Gingival Conditioning with Provisional Composite Veneer Prior to Final Dental Restoration: Three-year Follow-up.

This manuscript reports a three-year follow-up of a case of gingival conditioning with a provisional composite veneer prior to diastema closure and tooth recontouring with direct composites. This conservative treatment resulted in a natural and harmonious smile.

Fracture Load of Molars Restored with Bulk-fill, Flowable Bulk-fill, and Conventional Resin Composite After Simulated Chewing.

This study aimed to compare the fracture toughness of molars with wide mesio-occlusal-distal (MOD) cavities restored with regular and flowable bulk-fill resin composite and a conventional resin composite after 250,000 mechanical cycles of chewing simulation. Thirty-two extracted mandibular third molars were selected and class II MOD cavities involving 2/3 of the intercuspal width and 4 mm depth were prepared. Teeth were divided into four groups based on resin composite type and insertion technique (n=8): (1) CT, unprepared teeth (control); (2) CV, conventional resin composite (Tetric N-Ceram, Ivoclar Vivadent) with incremental technique; (3) R-BF, regular bulk-fill resin composite (Tetric N-Ceram Bulk Fill, Ivoclar Vivadent) with a single increment; and (4) F-BF, flowable bulk-fill resin composite (Tetric N-Flow Bulk Fill, Ivoclar Vivadent) with a single increment, except for a 1-mm-thick layer at the occlusal surface, restored with conventional resin composite (Tetric N-Ceram). All specimens were evaluated to detect the presence and propagation of enamel cracks using a LED transilluminator before and after 250,000 mechanical cycles (SD Mechatronic GmbH). After a chewing simulation, they were subjected to a compressive force in a universal testing machine (DL-2000, EMIC) until fracture. The maximum fracture load of the specimens was measured (N) and the fracture patterns were classified based on the fracture site (above or below the cementoenamel junction [CEJ]). Data were statistically analyzed with one-way ANOVA. All specimens survived after 250,000 mechanical cycles, and no statistically significant differences among groups were observed regarding the fracture toughness (p<0.05). The fracture analysis demonstrated that failures below the CEJ were more common in CV (75%), while CT, R-BF, and F-BF showed this type of failure in 38%, 63%, and 63% of the specimens, respectively. The results of the crack analysis showed that the occurrence of new cracks and crack propagation was also higher in CV (33.3%), followed by R-BF, F-BF, and CT (14%, 14%, and 11% of the specimens, respectively). Teeth restored with regular and flowable bulk-fill composites showed similar fracture toughness after the chewing simulation compared to those restored with the conventional resin composite and unprepared teeth. Furthermore, teeth restored with both regular and flowable bulk-fill composites showed a lower incidence of enamel cracks and fractures below the CEJ compared to those restored with the conventional resin composite.

Color Repair of a Composite Resin Restoration.

Fractured teeth with both enamel and dentin involvement might be treated with adhesive composite resin restorations. In cases where a perfect color match between the composite restoration and the remaining tooth structure is not achieved, a repair might be carried out to correct the color of restoration. This procedure avoids the restoration replacement, preserving tooth structure without compromising the esthetic outcome.

Color Match Between Composite Resin and Tooth Remnant in Class IV Restorations: A Case Series.

Rehydration of the tooth remnant and complete polymerization of the composite resin are aspects that should be considered in shade selection of composite resin. This article presents a case series of Class IV restorations performed to evaluate the color match between the composite resin and the tooth remnant. Thirteen Class IV restorations were performed in maxillary central incisors and evaluated according to the period following the restorative procedure: 10 minutes (baseline), 48 hours before and after finishing and polishing, and seven, 14, and 28 days. The color match of the restorations was evaluated by the ΔE values of the tooth remnant (TR) and the composite resin (CR) in each evaluation period using a spectrophotometer. The translucency, luminosity, and saturation were analyzed qualitatively in digital photographs of the restorations. The CR ΔE was statistically similar to the TR ΔE at 14 and 28 days ( p>0.05). The saturation and luminosity of most of the restorations remained unchanged, but there was a greater change in the translucency. The color match of the composite resin in Class IV restorations was observed after 14 days of clinical assessment in this case series.

Tooth fragment reattachment: a case report.

The aim of this article is to present a case report for the multidisciplinary treatment of anterior tooth fractures with invasion of the biologic width and pulpectomy. Successful esthetic and functional results were achieved by bonding the crown fragment, without any form of preparation or the utilization of intracanal posts.

Hypoplastic enamel treatment in permanent anterior teeth of a child.

In some patients with labial white stains involving the enamel and dentin, bleaching associated with a restorative procedure using composites may be an appropriate treatment alternative. Although bleaching makes the teeth and the stain whiter, the staining is less evident and easier to restore. Restorative procedures using adequate composites may then recover the natural optical properties while also providing appropriate mechanical properties, thereby ensuring the longevity of the treatment. In this article, the clinical case of a 9-year-old patient who reported dissatisfaction with her smile because of the presence of hypoplastic enamel staining at the central superior and inferior incisors is reported. The treatment consisted of a bleaching protocol followed by composite resin restorations using the stratification technique. The final esthetic result demonstrated the possibility of obtaining a natural smile with an adequate color and natural-looking restorations, thereby ensuring the esthetics and the patient's functional satisfaction.