Selamento dentinário imediato em restauração semidireta: relato de caso / Immediate dentin sealing in semi-direct restoration: case report

O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

Restauração indireta em resina composta: um relato de prontuário / Indirect resin composite restoration: a dental record report

Restaurações diretas em resina composta são amplamente utilizadas em odontologia para restaurar dentes posteriores. Todavia, quando há grande destruição coronária, onde a distância do istmo excede dois terços da distância intercuspídea, as restaurações indiretas em resina composta são indicadas. O presente estudo teve como objetivo relatar a análise de um prontuário de um paciente que recebeu uma restauração indireta em resina composta em dente posterior amplamente destruído. Através da análise de prontuários de pacientes atendidos nas disciplinas de Estágios Supervisionados do Curso de Odontologia da FSG Centro Universitário no ano de 2023, foi selecionado um prontuário de um paciente que compareceu a clínica odontológica da FSG com uma restauração em amálgama fraturada com reparo em resina composta que apresentou sintomatologia dolorosa. O procedimento diagnóstico ocorreu através de exame clínico e radiográfico, que constatou a indicação de substituição da restauração insatisfatória e realização de uma restauração indireta em resina composta. Os resultados estéticos e funcionais apresentados demostraram a viabilidade da técnica restauradora indireta em resina composta para reabilitar dentes posteriores com ampla destruição coronária(AU)

Direct composite resin restoration are widely used in dentistry to restore posterior teeth. However, when there is large coronary destruction, that the distance from the isthmus exceeds two- thirds of the intercuspal distance, indirect composite resin restorations are indicated. This study aimed to report the analysis of a dental record of a patient who received an indirect restoration in composite resin in a badly destroyed posterior tooth. Through the analysis of dental records of patients seen in the disciplines of Supervised Internship of the Dentistry Course at FSG Centro Universitário in the year 2023, the dental record of a patient who attended the FSG dental clinic with fractured amalgam restoration with composite resin repair was selected who had painful symptoms. The diagnostic procedure took place through clinical and radiographic examination, which revealed the indication of replacing the unsatisfactory restoration and carrying out an indirect restoration in composite resin.The aesthetic and functional results presented demonstrated the viability of the indirect composite resin restoration technique for rehabilitating posterior teeth with extensive coronal destruction(AU)

Restauração em resina composta semidireta em dente posterior: relato de caso / Semi-direct composite restoration in posterior toth: a case report

A escolha da técnica restauradora desempenha papel fundamental na eficácia e duração de um tratamento reabilitador. O objetivo deste relato de caso foi descrever a utilização da técnica semidireta para a confecção de uma restauração em resina composta em um primeiro molar inferior. A paciente apresentava uma restauração insatisfatória no dente 36, que necessitava ser substituída devido à infiltração por cárie. Optou-se pela técnica semidireta devido à amplitude da cavidade, que envolvia estruturas de suporte, e pela combinação das vantagens das abordagens direta e indireta. O procedimento envolveu a remoção de tecido cariado, a aplicação de hidróxido de cálcio pasta, seguida da aplicação de uma fina camada de ionômero de vidro e, posteriormente, resina fluída para realizar o selamento dentinário. O preparo foi realizado seguindo os princípios necessários. O elemento em questão foi moldado com silicone de adição e o arco antagonista, com alginato. Ambos modelos foram vertidos com silicone para modelos semirrígidos e montados em oclusor de peças de brinquedo. A restauração semidireta foi confeccionada em resina composta Filtek Z350 XT, respeitando a anatomia do dente 36. Pigmentos foram utilizados para aprimorar detalhes estéticos. Após acabamento e polimento, a peça foi condicionada e cimentada com cimento dual Relyx Ultimate. Pode-se concluir que a abordagem restauradora por meio da técnica semidireta construída em modelo semirrígido é uma opção terapêutica conservadora e vantajosa para dentes com extensa destruição coronária. Essa técnica possibilita a restauração de forma eficaz, garantindo tanto a estética quanto a função adequada do dente afetado(AU)

The choice of restorative technique plays a fundamental role in the effectiveness and duration of rehabilitation treatment. The objective of this case report was to describe the use of the semi-direct technique to create a composite resin restoration in a lower first molar. The patient had an unsatisfactory restoration on tooth 36, which needed to be replaced due to cavity infiltration. The semi-direct technique was chosen due to the amplitude of the cavity, which involved support structures, and the combination of advantages of the direct and indirect approaches. The procedure involved the removal of carious tissue, and the application of calcium hydroxide paste, followed by the application of a thin layer of glass ionomer and, subsequently, fluid resin to seal the dentin. The preparation was carried out following the necessary principles. The element in question was molded with addition silicone and the antagonist arch was molded with alginate. Both models were poured with silicone for semi-rigid models and mounted on toy parts occluders. The semi-direct restoration was made in Filtek Z350 XT composite resin, respecting the anatomy of tooth 36. Pigments were used to improve aesthetic details. After finishing and polishing, the piece was conditioned and cemented with Relyx Ultimate dual cement. It can be concluded that the restorative approach using the semi-direct technique built on a semi-rigid model is a conservative and advantageous therapeutic option for teeth with extensive coronal destruction. This technique allows for effective restoration, ensuring both the aesthetics and adequate function of the affected tooth(AU)

Effect of Different Adhesive Resin and Composite Veneering Materials on Adhesion to Polyetheretherketone.

OBJECTIVE: To evaluate the effect of different adhesives and veneering resins on the shear bond strength (SBS) of polyetheretherketone (PEEK). METHODS: A total of 138 PEEK specimens were randomly divided into 6 groups according to adhesive material application: Control (C, no application), Adhese Universal (A) (Ivoclar Vivadent, Schaan, Liechtenstein), Gluma Bond Universal (G) (Heraeus Kulzer, South Bend, IN, USA), G-PremioBOND (P) (GC Corporation, Tokyo, Japan), Single Bond Universal (S) (3M, Saint Paul, MN, USA) and visio.link (V) (Bredent, Senden, Germany). Each adhesive group was divided into two subgroups according to the type of veneering material: Estenia direct composite (D) and Gradia Plus indirect composite (IN) (both GC Corporation). After the veneering process, the specimens were aged by thermal cycling. Kruskal-Wallis and Mann-Whitney U tests were used for SBS analysis (P < 0.05). RESULTS: The highest SBS results were obtained in the VIN group, followed by the VD, PD, GIN, AIN, AD, SIN, SD, PIN, GD, CIN and CD groups, respectively (P = 0.001). There were no significant differences in terms of the type of veneering composite when the same adhesive was applied (P > 0.05), except for Gluma Bond Universal (P = 0.009). All the adhesives tested showed clinically acceptable SBS results. CONCLUSION: Visio.link offered the highest adhesion to PEEK, whereas the tested universal adhesives may be used as an alternative to visio.link in clinical settings. It was determined that changing the veneer type has no statistical difference when the same adhesive material is used.

Effect of phytopigments on discoloration of nanohybrid composite: An in vitro study.

Objective: The purpose of this study is to comparatively evaluate the effect of discoloration of nanohybrid composite by four different phytopigments. Materials and Methods: Fifty disk-shaped samples of nanohybrid (3M Filtek Z350) resin composites were prepared using an acrylic template of dimension 5 mm × 3 mm. They were randomly divided into five groups and immersed in solutions of tomato powder, beetroot powder, java plum powder, and turmeric powder. Distilled water was used as the control group. The samples were placed in respective solutions for 3 h daily and stored in artificial saliva for the rest of the day for 28 days. Color values (L*, a*, b*) were measured by colorimeter using the CIE L*a*b* system at the end of the 7th and 28th days of immersion. Color differences ΔE*ab were statistically analyzed. Results: All the samples showed a change in color of nanohybrid composite resin to varying degrees. The mean ΔE*ab value obtained with beetroot solution was the highest among all the groups at the end of the 7th and 28th days, depicting that beetroot solution showed maximum mean color variation, followed by java plum solution, turmeric solution, and tomato solution. Conclusion: All the phytopigments used in this study have the potential to discolor the nanohybrid composite resin, with beetroot causing the most severe discoloration.

Clinical Effectiveness of Ion-Releasing Restorations versus Composite Restorations in Dental Restorations: Systematic Review and Meta-Analysis.

BACKGROUND: To compare the clinical effectiveness of ion-releasing restorations (IRR) vs. composite resin (CR) in dental restorations. METHODS: A systematic search was carried out from articles published until January 2024, in the biomedical databases: PubMed, Cochrane Library, Scielo, Scopus, Web of Science and Google Scholar. Randomized clinical trials were included, with a follow-up time greater than or equal to 1 year, without time and language limits and which reported the clinical effect of IRR compared to CR in dental restorations. The RoB 2.0 tool was used to assess the risk of bias of the included studies and the GRADEPro GDT tool was used to assess the quality of evidence and the strength of recommendation of the results. RESULTS: The search yielded a total of 1109 articles. After excluding those that did not meet the selection criteria, 29 articles remained for the quantitative synthesis. The analysis found no statistically significant difference when comparing the dental restorations with IRRs or CRs. CONCLUSION: The literature reviewed suggests that there are no differences between the IRRs and CRs in dental restorations.

The Effect of Two Different Wavelengths of Diode Laser on the Shear Bond Strength of Composite to Dental Enamel after Bleaching Process: An In Vitro Study.

INTRODUCTION: In recent years, tooth whitening has become one of the most popular ways of achieving the original tooth color. The effect of whitening gel can be improved through heat, light or laser. The bond strength between the enamel and the composite can be reduced through bleaching and laser radiation. The purpose of this study is to assess the shear bond strength of resin composite to enamel after a bleaching process using hydrogen peroxide, with and without a laser (970 nm and 445 nm lasers). METHOD: This study used 51 extracted anterior teeth without caries that were divided into three groups. A 40% hydrogen peroxide gel was used on the enamel of all teeth. The control group received bleaching without a laser. Both the second and third treatment groups received bleaching with a laser, one with 970 nm and the other with 445 nm. After the bleaching process, all groups had etching, bonding and curing of the composite performed. Lastly, the shear bond strength between the enamel and the composite was measured and the failure modes were recorded. The data were compared using a one-way ANOVA test. RESULTS: The mean shear bond strength between the enamel and the composite in the 445 nm group three (445 nanometer) was significantly lower than the other groups (p < 0.05). There was no significant difference between the control and the 970 nm groups (p = 0.2). CONCLUSION: According to the laser wavelengths and parameters that were used in this study and the results of this study, office bleaching with a 445 nm laser weakened the shear bond strength between the enamel and the composite.

Survival Rates of Amalgam and Composite Resin Restorations from Big Data Real-Life Databases in the Era of Restricted Dental Mercury Use.

Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling or performing another treatment such as a root canal or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material, when using randomized clinical trials. To determine which material is superior, we performed a retrospective cohort study using a large database where the members of 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014-2021, 260,905 patients were treated. In total, 19,692 out of the first 113,281 amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) with 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury-containing amalgam.

Effect of Rapid High-Intensity Light-Curing on Increasing Transdentinal Temperature and Cell Viability: An In Vitro Study.

BACKGROUND: This study investigated effects of rapid high-intensity light-curing (3 s) on increasing transdentinal temperature and cell viability. METHODS: A total of 40 dentin discs (0.5 mm) obtained from human molars were prepared, included in artificial pulp chambers (4.5 × 5 mm), and subjected to four light-curing protocols (n = 5), with a Valo Grand light curing unit: (i) 10 s protocol with a moderate intensity of 1000 mW/cm2 (Valo-10 s); (ii) 3 s protocol with a high intensity of 3200 mW/cm2 (Valo-3 s); (iii) adhesive system + Filtek Bulk-Fill Flow bulk-fill composite resin in 10 s (FBF-10 s); (iv) adhesive system + Tetric PowerFlow bulk-fill composite resin in 3 s (TPF-3 s). Transdentinal temperature changes were recorded with a type K thermocouple. Cell viability was assessed using the MTT assay. Data were analyzed using one-way ANOVA and Tukey tests for comparison between experimental groups (p < 0.05). RESULTS: The 3 s high-intensity light-curing protocol generated a higher temperature than the 10 s moderate-intensity standard (p < 0.001). The Valo-10 s and Valo-3 s groups demonstrated greater cell viability than the FBF-10s and TPF-3 s groups and statistical differences were observed between the Valo-3 s and FBF-10 s groups (p = 0.023) and Valo-3 s and TPF-3 s (p = 0.025), with a potential cytotoxic effect for the FBF-10 s and TPF-3 s groups. CONCLUSIONS: The 3 s rapid high-intensity light-curing protocol of bulk-fill composite resins caused a temperature increase greater than 10 s and showed cell viability similar to and comparable to the standard protocol.

Enhancing Aesthetics and Functionality of the Teeth Using Injectable Composite Resin Technique.

In order to prepare composite restorations without the requirement for tooth preparation, the injectable composite resin technique uses a clear silicone index in a minimally invasive direct approach to imitate a diagnostic wax-up. This case report features a 34-year-old female patient having aesthetic and functional concerns, notably spacing between the teeth, insufficient tooth visibility, and diastema in the upper anterior region. Upon clinical examination, spacing and midline diastema were observed. The maxillary incisors and canines were to have composite veneers made as part of the treatment plan. A wax-up and transparent silicone index was prepared following the assessment of a try-in of the prepared mock-up. Subsequenty, for restoring the teeth, a clear silicone index was used to inject and polymerize the flowable composite. The desired outcomes included elongated teeth to enhance visibility, closure of diastemas, and reshaping of the canines. Over a 12-month follow-up period, the patient exhibited no signs of soft tissue inflammation or significant wear. The described technique is characterized by its minimal invasiveness, cost-effectiveness, and suitability for definitive and provisional restorations. Desirable results can be achieved by appropriate planning and adhering to a meticulous planning while minimizing tooth structure loss.

Esthetic Rehabilitation of Congenitally Peg-Shaped Lateral Incisors Using the Injectable Composite Resin Technique: A Clinical Report.

This report details the esthetic dental rehabilitation of a patient with peg-shaped and malformed lateral incisors, conditions that stem from congenital anomalies in tooth formation, using the injectable composite resin technique (ICRT). The ICRT clinical workflow initiates with a smile analysis and precise shade matching, followed by the construction of a diagnostic wax-up crafted according to esthetic and functional guidelines. Subsequently, a mock-up is developed to ensure that the planned restorations fulfill the patient's functional requirements and esthetic expectations. A transparent silicone index is employed to accurately transfer the patient-approved wax-up into the mouth, utilizing injectable flowable composite resin. This method enhances treatment predictability and ensures that the final direct restoration precisely reflects the approved design within a reasonable chairside timeframe.

Does dental material type influence bacterial adhesion under the same polishing conditions? Direct observation using a fluorescent staining technique: An in vitro study.

Highly polished 3, 4, and 5 mol% yttria-stabilized zirconia and CAD/CAM composite resin samples were prepared, and the influence of surface roughness (Ra and Sa, 21 areas/group), wettability (contact angle and surface energy, 3 samples/group), and surface chemical composition (2 samples/group) on single-strain bacterial adhesion models (Porphyromonas gingivalis, Streptococcus oralis, Streptococcus sanguinis, Streptococcus gordonii, and Streptococcus mutans) were compared via fluorescent staining with graphical analysis (21 areas/group). Statistical analysis was performed using the Shapiro-Wilk test followed by one-way analysis of variance with Tukey's test or the Kruskal-Wallis test with Dunn's test (α=0.05) and linear regression. For dental zirconia with the same surface roughness, the yttria content did not significantly influence the initial bacterial adhesion. However, higher bacterial adhesion was detected for the composite resin owing to its high C, O, and Si contents. There was no correlation between surface energy and bacterial adhesion for any bacterial strain (p<0.005).

Current trends in placing posterior composite restorations: Perspectives from Palestinian general dentists: A questionnair study.

Aim: The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of Palestinian general dental practitioners in placing posterior composites, examining the impact of work sector, experience, and gender on their choices. Materials and Methods: The study was conducted as an online cross-sectional questionnaire and involved 351 participants, with a response rate of 69.8%. The survey comprised 18 closed-ended questions covering demographics, material selection, and composite placement in special cases, techniques, and factors influencing the choices. Statistical analyses included descriptive statistics, chi-squared tests, and Fisher's exact tests. Results: Composite was the predominant choice for small-size (83.7%) and large-size posterior cavities (60.4%). Practitioners commonly opted for composite restorations in cases involving occlusal parafunctional activity (60%), poor oral hygiene (78%), and subgingival cavities (72.2%). Only 19.6% and 5.3% reported occlusal and gingival beveling, respectively. Rubber dams for isolation stood at 30%, one-step self-etch adhesives at 44.9%, and the oblique layering technique at 51%. Light-emitting diode curing units were popular (97.55%), but monitoring output with a radiometer was infrequent (93.5%). Tofflemire metal matrix usage was 46.1%, whereas a sectional matrix system was employed by 29.8%. A 2 mm layer exposure to light curing for 20 s was reported by 62%, and 27.75% utilized additional light-curing postmatrix band removal. Conclusion: The study highlights the need for Palestinian dental professionals to update their clinical approaches in placing composite restorations in posterior teeth. Gender, work sector, and experience influence practitioners' choices, emphasizing the importance of tailored continuing education programs for improving clinical practices.

Clinical guidelines for posterior semidirect composite resin restorations: a case report with a 17-month follow-up.

Patients are always looking for conservative, esthetic, and long-lasting dental restorations, and the technique used directly influences the longevity of the treatment. The location of the restoration in the mouth and the extent of the decay influence the treatment choice. The larger the dimensions of the cavity preparation, the greater the difficulties in restoring the tooth using direct techniques. The semidirect technique, when indicated, can achieve satisfactory results. It is a relatively easy procedure, consisting of tooth preparation to receive an indirect restoration, fabrication of an alginate impression, fabrication of the composite resin restoration on a flexible cast, cementation, removal of excess cement, and occlusal adjustment. The aim of this case report is to present a viable alternative to direct and indirect restorations for posterior teeth with extensive decay. The article describes the extraoral semidirect technique for fabricating a composite resin restoration, highlighting its indications and discussing advantages and disadvantages.

Study on the mechanical and aging properties of an antibacterial composite resin loaded with fluoride-doped nano-zirconia fillers.

Preventing the occurrence of secondary caries serves as one of the significant issues in dental clinic, thus make it indispensable to improving the properties of conventional composite resin (CR) by developing a novel CR. In present study, two groups of experimental CRs loaded with different contents of fluoride-doped nano-zirconia fillers (25 wt% and 50 wt%) were fabricated. The surface topography, mechanical performance, fluoride release, antibacterial effect, aging property and cytotoxicity of the experimental CRs were evaluated subsequently. A uniform distribution of the F-zirconia fillers over the whole surface of resin matrix could be observed. The experimental CRs showed continuous fluoride release within 28 days, which was positively correlated with the content of F-zirconia fillers. Moreover, the amount of fluoride release increased in the acidic buffer. Addition of F-zirconia fillers could improve the color stability, wear resistance and microhardness of the experimental CRs, without reducing the flexure strength. Furtherly, the fluoride ions released continuously from the experimental CRs resulted in effective contact and antibacterial properties, while they showed no cytotoxicity. As a consequence, considerations can be made to employ this new kind of composite resin loaded with fluoride-doped nano-zirconia fillers to meet clinical requirements when the antimicrobial benefits are desired.

Resistance of CAD/CAM composite resin and ceramic occlusal veneers to fatigue and fracture in worn posterior teeth: A systematic review.

Severe tooth wear is related to substantial loss of tooth structure, with dentin exposure and significant loss (≥1/3) of the clinical crown. The objective of this systematic review was to summarize and analyze the scientific evidence regarding the mechanical performance of computer-aided design/computer-aided manufacturing (CAD/CAM) composite resin and CAD/CAM lithium disilicate ceramic occlusal veneers, in terms of fatigue and fracture resistance, on severely worn posterior teeth. Currently, occlusal veneers are an alternative for treating worn posterior teeth. Although scientific evidence demonstrates the good performance of lithium disilicate occlusal veneers, there are less brittle materials with a modulus of elasticity more similar to dentin than ceramics, such as resin CAD/CAM blocks. Therefore, it is important to identify which type of material is best for restoring teeth with occlusal wear defects and which material can provide better clinical performance. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of the PubMed, Embase, Web of Science, Scopus, Cochrane, OpenGrey, Redalyc, DSpace, and Grey Literature Report databases was conducted and supplemented by a manual search, with no time or language limitations, until January 2022. We aimed to identify studies evaluating the fatigue and fracture resistance of CAD/CAM composite resin and ceramic occlusal veneers. The quality of the full-text articles was evaluated according to the modified Consolidated Standards of Reporting Trials (CONSORT) criteria for in vitro studies, and 400 articles were initially identified. After removing duplicates and applying the selection criteria, 6 studies were included in the review. The results demonstrated that the mechanical performance of CAD/CAM composite resin occlusal veneers is comparable to that of CAD/CAM lithium disilicate occlusal veneers in terms of fatigue and fracture resistance.

Longer light-curing time decreases the effect of ageing on composite resin hardness used in root reinforcement.

This study evaluated the hardness of a composite resin used for root reinforcement, considering the light-curing time, root canal region and ageing due to long-term storage. Twenty incisor roots were reinforced using composite resin, varying the photopolymerisation time (40 or 120 s). Following fibre post cementation, the roots were transversely sectioned into coronal, middle and apical regions. Composite hardness was measured initially and after 18 months of water storage. Data underwent repeated measures analysis of variance and Tukey's post hoc tests. The factors 'light-curing time', 'root region' and 'ageing' affected the hardness. Significant interactions were observed between 'light-curing time × root region' and 'ageing × light-curing time'. Regardless of time, resin hardness in the apical region was lower. After ageing, hardness in the coronal and middle regions decreased when the light-curing time was 40 s, while no significant effect on hardness was noted with a light-curing time of 120 s.

Repair versus Replacement of Defective Direct Dental Restorations: A Multinational Cross-sectional Study with Meta-Analysis.

OBJECTIVES: When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore international preferences for repair procedures and the clinical steps taken during the repair process. METHOD: An 11-question survey was distributed to dentists across 21 countries via different platforms. The survey comprised two sections: the first included five questions aimed at gathering demographic information, while the second consisted of six questions focusing on participants' practices related to the repair of composite or amalgam restorations A meta-analysis was employed to ascertain the pooled odds ratio of repairing versus replacement. The statistical analysis was carried out using the RevMan 5.3 program and forest plots were generated using the same program to visualize the results. RESULTS: The survey was completed by 3680 dental practitioners. The results indicated a strong tendency to repair defective composite restorations (OR: 14.23; 95% CI: 7.40, 27.35, p<0.001). In terms of amalgam, there was a significant tendency to replace the restorations (OR: 0.19; 95% CI: 0.12, 0.30, p<0.001). When repairing restorations, the most common protocols were etching with orthophosphoric acid and creating an enamel bevel, regardless of the restorative material used. CONCLUSION: The findings of this study indicate that there exists a knowledge gap among dental practitioners regarding restoration repair. It is imperative that dental practitioners receive proper education and training on restoration repair, to ensure the usage of adequate protocols and restoration survival.

Comparative evaluation of bond strength of diode and neodymium-doped:Yttrium aluminum garnet-assisted bleached enamel with nanofilled composite: An in vitro study.

Background: The world of esthetic dentistry is constantly making efforts toward the management of tooth staining. Laser-assisted bleaching is needed before adhesive restorations and has become common and advantageous as it accelerates bleaching action, reduces postoperative sensitivity, and promotes recrystallization of enamel. Aim: The study aimed to evaluate and compare the bond strength of diode (Biolace: EpicX) and neodymium-doped:yttrium aluminum garnet (Nd:YAG) (LightWalker, Fotona, Slovenia) assisted bleached (Pola Office, SDI) enamel with nanofilled composite (GC Solare Sculpt). Materials and Methods: The samples were divided into three groups (n = 11): Group A - Conventionally bleached enamel, Group B - Diode laser-assisted bleached enamel, Group C - Nd:YAG laser-assisted bleached enamel. After storing samples in Artificial Saliva for 2 weeks, bonding was performed, and nanofilled composite resin was applied through an incremental method. Samples were subjected to shear bond strength (SBS) analysis. Conclusion: The use of Nd:YAG laser on bleached enamel significantly increases the bond strength with nanofilled composite resin.

Effect of preheating on the viscosity of composite resins.

Aim: To determine the effects of time and temperature on the viscosity of preheated composite resins. Materials and Methods: Eleven composite resins were heated to 60°C, and temperature analyses were performed at intervals of 1 min until they had cooled to 25°C. The permanent oscillatory shear test was performed at 25°C, 35°C, 50°C, and 60°C for three composite resins under a shear rate of 1s-1. One- and two-way analysis of variance were used for the analysis (α = 0.05). Results: There was no significant interaction between the composite resin and time (P = 0.9304), and only the main effect time was significantly different (P < 0.0001). A difference was observed between T0 and T6 (P < 0.001), but not after T7. The increase in temperature resulted in a viscosity reduction (P < 0.05). At 25°C, Beautifil II presented higher viscosity. Palfique LX5 showed a significant viscosity reduction with increasing temperature compared with the others (P < 0.05). For Beautifil II and Z100, there was no difference at temperatures of 50°C and 60°C, while for Palfique LX5, no statistical difference was observed at 35°C, 50°C, and 60°C. Conclusions: Ten minutes of preheating were sufficient to reach a temperature of 60°C, reducing viscosity by at least 84%. However, 5 min after removal, the composite resin cooled to room temperature. Clinical Significance: Preheating composite resin has potential benefits. To determine how this approach will work in clinical practice, it is important to define the effects of time and temperature in the protocol of this technique and understand its limitations.