Enhancing Dental Student Learning and Skill with Dental Bonding Utilizing a Shear Bond Strength Test.

Teaching dental students the proper protocol and application of bonding agents for improved composite restorations in the preclinical setting can be challenging due to difficulty in translating their bonding technique to clinical outcomes. The aim of this study was to examine the effectiveness of utilizing a shear bond strength test and to evaluate if it improved student performance and confidence in adhesive dentistry. All 106 third-year and 106 fourth-year dental students (total N=212) at the University of California, Los Angeles, School of Dentistry were invited to participate in a shear bond strength workshop in 2016. The hands-on workshop used a bond strength testing instrument to demonstrate the various principles and techniques of adhesive dentistry. A total of 54 third-year and 34 fourth-year students (total N=88) participated, for response rates of 51% and 32%, respectively. For the total students, there was a significant difference in the mean bond strength between the first and second attempts (p<0.001). For the third-year students, an increase in the mean shear bond strength was seen but was not significant (p=0.097). For the fourth-year students, there was a significant difference between the first and second attempts (p<0.001). A significant difference was also found in the aggregate self-ratings before and after the exercise (p<0.001). The students rated the exercise as an enjoyable way to learn about adhesive dentistry and agreed that it increased their confidence in performing bonding procedures. This exercise served as an innovative method of emphasizing proper technique with adhesive dentistry, while helping to build student confidence in the preclinical laboratory.

The hemi-engaging fixed dental implant prosthesis: A technique for improved stability and handling.

Clinicians commonly contend that the screw-retained, implant-supported fixed dental prosthesis (FDP) should be fabricated with all nonengaging abutments to allow for the inherent nonparallelism of the implants and the inability of the abutment connections to draw together during insertion and removal. The problem with a fully nonengaging FDP is difficulty in handling and more strain on the abutment screws, ultimately leading to increased rates of breakage and loosening. The hemi-engaging FDP design regains much of the advantage afforded by the internal connection and improves prosthetic handing both clinically and in the laboratory. The benefits of this technique are best seen for short-span (fewer than 5 units), screw-retained, implant-supported FDPs.

Screw Access Mark for Cemented Implant Crowns: A Universal Technique to Simplify Retrievability.

The use of cemented implant prostheses for partially edentulous patients continues to increase in clinical practice. One of the primary complications of the cemented implant crown is difficulty in retrieval, should the need arise. Drilling through most prosthetic materials is of little difficulty for most clinicians, but the complication lies in determining where exactly the access hole needs to be drilled. During fabrication, the location of the screw access channel is marked with a strong contrasting color stain on the surface of the prosthesis. The technique proposed here marks the location of the screw access directly on the prosthesis, thus improving the ease and predictability of future retrieval.

Clinical and Molecular Perspectives of Reparative Dentin Formation: Lessons Learned from Pulp-Capping Materials and the Emerging Roles of Calcium.

The long-term use of calcium hydroxide and the recent increase in the use of hydraulic calcium-silicate cements as direct pulp-capping materials provide important clues in terms of how reparative dentin may be induced to form a "biological seal" to protect the underlying pulp tissues. In this review article, we discuss clinical and molecular perspectives of reparative dentin formation based on evidence learned from the use of these pulp-capping materials. We also discuss the emerging role of calcium as an odontoinductive component in these pulp-capping materials.

Systematic reviews in oral health: a quality imperative.

Systematic reviews must be conducted responsibly, eliminating any scope for error and bias. The reporting quality of a systematic review should follow and conform to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. AMSTAR (Assessment of Multiple Systematic Reviews) is an assessment tool, which has been developed specifically to assess the quality of the process used in conducting the review. There has been a significant increase in the number of systematic reviews in oral health and several reports have been published stating low AMSTAR ratings of systematic reviews in dentistry. Systematic reviews answer key clinical questions objectively, and are often used to underpin clinical guidelines in oral health. If the quality of these reviews is compromised, this can result in inadequate or inappropriate clinical guidelines. Consequently, ensuring consistent high quality is a key imperative for systematic reviews in oral health.

Microleakage resistance of minimally invasive Class I flowable composite restorations.

Minimally invasive flowable composite Class I restorations are widely used. However, flowable composites are characterized by low filler contents, modified resin formulations, low moduli of elasticity, low viscosity, generally poor mechanical properties, and decreased long-term stability. The purpose of this study was to compare the microleakage resistance of a wide variety of flowable composites used with their manufacturers' recommended bonding systems to that of a long-used and widely studied microhybrid composite when placed as minimally invasive occlusal restorations. Molar teeth were prepared in a standardized manner, restored, artificially aged, stained, sectioned, evaluated, and analyzed. Microleakage varied substantially, by a whole order of magnitude, among the material groups tested. The control group, a conventional microhybrid composite material, leaked significantly less than all the flowable composite groups. Microleakage varied very slightly among measurement site locations. Tiny microscopic bubbles were seen within many of the flowable composite specimens, as were a few voids.

Conservative and esthetic cast gold fixed partial dentures-inlay, onlay, and partial veneer retainers, custom composite pontics, and stress-breakers: part I: fundamental design principles.

Although in today's dental world implant restorations are considered the standard of care in the replacement of missing teeth, clinical contraindications and patient nonacceptance of implant placement can be encountered. Several scenarios are discussed here in which a single missing tooth can be restored with conservative fixed partial dentures (FPD) that employ cast gold retainers; each with a customized design in order to preserve tooth structure, maintain esthetics, and provide a long-term prognosis. The abutment teeth are prepared for conservative partial coverage restorations by using Brasseler burs (Brasseler USA, Savannah, GA, USA). Impressions are taken of the preparations, along with any retentive features, utilizing either the Vented Pin Channel technique or the Shooshan Plastic Pin technique. The latter technique utilizes Kodex twist drills and corresponding impression pins (Coltene Whaledent Inc., Mahwah, NJ, USA). The conservative FPD with non-rigid connectors is fabricated by using type III gold alloy. The pontic cage portion is chemically prepared utilizing the Panavia F2.0 cement kit (Kuraray America Inc., Houston, TX, USA) or other dual-polymerizing resin cement and restored with any type of direct composite resin material. A palette of opaquers and tints are used for chairside characterization of the esthetic pontic facing. The final polish of the pontic is completed by using FlexiDisc and FlexiBuff discs (Cosmedent Inc., Chicago, IL, USA). CLINICAL SIGNIFICANCE In cases where an implant restoration is contraindicated for replacement of a single tooth, a semi-precision FPD is a conservative, functional, and esthetic alternative.

Conservative and esthetic cast gold fixed partial dentures-inlay, onlay, and partial veneer retainers, custom composite pontics, and stress breakers: part II: utilization of additional retentive features and fabrication of custom pontic facings.

Although in today's dental world implant restorations are considered the standard of care in the replacement of missing teeth, clinical contraindications and patient nonacceptance of implant placement can be encountered. Several scenarios are discussed here in which a single missing tooth can be restored with conservative fixed partial dentures (FPD) that employ cast gold retainers; each with a customized design in order to preserve tooth structure, maintain esthetics, and provide a long-term prognosis. The abutment teeth are prepared for conservative partial coverage restorations by using Brasseler burs (Brasseler USA, Savannah, GA, USA). Impressions are taken of the preparations, along with any retentive features, utilizing either the Vented Pin Channel technique or the Shooshan Plastic Pin technique. The latter technique utilizes Kodex twist drills and corresponding impression pins (Coltene Whaledent Inc., Mahwah, NJ, USA). The conservative FPD with non-rigid connectors is fabricated by using type III gold alloy. The pontic cage portion is chemically prepared utilizing the Panavia F2.0 cement kit (Kuraray America Inc., Houston, TX, USA) or other dual-polymerizing resin cement and restored with any type of direct composite resin material. A palette of opaquers and tints are used for chairside characterization of the esthetic pontic facing. The final polish of the pontic is completed by using FlexiDisc and FlexiBuff discs (Cosmedent Inc., Chicago, IL, USA). CLINICAL SIGNIFICANCE In cases where an implant restoration is contraindicated for replacement of a single tooth, a semi-precision FPD is a conservative, functional, and esthetic alternative.

Histological evaluation of a self-priming etchant adhesive system.

Vital dentin is an extension of certain pulpal tissues, presenting the first line of defense against patient hypersensitivity and the long-term bacterial microleakage that can lead to recurrent caries and pulp inflammation. High-speed cavity preparation and forced air-drying of vital dentin causes the displacement of cells into vital dentinal tubules. However, after restoration, pulps recover and deposit reparative dentin deposition within 2 weeks. The purpose of the study discussed in this article was to observe the pulp healing response after cavity preparation and restoration with a total-etch or a calcium-hydroxide control. Teeth from adult monkeys were prepared with ultra-high-speed and water spray. Class V cavities were prepared and observed at three International Standardization Organization (ISO) time-usage periods. Tissues were collected following established procedures. A few pulps showed slight odontoblastic disruption at 7 days from cavity-preparation trauma. There was no pulp inflammation associated with any restorative system at the intermediate- and long-time ISO time periods. There was less deposition of reparative dentin associated with the one-bottle Tyrian system than with the calcium-hydroxide control or the total-etch system.