Triple scan evaluation of internal and marginal adaptation of overlays using different restorative materials.

OBJECTIVE: Problems in the confection of indirect restorations may increase the marginal and internal gap. This study aimed to quantify the marginal and the internal fit of overlays fabricated with three different materials. MATERIALS AND METHODS: Standardized cavities were prepared on endodontically treated human third molars and digital impressions were done using an intraoral camera (Trios 3). Restorations were designed (n = 15) and fabricated with three materials: Hybrid ceramic (Cerasmart; GC Corp, EUROPE), high-strength lithium disilicate (GC Initial® LiSi Press; GC Corp, Tokyo, Japan), and zirconia reinforced Lithium Silicate Glass Ceramic (Vita Suprinity; Vita, Germany). Axial, marginal, pulpal, and gingival gaps were calculated by measuring the distance between the restoration and the tooth at several reference points. Two-Way analysis of variance was used for statistical analysis. The significance level was set at α = 0.05. RESULTS: Mean gap was significantly influenced by the material (p < 0.001), gap localization (p < 0.001), and interaction between the factors (p = 0.002). For all materials, the highest gap was observed at gingival and pulpal surfaces (p ≤ 0.015). LiSi Press achieved the overall lowest values at axial values measurements (p ≤ 0.003). CONCLUSIONS: The performance of a CAD/CAM system relative to marginal adaptation is influenced by the restorative material used. High-strength lithium disilicate seems to be showed the best marginal adaptation. CLINICAL SIGNIFICANCE: Marginal and internal adaptation of CAD/CAM restorations could be influenced by the type of material chosen.

In-vitro evaluation of the shear bond strength and fluoride release of a new bioactive dental composite material.

BACKGROUND: The aim of this study was (1) to determine and compare the shear bond strength (SBS) of a bioactive composite "Activa Bioactive Restorative" with and without bonding agent and a nanocomposite "Filtek Z350 XT/Z350" and (2) to measure and compare the amount of fluoride release from a bioactive composite "Activa Bioactive Restorative" and a glass ionomer "Equia forte". MATERIAL AND METHODS: Forty two dentin surfaces from freshly extracted human molars were prepared for shear bond strength testing. The specimens were randomly divided into three equal groups. The restorative materials were applied to all dentin surfaces according to the manufacturer's instructions, using a special jig (Ultradent) in the following manner : Group 1 (Activa Bioactive Restorative with adhesive), Group 2 (Activa Bioactive Restorative without adhesive) and Group 3 (Filtek Z350 XT/Z350). The bonded specimens were subjected to thermocycling in 5°C and 55°C water baths then tested for SBS in a universal testing machine (1 mm/minute). Kolmogorov-Smirnov and Levene tests were used to evaluate the distribution of the variable and the equality of variances respectively and a Student's T- test was applied to compare the mean strength between the groups. In the next test, thirty disc shaped specimens were fabricated using Activa BioActive restorative and Equia Forte; 15 specimens from each material. The specimens of each group were immersed separately in 5 ml of deionized water. Fluoride release was measured daily throughout 15 days using a fluoride-specific ion electrode and an ion-analyzer. Repeated measures analysis of variance with one within-subject factor (time) and one between-subject factor (Activa Bioactive / Equia Forte) was applied to compare the amount of released fluoride between groups and within time. It was followed by univariate analyses and Bonferroni multiple comparisons tests. RESULTS: The mean shear bond strength of Activa Bioactive Restorative with adhesive was found to be 17.379 (± 8.5043) MPa and 19.443(± 8.3293) MPa for the Filtek Z350 XT/Z350 group. There was no significant difference between both groups. Regarding fluoride release, the amount of Fluoride released was significantly greater in the Equia Forte group compared to the Activa Bioactive group (-p-value<0.05). The mean amount of Fluoride has significantly decreased over time with Activa Bioactive group (-p-value<0.001); it showed the highest fluoride release during the first 24 hours post-setting. Also in the Equia Forte group, the mean amount of Fluoride release showed a progressive and significant decrease over time (-p-value<0.001), although the amount of Fluoride released was significantly greater in the Equia Forte group compared to the Activa Bioactive group (-p-value<0.05). CONCLUSIONS: Activa Bioactive Restorative with adhesive and a nanocomposite showed similar bond strengths. Activa Bioactive Restorative doesn't have the self-adhesive property. The fluoride ion release profile of Activa was lower than that of the Equia Forte. Key words:Bioactive composite, nanocomposite, glass ionomer, fluoride release, shear bond strength, thermocycling.

Knowledge, Attitudes, and Perceptions of Dental Assistants regarding Dental Asepsis and Sterilization in the Dental Workplace.

MATERIALS AND METHODS: A cross-sectional study was carried out. A 27-item prepilot tested close-ended questionnaire was designed and administered online to collect data on knowledge of asepsis, sterilization, instrument handling, disinfection, hand-hygiene practices, dental practice, age, education, and experience level from March 2020 to June 2020. RESULTS: Out of 70 dental assistants, the majority were aged between 21 and 29 years (44.30%), more than two-thirds (85.41%) of the dental assistants were working in a hospital, while 14.29% were working in private clinics, only 7.1% had a diploma in the dental assistant program, and 74% had more than 2 years of experience in practice. Dental assistants working in private practice (76.30) had a higher mean knowledge scores compared to those working in hospital (74.25), while those with less than 2 years of experience (75.61) had a higher scores compared to those with 2-5 years of experience (73.96). CONCLUSION: Better compliance with recommended infection control and waste management practices is needed for all dental assistants. Continuing education programs targeting such awareness are vital to improve the management of hazardous waste practices among dental assistants.

Effect of Inlays, Onlays and Endocrown Cavity Design Preparation on Fracture Resistance and Fracture Mode of Endodontically Treated Teeth: An In Vitro Study.

PURPOSE: To evaluate the fracture resistance and failure modes of endodontically treated mandibular molars restored with different designs of inlays, onlays and endocrowns. MATERIALS AND METHODS: Extracted mandibular third molars (n = 180) were used. An access cavity was prepared on the occlusal surface of each tooth and the roots were obturated with gutta percha. All specimens were randomly divided into 6 groups (n = 30/group) according to the cavity design and the restoration material used. C: control group without access cavity preparation. IE: MOD inlay preparation with EverX Posterior (GC Europe) in the pulp chamber. IG: MOD inlay preparation with G-aenial Universal Flo (GC America) in the pulp chamber. OE: onlay preparation with EverX Posterior (GC Europe) in the pulp chamber. OG: onlay preparation with G-aenial Universal Flo (GC America) in the pulp chamber. EC: endocrown with an empty pulp chamber. All restorations were fabricated with CAD/CAM system using CERASMART® (GC Dental products Europe, Belgium) CAD/CAM blocks. Specimens were thermal-cycled and were subjected to a compressive load applied at 30° angle relative to the long axis of the tooth with a universal testing machine. Results were statistically analyzed by ANOVA followed by Tukey post hoc tests. Chi-square test and Fisher Exact tests were used for the comparisons among groups. RESULTS: The mean fracture strength was significantly different between the groups (p < 0.001); it was significantly highest for intact teeth, followed by endocrowns (p = 0.021). The strength was significantly lower for inlays (with G-aenial Universal Flo and EverX Posterior), intermediate for onlays with EverX Posterior followed by onlays with G-aenial Universal Flo. CONCLUSIONS: Endocrowns exhibited higher fracture resistance than other tested composite resin groups. Endocrowns and onlays showed a more favorable failure mode than inlay restorations.

Clinical Evaluation of Microhybrid Composite and Glass lonomer Restorative Material in Permanent Teeth.

AIM: The aim of this study was to clinically compare glass ionomer cement (GIC) with microhybrid composite resin used in class I cavities on permanent teeth over a period of 9 months. MATERIALS AND METHODS: A total of 40 teeth with class I cavities were divided into two groups (n = 20) and restored with GIC (EQUIA; GC) and microhybrid resin composite (Amelogen Plus; Ultradent). Restorations were evaluated at ×4.5 magnification using the United States Public Health Service (USPHS) criteria every 3 months. Statistical analysis was performed using the Fisher's exact test (a < 0.05). RESULTS: The data obtained reported no statistical significance difference between both groups in regard to anatomical shape, color, postoperative sensitivity, secondary caries, material handling, adaptation, and marginal staining. CONCLUSION: The results of this clinical study showed that GIC (EQUIA; GC) can be used for the restoration of permanent teeth and may be more appropriate for certain clinical situations than the resin composite material. CLINICAL SIGNIFICANCE: EQUIA (GIC) is a viable alternative to resin composite in restoring class I cavities in permanent teeth.