A 1-year comparative evaluation of clinical performance of conventional direct composite restoration technique with a novel "custom shield" technique in class I compound lesions - A randomized clinical study.

Aim: The aim of the study is to evaluate and compare the 1-year clinical performance of conventional direct composite restoration technique with a novel "custom shield" technique in class I compound lesions. Subjects and Methods: After ethical approval, 72 patients who signed the informed consent form participated in the study. They were divided into two groups - Group A: Conventional direct composite restoration (n = 36) and Group B: Composite restoration using custom shield technique (n = 36) by computer randomization. In Group A, composite restoration was performed by the incremental layering technique. In Group B, restoration was performed using a novel custom shield and occlusal stamp along with the incremental layering technique. Patients were evaluated using the modified USPHS criteria by blinded evaluators for 1 year. Statistical Analysis: Chi-square test and Friedman test using SPSS version 21.0. Results: A statistically significant difference was obtained for marginal adaptation (P = 0.024), retention (P = 0.23), surface texture, and anatomic form (P < 0.001), and time taken to perform the procedure for Group B was higher than Group A. Conclusion: Conventional composite restoration and custom shield technique can be successfully used in class I compound lesions with custom shield technique having a higher edge over the conventional technique.

Three-dimensional printing: A revealing pathway to an unpredictable maze.

Three-dimensional (3D) technology has gained wide acceptance in dentistry. It has been used for treatment planning and surgical guidance. This case report presented a novel treatment approach to remove and preserve the cortical bone and root-end resection during periapical surgery with the help of cone-beam computed tomography (CBCT), computer-aided design, and 3D printing technology. A 22-year-old male patient presented with a large periapical lesion in the right maxillary central and lateral incisors was referred for endodontic surgery. The data acquired from a preoperative diagnostic CBCT scan and an intraoral scan were uploaded into surgical planning software and matched. A template that could be used to locate root ends and lesion areas was virtually designed based on the data and was fabricated using a 3D printer. With the guidance of the template, the overlying cortical bone was precisely removed and preserved, and apicectomy was performed. The patient was clinically asymptomatic at a 6-month follow-up review. Six months after the surgery, the lesion was healing well, and no periapical radiolucency was observed on radiographic examination. The digitally designed directional template worked in all aspects to facilitate the periapical surgery as anticipated. The root ends were accurately located and resected. The surgical procedure was simplified, and the treatment efficiency was improved. This technique minimized the damage and reduced iatrogenic injury.

An in vitro comparative evaluation of commonly consumed catechu and catechu with lime on surface roughness and color stability of the conventional nano-hybrid composite.

AIM: Comparative evaluation of commonly consumed catechu and catechu with lime on surface roughness and color stability of the conventional nano-hybrid composite. METHODOLOGY: A total of 50 uniform cylindrical disks of 10-mm diameter and 2-mm thickness prepared from the nano-hybrid composite were used in the study. Each sample was randomly divided into three subgroups of 20 samples each in two experimental groups (catechu, catechu, and lime) and 10 samples in the control group (artificial saliva). The samples were immersed in each agent for 15 days. Surface roughness and color changes measurements were noted at the baseline and 15th day by two-dimensional profilometer and spectrophotometer, respectively. RESULTS: It was found that nano-hybrid composite resin showed more surface roughness and color change when immersed in catechu and catechu with lime as compared to the control group. Intergroup comparison showed statistical significant increase in surface roughness and color change in the catechu group followed by the catechu with the lime group and artificial saliva. CONCLUSION: Within the limits of the present study, it can be concluded that all experimental specimens showed discoloration. At the end of 15th day, among the groups, catechu showed more surface roughness and color change followed by the catechu and lime and the control group.

A 1-year comparative evaluation of clinical performance of nanohybrid composite with Activa™ bioactive composite in Class II carious lesion: A randomized control study.

AIM: The aim of this study was to compare and evaluate the clinical performance of nanohybrid composite with Activa™ bioactive composites in Class II carious lesion. METHODOLOGY: After ethical approval, patients were selected according to the inclusion-exclusion criteria with minimum of two carious lesions in a single patient. Lesions were randomly divided into two groups: Group A - nanohybrid composite and Group B - Activa™ bioactive composite. After administration of local anesthetic agent, Class II cavity preparation was done followed by rubber dam application. For deep lesion, pulp protection was done with light-cured calcium hydroxide. Then, the cavities were restored. Finishing and polishing were done. Evaluation of the restorations was done at 1 week, 6 months, and 1 year time interval by second-blinded examiner according to the modified USPHS criteria. The results of the study were tabulated, and statistical analysis was done. RESULTS: The results showed no statistically significant difference in the clinical performance of nanohybrid composite and Activa™ bioactive composites in Class II carious lesions at the end of 1 week, 6 months, and 1 year. CONCLUSION: It can be concluded that both materials showed equal and acceptable clinical performance at the end of 1 year. Both materials can be successfully be used to restore Class II carious lesions.

Deducing a surgical dilemma using a novel three dimensional printing technique.

Persistent apical periodontitis even after nonsurgical retreatment demands for a surgical approach. This requires a thorough diagnosis and planning to eliminate the pathology and induce healing. This is sometimes challenging when the pathology is present in close relationship to the vital structures. In such cases, modern, sophisticated technology such as three-dimensional (3D) printing can come very handy in patient education as well as for planning and mock-up preparation of the surgery. In this case, a nonhealing persistent apical periodontitis in relation to 16 was surgically treated. However, the pathology was in close association with the maxillary sinus hence fused deposition modeling-based 3D printed models were fabricated for patient education and to locate and determine the extent of the lesion. This was followed by the surgical enucleation of the lesion and apicectomy of mesiobuccal and distobuccal roots and mineral trioxide aggregate retro-filling and as the symptoms subsided after the follow-up full coverage metal crown was fabricated and cemented. This technology has opened a new horizon for the use of 3D printing in conjugation with endodontic principles for more predictable endodontic success.

Evaluation of remaining dentin thickness and fracture resistance of conventional and conservative access and biomechanical preparation in molars using cone-beam computed tomography: An in vitro study.

AIM: The present study aimed to compare the remaining dentin thickness (RDT) and fracture resistance of conventional and conservative access and biomechanical preparation in molars using cone-beam computed tomography (CBCT). METHODOLOGY: A total of 60 freshly extracted human molars were selected and were randomly divided into two groups of conventional and conservative access preparation group (n = 30). Samples were subjected to pre-CBCT scan at the pericervical region for the measurement of total dentin thickness. For the conventional group, samples were accessed and biomechanical preparation was done using K3 XF file. For conservative group, samples were accessed using CK microendodontic burs using a dental operating microscope and biomechanical preparation was done using self-adjusting file. After obturation and postobturation with nanohybrid composite restoration, samples of both groups were subjected to post-CBCT scan at pericervical region for the measurement of RDT. The samples were then loaded to fracture in the Instron Universal Testing Machine, and the data were analyzed using paired sample t-test and independent sample t-test. RESULTS: The mean RDT was less in conventional group than conservative group. Pericervical dentin was preserved more in conservative group. The statistical difference among both the experimental group was highly significant (<0.001). The mean load at fracture was less in conventional group than conservative group (<0.001). CONCLUSION: Coronal dentin was conserved in molars when accessed through conservative than through conventional. The dentin conservation afforded an increased resistance to fracture in conservative group which is doubled the fracture resistance in conventional group.