Comparative evaluation of aesthetic outcome of direct polychromatic composite layering and the "index cut-back technique" for restoring class IV defects using a newly patented simulated 3D printed mould: An in vitro study.

Aim: The Purpose of This In-Vitro Study Was to Comparatively Evaluate the Aesthetic Outcome Of Direct Polychromatic Layering Of Anterior Composites Restoration With The "Index Cut-Back" Technique While Restoring Class IV Defects of Teeth. Methodology: An extracted tooth specimen of maxillary central incisor crown was 3-D scanned for obtaining its dimensions, these dimensions were transferred to AUTOCAD™ software and a customised 3-D Printed mould was fabricated (Temporary Patent no. 336763-001 ). 50 specimens of Maxillary Central Incisor Crowns were then constructed with the help of Composite restorative material (Palfique Estelite LX5, Tokuyama Dental Corporation, Japan) in this mould. Afterwards with the help of a Straight fissure diamond bur a standardized size (4 cm length x 4 cm width) class IV defect was created on all 50 specimens and then they were allocated to 2 groups, Group A & B. 25 specimens for each Group (N = 25). Group A was restored using conventional Direct Polychromatic Layering technique and Group B was restored using the "Index cut-back" Technique. Shade Outcome and Translucency were evaluated using Spectrophotometer and Time taken was evaluated using a stop-watch chair side. Results: There was a significant difference in the values (P < .05) between Group A (Polychromatic) & Group B (Index cut-back) in terms of both Shade Outcome & Translucency; Group B showed better aesthetic values (closer to baseline) than Group A. In contrast, Time required for restoring the Class IV defects was significantly lower in Group A compared to Group B (P < .05). Conclusion: The Index Cut-Back Technique showed superior aesthetic outcome restoring Class IV defects, however it requires a planned pre-operative course of action before executing the clinical procedure.

A 1-year comparative evaluation of clinical performance of conventional direct composite restoration technique with a novel "custom shield" technique in class I compound lesions - A randomized clinical study.

Aim: The aim of the study is to evaluate and compare the 1-year clinical performance of conventional direct composite restoration technique with a novel "custom shield" technique in class I compound lesions. Subjects and Methods: After ethical approval, 72 patients who signed the informed consent form participated in the study. They were divided into two groups - Group A: Conventional direct composite restoration (n = 36) and Group B: Composite restoration using custom shield technique (n = 36) by computer randomization. In Group A, composite restoration was performed by the incremental layering technique. In Group B, restoration was performed using a novel custom shield and occlusal stamp along with the incremental layering technique. Patients were evaluated using the modified USPHS criteria by blinded evaluators for 1 year. Statistical Analysis: Chi-square test and Friedman test using SPSS version 21.0. Results: A statistically significant difference was obtained for marginal adaptation (P = 0.024), retention (P = 0.23), surface texture, and anatomic form (P < 0.001), and time taken to perform the procedure for Group B was higher than Group A. Conclusion: Conventional composite restoration and custom shield technique can be successfully used in class I compound lesions with custom shield technique having a higher edge over the conventional technique.

Comparative Evaluation of Two Different Fiber-Reinforced Composite Materials in Class 1 Post-Endodontic Restorations in Molars-A Randomized Clinical Study.

This study aimed to evaluate and compare two different fiber-reinforced composite materials in class I post-endodontic restoration in molars. A total of 50 patients were randomly assigned into two groups (n = 25 for each group); group A: everX Posterior (packable composite) with a top layer of solareX (nano-hybrid composite) and group B: everX Flow (flowable composite) with a top layer of G-aenial universal injectable (flowable composite). Patients were evaluated immediately after the procedure (baseline), at 6 months, and at 1 year time intervals based on the modified USPHS criteria. The statistical analysis using a chi-square test showed no statistically significant difference in the clinical performance of group A and group B. Clinical performance of the combination of everX Flow with overlying G-aenial universal injectable composite proved to be comparable with everX Posterior with overlying solareX composite as post-endodontic restorations in class I lesions in permanent molars.

A 1-year comparative evaluation of clinical performance of nanohybrid composite with Activa™ bioactive composite in Class II carious lesion: A randomized control study.

AIM: The aim of this study was to compare and evaluate the clinical performance of nanohybrid composite with Activa™ bioactive composites in Class II carious lesion. METHODOLOGY: After ethical approval, patients were selected according to the inclusion-exclusion criteria with minimum of two carious lesions in a single patient. Lesions were randomly divided into two groups: Group A - nanohybrid composite and Group B - Activa™ bioactive composite. After administration of local anesthetic agent, Class II cavity preparation was done followed by rubber dam application. For deep lesion, pulp protection was done with light-cured calcium hydroxide. Then, the cavities were restored. Finishing and polishing were done. Evaluation of the restorations was done at 1 week, 6 months, and 1 year time interval by second-blinded examiner according to the modified USPHS criteria. The results of the study were tabulated, and statistical analysis was done. RESULTS: The results showed no statistically significant difference in the clinical performance of nanohybrid composite and Activa™ bioactive composites in Class II carious lesions at the end of 1 week, 6 months, and 1 year. CONCLUSION: It can be concluded that both materials showed equal and acceptable clinical performance at the end of 1 year. Both materials can be successfully be used to restore Class II carious lesions.

Comparison of apical sealing and periapical extrusion of the ThermaFil obturation technique with and without MTA as an apical barrier: an in vitro study.

AIM: The aim of the study was to compare the conventional ThermaFil obturation technique and ThermaFil obturation with mineral trioxide aggregate (MTA) as an apical barrier, with regard to apical sealing and extrusion. MATERIALS AND METHODS: Twenty extracted human canines were instrumented using a crown-down technique and divided into two groups. The experimental group was obturated using ThermaFil obturation with MTA as an apical barrier and the control group was obturated using the conventional ThermaFil obturation technique. AH Plus sealer was used in both the groups. Apical extrusion was recorded. Teeth of both the groups were coated with nail polish, except for the apical 3 mm. After 24 h, they were suspended in black India ink for 48 h. Canines were decalcified, rendered transparent, and linear dye penetration was measured under ×40 stereomicroscope. RESULTS: There was a significant extrusion noticed in conventional ThermaFil obturation technique. Frequency of extrusion of sealer and/or gutta-percha was supposed to be evaluated using χ² test, but since the values of the samples of ThermaFil plus MTA group were zero, statistical analysis could not be conducted, whereas linear dye leakage was calculated with Mann-Whitney U test because the distribution was abnormal. CONCLUSION: Although ThermaFil plus MTA group showed microleakage, extrusion of sealer and the core material was prevented in comparison with conventional ThermaFil obturation technique. It is advantageous to use MTA as an apical plug as there is no fear of apical extrusion and the root canal system can then be packed three dimensionally against this barrier using any thermoplasticized gutta-percha obturation technique.