced dental practitioners. These groups exchanged ideas about the best ways to integrate VDS into dental curricula. The Simodont® Dental Trainer system was used to design a curriculum for VDS. Results: The expert group agreed that VDS for manual dexterity exercises should be introduced in the first year of dental curricula. This should be followed by cariology exercises in the second year and crown preparation exercises in the third year, alongside traditional manikin-based simulation exercises. Additionally, VDS was recommended for senior students on an ad hoc basis for academic recovery purposes. However, VDS endodontic exercises were excluded from the proposed integrative dental curriculum. Other ways of utilising VDS were identified, such as student recruitment activities and intensive refreshment programs at the start of each academic year. Conclusions: This study proposes a flexible approach to including VDS in dental curricula. This proposed approach can be customised to meet the specific needs of each educational institution, providing a tailored learning experience for students.

Abstract Introduction Assessing the methodological quality of economic evaluations (EEs) is crucial for evidence-based decision-making. The study aimed to evaluate EEs in restorative dentistry and endodontics, while also analyzing the scientific landscape of researchers and publications through co-authorship and citation network analysis providing an insight into the distribution of scientific expertise. Methodology A systematic search for relevant articles from 2012 to 2022 was conducted using PubMed, Scopus, and EBSCO. The ten-point Drummond checklist was used to appraise the methodological quality of included studies. Bibliometric data for network analysis were extracted from the Dimensions database and visualized using VOSviewer software. Results Of the 37 articles, 81.08% scored good, 16.21% average, and 2.7% poor on the methodological rating scale. Most of the included studies were in Q1 journals, with limited representation in Q2 and Q3 journals. Compliance was highest in Q2 journals (95%), followed by Q1 (88.36%), while it dropped to 40% for Q3 journals. Co-authorship analysis revealed a dense network of researchers, with Prof. Falk Schwendicke V. having a significant influence. Moreover, the Journal of Dentistry had the highest impact, followed by Journal of Endodontics and BMC Oral Health. Conclusions Despite a diverse scientific landscape, participation from developing countries was limited emphasizing the need for inclusivity and diversity in the scientific network. While the quantity of good-quality studies was encouraging, the overall quality of evidence remains paramount for decision-making in healthcare policy and practice. Therefore, continuous efforts to improve methodological rigor and reporting practices are essential to contribute robust evidence.

Objective. In this study, the biological effect of MTA Repair HP (Mineral Trioxide Aggregate Repair High Plasticity) and Biodentine have been tested on a stabilized fibroblast cell line NCTC clone 929. Materials and Methods. We assessed quantitative and qualitative parameters related to cytotoxic effect of the investigated products. The experimental period was 96 hours. Statistical analysis was performed with Kruskal-Wallis and Wilcoxon tests. Results. The detached cells test showed no statistically significant difference on cell culture for Biodentine and MTA Repair HP, while for the cellular density assay we found the same biological effect on the tested fibroblasts in the first 24 and 48 hours, but a significant different cellular response for the investigated pulp capping materials for the next 48 hours of the experiment. Conclusions. The results demonstrated that the materials presented a very low level of cytotoxicity. Biodentine showed in all parameters better biological effects than MTA Repair HP, expressed by lower and limited cellular damage and a higher cell density.

Marginal enamel fractures (MEF) are a common clinical concern in dentistry, particularly in anterior teeth. These fractures occur at the enamel margins and their etiopathogenesis involves a complex interplay of mechanical, chemical, and biological factors. The ongoing research focuses on an overview of MEF to improve the knowledge about this condition. Understanding the multifaceted nature of MEF is crucial for devising effective preventive and therapeutic strategies in contemporary restorative dentistry. Indeed, mechanical stresses, such as occlusal forces and parafunctional habits are primary contributors for MEF. Additionally, it can happen at the enamel-restoration interface due to expansion and contraction of restorative materials. Chemical degradation, including acid erosion and the breakdown of adhesive bonds, further exacerbates the vulnerability of enamel. Biological factors, such as enamel composition and the presence of micro-cracks also play a role in the development of MEF. Clinical management of MEF involves subtractive or additive techniques, repairing or replacing the compromised tooth structure using techniques to ensure the integration with the natural enamel. [ABSTRACT FROM AUTHOR]

Universal shade flowable composites have been introduced to mimic tooth structure with reduced color mismatch and reduced chair time and cost. However, the polymerization shrinkage of resin material may lead to sensitivity and restoration failure. The purpose of this study was to compare the polymerization shrinkage of recently introduced universal shade flowable resin-based composites using both wet and dry density methods. Using two measurement methods, ISO 17304 (wet method) and a gas displacement pycnometry system (dry method), the density of the unpolymerized and the polymerized RBCs were measured, and the polymerization shrinkage was calculated from the density difference. Scanning electron microscopy was used to visualize filler particles. The polymerization shrinkage showed significant differences between many materials. In particular, Bulk Base HARD II Medium Flow showed significantly lower polymerization shrinkage than all the other materials. Shrinkages measured by different methods were significantly different in all cases. The wet method measured a smaller shrinkage than the dry method in most cases, but the shrinkage measured for Gracefil LoFlow was larger with the wet method. Shrinkage between universal shade flowable resin-based composites significantly varied based on both material and measurement method. The polymerization shrinkage of resin-based composites is an important factor in biomimetic clinical dentistry, and work must be conducted to measure it accurately and with more standardization. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) has added glass ionomer cement (GIC) to the WHO Model List of Essential Medicines since 2021, which represents the most efficacious, safe and cost-effective medicines for priority conditions. With the potential increase in the use of GIC, this review aims to provide an overview of the clinical application of GIC with updated evidence in restorative and preventive dentistry. GIC is a versatile dental material that has a wide range of clinical applications, particularly in restorative and preventive dentistry. It has unique properties, such as direct adhesion to tooth structures, minimal shrinkage or expansion, a similar coefficient of thermal expansion to natural tooth structure, biocompatibility, and long-lasting fluoride release. According to the chemical composition, GIC can be classified as conventional glass ionomer cement (CGIC) and resin-modified glass ionomer cement (RMGIC). It has been used as restorative materials, luting cement for indirect restorations, liner and base of restorations, and dental sealants. While its use as a base material and liner is debatable, the clinical application of GIC as restorative cement, luting cement, and dental sealant is supported by current research. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the bonding stability of three universal adhesives to a CAD‐CAM feldspathic ceramic with or without prior silane application. Materials and Methods: The universal adhesives tested were Ambar Universal (FGM), Single Bond Universal (3M), and Ybond Universal (Yller). Scotchbond Multipurpose Plus (3M) was used as a control. The silane used was RelyX Ceramic Primer (3M). Microtensile bond strength (μTBS) to Vitablocs Mark II was measured after 24 h or 6 months of water aging (n = 20). Failure modes were observed through scanning electron microscopy, and pH and degree of C=C conversion (DC) of the adhesives were measured (n = 3). Data were analyzed using one‐, two‐, and three‐way ANOVA. Results: The pH values differed significantly among the adhesives (p < 0.001), while the DC was similar (p = 0.141). The universal adhesives showed significant differences in μTBS, with higher immediate results when using silane and lower results after aging. Notably, a significant decrease in μTBS was observed after 6 months when silane was applied. In contrast, the control adhesive exhibited consistent results between the 24‐h and 6‐month storage periods. The universal adhesives showed a decrease in μTBS ranging from 25.5% to 40.1% after prolonged storage. Adhesive failures were predominant in all groups. The presence or absence of silane in the adhesive composition did not affect the bonding performance. Conclusions: The application of a separate silane coupling agent improved the immediate bond strength of universal adhesives to CAD‐CAM feldspathic ceramic. However, this bond strength significantly decreased after 6 months of water aging. The bond strength remained stable for universal adhesives when applied without silane after 6 months of aging. [ABSTRACT FROM AUTHOR]

Background: This study aims to compare the compressive strength and microhardness of four tooth-colored restorative materials: bulk fill glass hybrid (GH), resin-modified glass ionomer (RMGIC), conventional glass ionomer (CGIC), and resin-based composite (RBC). Methods: Stainless steel molds were used to prepare 20 specimens for each material. Half of the specimens were subjected to 10,000 thermal cycles; the materials were subjected to compressive strength and microhardness tests. Mean values were statistically compared using a one-way ANOVA Test and Bonferroni pairwise comparisons. Results: GH (147.03 ± 20.19 MPa) had lower compressive strength than RBC (264.82 ± 30.95 MPa) but showed no significant difference with CGIC (130.19 ± 30.38 MPa) and RMGIC (183.52 ± 18.45 MPa). RMGIC's compressive strength also significantly fell short of RBC (p < 0.05), but it significantly increased after thermocycling (160.14 to 183.52 MPa). As for microhardness, no significant difference was found between the groups. Thermocycling significantly increased the microhardness of CGIC (from 24.27 to 31.8 ± 2.66). Conclusion: Resin-based materials outperformed the other materials. Glass hybrid restorative material performed as well as resin-modified glass ionomer regarding compressive strength; however, further studies are necessary before considering glass hybrids for use as a permanent restoration. [ABSTRACT FROM AUTHOR]

The main goal of the modern dentist should be to address the urgent need to promote treatments focused on conservative dentistry, together with maintaining the health of the periodontium. Instead, iatrogenesis that results in the invasion of the biologic space is a significant and increasing problem in dentistry. The present case report illustrates a 5-year computed tomography follow-up of a successful minimally invasive rehabilitation involving ceramic veneers. The study highlights the importance of pretreatment planning as well as a step-by-step clinical execution to achieve long-term health, function, and esthetics, respecting both restorative and periodontal principles. [ABSTRACT FROM AUTHOR]

Background: Immediate implant placement (IIP) has shown predictable outcomes when specific requirements are met. The aim of the present study was to radiographically evaluate the dimensions of mandibular incisors and the alveolar bone to further determine the feasibility of IIP in this area. Materials and methods: A total of 404 intact mandibular incisor CBCT images from 101 patients (42 males, 59 females; mean age 49 ± 16.84 years) were analyzed. The mesiodistal tooth width and the distance between the incisal edge (IE), cementoenamel junction (CEJ), facial bone crest (bo, root apex (RA), and fenestration point (F) were registered, together with the alveolar bone width at 1 and 3 mm below BC. Finally, the angular discrepancy between the dental and the alveolar bone long axis (BLA) was recorded as the tooth torque (TT). Results: The CEJ to BC distance was 3.23 ± 1.67 mm. The RA to F mean distance was 15.02 ± 3.97 mm. The mean alveolar bone buccolingual widths at 1 and 3 mm below the facial BC were 7.12 ± 0.82 and 6.32 ± 0.71 mm in the lateral and central incisors, respectively (P < 0.001). The buccolingual width was less than 6 mm in more than 33% of the central incisors, but only in 3% of the lateral incisors, displaying increased alveolar width. The average was 165.66 ± 7.47 degrees. Conclusions: The results presented in this study point toward the need for careful consideration of the requirements for anterior mandibular IIP for success and predictability purposes. [ABSTRACT FROM AUTHOR]

The lack of standardised studies remains an obstacle to developing a consistent approach to integrating virtual dental simulation (VDS) into dental education. The aim of this study was to develop consensus among experienced educators and dental practitioners on the optimal integration of VDS at various stages of dental curricula. The goal was to propose clear yet flexible recommendations that could be implemented by most educational institutions. Focus groups were established, consisting of experienced academic educators involved in VDS, experienced academic staff who had not previously been involved in VDS, and experienced dental practitioners. These groups exchanged ideas about the best ways to integrate VDS into dental curricula. The Simodont® Dental Trainer system was used to design a curriculum for VDS. The expert group agreed that VDS for manual dexterity exercises should be introduced in the first year of dental curricula. This should be followed by cariology exercises in the second year and crown preparation exercises in the third year, alongside traditional manikin-based simulation exercises. Additionally, VDS was recommended for senior students on an ad hoc basis for academic recovery purposes. However, VDS endodontic exercises were excluded from the proposed integrative dental curriculum. Other ways of utilising VDS were identified, such as student recruitment activities and intensive refreshment programs at the start of each academic year. This study proposes a flexible approach to including VDS in dental curricula. This proposed approach can be customised to meet the specific needs of each educational institution, providing a tailored learning experience for students. [ABSTRACT FROM AUTHOR]

Introduction: Assessing the methodological quality of economic evaluations (EEs) is crucial for evidence-based decision-making. The study aimed to evaluate EEs in restorative dentistry and endodontics, while also analyzing the scientific landscape of researchers and publications through co-authorship and citation network analysis providing an insight into the distribution of scientific expertise. Methodology: A systematic search for relevant articles from 2012 to 2022 was conducted using PubMed, Scopus, and EBSCO. The ten-point Drummond checklist was used to appraise the methodological quality of included studies. Bibliometric data for network analysis were extracted from the Dimensions database and visualized using VOSviewer software. Results: Of the 37 articles, 81.08% scored good, 16.21% average, and 2.7% poor on the methodological rating scale. Most of the included studies were in Q1 journals, with limited representation in Q2 and Q3 journals. Compliance was highest in Q2 journals (95%), followed by Q1 (88.36%), while it dropped to 40% for Q3 journals. Co-authorship analysis revealed a dense network of researchers, with Prof. Falk Schwendicke V. having a significant influence. Moreover, the Journal of Dentistry had the highest impact, followed by Journal of Endodontics and BMC Oral Health. Conclusions: Despite a diverse scientific landscape, participation from developing countries was limited emphasizing the need for inclusivity and diversity in the scientific network. While the quantity of good-quality studies was encouraging, the overall quality of evidence remains paramount for decision-making in healthcare policy and practice. Therefore, continuous efforts to improve methodological rigor and reporting practices are essential to contribute robust evidence. [ABSTRACT FROM AUTHOR]

Oral rehabilitation is a crucial aspect of dental medicine, focusing on restoring and enhancing the function, aesthetics, and overall quality of life for patients with missing or compromised teeth. The use of technology in restorative dentistry has significantly advanced the field, offering various options for dental prostheses, including implant-supported caps, micro-supported dentures, fixed partial dentures, and removable dentures. Increasing the performance of restorations was the major objective of these digital techniques. Computer-aided design and manufacturing (CAD/CAM) technology is utilized for the production of dentures, record bases, radiographic guides, conversion dentures, and verification jigs. This technology has revolutionized the fabrication process, offering precision and efficiency in creating dental prostheses.

Aim: This study aimed to evaluate dental esthetic screening index (DESI) Intraoral component scores among patients attending Qassim University dental clinics and the factors affecting these scores. Materials and methods: This was a retrospective study that included 150 participants aged 18 years or older with full upper and lower anterior dentitions. Standardized intraoral frontal photographs of the patients’ upper and lower dentitions were acquired from their dental records, and the mean rank DESI intraoral scores were evaluated and compared across the demographic and dental characteristics of the study patients.The mean age of the patients sampled was 33.56; 57 % were female and 43 % were male. The mean DESI Intraoral score was 15.33. DESI scores were significantly higher in patients older than 35 years compared with subjects 35 years old or younger (p = 0.015). DESI scores were increased in patients who had anterior restorations compared with those who did not (p = 0.016). Conclusions: This was the first study of its kind to use the DESI in a large clinical setting. According to the DESI, most patients attending Qassim University dental clinics had good dentofacial aesthetics. Age and the presence of anterior restorations negatively impacted patients' dentofacial aesthetics. Sex, the nature of the chief complaint, a history of orthodontic treatments, and teeth bleaching did not affect the DESI scores.

Purpose: This retrospective case series of 9 patients aimed to describe clinical outcomes and patient satisfaction following the implementation of the posterior Dahl concept to manage localized posterior tooth wear. Materials and Methods: Localized occlusal space was created in the posterior dentition. Supra-occluding direct restorations were placed bilaterally for the restoration of molars. Intraoral scans were taken at the pre-treatment stage, immediately post-restoration, and during follow-up appointments. Scans were used to undertake analysis of any occlusal changes and re-establishment of the occlusion. A questionnaire was used to assess patient satisfaction, alleviation of any pre-treatment concerns, and evaluation of post-treatment complaints. Results: Immediately post-treatment, all patients showed an increase in the vertical dimension. Opening of the bite in the untreated areas following restoration of worn posterior molars resulted either in a tendency towards or the actual reestablishment of the occlusion. One patient completely lacked compensatory vertical tooth movement in the untreated areas, culminating in the persistence of a vertical open bite. One restoration displayed cohesive fracture after 4 months. Pre-treatment problems (eg, sensitivity) were fully resolved amongst all patients after 6 months. Post-treatment complaints were minor and demonstrated resolution within a relatively short period of time. Eight patients reported being "very satisfied" with their treatment outcomes. Conclusion: Application of the posterior Dahl concept appears to offer a promising, relatively simple, minimally invasive and effective approach for the management of localized posterior tooth wear, which is well accepted by patients. [ABSTRACT FROM AUTHOR]

Background: This study looks at the clinical applications of nanotechnology in dentistry, with an emphasis on implantology, preventive care, orthodontics, restorative dentistry, and endodontics. Methods: Following PRISMA criteria and registered in PROSPERO (ID: CRD 564245), a PubMed, Scopus, and Web of Science search was conducted for studies from January 2014 to April 2024. The criteria were English-language research on nanotechnology in dental coatings, with a focus on clinical trials and observational studies. The electronic database search yielded 8881 publications. Following the screening process, 17 records were selected for qualitative analysis. Results: Nanotechnology has revolutionized dentistry. In orthodontics, nanoparticles improve antibacterial characteristics, durability, and biocompatibility, lowering bacterial colonization and plaque. In preventative care, Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) combined with stannous fluoride (SnF2) and nano-sized sodium trimetaphosphate (TMPnano) substantially remineralizes enamel. Nanostructured surfaces in dental implants, particularly those containing calcium, improve osseointegration and stability. Nanoparticles in restorative dentistry improve composite and adhesive strength, aesthetics, and longevity. Conclusions: Nanotechnology improves dental materials and equipment, resulting in better treatment outcomes and increased patient comfort. Its integration provides more effective treatments, which improves dental care and patient outcomes. More research is needed to overcome present problems and expand nanotechnology's medicinal applications. [ABSTRACT FROM AUTHOR]

Background: Occlusal contacts can be stained and thereby visualised employing occlusal indicators. Qualitative and quantitative indicators are differentiated. The hybrid system OccluSense supposedly combines analogue contact marking and digital registration of contacts. The reliability and validity of its contact marking have not yet been validated. Objectives: The aim of this controlled randomised in‐vitro study was to examine the reliability and validity of analogue contact staining with OccluSense compared to Arti‐Fol and the reference standard Gnatho‐Film. Materials and Methods: An experimental apparatus was designed to simulate static occlusion. The occlusal contacts were stained 50 times with Gnatho‐Film to determine the average number and location of contacts registered. For comparison, the contacts were pre‐stained with Gnatho‐Film and then registered with Arti‐Fol or OccluSense 50 times each. Every staining was statistically evaluated and compared to Gnatho‐Film alone, regarding the number and location of contacts. Based on the observed characteristic staining behaviour of OccluSense, a modified evaluation strategy was developed for its colour markings (OccluSense (mod.)). Results: Both evaluations of OccluSense determine that the same number of contacts was registered in over 94% of all cases. Neither OccluSense nor Arti‐Fol stain the exact same number of contacts as Gnatho‐Film, but the modified evaluation OccluSense (mod.) did improve the results for validity. Conclusion: When employing the modified evaluation strategy, OccluSense staining achieves similar reliability and validity as the reference standard. Pre‐colouring of occlusal contacts with Gnatho‐Film and the modified evaluation strategy, might become standard for analysing occlusal contacts stained by OccluSense in the future. [ABSTRACT FROM AUTHOR]

A journal publishing house grows by maintaining and increasing the level of production of journals over the years. As a result, a non-decreasing trend becomes worrisome, because it may mean some likelihood of decline in journal publications. A declining trend warrants an investigation into this aspect, and possible intervention methods for a turnaround to increase journal publications. A respected publishing house in South Africa showed declining trends in its annual yield of various of its journals. The aim of the study was to measure the journal productivity of various journals in a specified publishing house with specific objectives being to determine the level of production over the years; to compare the level of production for the various journals; and to identify the most produced and the least produced journals. A categorical multivariate time series analysis-based study design was conducted. A trend of published articles in a South African oral health-based journal publishing house was investigated for 11-years from 2008 to 2018 in which 197 journals were used. The journals were under the subfields of direct restorative dentistry (DRD), direct restorative materials (DRM), endodontics and paedodontics. Publications of the paedodontics and direct restorative dentistry and materials journals showed a decline over the years, to their extinction. There was no journal on indirect restorative materials, which is a field related to other restorative journals. Merging these could enhance the popularity of a new one. Then, the constantly low endodontics may be augmented by increasing the journal scope. [ABSTRACT FROM AUTHOR]

Implant abutments are essential components of implant prosthetic restorations. The golden standard for abutment material is titanium; however, due to its properties, the esthetic result can be compromised. The most popular esthetic material alternatives are one- and two-piece zirconia. The study aimed to answer the questions of whether zirconia abutments can be used interchangeably with titanium in both anterior and posterior regions and how aging of the abutment affects durability. For this study, an electronic search of MEDLINE (PubMed) and Scopus (Embase) was conducted. The PRISMA guidelines were followed, and a systematic review was registered with PROSPERO. The search revealed 4031 results, of which 17 studies were selected. The strongest material for abutments is titanium, closely followed by two-piece zirconia. One-piece zirconia abutments were the weakest. The cyclic loading above 1,000,000 cycles decreased the fracture resistance of the abutments. Differences in implant diameter, angulation, and restoration affected the fracture strength of all compared materials. The main mode of failure for titanium abutments was screw bending or screw fracture. One-piece zirconia most often presented catastrophic failure with internal hexagon fracture below the implant neck. Two-piece zirconia exhibits a combination of failure modes. Two-piece zirconia abutments may be suitable for use in the posterior region, given their comparable fracture resistance to titanium abutments. Despite the fact that one-piece zirconia is capable of withstanding forces that exceed those exerted during mastication, it is recommended that it be employed primarily in the anterior dentition due to its propensity for unfavorable failure modes. [ABSTRACT FROM AUTHOR]

Aim: The objective of the present study was to investigate the association between the anatomical characteristics of different tooth groups and the diffusion and bleaching effect of hydrogen peroxide (H2O2). Materials and methods: Computed tomography (CT) images from five patients were used to assess the hard tissue thickness and pulp volume (PV) of four tooth groups: lower (mandibular) incisors (LI), upper (maxillary) incisors (UI), canines (C), and premolars (PM). Additionally, 80 bovine tooth disks were divided into four groups (n = 20) to match the thickness of each tooth group studied. All the specimens were exposed to a 35% H2O2 bleaching gel, with 50 pL applied for 45 min during the first, second, and third sessions. Diffusion was evaluated using the peroxidase enzyme method. Color change analyses (AE, AE00, and AWID) were performed after the three application sessions and 7 days after the bleaching treatment using a spectrophotometer. Results: The PM group showed greater thickness and PV, followed by the C, UI, and LI groups (P < 0.001). The LI group had six times greater H2O2 diffusion compared with the PM group (P < 0.001), while the PM group exhibited a PV nine times larger than the LI group. Furthermore, the LI and UI groups achieved color saturation with one fewer session than the C and PM groups. Conclusions: Specific tooth groups have anatomical characteristics that interfere with bleaching treatment in terms of the diffusion and whitening effect of H2O2. Furthermore, the diffusion capacity of H2O2 was inversely proportional to the thickness of the tooth groups. (Int J Esthet Dent 2024;19:268-280) [ABSTRACT FROM AUTHOR]

Featured Application: Sandblasting dental implants and abutments prior to their use in restorative dentistry is an important preconditioning stage for several compelling reasons: this process greatly improves the longevity, functionality, and success of dental restorations because it strongly affects surface topography, helps remove unwanted contaminants, aids wettability, and promotes a better mechanical interlocking between the abutments and the restorative works. Sandblasting materials used for dental restoration are a valuable preconditioning technique that enhances the physical properties and promotes osseointegration and cell adhesion. Triplicate groups of Ti medical grade 4 and Ti6Al4V were blasted with 16 series of various naturally occurring and synthetically produced spraying materials of controlled granulometry at three spraying durations each and two spraying pressures, and the results were tested for the determination of the surface roughness taken as an average of 80 points ±5 points for each particular series of operating parameters. SEM analysis and specific tests to see whether or not cell cultures proliferate on the treated materials were also conducted. It was found that in all cases, regardless of the spraying material or working conditions, the roughness profile achieved is a uniformly distributed one. A reduction in the blasting pressure by half led to a decrease in the roughness between 30 and 35%. The use of glass balls as blasting material led to decreased roughness and more uniformly distributed roughness values for Ti as well as for Ti6Al4V, regardless of spraying duration or applied pressure compared to other spraying materials. Blasting with olivine led to increased, as well as uniformly distributed, values, and hence the conclusion that one may control the roughness size by choosing one or another of the above materials without the need to change any other operating parameters. In the case of Ti, the achieved roughness is greater than in the case of Ti4Al6V, regardless of the blasting material; the differences are smaller the softer the sandblasting material due to the fact that Ti alloys have better mechanical properties and increased hardness compared to pure Ti. SEM analysis showed that the use of sintered hydroxyapatite as an additive to the blasting material does not necessarily lead to a substantial deposition of hydroxyapatite on the substrate materials; only traces of it were identified during the analysis. As a general conclusion, this study showed that by sandblasting Ti and Ti6Al4V with different spraying materials, one may control the surface roughness, and this technique may be an attractive method for preconditioning these materials for restorative dentistry. [ABSTRACT FROM AUTHOR]

Purpose: The main aim of the present study was to carry out a scoping review on the differences in degree of conversion of monomers regarding several types resin cements, indirect restorative materials, and light-curing procedures used in dentistry. Method: A bibliographic review was performed on PubMed using the following search items: “degree of conversion” OR “filler” AND “resin cement” OR “inorganic cement” AND “organic” OR “radiopacity” OR “refractive” OR “transmittance” OR “type” AND “resin composite.” The search involved articles published in English language within the last thirteen years. A research question has been formulated following the PICO approach as follow: “How different is the degree of conversion of monomers comparing several types of resin-matrix cements?”. Results: Within the 15 selected studies, 8 studies reported a high degree of conversion (DC) of the organic matrix ranging from 70 up to 90% while 7 studies showed lower DC values. Dual-cured resin-matrix cements revealed the highest mean values of DC, flexural strength, and hardness when compared with light- and self-polymerized ones. DC mean values of resin-matrix cements light-cured through a ceramic veneer with 0.4 mm thickness were higher (~ 83%) than those recorded for resin-matrix cements light-cured through a thicker ceramic layer of 1.5 mm (~ 77%). Conclusions: The highest percentage of degree of conversion of monomers was reported for dual-cured resin-matrix cements and therefore both chemical and light-induced pathways promoted an enhanced polymerization of the material. Similar degree of conversion of the same resin-matrix cement were recorded when the prosthetic structure showed a low thickness. On thick prosthetic structures, translucent materials are required to allow the light transmission achieving the resin-matrix cement. Clinical relevance: The chemical composition of resin-matrix cements and the light-curing mode can affect the polymerization of the organic matrix. Thus, physical properties of the materials can vary leading to early clinical failures at restorative interfaces. Thus, the analysis of the polymerization pathways of resin-matrix cements is significantly beneficial for the clinical performance of the restorative interfaces. [ABSTRACT FROM AUTHOR]

Objective: Agenesis of the maxillary permanent lateral incisors is a condition that requires treatment aimed at improving the esthetics, even at an early age. However, traditional therapeutic protocols are long, invasive and have limitations and contraindications imposed by the age of the patient. Clinical Considerations: Recent developments in restorative dentistry have provided a new approach to this clinical situation, in particular when the deciduous laterals are retained. We report two cases regarding the management of missing lateral incisors using Biologically Active Intrasulcular Restoration (BAIR) technique. The BAIR technique allows us to transform the shape of the deciduous lateral incisor into the permanent, acting both on the dental morphology and proportions, and on the appearance of the soft tissues and the gingival parables. Conclusions: The BAIR technique is a valid approach to cases of agenesis of the maxillary permanent lateral incisors, when the deciduous are retained. It does not require any preparation of the dental tissues, is reversible and minimally invasive. It is applicable to patients of all ages, and results are obtained in a single appointment. Clinical Significance: The BAIR technique allows a biomimetic conservative approach for the rehabilitation of congenitally missing permanent lateral incisors, when the deciduous are retained. It is a non‐invasive protocol and effective in successfully restoring esthetics. [ABSTRACT FROM AUTHOR]

Dental composites are gaining great popularity in restorative dentistry because of their aesthetic appeal and capacity to replicate the natural color of teeth. Nevertheless, their lifespan and durability rely on various factors, such as the polishing technique and the environmental conditions they are exposed to. The study aimed to assess the influence of the method of final polishing of dental composite on the surface roughness and microhardness of materials also considering the environment of different pHs. Disc-shaped samples (5 mm diameter and 2 mm thickness) have been prepared for microhardness and roughness tests from two dental composites: A2 Clearfil Majesty ES 2 Classic and A2D Clearfil Majesty Premium. One-third of samples were polished with polishing discs, OptiDisc, another one-third of samples were polished with Eve Diacomp Twist rubbers and polishing brush with diamond particles, and rest of the samples were stored without any polishing (the control group). Tested materials were incubated in distilled water or acidic buffer (pH = 2) for 3 weeks at a temperature of 37 °C. No statistically significant differences were found for roughness for the two materials tested after incubation in liquids. A decrease in Vicker microhardness was found for Clearfil Majesty ES 2 Classic after soaking in a low pH liquid, and no such relationship was found for Clearfil Majesty Premium. The improved resistance of these materials to the negative oral environment may result in the longer survival of composite restorations in patients with poor diet or diseases, causing a decrease in oral pH. [ABSTRACT FROM AUTHOR]

This cross-sectional study evaluates the incorporation of periodontal, orthodontic, and restorative treatment approaches in managing pathologic migration of anterior teeth. A sample of 180 subjects, divided into three groups (60 each), was analyzed to understand the effect of multidisciplinary interventions. The study used simulated data, employing a heat map to visualize treatment outcomes. A comparison to existing literature is discussed, highlighting the significance of comprehensive treatment planning. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to describe the approaches to reinstating posterior teeth following endodontic therapy; structural and biomechanical shifts, biological considerations, and various restoration modalities. Methods: A detailed analysis is performed by synthesizing the latest scientific research and clinical practices. Direct fillings, onlays, complete crowns, and new treatments like endocrowns are among the restoration approaches investigated. Recommendations are made based on material qualities and application procedures to improve the lifetime and function of repaired teeth. Results: The review emphasizes the need of retaining structural integrity using appropriate restoration procedures. The ferrule effect and proper use of posts are highlighted as critical aspects in guaranteeing the stability and endurance of recovered teeth. Advancement in materials and techniques, for instance the use of endo-crowns, provide new avenues for successful repair. Conclusion: By integrating current research and clinical insights, dental practitioners can make informed decisions that ensure the long-term health and functionality of endodontically treated posterior teeth. [ABSTRACT FROM AUTHOR]

Statement of Problem: Limited evidence is available for the effect of chairside adjustment using rotary cutting instruments on the surface roughness and optical properties of different zirconia types. Purpose: To evaluate the effect of simulated adjustments on surface roughness and optical properties of different zirconia types. Materials and Methods: Three Partially Stabilized Zirconia (PSZ) types based on mole percent yttria (Y) concentration from the same manufacturer (Katana; Kuraray) were used: 3Y‐PSZ, 4Y‐PSZ, and 5Y‐PSZ. Thirty disk‐shaped specimens (Ø14 × 1.2 mm) from different zirconia types (N = 90) were prepared. Specimens were either left without adjustment (NA), adjusted with Dialite ZR finishing and polishing system (Brasseler) (APol), or adjusted with course diamond instruments only (ADia). The specimens were distributed into 9 groups (n = 10): Group 3Y‐PSZ/NA, Group 3Y‐PSZ/APol, Group 3Y‐PSZ/ADia, Group 4Y‐PSZ/NA, Group 4Y‐PSZ/APol, Group 4Y‐PSZ/ADia, Group 5Y‐PSZ/NA, Group 5Y‐PSZ/APol, and Group 5Y‐PSZ/ADia. The surface roughness of specimen was analyzed using an Atomic Force Microscope (AFM) (Bruker's Dimension Icon, Bruker) and Root Means Square (RMS) were recorded (nm). Surface Gloss (SG), Translucency Parameter (TP), and Contrast Ratio (CR) values of all groups were recorded using an integrating sphere spectrophotometer. Statistical analysis was performed using analysis of variance (ANOVA) and Tukey's multiple comparison tests for pairwise comparisons at p < 0.05 and 95% confidence interval. Results: APol had no effect on the surface roughness (p = 0.88) while ADia had a significant negative effect (p < 0.05) despite the type of zirconia. Out of the three testes optical properties, only SG was negatively affected by ADia for all types of zirconia (p < 0.05). The two adjustment types did not affect the TP of all the tested zirconia (p = 0.91). The CR was not affected by the tested adjustments for all zirconia types (p = 0.726). Conclusion: Proper zirconia adjustment following a sequence of burs and polishers can maintain acceptable roughness and optical properties. Adjustment of zirconia with rough diamond can lead to deleterious effects and should be avoided. Clinical Significance: Chairside adjustment of zirconia could lead to rougher surface and unpredictable changes of surface gloss. Therefore, zirconia adjustment should be minimized to the greatest extent possible and a proper protocol should be followed if had to be done. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and compare the clinical performance of bulk-fill flowable composites and conventional nano-hybrid composites to restore posterior teeth. Methodology: A Randomized controlled trial was conducted at Bakhtawar Amin Dental College, Multan, from July 2022 to Jun 2023. A total of 140 subjects were included in the study, with 70 assigned to the bulk-fill flowable composite group (Group A) and 70 to the traditional composite group (Group B). The restorations were assessed for retention, marginal integrity, and postoperative sensitivity over a 3-month follow-up period. Data was analyzed with SPSS version 26.0. Results: 28 teeth were dropped out of the study, leaving 112 teeth. No significant differences were found between the two groups (A and B) in restoration outcomes according to USPHS criteria (taking p > 0.05 as significant), with chi-square values of 1.46 (p = 0.48), 2.53 (p = 0.28), and 3.77 (p = 0.15) for restoration retention, marginal integrity, and postoperative sensitivity, respectively. Conclusion: Both bulk-fill flowable composite and traditional composite materials in posterior teeth restorations show favorable clinical performance in terms of restoration retention and marginal integrity with minimal post-operative sensitivity. However, further research is needed to assess the long-term performance of these materials. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate dental esthetic screening index (DESI) Intraoral component scores among patients attending Qassim University dental clinics and the factors affecting these scores. This was a retrospective study that included 150 participants aged 18 years or older with full upper and lower anterior dentitions. Standardized intraoral frontal photographs of the patients' upper and lower dentitions were acquired from their dental records, and the mean rank DESI intraoral scores were evaluated and compared across the demographic and dental characteristics of the study patients. The mean age of the patients sampled was 33.56; 57 % were female and 43 % were male. The mean DESI Intraoral score was 15.33. DESI scores were significantly higher in patients older than 35 years compared with subjects 35 years old or younger (p = 0.015). DESI scores were increased in patients who had anterior restorations compared with those who did not (p = 0.016). This was the first study of its kind to use the DESI in a large clinical setting. According to the DESI, most patients attending Qassim University dental clinics had good dentofacial aesthetics. Age and the presence of anterior restorations negatively impacted patients' dentofacial aesthetics. Sex, the nature of the chief complaint, a history of orthodontic treatments, and teeth bleaching did not affect the DESI scores. [ABSTRACT FROM AUTHOR]

Oral rehabilitation is a crucial aspect of dental medicine, focusing on restoring and enhancing the function, aesthetics, and overall quality of life for patients with missing or compromised teeth. The use of technology in restorative dentistry has significantly advanced the field, offering various options for dental prostheses, including implant-supported caps, micro-supported dentures, fixed partial dentures, and removable dentures. Increasing the performance of restorations was the major objective of these digital techniques. Computer-aided design and manufacturing (CAD/CAM) technology is utilized for the production of dentures, record bases, radiographic guides, conversion dentures, and verification jigs. This technology has revolutionized the fabrication process, offering precision and efficiency in creating dental prostheses. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is increasingly prevalent in biomedical and industrial development, capturing the interest of dental professionals and patients. Its potential to improve the accuracy and speed of dental procedures is set to revolutionize dental care. The use of AI in computer-aided design/computer-aided manufacturing (CAD/CAM) within the restorative dental and material science fields offers numerous benefits, providing a new dimension to these practices. This study aims to provide a concise overview of the implementation of AI-powered technologies in CAD/CAM restorative dental procedures and materials. A comprehensive literature search was conducted using keywords from 2000 to 2023 to obtain pertinent information. This method was implemented to guarantee a thorough investigation of the subject matter. Keywords included; "Artificial Intelligence", "Machine Learning", "Neural Networks", "Virtual Reality", "Digital Dentistry", "CAD/CAM", and "Restorative Dentistry". Artificial intelligence in digital restorative dentistry has proven to be highly beneficial in various dental CAD/CAM applications. It helps in automating and incorporating esthetic factors, occlusal schemes, and previous practitioners' CAD choices in fabricating dental restorations. AI can also predict the debonding risk of CAD/CAM restorations and the compositional effects on the mechanical properties of its materials. Continuous enhancements are being made to overcome its limitations and open new possibilities for future developments in this field. [ABSTRACT FROM AUTHOR]

Objective. In this study, the biological effect of MTA Repair HP (Mineral Trioxide Aggregate Repair High Plasticity) and Biodentine have been tested on a stabilized fibroblast cell line NCTC clone 929. Materials and Methods. We assessed quantitative and qualitative parameters related to cytotoxic effect of the investigated products. The experimental period was 96 hours. Statistical analysis was performed with Kruskal-Wallis and Wilcoxon tests. Results. The detached cells test showed no statistically significant difference on cell culture for Biodentine and MTA Repair HP, while for the cellular density assay we found the same biological effect on the tested fibroblasts in the first 24 and 48 hours, but a significant different cellular response for the investigated pulp capping materials for the next 48 hours of the experiment. Conclusions. The results demonstrated that the materials presented a very low level of cytotoxicity. Biodentine showed in all parameters better biological effects than MTA Repair HP, expressed by lower and limited cellular damage and a higher cell density. [ABSTRACT FROM AUTHOR]

This report describes multidisciplinary care combining orthodontics and restorative dentistry for a patient with Class II occlusion and stained mandibular and maxillary resin composite veneers. The orthodontic treatment improved severe overjet and malocclusion prior to restorative care. Occlusal assessment was provided with a novel digital device (PlaneSystem, Zirkonzahn) that is integrated with digital workflows for the evaluation of the occlusal plane and condylar path inclination. Diagnostic digital impressions and digital wax-up for intraoral mock-ups led to the patient's treatment acceptance. Minimally invasive tooth preparation, final digital impressions, and bonding under dental dam isolation fulfilled the patient's esthetic and functional demands with all-ceramic restorations. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the impact of 2 visual diagnostic strategies for assessing secondary caries and managing permanent posterior restorations on long-term survival. We conducted a diagnostic cluster-randomized clinical trial with 2 parallel groups using different diagnostic strategies: (C+AS) based on caries assessment, marginal adaptation, and marginal staining aspects of the FDI (World Dental Federation) criteria and (C) based on caries assessment using the Caries Associated with Restorations or Sealants (CARS) criteria described by the International Caries Detection and Assessment System (ICDAS). The treatment for the restoration was conducted based on the decision made following the allocated diagnostic strategy. The restorations were then clinically reevaluated for up to 71 mo. The primary outcome was restoration failure (including tooth-level failure: pain, endodontic treatment, and extraction). Cox regression analyses with shared frailty were conducted in the intention-to-treat population, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were derived. We included 727 restorations from 185 participants and reassessed 502 (69.1%) restorations during follow-up. The evaluations occurred between 6 and 71 mo. At baseline, C led to almost 4 times fewer interventions compared with the C+AS strategy. A total of 371 restorations were assessed in the C group, from which 31 (8.4%) were repaired or replaced. In contrast, the C+AS group had 356 restorations assessed, from which 113 (31.7%) were repaired or replaced. During follow-up, 34 (9.2%) failures were detected in the restorations allocated to the C group and 30 (8.4%) allocated to the C+AS group in the intention-to-treat population, with no significant difference between the groups (HR = 0.83; 95% CI = 0.51 to 1.38; P = 0.435, C+AS as reference). In conclusion, a diagnostic strategy focusing on marginal defects results in more initial interventions but does not improve longevity over the caries-focused strategy, suggesting the need for more conservative approaches. [ABSTRACT FROM AUTHOR]

The ideal way to describe minimal invasive dentistry is to treat caries using a biological strategy as opposed to a conventional (surgical) operational dentistry strategy. In cases when surgical dentistry is necessary, treatment is now done as conservatively as possible, causing the least amount of damage to the tooth's structure. This novel method of managing carious lesions shifts the focus from identifying the lesions as cavities (and a recurring cycle of restorations) to identifying the ecological imbalance in the mouth and bringing about biological changes in the biofilm. Minimally Invasive Dentistry (MI) aims to maximize the tooth's ability to recover by first halting the disease process and then restoring lost tooth structure and function. Dietary and lifestyle choices, particularly those involving the frequency of carbohydrates, water consumption, and smoking, have a significant impact on the pathogenicity and ecology of biofilms. Chairside tools for measuring plaque and saliva enable risk to be evaluated and patient compliance to be tracked. Materials that release physiologically accessible calcium, phosphate, and fluoride ions (CPP-ACP and CPP-ACFP) may improve saliva's remineralizing qualities. The use of biocides may also change the pathogenic qualities of plaque. By using these MI therapy methods, early lesions may be repaired, and patient comprehension and compliance may be increased. A few of the main ideas and useful applications of minimally invasive dentistry are covered in this review article. [ABSTRACT FROM AUTHOR]