Artificial Intelligence: A Mighty Adjunct for Caries Detection.

Articifial intelligence (AI) is impacting many aspects of people's lives today. In fields such as finance, manufacturing, agriculture, insurance, education, and healthcare, AI has been commissioned to cut costs, increase efficiency, and improve accuracy. Like many innovations, the use of AI can have both positive and potentially negative consequences. As an example, if used in dentistry to detect interproximal carious lesions, AI technology does not have the ability (at least not yet) to recognize the individual uniqueness of each patient. For instance, some patients are highly caries prone and may be best served by prophylactic intervention of even small borderline lesions, while other patients are very caries resistant and may simply require the monitoring of suspected carious lesions.

Direct and Indirect Pulp Capping: A Brief History, Material Innovations, and Clinical Case Report.

Among the goals of pulp capping are to manage bacteria, arrest caries progression, stimulate pulp cells to form new dentin, and produce a durable seal that protects the pulp complex. This article will provide a general discussion of direct and indirect pulp capping procedures, offering practitioners a pragmatic and science-based clinical protocol for treatment of vital pulp exposures. A clinical case will be presented in which a novel light-cured resin-modified mineral trioxide aggregate hybrid material was used to manage a mechanical vital pulp exposure that occurred during deep caries excavation.

Effect of silane contamination on dentin bond strength.

STATEMENT OF PROBLEM: Intraoral repair of porcelain or other silica-based ceramics typically requires the use of silane in the repair protocol. Some porcelain intraoral repairs also involve bonding to exposed or involved tooth tissues including dentin. A study is needed to evaluate whether the cross-contamination of dentin with silane affects bond strength to this tissue. PURPOSE: The purpose of this in vitro study was to investigate the effect of silane cross-contamination on dentin bond strength. MATERIAL AND METHODS: Flat surfaces of human dentin specimens were created, followed by wet polishing with 320-grit silicon carbide paper. The dentin specimens were divided into 4 groups: group SE (All-Bond Universal Adhesive used in self-etching mode); group SiSE (silane applied to dentin followed by All-Bond Universal Adhesive used in self-etching mode); group ER (All-Bond Universal Adhesive used in total-etch (etch-and-rinse) mode); and group ERSi (Etch and rinse and silane applied to dentin followed by All-Bond Universal Adhesive). The dentin specimens were treated with a universal adhesive (All-Bond Universal) and bonded with a composite resin, using an Ultradent jig mold. Shear bond strength (n=10) was measured after 24 hours of water storage at 37°C. After the shear bond strength test, the dentin sides of fractured specimens in each group were examined with a stereomicroscope at ×15 magnification to determine failure modes. Data were statistically analyzed by 2-way and a 1-way ANOVA followed by post hoc Tukey honest significant difference test (α=.05). Scanning electron microscopy examination was used to evaluate the dentin surface morphology before and after bonding. RESULTS: The shear bond strength of composite resin to dentin was not affected adversely when the dentin was contaminated with silane prior to using All-Bond Universal in the self-etch or total- etch (phosphoric acid) mode. SE, 30.3 ±3.8 MPa; SiSE, 32.9 ±3.9 MPa; ER, 34.9 ±3.1 MPa; ERSi: 35.2 ±4.9 MPa (P>.05) CONCLUSIONS: Under the conditions of this study, cross-contamination of dentin with silane before the use of All-Bond Universal in the self-etch or total-etch with phosphoric acid mode did not adversely affect composite resin bond strength to dentin.

Universal adhesives: the next evolution in adhesive dentistry?

Every so often a new material, technique, or technological breakthrough spurs a paradigm shift in the way dentistry is practiced. The development and evolution of reliable enamel and dentin bonding agents is one such example. Indeed, the so-called "cosmetic revolution" in dentistry blossomed in large part due to dramatic advances in adhesive technology. It is the ability to bond various materials in a reasonably predictable fashion to both enamel and dentin substrates that enables dentists to routinely place porcelain veneers, direct and indirect composites, and a plethora of other restorative and esthetic materials. In fact, the longevity and predictability of many (if not most) current restorative procedures is wholly predicated on the dentist's ability to bond various materials to tooth tissues. Adhesive systems have progressed from the largely ineffective systems of the 1970s and early 1980s to the relatively successful total- and self-etching systems of today. The latest players in the adhesive marketplace are the so-called "universal adhesives." In theory, these systems have the potential to significantly simplify and expedite adhesive protocols and may indeed represent the next evolution in adhesive dentistry. But what defines a universal system, and are all these new systems truly "universal" and everything they are claimed to be? This article will examine the origin, chemistry, strengths, weaknesses, and clinical relevance of this new genre of dental adhesives.

Is total-etch dead? Evidence suggests otherwise.

Both the total-etch and self-etching systems of today have the potential to provide durable adhesive interface, and despite the proclamations of some, total-etch is alive and well. Indeed, evidence indicates that a viable and growing market remains for total-etch adhesive systems. This paper will discuss the origins, evolution, and idiosyncrasies of the total-etch technique as well as its place in dentistry today. New innovations, the use of antimicrobials to inhibit matrix metalloproteinases (MMPs), and sensitivity issues will also be discussed.

Adhesion. Adhesive dentistry: the good, the bad, and the ugly.

For more than 30 years, Compendium has provided its readers with university-based continuing education and editorial, demonstrating the latest advances in clinical procedures and techniques. Using the same peer-reviewed format and influence/direction from Compendium's distinguished editorial board, Special Report will provide insight on the latest advances in product technologies and the resulting benefits to both you and your patients. A discussion by the author on new clinical/laboratory research and product development strategies, as well as what the results could mean for dental treatment, will also be included. Focusing on one product category per issue provides a detailed review of the category and a comprehensive resource to help guide your treatment planning process.

Preparing porcelain surfaces for optimal bonding.

When placing an indirect restoration such as a porcelain veneer, inlay, or onlay, the intaglio surface is typically treated in some fashion to ensure optimal bonding to the resin-based adhesives and luting cements required to affix it to the tooth tissues. A variety of surface preparation techniques have been advocated, including the use of acids, particle abrasion, various adhesives, and chemical couplers such as silane. There is often equivocation in the literature regarding the effectiveness of these materials and surface preparation techniques. This article will attempt to make some sense of the various methodologies currently advocated for the treatment of porcelain surfaces before placement.

Considerations for the successful placement of laboratory-processed, indirect composite restorations.

Adhesive bonding techniques enable clinicians to predictably place tooth-colored materials and thus provide viable alternatives to amalgam and other metal-based restorations. This is significant because patient demand for esthetic restorations is greater than ever before. Options for tooth-colored restorations include ceramics and direct and indirect composite-based materials. However, successful treatment using this restorative modality depends on a number of factors. This article reviews the case selection, preparation design, and material selection as they relate to indirect composite inlays and onlays.