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Introduction Long bone refractures can be a common injury among pediatric population. Approaches to rehabilitation of children with refractures are similar to those used for primary injuries. However, refracture healing and bone repair involve specific pathways that should be considered in rehabilitative approaches to restorative treatment. Objective To identify morphological specific features of simulated reparative processes in long bone refractures of growing animals (rats) at different stages of observation. Material and methods Two series of experiments were carried out on 36 laboratory animals (rats) to explore histological picture at the healing site of primary and repeat fractures at different stages of reparative process. Transverse fracture of the tibial shaft was simulated and fixed with external fixation device in the first series (n = 18). Tibial shaft was refractured and fixed again with external fixation device after 21 days of primary injury in the second series (n = 18). Results Delayed osteogenesis and greater period of organotypical regenerate restructuring were observed in animals with long bone refractures. Mechanism of slower osteogenesis was found to be associated with disturbed blood supply affecting cell differentiation at the refracture site. Conclusion Delayed bone repair and longer period of organotypical regenerate restructuring were specifically detected in growing animals with long bone refractures.

Non-surgical periodontal therapy (NSPT) underpins all other restorative treatment which takes place in the mouth. Therefore a thorough understanding of the process of delivery of effective NSPT and long-term maintenance of periodontal health is essential for every dental practitioner. This article covers the steps involved and discusses the benefits and challenges which may be encountered. CPD/Clinical Relevance: This article highlights the benefits and challenges of non-surgical management of periodontal disease and the key role that the patient plays in achieving and maintaining periodontal health.

SUMMARYDetection and management of posterior approximal caries lesions are still problematic. Inspection of approximal surfaces is challenging, and bitewing radiographs are used when direct vision is not possible. Unfortunately, there is no definite radiographic appearance to identify lesion cavitation with absolute certainty. Many lesions detected radiographically within the outer half of dentin are not cavitated, often resulting in unnecessary restorative treatment. Our study compared radiographic depth of approximal caries lesions with presence of cavitation in adults using visual inspection following temporary tooth separation (TTS). We conducted this observational descriptive cross-sectional study at two dental schools in two cities in Chile. Clinicians were unaware of radiographic depths of lesions and examined 147 participants (57.3% female and 42.7% male) following TTS. Using the common classification system that consists of E0 (no lesion), E1 (lesion within the outer half of enamel), E2 (lesion within the inner half of enamel), D1 (lesion within the outer third of dentin), D2 (lesion within the middle third of dentin), and D3 (lesion within the inner third of dentin), a trained dentist evaluated all the processed films. Cavitation was detected in only three sites (0.22%) within the E0 category, seven sites (3.41%) in E1, five sites (14.8%) in E2, four sites (14.8%) in D1, six sites (50%) in D2, and eight sites (61.5%) in D3. Considering that restorative treatment should be indicated strictly for cavitated lesions, our findings support indication for restorative treatment for D3 lesions and the rationale for TTS for D1-D2 caries lesions to allow direct visual inspection to determine whether there is surface cavitation.

Parents/carers’ and dentists’ evaluations are important when assessing young children’s pain. However, there is little evidence on agreement regarding children’s pain according to proxy reports. The aims of this cross-sectional study were to investigate the agreement among paediatric dentists and parents/carers about children’s pain during treatment and the association between the reporting of pain and child behaviour. Participants were 81 parents/carers of uncooperative children undergoing restorative treatment, and five paediatric dentists. Pain during dental treatment was assessed after dental procedures using the Visual Analogue Scale (0–4 mm: no pain; 5–44 mm: mild pain; 45–74 mm: moderate pain; 75–100 mm: severe pain). Child behaviour was assessed by calibrated researchers using the Ohio State University Behavioural Scale. The agreement between respondents about a child’s pain was evaluated using the weighted kappa test. The association between the pain report and child behaviour was verified using the Kruskal–Wallis and Mann–Whitney tests. Parents/carers (36, 44.4%) and paediatric dentists (40, 49.4%) reported that children felt mild pain in all sessions. The parents/carers reported that the children experienced higher pain intensities compared to paediatric dentists. The agreement between respondents was slight (weighted Kappa

Background The antibacterial property of new atraumatic restorative treatment (ART) materials incorporated with Azadirachta indica (Neem) on Streptococcus mutans was carried out. Materials and methods The study was carried out by using the agar diffusion method to determine the antibacterial property of ART materials (ART-I and ART-II). The zone of inhibition was tabulated, and the data was statistically analyzed using the student t-test. The minimum inhibitory concentrations (MIC) and the minimum bactericidal concentrations (MBC) of the ethanolic extract of Neem were recorded. Results The MIC and MBC of the mixture of the ethanolic extract of Neem was 3.13% and 12.5% respectively. The zone of inhibition of ART-I and ART-II was 11.81 mm and 11.97 mm respectively. Significant differences were observed between these two ART materials (P = 0,08). Conclusion Both the new ART materials i.e. ART-I and ART–II have considerable antibacterial activity against S. mutans.

Objectives The purpose of this article was to review the fluoride release and uptake ability of some restorative materials which are used for minimally invasive procedures. Methods The literature search on published researches and review articles were carried out by using PubMed, Trip and Cochrane library databases. The search terms used were fluoride, restorative materials, atraumatic restorative treatment or ART, glass ionomer or GIC, resin modified glass ionomer cement or RMGIC. The articles included were between 2000 and 2015. Conclusion Fluoride release varies with m factors including the type of restorative materials used and also the media in which it is stored. Fluoride uptake is dependent on the type of the cement and the availability of fluoride including fluoride releasing capacity in the material.

As restorative treatment needs of patients become more challenging, how can funding appropriately support the quality of care?

Purpose To evaluate the challenges of the direct filling technique, the use of dental chairside CAD/CAM milling, the use of 3D printing, and the attitudes toward 3D printing-based applications for restorative treatments among Finnish dentists. Materials and methods An electronic questionnaire was sent to 3,777 Finnish dentists. Background information, challenges linked to the direct filling technique, use of dental chairside CAD/CAM milling, use of 3D printing, and attitudes toward 3D printing-based applications in restorative dentistry were asked in the questionnaire with multiple-choice questions. The number of replies was 760, and the response rate was 20.1%. Results Poor survival rates and moisture sensitivity were the main reported challenges associated with the direct filling technique. Use of chairside CAD/CAM milling was reported by 271 (35.7%) respondents. Use of 3D printing technique was reported by 54 (7.1%) respondents. Most respondents answered that they would consider using 3D printing for manufacturing tooth fillings in the future. Conclusion If dental chairside CAD/CAM technology can provide a solution for manufacturing long-lasting indirect restorations with good esthetic properties and an effective cost-benefit ratio, the wider use of chairside CAD/CAM systems might be indicated, especially in the public sector. New 3D printing-based applications used for restorative treatments are attracting interest among Finnish dentists, but also indicate a need for further development of 3D printing techniques for cost-effective restorative treatment.

Aim of the work. To evaluate the course of acute coronary syndrome in patients depending on the applied method of treatment and the formation of the components of the internal picture of health in the process of treatment and rehabilitation. Material and methods. The object of the study was 141 patients with ACS with ST elevation. The patients were divided into groups depending on the performed treatment: 63 patients who received conservative treatment tactics and 78 patients who had PCI. The course of ACS was analyzed, depending on the treatment tactics, on clinical-anamnestic and objective data, using psychometric techniques. Results. Estimation of the formation of components of the internal picture of health was performed on the basis of the ACS course analysis. There were low levels for all components, the lowest was the level according to the behavioral and value-motivational components. In patients with PCI, these levels were somewhat higher according to some indices. The importance of the application of evaluation and correction of the IPH components in patients after ACS was determined. Conclusions. In order to increase the effectiveness of restorative treatment of patients after ACS, it is necessary to evaluate the formation of components of IPH with optimization by participating in the “Program of clinical-psychological rehabilitation of patients by optimization of IPH”, which would allow us to influence the positive changes in the course of the disease.

Segmental injuries to peripheral nerves (PNs) too often result in lifelong disability or pain syndromes due to a lack of restorative treatment options. For injuries beyond a critical size, a bridging device must be inserted to direct regeneration. PN allografts from immunologically incompatible donors are highly effective bridging devices but are not a regular clinical option because of the expense and health risks of systemic immunosuppression (ISN). We have developed a method to deliver a single administration of ISN localized around a PN allograft that circumvents the risks of systemic ISN. Localized ISN was provided by regulatory T cells (Tregs), a potently immunosuppressive cell type, that was delivered around a PN allograft with a poly(ethylene glycol) norbornene (PEGNB) degradable hydrogel. Tregs are released from the hydrogel over 14 d, infiltrate the graft, suppress the host immune response and facilitate regeneration of the recipient rats equal to the autograft control. Furthermore, this method was effective in a segmental PN defect that included a branch point, for which there currently exist no treatment options. These results show that localized delivery of immunosuppressive cells for PN allografts is an effective new strategy for treating segmental PN defects that can also be used to regenerate complex nerve structures.

Background - The Public Dental Service (PDS) in Finland has catered for the overwhelming majority of the young for more than 50 years. They have had examinations, preventive measures and all other necessary treatment free of charge. This study aimed to survey the treatment needs and treatment measures provided for children and adolescents and changes in these during the period 2001–2013. Methods - Using each person’s unique identifier, data on patients ( 2, D + d > 0) and treatment received in the period 2001–2013 were collected retrospectively from municipal databases in five PDS-units covering 320,000 inhabitants. The National Institute for Health and Welfare gave ethical approval. Permission to use local data was received from the Directors in the PDS units. Treatment measures were grouped into 14 categories and patients into three age categories (0–6 years, 7–13 years and 14–17 years). Trend analysis was used to test changes over time. Results - About 40,000 children and adolescents visited the PDS each year and 2,488,805 treatment measures were provided for them during the entire study period. The proportion of those in need of treatment decreased from 44.4 to 33.2% during the study period. The most common treatment categories were examinations (613,753, 24.7%), orthodontics (499,033, 20.1%), preventive measures (372,473, 15.0%) and restorative treatment (355,325, 14.3%); these made up 74% of all treatment measures. During the study period, statistically highly significant (p p Conclusion - Although children’s oral health had improved and restorative treatment provided had decreased, the total number of treatment measures increased. Healthy children received frequent examinations and high numbers of preventive treatment measures. Targeting treatment according to needs was not satisfactory.

SUMMARY Direct composite resin veneers are a practical esthetic restorative treatment for reestablishing the shape and color of affected anterior teeth. The present clinical case reports aim to describe restorative treatment techniques for nonvital anterior teeth presenting color alteration. The direct composite resin layering technique has proven to be an efficient method for recovering the esthetics of darkened teeth. The direct vs indirect restorative treatments are debated as well. Clinical follow-ups of the presented case reports demonstrate that direct composite resin restorations are not affected by the darkened tooth substrate over time.

Introduction. Complex investigation of rehabilitation treatment possibilities in patients with Myofascial pain syndrome using osteopathy and extracorporeal shock wave therapy (ESWT) remains a very actual problem. Materials and methods. 120 patients with myofascial pain syndrome at the age of 49,65±0,89 years old were investigated. The average duration of the disease - 2,29±0,18 years. Results. Combination of standard therapy with osteopathic treatments and ESWT decreases severity of Myofascial pain syndrome measured with five-point vertebro-neurological symptoms scale after 12 months of observations for 59,2%. Standard therapy together with osteopathic treatment reduces severity of Myofascial pain syndrome for 43,3%. Standard therapy together with ESWT reduces severity of Myofascial pain syndrome for 34,2%. Standard therapy alone reduces severity of Myofascial pain syndrome for 31,6%. Dynamic of Visual analogue scale pain parameters was 77,1%, 62,2%, 52,8% and 30,9%, that was accompanied by The Oswestry Disability Index (ODI) average values decrease by 92,4%, 75,9%, 66,8% and 39,9%, respectively. Severity of Visual analogue scale symptoms were directly proportional to the parameters of IMS (r=0,231) and ODI (r=0,379), whereas the symptoms severity reduction level in this scale has strong correlation with the level of IMS scale dynamics (r=0,85). Conclusion. When forming the rehabilitation treatment Protocol of patients with myofascial pain syndrome using osteopathy and shock wave therapy one should consider that according to the 12-month prospective observation, it is the combination of these methods that shows the most positive effect on the severity of myofascial pain syndrome, measured with VAS scale, five-point vertebro-neurological symptoms evaluation scale and osvestri questionnaire.

Background Tertiary prevention is still an integral part of a child's healthcare. In community dental service (CDS), we aim to try to restore carious primary teeth in young children as a means of caries control. Aim To assess the survival rates of individual carious primary molars within CDS, based on the type of dental interventions. Design Retrospective observational study. Methods Fifty patients' notes were reviewed, and patients were selected using a defined protocol. The Kaplan-Meier method was used to estimate the survival curves. Results Out of 251 teeth, the estimated survival rates of teeth restored with stainless steel crowns (SSC) was the highest at 46.7 months, GIC-restored teeth at 45.8 months and unrestored teeth at 18.2 months. There was no correlation seen between the survival rates and the number of further interventions required. The difference between the survival rates of teeth restored with GIC, SSC and unrestored was statistically significant (p

We investigated factors associated with failure of adhesive restorations in primary teeth and whether repair may increase the survival of failed restorations placed in high–caries risk children. The sample comprised children who attended a university dental service to perform restorative treatment in primary teeth. Data were collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: “Success” (Level 1)—when any re-intervention was considered as failure; “Survival” (Level 2)—when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p

The 2018 ADTA International Panel presented the work of dance/movement therapists from around the world who are experts in implementing restorative methods and techniques that address the myriad psychological, emotional, and physical symptoms of those suffering from trauma. Panelists were asked to respond to the following questions: What is your specialty in the field of trauma? What is your country’s cultural, political, and social response to trauma issues? What are the specific DMT interventions that you implement as a restorative treatment for trauma? And finally, what tools do you utilize as a DMT clinician to recuperate from working with clients of trauma? Countries represented were Holland, Australia, Canada, United States, Israel, and Germany.

Background Silver fluoride 40% followed by 10% stannous fluoride (AgF) has been used in dental practice in some parts of Australia for many years. This study compared the effectiveness of application of AgF with atraumatic restorative technique (ART) in managing cavitated carious primary molars. Methods The study was a community effectiveness trial in two remote Aboriginal communities where AgF has been used for some time. Children between 4 and 8 years of age with caries on primary molars were randomized by birth date to receive AgF or ART. There were 210 children who were included in the study with 384 eligible teeth. Children were followed up for periods between 9 months and 4 years. Negative outcomes such as dental pain, extraction, use of antibiotics and more extensive restorative treatment were considered as the primary outcomes of the study. Results Those negative outcomes were infrequent in both treatment groups. The prevalence ratio of negative sequelae for children treated with AgF compared with those treated with ART was lower at 0.18. Conclusions Silver fluoride was well accepted, easy to use and at least as effective a treatment as ART for dental caries in primary molars in young Aboriginal children in remote areas.

ZusammenfassungLückensituationen bei Patienten stellen eine therapeutische Herausforderung für Zahnärzte und Kieferorthopäden dar und bedürfen einer komplexen interdisziplinären Behandlung. Für jeden Patienten muss ein stimmiges Gesamtkonzept erarbeitet werden, welches auf die individuellen Gegebenheiten angepasst ist. Dieser Artikel bietet einen Überblick über Ursachen und Therapieansätze bzw. Lösungen.

A mal oclusão é o alinhamento anormal dos dentes e maneira pela qual os dentes superiores e inferiores se encaixam. Normalmente, os dentes superiores se sobrepõem ligeiramente sobre os inferiores. Dentre os meios de tratamento para a mal oclusão, encontra-se o tratamento restaurador, que pode ser classificado em direito e indireto. Para fins desse estudo, escolheu-se focar no tratamento restaurador direto. Diante disso, essa pesquisa teve como objetivo analisar o melhor tratamento restaurador direto de má oclusão. Buscou-se encontrar dentre os restauradores diretos, aquele que pode ser utilizado no tratamento das más oclusões. Na metodologia foi realizado uma revisão integrativa da literatura baseado nas bases de dados periódicos, PubMed, Google Acadêmico e Scielo, cujo recorte temporal se deu entre os anos de 2017 a 2022. Nos resultados, ficou claro constatar que o tratamento restaurador direto com uso de resina composta se mostrou a melhor alternativa para o caso apresentado, por apresentar uma maior preservação dental, menor tempo clínico, baixo custo, boa lisura superficial, facilidade de polimento, dentre outras vantagens. La maloclusión es la alineación anormal de los dientes y la forma en que los dientes superiores e inferiores encajan entre sí. Normalmente, los dientes superiores se superponen ligeramente a los inferiores. Entre los medios de tratamiento de la maloclusión, se encuentra el tratamiento restaurador, que se puede clasificar en directo e indirecto. A los efectos de este estudio, optamos por centrarnos en el tratamiento restaurador directo. Por lo tanto, esta investigación tuvo como objetivo analizar el mejor tratamiento restaurador directo de la maloclusión. Se buscó encontrar entre los restauradores directos, aquel que pueda ser utilizado en el tratamiento de las maloclusiones. En la metodología se realizó una revisión integradora de la literatura con base en las bases de datos periódicas, PubMed, Google Scholar y Scielo, cuyo marco temporal fue entre los años 2017 a 2022. En los resultados se evidenció que el tratamiento restaurador directo con el uso de resina Composite demostró ser la mejor alternativa para el caso presentado, ya que presenta mayor conservación dental, menor tiempo clínico, bajo costo, buena lisura superficial, facilidad de pulido, entre otras ventajas. Malocclusion is the abnormal alignment of teeth and the way in which the upper and lower teeth fit together. Normally, the upper teeth slightly overlap the lower ones. Among the means of treatment for malocclusion, there is restorative treatment, which can be classified as direct and indirect. For the purposes of this study, we chose to focus on direct restorative treatment. Therefore, this research aimed to analyze the best direct restorative treatment of malocclusion. It was sought to find among the direct restorers, the one that can be used in the treatment of malocclusions. In the methodology, an integrative literature review was carried out based on the periodic databases, PubMed, Google Scholar and Scielo, whose time frame was between the years 2017 to 2022. In the results, it was clear to see that the direct restorative treatment with the use of Composite resin proved to be the best alternative for the case presented, for presenting greater dental preservation, shorter clinical time, low cost, good surface smoothness, ease of polishing, among other advantages.

This case report presents the use of prefabricated composite veneers for restorative treatment of amelogenesis imperfecta (AI). This technique bridges the gap between a conventional direct technique and a conventional indirect technique and introduces an alternative semidirect restorative technique for AI patients. The aim of this case report is to describe restoration of a young girl with severe AI using prefabricated composite veneers and to discuss the benefits and limitations of this technique compared to the alternative restorative techniques.

Aim: To investigate restorative decisions made by dentists and to examine what demographic characteristics are associated with the decisions for managing approximal and occlusal lesions. Methods: A questionnaire was randomly sent to 900 Palestinian dentists. It noted the demographic details of the dentists and the years of experience. The questionnaire evaluated the respondents for their treatment decisions regarding approximal and occlusal carious lesions. The data was analyzed using the IBM SPSS statistics for windows. The associations between gender and years of experience of the respondents and their restorative decisions were assessed. Results: The response rate was 58.2%. For occlusal carious lesions, 93.9% of the respondents would postpone operative treatment until the lesion was in dentine (grade 3 to 5). For approximal lesions, intervention was deemed appropriate by 92.6% of the respondents when there was radiographic evidence of a carious lesion reaching the DEJ or deeper. Around 53% preferred to prepare approximal lesions according to the traditional principles of cavity preparation. For both approximal and occlusal lesions, the participants opted for resin composites. Statistically, there was a significant association between the restorative decisions with the years since graduation and gender. Conclusion: The study showed variations between the treatment decisions of Palestinian dentists. The subjects chose conservative treatment plans but still adhered to traditional learned practices especially when cavity preparation for approximal lesions was concerned. The years since graduation and gender played a significant role in the choice of treatment opted for. Resin composites seemed to be a popular choice for treatment.

ObjectiveSilver diamine fluoride (SDF) is a non-surgical treatment for the arrest and prevention of dental caries that results in irreversible black staining of dental decay. The objective of this study was to evaluate the impact of SDF treatment on oral health-related quality of life (OHRQoL) relative to a standard package of glass ionomer sealants and atraumatic restorative treatment.MethodsCariedAway is a pragmatic, longitudinal, cluster-randomized non-inferiority trial of non-surgical interventions for caries. Secondary study outcomes included OHRQoL and academic performance. Oral health-related quality of life was measured at each study visit using the Child Oral Health Impact Profile. Change in OHRQoL was assessed using linear regression and non-inferiority was determined using t-tests.ResultsUntreated decay at baseline was associated with signifcantly worse ORHQoL and treatment in both groups resulted in incremental improvement. Quality of life in children receiving silver diamine fluoride was non-inferior to those receiving sealants and ART at least six months post-treatment. Additionally, change in OHRQoL did not depend on the severity of baseline decay.ConclusionsORHQoL is related to untreated dental caries, however no appreciable change was observed following SDF treatment relative to standard preventive therapies.

To evaluate whether dental crown topography influences the fracture resistance of premolars treated endodontically and with MOD preparation subjected to different restorative protocols. Sixty-four human premolars with one or two roots in equal numerical proportions (n) were selected and randomly divided into four groups (n = 8): (S = single-rooted; D = double-rooted) SS: sound single-rooted; SNR: endodontics (E) + MOD cavity preparation; SR: E + MOD + resin restoration (RS); SP: E + MOD + RS + horizontal zirconia post (ZP); DS: sound double-rooted; DNR: E + MOD; DR: E + MOD + RS; and DP: E + MOD + RS + ZP. After allocation to the groups, the samples were thermocycled and then subjected to the fracture resistance test. Failures after the fracture test were classified as irreparable (with pulp floor fracture) or reparable (without pulp floor fracture). Data were analysed using one-way anova and the Tukey test (α = 0.05). Single-rooted premolars were more resistant to fracture than double-rooted premolars. The restorative treatment using a horizontally transfixed zirconia post improved fracture resistance, resembling that of a healthy tooth.

Previous research has shown that virtual reality (VR) can be used to treat a number of mental disorders (anxiety disorders, phobias). Therefore, this study speculates that intelligent relaxation technology with virtual reality experience is helpful for emotional recovery and stress relief. The subjects were randomly assigned to experience the natural environment through 360-degree virtual reality (the experimental group) or through a traditional 2D video (the control group). Subjects will be induced respectively using HMD after the stress and desktop screen with music for 15 minutes restorative treatment, treatment of subjects at the same time with two aspects of subjective and objective physical measurement and psychological measurement. Two factors repeated analysis of variance and nonparametric Friedman detection analysis shows that using VR than having 2 d environment controls more relief effect and the positive influence. These findings suggest the potential importance of virtual reality as a tool in this area of research. To promote human mental health and ensure psychological security. It provides a prospect for research strategies in the complex field of human-nature interaction.

Maintenance of dental health has attracted attention of researchers at present. Various materials have been constructed and applied for curing different dental diseases, although limitation of biocompatibility and safety is still a big challenge. To overcome these limitations, nanomaterials with unique properties are incorporated into various dental treatment materials used in dental applications, including endodontic treatment, periodontal treatment, implant treatment, oral surgery, and restorative treatment, etc. Especially, reactive oxygen species-based nanomaterials equipped with nanoscale properties and reactive oxygen activities can be used as sterilization agents in dentistry, along with being used as good fillers in the dental field. This review concludes the common reactive oxygen species (ROS) nanomaterials and reviews the utilization of ROS in dentistry, highlighting the potential application and safety in clinical treatment. The future prospect will also be proposed to conduct the clinic dental cure.

Background Aerosol and droplet production is inherent to dentistry. Potential for COVID-19 spread through aerosols and droplets characterizes dentistry as having a high risk of experiencing viral transmission, with necessity for aerosol and droplet mitigation. Methods Simulations of restorative treatment were completed on a dental manikin with a high-speed handpiece and high-volume evacuation suction. Variable experimental conditions with use of an extraoral vacuum suction at different distances from the simulated patient's mouth and different vacuum settings were tested to evaluate extraoral suction ability for droplet reduction. Results Using the extraoral suction unit during dental procedure simulations reduced droplet spatter at the dentist’s eye level, as well as the level of the simulated patient's mouth. When the extraoral suction unit was used at level 10 and 4 inches from the simulated patient's mouth, less spatter was detected. Conclusions Extraoral suction units are an effective method of reducing droplet spatter during operative dental procedures and can be useful in helping reduce risk of experiencing COVID-19 spread during dental procedures. Practical Implications During the pandemic, dentistry and its aerosol-generating procedures were placed on hold. The process to getting back to patient care is multifactorial, including personal protective equipment, patient screening, and mitigating aerosol spread.

Microscopic studies performed on extracted human teeth after their preparation in advance is helpful in a relatively good reestablishment of the treatment steps that have been applied to these teeth, as well as an evaluation of the quality of such treatments. Therefore, we have used stereo- and optical microscopy, highlighting aspects of external morphology, as well as root canal space of an extracted mandibular second premolar, subjected to prosthetic and endodontic treatment. In order to verify some technical errors that might occur during the endodontic and restorative treatment, we tried to appreciate the quality of the root canal filling and cervical defect and access cavity restoration of an extracted premolar #45.Without having the data from clinical records, we concluded that the method used for root canal filling was the warm lateral condensation technic; we also appreciated the quality of the fusion of the gutta-percha cones used, so the introduction of heated spreaders only in the central part of the bunch of cones makes it possible to clearly detect the boundaries between these cones towards the outside of the filling.

Background: Despite the effectiveness of silver diamine fluoride (SDF) in arresting caries, black staining of carious lesions is a major drawback. Objective: To assess parental satisfaction after using SDF versus atraumatic restorative treatment (ART) to manage ECC in their children. Materials & Methods: A randomized controlled clinical trial with patient reported outcomes; 100 children with ECC (2-5 years) were equally and randomly divided into two groups; Experimental group (N=50, n=268) received 38% SDF; Control group received ART (N=50, n=286). Parental satisfaction was assessed after 2 weeks using 4-item, 5-level, Likert-scale questionnaire. Quantitative data were represented using mean, and standard deviation (SD). Qualitative variables were displayed using frequency and percentages. Monte Carlo simulation method for Pearson's chi square statistics was applied to compare both groups regarding parental satisfaction. Significance level was set at P value ≤ 0.05. Results: Eighty percent of parents/guardians strongly agreed, agreed or were neutral regarding their children’s esthetics after SDF versus 98% after ART (P=0.06). All SDF parents/guardians strongly agreed or agreed it was an easy procedure versus 30% among ART group (P

Introduction: Since the removal of caries in the Atraumatic restorative treatment (ART) is performed with hand excavation, its survival would increase if more bacteria could be inhibited under the restoration. The use of antibacterial agents such as Chlorhexidine gluconate (CHX) was found to hinder the growth of bacteria under restorations, reducing the risk of recurrent caries. Objective: Evaluate the effectiveness of CHX as a cavity disinfectant, on residual cariogenic bacteria, in ART restorations. Materials and methods: Atraumatic restorative treatment procedures were performed to the whole sample (N=40), with identical protocols except for the antibacterial agent used. Bacteriological samples from the center of the cavity were cultivated for Mutans streptococci (MS), Lactobacilli (LB) and total viable count (TVC). Chlorhexidine was applied onto the cavity floor in group I (N=20) and conventional ART without disinfectant was performed in group II (N=20). After 14 days, the restorations were removed and a second dentin sample was cultivated for bacteriologic assessment of the outcome. Results: After 14 days, Group I showed 22.17, 8.25, 6.88 mean percent reduction of MS, LB, and TVC, respectively whereas group II showed 12.67, 6.87, 6.11 mean percent reduction of MS, LB, TVC, respectively. MS and LB showed significantly higher percent reduction in group I compared to group II. Moreover, group I showed higher mean percent reduction in TVC than group II; however, it was not statistically significant. Conclusion: Chlorhexidine disinfection showed superior effectiveness in inhibiting residual bacteria under ART restoration compared to ART restorations using glass ionomer cement (GIC) alone.

Introduction. One of the challenges that clinicians encounter in the dental office is treating occlusal discrepancies. Malocclusion has been classified into three main classes that were further classified by researchers into more detailed subclasses later on. Pseudo-class III malocclusion has been called apparent or positional class III malocclusion, and its treatment usually consists of different modalities depending on how early the case is treated. When early orthodontic intervention was not possible, the restorative treatment becomes an excellent alternative especially when the teeth require restorative rehabilitation. Treatment. In this case report, the patient was suffering from dental wear, multiple failed old restorations, and edge-to-edge occlusal relationship which could be classified as pseudo-class III malocclusion. The patient’s esthetic complaint was addressed with full-coverage lithium disilicate and monolithic zirconia restorations that were successful in reestablishing the patient’s occlusal relationship and were able to eliminate the biological manifestations of dental caries. Conclusion. We were able to provide an alternative to orthodontic treatment where esthetic and functional needs of the patient were met after careful diagnosis and proper management. This clinical approach will give chance to treat patients suffering from minor occlusal discrepancies that require restorative intervention without the need to go through orthodontic therapy.

A combination of dental problems such as missing teeth, proclination of teeth and occlusal problems cannot be satisfactorily treated by prosthodontic approach alone. The rehabilitation of patients requiring an esthetic smile demands the collaboration of multiple dental specialists. the need for orthodontic tooth movement prior to restorative treatment is necessary for some patients, in order to optimize both esthetic and functional aspects of dental treatment.The present case report achieved successful implant based oral rehabilitation in a patient with absence of the right maxillary central incisor utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.

In modern world medicine, cerebrovascular diseases are one of the most pressing problems of modern neu�rology, given the high prevalence of this pathology in the population. In modern scientific works, the restorative treatment of post-stroke patients is widely used the method of combined neuroprotection. This approach is in our view the most effective and safe in the restorative treatment of patients. In our study, we prioritize in restorative treatment the combined pharmacotherapy "Citicoline" in integrated use with the drug "Cortexin." During the clin�ical study, we analyzed the statistics obtained, which also support the effectiveness of combined neuroprotection of cyticoline and cortexine in recovery treatment in the rehabilitation period of ischemic stroke.

La adecuación del medio bucal consiste en un conjunto de medidas que apuntan a la disminución de los niveles de microorganismos cariogénicos presentes en la cavidad bucal, proporcionando la paralización del proceso carioso. Las medidas se aplican después del diagnóstico y antes del tratamiento restaurador definitivo, siendo considerada una etapa intermedia. El presente trabajo tiene como objetivo discutir la adecuación del medio bucal, sus etapas y presentar el protocolo utilizado en la Clínica de Odontopediatría de la UNIGRANRIO, RJ Brasil.

During restorative treatment, premolars restored with resin filling materials using the conventional incremental-fill technique take longer restoration time and undermine the integrity of the tooth. The aim of this study was to assess fracture resistance of premolars restored by various types of novel bulk-fill composite resin materials. Forty-eight (n = 48) freshly extracted sound maxillary first premolars were used in this in vitro study. The teeth were divided into six groups, each having 8 specimens. Group A (positive control) was allocated for the intact teeth. For specimens in Groups B to F, a large cavity (Class-II MOD) was prepared with a standardized dimension of cavity (3 mm depth on the pulpal floor, 4 mm at the gingival seat, and 3 mm cavity width). Group B represented prepared teeth without any restoration. Group C, Group D, Group E, and Group F were restored with Tetric EvoCeram® incremental-fill (conventional), Beautifil bulk-fill, Filtek posterior bulk-fill, and SonicFill 2 bulk-fill restorative materials, respectively. All samples were finished and polished with an enhanced finishing kit and stored in distilled water for a month before the fracture resistance testing. All the samples were exposed to the axial loading (the speed of crosshead was 1 mm/min) in a computer-controlled universal testing machine (LARYEE, China) via a steel bar (6 mm in diameter) and the maximum applied force in Newton was recorded as the fracture resistance. One-way analysis of variance (SPSS 21) was used to compare the fracture resistance within the groups, and Tukey’s post hoc test was used to determine the difference between the groups. The lowest value of fracture resistance was recorded for Group B, and the highest value was recorded for Group A followed by the values of Group D, Group C, Group F, and Group E. One-way ANOVA revealed a statistically significant difference between the groups ( P < 0.05 ). Nonsignificant difference was found between the premolars restored by bulk-fill and conventional composites. Among the bulk-fill restored specimens, Beautifil restorative demonstrated significantly higher fracture resistance in comparison with the other two bulk-fill restored specimen groups (SonicFill 2 and Filtek). Bulk-fill composite such as Beautifil could be an alternative option to conventional incremental-fill composite for premolar restoration.

Objective: The aim of this study was to perform a brief literature review of chemo-mechanical caries removals and to describe a clinical case using the product. Case report: According to clinical and radiographic diagnosis, the tooth presented dentin caries lesion without any pulpal involvement. BRIX 3000®, a new chemo-mechanical caries removal product, was used with 1 gel application of 2 minutes. Afterwards, the cavity was restored using a bulk fill flow composite and a conventional resin composite final layering. Conclusion: Taking into consideration the presented clinical case, the application of BRIX 3000® gel seems to be a good alternative for caries removal followed by a restorative treatment, since the child’s discomfort decreased, resulting in a positive behavior. BRIX 3000 is an efficient chemo-mechanical caries removal method. O objetivo deste estudo foi realizar uma breve revisão da literatura sobre remoção químico-mecânica da cárie e descrever um caso clínico com a utilização de um novo produto. De acordo com o diagnóstico clínico e radiográfico, o dente apresentava lesão de cárie em dentina sem comprometimento pulpar. Foi utilizado um novo produto químico-mecânico, BRIX 3000®, para remoção da cárie com 1 aplicação de gel por 2 minutos. Posteriormente, a cavidade foi restaurada usando um compósito bulk fill flow e uma resina composta convencional para estratificação final. Levando em consideração o caso clínico apresentado, a aplicação do gel BRIX 3000® parece ser uma boa alternativa para a remoção da cárie seguida de um tratamento restaurador, uma vez que o desconforto da criança diminuiu, resultando em um comportamento positivo. BRIX 3000 é um método eficiente de remoção químico-mecânica da cárie.

A brief review of the nanorobots that are currently used in the biomedical engineering to cure various types of diseases is being presented. In the context, we are carrying out a literature survey for the treatment of cancer using the nanotechnology concept. The way we have picked is the union of nanotechnology and medicine. The mix of nanotechnology into medication is probably going to get some new difficulties restorative treatment. Nanorobot is a superb vision of medicine in the future. The most exceptional nanomedicine includes the utilization of nanorobots as small-scale specialists. Advancement in nanotechnology may allow us to build artificial red blood cells called respirocytes capable of carrying oxygen and carbon dioxide molecules (i.e., functions of natural blood cells). Respirocytes are nanorobots, small mechanical gadgets intended to work on the atomic level. Respirocytes can give a brief substitution to characteristic platelets in the instance of a crisis. Subsequently, respirocytes will truly change the treatment of coronary illness. We can imagine a day when you could infuse billions of these nanorobots that would skim around in your body. A standout among the most sensible and almost doable accomplishments is the cure for growth which is one of the primary centers of this work. Nanorobots could carry and deliver large amounts of anti-cancer drugs into cancerous cells without harming healthy cells, reducing the side effects related to the current therapies. These nanorobots will have the capacity to repair tissues, clean veins and aviation routes, change our physiological capacities. The work presented in this paper is this research work of the research scholar student that was undertaken under the guidance of the doctorates which just provides a brief review of the applications of the nanorobots that could be used in the medicine for the curing of the cancer treatment and is just a review paper, which serves as a basis for all the students, faculties as a base for carrying out the research in this exciting field of nanorobotics. At the end, once the review is over, we are presenting a simulation which we had developed in nanohive simulation tool for biomedical engineering applications.

Background Silver diamine fluoride (SDF) is an effective agent for the arrest of caries in children, is easy to apply and can be used outside the clinical environment. Interim restorative treatment (IRT) using glass ionomer cement has also been claimed to be a simple and effective method to arrest caries in deciduous teeth. Objective To examine whether, for underprivileged schoolchildren with cavities, treatment with 30% SDF gives better results than IRT for carries arrest. Method This randomised controlled study compares the effect of IRT (FUJI IX) with 30% SDF in 91 children aged 5-6 years. Results After 1 year, treatment with SDF was more effective [relative risk (RR) = 66.9%] than IRT (RR = 38.6%) for the arrest of caries; this was statistically significant (P Conclusion The SDF technique showed better results than IRT for the arrest of cavities in deciduous teeth, indicating that its use for underprivileged communities may justify a paradigm shift in paediatric dentistry.

Existem diferentes opções para o tratamento restaurador de dentes decíduos. O objetivo deste estudo foi avaliar a taxa de sucesso de restaurações convencionais e atraumáticas, lesões de Classe I e Classe II em molares decíduos. Este é um ensaio clínico randomizado que foi realizado em Olinda, Brasil. O grupo controle foi formado pelas restaurações convencionais com resina (205) e amálgama (198), e o grupo caso pelas restaurações atraumáticas (ART) (211) e pelos tratamentos com Hall Technique (117). Um total de 731 restaurações foram realizadas em consultório odontológico em 731 crianças (4 a 8 anos de idade). Todas as restaurações foram avaliadas após 6, 12 e 18 meses. A taxa de sucesso das restaurações Classe I foi maior (> 85% de sucesso) para todas as restaurações em comparação com a Classe II (16,9% -99,1%, sucesso / falha menor). As taxas de sucesso das restaurações Classe II após 18 meses não foram satisfatórias para restaurações convencionais com resina (16,9%, sucesso / falha menor) e ART (31%, sucesso / falha menor), enquanto foram satisfatórias para restaurações convencionais com amálgama (70, 3%, sucesso), e excelente Hall Technique (99,1%, sucesso). A taxa de sucesso para Classe I foi maior que II para todas as restaurações. Considerando a Classe II, o índice de sucesso foi baixo para ART e restaurações convencionais com resina, satisfatório para amálgama e excelente para Hall Technique.

Introduction The Finnish Defence Forces’ unique oral health-screening protocol (FDFsp) has been in use for decades. In FDFsp, restorative treatment need is determined based on the World Health Organization (WHO) criteria. The aim of this study was to compare the outcome of screening restorative treatment need with the outcome of using the International Caries Detection and Assessment System (ICDAS) classification at both individual and tooth levels. Our hypothesis was that the outcome of screening with FDFsp agrees with the outcome of using the ICDAS classification. Methods In this study, a trained, calibrated examiner estimated, in a visual–tactile manner the restorative treatment need of 337 young healthy adults using the FDFsp. During the screening, 74 conscripts were selected for a thorough inspection. The inclusion criteria for those selected were: having no, having one to five, or having six or more caries lesions needing restorative treatment. In the thorough inspection, the participants were inspected in a visual–tactile manner using the ICDAS classification. The association of the outcomes achieved using the two different methods was analysed at individual and tooth levels. Sensitivity, specificity, and kappa values were calculated. Wisdom teeth were excluded. Results At the individual level, the agreement between the outcomes of using FDFsp and ICDAS ≥4 was excellent: sensitivity, 94.1%; specificity, 97.5%; and kappa = 0.92. When ICDAS ≥3 was used, the values were 72.7%, 96.7%, and 0.66%, respectively. Conclusion Screening performed by a trained examiner using specific criteria is a reliable method for detecting individuals with restorative treatment need. The outcome of screening agrees strongly with results using the ICDAS classification.

Objectives This study assessed age-related variation in the volume and content of restorative dental care performed by private dentists for adults in Finland in 2012−2017. Methods This retrospective register-based observational study utilized the Social Insurance database of private dental services in 2012 and 2017, including all patients. The data were aggregated into 5-year age groups for 20–89-year-olds; those aged 90+ formed one group. A patient was one who had received at least one treatment, and a restoration patient one who received at least one restoration (direct/indirect), excluding prosthetic crowns. Attendance rate was the proportion of the population treated. Volume of restorative treatment was the proportion of restoration patients among all patients using private dental services. Content of restorative treatment was described as the number of teeth receiving restoration and the size of restoration (number of surfaces restored). Correlation coefficient demonstrated associations between age groups and numbers of restorations. Results Rate of restoration patients was 64.8 % in 2012 and 61.1 % in 2017, the rate for individuals aged under 80 years in each calendar year being smaller than in previous years. Mean number of restorations received per patient was 1.59 in 2012 and 1.42 in 2017, increasing with age (r = 0.85 in 2012; r = 0.95 in 2017). Small restorations dominated; one to two surfaces were covered in 72.3 % and 75.5 % of restorations in 2012 and 2017, respectively. Conclusions Volume and content of restorative dental care for adults vary by age and have decreased slightly over time. Clinical significance Restorative treatments are a prominent part of dental care for adults. This paper sheds light on the entity of restorative dental care for adults visiting private dentists. Variation in restoration volume and content is shown according to patient’s age group, and changes are assessed across six years.

Introduction: The epidemiological data in the Kingdom of Saudi Arabia indicate that there has been increased prevalence of dental caries and increased treatment needs, with negligible rates of restorative care among the population. The restorative treatments done among the population are very limited. There are no published reports that systematically document the barriers of restorative care among the residents of Jeddah. Aim: This present paper is a humble attempt toward the study of barriers of restorative care and systematic documentation of the dental patients in a private dental school in Jeddah. Materials and Methods: The methodology adopted by the study is the preparation of a questionnaire after validation and analyzing the responses from the sample of the universe of dental patients in Jeddah. The questionnaire broadly included (1) fear of consulting a dentist, (2) dental anxiety/fear to receive dental care, (3)cost of dental treatment, (4) fee for restoration, (5) pain, and (6) experience of a dentist (fear that a student may treat them). The completed questionnaire of 22 questions was proofread by a group of general dentists to check for clarity and meaning of the statements. After the changes, the questionnaire was distributed to 275 patients. The analysis of the data in the study was done by the SPSS version 23. Chi-square was calculated for the analyses of all the independent variables. Results: 41.4% of people have fear to visit a dentist. Hence, this is one of the barriers of restoration. Nearly 50% have responded that restorative treatment is painful. In addition, the experience of the dentist has an impact on the respondents getting treatments in the dental clinic. 76% of the respondents have a fear when a student who has lesser experience will be treating them in the dental clinic. Conclusion: Dentists have to distinguish between perceived barriers and the real barriers to choosing restorative treatments.

The management of compromised first permanent molars (FPMs) in children presents a clinical challenge to the dental team. Hypomineralised FPMs in molar incisor hypomineralisation (MIH) conditions could undergo post-eruptive breakdown, making them susceptible to caries, leading to their subsequent loss. The planned extraction of compromised FPMs is a valid alternative to complex restorative treatment. However, establishing the presence or absence of third permanent molars, amongst other considerations, is crucial to reaching a successful outcome. Clinicians should understand the importance of an orthodontic examination around the age of 8 years old with regard to establishing a differential therapeutic decision about the ideal timing of MIH-affected FPMs’ extraction in children. The aim of this article is to highlight that, with an interdisciplinary approach, a good outcome can be achieved following the extraction of poorly prognosed FPMs. The most cost-effective way of addressing MIH-affected FPMs is extraction, followed by orthodontic space closure when indicated. This obviates the need for the repeated restorative replacement and saves perfectly healthy premolars from being extracted for space creation in orthodontic treatment in several clinical scenarios.

Background: This randomized clinical trial (RCT) aimed to compare the 3-year survival rates of high viscosity glass ionomer restorations (HVGIC) using conventional cavity preparation and atraumatic restorative technique (ART) in primary molars. Materials and Methods: In this RCT, 139 schoolchildren aged 6–9 years with dentinal caries in primary molars were randomly allocated to groups, i.e. the ART group and the conventional group, utilizing a random number generator. Adequate allocation concealment was done. Intervention was delivered using standard procedure and GC Fuji IX ART HVGIC was used as restorations in both the groups. Analysis was carried in 92 participants, and survival rates in both the groups were compared at 12, 24, and 36-month intervals. IBM SPSS software was utilized to analyze the time taken for the procedure and the Kaplan–Meier estimate was used to assess the survival rates. P value of 0.05 was considered statistically significant. Results: The ART took longer to complete (16.48 ± 2.02 min) versus conventional rotary instrumentation (13.15 ± 1.32 min). The conventional method was slightly superior as compared to ART; excellent survival rates (i.e. >90%) were achieved in both groups at the end of 12-month follow-up with no significant differences at the end of 24 and 36 months as evident from Kaplan–Meier estimate (P = 0.255). Conclusion: Three-year follow-up showed that GIC restorations with ART and conventional method carried out using GC Fuji IX ART HVGIC were acceptably successful, substantiating the use of ART for the primary dentition in areas with high caries prevalence and limited access to dental care.

The aim of this study was to evaluate whether dentists and dental undergraduate students know the terminology of the International Caries Consensus Collaboration (ICCC), and make their restorative treatment decisions regarding carious tissue removal accordingly. Data collection was performed using an electronic questionnaire, considering: a) profile of the respondent; b) analysis of four clinical cases with respect to possible management strategies; and c) questions on cariology field terminology. Sample size consisted of 175 dentists and 66 last semester dental students. Statistical analyses were performed comparing profile, type of institution and dental specialty of the participants. Results showed students were less conservative and agreed less with the ICCC than dentists, and private schools, less than public institutions. Private institutions were 12% (95%CI = 0.833–0.949; p = 0.000) more likely to be less updated with the ICCC recommendations than public institutions, and dentists were 20% more likely to agree with them than students (95%CI = 1.118–1.302; p = 0.000). Dentists were 66% more likely to be conservative than students (95%CI = 0.203–0.554; p = 0.000); dentists and students who graduated or were graduating from public universities were twice as likely to be conservative as those from private universities (95%CI = 1.336–3.333; p = 0.001). In conclusion, students in the last semester are less conservative than dentists, and respondents who graduated or were graduating from public dental schools were more aligned with the current concepts of the ICCC. Several answers were not aligned with ICCC directives, thus showing that management of deep carious lesions still causes restorative therapeutic insecurity.