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However, when bone dehiscence is present at the time of implant placement, different bone regenerative techniques, such as guided bone regeneration (GBR), need to be used to allow the correct placement of a dental implant. "Biological complications" refer to disturbances in the function of the implant, characterized by biological processes that affect the supporting tissues, including peri-implant diseases [[62]]. A rise in requests for esthetic dental treatments has led to the introduction of new materials, treatments and procedures able to provide non-invasive, long lasting and predictable treatment options [[1], [3]]. The adhesive reattachment of a fragment, combined with vital pulp-therapy procedures, represents the first-choice treatment option in cases of both simple and complicated crown fractures [[4], [16]]. Microbial plaque accumulation is considered to be the most important factor in the pathogenesis of peri-implant diseases, similarly to periodontitis, and the presence of micro-gaps at the implant-abutment interface has been implicated in several studies as the source of bacterial penetration [[66]]. [Extracted from the article]

Background: This retrospective clinical study aimed to assess dental pulp tissue reactions to direct and indirect pulp capping after 10 years of follow-up. Methods: A total of 276 permanent teeth with deep carious lesions were evaluated and divided into five groups: Group (1), direct pulp capping with Mineral Trioxide Aggregate cement; Group (2), direct pulp capping with a resin-based glass ionomer; Group (3), direct pulp capping with TheraCal; Group (4), indirect pulp capping with a three-step total-etch adhesive system; and Group (5), indirect pulp capping with a two-step self-etch adhesive system. Results: A 72.5% success rate was achieved overall. A statistically significant difference was found when comparing direct and indirect pulp capping with a success rate of 23.8% and 93.8%, respectively. For direct pulp-capping procedures, the area of pulp exposure was correlated with pulp necrosis ( p = 0.035), while bleeding after exposure appeared independent ( p = 0.053). Patient age was significantly related to the maintenance of pulp vitality ( p = 0.013). A statistically significant correlation between the pulp-capping material and the occurrence of pulp necrosis was discovered ( p = 0.017). For the indirect pulp-capping treatments, a significant correlation between patient age ( p = 0.021) and the adhesive system ( p = 0.019) with pulp necrosis was described. Conclusions: The pulp-capping material, patient age, and the width of the pulp exposure before the procedure should be carefully considered when performing direct pulp-capping treatments. The performance of the etch-and-rinse adhesive systems was superior to the self-etch system during the indirect pulp-capping procedures.