Repair versus Replacement of Defective Direct Dental Restorations: A Multinational Cross-sectional Study with Meta-Analysis.

OBJECTIVES: When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore international preferences for repair procedures and the clinical steps taken during the repair process. METHOD: An 11-question survey was distributed to dentists across 21 countries via different platforms. The survey comprised two sections: the first included five questions aimed at gathering demographic information, while the second consisted of six questions focusing on participants' practices related to the repair of composite or amalgam restorations A meta-analysis was employed to ascertain the pooled odds ratio of repairing versus replacement. The statistical analysis was carried out using the RevMan 5.3 program and forest plots were generated using the same program to visualize the results. RESULTS: The survey was completed by 3680 dental practitioners. The results indicated a strong tendency to repair defective composite restorations (OR: 14.23; 95% CI: 7.40, 27.35, p<0.001). In terms of amalgam, there was a significant tendency to replace the restorations (OR: 0.19; 95% CI: 0.12, 0.30, p<0.001). When repairing restorations, the most common protocols were etching with orthophosphoric acid and creating an enamel bevel, regardless of the restorative material used. CONCLUSION: The findings of this study indicate that there exists a knowledge gap among dental practitioners regarding restoration repair. It is imperative that dental practitioners receive proper education and training on restoration repair, to ensure the usage of adequate protocols and restoration survival.

Role of individual and combined impact of simvastatin and α-TCP in rat calvarial bone defect: An experimental study.

Background: Bone substitutes have been used by doctors for a long time to treat osseous abnormalities. Recently, scientists have been searching for suitable materials to replace bone. Autogenous bone grafts are considered the gold standard for osseous regeneration. However, the limited availability of intraoral sources for grafting material often requires the use of secondary donor sites. Aim: This study aims to compare a control group of standard critical bone defect models treated without any bone transplants to critical size calvarial bony defects treated with various bone replacements, including simvastatin and α-tricalcium phosphate, while analyzing the healing patterns. Materials and Methods: In this investigation, 24 Wistar Albino rats weighing 200-250 g were utilized. The study included four groups, each consisting of six rats. Group I utilized deproteinized bovine xenograft, Group II used Simvastatin (0.1 mg), Group III used Simvastatin (0.1 mg) plus TCP, and Group IV served as the untreated calvarial defects group. After eight weeks of testing, the rats were euthanized, and the calvaria were extracted, decalcified in 20% formic acid, and prepared for histological analysis. Results: The newly produced osseous tissue consisted of woven and lamellar bone, which was observed in all deformities. The mean widths of new bone development in the SIMV with α-TCP (Group III) group after XENO (Group I) and the control group with no graft implantation were 160.33 ± 16.2 µm, 110.59 ± 11.5 µm, and 50.83 ± 5.5 µm, respectively. However, these differences did not show statistical significance (p > 0.05). Conclusions: The quantity and quality of newly produced osseous tissue were comparable in α-TCP with SIMV and XENO. However, inflammatory infiltration was 8more pronounced in regions where SIMV was present alone compared to the combination group.

The Antibacterial Effectiveness of Citrullus lanatus-Mediated Stannous Nanoparticles on Streptococcus mutans.

Introduction Dental caries is a prevalent oral health issue caused by the colonization of Streptococcus mutans in the oral cavity. Citrullus lanatus, commonly known as watermelon, is rich in bioactive compounds that possess antibacterial potential. In this study, we aimed to synthesize stannous chloride (SnCl2) nanoparticles (NPs) mediated by Citrullus lanatus extract and investigate their antibacterial effectiveness against Streptococcus mutans. Materials and method Stannous nanoparticles (SnNPs) synthesized by the green method were achieved by using the watermelon extract. Dilute stannous chloride solution was obtained by adding 0.45 g of stannous (Sn) chloride (Cl) powder to 60 mL of water, which was subjected to an orbital shaker with the watermelon extract. The nanoparticles obtained were subjected to characterization using antimicrobial testing, Fourier transform infrared (FTIR) spectroscopy, energy-dispersive X-ray (EDAX) analysis, and scanning electron microscopy (SEM). Agar well diffusion method was used against specific strains of S. aureus, S. mutans, and Escherichia coli. Results The novel nanoparticles demonstrated promising antibacterial activity against S. mutans providing 10 mm of inhibitory action. Conclusion Due to its abundance of naturally occurring bioactive chemicals and improved efficacy against S. mutans, watermelon extract can be utilized to create stannous nanoparticles as opposed to the use of toxic chemicals. They can also be employed as oral administration systems.

Factors Affecting the Decision-making of Direct Pulp Capping Procedures among Dental Practitioners: A Multinational Survey from 16 Countries with Meta-analysis.

INTRODUCTION: Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had 3 purposes: (1) to investigate the factors that affect clinicians' decisions in DPC cases, (2) to determine which method of caries removal is preferred, and (3) to evaluate the preferred capping material for DPC. METHODS: The questionnaire comprised 3 sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure, and patients' age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. RESULTS: A tendency toward more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR = 2.86, 95% CI: 2.46, 2.32; P < .001) as opposed to the clinical scenario with 2 pulp exposures (RR = 1.38, 95% CI: 1.24, 1.53; P < .001). Complete caries removal was significantly preferred to selective caries removal (RR = 4.59, 95% CI: 3.70, 5.69; P < .001). Among the capping materials, calcium silicate-based materials were preferred over calcium hydroxide-based materials (RR = 0.58, 95% CI: 0.44, 0.76; P < .05). CONCLUSIONS: While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of calcium silicate-based materials appears to have replaced calcium hydroxide-based materials.

The effect of surface treatments of tooth on the shear bond strength of direct composite veneers: An in vitro scanning electron microscope study.

Background: The bond strength between tooth structure and restorative materials is critical for the long-term success of dental restorations. This study sought to determine how the shear bond strength (SBS) and type of bond breakdown were affected by the inclusion of sandblasting (SB) as a conditioning step before acid etching (AE). Materials and Methods: A total of 40 extracted human molars were split into two groups at random: intervention (SB followed by AE) and control (AE only). Composite resin cylinders were constructed on the tooth surface following the application of the bonding agent. A universal testing device was used to determine the SBS, and scanning electron microscopy was used to assess the kind of bond failure. Results: In comparison to the control group, the intervention group displayed a significantly higher SBS (P < 0.05). In contrast to the control group, which showed more adhesive failure at the tooth-resin interface, the intervention group also demonstrated a larger percentage of cohesive failure within the composite resin. Conclusion: As an extra conditioning step, AE after SB considerably increased the SBS between tooth structure and composite resin. The fact that the intervention group experienced a higher percentage of cohesive failure shows that this technique could boost the bond's longevity.

Endodontic retreatment efficacy with and without solvents: A systematic review.

Introduction: This systematic review investigates the crucial need for solvent use in root canal retreatment, as it effectively removes filling materials, reduces apical debris extrusion, and alleviates postoperative pain, ultimately enhancing treatment success. The review aims to assess the success rates, compare outcomes, explore benefits and drawbacks, and identify subgroups where solvent use may be more effective during root canal retreatment. Materials and Methods: The search was performed in PubMed Central, Scopus, Cochrane, LILAC, ScienceDirect, Google Search, Web of Science, and manually using the search items alone and in combination by means of PUBMED search builder. The studies were assessed for eligibility according to the eligibility criteria by two independent reviewers. Groups containing solvent with nonsolvent groups and randomized control trials were included and in vitro studies, retrospective studies, and animal studies were excluded from the study. Quality assessment was performed using the risk of bias (RoB) 2.0 tool. Results: Out of the 596 articles obtained, 14 were shortlisted for full-text reading and finally two articles were included in the study. The studies were assessed for quality, and data were extracted in a tabulated form. Overall RoB is low, but due to the lack of homogeneity, meta-analysis could not be conducted. Conclusion: The use of solvent does not cause any significant difference in the postoperative pain levels or analgesic intake for retrieval of gutta-percha in cases of root canal retreatment. Due to the limited number of studies available and the lack of clinician-related outcomes such as time taken to retrieve the gutta-percha, these results should be taken into consideration with caution.