Clinical comparison of different glass ionomer-based restoratives and a bulk-fill resin composite in Class I cavities: A 48-month randomized split-mouth controlled trial.

OBJECTIVE: The aim of this study is to compare the retention rates (primary outcome) of high-viscosity glass ionomer (GI), glass carbomer (GC), zirconia-reinforced GI (ZIR), and bulk-fill (BF) composite resin restorations. Secondary outcomes included anatomical form, marginal adaptation, marginal discoloration, color match, surface texture, post-operative sensitivity and secondary caries. METHODS: Two calibrated operators placed 128 restorations in 30 patients with a mean age of 21 years. The restorations were evaluated by one examiner at baseline and at 6, 12, 18, 24, and 48 months using the modified US Public Health Service criteria. The data were statistically analyzed using Friedman test. Differences between restorations were analyzed using Kruskal-Wallis test. RESULTS: After 48 months, 23 patients and 97 restorations (23 GI, 25 GC, 24 ZIR, and 25 BF) were evaluated. Patient recall rate was 77%. No significant difference was observed between the retention rates of the restorations (p > 0.05). GC showed significantly lower results than the other three fillings in terms of anatomical form (p < 0.05). There was no significant difference in the anatomical form and retention between GI, ZIR, and BF (p > 0.05). No significant change was observed in the postoperative sensitivity or secondary caries for any of the restorations (p > 0.05). CONCLUSIONS: GC restorations showed statistically lower anatomical form values, indicating lower wear resistance than the other materials. However, no significant difference was observed in the retention rates (as primary outcome) as well as the other secondary outcomes of the four different restorative materials after 48 months. CLINICAL SIGNIFICANCE: GI-based restorative materials and BF composite resin restorations in Class I cavities yielded satisfactory clinical performance after 48 months.

Repair of aged polymer-based CAD/CAM ceramics treated with different bonding protocols.

PURPOSE: The aim of this study was to compare the microtensile bond strength (µTBS) of different CAD/CAM polymer-based ceramics to a repair composite resin using various bonding protocols. MATERIALS AND METHODS: Three different CAD/CAM polymer-based ceramics (LAVA Ultimate [LU], 3M ESPE; VITA Enamic [VE], VITA Zahnfabrik; and CeraSmart [CS], GC) were used. Ceramic slices were obtained and subjected to thermal cycling between 5°C and 55°C for 5,000 cycles with a 30-second dwell time. The samples were randomly separated into the following groups: universal adhesive (UB); hydrofluoric acid (HF); sandblasting (SN); HF + UB; HF + ceramic primer (PR) + adhesive (GB); SN + UB; and SN + PR + GB. The repair composite resin (G-aenial Universal Flo, GC) was applied to the samples and subjected to re-aging between 5°C and 55°C for an additional 5,000 cycles. Parallel sections were removed from the specimens, and multiple beam-shaped micro sticks (1.0 mm × 1.0 mm × 10 mm) were prepared for each group. Subsequently, the µTBS test was performed, and the obtained data were statistically analyzed via one- and two-way analysis of variance and Tukey post hoc tests. Scanning electron microscopy (SEM) analysis was also performed. RESULTS: Significant differences were found among the experimental groups (P < .05). The µTBS values of the UB bond groups were higher than those with the GB bond. The effect of pretreatment on µTBS (ηP2 = 0.556) was more significant than ceramic type (ηP2 = 0.481), and this result was supported by the SEM images. CONCLUSION: Pretreatment before application of universal adhesive is still needed to repair hybrid ceramic restorations with composite resins.

Microtensile Bond Strength of Self-Adhesive Resin Cements to CAD/CAM Resin-Matrix Ceramics Prepared with Different Surface Treatments.

PURPOSE: To investigate the effects of different combinations of self-adhesive resin cements and surface treatments on the microtensile bond strength (µTBS) of different CAD/CAM resin-matrix ceramics. MATERIALS AND METHODS: Two different types of CAD/CAM resin-matrix ceramics (LAVA Ultimate [LU] and Vita Enamic [VE]) were used. Slices 5 mm in thickness were obtained from each CAD/CAM material. Samples of each ceramic were randomly separated into the following surface treatment groups: (1) Control group with no surface treatment; (2) 9.5% hydrofluoric acid (HF) + universal adhesive (UA, Single Bond Universal, 3M ESPE); and (3) Sandblasting with 50-µm aluminum oxide particles (SN) + UA. Two different types of recently developed resin cement (RelyX U200, 3M ESPE; SET PP, SDI Dental Limited) were applied to the treated ceramic slices in each group. After 24 hours, parallel sections were removed from the specimens, and microbeam-shaped sticks (1.0 × 1.0 × 10 mm) were prepared. The µTBS test was performed, and the data were statistically analyzed. RESULTS: Statistical analyses revealed differences among the study groups (P < .05). The control groups of each resin cement exhibited lower µTBS values than the groups that received surface treatment (P < .05). The effect of surface treatment on µTBS (partial eta-squared [ηp2] = 0.381) was more significant than the effects of ceramic (ηp2 = 0.267) and self-adhesive resin cement (ηp2 = 0.184). CONCLUSION: Surface treatment is the most important factor affecting the µTBS of resin cement to CAD/CAM materials, followed by the type of resin-matrix ceramic and the type of resin cement, respectively.

Chairside Restorations of Maxillary Anterior Teeth with CAD/CAM Porcelain Laminate Veneers Produced by Digital Workflow: A Case Report with a Step to Facilitate Restoration Design.

Since the introduction of porcelain laminate veneers in the early 1980s, the anterior esthetic rehabilitation with PLVs has been provided with a conventional restorative technique for many years. Recently, a new concept named digital workflow has been raised that will lead to the abandonment of conventional procedures during the fabrication of PLVs. Digital workflow is a new concept facilitating applications by adapting digital systems to clinical applications, including intra- and extraoral photographs, diagnostic wax-up, mock-up, intraoral camera, and use of the CAD/CAM device. The aim of this case report is to describe the clinical procedures of porcelain laminate veneers using digital workflow with a facilitating step in a single session and to evaluate the PLVs after one year of clinical service.