Current trends in placing posterior composite restorations: Perspectives from Palestinian general dentists: A questionnair study.

Aim: The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of Palestinian general dental practitioners in placing posterior composites, examining the impact of work sector, experience, and gender on their choices. Materials and Methods: The study was conducted as an online cross-sectional questionnaire and involved 351 participants, with a response rate of 69.8%. The survey comprised 18 closed-ended questions covering demographics, material selection, and composite placement in special cases, techniques, and factors influencing the choices. Statistical analyses included descriptive statistics, chi-squared tests, and Fisher's exact tests. Results: Composite was the predominant choice for small-size (83.7%) and large-size posterior cavities (60.4%). Practitioners commonly opted for composite restorations in cases involving occlusal parafunctional activity (60%), poor oral hygiene (78%), and subgingival cavities (72.2%). Only 19.6% and 5.3% reported occlusal and gingival beveling, respectively. Rubber dams for isolation stood at 30%, one-step self-etch adhesives at 44.9%, and the oblique layering technique at 51%. Light-emitting diode curing units were popular (97.55%), but monitoring output with a radiometer was infrequent (93.5%). Tofflemire metal matrix usage was 46.1%, whereas a sectional matrix system was employed by 29.8%. A 2 mm layer exposure to light curing for 20 s was reported by 62%, and 27.75% utilized additional light-curing postmatrix band removal. Conclusion: The study highlights the need for Palestinian dental professionals to update their clinical approaches in placing composite restorations in posterior teeth. Gender, work sector, and experience influence practitioners' choices, emphasizing the importance of tailored continuing education programs for improving clinical practices.

The Classification and Selection of Adhesive Agents; an Overview for the General Dentist.

Adhesive agents are essential to most restorative procedures used in everyday practice. Depending on the clinical situation, the dentist will choose among a rapidly evolving variety of adhesive agents (bonding agents). Due to the availability of many adhesive agents, appropriate selection can take time and effort. Typically, a practitioner relies more on marketing and experience than in-depth material knowledge. The classification of adhesive agents may need to be clarified and easier to remember due to its lack of relevance to clinical procedures. This paper reviews the published literature retrieved from PubMed, Google Scholar, and Scopus by using specific keywords "adhesive agents", "classification", "dentin", "enamel", "universal", "self-etch", "etch-and-rinse", and "bonding". The titles and abstracts were screened, and the relevant literature was retrieved. The list of references from each identified article was examined to find other potentially relevant articles. Adhesive agents can be classified as etch-and-rinse, self-etch, or "multi-mode" according to their approach to interacting with the smear layer, and each approach can be further classified according to the number of clinical steps required during application. This article reviews the classification of current adhesive agents and discusses the properties that make a specific adhesive agent the optimal choice for a particular clinical indication. The review will assist the general dentist in understanding the various types of available adhesive agents and how they function. Overall, the review will facilitate decision-making and allow the selection of appropriate materials.

Restorative treatment decisions regarding approximal and occlusal carious lesions among general dental practitioners in Palestine

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

Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material.

Root canal treatment has been the treatment of choice for carious pulp exposures. In the perspective of minimally invasive dentistry and preventive endodontics, a direct pulp capping procedure with a reliable bioactive material may be considered an alternative approach provided that the pulp status is favorable. However, the treatment of pulp exposure by pulp capping is still a controversial issue with no clear literature available on this topic, leaving the concerned practitioner more confused than satisfied. Biodentine is a relatively new bioactive material explored for vital pulp therapy procedures. This article discusses its role in direct pulp capping procedures. A thorough literature search of the database was done using PubMed, Google Scholar, and Scopus using the keywords preventive endodontics, calcium silicate cement, direct pulp capping, Biodentine, and vital pulp therapy. Reference mining of the articles that were identified was used to locate other papers and enrich the findings. No limits were imposed on the year of publication, but only articles in English were considered. This paper is aimed at reviewing the current literature on Biodentine as a direct pulp capping material. The review will provide a better understanding of Biodentine's properties and can aid in the decision-making process for maintaining the vitality of exposed dental pulp with minimal intervention.

Cavity Bases Revisited.

OBJECTIVE: The aim of this paper was to review the current literature on cavity bases while focusing on the role of zinc oxide eugenol (ZOE) and resin-modified glass ionomers (RMGI) as cavity bases. MATERIALS AND METHODS: A thorough literature search between 1970 and 2020 was done using Scopus, PubMed, and Google Scholar databases. The keywords of the search strategy were as below: cavity liners and bases, pulp protection, zinc oxide eugenol, and resin-modified glass ionomer. No specific inclusion or exclusion criteria were applied as to what articles would be included in this review. CONCLUSION: This review emphasizes that the available literature provides very little evidence to support the routine use of a base under amalgam or composite restorations. This review favors the adoption of "no more lining or bases" in shallow and moderate cavity preparations. However, an exception might be a "protective base" of RMGI following the application of calcium hydroxide (CH) liners in deep cavities. Bonded RMGIs are suitable cavity base materials and should always replace zinc oxide eugenol bases in daily practice.

Knowledge and Attitudes of Dentists toward Adhesive System Selection: A Cross-sectional Study from Palestine.

AIM: The aim of this study was to determine the attitudes and knowledge of dentists in Palestine toward selecting adhesive agents for different clinical procedures and to investigate whether the time of clinical practice influences their choices. MATERIALS AND METHODS: A questionnaire was randomly sent by e-mail to 500 dentists registered with the Palestinian Dental Association. The questionnaire consisted of nine close-ended questions. The first two questions focused on demographics, whereas the other questions aimed to evaluate the respondents' knowledge toward selecting adhesive agents for different restorative procedures. STATISTICAL TEST USED: Statistical analysis was carried out using the Statistical Package for the Social Sciences software, version 16.0 (IBM, Armonk, New York). Descriptive analysis was obtained and the frequency of distribution was calculated in percentages. Nonparametric chi-square test was used to analyze the difference in the distribution of the preference of different bonding choices overall for every treatment scenario. Fisher's exact test with the Monte Carlo method was used to verify the association between the adhesive agent of choice and years of experience. RESULTS: The response rate was 74%. The respondents' choices were significantly different in all suggested treatment procedures (P < 0.05). A correlation was found between time since graduation and the choice of adhesive agent (P < 0.05). CONCLUSION: Irrespective of restorative treatment scenario, respondents' selection of adhesive agents diverged from recommendations made by the literature. Further efforts should be made to improve the level of knowledge of general dentists on this topic.

Supernumerary Teeth: A Retrospective Cross-Sectional Study from Palestine

Abstract Objective: To investigate the prevalence and characteristics of supernumerary teeth among patients attending the students' dental clinics at the Faculty of Dentistry of the Arab American University, Jenin, Palestine. Material and Methods: This is a descriptive, cross-sectional, retrospective study of 1970 digital panoramic radiographs of patients, age ranging between 12 and 50 years. The radiographs and dental records were reviewed for supernumerary teeth. For each patient with supernumerary teeth, were recorded the demographic variables, number, location, eruption status, type, and morphology, the developmental stages. Descriptive statistics were performed and results were tabulated. Results: Supernumerary teeth were detected in 17 subjects (0.86%), of which 13 were males and 4 were females with a male to female ratio of 3.25:1. Of the 17 patients, 64.7% had one supernumerary tooth while the others had two. The majority (78.3%) of the supernumeraries were located in the maxilla. Around 56.5% of the supernumeraries found in this study were located in the premaxilla. Half of the supernumeraries (52.2%) were erupted, and 47.8% were impacted. Mesiodens was the most frequently seen supernumerary teeth followed by distomolars and premolars. Most of the supernumeraries were fully developed, while 21.7% displayed only crown formation. Conclusion: The prevalence of supernumerary teeth in the study sample was found to be 0.86% and the most frequent type was mesiodens. Supplemental morphology was found to be the most common form of supernumerary teeth.

TheraCal LC: From Biochemical and Bioactive Properties to Clinical Applications.

BACKGROUND: Direct pulp capping is a popular treatment modality among dentists. TheraCal LC is a calcium silicate-based material that is designed as a direct/indirect pulp capping material. The material might be very attractive for clinicians because of its ease of handling. Unlike other calcium silicate-based materials, TheraCal LC is resin-based and does not require any conditioning of the dentine surface. The material can be bonded with different types of adhesives directly after application. There has been considerable research performed on this material since its launching; however, there are no review articles that collates information and data obtained from these studies. This review discusses the various characteristics of the material with the aim of establishing a better understanding for its clinical use. METHODS: A search was conducted using search engines (PubMed and Cochrane databases) in addition to reference mining of the articles that was used to locate other papers. The process of searching for the relevant studies was performed using the keywords pulp protection, pulp capping, TheraCal, and calcium silicates. Only articles in English published in peer-reviewed journals were included in the review. CONCLUSION: This review underlines the fact that further in vitro and in vivo studies are required before TheraCal LC can be used as a direct pulp capping material.

Maxillary lateral incisor agenesis; a retrospective cross-sectional study.

OBJECTIVE: This study aims to estimate the prevalence of congenitally missing lateral incisors in a sample of 2662 dental patients in Palestine. METHODS: A total of 2662 digital panoramic radiographs were retrospectively examined for the presence of congenitally missing permanent lateral incisors. The radiographs were obtained from the archival records of patients attending a local dental center at the city of Nablus in Palestine. RESULTS: The prevalence of missing lateral incisors among the examined population (n = 2662) was found to be 1.91%. Unilateral agenesis accounted for 66.6% of the total cases that showed at least one missing lateral incisor. Around 79% of the unilateral cases were on the left side while 21% were on the right side. Bilateral agenesis accounted for 33.3% of 34 cases that had at least one congenitally missing permanent maxillary lateral incisor. CONCLUSION: The prevalence of missing maxillary lateral incisors in this study population was 1.91%) which was within the range reported in different populations.

Calcium hydroxide liners: a literature review.

OBJECTIVE: This review integrates the literature on cavity liners and current concepts of pulp protection with the aim of establishing a better understanding of the role of calcium hydroxide as a cavity liner. MATERIALS AND METHODS: A search was conducted through PubMed, MEDLINE, and Ovid for articles with the criteria for the following terms: cavity liners and bases, pulp protection, and calcium hydroxide liners. No specific inclusion or exclusion criteria were applied as to what articles would be included in this review. It was hoped that the extent of the literature reviewed would be as comprehensive as possible. CONCLUSION: This review underlines the fact that calcium hydroxide liners should only be used in the deepest spots in the cavity where the remaining dentine thickness is ≤0.5 mm. A protective layer of resin-modified glass ionomer should always follow the application of calcium hydroxide liners.