Clinical effectiveness of direct resin composite restorations bonded using one-step or two-step self-etch adhesive systems: A three-year multicenter study.

The purpose of this multicenter clinical study was to compare the mid-term clinical effectiveness of direct resin composite restorations using one-step or two-step self-etch adhesives (1-SEAs or 2-SEAs). In total, 352 restorations of class I-V cavities and non-carious cervical lesions in vital teeth (1-SEAs; 52 cases, 2-SEAs; 300 cases) were placed at nine university hospitals and evaluated according to the modified USPHS criteria at baseline, and after 1, 2, and 3 years. The recall rates were 86.6% (1 year), 80.1% (2 years), and 62.2% (3 years). Two restorations failed due to fracture during the follow-up, and there was no significant difference in survival rates between 1-SEAs (97.6%) and 2-SEAs (99.4%). However, 2-SEAs exhibited significantly lower occurrences of discoloration, marginal discoloration, fracture, and plaque retention. Moreover, the subjects reported a significantly lower postoperative hypersensitivity and higher overall satisfaction at all evaluation periods if 2-SEAs were used.

The effect of additional photochemical treatments on the bonding of silanized CAD/CAM ceramic restorations after water-storage.

The development of dental CAD/CAM system has made metal-free ceramic restorations more available to patients. Silane coupling treatment is an essential clinical process to achieve reliable and good adhesion with silica-based indirect restoratives. However, long-term water-storage causes the hydrolysis of silane coupling agents and decreases the bond strength. The aim of this study was to examine the effect of additional treatments including photochemical treatments on silane coupling performance in ceramic restorations. The influence of water-storage periods (1d: one day, 1m: one month, and 3m: three months) for the silanized surface of CAD/CAM ceramic restorations was also investigated. In addition, bonding reliability was evaluated as a qualitative measure in order to characterize the bond strength of CAD/CAM restorations. The micro-tensile bond strength (µ-TBS) was measured to explore the benefits of additional photochemical treatments (UV: ultraviolet and VL: visible light irradiations) on silanized surfaces, compared to non-additional treated (CO) and dry heating (DR) conditions. In the CO specimens, µ-TBS decreased in the order of 1d > 1m > 3m. However, in DR, UV, and VL additional treatments, no significant differences could be observed in the 1d, 1m, and 3m groups. The Weibull modulus and 10% failure probability values of the UV and VL specimens were inclined to be significantly greater than those of CO specimens, regardless of the water-storage period. These findings reveal that additional photochemical treatments had a successful effect to improve the bond strength and bonding reliability of the CAD/CAM restorations, when compared to CO and DR conditions.

A report on the clinical use of bonding systems for coronal restorations produced from CAD/CAM resin blocks.

Computer-aided design and manufacturing (CAD/CAM) resin-produced restorations were approved by a health insurance system in Japan from the year 2014. In this study, we investigated the use of CAD/CAM resin blocks in Japan since 2014, and the clinical use of adhesive systems for CAD/CAM resin-produced restorations in dentistry. Our findings indicated a rise in the clinical application of these products; however, some studies have reported instances of debonding and fracture of the restorations. CAD/CAM resin blocks were implemented in the health insurance system in Japan as an alternative for alloys due to the continuous rise in the prices of gold and palladium. Thus, in order to reduce the number of failures in CAD/CAM resin-produced restorations due to debonding and fracture, the integration of these restorations with the tooth structures is of utmost importance.

Importance of interim restorations in the molar region.

Interim restoration protects abutment teeth and periodontal tissues until prosthetic treatment ends with the fabrication of a definitive prosthesis, restores and maintains the functions and morphology of the stomatognathic system, and preserves the occlusal contact relationship. Temporary prostheses are used for a short time, to confirm the diagnosis and treatment plan. However, because interim restorations are used only briefly, their importance in ensuring the success of definitive prostheses is often overlooked. This review includes a comprehensive literature review of interim restoration of molars and summarizes the current clinical understanding and status of this functionally important area. Peer-reviewed publications were identified by searching PubMed in November 2018. An interim restoration, even when used briefly, can help dentists evaluate many aspects of the treatment plan and contribute to accurate prognosis of prosthetic treatment.

Effect of immediate dentin sealing applications on bonding of CAD/CAM ceramic onlay restoration.

The effects of immediate dentin sealing (IDS) applications on the bonding of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic onlay restorations after cyclic loading were examined. Standardized mesial-distal-occlusal-palatal cavities in 32 extracted human molars were prepared. The cavities were divided into four groups: those receiving thin-layered (T), slope-shaped (S), and base-shaped (B) sealing, and the non-sealing group (N) as a control. The intra-cavity dentin walls of the T, S, and B groups were sealed with an all-in-one adhesive and a flowable composite. All cavities were scanned; hence, CAD/CAM onlays were fabricated using ceramic blocks and bonded with a resin cement system. Cyclic loading was applied and the microtensile bond strength (µ-TBS) was measured. It was found that IDS application improved not only the µ-TBS, but also the bonding reliability and durability of the CAD/CAM restoration. In particular, the S restoration exhibited the highest-performance as regards both robust bond strength and stable bonding.

Concept and clinical application of the resin-coating technique for indirect restorations.

The resin-coating technique is one of the successful bonding techniques used for the indirect restorations. The dentin surfaces exposed after cavity preparation are coated with a thin film of a coating material or a dentin bonding system combined with a flowable composite resin. Resin coating can minimize pulp irritation and improve the bond strength between a resin cement and tooth structures. The technique can also be applied to endodontically treated teeth, resulting in prevention of coronal leakage of the restorations. Application of a resin coating to root surface provides the additional benefit of preventing root caries in elderly patients. Therefore, the coating materials have the potential to reinforce sound tooth ("Super Tooth" formation), leading to preservation of maximum tooth structures.

Bonding state of metal-free CAD/CAM onlay restoration after cyclic loading with and without immediate dentin sealing.

To examine the bonding state of metal-free CAD/CAM onlay restorations made from two popular resin composite blocks and a typical glass-ceramic block after cyclic loading, with and without immediate dentin sealing (IDS). Standardized mesial-distal-occlusalbuccal (MODB) cavities in 24 extracted human molars were prepared. The intra-cavity dentin surfaces of half of the cavities were immediately sealed with all-in-one adhesive and flowable composite, while those of the other half were not. All cavities were scanned, from which CAD/CAM onlays were fabricated from three types of block and cemented with an adhesive resin cement system. The restored specimens were subjected to cyclic loading and the intra-cavity microtensile bond strength was measured. IDS improves not only the internal bond strength, but also the bond reliability of metal-free CAD/CAM onlay restorations. The resin composite block seems to be more effective than a typical glass-ceramic block for achieving both high bond strength and excellent bond reliability.

Bonding of flowable resin composite restorations to class 1 occlusal cavities with and without cyclic load stress.

To examine the bonding of flowable resin composite restorations (F-restoration) to class 1 occlusal cavities with and without cyclic load stress, compared with that of a universal resin composite restoration (U-restoration). Two flowable composites and one universal composite (control) were applied with an adhesive system to 42 standardized class 1 occlusal cavities. The restored specimens were subjected to cyclic load stress and no stress modes. The microtensile bond strength (µ-TBS) of the dentin floor was measured. The U-restoration did not show pretesting failure. The F-restorations exhibited pretesting failure, regardless of the stress mode. The µ-TBS was not significantly different among the three restorations, regardless of the stress mode. The cyclic load stress did not influence the µ-TBS of the F-restorations; however, it significantly reduced µ-TBS in the U-restoration. The bonding reliability of the F-restorations was inferior to that of the U-restoration, for both stress modes.

Symmetry of non-carious cervical lesions in canines and premolars.

OBJECTIVES: Clinically non-carious cervical lesions (NCCLs) are frequently seen. The aim of this study was to investigate the relationship between the shape and symmetry of NCCLs, wear of cuSPS and triangular ridge, and the curvature of the tooth root. METHODS: One hundred and twenty-nine extracted human upper canine teeth and 274 extracted human upper premolar teeth with NCCLs were used in this study. The specimens were studied using photographs and three-dimensional scanning. RESULTS: Asymmetric NCCL was observed in 69.0% of the canines and 44.5% of the premolars. Wear of cusp and lingual ridges was observed in 82.9% and 93.0% of the canines, respectively. Wear of the buccal cusp and buccal triangular ridge was observed in 85.4% and 89.8% of the premolars, respectively. On the other hand, the wear of lingual cusp and lingual triangular ridge was observed in 89.1% and 93.8% of the premolars, respectively. The curvature of the root was observed in 48.1% of the canines and 43.4% of the premolars. CONCLUSIONS: There was no relationship between the symmetry of NCCLs, and the wear of cuSPS and triangular ridges for either canines or premolars. Although there was a relationship (p < 0.05) between the symmetry of NCCL and the curvature of the root in the canines, no relationship was observed between the symmetry of NCCL and the curvature of the root in the premolars.