Enhancing subgingival margin restoration: a comprehensive review and meta-analysis of deep margin elevation's impact on microleakage.

INTRODUCTION: Restorative dentistry faces complex challenges with deep proximal surface destruction, requiring novel approaches like DME (Deep Margin Elevation). In order to achieve the best results while treating severe tooth damage, this study examines the advantages, disadvantages, and possible collaborations of different treatments. AIMS: This systematic review investigates the efficacy of DME as an adjunctive procedure in restorative dentistry, specifically focusing on its impact on microleakage. METHODS: The study adheres to PRISMA guidelines and employs the PICOS framework for eligibility criteria. 394 potentially qualifying studies were discovered and thorough literature search was carried out via databases. After applying inclusion criteria, 7 studies were included in the analysis. Articles were selected based on criteria that included indirect restoration and performing DME and were compared with indirect restorations without DME. Composite resin was used for DME. Other materials for DME performing, including GI and composite flow, were systematically reviewed. Data analysis was done by biostat software (α = 0.05). RESULTS: The meta-analysis of selected studies reveals a statistically significant positive effect of DME on reduction of microleakage (p = 0.001). CONCLUSION: The results of this study underscore the potential of DME in addressing subgingival margin challenges and provide valuable insights for restorative dentistry practices.

Bond Strength of Reline Materials to 3D-Printed Provisional Crown Resins.

(1) Purpose: The aim of the present study was to compare the bond strength between two 3D-printed resins designed for long-term provisional crowns and three different reline materials. (2) Materials and Methods: Rectangular specimens were prepared from two 3D-printed resins (Envision Tech and NextDent C&B) and a conventional self-cure PMMA. Transparent tubes filled with three different reline materials including composite resin, Bis-acryl, and PMMA were bonded to the 3D-printed specimens (n = 11 per group, total of 6 study groups). Tubes filled with PMMA were bonded to the prepared PMMA specimens which served as the control group (n = 11, control group). The specimens were subjected to a shear bond strength (SBS) test, and mode of failure was recorded using light microscopy. Statistical analysis was performed using a one-way ANOVA and post hoc Tukey's tests (alpha = 0.05). (3) Results: The highest SBS value was achieved to both 3D-printed materials with the PMMA reline material. The bond to both 3D-printed materials was lower with Bis-acrylic or composite resin relines in comparison to that with PMMA (p-value < 0.05). No significant difference was found between the control PMMA group and either 3D-printed material when relined with PMMA (p-value > 0.05). (4) Conclusion: The tested 3D-printed resins achieved a clinically acceptable bond strength when relined with PMMA.

The Effect of Silver Diamine Fluoride on Bond Strength of Three Types of Bulk-Fill Restorative Materials to Dentin.

Purpose: The purpose of this study was to evaluate the effect of 38 percent silver diamine fluoride (SDF) application on the shear bond strength (SBS) of three types of bulk-fill restorative materials to dentin. Methods: Eighty recently extracted deidentified, sound, human premolar teeth were sectioned to expose the mid-coronal dentin. A composite restorative material (ACTIVA™), a giomer (Beautifil®), and a high-viscosity glass ionomer (HVGI) cement (Equia Forte®) were used. The specimens were randomly assigned into eight groups (N equals 10 per group) according to the type of restorative material (ACTIVA™, Beautifil ®, Equia Forte ® with and without the conditioner) and pretreatment with one drop of 38 percent SDF. Both ACTIVA™ and Beautifil ® were bonded to dentin with a universal adhesive (Scotchbond™ Universal). The SBS was measured in a universal testing machine with a 0.5 mm per minute crosshead speed. One-way analysis of variance, Tukey's, and adjusted pairwise comparison tests were used for statistical analysis of data (α equals 0.05). Results: Pretreatment of dentin with SDF did not affect the SBS of the tested bulk-fill materials (P>0.05). The SBS of the ACTIVA™ and Beautifil® groups was similar (P>0.05) and significantly higher than all Equia Forte® groups (P<0.001). Application of conditioner had no significant effect on the SBS values of Equia Forte® (adjusted P>0.01). Conclusions: The application of silver diamine fluoride did not influence the shear bond strength of tested bulk-fill materials to dentin. Prior conditioning did not affect the SBS of the high-viscosity glass ionomer to dentin. The giomer and composite restorative materials showed significantly higher SBS than high-viscosity glass ionomer.

Effect of Photobiomodulation on the Incidence of Alveolar Osteitis and Postoperative Pain following Mandibular Third Molar Surgery: A Double-Blind Randomized Clinical Trial.

The current study aimed to evaluate the effectiveness of photobiomodulation therapy for the prevention of incidence of alveolar osteitis (AO) and postoperative pain following third molar surgery. In this double-blind clinical trial, the impacted teeth of patients having bilateral impacted mandibular third molars were surgically extracted; for each participant, one socket was randomly assigned to receive photobiomodulation treatment, the other received sham treatment. 660 nm 200 mW CW was applied at a distance of ~1cm to 4 points on the occlusal area of extraction socket (beam area at the tissue ~0.64 cm2 , 312.5 mW cm-2 , 1J, 1.6 J cm-2 ). Also, 810 nm 200 mW CW was applied at tissue surface at three points on the buccal and three points on the lingual gingiva, for 15 s (400 mW cm-2 , 3 J, 6 J cm-2 ). There was a statistically meaningful difference in AO frequency between the two groups, and the photobiomodulation group showed lower AO frequency compared with the sham PBM treatment (P-value = 0.035). According to the findings of this study, photobiomodulation therapy reduced the incidence of AO following surgical removal of impacted mandibular third molars. The incidence of AO typically occurs 3-7 days post-extraction, and our results suggest that PBM treatment within the 7 days could help reduce the risk of AO development.

A Novel Approach for Converting a Mandibular Complete Denture to a Fixed Interim, Screw-Retained Implant Prostheses: A Case Report.

For most of the last century, conventional complete dentures have been the standard of care and the most common treatment for edentulous patients. Technological advancements in fabrication techniques may significantly reduce the number of office visits required to fabricate complete dentures. Immediate occlusal loading with mandibular full arch prostheses has been extensively researched and is now one of the standards of care for edentulous patients. A clinical technique for converting a mandibular immediate complete denture to an interim full arch, screw-retained fixed prosthesis with novel implant restorative components for immediate loading on four implants is described.

Does Intra-Alveolar Application of Chlorhexidine Gel in Combination With Platelet-Rich Fibrin Have an Advantage Over Application of Platelet-Rich Fibrin in Decreasing Alveolar Osteitis After Mandibular Third Molar Surgery? A Double-Blinded Randomized Clinical Trial.

PURPOSE: To evaluate the effectiveness of chlorhexidine (CHX) gel and platelet-rich fibrin (PRF) compared with PRF alone in preventing the development of alveolar osteitis (AO). MATERIALS AND METHODS: In a double-blinded trial, patients undergoing surgical management of bilateral impacted mandibular third molars were randomly divided into 2 groups; 1 group received PRF in 1 extraction socket with the other socket as its control and the other group received 0.2% CHX gel plus PRF in 1 socket with the other socket serving as its control. The study and control sides were unknown to the surgeon and the patient. The predictor variables were PRF application (PRF vs non-PRF) and PRF plus CHX application (PRF-CHX vs non-PRF-CHX). The outcome variable was the development of AO during the first week after surgery. Age, gender, surgical difficulty score, surgeon's experience, number of anesthesia cartridges injected, and irrigation volume were other variables. Data were analyzed in SPSS 11.5 using the t test and χ2 test, with the confidence interval set at 95%. RESULTS: In total, 482 surgeries were performed on 241 patients (mean age, 24 yr). The overall frequencies of AO in all surgeries, the PRF group, and the PRF-CHX group were 15.14, 17.37, and 13%, respectively. The frequency of AO in the PRF and PRF-CHX sockets was significantly lower than in the non-PRF (relative risk = 0.46) and non-PRF-CHX (relative risk = 0.18) sockets, respectively (P < .05). Moreover, the risk of developing AO in the PRF-CHX sockets was significantly lower than in the PRF sockets (relative risk = 0.37; P < .05). CONCLUSION: According to the present findings, the application of CHX gel with PRF increases the efficiency of PRF in lowering the risk of developing AO after surgical removal of impacted mandibular third molars.

The Effect of Low-level Laser Therapy on Trigeminal Neuralgia: A Review of Literature.

The effect of low intensity laser radiation in the treatment of acute and chronic pain is now established in many studies. Tri-geminal neuralgia is a pain passes through nerve's branches and its trigger is located in skin or mucosa that could lead to pain with a trigger stimulus. The pain involved branches of trigeminal nerve that sometimes has patients to seek the treatment for several years. Nowadays different treatments are used for relief of pain that most of them cause tolerance and various side effects. This paper reviews and summarizes scientific papers available in English literature publishedin PubMed, Scopus, Science Direct, Inter science, and Iran Medex from 1986 until July 2011 about the effect of these types of lasers on trigeminal neuralgia which is one of the most painful afflictions known. In different studies, the effect of laser therapy has been compared with placebo irradiation or medicinal and surgical treatment modalities. Low-level laser therapy (LLLT) is a treatment strategy which uses a single wavelength light source. Laser radiation and monochromatic light may alter cell and tissue function. However, in most studies laser therapy was associated with significant reduction in the intensity and frequency of pain compared with other treatment strategies, a few studies revealed that between laser and placebo group there was not any significant difference according to the analgesic effect. Low-level laser therapy could be considered in treatment of trigeminal neuralgia without any side effects.

Platelet-rich fibrin: an autologous fibrin matrix in surgical procedures: a case report and review of literature.

INTRODUCTION: The healing process after surgery is a challenging issue for surgeons. Various materials and techniques have been developed to facilitate this process and reduce its period. Fibrin adhesives are often used in cardiothoracic and vascular surgery to seal diffuse microvascular bleeding and in general and plastic surgery to seal wound borders. This Case report and literature review will introduce the various usages of platelet-rich fibrin in different surgical procedures and the method of producing the matrix. CASE REPORT: A 24-year old man with periorbital skin avulsion treated with PRF membrane has been reported and discussed in this paper. CONCLUSION: Platelet-rich fibrin is a natural autologous fibrin matrix, which can be produced with a simple blood sample and a table centrifuge. The material has been used in a wide range of surgical procedures to shorten the healing period and reduce post-surgical complications.