Two-year performance of CAD/CAM fabricated resin composite inlay restorations: A randomized controlled clinical trial.

OBJECTIVE: The aim of this study was to evaluate the 2-year clinical performance of computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite inlay restorations in comparison with direct resin composite restorations. MATERIALS AND METHODS: In 44 patients, 120 class II (mesio-occlusal/disto-occlusal) cavities were randomly assigned into two groups; CAD/CAM resin composite inlay group (Lava Ultimate), direct resin composite group (Clearfil Majesty Posterior). Clinical evaluations were performed after 1 week, 6 months, 1 year, and 2 years according to the FDI criteria. The data were analyzed using Friedman's ANOVA and Mann-Whitney U tests (α = .05). RESULTS: In 41 patients, 114 restorations were evaluated at the second year (recall rate 93.2%). All restorations were ideal or clinically acceptable. At the first year, considering all criteria, there were no statistically significant differences between the groups. However, there was a significant difference in terms of surface luster at second year, in favor of inlay restorations (P = .015). The marginal staining of resin composites increased after 2 years (P = .046), but there was no significant difference between the groups. CONCLUSIONS: Except the surface luster, 2-year clinical performance of CAD/CAM resin composite inlay restorations was found similar to direct resin composite restorations according to FDI criteria CLINICAL SIGNIFICANCE: The clinical performance of CAD/CAM resin composite inlays was acceptable in class II cavities subsequent to 2-year evaluation.

Effects of different antibacterial agents on enamel in a biofilm caries model.

Using a mature biofilm model, the aim of this study was to evaluate the effectiveness of different antibacterial agents in comparison with silver diamine fluoride (SDF). Forty-eight saliva-coated enamel slabs were inoculated with Streptococcus mutans monospecies biofilm. The biofilms were then exposed to 10% sucrose in tryptone yeast-extract culture medium, 8 times per day for 7 days. After the biofilm growth period, the enamel slabs were treated with one of the following substances: 1) distilled water; 2) SDF; 3) acidulated phosphate fluoride (APF); 4) ammonium hexafluorosilicate (AHF); 5) ammonium hexafluorosilicate + cetylpyridinium chloride (AHF+CPC); or 6) 0.2% chlorhexidine (CHX). After these treatment procedures, the samples were incubated at 37ºC for 2 days, and the numbers of viable microorganisms in the biofilms were counted. The number of viable bacteria was significantly reduced by all of the antibacterial agents (P < 0.05). However, SDF showed the highest antibacterial activity (P < 0.05), and the effectiveness of the other agents was lower (P < 0.05). SDF has a highly effective antibacterial action against cariogenic Streptococcus mutans biofilm; none of the other fluoride agents used in this study, or 0.2 CHX agent, showed an antibacterial effect comparable to that of SDF.