Comparative Evaluation of Mechanical Properties and Color Stability of Dental Resin Composites for Chairside Provisional Restorations.

Resin composites have become the preferred choice for chairside provisional dental restorations. However, these materials may undergo discoloration, changes in surface roughness, and mechanical properties with aging in the oral cavity, compromising the aesthetics, functionality, and success of dental restorations. To investigate the color and mechanical stability of chairside provisional composite resins, this study evaluated the optical, surface, and mechanical properties of four temporary restoration resin materials before and after aging, stimulated by thermal cycling in double-distilled water. Measurements, including CIE LAB color analysis, three-point bending test, nanoindentation, scanning electron microscopy (SEM), and atomic force microscopy (AFM), were conducted (n = 15). Results showed significant differences among the materials in terms of optical, surface, and mechanical properties. Revotek LC (urethane dimethacrylate) demonstrated excellent color stability (ΔE00 = 0.53-Black/0.32-White), while Artificial Teeth Resin (polymethyl methacrylate) exhibited increased mechanical strength with aging (p < 0.05, FS = 68.40 MPa-non aging/87.21 MPa-aging). Structur 2 SC (Bis-acrylic) and Luxatemp automix plus (methyl methacrylate bis-acrylate) demonstrated moderate stability in optical and mechanical properties (Structur 2 SC: ΔE00 = 1.97-Black/1.38-White FS = 63.20 MPa-non aging/50.07 MPa-aging) (Luxatemp automix plus: ΔE00 = 2.49-Black/1.77-White FS = 87.72 MPa-non aging/83.93 MPa-aging). These results provide important practical guidance for clinical practitioners, as well as significant theoretical and experimental bases for the selection of restorative composite resins.

The color-matching ability of single-shade universal composites in extracted human teeth.

OBJECTIVES: To evaluate the color-match with extracted natural teeth of three single-shade universal composites, a group-shade universal composite, and a highly translucent-shade conventional composite. METHODS: Twenty extracted human teeth were divided into light- and dark-shade groups (n = 10, LSG and DSG). A preparation was restored with the 3 single-shade universal composites, OMNICHROMA (OMC), Admira Fusion x-tra U (AFU), and Essentia U (ESU); a highly translucent-shade conventional composite, Tetric EvoCeram T (TEC-T); and two shades of a group-shade universal composite-Filtek Universal Restorative (FUR A1 and A4). Composites were photopolymerized, polished, and stored in water for 24 h. The ΔE00 value between the unprepared and restored surfaces was obtained using a spectrophotometer. Composite placement and measurements were repeated three times per tooth. Color differences were statistically analyzed with the within-between-subjects t-test and repeated-measures analysis of variance (ANOVA), followed by post hoc pairwise comparisons with a Bonferroni adjustment (α = 0.05). RESULTS: There were no statistically significant differences between OMC and FUR (A1 and A4). AFU and ESU showed significantly higher ΔE00 values than OMC and TEC-T (p < 0.05). Single-shade composites exhibited significantly higher ΔE00 values in the DSG than in the LSG except ESU (p < 0.05). None of the composites satisfied the criteria for an acceptable match (ΔE00 >1.8). CONCLUSION: OMC showed the same color matching ability as a group-shade universal composite. A highly translucent-shade conventional composite and OMC exhibited better color matching ability than other single-shade composites. Overall, single-shade universal composites performed better in lighter-shaded teeth. CLINICAL SIGNIFICANCE: Single-shade universal composites have the potential to reduce chair time by eliminating shade selection in cavities with lighter-shade teeth. Highly translucent incisal conventional composites also may be used if the appropriate shade of composite is not available.

[Surface roughness of two composite resins after immersion in soda drinks: in vitro study]. / Rugosidad superficial de dos resinas compuestas después de la inmersión en bebidas gaseosas: estudio in vitro.

Objective: Compare the surface roughness of two composite resins after immersion in carbonated beverages. Materials and methods: 160 resin discs (6 x 2 mm) were divided into 8 groups (n=20 per group) according to type of resin (Filtek™ Z350 XT® and Palfique LX5®) and type of immersion in beverages (distilled water, Coca Cola®, Inca Kola® and Kola Escocesa®. The immersions were carried out under a structured cycle: 4 immersions a day for 5 days, intermediate storage in distilled water and overnight incubation for 8 h at 37°C. The measurements with the roughness meter were evaluated in three times: baseline, 7 and 14 days. The three-way Anova test was used at P<0.05. Results: Roughness showed differences only for the individual factors of time (P<0.000) and resin (P=0.000), and for the interaction time*drink (P=0.000) and resin*drink (P=0.003). Roughness was higher with Filtek Z350 XT® immersed with Inca Kola® (0.85 ± 0.37) than 14 days compared to other times (P=0.035) and with Palfique LX5 immersed in Coca Cola® at 7 days (1.61 ± 0.42) and in Inca Kola® at 14 days (1.66 ± 0.56) compared to distilled water (P<0,05). Conclusion: Surface roughness was affected by the type of resin, the type of soft drink and the immersion time. The roughness was greater with the Palfique LX5® nanohybrid resin, the Inca Kola® drink and after 14 days of immersion.

Pre-Sealing of Endodontic Access Cavities for the Preservation of Anterior Teeth Fracture Resistance.

OBJECTIVE: Sodium hypochlorite solution (NaOCl) is an effective canal irrigant but interferes with the mechanical features of dentin and the bonding capability of adhesives when restoring endodontically treated teeth. This study evaluated whether access cavity resin sealing before using canal irrigant would augment the resistance of endodontically treated anterior teeth against fracture. METHODS: Sixty maxillary incisors underwent endodontic treatment in five groups (n = 12). Irrigation with 5.25% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) was performed in all groups except for Group 5. After root canal obturation, in Group 1, the access cavity was kept unrestored. In Group 2, immediate restoration after obturation was achieved. For Group 3, delayed restoration after 1 week was provided. In Group 4 (pre-sealed), before canal irrigation, the dentin surface of access cavities was sealed using self-adhesive composite resin (Vertise Flow) and then restored after obturation. In Group 5, which was saline irrigated, immediate restoration was performed. After storage and thermal cycling for 5000 cycles at 5°C-55°C with a dwell time of 15 s and a transfer time of 5 s, teeth were statically loaded by a universal testing machine until a fracture occurred. Data were collected as the fracture resistance (FR) and analyzed using the one-way analysis of variance and Tukey's tests. RESULTS: FR significantly differed between all groups (p < 0.001). The lowest FR was recorded in the unrestored group (284 ± 86 N), which was not statistically different from the immediately restored group (p = 0.065). The pre-sealed group exhibited the highest FR value (810 ± 127 N, p ≤ 0.02 vs. other groups). The FR of the saline-irrigated and delayed restored groups was almost similar (p = 0.13). CONCLUSIONS: NaOCl/EDTA irrigation resulted in an adverse effect on FR. Delayed restoration could reduce this adverse effect. Access cavity pre-sealing with flowable composites led to a higher FR than conventional methods and may be considered an effective step during treatment procedures.

An in vitro evaluation of the fatigue behavior of resin composite materials as part of a translational research cycle.

PURPOSE: This study aimed to reproduce and translate clinical presentations in an in vitro set-up and evaluate laboratory outcomes of mechanical properties (flexural strength, fatigue resistance, wear resistance) and link them to the clinical outcomes of the employed materials in the Radboud Tooth Wear Project (RTWP). MATERIALS AND METHODS: Four dental resin composites were selected. 30 discs (Ø12.0 mm, 1.2 mm thick) were fabricated for each of Clearfil TM AP-X (AP), Filtek TM Supreme XTE (FS), Estenia TM C&B (ES), and Lava Ultimate (LU). Cyclic loading (200 N, 2 Hz frequency) was applied concentrically to 15 specimens per group with a spherical steatite indenter (r = 3.18 mm) in water in a contact-load-slide-liftoff motion (105 cycles). The wear scar was analysed using profilometry and the volume loss was digitally computed. Finally, all specimens were loaded (fatigued specimens with their worn surface loaded in tension) until fracture in a biaxial flexure apparatus. The differences in volume loss and flexural strength were determined using regression analysis. RESULTS: Compared to AP and FS, ES and LU showed a significantly lower volume loss (p < 0.05). Non-fatigued ES specimens had a similar flexural strength compared to nonfatigued AP, while non-fatigued FS and LU specimens had a lower flexural strength (p < 0.001; 95 %CI: -80.0 - 51.8). The fatigue test resulted in a significant decrease of the flexural strength of ES specimens, only (p < 0.001; 95 %CI: -96.1 - -54.6). CLINICAL RELEVANCE: These outcomes concur with the outcomes of clinical studies on the longevity of these composites in patients with tooth wear. Therefore, the employed laboratory test seems to have the potential to test materials in a clinically relevant way.

Long-term clinical comparison of a resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions.

This 72-month study compared the clinical effectiveness of a resin-based composite (RBC) (Spectrum TPH3, Dentsply Sirona) with a resin-modified glass ionomer cement (RMGIC) (Riva Light Cure, SDI) in restoring cervical caries lesions (CCLs). Thirty-three patients, each with at least two CCLs, were enrolled. After caries removal, the dimensions of the cavities were recorded. In a split-mouth study design, a total of 110 restorations were randomly placed. Fifty-five restorations were placed with RBC using an etch-and-rinse adhesive system (Prime&Bond NT, Dentsply Sirona), while the remaining 55 were restored with RMGIC. The restorations were assessed at baseline, 6, 12, 18, 24, 36, 60, and 72 months according to modified USPHS criteria. Statistical analysis included Pearson Chi-square, Friedman tests, Kaplan Meier, and Logistic Regression analysis (p < 0.05). After 72 months, 47 restorations in 19 patients were evaluated (55% follow-up rate). Seventy-five percent of the RBC (n = 26) and 74% (n = 21) of the RMGIC restorations were fully retained. There were no significant differences between materials regarding retention and marginal adaptation (p > 0.05). Cavity dimensions, caries activity, and retention exhibited no correlation (p > 0.05). The increase in marginal staining in both groups over time was significant (p < 0.001). RMGIC restorations exhibited higher discoloration than RBC restorations (p = 0.014). At 72 months, three secondary caries lesions were detected in both restoration groups: two RMGIC and one RBC. There were no reports of sensitivity. After 72 months, both RBC and RMGIC restorations were clinically successful, with similar retention and marginal adaptation scores. However, it is noteworthy that RMGIC restorations tend to discoloration over time compared to RBC. The trial is registered in the database of "Clinical Trials". The registration number is NCT0372-2758, October 29, 2018.

Color change of tooth-colored restorative materials bonded to silver diamine fluoride-treated dentine: a systematic review.

BACKGROUND: The desirable properties of silver diamine fluoride (SDF) make it an effective agent for managing dental caries and tooth hypersensitivity. There are several clinical instances that SDF application might precede the placement of direct tooth-colored restorations. On the other hand, SDF stains demineralized/carious dental tissues black, which might affect the esthetic outcomes of such restorations. Color is a key parameter of esthetics in dentistry. Therefore, this study aims to systematically review dental literature on color/color change of tooth-colored restorations placed following the application of SDF on dentine. METHODS: Comprehensive search of PubMed, Embase, Scopus and ISI Web of Science databases (until August 2023) as well as reference lists of retrieved studies was performed. In vitro studies reported color or color change of tooth-colored restorative materials applied on SDF-treated dentine were included. Methodological quality assessment was performed using RoBDEMAT tool. Pooled weighted mean difference (WMD) and 95% confidence interval (95% CI) was calculated. RESULTS: Eleven studies/reports with a total of 394 tooth-colored restorations placed following a) no SDF (control) or b) SDF with/without potassium iodide (KI)/glutathione dentine pre-treatments were included. Color change was quantified using ∆E formulas in most reports. The pooled findings for the comparison of resin-based composite (RBC) restorations with and without prior 38% SDF + KI application revealed no statistically significant differences in ∆E values at short- and long-term evaluations (~ 14 days: WMD: -0.56, 95% CI: -2.09 to 0.96; I2: 89.6%, and ~ 60 days: WMD: 0.11; 95% CI: -1.51 to 1.72; I2: 76.9%). No studies provided sufficient information for all the items in the risk of bias tool (moderate to low quality). CONCLUSIONS: The limited evidence suggested comparable color changes of RBC restorations with and without 38% SDF + KI pre-treatment up to 60 days. The included studies lacked uniformity in methodology and reported outcomes. Further studies are imperative to draw more definite conclusions. PROTOCOL REGISTRATION: The protocol of this systematic review was registered in PROSPERO database under number CRD42023485083.

Tribochemical silicoating of amalgam promotes effective amalgam-resin repairs.

The purpose of this study was to determine the most effective method for bonding composite resin to artificially aged amalgam. A spherical amalgam alloy was triturated and condensed by hand into cylindrical plastic molds (6 mm in diameter and 4 mm in height) to create 90 specimens, which were then aged for 2 weeks in closed plastic containers at 23°C. The amalgam surfaces underwent 1 of 3 surface treatments (n = 30 per treatment): (1) air particle abrasion (APA) with 50-µm aluminum oxide particles applied with a force of 45 psi from a 10-mm distance, followed by rinsing with deionized water for 60 seconds; (2) APA following the same protocol with subsequent application of a metal primer (Alloy Primer); or (3) coating with 30-µm silica (CoJet) at a force of 45 psi from a 10-mm distance until the surface turned black. Specimens were then treated with 1 of 3 adhesives (n = 10 per adhesive per surface treatment): (1) 2-step total-etch adhesive (OptiBond Solo Plus), (2) 1-step self-etching adhesive (Scotchbond Universal), or (3) dual-cured resin cement (Panavia F 2.0). Each adhesive was applied to the treated amalgam surfaces following its manufacturer's instructions. The specimens were placed in a bonding clamp, and nanocomposite resin columns, 2.38 mm in diameter and 2.00 mm in height, were photocured (40 seconds, 500 mW/cm2) against the treated amalgam surfaces. The specimens were stored for 24 hours in 37°C deionized water and underwent shear bond strength testing at a crosshead speed of 0.5 mm/min. Data were analyzed using 2-way analysis of variance and post hoc analysis with the Tukey test at 95% confidence. The mean (SD) shear bond strength values ranged from 12.3 (1.2) MPa for aluminum oxide-treated surfaces bonded with OptiBond Solo Plus to 25.9 (4.6) MPa for silicoated surfaces bonded with Panavia F 2.0. All bonding agents produced the highest shear bond strength when the amalgam surface was silicoated. These results indicate that composite can be effectively bonded to amalgam via silicoating.

Performance of a novel self-adhesive bulk-fill composite hybrid in endodontically treated maxillary premolars: analysis of fracture resistance and failure mode.

This study evaluated the fracture resistance of endodontically treated maxillary premolars restored with a new self-adhesive composite hybrid material (Surefil one [SO]) using different protocols. A total of 72 maxillary premolars were divided into 6 groups (n = 12). The control group included intact teeth, and the other 5 groups included teeth in which disto-occlusal cavities were prepared and endodontic treatment was performed. The prepared cavities were assigned to groups that were based on the restorative procedures: bulk-fill group, universal adhesive plus conventional bulk-fill composite resin plus a layer of conventional composite resin; SO-SC group, self-cured SO; SO-LC group, light-cured SO; SO-UA group, universal adhesive plus SO; or SO-core group, a 4.0-mm layer of SO covered by a layer of conventional composite resin. Specimens in each group underwent thermocycling and load cycling to test the fracture strength and fracture mode. The results were analyzed using analysis of variance and the Tukey test (α = 0.05). The SO-core group showed the highest mean (SD) fracture resistance, 959.9 (171.8) N, among the restored groups. The SO-core group did not differ significantly from the control group (P > 0.05) but did show significantly higher strength than all other test groups (P < 0.05) except SO-SC (P = 0.364). No significant differences were found between the bulk-fill, SO-SC, SO-LC, and SO-UA groups (P > 0.05). The SO-core group showed the highest number of unrestorable fractures, while the main fracture mode for the other groups was restorable fracture. Although the use of SO as a core material restored the fracture strength of endodontically treated premolars to the level of intact teeth, it also resulted in a higher incidence of unrestorable fractures. The SO-SC group demonstrated a high fracture resistance comparable to that of the SO-core group and had a greater tendency to experience restorable fractures.

Polishing methods for composites restoration: the influence on human gingival fibroblasts behaviour.

BACKGROUND: Carious/Non-carious cervical lesions with gingival recessions may require both dental and periodontal reconstructive therapy, where flaps/grafts may be placed in contact with a dental filling material. Human Gingival Fibroblasts (HGF-1) response during the early phase of healing could vary according to the procedures employed to cure the dental composite. Moreover, oxygen diffusion into dental composite inhibits the polymerization reaction, creating an oxygen-inhibited layer (OIL) that presents residual unreacted monomers. The aim of this study was to assess the effect of different polishing techniques and OIL on HGF-1. METHODS: Composite discs polished with different techniques (diamond rubber, abrasive discs and tungsten carbide burr) were used. An additional not polished smooth group obtained with and without OIL was used as control. Samples were physically characterized through the analysis of their hydrophilicity and surface topography through contact angle measurement and SEM, respectively; afterwards the biologic response of HGF-1 when cultured on the different substrates was analyzed in terms of cytotoxicity and gene expression. RESULTS: The finishing systems caused alterations to the wettability, even if without a proportional relation towards the results of the proliferation essay, from which emerges a greater proliferation on surfaces polished with one-step diamond rubber and with abrasive discs as well as a direct effect of the glycerin layer, confirming that surface roughness can heavily influence the biological response of HGF-1. CONCLUSIONS: Surfaces wettability as well as cellular behavior seem to be affected by the selection of the finishing system used to lastly shape the restoration. Especially, the presence of OIL act as a negative factor in the regards of human gingival fibroblasts. The present study may provide the first clinical instruction regarding the best polishing system of composite material when the restoration is placed directly in contact with soft tissue cells. Understanding HGF-1 behavior can help identifying the polishing treatment for direct restoration of carious/non-carious cervical lesions associated with gingival recessions.

Inverted Layering Technique as a Biomimetic Procedure in a Multidisciplinary Resolution of Discolored Teeth: A Case Report.

The objective of this work is to report a restorative approach with composite resin applied in reverse in the aesthetic resolution of darkened anterior teeth. A 27-year-old female patient presented with the main complaint of dissatisfaction with the aesthetics of her smile due to dental darkening, a result of childhood trauma, without painful symptoms, pathological clinical signs or change in care. In the intraoral examination, a darkening of teeth 11 and 21 was observed, which radiographically showed thickening of the periodontal ligament, with disharmonious configuration of the marginal gingiva. From the clinical and radiographic characteristics, we opted for periodontal intervention for recovery and gingival levelling, followed by endodontic intervention and aesthetic restorative restoration. The restorative step was carried out sequentially by internal tooth bleaching, removal of dentin still pigmented after bleaching and enamel preservation. Soon after, it was restored in an alternative way and layered using a technique called reverse, using strips of polyethylene fiber over the dentin resin. The technique preserved the remaining enamel with the maintenance of the original remaining guides, proving to be a viable conservative alternative since of the diagnosis to the restorative conclusion in view of the longitudinal confirmation of the restorative efficacy after 1 year.

Evaluation of pre-heated composite resins with soft-start polymerization and conventional composite restorations in class-I carious lesions - A randomized clinical trial.

Background: By increasing fluidity and conversion, pre-heated composites enhance adaptability and strength, while soft-start polymerization decreases internal stresses. Aim: Over a period of a year, this split-mouth design, randomized controlled clinical trial (RCT) compared pre-heated composites with soft-start polymerization to conventional composites in class-I lesions, with the goal of improving restoration outcomes. Methods: and Findings: Immediately following ethical approval and registration with CTRI, 37 patients with in-formed permission who met specified inclusion and exclusion criteria for class-I lesions were chosen for enrollment. Using a 1:1 ratio, teeth were randomly assigned to Group-A (pre-heated composite with soft-start polymerization) or Group-B (traditional composite restoration). At three-time intervals, the evaluation was blinded and calibrated using Modified United States Public Health Service (USPHS) criteria: baseline, six-month, and one-year marks. Statistical analysis was performed using SPSS 21.0 and the Mann-Whitney U test for inter-group comparisons and the Friedman test for intra-group comparisons. Interpretation: Pre-heated composites with soft-start polymerization performed better in terms of marginal adaptation with a statistically significant difference (p = 0.019) and in terms of color match they performed better clinically (p = 0.062) at 12 months. Other variables like marginal discolouration, sec-ondary caries, anatomic form, post-operative sensitivity, surface texture and retention showed no statistically significant difference (p < 0.05). Pre-heated composites with soft-start mode performed marginally better than nanofilled composites. However, both techniques can be used to successfully restore simple class-I carious lesions.

Assessment of knowledge, attitude, and practice of faculty and postgraduates toward Bisphenol A (BPA) exposure in dental care.

Bisphenol A (BPA) is commonly used in resin-based dental materials and is categorised as an endocrine-disrupting compound. This study aimed to evaluate the knowledge, attitudes, and practice toward the use of BPA among faculty members and postgraduate students. In this descriptive study, a validated self-administered questionnaire was used, and 204 dentists were included, with a response rate of 56.2%. The findings revealed that faculty members had significantly better knowledge (p=0.024) and practice (p=0.036) and more positive attitudes (p=0.024) toward BPA exposure. Regression analysis showed a significantly positive effect of attending a workshop/lecture or reading an article about BPA on the participants' total mean knowledge (p<0.001) and practice scores (p<0.001). Furthermore, faculty members showed a significantly more positive attitude (p<0.001) toward BPA exposure. These results emphasise the importance of increased awareness and education concerning BPA exposure to ensure optimal dental care.

Color Stability of Bioactive Restorative Material vs Nanohybrid Resin Composite: An In Vitro Study.

AIM: This study aimed to assess the color stability of bioactive restorative materials vs nanohybrid resin composites after 3 months of immersion in three frequently consumed beverages. MATERIALS AND METHODS: Thirty disk-shaped specimens of Giomer dental restorative material (Shofu, Japan) and nanohybrid resin composite (Tokuyama, Japan) were performed using a Teflon mold. Super-Snap system (Shofu, Japan) was utilized to finish and polish the specimens to be preserved for 24 hours in distilled water at 37°C. The samples had been divided into three subgroups (Coffee, tea, Pepsi) (n = 5). The initially displayed color measurements of the samples were performed using a spectrophotometer (VITA Easyshade® V). After 7 days, 30 days, and 90 days, color measurements were repeated, and the E of each sample was estimated. E of each sample was calculated. RESULTS: The Giomer group showed statistically significant higher E values than the nanohybrid resin composite where the p-value was ≤0.0001. Tea subgroup showed the highest statistically significant E values in both groups where the p-value was ≤ 0.0001. The highest statistically significant color change was recorded at 3 months. CONCLUSION: The color of bioactive restorative material is less stable if compared with nanohybrid resin composite. CLINICAL SIGNIFICANCE: As tea and coffee are popular beverages, particularly in Middle Eastern nations, dentists must advise patients about the color change of resin restorations. Patients are advised to brush their teeth immediately after consuming these beverages. How to cite this article: Saber EH, Abielhassan MH, Abed YA, et al. Color Stability of Bioactive Restorative Material vs Nanohybrid Resin Composite: An In Vitro Study. J Contemp Dent Pract 2024;25(3):221-225.

Preventive and restorative alternatives to caries by irradiation: a scoping review.

PURPOSE: This study is to conduct a comprehensive scoping review to map scientific evidence and clarify concepts regarding the commonly recommended preventive and restorative dental treatments for patients diagnosed with head and neck cancer (HNC) and subjected to radiotherapy. MATERIAL AND METHODS: This systematic scoping review was performed under the PRISMA-ScR guidelines. The study's experimental design was registered in the Open Science Framework. In vitro studies that evaluated preventive and restorative dental treatment over 50 Gy radiation doses were included. The search was conducted in November 2023 in five electronic databases (PubMed, Scopus, Web of Science, Cochrane Library, and Embase) without language or date restriction. A search strategy was applied based on keywords, MeSh terms, or synonyms. A descriptive analysis was conducted. RESULTS: A total of 49 studies, out of 3679 original articles identified, were included and reviewed. Of the included studies, three evaluated saliva stimulants and 35 evaluated fluoride-based preventive materials: gel (n = 18) toothpaste (n = 11) mouth rinse (n = 8) and varnish (n = 5) while 14 evaluated restorative materials: resin composite (n = 12) glass ionomer cement (n = 6) and amalgam (n = 1) Of those studies, 36 were clinical trials and 13 were in vitro studies. CONCLUSION: Fluoride gel was the most frequently recommended preventive material for preventing radiation caries with supportive clinical evidence. Resin composite and glass ionomer were the most frequently used restorative materials, respectively. However, there is not yet clinical evidence to support the use of resin composite in irradiated teeth.

Biaxial flexural strength of hydrothermally aged resin-based materials.

PURPOSE: The strength of temporary restorations plays a vital role in full-mouth reconstruction, and it can be impacted by the aging process. The aim of this in vitro study was to evaluate the biaxial flexural strength and fractographic features of different resin-based materials submitted to thermal aging. MATERIAL AND METHODS: One hundred and ninety-two resin disc-shaped specimens (6.5 mm in diameter and 0.5 mm in thickness) were fabricated and divided into six experimental groups according to the resin-based materials (Filtek Bulk-Fill flowable resin; J-Temp temporary resin; and Fuji Lining glass ionomer cement) and aging process (before and after thermal cycling). Biaxial flexural strength test was performed using a universal testing machine at a crosshead speed of 0.5 mm/min before and after thermal cycling (5 °C and 55 °C, 5760 cycles, 30 s). The mechanical properties were assessed using Weibull parameters (characteristic strength and Weibull modulus) (n = 30). Fractured specimens were examined under a polarized light stereomicroscope to identify crack origin and propagation direction. The surface microstructure of the resin-based materials was assessed by scanning electron microscopy (n = 2). The Weibull modulus (m), characteristic strength, and reliability properties were calculated, and a contour plot was used to detect differences among groups (95% confidence interval). RESULTS: The Weibull modulus (m), characteristic strength, and reliability of the resin-based compounds were influenced by material type and thermal aging (p < 0.05). Weibull modulus (m) revealed no differences when comparing the materials and aging process (p > 0.05), except for the preceding aging period where Filtek Bulk-Fill exhibited higher values compared to J-Temp (p < 0.05). Filtek Bulk-Fill demonstrated superior characteristic strength and reliability compared to J-Temp and Fuji Lining before and after thermal cycling (p < 0.05). Fractography of the resin-based materials showed fractures originating from surface defects exposed to tensile side and their propagation toward the compressive side. Generally, no differences in surface microstructure were observed on micrographs before and after thermal aging for Filtek Bulk-Fill and Fuji Lining. However, the aging process developed flaws in J-Temp. CONCLUSION: Resin-based material composition resulted in different flexural strength performance, impacting the Weibull modulus (m), characteristic strength, and reliability of the resin-based restorations.

Development of a three-dimensional printed model from a digital impression of a real patient for aesthetic dentistry undergraduate teaching.

INTRODUCTION: The acquisition of skills and manual dexterity in aesthetic dentistry in undergraduate teaching requires preclinical practices with simulation that should approximate real clinical situations. OBJECTIVE: We will present a digital procedure for the creation of three-dimensional (3D) resin models adapted to the practices of the Aesthetic Dentistry course. MATERIAL AND METHOD: Stereolithography or Standard Tesellation Language (STL) files of a real patient were previously obtained with a 3-shape intraoral scanner. Using the Exocad computer programme for dental prosthesis design, various modifications were made, such as incisor rotation, surface alterations imitating dysplasias or erosions, the creation of diastemas, or even changes in tooth size. The virtual model was printed in resin for use by students. Once the practices were finished, the students and the teachers evaluated the use of the 3D printed models. RESULTS: The result is the typodont model, in which seven laboratory sessions took place: 1-Restoration of conoid tooth morphology, 2-Cervical abrasion/ erosion restoration, 3-Direct Composite Veneer, 4-Aesthetic correction in a tooth with rotation, 5-Diastem closure, 6-Occlusal abrasions/ erosion, and 7-Maryland bridge. 90.48% of the students evaluated the designed 3D model as the best method for laboratory practice compared to other methods, obtaining a general assessment of 8.3 out of 10. CONCLUSION: The method used has provided a reproducible standard analog model for direct aesthetic dental restoration practice, with a good assessment by students and teachers.

Assessment of Prevalence and Causative Factors for Replacement of Composite and Amalgam Restorations: An Observational Study.

Aim: This study intends to evaluate the frequency and causes of replacement for failed amalgam and composite dental restorations. Methodology: A cross-sectional study comprising female patients with failed permanent composite and amalgam restorations aged 15-60 years old was carried out at the dental clinics of Qassim University. Using a self-structured proforma, demographic data and causes for restoration failure were recorded. The effectiveness of the restorations was assessed by using the Ryge criteria after performing clinical and radiographic examinations. The Statistical Package for Social Science was used for the statistical analysis. Results: It is found that 84.6% of the 299 unsuccessful restorations examined were composite, and 15.4% were amalgam. The main reason for dental failure for both amalgam (95.6%) and composite (93.28%) restorations was secondary caries. Failure of amalgam restoration was largely caused by poor marginal adaptation. With varied incidences between amalgam and composite restorations, typical complaints included discomfort, sensitivity, pain, and food impaction with soreness. The main justification for replacement in amalgam restorations was sensitivity. Repair and replacement rates were similar for amalgam, composite, and mandibular/maxillary restorations. Moreover, 21.1% of individuals overall reported no symptoms, with 8.7% in the amalgam group and 23.3% in the composite group with significant differences (χ2 = 34.28, P = 0.001). Conclusion: According to the current study, secondary caries was found to be the main reason for both amalgam and composite restoration failure. The main problems reported were sensitivity, discomfort, and pain with amalgam showing more sensitivity-related failures.

New Technique for Wedge Selection in Direct Class II Restorations: A Pilot Study.

Background: Performing an appropriate Class II direct restoration is a great challenge. The correct selection of the matrix system and the elements used for its stabilization will have a great impact on the result. The aim of this study is to show a new digital method for a predictable selection of the wedge and compare it with the conventional method. Methods: Sixty patients were randomly divided into two groups. In Group 0, the wedge was selected intraoperatively by visual examination, while in Group 1 the wedge was selected preoperatively through the measurement of the cervical embrasure on the bite-wing radiography. The number of wedges used, modifications to them, and tissue damage were registered, along with the quality of the proximal contact and the marginal adaptation. Results: Student's t-test revealed a statistical difference between the number of wedges used, which was higher in Group 0 (p < 0.05). Pearson Chi-square test showed that tissue damage was statistically higher in Group 0 (p < 0.05), while there was no statistically significant difference between groups in wedge modifications (p > 0.05). Group 1 revealed a higher frequency of satisfactory proximal contact and marginal adaptation (p < 0.05). Conclusions: This new technique reduces wedges waste and tissue damage and provides an adequate interproximal anatomy.