Search

Objective: Artificial intelligence (AI) applications in restorative dentistry have remarkably increased in the past 5 years. This review outlines the applications, promises, and limitations of AI in the most performed procedures in restorative dentistry. Method and materials: An electronic search was performed in four databases: MEDLINE/PubMed, Embase, Web of Science, and Scopus. The search included articles published in English language without date restriction. Two independent reviewers assessed the eligibility of the studies and performed data extraction. Any discrepancy was resolved by the consensus of a third reviewer. Results: A total of 33 studies were included in this review. For AI applications in restorative dentistry, the included studies were classified into three main groups: (1) diagnosis, detection, and prediction of the disease, (2) detection and prediction of the longevity of dental restorations, and (3) teeth detection and treatments. For each study, the AI model, type of dataset, sample size, and main results (accuracy, precision, sensitivity, and specificity) were reported. Conclusions: AI systems are promising as advantageous aids for diagnosis, prediction, and treatment in dentistry, with a high degree of accuracy. Despite the AI promises, several limitations are still unresolved and must be addressed to bridge the gap between technology and clinical applications. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Material and Methods Results Conclusions Clinical Significance To analyze survival and complication rates for anterior and premolar laminate‐veneers out of different ceramic materials (feldspathic, leucite‐reinforced glass–ceramic [LRGC], lithium‐disilicate [LDS] and zirconia).A systematic literature search was conducted across multiple databases for clinical studies on ceramic laminate‐veneers with a minimum‐follow‐up of ≥ 1 year. The date of last search was on February 19, 2024. Survival, technical, esthetic and biological events were assessed for different laminate‐veneer materials at three observation periods (short‐ [1–3 years], mid‐ [4–6 years] and long‐term [≥ 7 years]).Twenty‐nine studies were included. Meta‐analysis revealed a pooled survival‐rate of 96.13% for feldspathic, 93.70% for LRGC and 96.81% for LDS at 10.4 years. No difference was found between materials. Complication rates (technical/esthetic/biological) were as follows: Feldspathic: 41.48%/19.64%/6.51%; LRGC: 29.87%/17.89%/4.4%; LDS: 6.1%/1.9%/0.45% at 10.4 years. Zirconia showed a 100% survival‐rate with no complications at 2.6 years. No long‐term data was available for zirconia.Feldspathic, LRGC and LDS laminate‐veneers showed high survival‐rates at long‐term observation. LDS slightly outperforms feldspathic and LRGC laminate‐veneers with lower long‐term complication rates. More studies providing long‐term data on zirconia laminate‐veneers are needed.Ceramic laminate‐veneers are a reliable treatment option. LDS may be preferred as a restorative material for long‐term success. [ABSTRACT FROM AUTHOR]

The aim of this prospective, multi-center, practice-based cohort study was to analyze factors associated with the success of implant supported all-ceramic single-unit crowns, made by computer-aided-design/computer-aided-manufacturing (CAD-CAM). All-ceramic crowns placed in a private practice-based research network (Ceramic Success Analysis, AG Keramik) were analyzed. Data from 567patients with CAD-CAM implant supported all-ceramic crowns placed between 2008–2023 by 54dentists were evaluated. Firstly, all crowns with at least one follow-up control were included (n = 907). Secondly, all crowns being followed up for ≥ 5years and all failures were included (n = 151). At the latest follow-up visit, crowns were considered as successful (not failed) if they were still in function without the need for additional therapy. Multi-level Cox proportional hazards models were used to evaluate the association between a range of predictors and time of success. Within a mean follow-up period (SD) of 2.5 (2)years (first scenario) and 6.2 (1.2)years (second scenario) [maximum:12years], 27crowns failed (annual failure rate [AFR]:0.74 %). The main failure types were decementation, (n = 11), fracture of the ceramic (n = 4) or Ti-Base (n = 4). In 5-year-scenario, crowns fabricated in the laboratory had 26times lower failure rate than those fabricated chairside (95 %CI:0.0–0.7;p = 0.038). Furthermore, the use of a silane (HR:0.051;95 %CI:0.0–0.5;p = 0.014) and etching of the ceramic (HR:0.053;95 %CI:0.0–0.8;p = 0.035) resulted in a significantly higher risk for failure than their non-use. For CAD-CAM manufactured implant supported all-ceramic crowns, high success rates were found in up to 12-year evaluation. Furthermore, after 5years, no patient-or implant-level factors, but operative-level factor (i.e.fabrication method, use of silane/etching) were significantly associated with failure. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00020271). • Implant-supported ceramic crowns showed high success rates (97 %) after up to 12 yrs • After 5 years no patient-level factors were significantly associated with failure • After 5 years no implant-level factors were significantly associated with failure • Lab-side fabricated crowns showed a 26x lower failure rate than chairside ones [ABSTRACT FROM AUTHOR]

Objective: To evaluate the fracture behavior of human molars with extensive MOD restorations using short‐fiber‐reinforced resin composite of varying viscosities. Materials and Methods: Human molars were randomly divided into seven groups (n = 12): intact teeth (control); restoration using conventional high‐viscosity resin composite without (Filtek Z350XT, 3M) or with fibers (everX Posterior, GC); conventional low‐viscosity resin composite without (Filtek Supreme Flowable, 3M) or with fibers (everX Flow Dentin Shade, GC); bulk‐fill low‐viscosity resin composite (Filtek Bulk Fill Flow, 3M) or with fibers (everX Flow Bulk Shade, GC). Restorations were performed on extensive MOD preparations, following the manufacturers' recommendations for each material. Specimens underwent fracture strength testing (N) and fracture pattern (%) categorized as repairable, possibly repairable, or non‐repairable. Results were analyzed using a generalized linear model (N) and Fisher's exact test (%), with α = 0.05. Results: Restorations performed with high‐viscosity materials showed fracture strength values similar to the control and higher than those of restorations using low‐viscosity resin composites (p < 0.0001), except for the bulk‐fill low‐viscosity resin composite with fibers (p > 0.05). Teeth restored using low‐viscosity resin composite with fibers showed a higher % of repairable and possibly repairable fractures than the control (p = 0.0091). Conclusions: The viscosity of materials mediated the fracture strength, with restorations using high‐viscosity resin composites promoting values similar to the intact tooth; however, the presence of fibers influenced the fracture pattern. Clinical Significance: Teeth with MOD cavities restored with high‐viscosity resin composites showed similar fracture strength to intact teeth. Fiber‐reinforced low‐viscosity resin composite for the base of restoration resulted in a more repairable/possibly repairable fracture pattern. [ABSTRACT FROM AUTHOR]

In contemporary dental practice, clinicians have a variety of materials and options for restoring single teeth compromised by carious or non-carious diseases. According to studies and new concepts in biomimetic restorative dentistry, indirect ceramic restorations will play an increasingly important role in daily practice. We follow up and evaluate clinically three times over a 10-year period on eighty-six indirect restorations (n = 86) of lithium disilicate e.Max Press (Ivoclar, Schaan, Liechtenstein) in 32 patients. Restorations are evaluated in the 2nd, 5th, and 10th years after the fixation. Four of the restorations studied (n = 86) had to be replaced at year 5 follow-up because of fracture (failure rate: 4.65%; Kaplan–Maier). There are no restorations with bulky, cohesive fractures. Lithium disilicate ceramic restorations provide a good treatment alternative for a 5- to 10-year period of observation, and they can be successfully applied in dental practice in 91.73% to 98.84% of cases. Advancements in digital dentistry, including the use of intraoral scanners and CAD/CAM technology, are set to further refine the precision and efficiency of indirect restorations for distal teeth, enabling quicker turnaround times and improved fit. Additionally, ongoing developments in biomaterials promise to enhance the durability and biocompatibility of these restorations, potentially leading to better long-term success rates and patient satisfaction. The goal of this clinical study was to look at how well biomimetic ceramic overlays and onlays made of lithium disilicate held onto teeth with a IV-generation adhesive system for 10 years. The study also looked at how well the edges of the teeth adjusted and how strong the teeth were overall. [ABSTRACT FROM AUTHOR]

Background: Several clinical and individual factors may play a role in the survival rate of dental restorations, such as characteristics related to the child's age and oral hygiene, and factors associated with the tooth, such as the type of material and number of surfaces to be restored. Aim: To analyse the survival rate of adhesive restorations on primary teeth and factors associated with restoration survival. Design: The study included dental records of children aged 3–12 years having received adhesive restorations on primary teeth at a Brazilian dental school between 2009 and 2019. A Kaplan–Meier survival curve was used to plot survival rates using the log‐rank test. A multivariate Cox regression model was run to identify individual and dental factors associated with restoration failure. Result s : The sample comprised 269 restored teeth in 111 children. Survival curves were similar for all materials (p =.20) and types of isolation (p =.05). The annual failure rate was 3.60% for glass ionomer cement, 1.23% for resin‐modified glass ionomer cement and 0.40% for composite resin. The following variables were associated with more failures: Class II restoration compared with Class I (HR = 1.96; 95%CI: 1.28–2.99, p <.001), proportion of decayed teeth (HR = 11.89; 95%CI: 2.80–50.57, p <.001) and child's age (HR = 1.17; 95%CI: 1.06–1.29, p <.001). Conclusion: The different materials and types of isolation had similar survival rates. Children with more decayed teeth have an increased risk of restoration failure. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusions Clinical Significance To map the evidence regarding the clinical performance of posterior restorations with bulk‐fill resin composites and identify research gaps.This mapping review was conducted following PRISMA‐ScR guidelines for scoping reviews, and its protocol was registered on the Open Science Framework platform. Systematic searches were conducted, considering studies published between 2013 and February 2024 in the PubMed, Embase, and Cochrane databases. Clinical studies investigating the performance of bulk‐fill resin composite restorations in class I and/or class II preparations with increments of 4 to 5 mm were included.A total of 147 articles were identified, and based on the eligibility criteria, 26 studies were selected for descriptive analysis. Of the reviewed studies, 73% (n = 19) investigated high‐viscosity bulk‐fill composites, while 30% (n = 8) focused on low‐viscosity bulk‐fill composites. Evaluation periods ranged from 1 week to 10 years. Reported annual failure rates varied from 0% to 3%, with survival rates between 78.9% and 100%.Bulk‐fill resin composites of high viscosity were the most analyzed in the published studies, with evaluation periods of up to 10 years. The review of available scientific evidence showed clinically acceptable performance for composite bulk‐fill restorations, with high survival rates and minimal annual failure rates. There is a need for long‐term clinical studies on bulk‐fill resin composites.This review demonstrates that both high and low‐viscosity bulk‐fill resin composites exhibit satisfactory clinical performance, which can help clinicians optimize chairside time. However, it is important to highlight the need for further studies with longer follow‐up periods. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the reasons for retreatment of dental restorations is crucial to preventing potential tooth failure. Due to limited information on retreatment causes in our region, this study aims to compare the factors leading to the failure of posterior amalgam and composite restorations. Materials & Methods: This cross-sectional, observational study was conducted on patients referred to the restorative department of Ilam Faculty of Dentistry and private clinics who required retreatment of existing posterior restorations. Failure criteria for posterior restorations were evaluated based on established reference guidelines. Results: The study found that secondary caries had an odds ratio (OR) of 3.08 (95% CI: 2.85 - 3.29; p < 0.001), indicating a strong association with restoration failure. Additionally, restoration fractures were significantly correlated with retreatment, with an adjusted OR of 2.50 (95% CI: 2.46-2.86; p < 0.001). Conclusion: Secondary caries emerged as the most common reason for retreatment, regardless of whether composite or amalgam materials were used. Restoration fractures also significantly contributed to the need for retreatment. Therefore, it is essential to consider factors such as restoration material, classification, and the number of restoration levels to reduce the likelihood of retreatment. [ABSTRACT FROM AUTHOR]

With the advancement of science over time, composite resins have undergone several scientific updates. Among these updates is the development of flow resins, characterized by high viscosity particles. But resins have some disadvantages, sunch as the formation of bubbles, a problem that was explored in this research. This article compared 4 different brands of flow resin (Opus Bulk Fill Flow Resin (FGM) - Filtek MR Bulk Fill Flowable (3M) - Tetric N-Flow Bulk Fill Resin and SDR Plus Bulk Fill Flowable Resin (DENSTPLY) took it under the microscope after applying these resins to laboratory prototypes, so that the formation of these bubbles can be evaluated more closely. As a result, it was possible to conclude that the Tetric N-Flow Bulk Fill brand resins are the flow composite resins that enable the formation of the smallest amount of bubbles in the process restorative. Tetric N-Flow Bulk Fill, due to its in vitro clinical performance superior to the competitors compared in this article, must be applied below the layer of conventional resin that will be used by the incremental technique with care in spatulation, so that formation can be avoided. of bubbles in a way that harms the restoration. [ABSTRACT FROM AUTHOR]

Ichraq Oulghazi, Amal El Yamani, Bouabid Morchad Prosthodontics Department, Mohammed V University, Rabat, MoroccoCorrespondence: Ichraq Oulghazi, Prosthodontics department, Mohammed V University, Rabat, 10112, Morocco, Tel +212707163587, Email ichraqoul98@gmail.comPurpose: The aim of this work is to conduct a literature review to highlight all the parameters involved in sub-prosthetic radicular fractures of teeth supported by metallic dental core.Materials and Methods: The following research was performed among published studies over the last 10 years in two PubMed/Medline and Scopus and supplemented by manual searching within the bibliographies. The search was restricted to publications in English and French.Results: Out of the 1464 articles initially identified, 18 studies met our inclusion criteria and were subsequently included in the literature review. These consisted of eight Finite Element Analysis Studies, two Retrospective Studies and one Randomized Controlled Trial. The results of this review show that radicular fractures are influenced by several variables, including predisposition, with maxillary premolars and mandibular molars being the most commonly affected teeth. Intracanal preparation can induce crack formation, leading to localized high stress concentrations. Increased ferrule height to 2 mm significantly enhances dental fracture resistance. Using high modulus of elasticity alloys results in nearly complete stress transmission to dentin due to their limited deformability and absorption capacity. The highest fracture resistance is achieved when posts are sealed using resin-modified glass-ionomer cement. Longer posts may be preferable to prevent vertical fractures. Additionally, occlusal factors, through repetitive stresses, contribute to crack propagation from surface defects, a phenomenon termed fatigue fracture.Conclusion: These findings have significant implications. Practitioners should be aware of the predisposition of certain teeth, the importance of preserving the ferrule effect, the choice of root post materials, post Cement Material and the role of occlusal forces in managing and preventing vertical root fractures.Keywords: endodontically treated teeth, root fracture, radicular fracture, tooth fracture, dental restoration failure, biomechanical factor, stress factor, cast post, metal post, post and core technique, dental posts, metallic coronoradicular restoration

Abstract Background While the concept of angled screw channels has gained popularity, there remains a scarcity of research concerning the torque loss and fracture strength of monolithic zirconia restorations with various screw channel angulations when exposed to thermomechanical cycling. This in-vitro study aimed to evaluate the reverse torque value and fracture resistance of one-piece screw-retained hybrid monolithic zirconia restorations with angulated screw channels after thermomechanical cycling. Methods One-piece monolithic zirconia restorations, with angulated screw channels set at 0°, 15°, and 25° (n = 6 per angulation) were fabricated and bonded to titanium inserts using a dual-cure adhesive resin cement. These assemblies were then screwed to implant fixtures embedded in acrylic resin using an omnigrip screwdriver, and reverse torque values were recorded before and after thermomechanical cycles. Additionally, fracture modes were assessed subsequent to the application of compressive load. One-way ANOVA and Bonferroni post hoc test were used to compare the groups (α = 0.05). Results The study groups were significantly different regarding the fracture resistance (P = 0.0015), but only insignificantly different in the mean percentage torque loss (P = 0.4400). Specifically, the fracture resistance of the 15° group was insignificantly higher compared to the 0° group (P = 0.9037), but significantly higher compared to the 25° group (P = 0.0051). Furthermore, the fracture resistance of the 0° group was significantly higher than that of the 25° group (P = 0.0114). Conclusions One-piece hybrid monolithic zirconia restorations with angulated screw channels can be considered an acceptable choice for angulated implants in esthetic areas, providing satisfactory fracture strength and torque loss.

The aim of this study was to assess whether immediate bone reconstruction after removal of a fractured dental implant in the posterior mandible provides a sound base for implant replacement, with a favourable treatment outcome and high patient satisfaction. Eight consecutive patients with a fractured implant neck were included. The implant was removed via osteotomy, following which the site was immediately repaired with a mixture of autogenous bone and bone substitute. After a 4-month healing period, sufficient bone and favourable soft tissue conditions were present, allowing implant placement with adequate primary stability. After a further 3 months, the implants were restored with an all-ceramic restoration. Patient satisfaction, the aesthetic outcome, complications, and postoperative morbidity were assessed using standardized clinical and radiographic examinations up to 5 years after crown placement. No implant failures were observed during the follow-up. Plaque accumulation, the presence of calculus, bleeding tendency, and peri-implant inflammation indices were low, indicating healthy peri-implant conditions. The mean marginal bone level change at the 5-year follow-up was − 0.17 ± 0.46 mm. All patients reported a high level of satisfaction (mean overall score 9.3 ± 0.5). In conclusion, immediate reconstruction of the hard tissue after removal of a fractured dental implant is a viable treatment option. This approach facilitates rehabilitation, reduces morbidity, and leads to favourable aesthetic outcomes. [ABSTRACT FROM AUTHOR]

PURPOSE. The study aims to investigate the influence of the ferrule effect and types of posts on the stress distribution in three morphological types of the maxillary central incisor. MATERIALS AND METHODS. Nine models were created for 3 maxillary central incisor morphology types: "Fat" type - crown 12.5 mm, root 13 mm, and buccolingual cervical diameter 7.5 mm, "Medium" type - crown 11 mm, root 14 mm, and buccolingual cervical diameter 6.5 mm, and "Slim" type - crown 9.5 mm, root 15 mm, and buccolingual cervical diameter 5.5 mm. Each model received an anatomical castable post-and-core or glass-fiber post with resin composite core and three ferrule heights (nonexistent, 1 mm, and 2 mm). Then, a load of 14 N was applied at the cingulum with a 45° slope to the long axis of the tooth. The Maximum Principal Stress and the Minimum Principal Stress were calculated in the root dentin, crown, and core. RESULTS. Higher tensile and compression stress values were observed in root dentin using the metallic post compared to the fiber post, being higher in the slim type maxillary central incisor than in the medium and fat types. Concerning the three anatomical types of maxillary central incisors, the slim type without ferrule height in mm presented the highest tensile stress in the dentin, for both types of metal and fiber posts. CONCLUSION. Post system and tooth morphology were able to modify the biomechanical response of restored endodontically-treated incisors, showing the importance of personalized dental treatment for each case. [ABSTRACT FROM AUTHOR]

Background: While the concept of angled screw channels has gained popularity, there remains a scarcity of research concerning the torque loss and fracture strength of monolithic zirconia restorations with various screw channel angulations when exposed to thermomechanical cycling. This in-vitro study aimed to evaluate the reverse torque value and fracture resistance of one-piece screw-retained hybrid monolithic zirconia restorations with angulated screw channels after thermomechanical cycling. Methods: One-piece monolithic zirconia restorations, with angulated screw channels set at 0°, 15°, and 25° (n = 6 per angulation) were fabricated and bonded to titanium inserts using a dual-cure adhesive resin cement. These assemblies were then screwed to implant fixtures embedded in acrylic resin using an omnigrip screwdriver, and reverse torque values were recorded before and after thermomechanical cycles. Additionally, fracture modes were assessed subsequent to the application of compressive load. One-way ANOVA and Bonferroni post hoc test were used to compare the groups (α = 0.05). Results: The study groups were significantly different regarding the fracture resistance (P = 0.0015), but only insignificantly different in the mean percentage torque loss (P = 0.4400). Specifically, the fracture resistance of the 15° group was insignificantly higher compared to the 0° group (P = 0.9037), but significantly higher compared to the 25° group (P = 0.0051). Furthermore, the fracture resistance of the 0° group was significantly higher than that of the 25° group (P = 0.0114). Conclusions: One-piece hybrid monolithic zirconia restorations with angulated screw channels can be considered an acceptable choice for angulated implants in esthetic areas, providing satisfactory fracture strength and torque loss. [ABSTRACT FROM AUTHOR]

In contemporary dental practice, clinicians have a variety of materials and options for restoring single teeth compromised by carious or non-carious diseases. According to studies and new concepts in biomimetic restorative dentistry, indirect ceramic restorations will play an increasingly important role in daily practice. We follow up and evaluate clinically three times over a 10-year period on eighty-six indirect restorations (n = 86) of lithium disilicate e.Max Press (Ivoclar, Schaan, Liechtenstein) in 32 patients. Restorations are evaluated in the 2nd, 5th, and 10th years after the fixation. Four of the restorations studied (n = 86) had to be replaced at year 5 follow-up because of fracture (failure rate: 4.65%; Kaplan–Maier). There are no restorations with bulky, cohesive fractures. Lithium disilicate ceramic restorations provide a good treatment alternative for a 5- to 10-year period of observation, and they can be successfully applied in dental practice in 91.73% to 98.84% of cases. Advancements in digital dentistry, including the use of intraoral scanners and CAD/CAM technology, are set to further refine the precision and efficiency of indirect restorations for distal teeth, enabling quicker turnaround times and improved fit. Additionally, ongoing developments in biomaterials promise to enhance the durability and biocompatibility of these restorations, potentially leading to better long-term success rates and patient satisfaction. The goal of this clinical study was to look at how well biomimetic ceramic overlays and onlays made of lithium disilicate held onto teeth with a IV-generation adhesive system for 10 years. The study also looked at how well the edges of the teeth adjusted and how strong the teeth were overall.

Introduction and Objective: Although the use of ceramic veneers is widespread, their failures are seldom reported. When fractures do occur, they are often related to treatment planning. This case report describes a 6.5-year follow-up of a restorative treatment involving ceramic laminate veneers on a patient with a nail-biting habit. Case report: After two restorations failed, repair with composite resin was chosen as an intermediary treatment, and the clinical steps until the ultimate replacement of the ceramics are described. Results and Conclusion: The repair resulted in postponing the restorations replacement for almost five years. It highlights that replacement does not need to be the first treatment option in cases of failures of feldspar ceramic laminate veneers. These failures may be managed conservatively with a composite resin repair, with the advantage of postponing the need for replacement. [ABSTRACT FROM AUTHOR]

Abstract Resin composites containing surface pre-reacted glass (S-PRG) have been introduced to reduce demineralization and improve remineralization of the tooth structure. However, water diffusion within the material is necessary for its action, which can impair its overall physicomechanical properties over time, including color stability. This study aimed to evaluate the color stability and related degree of conversion (DC) of four resin composites. Discs (6 x 4 mm, n = 5/group) of microhybrid (MH), nanofilled (NF), nanohybrid (NH), and S-PRG-based nanohybrid (S-PRG-NH) composites with two opacities (A2/A2E and A2O/A2D) were prepared. Color (CIELab and CIEDE2000) was evaluated with a spectrophotometer after aging in grape juice (2 x 10 min/10mL/7days). The DC was analyzed by using Fourier transform infrared spectroscopy before and after light-curing. Data were statistically analyzed by using two-way analysis of variance and post-hoc least significant difference tests (p

Teeth with altered size and shape, incisal wear, and inadequate position affect the smile and dentofacial harmony. The aim of this article was to describe a simple and safe protocol for an additive technique with composite resin and cosmetic enameloplasty to improve a patient's smile. A 24-year-old man complained about the appearance of his smile regarding color, shape, and position of the maxillary anterior teeth. Relevant dental history included previous orthodontic treatment with inadequate completion. The clinical examination revealed a disharmony of the smile caused by size and shape alterations of the incisors, a white spot on the right central incisor, incisal wear of the canines, and uneven incisal edges between the maxillary anterior teeth. Treatment with direct composite restoration and enameloplasty was performed in line with the current conservative approach in dentistry. The patient was recalled for 54 months. The use of appropriate techniques in enameloplasty allowed the desired outcome to be observed over the 54 months of follow-up. With this method, it is possible to perform future repair and/or modification, and it may increase the longevity of the restoration. Esthetic and functional results were achieved by careful planning and execution as well as periodic recalls. This conservative approach is a useful alternative to conventional restorations, reducing invasive treatments, chairside time, and costs. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the load-to-fracture of procedures changing crown-to-root ratio (RCRR) aimed to restore severely damaged upper central incisors to avoid tooth extraction compared to implant placement. There is no evidence on load capability after apical root resection (AR), orthodontic extrusion (OE), and surgical crown lengthening (SCL) in respect to RCRR, respectively. Material and methods: Human maxillary central incisors were endodontically treated, decoronated, and divided into 4 groups (n = 48). The following specimen preparation was performed: (I) adhesive core-and-post build-up (control), (II) as (I) and 2 mm apical root resection (AR), (III) before adhesive core-and-post build-up teeth were shortened 2 mm coronally (OE) (IV) as (I), but specimens were embedded 4 mm instead of 2 mm below the CEJ (SCL), group (V) implant-borne restoration with individual all-ceramic abutments (n = 12; ∅4.1/l = 12 mm) (IBR). All specimens received all-ceramic crowns, thermo-mechanical (TML), and subsequent linear loading (LL) until failure. RCRR were calculated and log-rank, Kruskal–Wallis, Mann–Whitney U, ANOVA, and chi-square tests applied (p = 0.05). Results: Fracture loads after subsequent LL differed significantly (p = 0.001) between groups, while implants showed the highest values. Fmax median (min/max) were as follows: (I) 252 (204/542), (II) 293 (243/443), (III) 253 (183/371), (IV) 195 (140/274), and (V) 446 (370/539). Pair-wise comparison showed significant differences (p = 0.001) between group I/IV and group V, I, and IV (p = 0.045), II and IV (p = 0.001), and III compared to IV (p = 0.033), respectively. RCRR below 1 significantly increased load capability compared to RCRR = 1. Conclusions: OE appears to preferably ensure biomechanical stability of teeth that are endodontically treated and receive core-and-post and crown placement compared to SCL. AR has no adverse biomechanical impact. RCRR < 1 is biomechanically beneficial. Clinical relevance: For endodontically treated and restored teeth, orthodontic extrusion should be preferred compared to surgical crown lengthening prior single-crown restoration. As orthodontic extrusion, apical root resection has no adverse effect on load capability. Single-crown implant-borne restorations are most load capable. [ABSTRACT FROM AUTHOR]

Despite the widespread use of titanium implants in orthopedic and dental surgeries, concerns have recently emerged regarding potential deformations and fractures after osseointegration. In a recent clinical case, a titanium implant fractured after successful osseointegration. This fracture occurred despite the absence of any significant trauma or excessive external force applied to the area. The fracture was attributed to a combination of factors, including abutment design flaws, material fatigue, and biomechanical stress imposed on the implant during functional loading. This raises concerns about the long-term durability and reliability of titanium implants, particularly in high-stress areas such as the posterior region or weight-bearing bones. An image was made with scanning electron microscopy showing the fracture region near the prosthetic platform and highlighting the knowledge that despite their ductility, titanium implants can fracture. [ABSTRACT FROM AUTHOR]

Abstract Objectives The term “cracked tooth” is used to describe an incomplete fracture initiated from the crown and progressing towards a subgingival direction. Despite the high prevalence of cracked teeth and their frequent association with symptoms and pulpal or periapical pathoses, there is still no consensus in the literature with regard to their restorative and endodontic management. Therefore, the aim of this narrative review was to evaluate the most relevant research and provide an up‐to‐date comprehensive overview regarding the treatment of cracked teeth. Materials and Methods An electronic literature search was carried out in MEDLINE (via Ovid), Embase (via Ovid), Scopus, and Web of Science as well as several “Grey literature” sources up to February 22nd 2022 using a combination of pre‐specified ‘free‐text' terms (keywords) and “subject headings.” The search process was supplemented by handsearching in relevant dental journals and reference lists. This narrative review focused on clinical follow‐up studies (observational or interventional studies, case series/reports), laboratory studies and systematic reviews written in English language that reported data on treatment of permanent cracked teeth. The selection of relevant studies was carried out by two reviewers (AK and DG) working independently in two consecutive stages: title/abstract screening and full‐text retrieval. Any discrepancies in the study selection were resolved by discussion between the reviewers. Results In total, 64 articles were selected for inclusion in this narrative review. Conclusions Cracked teeth with normal pulp or reversible pulpitis have exhibited high pulp and tooth survival rates by the provision of direct or indirect composite restorations. Besides, recent data favour monitoring, especially in the absence of symptoms or compromised tooth structure. When endodontic intervention is required, current evidence suggests that along with appropriate restorative management, outcomes of cracked teeth may be comparable to those of non‐cracked root filled teeth.

Introduction: This randomized clinical study aimed to evaluate the clinical performance of composite and compomer materials in primary molars over two years. Methods: Children aged five to six years with at least two carious proximal surface primary molars were screened for resin-hybrid composite (Kerr Herculite Classic) and compomer (Dyract XP and R&D Series Nova) restorations. The restorations were clinically evaluated after 3, 6, 9, 12, 15, 18, and 24 months using the modified United States Public Health Service criteria. Statistical analyses were performed using Chi-square, McNemar, z-tests, and Kaplan-Meier survival analysis. P0.05). No significant differences were observed between the three materials concerning retention, color matching, marginal discoloration, anatomic form, marginal integrity, secondary caries, and surface texture (P>0.05). No statistically significant differences were also found between the effects of the cavity type, the tooth position in the arch, the age of the patient, the restorative material, and the lining material on the survival rates of the teeth (P>0.05). Restoration loss was higher in males than females, and a statistically significant relationship was observed in terms of gender (P=0.017). Restoration loss in the first primary molars (8.3%) was greater than that in the second primary molars (6.7%) (P=0.041). Conclusion: Both composite and compomer restorations were clinically successful over two years.

Damage in the bonding interface is a significant factor that leads to premature failure of dental bonded restorations. The imperfectly bonded dentin-adhesive interface is susceptible to hydrolytic degradation and bacterial and enzyme attack, severely jeopardizing restorations' longevity. Developing caries around previously made restorations, also called "recurrent or secondary caries," is a significant health problem. The replacement of restorations is the most prevailing treatment in dental clinics, leading to the so-called "tooth death spiral". In other words, every time a restoration is replaced, more tooth tissue is removed, increasing the size of the restorations until the tooth is eventually lost. This process leads to high financial costs and detriment to patients' quality of life. Since the complexity of the oral cavity makes prevention a challenging task, novel strategies in Dental Materials and Operative fields are required. This article briefly overviews the physiological dentin substrate, features of dentin bonding, challenges and clinical relevance. We discussed the anatomy of the dental bonding interface, aspects of the degradation at the resin-dentin interface, extrinsic and intrinsic factors affecting dental bonding longevity, perspectives on resin and collagen degradation and how these subjects are connected. In this narrative review, we also outlined the recent progress in overcoming dental bonding challenges through bioinspiration, nanotechnology and advanced techniques to reduce degradation and improve dental bonding longevity. [ABSTRACT FROM AUTHOR]

Purpose: To report the performance of a repair service set for the retrieval of fractured screws and to compare three clinical assessments to an in vitro assessment to verify the completeness of removal of the fractured screws. Materials and Methods: Twelve clinicians were asked to remove fractured implant abutment screws from prepared specimens by means of a repair service set. The completeness of the removal of any abutment screw material was measured by the fit of an impression post, a dental surgery microscope, and the use of an elastomeric impression material. Results: After the participants attempted to remove the fractured screw with the repair service set, 100%, 83.3%, 66.7%, and 75% of the fractured screws were considered successful in the impression post, dental surgery microscope, silicone replica, and stereomicroscope assessments, respectively. Conclusion: The retrieval of fractured screws succeeded in 75% of the cases. The silicone replica technique and the dental surgery microscope had similar diagnostic values to the stereoscopic microscope assessment. [ABSTRACT FROM AUTHOR]

Objectives: To test if cigarette smoke (CS) causes discoloration of enamel, dentin, and composite resin restorations and induces color mismatch between dental hard tissues and the restorations, and to compare the findings with the effects of aerosol generated by the tobacco heating system (THS) 2.2. Method and materials: Twenty-two human premolars were prepared with Class V cavities restored with Filtek Supreme Ultra (3M Espe) composite resin. Teeth were divided into two groups and exposed to either CS from 20 reference cigarettes (3R4F) or aerosol from 20 THS 2.2 tobacco heat sticks 4 days a week for 3 weeks. CIE L*a*b* color was assessed before and after exposure and brushing at 1, 2, and 3 weeks. Color match, marginal discoloration, marginal integrity, and surface texture of the Class V restoration were assessed according to a modified US Public Health Service (USPHS) criterion. Results: Marked discoloration of enamel and dentin was observed following 3 weeks of CS exposure (ΔE = 8.8 ± 2.6 and 21.3 ± 4.4, respectively), and color mismatch occurred between the composite resin restorations (ΔE = 25.6 ± 3.8) and dental hard tissues. Discoloration was minimal in the enamel, dentin, and composite resin restorations in the THS 2.2 group, and no color mismatch was observed after 3 weeks of THS 2.2 aerosol exposure. Conclusion: CS causes significant tooth discoloration and induces color mismatch between dental hard tissues and composite resin restorations. Reducing or eliminating the deposits derived from tobacco combustion could minimize the impact of tobacco products on tooth discoloration. [ABSTRACT FROM AUTHOR]

Dental treatment after endodontic therapy is quite challenging in clinical practice. While multiple post-and-core systems emerged and disappeared in the dental field, the historical process was laborious and still requires several up to date scientific evidence. Furthermore, once considered the gold standard, rigid metallic post-and-cores might be considered a limited option. Moreover, the development of glass-fiber posts and the biomechanical principles for root preparation bring multiple advantages, but also raise concerns over guidelines and indications. This review examined the classic literature so that clinicians may understand the concepts behind post endodontic restorative treatments and the doubts that still remain in the daily practice before performing this restorative modality.

No evidence-based prosthetic treatment concept for 3-unit fixed-dental-prostheses (FDPs) on ceramic implants is currently available. Therefore, the aim of this in vitro study was to investigate the failure load and fatigue behavior of monolithic and bi-layer zirconia FDPs supported by one-piece ceramic implants. Eighty 3-unit FDPs supported by 160 zirconia-implants (ceramic.implant; vitaclinical) were divided into 4 groups (n = 20 each): Group Z-HT: 3Y-TZP monolithic-zirconia (Vita-YZ-HT); Group Z-ST: 4Y-TZP monolithic-zirconia (Vita-YZ-ST); Group FL: 3Y-TZP zirconia (Vita-YZ-HT) with facial-veneer (Vita-VM9); Group RL (Rapid-layer): PICN "table-top" (Vita-Enamic), 3Y-TZP-framework (Vita-YZ-HT). Half of the test samples (n = 10/group) were fatigued in a mouth-motion chewing-simulator (F = 98 N, 1.2 million-cycles) with simultaneous thermocycling (5–55 °C). All specimens (fatigued and non-fatigued) were afterwards exposed to single-load-to-failure-testing (Z010, Zwick). Statistical analysis was performed using ANOVA, Tukey's post-hoc tests and two-sample t-tests (p < 0.05, Bonferroni-corrected where appropriate). All specimens withstood fatigue application. While the effect of fatigue was not significant in any group (p = 0.714), the choice of material had a significant effect (p < 0.001). Material FL recorded the highest failure loads, followed by Z-ST, Z-HT and RL, both with and without fatigue application. Taken together, all tested FDP material combinations survived chewing forces that exceeded physiological levels. Bi-Layer FL and monolithic Z-ST showed the highest resilience and might serve as reliable prosthetic reconstruction concepts for 3-unit FDPs on ceramic implants. [ABSTRACT FROM AUTHOR]

Abstract Objectives This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. Methodology A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson’s Chi-square test were used (α=0.05) for statistical analysis. Results After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p

(1) Background: The paper addresses the computer simulation and prediction of the service life of the base of removable complete dentures (RCDs) under typical loads caused by biting and chewing food. For this purpose, the finite element method (FEM) was used. It is assumed that various blocks of teeth, such as incisors, canines, premolars and molars, are subjected to cyclic impacts during a human life. (2) Methods: Both symmetric and asymmetric mastication (two- and one-sided loads, respectively) cases were considered. The load level was assumed to be 100 N, which corresponds to the average muscular compression force of typical human jaws. (3) Results: The FEM analysis of the stress–strain state evolution for RCDs under cyclic loads was carried out. Maps of equivalent lines were drawn for the denture base in terms of its durability. A multi-axial criterion was implemented to determine the number of cycles prior to failure by the mechanism of a normal opening mode crack. The FEM-based assessment of the service life of RCDs enabled us to establish the critical stress concentration areas, thereby allowing for further planning for the correction of an occlusal scheme or teeth inclinations. As a result, the service life of RCDs under cyclic loading can be improved. (4) Conclusions: An algorithm for designing RCDs in the case of edentulism based on the FEM simulation using commercial software as part of the procedure is proposed. [ABSTRACT FROM AUTHOR]

Dental implant restoration is a predictable treatment option for replacing missing or damaged teeth. Conventional loading requires a prolonged treatment period and second surgical interventions. The aim of this study was to compare the clinical outcomes between immediate and non-immediate (early or conventional) loading in single-implant restorations. A literature search of the PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases was performed in January 2020. Only randomized clinical trials (RCTs) were included. The overall risk ratios (RRs), mean differences (MDs), and 95% confidence intervals (CIs) were used in the analyses. A total of 10 RCTs reporting on 423 patients were included. There was no significant difference in any of the outcomes of interest between the immediate and non-immediate loading cases: implant failure at the patient level (RR 1.29, 95% CI 0.35 to 4.78, P = 0.71), implant failure at the implant level (RR 1.19, 95% CI 0.40 to 3.51, P = 0.75), marginal bone loss (MD −0.04, 95% CI −0.16 to 0.08, P = 0.54). Subgroup analyses showed similar results. Immediate loading had predictable long-term clinical outcomes if the indicated patients were carefully selected. The influences of several technical factors need to be confirmed in additional clinical trials. [ABSTRACT FROM AUTHOR]

Restoration of structurally compromised endodontically treated teeth presents a great challenge due to associated high risk of fracture compared to vital teeth. The conventional invasive restoration techniques with a cast post and core followed by coronal prosthesis increase the risk of tooth fragilization and root fracture. To avoid this, a new alternative to reinforce structurally compromised posterior teeth with the use of fiber-reinforced composites has been developed, so as to replace dentin, improvise strength, and provide biomimetic restoration of teeth thereby alleviating the need of extensive prosthetic needs. The following case series elaborates the technique of reinforcing endodontically treated teeth with two different fiber-reinforced composites. [ABSTRACT FROM AUTHOR]

Objectives: The term "cracked tooth" is used to describe an incomplete fracture initiated from the crown and progressing towards a subgingival direction. Despite the high prevalence of cracked teeth and their frequent association with symptoms and pulpal or periapical pathoses, there is still no consensus in the literature with regard to their restorative and endodontic management. Therefore, the aim of this narrative review was to evaluate the most relevant research and provide an up‐to‐date comprehensive overview regarding the treatment of cracked teeth. Materials and Methods: An electronic literature search was carried out in MEDLINE (via Ovid), Embase (via Ovid), Scopus, and Web of Science as well as several "Grey literature" sources up to February 22nd 2022 using a combination of pre‐specified 'free‐text' terms (keywords) and "subject headings." The search process was supplemented by handsearching in relevant dental journals and reference lists. This narrative review focused on clinical follow‐up studies (observational or interventional studies, case series/reports), laboratory studies and systematic reviews written in English language that reported data on treatment of permanent cracked teeth. The selection of relevant studies was carried out by two reviewers (AK and DG) working independently in two consecutive stages: title/abstract screening and full‐text retrieval. Any discrepancies in the study selection were resolved by discussion between the reviewers. Results: In total, 64 articles were selected for inclusion in this narrative review. Conclusions: Cracked teeth with normal pulp or reversible pulpitis have exhibited high pulp and tooth survival rates by the provision of direct or indirect composite restorations. Besides, recent data favour monitoring, especially in the absence of symptoms or compromised tooth structure. When endodontic intervention is required, current evidence suggests that along with appropriate restorative management, outcomes of cracked teeth may be comparable to those of non‐cracked root filled teeth. [ABSTRACT FROM AUTHOR]

This study uses fracture tests and fractographical analysis to compare computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate molar crowns with the previous occlusal thickness recommendation of 1.5-mm, the new recommendation of 1.0-mm, and a less invasive thickness of 0.8-mm. After fatigue application, fracture tests and fractographic analysis were conducted. The fracture resistance of CAD/CAM lithium disilicate molar crowns was different depending on the occlusal thickness of the restoration, and decreased with lower the thickness. However, the fracture resistance of crowns of all three thicknesses exceeded the reported maximum bite force in the first molar region after the fatigue process, and can be considered acceptable for use in the clinic. [ABSTRACT FROM AUTHOR]

Introduction: This randomized clinical study aimed to evaluate the clinical performance of composite and compomer materials in primary molars over two years. Methods: Children aged five to six years with at least two carious proximal surface primary molars were screened for resin-hybrid composite (Kerr Herculite Classic) and compomer (Dyract XP and R&D Series Nova) restorations. The restorations were clinically evaluated after 3, 6, 9, 12, 15, 18, and 24 months using the modified United States Public Health Service criteria. Statistical analyses were performed using Chi-square, McNemar, z-tests, and Kaplan-Meier survival analysis. P<0.01 and P<0.05 values were considered statistically significant according to the test used. Results: The survival rates were 95.3% for Kerr Herculite Classic resin-based composite, 97.6% for Dyract XP, and 95.4% for R&D Series Nova compomer restorations with no statistically significant differences (P>0.05). No significant differences were observed between the three materials concerning retention, color matching, marginal discoloration, anatomic form, marginal integrity, secondary caries, and surface texture (P>0.05). No statistically significant differences were also found between the effects of the cavity type, the tooth position in the arch, the age of the patient, the restorative material, and the lining material on the survival rates of the teeth (P>0.05). Restoration loss was higher in males than females, and a statistically significant relationship was observed in terms of gender (P=0.017). Restoration loss in the first primary molars (8.3%) was greater than that in the second primary molars (6.7%) (P=0.041). Conclusion: Both composite and compomer restorations were clinically successful over two years. [ABSTRACT FROM AUTHOR]

The purpose of this study is to compare bond durability, in terms of fatigue bond strength, of a two-step HEMA-free universal adhesive and representative adhesives in each systematic category. The adhesives used in this study were OptiBond FL, Prime&Bond NT, Clearfil SE Bond 2, G2-Bond Universal, and Scotchbond Universal Plus Adhesive. Fatigue bond strength testing and scanning electron microscopy analysis of adhesively bonded enamel and dentin interfaces were performed. For the adhesives in etch-and-rinse mode, the enamel fatigue bond strength of the G2-Bond Universal adhesive was significantly higher than those of other adhesives, and the dentin fatigue bond strength of Prime&Bond NT was significantly lower than the others. For adhesives in self-etch mode, the enamel fatigue bond strengths of Clearfil SE Bond 2 and G2-Bond Universal were significantly higher than that of the Scotchbond Universal Plus Adhesive, and the dentin fatigue bond strength of G2-Bond Universal was significantly higher than Clearfil SE Bond 2 and the Scotchbond Universal Plus Adhesive. The two-step HEMA-free universal adhesive showed higher enamel and higher or equal dentin fatigue bond strength than other selected representative adhesive systems in etch-and-rinse mode and higher or equal enamel and higher dentin fatigue bond strength than adhesive systems in self-etch mode. [ABSTRACT FROM AUTHOR]

Objectives: The primary objective of this study was to compare implant survival rates (ISR) in patients undergoing maxillary sinus floor augmentation (MSFA) with lateral approach with and without membrane perforation. Secondary objectives were to establish the percentage of perforations in these procedures and to evaluate the influence of perforation size on ISR., Materials and Methods: This retrospective study included patients requiring MSFA with lateral approach. Cases were assigned to two groups according to the occurrence or not of perforation. The exact size of each perforation was registered. Descriptive statistics and associations between the groups were calculated., Results: This study analyzed data from 90 MSFA in 72 patients. Membrane perforation occurred in 24.44%. A total of 170 implants were placed; 72.35% were placed under intact membranes and 27.65% on repaired membranes. The overall ISR in MSFA procedures with intact membranes was 98.37%, and 93.62% in perforated membranes. No statistically significant relationship between groups was observed although the odds of implant failure increased by 4.125 times when perforation occurred. In turn, no statistically significant relationship was observed between perforation size and ISR., Conclusions: Implants inserted below repaired membranes had a lower ISR compared with implants inserted below intact membranes although the difference was not statistically significant. Moreover, no significant statistical correlation was observed between perforation size and ISR., Clinical Relevance: Membrane perforation does not have a significant influence on subsequent implant survival rates. Knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Various types of crowns are used for full-coverage restoration of primary teeth affected by caries, developmental defects, or after pulp therapy. Prefabricated Stainless Steel and Zirconia crowns are commonly utilized. Bioflx crowns, which blend the properties of Stainless Steel and Zirconia, provide a flexible and aesthetically pleasing alternative., Aim: This study aimed to evaluate the vertical marginal gap and fracture resistance of Bioflx pediatric crowns compared to Zirconia and Stainless Steel crowns following thermomechanical aging., Methods: This in-vitro study was conducted using mandibular second primary crowns of three different materials (n = 30). Crowns were divided into three groups; Zirconia crowns group (n = 10, Nu Smile, USA), Bioflx crowns group (n = 10, Nu Smile, USA) and Stainless Steel crowns group (n = 10, Nu Smile, USA). The crowns were cemented onto standardized acrylic resin dies and subjected to thermomechanical aging. Vertical marginal gap measurements were obtained using a USB digital microscope with an integrated camera, while fracture resistance was assessed with a universal testing machine. Data were analyzed for outliers and tested for normality using the Shapiro-Wilk or Kolmogorov-Smirnov tests, with statistical significance set at 0.05., Results: Significant differences were observed in the vertical marginal gaps among the groups after cementation and thermomechanical aging (P = 0.013 and P = 0.001, respectively). Zirconia crowns exhibited the largest average marginal gap, followed by Bioflx and Stainless Steel crowns. Stainless steel crowns demonstrated the highest fracture resistance, followed by Bioflx crowns, while Zirconia crowns showed the lowest., Conclusions: Bioflx crowns exhibit the largest vertical marginal gap but show greater fracture resistance compared to Zirconia crowns, although they are still less resistant than Stainless Steel crowns after undergoing thermomechanical aging., (© 2024. The Author(s).)

Aim: to compare two-year clinical success rates of caries management in children (Hall Technique HT, Nonrestorative caries treatment NRCT, Conventional restorations CR), and to evaluate pain perception, behaviour, technique acceptability by patients, parents and dentists., Methods: 122, 3-8-year-olds were enrolled in 2-year parallel group randomised controlled trial (CR, n = 52, HT, n = 35, NRCT, n = 35). Caries was recorded using Nyvad criteria to measure clinical success/ failure rates. Child's pain perception (Visual Analogue Scale of Faces), child behaviour (Frankl scale), parents' and dentists' treatment opinions (5-point Likert scale) were assessed. Statistical analysis included Chi-square, non-parametric Kruskal-Wallis, Bonferroni-corrected Mann-Whitney U tests (p < 0.05), absolute risk reduction (ARR) and number needed to treat (NNT)., Results: After two years, with 116 participants, clinical success rates were: CR=60.8 % (n = 31), HT=93.8 % (n = 30), NRCT=42.5 % (n = 14) (p < 0.001). Major/minor failure rates differed: CR=17.6 % (n = 9) / 21.6 % (n = 11); HT=6.2 % (n = 2)/ 0 %, NRCT=33.3 % (n = 11)/ 24.2 % (n = 8), (p < 0.05). When comparing HT to CR, ARR = 0.33; NNT= 3 (95 % CI 0.02 -0.58); NRCT to CR, - no observed benefit from NRCT. More than 70 % of children demonstrated "positive/definitely positive" behaviour during treatment. Pain intensity was "very low/low" in 92.3 % of cases for CR, 88.6 % for HT, and 77.1 % for NRCT . NRCT was "very easy" to perform for 82.9 % of participants, compared to 42.3 % for CR and 17.1 % for HT (p < 0.05). CR were reported to take longer than NRCT and HT (p < 0.05)., Conclusion: Clinical success rates of HT were superior to CR and NRCT. All treatment techniques were well tolerated by children, CR was more time-consuming and HT - technically more difficult to perform., Clinical Significance: caries management in primary molars can be successfully performed using minimal intervention, particularly, sealing in caries lesions with Hall technique. NRCT can prevent caries progression when adequate access to mechanical plaque disruption and fluoride is provided. However, occasional fluoride application, and uncontrolled toothbrushing with fluoride toothpaste cannot replace restorative procedures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: There is a paucity of data on the outcome of fixed tooth- and implant-supported porcelain-fused-to-metal (PFM) and ceramic-based (CB) restorations fabricated during undergraduate dental education. Therefore, this retrospective study examined the outcome of fixed restorations placed in patients participating in an undergraduate program., Methods: Patient records were searched for data on fixed PFM and CB restorations. For these restorations, the functional period in situ and technical and biological complications, namely restoration fracture, decementation, screw loosening, secondary caries, and loss of vitality, were recorded. Periodontal parameters were also documented. Kaplan-Meier survival and complication estimates after 1 and 5 years were calculated for restoration types, materials, designs (veneered/non-veneered), cementation/retention modes and localizations with group sizes ≥ 15. Regression models were used to analyze the influence of demographic data and abovementioned restoration characteristics on restoration survival, technical and biological outcome., Results: 1196 restorations with a mean observation time of 5 years were included in the analysis. The different restoration types exhibited survival rates of > 90.8% after 5 years, accompanied by a favorable biological outcome. However, monolithic resin-matrix or feldspathic ceramic restorations were found to have a higher fracture rate than lithium disilicate or zirconium dioxide ceramic restorations resulting in lower survival rates for these restorations. Additionally, resin-matrix ceramic restorations showed a higher decementation rate than lithium disilicate restorations., Conclusions: Fixed tooth- and implant-supported CB restorations fabricated from lithium disilicate and zirconium dioxide ceramics demonstrated better survival and lower complication rates than restorations fabricated from resin-matrix or feldspathic ceramics in an undergraduate dental education program., Clinical Significance: Due to the more favorable outcome of CB restorations fabricated from lithium disilicate or zirconium dioxide ceramics, undergraduate dental education should focus on the application of these ceramics to increase restoration survival by reducing technical complications., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: To assess the clinical performance of monolithic screw-retained implant-supported zirconia crowns (MSI) bonded or mechanically retained on prefabricated Ti-bases using a complete digital workflow., Methods: A retrospective analysis was conducted on patients who underwent single dental implant procedures between January 2017 and May 2018. Inclusion criteria were: patients over 18 years of age; implants placed in posterior sites; MSI on prefabricated Ti-base realized by using a complete digital workflow; a minimum follow-up period of 2 years. Cemented crowns and fixed dental prosthesis were excluded. Mechanical complications included: fracture of Ti-base; loss of retention; loosening of Ti-base screws. Technical complications included: fracture and debonding of monolithic zirconia. Biological complication was set strictly at a probing pocket depth of 5 mm and bleeding on probing or pus secretion., Results: A total of 144 dental implants placed in 127 patients were included, 73 with a fully tapered implant system (BLX) and 71 with a conical connection system (Nobel Parallel CC). Of the 73 BLX implants, 4 experienced loosening of the Ti-base screw, while 3 Nobel Parallel CC implants experienced the same problem. In addition, 4 fractures of the Ti-base and 6 fractures of the inner surface of the monolithic zirconia were observed in the Nobel Parallel CC implants. Cumulative survival was 100 % for bonded crowns and 85 % for mechanically retained crowns. Radiographic evaluation revealed a mean CBL of 0.12 mm for the BLX and 0.13 mm for the Nobel Parallel CC implants with no statistically significant differences between the Ti-base types. There was no evidence of bleeding on probing or pus secretion. All probing pocket depths were <3 mm., Conclusion: The use of a prefabricated Ti-base remains a clinically acceptable choice, however, MSIs bonded to prefabricated Ti-bases had fewer mechanical and technical complications than the MSI mechanically retained to a prefabricated Ti-base., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: This systematic review attempted to assess patient acceptance of repairs instead of complete replacement for partially defective restorations and to identify factors affecting patients' decision-making for or against repairs., Study Selection: Observational and qualitative studies reporting on (1) the proportion of patients accepting or preferring repairs, (2) the proportion of dentists / dental students / dental schools stating that their patients accept or prefer repairs, (3) factors affecting patients' decision-making for or against repairs., Sources: Electronic databases (MEDLINE via PubMed, Scopus, EMBASE via Ovid, and Web of Science) were last searched in August 2024 (PROSPERO database: CRD42023449437)., Data: Twenty-one sources reporting on 20 survey studies addressing individual dentists / dental students and dental schools were included. None of the included studies directly addressed patients (e.g., by interviewing patients). Of the surveyed dentists and dental students, 86.3 % (95 %-CI: 77.8-91.8 %) reported that their patients accept or prefer repairs. Dental schools rated patient acceptance as high as 93.0 % (95 %-CI: 82.3-97.4 %). None of the included studies reported factors affecting patients' decision-making for or against repairs., Conclusions: Repairs of partially defective restorations instead of complete replacement seem to be associated with a high level of patient acceptance as most dentists, dental students, and dental schools stated that their patients accept or even prefer repairs instead of complete replacement., Clinical Significance: Within the shared decision-making process, dentists can expect their patients to accept or even prefer repairs instead of complete replacement., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Statement of Problem: Cementation is one of the most critical steps that influence the failure rates of indirect restorations. Self-adhesive resin cements arose out of the need for technical simplification of this procedure to reduce the risk of operative errors, with good acceptance by clinicians. How the failure rate of indirect single-tooth restorations cemented with self-adhesive resin cements compares with the failure rate of those cemented conventionally is unclear., Purpose: The purpose of this systematic review and meta-analysis of randomized clinical trials was to compare self-adhesive resin cements versus conventional cements on the failure rates of indirect restorations., Material and Methods: The review was registered at the International Prospective Register of Systematic Reviews (PROSPERO - CRD42020215577). The search strategy was adapted for 5 databases (PubMed, The Cochrane Library, EMBASE, Web of Science, and LILACS) and 1 nonpeer-reviewed literature source (clinicaltrials.gov). The strategy was guided by the problem/population, intervention, comparison, outcome (PICO) question: adults indicated for indirect restorations -P, self-adhesive resin cement -I, conventional cement-C, failure rates-O. The risk of bias was assessed using the Cochrane risk of bias (RoB2) tool and guidelines. Meta-analysis merged the results from included studies by pooling the hazard ratios and standard errors, available or estimated. The certainty of evidence was assessed by using the classification of recommendations, evaluation, development, and evaluation (GRADE) approach., Results: Nine randomized clinical trials were included in qualitative and quantitative analysis. Eight studies detected nonsignificant differences in failure rates between cements. Only 1 study reported a significantly higher failure rate on single-tooth ceramic crowns luted with self-adhesive resin cement. Nonsignificant differences were detected after the results from all studies had been pooled., Conclusions: Based on clinical evidence, self-adhesive resin cements can be recommended for the cementation of indirect single-tooth restorations with a similar risk of failure to conventional cements., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Knowledge on the biomechanical behavior of glass-ceramics, their survival rate over time, and their potential failures is essential for decision-making in clinical practice. Systematic reviews and meta-analysis of their survival rates and irreparable failures are lacking., Purpose: The purpose of this systematic review and meta-analysis was to evaluate the survival rates and irreparable failures of various monolithic glass-ceramic dental restorations to help determine biomechanical indications., Material and Methods: A comprehensive literature search was conducted across the PubMed, Scopus, Web of Science, and EMBASE databases based on the population, intervention, comparison, and outcome (PICO) question, risk of bias assessment, data extraction, subgroup analysis, and meta-analysis. Both randomized and nonrandomized clinical trials that reported survival rate and irreparable failure were screened. The risk, with a 95% confidence interval, was calculated by using the Mantel-Haenszel method., Results: A total of 46 articles met the inclusion criteria: 8 for laminate veneers, 20 for partial coverage restorations, 11 for single crowns, and 6 for fixed partial dentures, encompassing 1715 participants rehabilitated with 4209 restorations. The estimated cumulative survival rate for partial coverage restorations was 90% over an average span of 6.2 years, with an irreparable failure occurrence of n=5.9. Laminate veneers had a survival rate of 90.2% over 6.5 years, with an irreparable failure occurrence of n=8.2. Single crowns had a survival rate of 96% over 4.6 years and an irreparable failure of n=2.7. Conversely, fixed partial dentures had a survival rate of 76.1% over 6.5 years with an irreparable failure of n=5.2., Conclusions: Glass-ceramic materials demonstrate relatively high survival rates, indicating that they provide a safe and reliable option for partial coverage restorations, laminate veneers, and single crowns. However, fixed partial dentures had a higher proportion of irreparable failures and a lower survival rate, and caution is required., (Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Technical complication rates of standard metal-ceramic implant-supported posterior restorations are relatively high. Whether monolithic zirconia crowns represent a more successful alternative is unclear., Purpose: The purpose of this systematic review and meta-analysis was to compare the clinical outcomes of posterior monolithic zirconia and metal-ceramic implant-supported single crowns., Material and Methods: A search was conducted in MEDLINE, Scopus, Embase, Web of Science, and CENTRAL databases for randomized controlled trials up to April 2023 with a follow-up time of at least 1 year. Restoration and implant survival and failure rates, marginal bone loss (MBL), bleeding on probing (BOP), and technical complications were analyzed by 2 reviewers. Statistical analyses were conducted using the R-statistics software program. The risk of bias was assessed by the Cochrane Risk of Bias Tool 2 (RoB 2), and the certainty of evidence by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach., Results: A total of 11 out of 2030 records were identified by title and abstract, and 4 records were included after full-text analysis. The statistical analysis revealed no significant difference in MBL (MD -0.11, 95% CI: [-0.25; 0.03]), BOP (OR 0.66, 95% CI: [0.25; 1.77]), or implant failure (OR 1.30, 95% CI: [0.24; 7.08]). Monolithic zirconia presented significantly less chipping over 1 year (OR 0.17, 95% CI: [0.03; 0.99]). The chipping rate was 0% for monolithic zirconia and 7.61% for metal-ceramic. Based on a narrative review, the restoration survival rate was 97.5% in the monolithic zirconia group and 99.1% in the metal-ceramic group., Conclusions: Monolithic zirconia showed favorable short-term survival rates and had significantly less chipping over 1 year. Regarding MBL, BOP, and failure rates, both restoration types presented similar results at the 1-year follow-up., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Paediatric-preformed zirconia crowns have been associated with several issues, primarily their inability to be crimped and the need for extensive tooth preparation. Additionally, the capacity to adjust the size, shape, and fit of these crowns is very limited., Aim: To evaluate and compare the fracture strength of four different types of dental crowns intended for paediatric patients., Design: The fracture resistance of four types of paediatric crowns was evaluated using the universal testing machine; freshly extracted primary molars received one of the following: preformed zirconia crowns, custom-made computer-aided design and computer-aided manufacturing (CAD-CAM) zirconia crowns, custom-made CAD-CAM ceramic crowns, and custom-made CAD-CAM hybrid composite crowns. Data were statistically compared using the Kruskal-Wallis test followed by the Bonferroni test, and the level of significance was set at 5%., Results: Results showed that there was a statistically significant difference among the four groups (p < .001). The highest value of fracture force was observed for the milled zirconia crown and the lowest for the prefabricated zirconia., Conclusion: The implementation of the CAD-CAM digital crown fabrication technique has the potential to address issues associated with preformed crowns in paediatric patients, particularly in terms of fracture resistance., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)

Statement of Problem: Because the use of zirconia in dentistry is relatively new, the number of published studies on the subject is scarce, even though material selection is an important factor in clinical performance. Therefore, a systematic assessment of the impact of the prosthetic material, framework design, veneering material, and manufacturing process is required., Purpose: The purpose of this systematic review and meta-analysis was to investigate the survival and success rates of feldspathic porcelain veneered zirconia (VZir) in comparison with monolithic zirconia (MZir) complete arch implant-supported prostheses (CAISPs). A secondary objective was to assess the influence of the type of loading, the presence or absence of a cantilever, the type of zirconia used, the location, and the opposing arch on complications rates and patient satisfaction., Material and Methods: An electronic search of the MEDLINE database (via PubMed), Scopus, Science Direct, Cochrane Library, and OpenGrey was carried out. The criteria described in the preferred reporting items for systematic reviews and meta-analyses statement were used. The search was restricted from January 2000 to January 2022., Results: The systematic search resulted in 20 articles that met the established criteria. In total, 751 patients (VZir=302; MZir=449) with 3038 CAISPs (VZir=368; MZir=2670) were analyzed. Higher prosthetic survival and success rates were found in MZir compared with VZir CAISPs (100% and 95.45%, respectively). The meta-analysis found significantly fewer complications related to MZir (9.4% [4.8%-14.1%]) compared with VZir (33.7% [17.5%-49.9%])., Conclusions: Based on the findings of this systematic review, MZir CAISPs had higher survival and success rates than VZir CAISPs, with significantly fewer prosthetic complications. The influence of factors such as the type of functional loading, the presence of a cantilever, the material used in the prosthodontic workflow, the location of the CAISP, and the type of antagonist arch on the performance of Zir CAISPs remains unclear., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: The use of tilted implants has been considered a suitable option for completely edentulous patients. However, consensus on their clinical performance is lacking, specifically for partial rehabilitation., Purpose: The purpose of this systematic review and meta-analysis was to evaluate the marginal bone loss and implant survival rate of tilted implants compared with those of axial implants for implant-supported fixed partial dentures (ISFPDs)., Material and Methods: A systematic search of the MEDLINE/PubMed, Web of Science, Embase, Cochrane, and ProQuest databases and reference lists for articles published until May 2022 was performed by 2 independent reviewers without language or publication date restrictions. A meta-analysis was performed using the RevMan version 5.4 program. Quality assessments were performed using the Newcastle-Ottawa scale., Results: Nine studies were included, totaling 258 participants and 604 implants (269 tilted implants and 335 axial implants). No significant differences were found between the tilted and axial implants for the implant survival rate (P=.81; risk ratio: 1.14). However, higher marginal bone loss values were observed for tilted implants (P=.001; mean difference: 0.12 mm). No significant heterogeneity was observed in either analysis., Conclusions: No significant relationship was found between tilted and axial implants for ISFPD rehabilitation. However, tilted implants presented greater risks of marginal bone loss than axial implants., (Copyright © 2022 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Abutment screw fracture is a mechanical complication associated with the failure of dental implant-supported restorations. Retrieval of fractured abutment screws without damaging the internal surface of implants is challenging and can be time-consuming. Microtube extraction devices are used to remove separated endodontic instruments. This article presents a conservative method of retrieving a fractured implant abutment screw using a microtube device., (Copyright © 2022 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: The present in vitro study aimed to evaluate the fatigue behavior of teeth filled with a calcium silicate-based sealer (Bio-C Sealer, BC) or an epoxy resin-based sealer (AH Plus, AH), in bulk or associated with gutta-percha as main core material., Methods: Seventy-two sound human maxillary anterior teeth were initially selected. Sixty of them, were randomly chosen, and had their root canals prepared using nickel-titanium reciprocating instruments, being again randomly assigned to five experimental groups ( n = 12): C+ (control + prepared but not filled); BC-B (BC in bulk); BC-GP (BC+ gutta-percha); AP-B (AH in bulk); AP-GP (AH+ gutta-percha). An additional negative control group (C-) was considered ( n = 12), consisting only on sound teeth, without preparation and filling. The specimens were submitted to a survival analysis after the cyclic fatigue test., Results: Sound teeth (C-) presented the best fatigue performance ( P < 0.05), being similar only to the AP-GP group ( P > 0.05). Despite that, all experimental groups showed similar fatigue behavior ( P > 0.05) to C+ (BC-B = BC-GP = AP-B = AP-GP = C+). Based on that, it can be seen that the use of gutta-percha, as a main core material, associated with the AH Plus sealer, reestablished the mechanical fatigue performance of endodontically treated teeth comparable to sound teeth, still consisting on the most promising approach to rehabilitate such scenario. Teeth filled in bulk, had discreetly higher risk of premature failures and inferior fatigue performance., Competing Interests: João Tribst is an Academic Editor for PeerJ., (© 2024 Lena et al.)