A carbon calculator: the development of a user-friendly greenhouse gas measuring tool for general dental practice (Part 2).

The need to reduce carbon emissions and limit global warming to 1.5 °C has spurred various sectors towards net-zero emission goals. This paper introduces a specialised carbon calculator for dental practices to compute and monitor their carbon footprints (CFPs). The carbon calculator is developed using recent carbon modelling, utilising methodologies and data from estimating the average NHS dental practice's CFP. It employs both spend-based and activity-based carbon accounting methods, simplifying carbon emission estimation. It offers dental practices a user-friendly, rudimentary, cost-free tool to determine their baseline CFP and track sustainability progress. It includes conversion factors for patient travel, procurement and waste management, enabling practices to input data and generate personalised CFP charts. It also acknowledges assumptions and uncertainties related to procurement and waste management, emphasising the availability of personalised consultancy services for more precise carbon footprinting. This carbon calculator supports environmental sustainability in dental practices as an accessible starting point. By raising awareness of their CFP, it encourages progress in 'green dentistry' and promotes environmental responsibility in oral healthcare. The calculator is freely downloadable and part of a broader 'green dentistry' initiative. Continuous carbon emission measurement and monitoring are crucial for a sustainable future, with this tool aiding dental practitioners in their environmental contributions.

What's New in Dentine Bonding?: Universal Adhesives.

The ability to bond restorations to dentine successfully is central to minimally invasive restorative dentistry. While dentine-bonding agents have gone through a variety of 'generations', it is the purpose of this paper to describe the latest dentine-bonding agents, the Universal Bonding Agents. These materials may be considered 'Universal' insofar as they may be considered to be capable of being used for direct and indirect dentistry, as well as being suitable for use in whichever etching modality the clinician considers appropriate, namely self-etch, etch and rinse or selective enamel etch. Laboratory investigations and initial clinical studies hold the promise that Universal Bonding Agents are a forward step in the quest for the ultimate bond to tooth substance. Clinical relevance: New Universal Bonding Agents appear to present a promising advance in bonding to dentine.

Five Year Clinical Evaluation of Restorations Placed in a Low Shrinkage Stress Composite in UK General Dental Practices.

This paper evaluates the five year clinical evaluation of restorations formed in a low shrinkage stress resin composite material (3M ESPE Filtek Silorane, Seefeld, Germany) and placed in the general dental practices of five members of the PREP Panel, a group of UK practice-based researchers. Results indicated satisfactory performance of the material under evaluation, other than for marginal staining, which affected 60% of the restorations evaluated after five years, albeit with less than 10% of the circumference of the restorations being affected. CLINICAL RELEVANCE: The low shrinkage stress material, Filtek Silorane™, demonstrated good clinical performance in the majority of parameters which were assessed at five years.

Minimally Invasive Long-Term Management of Direct Restorations: the '5 Rs'.

The assessment and operative long-term management of direct restorations is a complex and controversial subject in conservative dentistry. Employing a minimally invasive (MI) approach helps preserve natural tooth structure and maintain endodontic health for as long as possible during the restorative cycle. This paper discusses how minimally invasive techniques may be applied practically to reviewing, resealing, refurbishing, repairing or replacing deteriorating/failed direct coronal restorations (the'5 Rs') and provides an update of contemporary MI clinical procedures. CPD/CLINICAL RELEVANCE: The assessment and long-term clinical management of deteriorating/failing direct restorations is a major component of the general dental practice workload and NHS UK budget expenditure for operative dentistry.

The minimally invasive management of early occlusal caries: a practical guide.

Pits and fissures on the occlusal surfaces of posterior teeth are sites affected commonly by demineralisation caused by the caries process. Clinicians face daily challenges in detecting these lesions, accurately diagnosing their activity and choosing from a range of management options. Traditionally, the detection of an active (or potentially active) occlusal lesion invariably resulted in the preparation of a standardised occlusal cavity, often extending beyond the confines of diseased tissue, followed by the insertion of a direct restorative material, most commonly dental amalgam. The overwhelming weight of contemporary evidence now favours minimally invasive (MI) operative management when required (usually after non-operative prevention has failed), and a wide range of equipment, materials and operative techniques is available to help operators to preserve the maximum amount of healthy/repairable tooth tissue and to allow restoration with more biologically respectful, tooth-preserving materials. This paper aims to provide clinicians with practical guidance in the prevention, early detection, predictable diagnosis and minimally invasive management of early occlusal carious lesions.

Dental materials--what goes where? Class I and II cavities.

UNLABELLED: Dental amalgam has helped maintain dental public health in the developed world for over a century. However, its days appear to be numbered. Notwithstanding the environmental consideration, there is an ever increasing demand from dental patients for non-metallic and tooth-coloured restorations in their posterior teeth. This paper gives a brief history of dental amalgam and critically appraises the alternative materials, the principal of these being resin-based composite. CLINICAL RELEVANCE: The majority of practitioners carry out large numbers of Class I and II restorations, so an appraisal of the pros and cons of the alternatives may assist in decision-making.

Direct anterior composites: a practical guide.

UNLABELLED: For more than 40 years dentists worldwide have been using directly placed resin-bonded composite to restore damaged anterior teeth. While such techniques are invariably more conservative of tooth tissue than indirect procedures, operative techniques using direct composite can be challenging and are considered technique sensitive. Clinicians require both technical and artistic skill to provide composite restorations that restore function and aesthetics to blend seamlessly with the residual dentition. This paper provides an update on the aesthetic considerations involved in the restoration of anterior teeth with directly placed composite and outlines the contemporary materials, equipment and techniques that are available to optimize every clinical stage. CLINICAL RELEVANCE: Successful restoration of anterior teeth with direct composite is an integral component of contemporary clinical practice.

Efficacy of a step-by-step carving technique for dental students.

This study demonstrates the effectiveness of a step-by-step carving technique that is quickly and efficiently mastered by dental students. Thirty-six final-year dental students volunteered to participate in this study. The students were given pre-prepared lower right first molar simulation teeth that had the occlusal half replaced in carving wax. The study was conducted in three time phases: pre-test (Time 1), participative learning (Time 2), and post-test (Time 3). The pre-test had the students carve the wax with no instruction. Instruction and demonstration of the technique were given at Time 2, and the post-test had the students carve the tooth again with no guidance but with training. A statistically significant increase with a nearly medium effect size was found from Time 1 to Time 2. A statistically significant increase with a medium effect size was found when comparing Time 2 to Time 3. A statistically significant increase with a large effect size was found when comparing Time 1 to Time 3. This technique has proved to be an effective method of simultaneously teaching a large cohort of predoctoral dental students. The technique is consistent with constructivist learning theory.

Posterior composites: a practical guide revisited.

UNLABELLED: Direct placement resin composite is revolutionizing the restoration of posterior teeth. Compared to amalgam, its use not only improves aesthetics but, more importantly, promotes a minimally invasive approach to cavity preparation. Despite the benefits, the use of composite to restore load-bearing surfaces of molar and premolar teeth is not yet universally applied. This may be due to individual practitioner concerns over unpredictability, time and the fact that procedures remain technique sensitive for many, particularly with regard to moisture control, placement and control of polymerization shrinkage stress. New materials, techniques and equipment are available that may help to overcome many of these concerns. This paper describes how such techniques may be employed in the management of a carious lesion on the occlusal surface of an upper molar. CLINICAL RELEVANCE: Direct posterior composite is the treatment of choice for the conservative restoration of primary carious lesions.

Direct posterior composites: a practical guide.

UNLABELLED: The restoration of posterior teeth with directly placed resin-bonded composite requires meticulous operative technique in order to ensure success. Case and material selection; cavity preparation; matrix selection; isolation; bonding; management of polymerization shrinkage; placement; finishing and curing of posterior composites--all present a series of challenges that dentists must master in order to ensure high-quality, long-lasting restorations. This paper describes and discusses these aspects of the provision of composites for loadbearing situations in posterior teeth. CLINICAL RELEVANCE: Successful restoration of posterior teeth with composite is an essential component of contemporary dental clinical practice.