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Objectives: To evaluate the effects of enhanced personal protective equipment (Enhanced_PPE) on student‐operator's experience and restorative procedure. Methods: Student‐operators (N = 29 Year 3 dental students) performed Class II composite restorations (SimpliShade, Kerr) in typodont upper molars (OneDental) equipped with N95 respirators, full‐face shields, disposable headwear and gowns (Enhanced_PPE) or surgical masks, protective glasses/goggles and non‐disposable gowns (Standard_PPE) 2 weeks later. Cavity dimensions were measured on cone beam computed tomography images. The quality of composite restorations was assessed using selected FDI criteria and Vickers hardness. A questionnaire assessed the operators' discomfort, anxiety, confidence, ability to perform, and procedure outcome. Data were analyzed using paired t‐test and McNemar test (alpha = 0.05). Results: Student‐operators experienced greater discomfort and anxiety, reduced confidence and ability to perform, and rated the procedure as less satisfactory with Enhanced_PPE (p < 0.05). Differences in proximal box width were marginally significant (Enhanced_PPE 1.8 ± 0.4 mm, Standard_PPE 1.6 ± 0.3 mm) (p = 0.047). Other cavity dimensions were similar between groups (p > 0.05) as were restorations regarding surface luster, anatomical form, marginal adaptation, proximal contour, and contact (p > 0.05). There were no differences in the hardness of composite restorations (top p = 0.349, bottom p = 0.334). Conclusions: Enhanced_PPE led to student‐operator discomfort, anxiety, and reduced confidence, but did not impact the quality of Class II preparation and composite restorations versus Standard_PPE. [ABSTRACT FROM AUTHOR]

This study aimed to compare the biological properties of newly synthesized cements based on calcium phosphate with a commercially used cement, mineral trioxide aggregate (MTA). Strontium (Sr)-, Copper (Cu)-, and Zinc (Zn)-doped hydroxyapatite (miHAp) powder was obtained through hydrothermal synthesis and characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy dispersive X-ray spectrometry (EDX). Calcium phosphate cement (CPC) was produced by mixing miHAp powder with a 20 wt.% citric acid solution, followed by the assessment of its compressive strength, setting time, and in vitro bioactivity. Acetylsalicylic acid (ASA) was added to the CPC, resulting in CPCA. Biological tests were conducted on CPC, CPCA, and MTA. The biocompatibility of the cement extracts was evaluated in vitro using human dental pulp stem cells (hDPSCs) and in vivo using a zebrafish model. Antibiofilm and antimicrobial effect (quantified by CFUs/mL) were assessed against Streptococcus mutans and Lactobacillus rhamnosus. None of the tested materials showed toxicity, while CPCA even increased hDPSCs proliferation. CPCA showed a better safety profile than MTA and CPC, and no toxic or immunomodulatory effects on the zebrafish model. CPCA exhibited similar antibiofilm effects against S. mutans and L. rhamnosus to MTA. [ABSTRACT FROM AUTHOR]

Objective: To measure degree of conversion (DC) of a flowable composite, microtensile bond strength (MTBS) to dentine in the snow‐plow technique with/without preheating and temperature in the preheated composite. Materials and Methods: For DC, snow‐plow specimens of Filtek Ultimate Flowable (Flow) and Filtek Bulk Fill (Bulk) (3M) were prepared by light‐curing composites simultaneously in standardized molds while in control groups light‐curing was separate. DC of Flow was measured using micro‐Raman spectroscopy. For MTBS, specimens were prepared on dentine of human extracted molars by simultaneous (snow‐plow) or separate (control) light‐curing. MTBS was measured using a universal testing machine after 24 h and 6 months. Data were analyzed using ANOVA with Tukey's post hoc (α = 0.05). Results: Increased curing time significantly increased DC in snow‐plow from 13.4% ± 11.6% (10 s) to 31.8% ± 4.4% (40 s) albeit significantly lower than controls (p < 0.05). Preheated Bulk improved conversion in snow‐plow (44.3% ± 1.7%) and control (50.5% ± 2.6%) (p < 0.05). No significant differences occurred in MTBS between groups (p > 0.05). MTBS values ranged between 66.7 ± 8.4 MPa (snow‐plow group_21°C_baseline) and 54.1 ± 15.8 MPa (control_21°C_long‐term). Temperature in the preheated Bulk dropped to ~38°C after 30 s. Conclusions: Snow‐plow technique, irrespective of preheating, resulted in lower DC of Flow than separate light‐curing of composite increments. Snow‐plow, irrespective of preheating, resulted in similar initial and long‐term MTBS to dentine. Clinical Significance: Clinicians with preference for flowable composite liners in Class II restorations should be aware that the snow‐plow technique of simultaneous light‐curing of flowable and bulk‐fill composite increments affects monomer‐to‐polymer conversion, albeit no effect on immediate, and long‐term bonding to dentine was detected. Preheating sculptable bulk‐fill composite improves conversion of the flowable liner in the snow‐plow technique but has no detectable effect on bond strength to dentine. [ABSTRACT FROM AUTHOR]

The objective of this study was to measure temperature changes in the pulp chamber induced by polymerization of resin-based dental restoratives following a simulated procedure of direct pulp capping. Class I cavities with a microperforation at the pulp horn were prepared in extracted human molar teeth. The complete procedure of direct pulp capping and cavity restoration was performed with the root part of extracted teeth fixed in a water bath at 37 °C. Mineral trioxide aggregate, bioactive dentin substitute or calcium-hydroxide paste were used as pulp capping materials. Cavities were restored with a light-cured or chemically-cured resin-modified glass ionomer, universal adhesive and a bulk-fill composite, cured with a high-intensity LED unit. Pulp capping materials caused a slight temperature decrease. Lower temperature increase was recorded during light-curing of the glass ionomer liner after direct capping with mineral trioxide aggregate and calcium-hydroxide than that recorded for the bioactive dentin substitute. Adhesive light-curing increased temperature in all groups with higher mean temperatures in groups with chemically-cured as compared to those for the light-cured glass ionomer liner. Direct pulp capping with mineral trioxide aggregate or calcium-hydroxide followed by the light-cured resin-modified glass ionomer liner and a bonded bulk-fill composite restoration induced temperature changes below the potentially adverse threshold of 42.5°C. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. ON172007]

This study aimed to (1) comparatively analyze properties of Sr‐ and Mg‐substituted hydroxyapatite (HAP)‐based dental inserts; (2) evaluate insert bonding to restorative materials, and (3) evaluate the effect of doped HAP inserts on fracture resistance (FR) of human molars with large occlusal restorations. By ion‐doping with Sr or Mg, 3 insert types were obtained and characterized using XRD, SEM, Vickers hardness and fracture toughness. Shear bond strength (SBS) was determined between acid etched or unetched inserts and following materials: Maxcem cement (Kerr); Filtek Z250 (3M) bonded with Single Bond Universal (SBU; 3M) or Clearfil Universal (Cf; Kuraray). Modified Class I cavities were prepared in 16 intact molars and restored using insert + composite or composite only (control) (n = 8/group). FR of restored molars was determined by static load until fracture upon thermal cycling. Fracture toughness was similar between Sr/Mg‐doped inserts (0.94–1.04 MPam−1/2p =.429). Mg‐doped inserts showed greater hardness (range 4.78–5.15 GPa) than Sr6 inserts (3.74 ± 0.31 GPa; p <.05). SBS for SBU and Cf adhesives (range 7.19–15.93 MPa) was higher than for Maxcem (range 3.07–5.95 MPa) (p <.05). There was no significant difference in FR between molars restored with insert‐containing and control restorations (3.00 ± 0.30 kN and 3.22 ± 0.42 kN, respectively; p >.05). HAP‐based inserts doped with Mg/Sr had different composition and mechanical properties. Adhesive bonding to inserts resulted in greater bond strength than cementation, which may be improved by insert acid‐etching. Ion‐doped HAP inserts did not affect FR of restored molars. In conclusion, HAP‐based dental inserts may potentially replace dentin in large cavities, without affecting fracture resistance of restored teeth. [ABSTRACT FROM AUTHOR]